Blood Advice Please

Pharma / TRT Testosterone Replacement
1

Hey fellas,
New posting here but been reading for a while.

I’m at the end of my rope here and I would appreciate some sage advice as i’m still learning what does what.

50 year old male
6ft
14st
I’ve been trying to get a diagnosis of low T on the NHS (UK) for about 10 years although i’ve been heavily symptomatic for 30 plus years, yeah I know why did I waited so long…apathy pure and simple.
No motivation in anything untill recently when I decided enough is enough.

Many many tests over the time including one that told me I have Osteoporosis as well!
Anyway here it is…

Full blood count
Haemoglobin 138 g/L [135.0 - 175.0]
Total white blood count 6.3 109/L [4.5 - 11.0]
Haematocrit 0.419 [0.41 - 0.53]
RBC 4.41 1012/L [4.5 - 6.5]
Mean cell volume 95.0 fL [80.0 - 100.0]
Platelet count - observation 218 109/L [150.0 - 450.0]
Neutrophil count 3.1 109/L [1.8 - 7.7]
Lymphocyte count 2.3 109/L [1.0 - 4.8]
Monocyte count - observation 0.7 109/L [0.2 - 0.8]
Eosinophil count - observation 0.2 10*9/L [<0.6]

Haemoglobin A1c level - IFCC standardised 37 mmol/mol
NICE guidance:
Pregnancy or diet controlled patients <48 mmol/mol
Tablet treated 48 - 59 mmol/mol
Insulin treated 53 - 59 mmol/mol

Serum lipid levels
Serum cholesterol level 4.7 mmol/L [3.1 - 6.5]
Serum LDL cholesterol level 2.7 mmol/L
Serum HDL cholesterol level 1.27 mmol/L [1.0 - 1.6]
Serum cholesterol/HDL ratio 3.7
Serum triglyceride levels 1.6 mmol/L [0.2 - 2.0]
Non-HDL cholesterol 3.43 mmol/L

Urea and electrolytes
Serum sodium level 143 mmol/L [132.0 - 145.0]
Serum potassium level 3.6 mmol/L [3.5 - 5.0] (sample was greater than 6 hours old when processed)
Serum urea level 7.5 mmol/L [3.0 - 6.5]
Serum creatinine level 75 umol/L [50.0 - 120.0]
GFR calculated abbreviated MDRD >90 mL/min/1.73m*2

Serum TSH level 2.59 mu/L [0.2 - 4.5]
SHBG level 49 nmol/L 13.0 - 88.0]
Serum LH level 1.3 iu/L [1 - 9]
Serum FSH level 2.5 iu/L [1 - 11]
Serum prolactin level 248 miu/L [<300]
Serum testosterone level 14.2 nmol/L [8.0 - 35.0]
Free androgen index 29.0 [>23.0]

Well, like I said my gp and endo tell me everything is fine even though I’ve felt like shit every single day for decades.

Not sure what my next move should be, without a diagnosis on the NHS i’ve got no chance of getting treated and private clinics over here require a diagnosis before they’ll help sooo…

Opinions…advice…insight…
Cheers fellas.

2

Based on a cursory look at your blood work your testosterone levels are in fact fine. Perhaps three decades of feeling like shit were from an untreated mental illness rather than perfectly healthy endocrine system? In fact, I would argue (as would any shrink) that leaving yourself unchecked and feeling lousy for three decades is sort a giant sign that all is not well in your mental health.

3

Testosterone is not fine, Total T is below midrange and SHBG well above midrange and no idea about Free T. LH is very low and indicates testicles aren’t receiving much stimulation at all. TSH isn’t a thyroid hormone, Free T3 is the master thyroid hormone.

Hematocrit and hemoglobin are bottomed out and I wouldn’t be surprised if OP is suffering from metabolic syndrome, his tissues and organs are not getting enough iron rich oxygen. Remember olympians and athletes trained at high altitude to take advantage of the extra oxygen rich hemoglobin.

Testosterone is sold over the counter like an asprin.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

The locally weighted regression showed that total testosterone levels of 440 and 480 ng/dL were associated with increased Framingham CVD risk and an increased probability of increased hsCRP, respectively. Men with sexual dysfunction (poor sexual performance, decreased morning erection, and loss of libido) had significantly greater CVD risk.

1 Like
4

He’s 50 and clinically depressed. Within that context don’t you think his numbers are adequate?

5

Are you on Metformin?

6

His T is low, but there are possibilities other than TRT to fix him. I think you are making a good point. He might need T, but he probably needs something else. Either way, no way is NHS going to prescribe him at those levels,

7

Thank you my friend for the intelligent response, this is also my opinion.
I have been advised to book an MRI to rule out Hypopituitarism so we’ll see what becomes of it.

For the others chiming in, i have a long history of fluctuating markers in my bloods so investigations are as far as it has progressed, I am still searching for that elusive diagnosis and will continue to do so regardless of what some noname thinks or even the majority of Dr’s whom share the same toxic opinions on what is subjectively normal for an individual.

Thank you again.