I looked at it, thought it was stupid and then wrote you a comment asking whether you thought 10 out of a range of 7-19 was high.
For the record the stupid graph says normal is 50% higher than 10.
OK seriously Iām not going to converse with someone who sounds like my 5 year old.
All the best.
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For anyone who is interested in comparing the free t value to the graph, then multiply 0.363 by 100.
@lenono
The graph is stupid because no where on it does it say the symptoms the guy listed are normal
Symptoms: low libidio, anxiety, feeling down, tired, no morning erections and cant get hard most of the time, low self confidence.
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Thatās marginally better than saying something is stupid just because you donāt like it.
The graph shows average free testosterone levels for males. Why and how could it possibly include the symptoms you list?
What it does indicate, which would highly likely be validated by any competent medical person, is that the the posters symptoms are not related to his testosterone levels which are completely adequate.
I had the exact same symptoms, higher T pre-trt than him and alleviated those symptoms at basically every dosage I tried after being told I didnāt need trt likely because they looked at a graph. So I disagree. The graph doesnāt represent ideal T levels for each range nor does it represent people at X range have no symptoms related to T levels. Really, the graph doesnāt represent anything that helps this guy.
So you are recommending to take testosterone to mask his symptoms rather than actually find out the real issue?
Abusing drugs often make people feel better. It doesnāt make it the correct answer.
The poster appears to have e2 below range. This can cause the symptoms listed. Iād investigate this before a lifetime commitment to trt.
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I suggested TRT and you suggested to look at the graph. I say try both.
So look at the graph which shows his levels are normal and take test anyway.
Correct. Look at the graph, realize it states nothing about the people on it and that maybe basing what to do on it makes no sense, talk to a doc and get on TRT.
Hi Lenono, Could you please look at my storyā¦ Im in a similar situationā¦ I have Total T in the upper 600ās, but have all the symptoms of low t,
no libido, numb genitals, loss of morning+spontaneous erections, horrible body odor, itchy face/chin/nostrils etcā¦
Im not getting any help from my doctors but clearly something is wrong. I have elevated ggt,alt, billirubin, uric acid, creatine, albumin
low: dht 176 (350-850) and e2 12 (11-45)
I am not on trt, and this literally happened out of the blue and is ruining my lifeā¦ Does it not point to a liver/kidney issue?
With T levels like mine it is obivous something is supressing DHT + e2 in my body is it not?
We know that reference ranges differ between labs but also between populations. Lets try a table this time (maybe less emotional than a graph 
).
His freetT is 10.5 (not 10) ng/dl. According to the table the average of freeT of healthy, non symphtomatic people (yes you actually do ask the people if they feel healthy or not when establishing reference ranges if you do it carefully) is 12.3 in his age group, with a sd of 2.8.
This means that 68% of healthy people have freeT levels between 9.5 and 15.5 ng/dl. Approximately 30% of healthy people in his age group have lower freeT levels.
Its again about bias. His symptoms can be caused by a hundred of other causes.
I am not saying that his symptoms are not caused by low T, thats impossible to know anyway. I am saying however, that the probability is low.
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To approach it from a more clinical angle.
The population based study ba Araujo et el looked into low T (defined as below 300 TT), low freeT (defined as below 5 ng/dl) and symptoms of androgen deficiency (AD).
The Venn diagram below illustrates the main results. From the subjects younger than 50 years about 40% had either low T or any symptoms of low T. 4.2% had low freeT and had at least one symptom of AD. 2.1% had low freeT (below 5 and not below 10 ng/nd) but had no symptoms of AD at all.
Its not black or white. Low freeT doesnt necessarily cause symptoms no symptoms of AD mean that they are caused by lowT or low freeT.
https://academic.oup.com/jcem/article/92/11/4241/2598366/
I wish you a nice day, wife and kids are complaining what the hell i am doing on my computer on a sunday morning. Off we go 
I think my thread went a bit of course guys. Iām still none the wiser around my relatively high LH, High Prolactin and Low E2 (43 pmol/l or 11.7 pg/ml) when iām not taking any medication. I want to understand if these can be fixed naturally.
Overall I have got many full blood panels where everything else is āfineā and these hormones seem off kilter compared to ranges and my symptoms have steadily increased. This is why I came to this forum. Its hard to find a doctor in Ireland who is well read on hormones.
The main question is about TRT yes or no. This the subject of the discussion.
High LH could mean that your testis are not responsive as they should (going towards primary hypogonadism) but any way your HPTA is able to compensate for this.
It could also simply mean that you got your blood drawn exactly when the pituitary fired a pulse of LH.
The slightly elevated prolactin could hint to a tumor in the pituitary. But it could also just be a conincidene as many things mess with prolactin.
The low estrogen could mean that conversion T to E2 is reduced. It could mean that freeT is actually lower, but it could also just mean that the value is an artefact of the E2 assay (bad accuracy and precision).
If you have additional labs result post all of them.
I got my first hormone bloods done about 1.5 years ago as I was feeling terrible for quite a few years and had a low libido and bad ED. Results below:
Testosterone 450 ng/dl [264-916 ng/dl]
SHBG 43 nmol/L [18.3 - 54.1 nmol/L]
Oestradiol 9 pg/ml [15 - 55 pg/ml]
Prolactin 300 mU/L [86-324 mU/L]
LH 7.9 mU/L [1.7 - 8.6 mU/L]
FSH 1.6 mU/L [1.5 - 12.4 mU/L]
Albumin 52 g/L [35 - 50 g/L]
Free Testosterone (calc) 7.22 ng/dL [5.05-19.8 ng/dL]
The doc recommended I clear up my diet, stop drinking etc and then get bloods done again 6 & 12 months later. I had an MRI for the pituitary gland but it was ok. They all came back similar over the past year except my testosterone gradually raised from 450ā> 500ā>550 6-12 months later. SHBG stayed the same and Free T slowly raised from 7->9.
My symptoms have definitely improved since 1.5 years ago and my most recent assays came back with the following (as mentioned in first post):
FSH: 2.0 u/L (<12.0)
LH: 8.0 u/L (<8.0) *
Prolactin: 332 mU/L (90-320) *
TSH: 1.86 mU/L
Free T4: 16.6 pmol/l (12.0-22.0)
Albumin: 48 (35-50)
Oestradiol: 43 pmol/l (60-190) * 11.7 pg/ml [15 - 55 pg/ml]
Testosterone Total: 20.9 nmol/l (8.80-35.00) ā which is around 600 ng/dl in US (range:300-950)
SHBG: 43.30 nmol/l (13.00-71.00)
Iāve been weight training since my early 20ās and go to the gym most days so its a bit disappointing to feel like crap most of the time. I tried 2 SSRIs last year and they made me feel way worse. Anyways thats my story, hence why Im researching ways to get my hormones on a more even keel.
So thereās two forms of thought.
-
I definitely know you shouldnāt do TRT but give no other option
-
TRT will bring you to where you want to be based on the fact that I had basically identical labs to you pre-trt and feel great now. Call it masking the problems or whatever you want but I donāt have any problems any more.
There you go. Thatās your two options. TRT or donāt take TRT. One will definitely improve your life.
You increase testosterone by increasing LH, but because LH is already at the max, this is the best youāre going to get because you have hit redline.
You would need LH in the supraphysiological ranges and I donāt think your doctor has thought this through.
After making my way through the thread, I want to say this. E2 comes from the conversion of free T. Low E2 would indicate that either he needs more aromatase enzyme or he needs more free T, standard population graphs not withstanding. My guess id that his symptoms are related to low E2. He could take some estrogen and see what happens, or he could crank up his free T via TRT and see what happens. Either way, heās not making enough E2 and thatās what he needs to address.
Dude, thatās not what I was saying.
I said āI am not saying that his symptoms are not caused by low T, thats impossible to know anyway. I am saying however, that the probability is low.ā
And saying that TRT will ādefinitely improve your lifeā is a bit of a bold statement.
You keep oversimplifying things. Itās not black or white.
@irishlad1989
I recommend you the following staggered approach:
-Your situation obviously improved with life style modification. Stay with this.
-Test some inositol. You mentioned testing SSRIs and your symptoms can also be coming from a depression/anxiety disorder. Yes, it can be related to ālow Tā but it doesnāt have to be the case. Many men have this even when their T or freeT is high.
Inositol was described as an antidepressant with similar clinical efficacy as SSRIs. Try out 2x4 g per day and see what it can do for you. Itās easy to get and doesnāt do any harm if itās not working. Itās a 50:50 chance.
-I agree with @systemlord and @lenono that your symptoms might be related to low estrogen. If you are not feeling better on inositol try to convince your doc to improve in this area. Keep in mind that estrogen is part of the feedback mechanism and can lead to lower T.
-If this doesnāt improve your situation try TRT. Personally I donāt think it will resolve your issues but itās worth a try, who knows. Keep in mind thatās a life long commitment and can have side effects such as polycythemia. But if it works the benefits definitely outweigh the risks.
Keep us posted about your progress.
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