Blood Test In! Advice Appreciated

Pharma / TRT Testosterone Replacement
1

Hi All,

I’m new to this forum and I would like to get some advice, if I may, regarding some test results I’ve just had back from the lab.

Background

I’m a 32 mixed race (white/black caribbean) male from the UK, 5’10, weigh 178lbs and my body fat % is 12% (with calipers). I work out with heavy weights 3-5 times per week (push, pull, legs routine) and usually get in around 140-180g of protein per day. At the time of the test, I was cutting at 1800kcal per day and took it at noon while fasted (had not eaten for roughly 15 hours prior).

The reason I had my blood tested was because I was experiencing the following symptoms;

  • low libido
  • never had morning wood
  • felt not at my peak
  • mood swings
  • felt tired irrespective of sleep/nutrition
  • little too emotional/childish when compared to my male peers.
  • Absence of competitive drive

I work in an office Monday to Friday and do Maui Thai once per week. Lastly, I am a productive person and do not suffer from lack of drive, depression.

I’ve improved my diet massively these past two weeks which has somewhat improved my libido, energy, and mood but I think there’s plenty of room for improvement. I suppose I’m looking for that fierceness, competitive spirit and emotional groundedness (stoicness).

Blood tests

https://imgur.com/a/WnUpY

My testosterone is decent (26.4nmol or 761ng/dl), however, my free testosterone is borderline deficient (0.398 nmol/l or 67 pg/ml). My SHBG is definitely too high and prolactin is almost too high. My oestradiol is a little too low.

I can convert some of these figures to other types of metrics if it helps.

My cocktail of supplements

  1. Omega 3 (Life Extension)
  2. Multivitamins (Life Extension)
  3. Vitamin D3 5000IU (Now Foods)
  4. Coq10
  5. ZMA (Optimum Nutrition – Dreams have been crazy the past two weeks since I started using this!)

My thoughts

I would like to lower my SHBG as much as possible to improve my testosterone. I’ve read some articles online and apparently Stinging Nettle and Boron has significant positives effects on lowering SBHG so I am considering trying them out.

I’ve spoken with a private doctor for TRT and they have suggested that TRT would be an effective treatment to decrease SBHG while increasing total and free testosterone.

Based on my the above, could someone please answer the following?

  • Would you recommend I start TRT?

  • What are the optimal total and free testosterone levels for increase muscle mass, lower body fat, and the beneficial psychological benefits? I have heard total testosterone levels of 1100-1400 is godly, but I cannot find a number for free testosterone.

  • Is there a way I can significantly lower my SHBG without TRT?

I am going to try Iodine and Boron for the next month to see if my SBHG falls which I believe will improve my free T and increase my e2. If this doesn’t work, I will have my doctor perform thyroid and liver/blood tests to see if I have anything wrong with my liver/thyroid which is creating too much SHBG.

Thank you in advance for your responses. If you need any more information then please let me know.

2

Your efforts to reduce SHBG will likely go wasted. Its simply not something you have control over. Any feelings of low T could be a result of you high SHBG. If you’re symptomatic then TRT could help but remember, its for life and comes with its own risks/problems.

3

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

FT is indicating a problem. But FT is pulsatile and a lab might catch highs or lows, so you really do not know the status. Normally, TT is the better indicator or T status. But in your case with high SHBG, your TT result is inflated with a high amount of SHBG+T which is not bio-available. So your T status is worst than TT=761 implies.

E2=67 is not high, so we do not expect that the liver is creating more SHBG because of that. Perhaps another estrogen [E1, E3], but that is strictly conjecture.

You cannot directly lower SHBG. Estrogens increase SHBG and T decreases SHBG.

Prolactin may be reducing LH/FSH. You really do not have a diagnosis until LS/FSH are tested and absolutely should not do anything before that is done.
Lab ranges do vary, nothing universal.

Where are you located? Affects diagnostic and treatment options.

In most USA States, you can do your own lab work. Also via LEF.

LH/FSH are not been depressed by high E2 and prolactin may be having some effect. LH/FSH can be down from damage caused by a blow to the head. Low thyroid function seems to lower LH/FSH [secondary hypogonadism]. SHBG is a major factor and low FT contributes to this. When we look for causes, we need to differentiate recent issues VS problems that have persisted for years. Sounds like your T levels may have always been lower. In that case, we can expect to see, not always, weaker facial bone structure and less facial and body hair. Some of that needs to be evaluated in the context of such traits of your father and brothers.

Your E2 is OK vs your FT, not low.

Labs:
TT
FT
E2
prolactin
LH/FSH
CBC
hematocrit
AST/ALT
fasting cholesterol
fasting glucose
TSH
fT3
fT4

You can eval overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. You can have problems caused by not using or not using enough iodized salt. LEF multi-vits will have a maintenance dose of iodine and ample selenium. How long have you used this multi-vit or similar? Any thyroid problems in your family.

I do not expect a thyroid-SHBG connection.

Have you been using any medications, Rx or OTC?
Ever used a hair loss drug?

Please provide time-line for symptoms.

4

Hi Ksman,

Thank you for the in-depth response, you can’t imagine how much this is appreciated!

My private doctor has asked that I have another blood test on the same metrics this week to do, as you suggested, check for variances. I will come back to this further down.

Ahh… I ordered Boron and Iodine (12.5mg) and they arrived today. I was hoping that they would improve the SHBG, will take them for a couple of weeks and get retested. Will seem if it makes much of a difference or not, if it does then it could be just a variance like you mentioned above but no harm doing this little experiment.

UK - I am with a private Doctor and he would be prepared to administer sustanon but dosages, frequency etc won’t be discussed until I have another blood test. They don’t want to prescribe TRT based on the results of one blood test.

I have an appointment on the 16th February to see my NHS doctor and will request that I have these labs tested on the basis that my SHBG is very high and FT low (seems like my TT might also be low also from what you said earlier.)

If they won’t give me these tests for free, I will purchase them from private labs like I did for the test results I previously linked.

I have taken the LEF two-per day multivitamins for roughly 2 years. I will purchase a thermometer today and track my results once they arrive. I am taking Iodine and Boron from today (bought the former based on reading one of your posts last week.)

I have not heard about any thyroid issues in my family.

The only medicine I’ve ever taken are antibiotics (many years ago) and different variants paracetamol (for headaches/colds). No hair loss drugs, I have all my hair.

I have had the symptoms throughout my adulthood, so for at least 10 years.

So based on your suggestions, I am going to have all the tests you suggested done and come back to the forum with my results. This will likely take 2-3 weeks. The tests are expensive so I want to see if I can get them ‘free’ on the NHS first.

Thanks again for your help, if I missed something you needed to know then let me know and I will come back to you asap.

5

Any news re iodine and body temperatures?

How long have you been using Vit-D3 5000iu?
With your darker skin and UK climate, you really do need that.

6

Hi Ksman,

I have been using Vitamin D3 - 5000IU every day after receiving a blood test score of 42 for Vitamin D (50 was the start of the normal range) since October 2015,

I’ve been using iodine and boron for about 10 days now, noticed a definite improvement in mood. Much more grounded and less anxious.

I have only just received my thermometer and tested myself just before posting this three times. It’s 00:45 here and my results were 96.6, 96.1 and 96.2. I will check my temperature tomorrow morning, afternoon and night for the next week.

My GP refused to give me the majority of the tests you listed previously so I have gone with a private test. I should have it done and the result back in the next 7-10 days. As soon as I get back the results, I will post there here!

My private doctor said that if I am viable for TRT after my next test then he said he is looking at 125mg of Sustanon once per week. He is looking at TT above 1000ng and FT of 1.00-2.00. He wants my TT to dip to around 800ng after 7 days (the day I take my next injection).

That promise of FT at that level looks amazing, my last test said my FT was 0.398 (range 0.03-1:00), so I could potentially get 3-5x more FT if everything goes well.

7

Hi All,

Following on from my previous e-mail, I have now received my second blood test results. I managed to get all the tests done except LH/FSH.

1216×844 71 KB

1196×861 86.7 KB

It seems that despite the Iodine and Boron supplementation since my last blood test, my SHBG has barely improved and my Free T has worsened. I’m not saying there is a correlation, just an observation. My prolactin has halved and Total T has decreased from 26.4 (761ng) to 23.3 (672ng). Both this and my previous blood test were taken in the morning while fasted so these are my best case scenario and would worsen throughout the day.

My liver and thyroid looks good.

According to the Nebido Free T calculator, my Free T is sitting at approximately 0.3% which is almost exactly the same as my last blood test. My Google “research” suggests that my Free T should be between 2-3% to be healthy, let alone optimal. So my Free T is roughly 7-10x lower than it should be.

Based on my results, would it be recommended I start TRT to bring my Free T to at least the 2-3%+ range?

Kind Regards

Kazekage2

8

Iodine and selenium …

See if you would be able to do this:

  • self inject 62.5 mg T Sustanon twice a week, use insulin needles
  • 0.5mg anastrozole at time of injections, objective is near 80 pmol/L
  • 250iu hCG SC EOD to preserve testes and fertility.
9

Hi KSman,

Thank you.

Have you seen my last post about 15 mins ago with my second blood results?

What do you mean by “Iodine and selenium…”. I’ve been taking 12.5mg every day for two weeks and the selenium I take is whatever is in LEF multivitamins.

In terms of HCG, I’m not too bothered with testes shrinkage and fertility. I don’t want children and I doubt the size of my balls will make that much difference with women.

If my estrogen gets too high I definitely will take a Anastrozole.

10

Some guys get 24x7 low level ache in their testes which hCG can resolve.

You are good re selenium.

Do you have an idea why prolactin is lower?

FT moves hour to hour. Cannot conclude anything.

#Thyroid is not good.
fT3 is way below mid-range, causing TSH to be up.
Check AM and mid-afternoon body temperatures to see how low.
History of using iodized salt?
TSH should be nearer to 1.0
t3, T4, fT3, fT4 should be near mid-range or a bit higher.
The lab ranges are bogus. Doc thinks things are good.

  • Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

fT4 is good, T4–>T3 conversion would seem to be impaired.

Any idea why potassium may be high?
Odd relative to low chloride. Sodium normal.
Are you drinking softened water?

Seems like high iron is leading to the above.
Are you taking a supplement that lists iron? Typically men should avoid that as well as iron fortified cerals, breads and pasta etc.

Lower FT leads to lower E2.
High SHBG creating more SHBG+T that inflates TT.
T status is low as indicated by FT and TT needs to be ignored.

Is LH/FSH coming?
We do not know if you are primary or secondary.
Get this done if possible.
Missing fasting glucose.

Cholesterol may improve with TRT.
Your good HD is protective.

HTC [hematocrit] is very strong for your low-T status.
TRT could easily take HTC too high, HTC will need to be monitored.
Then avoiding dietary iron is of greater importance.
If you are able to donate blood, that will be very useful.

11

No, I have made no conscious attempts to lower my prolactin. It’s basically halved since my last test. It might have something to do with Zinc supplementation.

I took my first blood test on the 26th Jan, and I was only taking ZMA for the first time starting a couple of days prior (never took Zinc before that). As you know, my prolactin was borderline too high and since then I’ve been taking ZMA most nights. I’ve just read on anabolicmen that Zinc supplementation of 50mg a day has been shown to halve prolactin. This is obviously just a theory, but plausible?

Could you confirm what it ideally should be? 4.9 - 5.1?

I will, throughout last week I was getting numbers between 93-96. But I will do a more robust analysis between now and Monday and provide feedback.

I’ve been taking 12.5mg Iodine daily since the 6th Feb. I have no awareness of taking iodized salt prior unless used inadvertently on my food. Image below of the Iodine I’m using.

4032×3024 1.48 MB

I suspect it’s because I am supplementing Iodine which has 7.5mg of potassium salt (see above image) and LEF Multivitamins (25mg as potassium citrate) daily. I don’t eat potassium rich foods.

My water supplier’s website states that where I live the water is hard. Where I work, it is soft.

Not taking any supplements that have iron. LEF Multivitamins do not have iron. Very rarely eat bread and pasta. The only cereal I eat is oatmeal and I’ve just checked and it’s not fortified with iron. Apparently oatmeal is good for iron, but I don’t eat other iron rich foods so I don’t see how a bowl of oatmeal every other day could cause high iron blood levels.

I’m starting to get worried now about my blood results. Didn’t realize I was such a mess.

So you believe I may have primary or secondary hypergonadism? I will look into having this tested soon.

Checked webmd and I don’t eat any of the iron rich foods, no idea why it is so high.

Thanks a lot for all your help.

Is it possible, if you could sum up in sentence what you believe is wrong with me based on my results? Things are starting to spiral out of control. I may need to see an endocrinologist.

Regards

Kazekage2

13

Your FT3 was enough below mid-range that your body temps may be low. Around ~5 would be desirable.

With iodine you reported good changes. Where are body temps now?

SERM iron can change a lot with recent meals. The other measures are more reliable indicators. Wait and see, sometimes things change without intervention. Dehydration can be a factor in electrolyte levels, when fasting, you still need water.

Interesting thoughts re zinc and prolactin. Typical thinking is that when a trace element is adequate to support specific enzyme functions there is no need for more. Perhaps there is more to this with zinc.