Blood Work Results - Some Opinions Needed

Pharma / TRT Testosterone Replacement
1


Hi to all, came across this awesome site while searching on the net.

Anyway I have some blood work results that I would like some opinions on.
I am training pretty hard, eating well and the problems I am facing I really think are related to my lower testosterone levels. Strength not really increasing, feeling tired constantly and overall less energy.

All doctors that I have seen have said I look fine and that my testosterone levels are within the normal range…

Just today I thought I would dig deeper into this and found a table from 1996 where they list the average testosterone levels by age.

Looking at my results:
Testosterone 10nmol/L (6-30)
SHBG - 24 (15-70)
FAI 41.7 (18 - 210)
Free Test - 233 (170 - 500)

Now placing those values against the table of averages
I have the testosterone lower than the 85-100 year category
Free Test I am around the 65-74 year bracket

So yes my test levels are normal but that of a 85 year old while being 33 years old.

Doctors also say that while training, not being obese you raise your testosterone. I can only imagine if I stopped training and this was true my values would be even lower.

I really feel I should be getting stronger with what I am doing, but it is not happening. I have a feeling the lower test levels are the culprit? Is this a possibility?

I am also having a hard time talking to doctors, they all say why am I complaining about testosterone levels that I look good etc… But they just don’t get it.

So what is the best way to convince a doctor to give me a test run on some HRT to see how it goes say for 3-4 months. Any advice guys?

While being on HRT will this stop my natural test production any problems with maybe having children etc?

I would just like to see what it would feel like if I had say double the testosterone to what I have now. So instead of the 10-12 range being in the 20-24 range. Will I feel a dramatic difference?

I should also mention that when I saw an Endo, he checked my testicles and also did a blood test to check the pituitary gland. Everything was fine going by what he said. As usual when I asked him about my low test levels for my age, he said they are fine, yes lower but not drastically low to warrant any further action. When I questioned him about strength gains almost non existent he said that could be contributed to the fact of my lower but normal testosterone levels.

I have gone through a few of the stickies on here and have made note of the blood work that I need done. Funny thing is last time I went and had a blood test I asked to have my estrogen levels checked. I was told I am male no need to have that tested.

So now I plan to visit a new doctor and hopefully get somewhere, otherwise I might just have to keep searching. Up and till now I just get brushed off, might have to change the wording around when I talk to doctors.

Any people with a similar situation to me, how did it go?

2

yes, most people here are in the same boat.

don’t jump into HRT.

please read through the stickies (again) because they answers your fertility questions, etc. (and other threads as time permits) - especially how to find a good HRT doctor.

when you find a doctor - don’t complain about low testosterone - complain about your symptoms and then later mention T as a possible issue - after you have ruled out Estrogen, Thyroid, Cortisol, CHOL, vit D, b12, ferritin, etc. etc. etc.

HRT is not something that you can test out for 4-5 months.

3

Interesting chart. But hard to use as results can vary by lab and testing technique. The chart does show that SHBG is increasing as FT is increasing. A nice demo of what is expected. The chart really needs E2. E2 increases SHBG, so we can infer that E2 is going up with age as well.

Get copies of lab work and retain. Post more lab results now if you can.

Where are you located?

Read some older posts where you find others near your age and what is going on in those posts.

Read the stickies, that is the best place to gain practical knowledge.

4

Thanks for the responses. I am living half in the Czech Republic and half in Australia (Melbourne). Will be in Australia soon for some time. I plan on seeing a doctor in about 10 days. Will do exactly as mentioned and not mention testosterone and mention all my issues and then maybe hint that I did some research and that Testosterone might be the issue. Not sure if I should mention anything about strength gains as that usually seems like a piss poor excuse for them.

I read about the fertility issues and how they can be overcome with some medication in one of the stickies. So that is good news. I have really yet to find any negative issues with having elevated testosterone levels while they remain in the normal ranges. So I am not sure why doctors make such a big deal out of it, and seldom offer any help. I hope this doctor I see next will be a little more willing to dig deeper into the issue.

I actually had thyroid tests and they turned out to be fine. I had an ultrasound on my liver and that turned out fine. The one thing that I do have is slightly elevated cholesterol levels. Say the normal range is 1.5 - 5.3 I am around 5.7… (with my good cholesterol HDL being on the low end) I eat heaps of oats and eat pretty clean. I did however read that high cholesterol usually is associated with eating hi GI index foods and not high cholesterol foods. The sugars is what elevates cholesterol from what I have researched.

In one of the stickies there is mention of what to get tested before jumping into HRT. I will ask for all those tests as well as the ones mentioned above by Purechance.

I read somewhere that having lower SHBG should mean you should have lower estrogen but only one way to find out.

Doctors say that the testosterone fluctuates throughout the day. Is there an optimal time to have all these tests done? For example in the morning is testosterone at its highest? All my tests so far have been in the morning usually. From 3 tests over the past 2 years my average Testosterone is 11nmol/L.

I remember what a doctor told me once which I found odd. He said that as long as being within the normal range of testosterone I will see no difference what so ever if I have 10nmol or 30nmol. He said if I go beyond the normal range then I will see a difference. Anyway I think it was BS and just another way to brush me off.

I’ll post my results as soon as I get them and see if anything has changed. As long as I walk in there speaking like I know a thing or 2 it will make it hard for the doctor to feed me BS to get rid of me.

5

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I went looking through my papers and found some test results so I have attached them.

on another paper from 2006 I have a note for eGFR value of > 60
(Does not exclude mild renal impairment)

Not sure what this means as the doctor never went into any detail about it. In the 2008 results the value is >69 and no note so maybe okay?

Going back to 2006 - Thyroid Stimulating Hormone 2.39mIU/L (0.35 - 5.50)
note: Consistent with euthyroidism

Here are some other recent results which were tested because of my elevated high blood pressure:

S_Cholesterol 5.90
S_LDL Cholesterol 3.97
S-HDL Cholesterol 0.84
Triacylglyceroly 1.05 mmol/L
Apolipoprotein 1.4 g/l
S_ALT 0.68
S_AST 0.56
S_ALP 0.88
S-GMT 0.65
Chloride 101
Bilirubin 10 umol/L

The next test I get done I hope to get everything checked out that is important. I should also mention that back in 1999 I got infected with mononucleosis or better known as Glandular fever. The endo that I saw last time said it could have an effect in someway…

I do have other results somewhere but can’t seem to find them…

6

Well looking into the Kidney issue it seems some sort of issue.

So I might have to get that looked into further.

7

TRT in Australia is a sorry mess. Everything is cookie cutter and very few docs know much about TRT. Getting an AI or hCG is very difficult.

8

Yeah I get the feeling I am fighting an up hill battle when it comes to this in Australia. I’ll be there for about 4 months so will see what happens. If I have no luck I have to find someone here in Czech maybe.

Anyway I asked for my test results that I had in May. I received them by email today but they do not list ranges. So will compare my figures to what I find in the stickies as optimal ranges to get a rough idea.

Bit better test readings on this one from 10 to 14.6.

Hormones:
Tyreotropin (ultras. TSH) 5.15 mU/l,
Free tyroxin (fT4) 19.55 pmol/l,
Trijódtyronin (T3) 1.71 nmol/l,
Testosterone 14.64 nmol/l

Minerals:
Natrium 142 mmol/l,
Kalium 4.6 mmol/l,
Chloride 101 mmol/l

Triacylglyceroly 1.37 mmol/l,
Apolipoprotein AI 1.19 g/l,
Apolipoprotein B 1.11 g/l
Cholesterol 5.88 mmol/l,
HDL-Cholesterol 1.14 mmol/l,
LDL-Cholesterol 4.12 mmol/

AST 0.92 ukat/l,
ALT 1.27 ukat/l,
ALP 0.82 ukat/l,
GGT 1.21 ukat/l

Since then I started taking a table spoon of cod liver oil. This was supposedly to raise my HDL cholesterol but when I had the blood test 8 weeks later, it had no effect at all. I had slightly lower HDL!

9

uhmmmm…

TSH was 2.39 and is now 5.15

you do know that is a bad result, right? Terrible actually. Horribly terrible to be more precise.

people have problems with TSH > 1.5

please read everything on the STTM site including all of the links on the left.

10

Good point there! I just looked into it and checked the link you posted. hmmm…
read through some symptoms of high TSH levels and they state weight gain. Well that is really not my case at the moment. I have really been stuck on about 205lbs at around 12-15% BF @ 184cm.

Looking more into I have read that these additional tests are recommended:

* Free triiodothyronine (fT3)
* Free levothyroxine (fT4)
* Total T3
* Total T4

Additionally, the following measurements may be needed:

* 24-Hour urine-free T3[21]
* Antithyroid antibodies �¢?? for evidence of autoimmune diseases that may be damaging the thyroid gland
* Serum cholesterol �¢?? which may be elevated in hypothyroidism
* Prolactin �¢?? as a widely available test of pituitary function
* Testing for anemia, including ferritin
* Basal body temperature

Another one to test for is Iodine.

I am going to prepare all this and take it to my doctor. Will print everything out and also the suggestions and comments pointed out here. Hopefully this will give me some ammo and get somewhere with this new doctor.

The doctors that I have seen in the past have really not been any help. Most likely they don’t like being what could be wrong etc… and they like to call the shots. Sometimes I think they should leave their ego at home and listen to patients more open minded.

Even if I do check out fine why is it such a pain to have these tests done when you ask for them. That is the main thing I don’t understand.

11

[quote]PureChance wrote:
uhmmmm…

TSH was 2.39 and is now 5.15

you do know that is a bad result, right? Terrible actually. Horribly terrible to be more precise.

people have problems with TSH > 1.5

please read everything on the STTM site including all of the links on the left.
http://www.stopthethyroidmadness.com/things-we-have-learned/[/quote]

Just dug up my latest blood test results. Doctor said nothing about it so I assumed all good. Just looking at the TSH and it came back as 6.50!

12

yet another example for the WTF Stupid Doc thread.

you need to find a new doctor and discuss treatment options NOW. Call around to compounding pharmacies and ask for a referral to a good Thyroid/HRT doc who prescribes Armour or dessicated thyroid.

13

Will take your advice purechance. Once I land in Melbourne on Monday I’ll get right onto it.

Thanks!

14

good luck

15

Following this thread. Only shows the importance of good discipline in obtaining proper bloodwork, both on and off substance. Kudos to the OP, and good luck with your endeavor. I’ll be in touch with my doc for testing come Monday after reading your query.

16

hi iroczinoz,
When u come back to Oz, if theres any chance of holidaying in brisbane or gold coast, i know of a doc who is switched on to TRT and using AI’s etc. If interested let me know and i will PM u.

cheers!!!

17

I got an appointment tomorrow with a GP. Have notes that I will be printing out and taking with me. I have a list of everything I am going to ask to get tested. I can see I have a pretty big list so he is probably not going to be easy to persuade I imagine.

E2 (Estradiol)
Testosterone
Free Testosterone Bio -T
LH and FSH:
Prolactin:
Prostate Specific Antigen PSA:
Chemistry Panel (Metabolic panel with lipids)
Homocysteine
C-reactive protein
Iodine:
T3
T4
fT3
fT4
rT3
DHEA-S
Cortisol
Pregnenolone
Liver Markers
Fasting Cholesterol
CBC (complete blood counts)
Ferritin
SHBG
DHT
B12/Folate Serum
Progesterone
Zinc
Vitamin D, 25-OH Total (should be 70-100 I think - almost everyone is deficient)
Vitamin D, 25-OH D3
Thyroglobulin Antibodies
Thyroid Peroxidase
TSH

If there is anything that I should take out or add in please let me know. I hope to get somewhere tomorrow and at least get some thorough blood tests done.

Thanks for the offer Danny. I will let you know I go with this doctor. This doctor that you have in mind does he work over the net with you or do you need to see him in person?

18

read through the finding an HRT doctor, there is some good advice there.

Go in with a comprehensive list of symptoms first.
then listen to what the doctor says and what he advises.
then if he doesn’t mention the tests you want, and only then, mention some of the additional tests you want and why you want them.

19

[quote]iroczinoz wrote:
I got an appointment tomorrow with a GP. Have notes that I will be printing out and taking with me. I have a list of everything I am going to ask to get tested. I can see I have a pretty big list so he is probably not going to be easy to persuade I imagine.

E2 (Estradiol)
Testosterone
Free Testosterone Bio -T
LH and FSH:
Prolactin:
Prostate Specific Antigen PSA:
Chemistry Panel (Metabolic panel with lipids)
Homocysteine
C-reactive protein
Iodine:
T3
T4
fT3
fT4
rT3
DHEA-S
Cortisol
Pregnenolone
Liver Markers
Fasting Cholesterol
CBC (complete blood counts)
Ferritin
SHBG
DHT
B12/Folate Serum
Progesterone
Zinc
Vitamin D, 25-OH Total (should be 70-100 I think - almost everyone is deficient)
Vitamin D, 25-OH D3
Thyroglobulin Antibodies
Thyroid Peroxidase
TSH

If there is anything that I should take out or add in please let me know. I hope to get somewhere tomorrow and at least get some thorough blood tests done.

Thanks for the offer Danny. I will let you know I go with this doctor. This doctor that you have in mind does he work over the net with you or do you need to see him in person?

[/quote]
Im not sure if he would over the net, but maybe need an initial consult, have heard he does phone consults as well. Dr deed is his name, mediwell medical centre at cooparoo, atleast 3-4 weeks wait to get appointment.

20

Okay saw the doctor today, went over my symptoms and problems. He looked at my blood test results that I took in with me. To cut a long story short he is going to 1st look at my thyroid. He said all my symptoms can be associated with my thyroid. So he wants to see how low it really is.

At the end when he printed out my referral to get blood drawn I handed him my sheet of things I wanted to have checked. He went over each one quickly and either said YES or NO.

I am pretty sure he said NO to having these tested:
Iodine
E2
DHEA-S
Progesterone

and a couple others that I am not sure of. So majority of what I wanted will be tested. Just a bit pi$$ed with the fact E2 not going to be tested. Since I am having blood taken why not just have that added… Well he said once the results come back we will know in what direction to go in. So hopefully I will get a little more help with this doctor.

A few things that did not go well was the fact that we discussed my Testosterone levels. Once again if I am within normal limits I will not see any improvement if I am 350 or 700. So that was a bit of a minus. He did however say that testosterone fluctuates throughout the day and to really know if I am on the low end scale all day long we would have to take 30 tests in a day and that is just impractical. So really he was saying that if I was on the lower end of the scale and it was like that for the whole day then yes it could be a concern. But I think he believes I fluctuate say between 10 and 20 just depends on the time etc… Oh well we shall see when I get the tests back. Going in tomorrow at 8am to get blood taken.

I asked him would an under-active thyroid make me feel like $hit and weak,fatigued losing strength, he said definitely yes. Since my grandma is taking medication for an under-active thyroid he said there is probably a good chance I have something similar.

Danny thanks for the info will keep this doctor in mind depending on how I go.
I just want to thank everyone in this thread for their help so far!