Final Bloodwork Received - Need Help Understanding

41 year old male, tired a lot, difficulty building muscle and recovering from workouts - workouts wipe me out! Injured often with strains and take a while to heal. Libido low. Probably started getting real tired in my mid 30s. Been on an ssri and Wellbutrin for 20 years.

Testosterone appears low normal and estrogen super low. What’s this all mean? What does low estrogen mean and what does one do about it?

Testosterone, total 389 ng/dl (range 264-916)
%Free 2.2% (1.5-3.2)
Testosterone, Free 86 pg/ml (52-280)
Estradiol <5 pg/mL (7.6-42.6)
Prolactin 12.4 (4-15.2)
Vitamin D 25.9 (30-100)

Ask Dr. for another round of blood work in a few weeks. If that confirms low T, ask for script.

Start supplementing with Vit D3 5000iu sublingual daily.

i had testing done two years ago - testosterone was 377. so same lowness.

Free T is low (still in range, but low). Estrogen is super low.

You trying to get on TRT or looking for other options? TRT makes sense for this IMO.

1 Like

Curious if you’re super low bf?

ideally i want TRT. doctor mentioned Clomid but i’m not open to the possible vision side effects. what does TRT have to do with low estrogen?

nope - 5-8 about 175, id say about 25% body fat.

Test converts to Estrogen, so by boosting your T - you would also be boosting your E. Although if your estrogen needs further boosting beyond that, it can be addressed with other compounds (would name them if I were more familiar, but I know they exist). If nothing else, HCG added into your TRT would definitely increase estrogens.

Most of our estrogen (E2) is converted from Free T, so often it’s not surprising to see both low together. So to increase the estrogen, you also need to increase the T. You may also have a degree of aromatase deficiency, because your estrogen is substantially low in comparison to your Free T.

You may find it difficult to get a doctor to sign off on a low-T diagnosis due to most insurance companies refusing TRT 350>. The estrogen deficiency can cause osteoporosis and if it’s been this low for years.

So low I wonder if you’re taking a supplement with anti-aromatase effects.

SSRI’s can lower testosterone.

https://www.sciencedirect.com/science/article/pii/B9780128130735000320

what is aromatase and aromatase deficiency?

Aromatase is an enzyme in the body that converts T to E2, without this enzyme, you rely solely on E2 made in the testicles. DHT is also converted from T, which has many positive effects on the brain, sex drive, wellbeing etc.

I bet you’ll find this low as well.

If your doctors try to tell you your testosterone is not low, not so fast->

Regardless of which assay used, most authors agree that those patients who are clinically symptomatic with confirmed total serum testosterone levels < 230 ng dl−1 will benefit the most from treatment. In symptomatic men with confirmed levels > 350 ng dl−1, several guidelines suggest that these patients may not experience benefit from treatment. However, some experts advocate for treatment in clearly symptomatic men regardless of serum testosterone levels, including those with levels > 350 ng dl−1.77Within this group, experts attribute benefit of treatment to modulation of the androgen receptor, mediated by genetic polymorphisms in exon one of the androgen receptor gene in the form of increased cysteine adenosine guanine (CAG) repeats. Certain data have shown increased CAG repeats are associated with decreased sensitivity in the receptor to testosterone and manifestation of TD symptoms despite “normal” serum testosterone levels.

will take Vitamin D for 6 months or a low amount of injectable TRT. not sure yet.

Considering that Vitamin D doesn’t turn off your balls, I’d start with Vitamin D.

TRT isn’t something to just lightly dabble in.

1 Like

This may set you up for failure, exogenous T shutdowns what natural T your body is making now potentially leaving with similar or even lower T levels than you have now.

You’re either all in or not at all and ready to make a life long commitment. You have three options, continue to decline further, improve diet and go to the gym and try to fix things from there, or TRT.

Whatever you’re doing now isn’t working, so something’s got to change.

1 Like

yup, gonna go with vitamin D and nutrition - gym is tough because of the exhaustion - and if not better in 6 months or a year, will then go with test.

3 Likes

Your e2 is very low, and likely a large part of your symtoms

Starting 5,000iu vitamin D tomorrow and b12 a week after that. Retesting in a month. If no change starting TRT.

Took some Thorne Vitamin D 5000iu today and feel a bit worse (foggy). Will give it a couple days though to see if that calms down and is not just an anxiety reaction but i tend to be very sensitive to supplements. don’t want to go down the process of adding magnesium and k2 to work with the vitamin D as i have gone through enough chemistry projects before.

Is 25 vitamin D level even that low where my testosterone/estrogen can be helped? it is technically an inefficiency and not a deficiency. i have been told that Vitamin D is really only low when down in the 10s.

my endocrinologist was ready to prescribe Clomid or Testosterone if he could (he works in hospital setting so said i’d have to go to a clinic for testosterone but gave a wink wink approval of it) but i pushed for the Vitamin D first. Thanks.