First Post, Probably Overdue. Did Bloodwork

Pharma TRT
1

Hello. as title suggests, long time, first time and likely overdue. seeking advice on what to expect next visit to endocrinologist.

A little background in chronological order. At around age 40-41 started to feel all the symptoms of low t ( just didn’t know it) went to family doctor and described what i was going through, depression, no energy, emotions like a roller coaster, etc… family doctor says I am suffering from depression, prescribes anti depression meds, orders me off work (law enforcement) and orders blood work. Lab results in 2016 came back as all in normal range. i noted my total testosterone levels were 11.7nmol/L range 8.4-28.8 When the dr told me these were “normal” i took his word for it.

Fast forword about a year, i took myself off anti depressants, symptoms still existed but manaageble. because of the time off work i get to see a psychologist ever 2 months.

late 2018 I make another family drs appt as things arent getting better and sex drive is now on the list of issues. Another blood test reveals everything normal with total testosterone level now 11.6nmol/L. Since talking to psychologist regularly i suggest maybe seeing a specialist to see if there are other things going on in my blood to explain my symptoms. Family dr agrees to send me to local endocrinologist to get a call 4 months later that the lab results my dr sent over seem normal and would not see me.

just recently psychologist on one of my sessions calls an endo the she knows and is willing to see me without a family dr referral. its a 2 hour drive but i jump on the appt. he was quite frank up front saying that he would order more complete blood work, BUT if something doesnt come back out or range his hands were tied.

most recent blood work done this month shows well within normal range except the following which are either low, or real close to being low.

MCV

lab results: first post likely long over due.
2

You’re in for a long haul brother. Others will chime in but its likely that your low T and related hormones are at least a part of your issues. I would suggest getting away from mainstream medicine and seeing a TRT specialist, even if it means self pay. You will save yourself a ton of frustration and time.

Edit: You are not alone. It important that you know this and that you are not unique. TONS of guys have walked this path before you. It was a good decision to come here. We have a lot of info and guidance from our own personal experience.

2 Likes
3

first post, but long time visitor. i will try and keep it short.

45yr old male 6’4" 315lbs ( 275lbs 4 years ago active and strong)

3 years ago all the symptoms of low t, family dr says im suffering from depression, puts me on meds and orders blood work. says all is normal, total t is 11.6 nmol/L with a range of 8.4-28.8

took myself off meds after about 4 months, symptoms still there but lived with them.

last year another visit to family dr. more blood work which comes back normal with a total T of 11.5nmol/L this time. after some discussion he agreed to refer me to our one and only endocrinologist.

4 months later I am informed that the specialist doesn’t need to see me, my levels look normal.

Just recently i pulled some strings and got a endocrinologist 2 hours away to see me in person. He ordered more complete blood work but was clear that if nothing came back low his hands were tied ( reside in Canada, not sure if that makes a difference)

here are the results from this months blood work, i only included the results that were out of range or close to out of range.

MCV 80fl range 80-100
MCH 27.6pg range 27.5-33
FSH 5.4
LH 5.1
Estradiol 131 range<162
Free test LO 162pmol/L range 196-636
Bioavail test 3.8nmol/L range 3.6-11.2

everything else was in check, even blood pressure was great which shocked the nurse due to my size.

Just curious what to expect with my followup visit. its clear my free test is low. is there something i should insist on? or questions i should ask that i would not know to ask.

any advice is appreciated, and my apologies if something was not included in post that should have been. as i mentioned this is my first post.

4

Studhammer.

thanks for the response. I accidentally posted this before it was complete while typing out blood work ( i think i hit the tab button )? that is why it appears unfinished.

regardless… there is a followup post hopefully coming soon with some blood work included which i would love comments on

thanks

5

I’m afraid you are dealing with a healthcare system that is extremely ignorant in what constitutes normal testosterone. Now you must fight the doctors to pull their heads out of their ass and educate themselves because most doctors are completely ignorant in sex hormones.

Your levels are normal alright, for an 80 year old man. Testosterone peaks at about 30 and begins to decline gradually thereafter and by the time you reach old age, levels are low. Only these EDC’s your country has unleashed on the population is causing it to happen much sooner and your doctor has the audacity to tell you that your levels are normal.

You need to seek private care for your TRT because ordinary endocrinologist’s/doctors are utterly clueless. It damn repetitive to see new members saying that their doctor told them their testosterone levels are normal, “within range”, “your levels are normal” it gets old fast!

It doesn’t appear the EU healthcare system knows about normal thyroid status either, studies are showing normal TSH reference ranges for healthy individuals is 1-1.5 mU/L and yet the ranges go all the way to 4.5 mU/L to include unhealthy obese people with at least one disease.

I had the these same MCV and MCH numbers right before critical iron deficiency hit me hard, when MCH dropped below 27, the real suffering began! Your iron is more than likely low and you are looking at iron deficiency in the not so distant future.

You require a complete CBC, iron panel and ferritin to diagnose iron deficiency, just don’t expect your doctor to know how to properly diagnose iron deficiency. I has to see multiple doctors and fight them to see I was iron deficiency, I had to explain to them what iron deficiency looks like on paper, it seems like the patient these days is more informed than the doctors.

Cost of hormone-disrupting chemical exposure in Europe in billions

Exposure to endocrine-disrupting chemicals (EDC) is estimated to cost the European Union more than €150 billion ($209 billion) a year in health care expenses and lost earning potential, according to studies by a team of 18 international researchers, including two Harvard T.H. Chan School of Public Health faculty. Conditions linked to the chemicals included lowered IQ, male infertility, diabetes, and obesity.

EDCs interfere with the body’s hormones. Found in food and food containers, plastics, furniture, toys, carpeting, building materials, and cosmetics, they contain chemicals such as, phthalates, and pesticides such as chlorpyrifos. They are often released from such products and enter the bodies of humans through ingestion, dermal contact or inhalation.

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 (16.6 nmol/L) 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.

6

Thanks for the replies so far. and again sorry for the double post that was eventually joined together. one with blood work, one without.

I can only assume/hope with the low free test level i will be offered some sort of TRT? again is there anything in particular i should request? is one form better than another? also hopefully this doesn’t sound stupid but does the size of the patient make a difference in amount of testosterone prescribed? i.e. would the same amount of prescribed testosterone have similar effects on people who are 150lbs and 300lbs respectively?

7

Your FT (the active portion of testosterone) is below ranges and even if it was in range and about midrange, symptoms of low testosterone would still be expected, something few doctors understand. Testosterone binds to a protein produced in the liver (SHBG) and can affect FT by 50 percent going from about midrange to high normal.

Based off your TT (not bioavailable) and FT ratios, your SHBG is about midrange and you seem to convert a moderate portion of your FT–>estrogen which should then dictate your injection frequencies. The smaller the dosage of testosterone injected, the less conversion of FT–>E2 and therefore lower estrogen.

Men are supposed to have proper testosterone to estrogen ratios or else you’ll be closer to estrogen dominance, testosterone needs to higher in relation to estrogen, a typical example in a healthy man with natural testosterone is a TT at 800 (27 nmol/L) and estrogen at 25-30 (90-110 pmol/L).

T dosing has nothing to do with the weight of an individual. I thrive at 7-10mg (49-70mg weekly) cypionate daily, I’m 235 pounds 6ft tall.

Anyone about to undertake TRT should at least have a complete thyroid workup, low testosterone and low thyroid function can overlap, I would expect to see low iron absorption in someone with low thyroid function, unless you have no vitamin C in your diet, vitamin C increases iron absorption, so if you are not including vitamin C in your diet, low iron is expected.

You should request TSH, fT4 fT3, rT3 and antibodies. I doubt you get all of these tests without fighting your doctor.

8

No doctor is likely to look at or care about free test, they will look at Total Test. If you are at the threshold to qualify for TRT, he may offer it. We don’t know where you live, so it’s hard to predict the reaction. There are plenty of things to check, but it’s hard to advise without seeing your full normal labs.

9

system lord. thanks for the information. learning on the fly here. as far as thyroid "TSH was measured at 1.41mlu/L and says normal range is 0.32-4.00,

Again sorry for lack of detail, but truly is my first internet post of any kind. hence the double post being joined as one. I try to copy and paste all lab results but it doesn’t transfer over into same easily readable format.

thanks again to all

10

More than likely there are no thyroid problems, rarely do I see abnormally low fT3 with TSH this low.

11

@long_time_first_time
If you are willing to pay out of pocket (around $150/month) you can be on Testosterone tomorrow. There’s a ton of docs out there that will treat you with those numbers. If you can’t find one on your own I would be happy to put you in touch with mine. It’s over the phone, they send you a lab requisition that you take to labcorp, get bloods done, when results come in they’ll ship you T in the mail every 2 months. I’ve been doing it for 2 years. My pre-trt total T was higher than yours is. If you need my doc email me (email in bio) and I’ll put you in touch. There’s a ton of telemedicine places out there.

12

Thanks. Im hoping the endocrinologist sees my free testosterone level is quite a bit below normal range and is able to assist

13

Thanks dextermorgan. I will keep that in mind if things do not work out. Im hopefully optimistic now that i actually have lab proof that my free t is below the low range minimum. Does it matter where you reside, I am in Ontario Canada?

14

Yeah I thought you were US sorry. @enackers may be able to direct you to a good doc in Canada though

15

Depends on your doc. Young guy or old guy? Are you in Southern Ontario or out in the sticks?

1 Like
16

There are lots of option in Ontario Canada for private clinics if your situation doesn’t work out with your doctor.

1 Like
17

45 in southern ontario. endocrinologist I’ve only seen once… he said he couldn’t do anything IF my bloodwork didnt result in any low values… since one is below the low range I’m hoping he can work with me… fingers crossed…

18

thanks… good to know. if I need another route… I’ll post follow up decisions with endocrinologist… I realize they have to ween out some patients, but based on lab results confirming low free t… and symptoms for past 4 years he should be able to assist… fingers crossed…

19

Do a Google search if he doesn’t work out, there’s a clinic in Burlington.

20

Even if he does, experience tells me that he will resist getting you to “optimal” levels and, he will look for injections every two weeks and, using an aromatase inhibitor. All bad medicine. Just be careful and do your homework