Interpreting Lab Results, Next Step?

Pharma / TRT Testosterone Replacement
1

Hey guys,

A little background - I’ve been working out for the good part of 3/4 years and have been training consistently with a number of different routines predominantly focusing on building strength (compound movements). I started as a chubby kid and have gotten down to around 170lbs with my stats being: B: 100kg, D: 185/190kg and S: 150kg. I’ve always found it hard to progress in the gym in terms of lifts and physical appearance seems like I’m spinning wheels half the way but I’m still pretty disciplined and stayed at it. I decided to get my blood work done recently due to a number of symptoms which are linked to low testosterone and me pretty much ignoring them and trying to cover them up hoping they’d go away. Turns out my first initial blood work came back as a Low T reading which entailed a follow up blood test. Here are my readings so far: the GP says I shouldn’t be concerned but I pushed for a referral to see an Endo as my Free Test came back well below the lab ranges. I’m having difficulty making sense of these readings and the conversation with the GP today, honestly I feel like a majority of the low T symptoms resonate strongly with me (originally went in to seek help for potential depression).
Stats:

21 YO male,
170 lbs - fit, healthy not overweight
Lift heavy, eat well & don’t smoke or drink.
No previous medical history

Lab results:
Testosterone: 9.3 (11.5-32.0) 2nd test: 11.5
SHBG: 37 (15-50)
FAI: 31.1 (15-100)
Free Testosterone: 211 (260-740) Low
TSH: 1.08 (0.40-3.50)
FSH: 2.6 (1-12)
LH: 3.2 (0.6-12)

Really appreciate any help on this. My first question would be - are these levels low, or extremely low for someone in my situation? What would be a potential appropriate next step?

Cheers

2

I’m not sure what units those are but going by the numbers you’re definitely low, Free T measurements are problematic and not very reliable. Total T more accurate of T status, would like to see hemoglobin and hematocrit. There quite a few tests missing, TSH only tells us your thyroid is being stimulated, if you want to know if thyroid is producing enough thyroid hormones you must run Free T3, Reverse T3, Free T4 and antibodies.

A good indicator of thyroid status is waking (97.7) and afternoon (98.6) oral body temperatures, see thyroid sticky. Many doctors fail to test Free T3 which is the only active thyroid hormone. Free T3 levels can be plentiful and if reverse T3 is high enough it can block Free T3 from soaking into your cells, effectively negating good Free T3 levels. If reaching 98.6 by 2pm, you can forgo expensive thyroid testing.

We have many here who have optimal TSH (1.0) with free thyroid hormones below the reference ranges, most doctors would stop investigating once they see TSH is within range, this is a mistake as these ranges are too wide and have many within them who present with hypothyroidism.

Your SHBG level is optimal, as we age our SHBG increases reducing our free testosterone and older men become estrogen dominant, men then lack exercise capacity and start losing muscle mass. TRT can be useful in keeping SHBG levels lower as we age preventing our free testosterone from decreasing as we age.

You may need HCG together with your TRT protocol if you wish to remain fertile, HCG mimics LH which TRT all but eliminates. You will likely need Arimidex (AI) to help control estrogen levels, TRT increases estrogen is most men. Your doctors has failed to test for estrogen, this isn’t a good indication of doctor knowledge.

Your best chance of successful TRT is finding a good private doctor, androgen therapy is in its infancy and most endo’s lack the knowledge on how to balance out your hormones. Stay the hell away from these T-clinics, they lock you into a financial straitjacket charging insane prices and staff incompetence, there not doctors and can’t diagnose most medical conditions.

Your spinning your wheels trying to gain muscle with your hormone status, I would say you could have problems trying to hold onto what you already have at these levels.

3

Thanks for such a detailed response. Appreciate it, I’m getting referred to an Endo next week to run some further tests. Will the Endo run all of the tests you mentioned to determine this into more detail or will it go back to the GP to do? Also another concern is that I’m currently in Australia from the U.K. and plan to be here for another 9-10 months. If I potentially start TRT over here, how will this translate to back home? Would you say hold fire until I’m back in the U.K. if the Endo recommends TRT over here?

4

You’re welcome,

If you have a knowledgeable doctor in Australia go ahead and start with him because the UK is a terrible place for TRT, the NHS is a nightmare! Keep all medical records as you will need them when you return to the UK to get treatment there, stay away from NHS.

Don’t even consider Nebido or pellet therapy, test ethanate is your best choice, if you can get ahold of test cypionate it’s like finding gold at the end of the rainbow. Sustanon is alright, previous choices are better. Low hormones is not healthy, I see no reason to wait.

5

Yeah I’m keeping all records - just a quick one ^ obviously I’m missing some important tests like E3, will the Endo do that or shall I speak to my GP to get those tests done? Yes honestly I’m a bit overwhelmed with this all, symptoms are profound and resonating with me but I’m unsure what to do with all of this information and obviously keen to explore ALL avenues before considering TRT…

Also to add - I’m in contact with two GP’s both have said they’re both healthy ranges and I shouldn’t be concerned, depression could cause these symptoms. Ed, brain foginess, memory etc but my question is - is that a load of rubbish and Low T could be the root cause of these symptoms versus depression?

6

Healthy ranges, seriously?! Your profoundly hypogonadal and below the reference ranges, don’t allow these doctors to charm you.

Studies are showing men with low testosterone have a higher mortality rate, men with high normal testosterone are 30% less likely to have cardiac events than those in the middle ranges.

Low testosterone can cause anxiety and depression, also low thyroid function can cause both as well.

7

Thanks for the help dude. Once I see my Endo and get my results back I’ll post back on here.

8

I’ve done a bit more digging - could a restart be on the table as well with Clomid depending on levels? This seems like a very good start versus jumping on TRT right off the bat…?

9

Yes try restart. 21 is a great age where it may work.

10

You mention being chubby for most of your life, low thyroid function can cause fat gain.