Was hoping to get some opinions here. I just got some test results back last week.
Total test 635ng/dl reference range 240-950
Free Test 13.4 ng/dl reference range 4.26-16.4
Bio available Test 53ng/dl reference range 61-210
All other blood and health markers are good.
As you can see, I have normal free and total test score but my Bio available is low.
I’m 5’8 165lbs. My diet is on point. As is my training 4 times a week EOD all hypertrophy based.
Plus 20min cardio EOD
I’m feeling extremely symptomatic.
Low libido
low energy
brain fog
Moody/ irritable
Hard time putting on muscle.
No drive. I just can’t get shit done.
Whenever I try to bulk I just get fat for the most part. Even the leanest of calorie surplus’s
Mind you I have put on a fair amount of muscle. I just feel like I could be and should be doing better going into my 4th yr. of training.
I do have an appointment with an endocrinologist coming up in Nov.
I can only assume I have high SHBG or something. I have been taking Boron 3mg and 5,000iu’s of vit D for some time now.
Just wondering if anyone has any experience with this or advice going into my Endo appointment. I’m just wondering if this is where I should try to advocate for TRT? or can Low Bio T be treated differently?
Just wondering.
Thank you!
Hey man, Thanks for the response. I’ve been following the Pharma page for a long time, and this doesn’t make sense to me either. Blood lipids are good. FSH was 5.1 (on the lower end) I feel like I show most signs of having low T. To be honest that’s what started all this in the first place. I just had a routine physical and asked them to run a few tests because of my symptoms. They kind of blew me off at first. But because I was feeling the way I was. They still tested.
Thanks for your response.
I had a whole list of tests I wanted run this time around and estrogen was one of them. Unfortunately, they never tested for it. I guess they will probably request a bigger blood panel. On or before my Endo visit. I would hope so anyways.
I’m Totally speculating here. But maybe I have high SHBG?
I would surely hope that someone would call for a more elaborate blood panel before my Endo visit.
Or is that wishful thinking?
Great question. I did reach out to “Defiy” online. They are obviously interested in helping me. I told them that I was working with my GP. doc and have an Endo visit coming. It seemed like they are more than willing to help. Just thought I would go this route first and see what happens and hopefully have insurance cover some of the cost. I can’t say that I have any experience with this at all outside of this forum. So, any advice is so very much appreciated.
Thanks
No sick care doctor would give you TRT if these numbers are repeated on a second blood test. Free T would have to be low normal, or bottom 25 percentile.
The Free T normal ranges are poorly defined, ranges lack consistency between lab companies. Free T at 16 ng/dL and above is considered healthy ranges.
Most insurance companies don’t cover TRT Total T 350 > or Free T low normal.
Yup, I just sent my doctor a message a few minutes ago. Asking about additional blood work before my Endo visit. In order to get a better overall picture. I would like to have this information before I get to my Endo visit and I’m told " We’ll take more blood tests and get back to you"
" Before your next visit"
I just don’t understand how all “Tested” blood markers show good. Then show Low Bio available test.
I feel like I’m showing some clear symptoms.
Hella confused and a little nervous!
You need to use the Equilibrium Dialysis method for the Free T, the Direct method is known to be inaccurate. If your Endo is a good doctor, he won’t base his entire decision on your labs alone, he will do what is called a dual differential diagnosis.
The doctor will weigh the symptoms and clinical picture of the patient as well as labs. There is a small subset of men that will be lean and muscular while also having low-T.
I wasn’t sure if I was going to get much of a response on this one. So, THANK YOU and everyone else who has taken the time to read and respond.
I’m not sure what this means but, here is a copy and paste of how the Total test and Bio test was run. Testing performed by Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.
It Doesn’t say much of anything about how the (Free test) was performed.
You can calculate your SHBG using TT and FT, at least you’ll get an estimate, assuming your FT reading is accurate (it may not be). But, all variables accounted for, your SHBG is 35nmol, totally normal.
Absolutely great information on the SHBG. Maybe I’ll just chalk it up to an inaccurate initial test.
As far as normal vs.Optimal? Thats a great question. Every time I read about low T symptoms. I just say to myself. " Thats exactly how I feel. "
Damn near every one of them.
Now, with all that being said. How should a 49yr old man feel?
Ha, honestly? I have no idea. But, I do know this. I thought that all the dieting, training, and general health practices would make me feel like a brand new hundred dollar bill and not an old man who feels like he’s been thrown off the roof everyday and landed on the one good boner he had left! LOL
All Free T testing, even the equilibrium dialysis method has it’s problems, the CDC is currently working on standardized, hormonal reference ranges and testing methods.
When it comes to testosterone, there’s no clear defined line defining testosterone deficiency, it will vary person to person, it’s very individual.
An example, a member over at ExcelMale, had prostate cancer, Total T <100 and can’t handle anything 300> on TRT.
Hey Brick,
Thats another great question. I’m not sure what Bf % I was in that picture ( probably late June of this year) . I’m not far off that as we speak. Last years bulk was for the most part a flop. I feel like every fall/winter I work my ass off and gain 20+ lbs. Then cut only to weigh the same as last summer. It’s been frustrating for sure. With that being said I started (12 weeks of pain and suffering) by John Meadows and started a custom built Mountain dog diet that has me at 2,300 cals ( Highish fat/highish) protein on off days. Then its 3,000cals moderate carbs, high protein, lowish fat on training days. I have literally eaten that same exact thing right down to the gram everyday for going on 6 weeks now. I’ve gained about 2-3lbs +/- in the last 6 wks. Mostly glycogen a little muscle and a little fat I’m sure. It’s going fairly well so far.
I’ve always eaten pretty big while trying to gain muscle and know that fat and muscle gain walk hand in hand. However, it just seems like I don’t seem to make a hell of alot of progress.
Thats the primary reason I wanted to get some blood work done. It seems like if I found out i was low on test. Things would make a little better sense to me.
However, Now that I’ve got my test score back. Its about as clear as mud.
I think this is pretty normal after a certain point. You are close to your genetic limit given the circumstances (age, diet, training, recovery, hormone levels…). If you can make improvements to one of those areas, then you might see some physique changes down the road. But since you are close to your current genetic limit, gaining 20 lbs will likely be mostly fat. Yes, you can hold a bit more muscle if you let your body fat go up, but it is then dependent on you keeping that fat if you want to keep the muscle.
Just my opinion, I don’t think you have low T based on the labs. Getting a few rounds of labs is a good idea here though. I think what you are experiencing as far as symptoms is just the reality of aging. Testosterone can help with that if you go more for optimization than replacement (I don’t think you’d see much benefit with something that brought you to middle to middle high range, since you are there already). You’d likely have to be above range to see those symptoms of aging improve, as well as improve physique (especially since you are already in shape).
I’d guess TRT even with higher amounts is only going to give you marginal improvements. Ask yourself if that is worth it? Energy and mood are IMO over exaggerated on TRT or even on cycle levels of Testosterone. It is a tiny improvement for me. Almost can’t tell TBH. Still hard to get out of bed even on cycle levels for me.
