Test Question for the Knowledgeable

Pharma TRT
1

Got 99% of my bloods tested a few weeks ago and want an opinion from the most knowledgeable persons On here if possible.
I will post the full thing but for now can a question be answered?
I thought I might be suffering from Low T most or all my life without being diagnosed, so I had the bloods done.
But they don’t seem to be bad. everything except glucose came out as NORMAL because they were all close to the middle of REFERENCE

I’m 43 years old
5’6
155 to 156.5lb
30"waist about

My total test is 404 ng/dl TOTAL LC/MS /MS 250-1100
Don’t know what lc/ms/ms is does anyone?
Free test 62.6 pg/ml 35.0-155.0
SHBG 26 nmol/L (10-50 LISTED AS REFERENCE)
ESTRADIOL 34 PG/ML REFERENCE INTERVAL: < OR = 39
There is a note here for patients on fulvestrant the lcmsms test could cause reactivity and an falsely elevated estrogen level they recommend a special estradiol lcmsms test…i’m not on meds but it seems elevated
HEMATOCRIT 44.5 % 38.5-50.0
TSH 1.29 mIU/L 0.40-4.50
AST19 U/L 10-40
ALT 14 U/L 9-46
PROTEIN 7.2 g/dl 6.1-8.1
GLUCOSE 101MG/DL REF:65-99 PRE DIABETIC (100-125)
A few months back I was in the 68 to 70’s range as always at fasting, wife takes my sugar reading every now and then as she is diabetic
TOTAL CHOLESTEROL 174 MG/DL 125-200
NON HDL CHOLESTEROL 138
LDL/HDL RATIO 3.0 NORMAL average risk 2.29-4.0 Below average risk <2.28 moderate risk 4.91-7.12 high risk > 7.13
CHOL/HDLC RATIO 4.8 <OR = 5.0
LDL 109 MG/DL <130
HDL CHOLESTEROL 36 mg/dl {below normal low} >OR = 40
TRYGLYCERIDES 146MG/DL <150
ALBUMIN 4.8G/DL 3.6-5.1
GLOBULIN 2.4 1.9-3.7
ALBUMIN/GLOBULIN RATIO 2.0 1.0-2.5
BILIRUBIN 0.4 0.2-1.2
CREATININE 0.97 0.60-1.35
SODIUM 139NMOL/L 135-146
POTASSIUM 4.0 3.5-5.3

Looking at all this what does it say about my testosterone and associated hormones?
what should a normal 43 year old have?
and although I see guys in the 289 and lower or slightly higher range here and mine don’t look to be technically Low T Is it lower than Should be expected.
I Have always had lack of body hair compared to some or most, chronic fatigue all life Depression, no aggressive or take control of things nature, and I thought I could blame my tinny vocal chords on it too, lol.
Have no baseline obviously when younger, and Time spent in the gym doing squats etc., could have raised it more slightly I guess but maybe less than 400 if I weren’t exercising to lift heavy.
Also I’m always weak. I love to lift but can never become aggressive or work as hard as others.
Build muscle slightly in spurts, which usually occur after missing sessions for weeks or months. Muscle memory kicks in I grow within a few weeks to regain my weight and muscle then a little more, then growth slows almost to stop. Been prone to panic attacks in the past if I worked the body too hard to fatigue so that to me says there was something changing metabolically.

2

Please edit you post above, directly, by using the edit function, see the pencil icon above, and add lab ranges, always needed, especially for FT where ranges are not standardized.

Glucose=101 was fasting or not?
Low thyroid function makes this worse, please see last paragraph in this post to self-evaluate.
TRT would improve insulin sensitivity.

E2=34 is a problem as it will be reducing LH/FSH, TT and FT.
E2 can be higher from low liver E2 clearance which can be from liver conditions [AST/ALT are great] or medications, Rx or OTC that interfere with E2 clearance by completing for the same enzyme pathways that metabolize estrogens.

Are you using a statin drug to lower cholesterol? 174 is a great number.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

3

Will add ranges, but I thought they were standardized across the board.
Glucose was taken fasting nothing to eat or drink after 11:45pm night before and the actual blood sample was taken around 10:30 to 11am I was intending 9am but didn’t happen.
In reference to cholesterol I take absolutely no meds rarely even an aspirin or Ibuprofen for headache.
I have been reading the posts on people taking body temps to evaluate thyroid, will do.
So estradiol is high at 34 you say? and my test and free test are ok for age or rather low??
Thanks.

4

Your TT and FT are not extremely low, but definitely low enough to damage quality of life.

With guys on TRT with high-normal TT and FT, E2=22pg/ml seems to be optima for energy, mood, libido, fat loss, fat patterns, initiative and socialization. A very few are wired differently and need more E2. E2=34 will spoil the game for most who have high T levels. In your case, lower T and E2=34 makes you estrogen dominant. Any mood issues?

Lack of body hair suggests low T has been long term. May have lost hair on lower legs, a classis sign and perhaps shiny skin there too.

Your high E2 with low FT suggests liver clearance issues and liver AST/ALT needs to be looked at. We can rule out effects of meds as you do not use any. And we can rule out increased T–>E2 aromatization from abnormal amounts of body fat as you are very lean. So back to liver considerations.

At age 43 there is a great diversity in T levels, so there is no “should … have”.

If you get on TRT and become very sexual, will your wife keep up? This can be a source of tension in a relationship.

I think that you should pursue this issue vigorously. But most doctors are going to reject you. Please read the suggested stickies, this is the best thing that you can do and you my make some connections that we cannot in these posts.

Do get the oral body temps I requested, check your wife’s too. If you have not been using iodized salt, there are expected problems. Thyroid hormone fT3 regulates your metabolism by controlling mitochondrial production of ATP, the source of energy for your cells - a strong possible factor in “weakness”. Vit-D3 is also very important and if you do not drink milk, get lots of sun exposure or take vitamins, you are deficient. Vit-D3 is converted to Vit-D25, an essential hormone, that oddly is anther steroidal hormone derived from cholesterol.

5

Thank you for help.
. I used to be skinny at early age, but started putting weight on as I ate more, wasn’t exercising just enjoying eating out at buffets type of thing.
So that said I probably am at 20% body fat. I wear a size 30 if that helps. because I have lifted for the past 3 years almost, and have done no weight loss or cutting just eat 3 to 4 times a day to gain muscle.
I seem to have valleys on my lower legs like skin is dying, but I drink water. At the gym I will drink every time I do a set no one else I ever seen does that but I do. I’ll drink a half gallon in an hour and a half there.
Ive always had mood issues as depression,. or just getting agitated easily.
the slightest thing bothers me and can do so for rest of day. for example someone did something wrong to me or said something rude. I don’t fly off the handle at people though.
not truly bi polar. so maybe that is the mood issues showing.
Can I just try to control that estrogen a bit before trying TRT?

6

What has doc said about that skin condition?
Pix?

You can see what happens if you lower E2. Will be helpful, but T will not get high normal.

Are you ignoring thyroid and body temp issues?

7

Have not seen a doc in years. Don’t know what pix is.
Still need to take body temps of course. Do bloods suggest thyroid issues?

8

TSH looks good, but often is not definitive. Checking your oral body temps is the bottom line for balance of many factors, and zero cost.

pix = picture or photo