25 years old, total t levels averaging 350, help with bloodwork

[rhs88]

25 years old, 5-8, good shape, 155lbs fairly lean (round 12% bf).

I started noticing possible effects of low T about a year ago. Only recently got blood work however. I have been lifting weights regularly for two years and just did not see the progress I was expecting or where I thought I should be after that amount of time (my diet and training has been dialed in). My workouts have really been dragging lately. Noticed a lot of fatigue over the last year and been pretty moody. More recently I have been noticing a big decrease in my sex drive (past three months). Also, I have not been waking up with morning wood anymore (also for the past three months).

Here's the tests results from the blood work I have had done. All testosterone tests done except the first one have been done between 8am-9am. First was taken at 2pm.

1st T test: Taken at 2pm
Testosterone Free 27.5 46.0 - 224.0 pg/mL
Testosterone, Bioavailable 57.7 110.0 - 575.0 ng/dL
Sex Hormone Binding Globulin 27 10 - 50 nmol/L
Albumin 4.6 3.6 - 5.1 g/dL
Testosterone Total 193 250 - 1100 ng/dL

2nd T test Taken at 830am
Testosterone Total 319 250 - 1100 ng/dL
Testosterone Free 72.4 35.0 - 155.0 pg/mL

3rd T test Taken at 930am
Total Testosterone 397 250-1100 ng/dL
Free Testosterone 79.9 35.0-155.0 pg/mL

Most recent T test Taken at 830am
Testosterone, Free 60.5 46.0-224.0 pg/mL
Testosterone, Bioavailable 119.1 110.0-575.0 ng/dL
SHBG 21 10-50 nmol/L
Albumin,Serum 4.3 3.6-5.1 g/dL
Total Testosterone 329 250-1100 ng/dL


Other tests results:

LH: 1.4 0.8-7.6 uIU/mL
Prolactin: 7.5 2.1-17.7
FSH: 4.2 0.7-11.1 uIU/mL
Free T4 1.20 0.59-1.61 ng/dL
TSH 0.93 0.34-4.82 uIU/mL
Alpha Subunit 0.1 .1-.5 ng/mL
Estradiol 20 <56 pg/mL
Iron 115 35-150 ug/dL
Iron Binding 326 250-450 ug/dL
Iron % Saturation 35 20-50 %

Also had a semen analysis done, and it came back excellent.

I have seen two endocrinologists. The first looked at my result of total t=319 and said something is definitely up and ordered more tests. 2nd t test came back at total t=397. At this he said that I'm probably fine but ordered another test and it came back at total t=329. Now he is open to TRT.

The second endo I saw said my levels are completely within normal range, kind of brushed off my symptoms and said check to check my levels again in 6 months and come back.

So....I don't think everything "normal" here like the 2nd endo was saying. I thought it was interesting that he looked at my lab numbers and immediately dismissed the possibility that low t could be causing my symptoms because they were within a labs reference range. Should I pursue TRT with the first endo? I do not like the idea of being on TRT for the rest of my life and have been looking for alternative causes to my symptoms, however, I do think my levels are low for my age...Thoughts?

p.s. Any concern of a pituitary tumor based on this bloodwork?

 

[rikardo82]

your LH is extremely low even for this T I have similar T ~360-380 LH is 2.6-3.6 have no idea about tumor but could be before jumping to TRT just ask doctor to check it. Also how about cortisol? It's one of #1 enemy for T!!! How is sleeping?

 

[rhs88]

your LH is extremely low even for this T I have similar T ~360-380 LH is 2.6-3.6 have no idea about tumor but could be before jumping to TRT just ask doctor to check it. Also how about cortisol? It's one of #1 enemy for T!!! How is sleeping?

I have not had cortisol checked. I'll get it done. I think I am sleeping ok, although the past year I have been sleeping MUCH lighter and tossing and turning a lot. I don't think I have sleep apnea, but I am getting a sleep study done to be sure.

 

[hiram1st]

Welcome to ology.

You should read this and educate yourself on TRT:
http://www.steroidology.com/forum/testosterone-replacement-therapy/662394-basic-trt-overview.html

At 350 your test levels are in the normal range as far as the dr. is concerned. I know you don't want to hear that you want to feel better and feel better now. Take your time and find out why your TT is low. There are a lot of things that can cause it. Pituitary Tumor(usually benign), sleep apnea, past drug use, head/teste trauma, stress, depression and so on. Read that link has a lot of good educational value.

 

[rhs88]

Welcome to ology.

You should read this and educate yourself on TRT:
steroidology.com/forum/testosterone-replacement-therapy/662394-basic-trt-overview.html

At 350 your test levels are in the normal range as far as the dr. is concerned. I know you don't want to hear that you want to feel better and feel better now. Take your time and find out why your TT is low. There are a lot of things that can cause it. Pituitary Tumor(usually benign), sleep apnea, past drug use, head/teste trauma, stress, depression and so on. Read that link has a lot of good educational value.

Hi, thank you!

I have read that link its all good info. I've also been educating myself through various other sites and forums.

What I have found interesting through all this is lab reference ranges. Some labs like quest say 250 and under is out of range while others like labcorp say 348 and below is out of range even though they are both using the same unit of measurement.

 

[Megatron28]

Hi, thank you!

I have read that link its all good info. I've also been educating myself through various other sites and forums.

What I have found interesting through all this is lab reference ranges. Some labs like quest say 250 and under is out of range while others like labcorp say 348 and below is out of range even though they are both using the same unit of measurement.

It is kind of like your scale at home saying you weigh 180 pounds and the one at the gym saying you weigh 185 pounds.

 

[Profion9k]

Something is up.


Ive been low T and feels shit.... But trust me on this one, before you go further..

Fix up a proper diet 150g protein 300g carbs and 90g fat.. The fat/cholesterol turns into hormones such as testosteron, thats why fats play an important role in a proper functioning human! Refix your sleep and exercise 3times with weight and light jogs on rest days. This is the time you want to try to crank up your bodys own production, if this fails with all means perfect! then you should go ahead on TRT.

We are speaking of a month of full dedication.

 

[halfwit]

I'd also look at vitamin D deficiency and external stress factors. The pituitary is very sensitive to stress (as cortisol was mentioned above), and will react accordingly by taking a nap.

I wouldn't hop on the needle until you've exhausted all options first. It's a life-long commitment, and the decision should not be taken lightly.

My .02c

Note: profion9k, while I agree with the general message in your post, you have to remember that the macro combination that works for you may not work for others. In fact, I would shrivel up with that kind of calorie restriction.

 

[rhs88]

Something is up


Ive been low T and feels shit.... But trust me on this one, before you go further..

Fix up a proper diet 150g protein 300g carbs and 90g fat.. The fat/cholesterol turns into hormones such as testosteron, thats why fats play an important role in a proper functioning human! Refix your sleep and exercise 3times with weight and light jogs on rest days. This is the time you want to try to crank up your bodys own production, if this fails with all means perfect! then you should go ahead on TRT.

We are speaking of a month of full dedication.

Definitely good advice in regards to training and eating right. unfortunately it does not really help me much as I already lift regularly and run as I mentioned in my original post. My diet is also on point. I make sure to get plenty of fat from meat and nuts. I'm not sure that there's much I can do other than what I'm already doing to boost my levels.

 

[rhs88]

I'd also look at vitamin D deficiency and external stress factors. The pituitary is very sensitive to stress (as cortisol was mentioned above), and will react accordingly by taking a nap.

I wouldn't hop on the needle until you've exhausted all options first. It's a life-long commitment, and the decision should not be taken lightly.

My .02c

Note: profion9k, while I agree with the general message in your post, you have to remember that the macro combination that works for you may not work for others. In fact, I would shrivel up with that kind of calorie restriction.

And this lifelong commitment is what has me hesitant to just hop on trt. That being said I hate how I have been feeling. I did mention vitamin D to the doc that was suggesting trt. he said it is not worth testing for, however, due to the fact a take a multi vitamin and drink a glass of milk with every meal. Does this sound right or should I push to test it?

He also was not interested in testing cortisol.

 

[rhs88]

Little update here, went ahead and got more testing done, this time instead of using quest labs we used lab corp. Here were the results:

Testosterone, Serum 319 (348-1197 ng/dL)
LH 1.7 (1.7-8.6 mIU/mL)
FSH 2.9 (1.5-12.4 mIU/mL)
Estradiol 9.4 (7.6-42.6 pg/mL)

So i think it is safe to say I hover around 319 total T in the morning. Lh looking low. FSH on the low normal end I think?

My doc went ahead and ordered an MRI to check out my pituitary. I have had a few complete metbolic panels and they have both come back completely in range, cholesterol is very good also. Anything else anyone can think of checking? I might try and push my doc to check vitamin D and cortisol but he was pretty adamant that testing these is not worth the time....

 

[halfwit]

I'd push for vitamin D testing and a sleep study. If your MRI comes back clean, and you can rule out those last two items, I would consider that due diligence on your part and then look into your last two remaining options: TRT and a SERM-assisted restart. The latter being a course of clomid to try to stimulate the pituitary back into production.

I'll keep my fingers crossed for you, and hope you find a solution.