Normal total test but low free test. feel like sh*t

[xplicid]

About 6 months ago I started to get extremely fatigued and tired all the time. Anxiety with low mood settled in. Libido was shot and worst of all my erections would only be about 70% of normal. My gym performance started to suffer, lost a lot of weight, just cascading of sh*t. My 2 favorite things, the gym and sex started to become a choir.

I got some labs done but mostly everything was normal, below are the results. Ive been to two doctors, one says its depression prescribed SSRI, the other says its testosterone/thyroid issue and need to experiment with test and/or T3. the only issue is low free test, could these be an issue even though total test is fine? I dont want to TRT at the age of 28 but there is also a big part of me that hopes if it is the issue, im lucky that its treatable and will allow me to start feeling better.



any comments welcome and on a side note ive never done AAS before


Glucose, Serum 91 mg/dL 65 - 99 01
Uric Acid, Serum 3.6 Low mg/dL 3.7 - 8.6
BUN 22 High mg/dL 6 - 20 01
Creatinine, Serum 1.02 mg/dL 0.76 - 1.27
eGFR If NonAfricn Am 100 mL/min/1.73 >59
eGFR If Africn Am 115 mL/min/1.73 >59
BUN/Creatinine Ratio 22 High 8 - 19
Sodium, Serum 138 mmol/L 134 - 144
Potassium, Serum 4.4 mmol/L 3.5 - 5.2
Chloride, Serum 100 mmol/L 97 - 108
Calcium, Serum 9.4 mg/dL 8.7 - 10.2
Phosphorus, Serum 3.1 mg/dL 2.5 - 4.5
Protein, Total, Serum 6.7 g/dL 6.0 - 8.5
Albumin, Serum 4.6 g/dL 3.5 - 5.5
Globulin, Total 2.1 g/dL 1.5 - 4.5
A/G Ratio 2.2 1.1 - 2.5
Bilirubin, Total 0.8 mg/dL 0.0 - 1.2
Alkaline Phosphatase, S 129 High IU/L 39 - 117
LDH 200 IU/L 121 - 224
AST (SGOT) 36 IU/L 0 - 40
ALT (SGPT) 28 IU/L 0 - 44
GGT 16 IU/L 0 - 65
Iron, Serum 56 ug/dL 40 - 155

Cholesterol, Total 113 mg/dL 100 - 199
Triglycerides 62 mg/dL 0 - 149
HDL Cholesterol 35 Low mg/dL >39
LDL Cholesterol Calc 66 mg/dL 0 - 99
T. Chol/HDL Ratio 3.2 ratio units 0.0 - 5.0

CBC, Platelet Ct, and Diff
WBC 8.8 x10E3/uL 3.4 - 10.8
RBC 5.11 x10E6/uL 4.14 - 5.80
Hemoglobin 15.9 g/dL 12.6 - 17.7
Hematocrit 46.5 % 37.5 - 51.0
MCV 91 fL 79 - 97
MCH 31.1 pg 26.6 - 33.0
MCHC 34.2 g/dL 31.5 - 35.7
RDW 13.3 % 12.3 - 15.4
Platelets 168 x10E3/uL 150 - 379
Neutrophils 70 %
Lymphs 18 %
Monocytes 11 %
Eos 1 %
Basos 0 %
Neutrophils (Absolute) 6.1 x10E3/uL 1.4 - 7.0
Lymphs (Absolute) 1.6 x10E3/uL 0.7 - 3.1
Monocytes(Absolute) 1.0 High x10E3/uL 0.1 - 0.9
Eos (Absolute) 0.1 x10E3/uL 0.0 - 0.4
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2
Immature Granulocytes 0 %
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1

Testosterone, Serum 596 ng/dL 348 - 1197
Testost., % Free+Weakly Bound 17.6 % 9.0 - 46.0 02
Testost., F+W Bound 104.9 ng/dL 40.0 - 250.0
Sex Horm Binding Glob, Serum 46.7 nmol/L 16.5 - 55.9 0

Testosterone, Serum (Total) 529 ng/dL 0
% Free Testosterone (Dialysis) 1.1 Low % 1.5 - 3.2
Free Testosterone, Serum 58 pg/mL
Bioavailable Testosterone, % 33.5 % 03
Bioavailable Testosterone, S 177 ng/dL

LH 4.6 mIU/mL 1.7 - 8.6 01
FSH 2.6 mIU/mL 1.5 - 12.4 01
Prolactin 8.7 ng/mL 4.0 - 15.2 01
Estradiol 22.7 pg/mL 7.6 - 42.6

T4,Free(Direct) 1.63 0.82-1.77 ng/dL
Reverse T3, Serum 22.4 9.2-24.1 ng/dL
Triiodothyronine,Free,Serum 3.0 2.0-4.4 pg/mL
Triiodothyronine (T3) 88 71-180 ng/dL
Tsh 2.250 0.450-4.500 uIU/mL

 

[Megatron28]

All your numbers look good. Doesn't appear to be hormonal.

Have you been tested for Sleep Apnea? That can cause all your symptoms.

Don't take the SSRI if you can avoid it. They are known to lower your testosterone and affect prolactin.

Have you tried 5mg of cialis every day for the ED? Works great. Give you pumps in the gym and lowers BP too. Good for BPH as well.

 

[xplicid]

All your numbers look good. Doesn't appear to be hormonal.

Have you been tested for Sleep Apnea? That can cause all your symptoms.

Don't take the SSRI if you can avoid it. They are known to lower your testosterone and affect prolactin.

Have you tried 5mg of cialis every day for the ED? Works great. Give you pumps in the gym and lowers BP too. Good for BPH as well.

Really appreciate your response and input brotha. Any idea what the percent free testosterone means? Its below the normal range by about 25%

What's bothersome is I have the emotional issues on top of the sexual issues. People have told me the sexual issues could be from me thinking about it but I don't often have nocturnal errections and when I do get them, they are still only about 70% of a full errection. I'd like to take care of both issues but the sexual issues are debilitating; lost an erection in the middle of inter course with a new partner... When I do orgasim it's not nearly as intense. Im being completely objective when say even flaccid my penis is smaller.... My pumps in the gym and greatly reduced as well. Maybe it could be a vascular issue?

I haven't been tested for sleep apenia but I'm willing. In not a snorer nor am I over weight, still something I should look into?

Being 28 dealing with this shit is awful because I would love to utilize cialis but an afraid I could become Dependant and later on in life have it lose its effectiveness.... Rendering my Wang useless.

Oh and SSRI are supposed to make these issues worth, we can't win! But would it be worth the shot?

One doc suggested a 3 month trial run of 1x weekly test cyp at 150mg to see if it helps. Is this something I should consider?

Would suggesting sleep apenia and cialis be a better option? Others have said adrenal fatigue, any merit?

Thanks guys, helps knowing there's a community to turn to

 

[Megatron28]

That's a lot of questions!

Sleep issues can affect Penile Tumescence. The mechanism isn't fully understood, but REM sleep is believed to be what triggers it. So I definitely think it would be worth while to have a sleep study done. It could explain a lot of your issues. It could be apnea, hypopnea or even something like restless leg syndrome.

Try the daily cialis at 5mg. It will help you mentally. Once ED gets in your head it is really hard to get it out of your head and you dwell on it. That just makes it worse and it becomes a self fulfilling prophecy. Ask to be examined by a Urologist too. Make sure all your "plumbing" is working well.

I really would save the SSRI for last resort. Ask yourself and people around you if you seem depressed or anxious. And even if you do try the SSRI, know that it is meant to only be a temporary crutch. Not a permanent solution. The permanent solution involves doing Cognitive Behavior Therapy with a psychologist.

Also make sure you are fully aware that SSRI's can make sexual performance even more difficult. They can make it extremely difficult to achieve orgasm. That is likely the prolactin at work. And prolactin lowers Testosterone too.

I don't think you need TRT. Your TT is right at the average for your age. Yes, Free T is low, but that is an innacurate measure as it is usually estimated. It bounces around a lot too. And perhaps more important than Free T, is Bioavailable T which you didn't check. I personally would not get hung up on the Free T number. I don't think it explains what you are experiencing.

Going on TRT at 160mg/week would likely just get you back to your current natural TT level. It would introduce a whole new set of problems that you would have to manage such as estradiol (aromatization) and hematocrit. And there is a good chance that running it for three months or however long would result in your natural TT never fully recovering to where it is today. We often see that each "cycle" results in natural TT being lowered. Besides, did your doc discuss what you would have to run after your "cycle"? You shouldn't just come off cold turkey. Other medications need to be used in what is known as Post Cycle Therapy (PCT).

Adrenal Fatigue? Perhaps. You could run labs to see.

Have you read the Basic TRT Overview sticky thread? I think that would give you a better sense for what TRT involves. TRT is a life saver if you need it. But most of us that ended up on TRT would trade pur left nut to not need TRT.

 

[IMT staff]

Your free t % is low, about half of what it should be. Should be at least 2-3 %

This is confirmed by your low HDL cholesterol. It is possible you do have a testosterone deficiency.

Your FSH is pretty low as well, I would suggest getting a 24 hour urine sample to get an accurate assessment of your LH and FSH.

 

[xplicid]

That's a lot of questions!

Sleep issues can affect Penile Tumescence. The mechanism isn't fully understood, but REM sleep is believed to be what triggers it. So I definitely think it would be worth while to have a sleep study done. It could explain a lot of your issues. It could be apnea, hypopnea or even something like restless leg syndrome.

Try the daily cialis at 5mg. It will help you mentally. Once ED gets in your head it is really hard to get it out of your head and you dwell on it. That just makes it worse and it becomes a self fulfilling prophecy. Ask to be examined by a Urologist too. Make sure all your "plumbing" is working well.

I really would save the SSRI for last resort. Ask yourself and people around you if you seem depressed or anxious. And even if you do try the SSRI, know that it is meant to only be a temporary crutch. Not a permanent solution. The permanent solution involves doing Cognitive Behavior Therapy with a psychologist.

Also make sure you are fully aware that SSRI's can make sexual performance even more difficult. They can make it extremely difficult to achieve orgasm. That is likely the prolactin at work. And prolactin lowers Testosterone too.

I don't think you need TRT. Your TT is right at the average for your age. Yes, Free T is low, but that is an innacurate measure as it is usually estimated. It bounces around a lot too. And perhaps more important than Free T, is Bioavailable T which you didn't check. I personally would not get hung up on the Free T number. I don't think it explains what you are experiencing.

Going on TRT at 160mg/week would likely just get you back to your current natural TT level. It would introduce a whole new set of problems that you would have to manage such as estradiol (aromatization) and hematocrit. And there is a good chance that running it for three months or however long would result in your natural TT never fully recovering to where it is today. We often see that each "cycle" results in natural TT being lowered. Besides, did your doc discuss what you would have to run after your "cycle"? You shouldn't just come off cold turkey. Other medications need to be used in what is known as Post Cycle Therapy (PCT).

Adrenal Fatigue? Perhaps. You could run labs to see.

Have you read the Basic TRT Overview sticky thread? I think that would give you a better sense for what TRT involves. TRT is a life saver if you need it. But most of us that ended up on TRT would trade pur left nut to not need TRT.

Hey man, nothing but respect for taking the time to respond to such a vigrous question lol, thank brotha, sorry for the delay in getting back.


I have a Drs. Apt. coming up and I will absolutely bring up the sleep study. I am an atrocious sleeper, I dont get deep sleep and wake up easily, sometimes even when im on my back and snore ill wake myself up.

You get to the point where you become desperate, like I mentioned previously, I always wanted to save prophylactics until I was older and needed them but at this point im willing to try anything. Not to mention, increase pumps in the gym is more then welcome, especially after the drop off. I know ED is quite mental and im no exception but I do tend to think there is a correlation between poor pumps, weak erections and the fatigue. I hope the doc will prescribe it, im sure he will, but im so young, its really not easy for me to talk about

Thats why im so concerned about TRT, the life long commitment. I looked at some lab work from Feb. The free test has improved!
Total Test: 507ng/dl
Bioavable Test: 247ng/dl
free testosterone 10.3 pg/m;

The reason the doctor suggest the 3 month trial was because he told me there is a lot of test bound up and not circulating in my blood and by testing the water I could see tons of improvement. He mentioned we would do HCG throughout and than use clomid at the conclusion. He also said he would do lab work and if required prescribe aromasin. The doctor is a PCP and covered by my insurance and he really knows what he is doing, so im extremely fortunate. Bashed on doctors who think 1 shot every two weeks is protocol, swears by HCG for patients at my age and told me he is interested to read about what ive learned online. I listen to a podcast about prop vs cyp and brought it up with him, he said he will try whatever as long as he can understand the logic. All that being said, he does want to make a buck, you can tell.

Ive read the thread, the author of that thread seems to be real informed good work on that thread to man.


here is where i stand at the moment, i am going to see what he has to say about the labs, im sure he will be happy with the improvement to TT. Ask for a sleep study and his thoughts on ED cialis. I will follow up with you guys

Your free t % is low, about half of what it should be. Should be at least 2-3 %

This is confirmed by your low HDL cholesterol. It is possible you do have a testosterone deficiency.

Your FSH is pretty low as well, I would suggest getting a 24 hour urine sample to get an accurate assessment of your LH and FSH.

Thanks for the input man, do you think the low free t% could cause all the sexual side effects along with the fatigue? Outside of fatigue/ed/low libido and low mood, i dont really have any other signs of low T (no abdominal fat or loss of body hair etc) but as you can imagine at 28 its pretty alarming to have your package not work as well.

it just sucks because I used to have this like an animalistic urge to take down chicks, was always proud my favorite little bber size and my sexual prowess. Girls would feed off that sexual energy, Id get tingly skin and rushes of blood to my face; overwhelming sensations to ravage them, their bodies just turning me on like crazy, it made for a much better sex life. Now, my interest in sex low and the whole experience isnt nearly as satisfying.

Even just writing that was depressing, ugh.