Test Results: Low Free Testosterone

[Bobby]

Been struggling with lack of sex drive/urge for years. Weird thing about it is that I have no problem with erections (morning, etc); when I am actually with another person, no performance problems. I just don't have any desire or sex urge at all; no urgency to ejaculate after a prolonged time of abstinence (weeks, not days !!!), no response or excitement to visual stimulation. Also noticed that penis sensitivity is decreased from what it used to be and intensity of orgasm is about 30-40% reduced. Was on TRT about 5 years ago (worked great but for some reason just stopped producing results); no longer on TRT at this time.

52 y.o. 5'6" 128 lbs

Labs:I know they are not complete, but if any suggestions could be made from what is here, they would be appreciated. I am basically dictating to my doctor what tests I want done as he is basically not concerned or interested in further testing once he saw my total T was 719.......(typical GP attitude)

Total test: 719 ng/dl (normal)
Free test: 6.8 pg/ml (Low) *******
Estradiol (sensitive): 8 pg/ml (normal)

T4: 8.5 ug/dl (normal)
TSH: 1.32 uIU/ml (normal)
T3 Uptake: 23 % (Low) (archaic calculated measurement)
Free Thyroxin Index : 2 (normal)
Igf 1: 165 ng/ml (normal)

Cortisol: 11.1 ug/dl (normal)

Cholesterol total: 189 mg/dl (normal)
LDL: 102 mg/dl (high)
HDL: 66 mg/dl (normal)
Triglycerides: 87 (normal)

All other values of CBC, urinalysis, metabolic panel, etc are normal.

*****If free test is supposed to be at least 2% of total test, my free test is VERY low, should be 14 min. Also understand that there is nothing that can be done to increase free test; is this true? I think this is where all the trouble is.

Any feedback would be appreciated...thanks. I am assuming I should be seeing a hormone specialist due to the low free t issue. Something with the "axis" is probably messed up from being on TRT 5 years ago.

 

[Kelly]

Do you have a range for free Test?
E is low as well. Low E will cause libido issues which is probably where you issue lies.
Curious what your SHBG level is?
Vit D level? D can lower SHBG thus improving free T.

 

[Bobby]

Free test range is: 7.2 - 24 pg/ml
Vit D: 33.5 ng/ml (normal)
Agreed----need to get SHBG, may be binding up too much test.

 

[Nelson Vergel]

So, these values reflect your natural T levels without TRT, right? Your total testosterone is great so I would not use TRT if I was you.

If so, I agree that your free testosterone is lower than it should be. Your sex hormone binding globulin is probably high. Your estradiol is under 20 pg/mL which may be tied to your low sex drive.

Your BMI seems good.

Are you taking any other medications? Do you have stress or depression?

It is a good thing that you have no ED when you need to have sex. Lack of libido is tied to so many issues beyond hormones, though.

I wish I could tell you more but I have such little information.

 

[Bobby]

Hi Nelson, thanks for replying. Yeah, the values for the total test is natural. I guess at 52 years old I am lucky in that respect. I agree with you that the most likely problem(s) is/are high SHBG and/or low Estro. Was doing some research.....I think my low body weight 129 lbs (BMI), may have a lot to do with high SHBG. Studies show that low BMI, low calorie diet and low protein diet will raise SHBG. So.......will try to increase my caloric intake (reluctantly), and also try to add some soy to my diet to increase estro.

Even if it proves true that SHBG is elevated and we already know estrogen is low........what else really can be done as an antidote other than the aforementioned?

Thanks for your response.....

 

[Nelson Vergel]

Are you taking zinc supplements? I am seeing some guys have a dramatically noticeable decrease in estradiol to very low levels in some guys taking zinc.

Soy is a good way to increase your estradiol.

It would be interesting to see what your new diet will do to lower SHBG and increase your free testosterone. Higher insulin levels lower SHBG so adding carbs to your diet may be a way to do the trick. Let us know!!

 

[Bobby]

Only Zinc I am taking is in the form of a "natural" liquid multi - vit/min supplement (It only gives me about 25% of RDA for zinc however, and I don't take the supplement every day.) So I will look into further zinc supplementation.

Thanks for your help !

 

[Kelly]

Free test range is: 7.2 - 24 pg/ml
Vit D: 33.5 ng/ml (normal)
Agreed----need to get SHBG, may be binding up too much test.

From memory most ranges seem to be around 30 - 100. If so, you're low in my opinion. Elevating your D will help reduce your SHBG. Stinging Nettle and avenacosides may help as well.

 

[Bobby]

@ Kelly.....Yes you are correct, the range is 30-100 ng/ml as per Labcorp so I am on the low side of normal. Plan to incorporate a few strategies to lower the SHBG....

increase caloric intake and bring body weight up, I think this alone will help a great deal.
soy to increase estro
increase Vit. D
will look into the nettles and Avena Sativa

One good thing ........at least there is more than enough Test in the tank....just have to find a way to make it usable.
Thanks for your input and help !

 

[Vettester Chris]

I would really encourage looking at a comprehensive thyroid panel, and post the reference ranges. As you noted, the T3 Uptake is archaic, and truthfully it's a waste, it has nothing to do with your T3. Notice how that particular lab came back "low", but the FT4 index is "normal" at 2. To get the FT4 index, you simply calculate the Total T4 with T3 uptake (8.5 x .23 = 1.955, roundup and you have 2). So the two labs are mutually exclusive, yet one is normal and one is low. If you can get Free T4, Free T3, Reverse T3, TPO & TgA, we can provide better comments.

In many physicians eyes, the thyroid is a lot like testosterone. The reference ranges can have a lot of variance, and it's real easy to call it "normal" when in reality it might be far from it. The thyroid can have additional complexities, because you're not only counting on T4 to convert sufficiently to T3, but then you're counting on T3 to get into the body and work at the cellular level. Other variables like iron, cortisol, D3, B12, etc., ALL play a role with this, and running a RT3 lab will help you and your physician know that your FT3 isn't backing up, better known as "pooling".

The guys are giving you some good advise with everything else, so hopefully some or all of this will be beneficial for you. Just let me know if you have any questions with anything I posted above.

 

[fireeater49]

I would really encourage looking at a comprehensive thyroid panel, and post the reference ranges. As you noted, the T3 Uptake is archaic, and truthfully it's a waste, it has nothing to do with your T3. Notice how that particular lab came back "low", but the FT4 index is "normal" at 2. To get the FT4 index, you simply calculate the Total T4 with T3 uptake (8.5 x .23 = 1.955, roundup and you have 2). So the two labs are mutually exclusive, yet one is normal and one is low. If you can get Free T4, Free T3, Reverse T3, TPO & TgA, we can provide better comments.

In many physicians eyes, the thyroid is a lot like testosterone. The reference ranges can have a lot of variance, and it's real easy to call it "normal" when in reality it might be far from it. The thyroid can have additional complexities, because you're not only counting on T4 to convert sufficiently to T3, but then you're counting on T3 to get into the body and work at the cellular level. Other variables like iron, cortisol, D3, B12, etc., ALL play a role with this, and running a RT3 lab will help you and your physician know that your FT3 isn't backing up, better known as "pooling".

The guys are giving you some good advise with everything else, so hopefully some or all of this will be beneficial for you. Just let me know if you have any questions with anything I posted above.

Took the words out of my mouth about follow up with free T4 and T3 and the associated tests would help give more insight to problem. Also look at your personal life situations that you may be going thorugh but not realize that it is possible taking a toll on you. Hormone testing is fantastic but could be just another tool to be used. Counseling did also wonders for me. I am on TRT for almost 1 1/2 years and took roughtly 8 months to get dialed in but it also took some counseling visits for me. Over 25 years as a front line medic and firefighter for one of the busiest city department had also took its toll on me I just did not realized it. I had many harden "layers" I had accumulated over the years in dealing with the tragedies I encounter. Hope this helps brother. Good luck

 

[ironman]

I'd say your low E2 is why you don't ejaculate for a while and you said you were going to look into more zinc supplementation and unless I misunderstood you about that you won't to avoid more zinc because it will reduce your E2. You said you were on TRT 5 years ago, what were your levels then and what did you do to get them up? Good luck man.

 

[Bobby]

Thanks for replying VC. To be honest, I have to review the functions of the Thyroid in order to acquaint myself with the tests you mentioned, but will see if those tests could be done. The trick is to get my MD to write a script for them, I don't think many doctors like to be told what tests to run by their patients. I guess with some explanation he will not be resistant.

What I do know is that there is a condition called "Euthroid Sick Syndrome" where low total and unbound T3 and normal T4 and TSH levels are seen, but the Thyroid gland is not dysfunctional. This is caused from prolonged low calorie intake.....something I have been doing. Would not be surprised if this is what's happening.

In any case, I have upped my body weight by 5 lbs (now at 132 lbs) through increased calories; taking soy to increase my estrogen; and will be trying a compound that has avena stavia to try to increase free T. So far........I have been noticing the following good things:

1. No more joint pain. I used to have strong joint pain in elbows, knees, shoulders even fingers. I believe body builders call this, "being too dry" from low estrogen.
2. Felt a rush of warmth when my body weight increased. No more ice cold hands, feet, skin and "chilled" feeling all the time.
3. Felt an ache in both testicles for about a minute (no trauma) but felt like I was kicked there.

I assume these are all signs that the hormonal system is resetting or trying to reset back to normal. Just hope that there is no permanent damage. Now just waiting for the normal sex drive to return.

Again....thank you for your input and knowledge....very much appreciated..... Best.....

 

[Bobby]

@ fireater49. Yes I agree, just living 52 years of life will take its toll. Like everyone else, I have seen some hard times also, and taking my weight down to 128 probably put a lot of extra stress on things. It's great having low body fat at that weight, but i don't think it is worth the hormonal problems.

Thanks for replying !

 

[Bobby]

@ ironman. Yes, I also believe it's the low E2 also that is causing the lack of sex urge along with low free T. Trying to correct the problem at this time. Was on TRT 5 years ago but I do not know what the exact test levels were at that time. I used a topical formula (androgel,etc.), did not inject. Right now my level is 719 (natural). Just sucks that my free T is very low, so all that test in the tank is not being used.

Thanks for replying !

 

[Kelly]

Always love your thyroid diatribes Chris!