Help with Blood Work: Low T/Low E

Thread starter #1
My current bloodwork

Testosterone, Serum Testosterone, Serum 228 LOW 264-916 ng/dL 01
Luteinizing Hormone(LH), S LH 5.4 NORMAL 1.7-8.6 mIU/mL 01
FSH, Serum FSH 4.9 NORMAL 1.5-12.4 mIU/mL 01
Estradiol Estradiol <5.0 LOW 7.6-42.6 pg/mL 01 Roche ECLIA methodology

Also I included previous years blood work. 36 years old, fit, muscular, athletic. In the past I have run mild prohormone cycles. Haven't ran any in 2 years. Wondering if I have recovered completely or if I damage my self. Waiting to see a Dr. don't know what specific route I want to go, I don't want to go on TRT if possible.
 

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#2
do you have any recent labwork within last three months? these two labs are old. 2016, 2017.You are probably primary.I think for you only TRT will help, clomid or hcg wont.
 
#4
Whoever ordered you blood testing is using the wrong estrogen testing, the Roche ECLIA methodology is for women, men require the Sensitive E2 test or LC/MS/MS method. SHBG binds sec hormones and is the single most important test, your TRT protocol should always consider your SHBG levels.

You're severely hypogonadal, nobody wants TRT, but if you want a high quality of life free of disease, then TRT is unavoidable at this point.
 
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#5
Normal LH and FSH are more suggestive of secondary hypogonadism; primary is actually pretty rare. You likely do have the option of trying any of Clomid/enclomiphene/hCG as monotherapy. These are not as likely to resolve symptoms as TRT, but Clomid/enclomiphene in particular have simpler protocols and keep your HPTA working more naturally.

The fact that you have undetectable estradiol with the ECLIA test means it's fairly safe for you to use this test method, as long as you don't expect it to be very accurate below 10-15 pg/mL or so. The problems with immunoassays generally arise from cross-reactivity with C-reactive protein, etc., leading to falsely high results. But this obviously didn't happen in your case. Otherwise, immunoassay tests are generally more reliable than the "sensitive" mass spectrometry-based tests. These latter are tricky to do, and LabCorp in particular has had some serious quality problems with theirs.
 
Thread starter #6
Whoever ordered you blood testing is using the wrong estrogen testing, the Roche ECLIA methodology is for women, men require the Sensitive E2 test or LC/MS/MS method. SHBG binds sec hormones and is the single most important test, your TRT protocol should always consider your SHBG levels.

You're severely hypogonadal, nobody wants TRT, but if you want a high quality of life free of disease, then TRT is unavoidable at this point.

This is due to a not a very thorough primary care doctor. I had been referred to a endocrinologist. But feeling like they are not up to date on how to handle this. Should I be searching for a private doctor for this specific issue? A hormone therapy doctor. I live in a small area so I may have to search broad. Any advice on who or where to look for this in area?
 
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#7
This is due to a not a very thorough primary care doctor. I had been referred to a endocrinologist. But feeling like they are not up to date on how to handle this. Should I be searching for a private doctor for this specific issue? A hormone therapy doctor. I live in a small area so I may have to search broad. Any advice on who or where to look for this in area?
On average endocrinologists aren't much better, especially in a small town cut off from the rest of the world.

Your best bet is finding a private doctor in anti-aging and sports medicine, Defy Medical is such a place that offers telemedicine and has experience TRT doctors.
 
#8
This is due to a not a very thorough primary care doctor. I had been referred to a endocrinologist. But feeling like they are not up to date on how to handle this. Should I be searching for a private doctor for this specific issue? A hormone therapy doctor. I live in a small area so I may have to search broad. Any advice on who or where to look for this in area?
We're a telemedicine clinic so we can treat you completely remotely, feel free to email me directly at Jesse@defymedical.com if you'd like more information.
 
#9
My current bloodwork

Testosterone, Serum Testosterone, Serum 228 LOW 264-916 ng/dL 01
Luteinizing Hormone(LH), S LH 5.4 NORMAL 1.7-8.6 mIU/mL 01
FSH, Serum FSH 4.9 NORMAL 1.5-12.4 mIU/mL 01
Estradiol Estradiol <5.0 LOW 7.6-42.6 pg/mL 01 Roche ECLIA methodology
your LH =4 and FSH=4.9 which is normal and not low.But still your total testosterone is low that's why I am thinking you are primary.You might not benefit from HCG or Clomid much.
 
#10
your LH =4 and FSH=4.9 which is normal and not low.But still your total testosterone is low that's why I am thinking you are primary.You might not benefit from HCG or Clomid much.
More commonly with primary you find that the pituitary is screaming for more testosterone and LH is near or over the top of the range.
 
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