2 very different test results. Confused & seeking advice.

[supman1989]

Hi folks -- i heard this forum was where the experts are at

Seeking advice on blood results.

My first testosterone blood was 59 ng/dl (i know crazy low) but the next test they did came back at 400 ng/dl. Both tested in morning and 2 weeks apart.

Symptoms (really bad past 12 months but have always been present for my 20's in some shape or another):
V low sex drive / ED all of the time / NO spontaneous erections or morning wood
High levels of Anxiety, especially social anxiety (daily)
Low mood
Tired (and tired muscles)
Low confidence
Some belly weight that just cant get rid of

My Profile:
BMI is 25 and considered slightly out of normal range
Diet is ok but could be better (sugar)
No caffeine
Cardio 3-4 times per week (+walk everywhere)
Weights 3-4 times per week
Drink once a month or less (3-4 beers)
Dont smoke
Was on SSRi’s until end of 2018 (for all of the symptoms mentioned above!)

Testosterone: 2.0 nmol/l [Low] - (range 7.6- 31.40) (I'm not sure if this is free or serum)
FOLLOW UP BLOOD TEST CAME BACK WITH 14 nmol/l

17-beta oestradol: 68 pmol/l [Low] (range 99.40-192.00)
Albumin 50 g/L (range 35.00-50.00)
Free T4: 15.59 pmol/L (12.00 -22.00)
Progestrone: 0.53 nmol/L (Did not include ref range but also did not say it was Low)
Prolactin: 253 mU/L (range 86.00-324.00)

 

[Vince Carter]

Using the same lab? Is everything that way the same?

 

[supman1989]

Using the same lab? Is everything that way the same?

No! It was actually a different doctor.
I am waiting on endo appointment since the first test. In the meantime I decided to get checked by another doctor which showed a completely different result for testosterone but E2 was the same.

 

[antelopers]

It is possible that you had a lab error.

 

[supman1989]

It is possible that you had a lab error.

Yes, seems that way. Going back to doc to get third test.

Are my levels considered normal if second test is true?

 

[antelopers]

Yes, seems that way. Going back to doc to get third test.

Are my levels considered normal if second test is true?

It depends on who you ask. 400 is probably a little on the lower end of normal but not drastically low.

 

[Vince Carter]

Labs aren't the same, if it's labcorp one-time and then Quest the next it's not quite possible to compare them side-by-side, per se. I do think the particularly low test is lab error, they do make mistakes.

 

[supman1989]

Thanks guys - i was a bit disappointed as I was hoping TRT would be the answer to my problems!

29 years old with 400 ng/dl (with symptoms) just doesn't feel right!

 

[Vince Carter]

The total T isn't per se what the problem is, it's the Free T, so even when it says 400/500/600...the total kind of determines the diagnosis but it's whatever the Free T sits at is where the problem lies.

 

[supman1989]

The total T isn't per se what the problem is, it's the Free T, so even when it says 400/500/600...the total kind of determines the diagnosis but it's whatever the Free T sits at is where the problem lies.

Looks like this wasnt tested by my doctor. Should i ask for free t?

 

[Systemlord]

Looks like this wasnt tested by my doctor. Should i ask for free t?

The majority of doctors (endocrinologists & urologists) aren't knowledgeable in this area of medicine, few doctors know what labs to order or know how to interpret lab values and few specialize in this area of medicine.

Your SHBG levels going from low normal to high normal levels can affect your Free T by 50%, Free T is where the rubber meets the road, it is the bioavailable portion of testosterone circulating in the blood. Total T is not bioavailable because it is bound to SHBG rending it unavailable to your bodies tissues.

Chances are no matter which doctor you see, they will all be inexperienced and are operating in the dark. Your best bet is to seek a doctor who specialized in sex hormone therapies in anti-aging and sports medicine.

I'm on TRT and recently scored a 406 Total T and Free T 16 (ranges 6.8-21.5) and while things weren't too bad, I did have low energy, poor sleep and scatterbrained throughout the day.

My symptoms of low testosterone disappear when Free T is high normal.

Tests needed:
Total T
Free T
SHBG
Estradiol Sensitive (E2)
LH-Luteinizing Hormone
FSH-Follicle stimulating hormone
Prolactin
Cortisol
Ferritin
Thyroid Panel
CBC-complete blood count
Comprehensive Metabolic Panel
Lipid profile/panel

 

[Cataceous]

Your results are at least borderline abnormal, one way or another. A total testosterone of 400 ng/dL is well below the 600-700 that's average for your age. You could have decent free testosterone, but then SHBG would be unusually low, which isn't ideal either. Do measure total testosterone and SHBG next time. You can calculate free testosterone from these and skip measuring it, unless you want to spend a lot on an accurate test.

 

[supman1989]

Hi guys,
I got SHBG and another total test, aswell as Albumin.

Testosterone: 15.90 nmol/L
range : 7.6 - 31.4 nmol/L

SHBG: 51 nmol/L
range: 16-55 nmol/L

Albumin: 50 g/L
Range: 35-50 g/L

I calculated Free Testosterone and its coming back as 6.3 ng/dl which seems quite low?

Doc says its ok though so im v confused.

Symptoms = no libido, anxiety, belly fat that wont budge,ed, low mood etc

Any advice appreciated!!

 

[Cataceous]

Low-normal testosterone and elevated SHBG mean your free testosterone is low, and is likely responsible for some of your symptoms. It's a difficult situation because not many doctors are willing to treat based on free testosterone. TRT isn't ideal for younger guys, but it's the most effective treatment because it lowers SHBG and raises testosterone. You can try some natural methods first, but they are less effective. Before TRT you should still fill in some of the missing tests suggested by @Systemlord: in particular, the thyroid hormones, LH, FSH. Also vitamin D status, as low levels can suppress testosterone.