Bloodtest result back, test high but have all the symptoms of low test

Jack020

New Member
Hi Guys! Im new here, 35yr old male and pretty much tick off all the boxes of low test symptoms but just got my results back and I'm on the high side ( I do not know what kind of tests they ran), so my question to the experienced guys, whats next ? My doctor already told me regardless of the test results they wont help to optimize testosterone so I'm in this by myself (and this forum)

My results are:
Testosterone 38.9 nmol/L - 1121.95 ng/dl
Albumin 45.8 g/L
SHBG 64nmol/L - 1845.88 ng/dl
Free Testosterone 0.526 nmol/L - 15.17 ng/dl - 1.51%
Bioavailable Testosterone 13.1 nmol/L - 377.83

I have used this website to calculate the free test, as my doctors lab didn't calculate it: Free & Bioavailable Testosterone calculator

Cheers,

Jack
 

Vince

Super Moderator
High shbg could be causing your issues.

HOW TO TREAT ELEVATED SHBG


1.Remove any of the agents or treat the condition, which lead to elevated SHBG. In some cases it may be difficult to identify the cause of elevated SHBG.

2.Use anti-aromatase meds such as Anastrazole, Letrazol, if E2 is elevated,

3.Stop smoking and/or abusing alcohol,

4.Increase protein intake, if low. Avoid soy, which is an incomplete protein,

5.Avoid plant estrogenic herbs and foods,

6.Use androgens like natural T if medically indicated,

7.Increase intake of Omega-3 fish oils (EPA/DHA) consumption to about EPA=1.2 to 1.4 gram and DHA= 1.0 to 2 gram

8.Nettle root (Ulrica urens) in highly concentrated extracts can be effective in binding to SHBG and thereby displacing T and DHT from SHBG and into the free form for cell use. Potent Nettle root concentrates also can act as a 5-alpha reluctance inhibitor, which can partially inhibit the conversion of T to DHT and overall decrease SHBG levels.

9.Artificial progesterones like Norgestrol, Noresthisterone can reduce SHBG. That is bad idea since these androgenic like progestin's can lower the good HDL cholesterol and produce negative mood effects in men.

Note from Nelson: Danazol is also prescribed off label by some doctors to lower SHBG.

 

Cataceous

Super Moderator
With those numbers it seems unlikely that low testosterone is your problem. Even with elevated SHBG your calculated free testosterone comes up high in range or above. What exactly are your symptoms? Some other tests you might run are listed here. I think TRT would be a mistake. If your other test results don't show much and you're determined to see if extra testosterone helps then look into Nastesto or an equivalent generic testosterone nasal gel. These products boost your testosterone for short periods and don't significantly disrupt your own production.
 

madman

Super Moderator
Hi Guys! Im new here, 35yr old male and pretty much tick off all the boxes of low test symptoms but just got my results back and I'm on the high side ( I do not know what kind of tests they ran), so my question to the experienced guys, whats next ? My doctor already told me regardless of the test results they wont help to optimize testosterone so I'm in this by myself (and this forum)

My results are:
Testosterone 38.9 nmol/L - 1121.95 ng/dl
Albumin 45.8 g/L
SHBG 64nmol/L - 1845.88 ng/dl
Free Testosterone 0.526 nmol/L - 15.17 ng/dl - 1.51%
Bioavailable Testosterone 13.1 nmol/L - 377.83

I have used this website to calculate the free test, as my doctors lab didn't calculate it: Free & Bioavailable Testosterone calculator

Cheers,

Jack

Welcome!

What is your protocol (dose T/injection frequency)?

When were labs done (trough)?

With a TT 1121 ng/dL I would put money on it that your FT level is higher than you think and most likely on the higher end even with high SHBG 64 nmol/L.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysisor Ultrafiltration (next best).

I would not rely upon the piss poor direct immunoassays which are known to be inaccurate let alone the older outdated cFTV you had done when testing FT especially in cases of altered SHBG!

I would retest your FT using an accurate assay ED or UF before jumping to any conclusions let alone jacking up your T levels further.

Even then you never posted your estradiol which can have a significant impact on the effectiveness of a trt protocol.

Let alone you left out important blood markers such as RBCs/hemoglobin/hematocrit.

Post full set of labs.

We are playing the guessing game here.
 

madman

Super Moderator
Critical that you have your FT tested using the most accurate assays especially in cases of ALTERED SHBG!



 

madman

Super Moderator
Hi Guys! Im new here, 35yr old male and pretty much tick off all the boxes of low test symptoms but just got my results back and I'm on the high side ( I do not know what kind of tests they ran), so my question to the experienced guys, whats next ? My doctor already told me regardless of the test results they wont help to optimize testosterone so I'm in this by myself (and this forum)

My results are:
Testosterone 38.9 nmol/L - 1121.95 ng/dl
Albumin 45.8 g/L
SHBG 64nmol/L - 1845.88 ng/dl
Free Testosterone 0.526 nmol/L - 15.17 ng/dl - 1.51%
Bioavailable Testosterone 13.1 nmol/L - 377.83

I have used this website to calculate the free test, as my doctors lab didn't calculate it: Free & Bioavailable Testosterone calculator

Cheers,

Jack

Any one of the 4 test panels would suffice!

post #6
 

RickB

Member
High shbg could be causing your issues.

HOW TO TREAT ELEVATED SHBG


1.Remove any of the agents or treat the condition, which lead to elevated SHBG. In some cases it may be difficult to identify the cause of elevated SHBG.

2.Use anti-aromatase meds such as Anastrazole, Letrazol, if E2 is elevated,

3.Stop smoking and/or abusing alcohol,

4.Increase protein intake, if low. Avoid soy, which is an incomplete protein,

5.Avoid plant estrogenic herbs and foods,

6.Use androgens like natural T if medically indicated,

7.Increase intake of Omega-3 fish oils (EPA/DHA) consumption to about EPA=1.2 to 1.4 gram and DHA= 1.0 to 2 gram

8.Nettle root (Ulrica urens) in highly concentrated extracts can be effective in binding to SHBG and thereby displacing T and DHT from SHBG and into the free form for cell use. Potent Nettle root concentrates also can act as a 5-alpha reluctance inhibitor, which can partially inhibit the conversion of T to DHT and overall decrease SHBG levels.

9.Artificial progesterones like Norgestrol, Noresthisterone can reduce SHBG. That is bad idea since these androgenic like progestin's can lower the good HDL cholesterol and produce negative mood effects in men.

Note from Nelson: Danazol is also prescribed off label by some doctors to lower SHBG.

Since you brought up SHBG...Injecting more often raises it, but does the inverse hold true? Are high SHBG guys better off pinning less?
 

Vince

Super Moderator
The higher the T dose, the lower the SHBG. Guys with low SHBG are trying to avoid high T peaks that may further decrease their SHBG. High shbg guys, inject once or sometime twice a week.
 

Jack020

New Member
I appreciate all the answers! wasnt expecting so many. thank you guys, I feel welcome already
High shbg could be causing your issues.

HOW TO TREAT ELEVATED SHBG


1.Remove any of the agents or treat the condition, which lead to elevated SHBG. In some cases it may be difficult to identify the cause of elevated SHBG.

2.Use anti-aromatase meds such as Anastrazole, Letrazol, if E2 is elevated,

3.Stop smoking and/or abusing alcohol,

4.Increase protein intake, if low. Avoid soy, which is an incomplete protein,

5.Avoid plant estrogenic herbs and foods,

6.Use androgens like natural T if medically indicated,

7.Increase intake of Omega-3 fish oils (EPA/DHA) consumption to about EPA=1.2 to 1.4 gram and DHA= 1.0 to 2 gram

8.Nettle root (Ulrica urens) in highly concentrated extracts can be effective in binding to SHBG and thereby displacing T and DHT from SHBG and into the free form for cell use. Potent Nettle root concentrates also can act as a 5-alpha reluctance inhibitor, which can partially inhibit the conversion of T to DHT and overall decrease SHBG levels.

9.Artificial progesterones like Norgestrol, Noresthisterone can reduce SHBG. That is bad idea since these androgenic like progestin's can lower the good HDL cholesterol and produce negative mood effects in men.

Note from Nelson: Danazol is also prescribed off label by some doctors to lower SHBG.


I think diet and lifestyle wise there is little I can do. I will uptake my EPA and check out that Nettleroot.


With those numbers it seems unlikely that low testosterone is your problem. Even with elevated SHBG your calculated free testosterone comes up high in range or above. What exactly are your symptoms? Some other tests you might run are listed here. I think TRT would be a mistake. If your other test results don't show much and you're determined to see if extra testosterone helps then look into Nastesto or an equivalent generic testosterone nasal gel. These products boost your testosterone for short periods and don't significantly disrupt your own production.

I tick off many boxes
- Low libido
- Low semen volume
- Balding (then again my father is bald as well)
- Fatigued
- Struggle gaining muscle mass
- Lot of stubborn body fat around waist, hard to get rid of even on a deficit
- Memory
- Struggle taking risks (need that for work)

I was really convinced my test levels would be low. The more I read up on it the more I felt that my "issues" were caused by that.

Welcome!

What is your protocol (dose T/injection frequency)?

When were labs done (trough)?

With a TT 1121 ng/dL I would put money on it that your FT level is higher than you think and most likely on the higher end even with high SHBG 64 nmol/L.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysisor Ultrafiltration (next best).

I would not rely upon the piss poor direct immunoassays which are known to be inaccurate let alone the older outdated cFTV you had done when testing FT especially in cases of altered SHBG!

I would retest your FT using an accurate assay ED or UF before jumping to any conclusions let alone jacking up your T levels further.

Even then you never posted your estradiol which can have a significant impact on the effectiveness of a trt protocol.

Let alone you left out important blood markers such as RBCs/hemoglobin/hematocrit.

Post full set of labs.

We are playing the guessing game here.
I don't have a protocol. Ive been reading up on it convinced my levels would be low so I got blood tests done the 10th of September.

I will see what the options are for me to get better tests done, I'm in the Netherlands, I'm definitely getting a second opinion. The guy that took the test mistakenly took 2 vials, minutes apart, for the Testosterone test and it gave me 2 different results (34.9 mmol/l & 38.9 mmol/l), which show the inaccuracy.

Stupid, I forgot to request the Estradiol test, Ill upload a picture with the other results.

Once again, thank you guys for your help. The medical world are lightyears behind here in the Netherlands.
 

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Cataceous

Super Moderator
...
I tick off many boxes
- Low libido
- Low semen volume
- Balding (then again my father is bald as well)
- Fatigued
- Struggle gaining muscle mass
- Lot of stubborn body fat around waist, hard to get rid of even on a deficit
- Memory
- Struggle taking risks (need that for work)

I was really convinced my test levels would be low. The more I read up on it the more I felt that my "issues" were caused by that.
...
Low thyroid hormones can cause many of these. Be sure to check free T3, free T4 and reverse T3. Also estradiol. Also cortisol. Also test prolactin. High levels are known to harm libido independently of testosterone. Low dopamine can account for several of these symptoms. There's no easy way to test brain levels. You could start by making sure you have the raw material for it: run a trial with N-acetyl L-Tyrosine (NALT). A more aggressive approach might include an overt dopamine/dopamine receptor booster, such as selegiline or bupropion.
 

Graham

Member
Low thyroid hormones can cause many of these. Be sure to check free T3, free T4 and reverse T3. Also estradiol. Also cortisol. Also test prolactin. High levels are known to harm libido independently of testosterone. Low dopamine can account for several of these symptoms. There's no easy way to test brain levels. You could start by making sure you have the raw material for it: run a trial with N-acetyl L-Tyrosine (NALT). A more aggressive approach might include an overt dopamine/dopamine receptor booster, such as selegiline or bupropion.
I believe the last part is a big undiagnosed issue in a lot of men on trt who have issues but look good on paper.
 

MIP1950

Member
Vitamin D increases dopamine. The more I read about D, the more I believe virtually everyone needs to supplement and especially if one lives in the northern hemisphere. I live in Florida, on the beach a lot and my serum D was 28 ng. That's insufficiency. With my high hsCRP, 3.7, I've worked up to 50,000 IU, daily, along with 10 mg K2/Mk4, 600 mg calcium/300 mg magnesium. Going for labs in a couple of weeks.
 

Cataceous

Super Moderator
Vitamin D increases dopamine. The more I read about D, the more I believe virtually everyone needs to supplement and especially if one lives in the northern hemisphere. I live in Florida, on the beach a lot and my serum D was 28 ng. That's insufficiency. With my high hsCRP, 3.7, I've worked up to 50,000 IU, daily, along with 10 mg K2/Mk4, 600 mg calcium/300 mg magnesium. Going for labs in a couple of weeks.
Too much is also bad, however:
The Dangers of High Vitamin D
Among others:
The authors wrote that "analysis of 24,094 adult patients showed that 25(OH)D levels less than 20 ng/mL and 60 ng/mL or greater before hospitalization were associated with an increased odds of 90-day mortality. Although previous reports have suggested an association between low vitamin D status and mortality, these data raise the issue of potential harm from high serum 25(OH)D levels, provide a rationale for an upper limit to supplementation, and emphasize the need for caution in the use of extremely high doses of vitamin D among patients."
Why Are So Many People Popping Vitamin D?
Have We Been Wrong About the Benefits of Vitamin D?
Vitamin D: Don't Overdo a Good Thing
 

MIP1950

Member

HYPOTHESIS AND THEORY article​

Front. Immunol., 07 April 2021 | Vitamin D Resistance as a Possible Cause of Autoimmune Diseases: A Hypothesis Confirmed by a Therapeutic High-Dose Vitamin D Protocol

Vitamin D Resistance as a Possible Cause of Autoimmune Diseases: A Hypothesis Confirmed by a Therapeutic High-Dose Vitamin D Protocol​

Dirk Lemke1*‡, Rainer Johannes Klement2*†‡, Felix Schweiger3, Beatrix Schweiger3 and Jörg Spitz4

And always with K2, preferably Mk4. Several years ago, at 50K daily, my serum vitamin D was 35 ng. In light of my reading and research, that number implied resistance but the doctor I was seeing thought it was 'Okay' since it was within the lab range.
 
Last edited:

Cataceous

Super Moderator

HYPOTHESIS AND THEORY article​

Front. Immunol., 07 April 2021 | Vitamin D Resistance as a Possible Cause of Autoimmune Diseases: A Hypothesis Confirmed by a Therapeutic High-Dose Vitamin D Protocol
...

And always with K2, preferably Mk4. Several years ago, at 50K daily, my serum vitamin D was 35 ng. In light of my reading and research, that number implied resistance but the doctor I was seeing thought it was 'Okay' since it was within the lab range.
This seems to be quite unusual. Where did the missing vitamin go? Have they ruled out poor absorption? Interestingly I've seen a graph showing that maximum natural testosterone levels occur when serum vitamin D is in the 30s ng/mL. It drops off at higher levels.
 

Guided_by_Voices

Active Member
I would evaluate all vitamins and minerals but with a particular focus on B12. In theory I should not be low in B12 but supplementing seems to be helpful for me. There is a school of thought that B12 deficiency is much more common that generally believed and it could cause some of those symptoms.
 

MIP1950

Member
This seems to be quite unusual. Where did the missing vitamin go? Have they ruled out poor absorption? Interestingly I've seen a graph showing that maximum natural testosterone levels occur when serum vitamin D is in the 30s ng/mL. It drops off at higher

This seems to be quite unusual. Where did the missing vitamin go? Have they ruled out poor absorption? Interestingly I've seen a graph showing that maximum natural testosterone levels occur when serum vitamin D is in the 30s ng/mL. It drops off at higher levels.

Cataceous, you're immersed in the science, as am I. That paper wasn't bro science. It was written by clinician/researchers. Polymorphisms in Vitamin D receptors is discussed in many abstracts. As you read, those Finnish students were give 80,000 IU yet their vitamin D blood level was low. Dr. Coimbra, a neurologist in Brazil, is using anywhere from 50,000 IU to 1,000,000 IU, daily, to cure MS and other autoimmune disorders/diseases.
 

Cataceous

Super Moderator
Cataceous, you're immersed in the science, as am I. That paper wasn't bro science. It was written by clinician/researchers. Polymorphisms in Vitamin D receptors is discussed in many abstracts. As you read, those Finnish students were give 80,000 IU yet their vitamin D blood level was low. Dr. Coimbra, a neurologist in Brazil, is using anywhere from 50,000 IU to 1,000,000 IU, daily, to cure MS and other autoimmune disorders/diseases.
Are there any large controlled trials demonstrating these cures? The stuff regarding MS sounds promising, but science doesn't accept anecdotes as evidence. The cited paper also contains some hand waving and assumptions that go beyond the available evidence. As an aside, aren't receptor polymorphisms a separate issue compared to low serum levels relative to dose? Is the claim that there's insufficient 25-hydroxylation in the liver? In any case, the larger controlled trials are failing to find benefits in supplementing vitamin D, and even point to the possibility of harm at higher levels. The reality is that most people should not be concerned unless their levels naturally fall below 20 ng/mL.
 

Vince

Super Moderator
Vitamin D increases dopamine. The more I read about D, the more I believe virtually everyone needs to supplement and especially if one lives in the northern hemisphere. I live in Florida, on the beach a lot and my serum D was 28 ng. That's insufficiency. With my high hsCRP, 3.7, I've worked up to 50,000 IU, daily, along with 10 mg K2/Mk4, 600 mg calcium/300 mg magnesium. Going for labs in a couple of weeks.
Most hospitals will prescribe 50,000 IU of vitamin D2, not D3. So I'm wondering, which are you using D2 or D3?
 

FlowRW

New Member
D3 is the most common D deficiency. One Dr we follow suggest up to 20,000 units of D3 daily. But also says with large D3 supplements, it can create certain calcium build ups so to combat that, take 100 units of Vitamin K2 for every 10,000 units of D3. Vitamin D deficiencies don't always show up in the blood. The key is how much your cells are absorbing. And that test is more intense and expensive.
 

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