Quick opinions?

ef88

New Member
I've only had one test, fasted, in the morning.

I was 31 at the time, 32 now, but I only had my Total and free test done. Getting more labs done very soon.

Total Testosterone 390 ng/dl
Free test 6ng/dl (66.2 pg/ml)

I have far too many symptoms and hate how it makes me feel and negative consequences it has on my relationship.

Do those numbers cause concern to you at age 31? I'll post up my more in depth labs soon.
 

madman

Super Moderator
I've only had one test, fasted, in the morning.

I was 31 at the time, 32 now, but I only had my Total and free test done. Getting more labs done very soon.

Total Testosterone 390 ng/dl
Free test 6ng/dl (66.2 pg/ml)

I have far too many symptoms and hate how it makes me feel and negative consequences it has on my relationship.


Do those numbers cause concern to you at age 31? I'll post up my more in depth labs soon.

Gonna kick my 2 cents here.

For your age, a TT 390 ng/dL is sub-par let alone far from optimal and more importantly, your FT would be low/lowish depending on SHBG.

Keep in mind that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Natural 24hr circadian rhythm of a healthy young male: levels peak in the early am and decline in the late afternoon/early evening.

Endogenous testosterone secretion is likewise pulsatile and diurnal, with the highest plasma concentrations occurring at about 8 A.M. and the lowest at about 8 P.M.

We want to test at peak so lab work should be done in the early am.

When it comes to having blood work to check your testosterone levels it is critical that you have fasted and get your test done in the early am as in 8-10 am and the earlier the better.

Would also be a wise move to take a week off from lifting as one can easily be overtrained from excess heavy lifting, poor sleep, lack of recovery (poor diet/rest), excess stress (physical/mental) which can hammer down testosterone.

It is also critical to use the most accurate assays for TT/e2 (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration).

Unfortunately, most men tend to use inaccurate assays when having blood work done especially for free testosterone.

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 Dialysis or Ultrafiltration (next best).

Most men use/rely upon the piss poor direct immunoassay which is known to be inaccurate.

You most likely had your FT tested on the above labs you posted using the piss poor direct immunoassay.

Mind you with a sub-par TT 390 ng/dL it would be a given that your FT is low/lowish depending on your SHBG.

Top it all off that your labs are from over a year ago and that was then this is now.

We would need to see recent lab work let alone using accurate assays.

Although you stated that you are experiencing possible low-t symptoms do understand that dysfunction thyroid/adrenals can mimick low-t symptoms let alone cause one to feel unwell.

You need to get a full set of labs which should include TT (LC/MS-MS), FT (Equilibrium Dialysis or Ultrafiltration), SHBG, estradiol (LC/MS-MS), DHT, Prolactin, LH/FSH, DHEA, Vit D, PSA, TSH (full thyroid panel), cortisol (4-point), CBC (includes RBCs/hemoglobin/hematocrit), CMP, lipids.

If you do not want to spend the money then at the very least test TT/FT/estradiol/SHBG and LH/FSH.

To be honest the pre-trt hormone wellness panel would be your best bet.

You can purchase through Nelson's discounted labs:

 

madman

Super Moderator
These are the most accurate assays for TT (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration).

Either would suffice and many end up getting #2 - TT (LC/MS-MS) and FT (Equilibrium Ultrafiltration).

1. Testosterone, Total and Free (NO Upper Limit) plus Hematocrit

2. Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)




Most accurate assay for estradiol (LC/MS-MS).

 

madman

Super Moderator

I'm 32, too young I know, and for about 5 years now I've had consistent and concerning signs of low-T.

I am extremely active and have a healthy diverse diet. I lift weights 5-6 days a week and do cardiovascular exercise 7 days a week. I sleep an average of 7-8hrs a night. Alcohol consumption is low.

I have never used anabolic steroids, SARMS, SERMS, nothing. Just creatine, caffeine, amino acids, protein powder.

For the past 5 years I've had zero energy. A couple times a week I feel my head bobbing at work. Although I am working out as hard as ever, I am losing muscle. I don't have vascularity in my arms anymore and I'm gaining fat in my stomach, chest, and love handle areas. It's been YEARS since I've had an erection in the morning. I struggle to get them now, even though my gf is drop dead gorgeous. I can lose an erection for no reason at all. As far as libido, I want it maybe once every 3 weeks to a month. I don't feel like a man. Brain fog and just an overall sense of confusion clouds my mind most days and I'm happy I'm so capable and good at what I do because I can still make things work fine at the office. Facial hair and body hair....I have an embarrassing patchy beard which has always been the case. My arms and legs have minimal hair and my chest has hardly any as well.

I had a single blood test done about a year ago because I just got tired of feeling weird. My levels were "normal", 390 ng/dl Free, and 6.62 ng/dl or 66.2 pg/ml free. I didn't have FSH, SHBG or Estradiol tested which I know isn't the best screenshot of my health. I am going through an online male clinic to have another blood test done. It is going to test Testosterone, estradiol, t3, DHEA-s and PSA . I spoke with an endocrinologist and they informed me that if levels are still low normal, they may explore Clomid mono-therapy. I DO NOT WANT THIS. I also am unsure of daily injections for the rest of my life due to fertility reasons...all I know is I'm tired of feeling and performing like this. I'm too young.




Keep in mind that some of these men's clinics can turn out to be one of those dime a dozen T-mills where they will jump on any chance to put you on trt let alone jack up your T levels from the get-go.

Many are hard up for putting you on an AI to control the aftermath of jacking up your T levels.

Need to take a step back and think about this deeply as it is a big decision to shut down your hpta especially for your age let alone the impact exogenous testosterone can have on fertility.

You have other options such as Natesto or hCG monotherapy before jumping on testosterone!

If you are dealing with a men's clinic demand that you want your TT/FT tested using the most accurate assays LC/MS-MS/Equilibrium Dialysis or Ultrafiltration.

This is critical as unfortunately many use/rely upon the piss poor direct immunoassay.
 

ef88

New Member
Morning Madman. I do feel that my levels are not the best. And yes, it was a year ago so I'm getting tested again SOON. Luckily the tests were lcms and dialysis, I somehow lucked out. Funnily, I was confused looking at the sheet seeing the word "dialysis". Knowing what I know now, I wish I would of gotten estradiol and shbg tested.

I know life changes, but the last time I had labs done, a simple CBC test showed absolutely no issues, which I know isn't very helpful. But at least serum albumin wasn't off the charts.

I plan to refrain from exercise and sex (lol) for 48 hrs prior to my test, maybe longer.

I am also aware that an underactive thyroid can cause most if not all of my issues. It's just so weird, I've been so healthy. But little by little the past few years have caught up to me.

I wanted the pre-trt test, but 3-500 bucks seemed pretty crazy. I am getting a free/total test, estradiol, t3, dhea-s and psa test soon. I think it will give a decent idea of where I'm at and if things look weird, I can explore more testing.
 

ef88

New Member
I'm not sure if we can use company names here, and I'm not advertising, but I found the site Male Excel HRT which sounded an awful lot like this forum's name. I have a decent understanding of these things and have some hands on experience with TRT trials through my job. My good friend is the chief of endocrinology at my hospital as well so I can usually get some advice from her.

I do not want an AI and I think monotherapies are not a good long term solution. But I am also uneasy with the idea of pinning myself for the rest of my life. There are alternatives but it's still a huge decision. I don't want to shut down my hpta system and would like to remain fertile, but it's all just a lot to think about. Worst case scenario, say I need trt...I'd probably want hcg as well to maintain fertility. But you read that most men can become fertile again by getting off trt, suffering for a 6 months to a year, hop on Clomid, hcg, hmg....it's so much work.

and as lame as it might sound, the idea of testicular shrinkage sort of bums me out.

I've done as much as I can regarding good diet, exercise, weight control, supplementation, etc. It's just time to get some legitimate bloodwork done. I'm at a weird spot. I don't feel like death. I am not extremely depressed. But I am annoyed, and I'm afraid all of my shortcomings have become so "normal" for me that they aren't on my mind as much anymore. I'd love to look down one morning and see an erection. I'd love to be intimate with my girl as much as possible. I'd love to have a motivation and drive to have more sex. I want to be as sharp minded as I was a few years back. Alert. No more fog. I'm young and I feel like a loser or failure somehow. I want to correct all of this "naturally", whatever that means. Living the remaining 2/3 of my life on hrt just sounds scary and tiring. But would the outcomes and "fixes" make it all worth it?

Let's just hope something in my next test gives me a starting point and guides me to a better quality of life regardless of what that entails.
 

Cataceous

Well-Known Member
...
I wanted the pre-trt test, but 3-500 bucks seemed pretty crazy. I am getting a free/total test, estradiol, t3, dhea-s and psa test soon. I think it will give a decent idea of where I'm at and if things look weird, I can explore more testing.
Although it's good to support this site by using Discounted Labs, if money is tight or LabCorp is more convenient then be aware that LEF.org is having its annual sale and there are two male panels that give you a lot of tests for a little over $200. Even the Male Basic panel gives you a lot for only $56.

You are wise to want to avoid an HPTA shutdown; it should be a last resort. Along with Natesto, enclomiphene is another treatment option that preserves function.
 

Vince

Super Moderator
You really need to know if you have primary or secondary hypogonarism. So make sure you test your FSH and LSH. Then you can decide on your treatment.

Are you on any ssris?
 

ef88

New Member
I'm literally taking no prescription medications. I have no health issues that I can think of. I have never had any specific labs done for hormone problems though.

I have been concerned for years regarding these issues and always brushed it off as normal life changes. But after seeing tons of people's tests online, and comparing their numbers to mine, something didn't add up. There's men in their early 50s with much better total and free test than me. And I know it was one test a year ago, and that everyone is different, but it's still strange. Especially because I do have many of the symptoms associated with some sort of hormone issue.

I don't want trt or thyroid hormone or anything. But I don't want to feel like this. Whatever happens after my test, I want the least amount of anything that will provide some relief. The less, the better.
 

ef88

New Member
Update to my recent test on 3/27

total test: 240 ng/dl
Estradiol: 21 pg/ml
DHEA-S: 238 μg/dl
PSA: 19.4 ng/ml (super off the charts high. False?)
T3: 3 of/ml

my free test dropped a lot in a year. 390 to 240. Sad. No free test number apparently but it was low a year ago, so I’m assuming if one fell the other did too. Not sure how to analyze the other numbers. That PSA is crazily high. I have no signs of bph or infections or anything else. At 32 I don’t like these numbers.
 

Fortunate

Member
Update to my recent test on 3/27

total test: 240 ng/dl
Estradiol: 21 pg/ml
DHEA-S: 238 μg/dl
PSA: 19.4 ng/ml (super off the charts high. False?)
T3: 3 of/ml

my free test dropped a lot in a year. 390 to 240. Sad. No free test number apparently but it was low a year ago, so I’m assuming if one fell the other did too. Not sure how to analyze the other numbers. That PSA is crazily high. I have no signs of bph or infections or anything else. At 32 I don’t like these numbers.
Recheck that PSA before considering TRT. Missing a prostrate issue would not be good.
 

tLearner

New Member
You have other options such as Natesto or hCG monotherapy before jumping on testosterone!
Is natesto not testosterone?
Is hcg not really for primary so more tests would be required? I haven't heard much about hCG monotherapy. What are the side effects? Since people use hCG with TRT to "backfill" wouldn't this process be occuring or at least some kind of effects in that area?
 

madman

Super Moderator
Is natesto not testosterone?
Is hcg not really for primary so more tests would be required? I haven't heard much about hCG monotherapy. What are the side effects? Since people use hCG with TRT to "backfill" wouldn't this process be occuring or at least some kind of effects in that area?
Is natesto not testosterone?

Sure is!

post #7


Is hcg not really for primary so more tests would be required? I haven't heard much about hCG monotherapy. What are the side effects?








Since people use hCG with TRT to "backfill" wouldn't this process be occuring or at least some kind of effects in that area?

post #15
 

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