My Father is 70 years old and we just got his labs done. I'd like your advice

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Sb32

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Hello, my Father is 70 years old and is not feeling good. He has diabetes, I offered to check his lab panels and we got his results. He said he would be willing to get on TRT if he needed it.

His Ferritin was 48 ng/ml on 8/15/2025
his A1C was 7.3% with an estimated Average Glucose was 163 mg/dl on 8/15/2025

He's currently on metformin 2500mg daily

What do you guys think? I'd like your opinion. Thanks!
 

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Personally, I don't believe he needs TRT. He does need to control his diet. If he could go on a low-carb diet it would definitely help his diabetes. It would be scary to have that high of a A1C.
 
His Vermeulen calculated free testosterone is 9.8 ng/dL. It's considered borderline, but not really into hypogonadal territory. I would not be looking at that first as a cause of his issues, particularly if sexual function is ok. Of course being diabetic harms sexual function on its own. Having LH high in range could be suggesting the beginnings of testicular insufficiency. This is common in older men. I would definitely not consider traditional TRT at this point. A relatively safe way to check if higher testosterone is useful is with a trial of testosterone nasal gel. This short-acting form of testosterone is less disruptive of everything else.

Can you be more specific about how he is "not feeling good"? The lab work isn't saying too much otherwise—except there's a slight electrolyte imbalance, he might be heading towards anemia, and estradiol seems low relative to testosterone.
 
Cataceous said:
His Vermeulen calculated free testosterone is 9.8 ng/dL. It's considered borderline, but not really into hypogonadal territory. I would not be looking at that first as a cause of his issues, particularly if sexual function is ok. Of course being diabetic harms sexual function on its own. Having LH high in range could be suggesting the beginnings of testicular insufficiency. This is common in older men. I would definitely not consider traditional TRT at this point. A relatively safe way to check if higher testosterone is useful is with a trial of testosterone nasal gel. This short-acting form of testosterone is less disruptive of everything else.

Can you be more specific about how he is "not feeling good"? The lab work isn't saying too much otherwise—except there's a slight electrolyte imbalance, he might be heading towards anemia, and estradiol seems low relative to testosterone.
Click to expand...
He feels tired all the time, fatigue, low mood, and depression
 
I too think some attention with the Diabetes would be the most helpful. Numbers otherwise seem to be pretty good for a 70 YO. Liver, kidneys, thyroid, Estrogen, all look good. Free T is borderline as noted, SHBG level is driving that but there's nothing to do there that isn't TRT. TSH IMHO is a poor test on it's own but I don't see a problem there but T3/Free T3 could be something to look at.
 
That's the T reference for <39 yrs.
How is the blood pressure.
Would fix low sodium levels.
Check B12 and folate.
Metformin is a high dose and maybe too high. Is it once per day or split?
 
Last edited:
I would second that metformin might be the source of unwellness, on another note, again we see that prediabetes is not always accompanied by low shbg.
 

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