Blood results: Low T, Low SHBG, High Prolactin, E2 not sure?

[teep]

Hi all,

I have never cycled or used steroids etc before and was suffering from Low T symptoms so decided to get some bloods done:

Results (31 year old male):

TESTOSTERONE: 7.53 nmol/L (7.60 - 31.40)
FREE-TESTOSTERONE(CALCULATED): 0.225 nmol/L (0.30 - 1.00)
BETA OESTRADIOL: 33.4 pmol/L (0.00 - 191.99)
SEX HORMONE BINDING GLOB: 12.5 nmol/L (16.00 - 55.00)
PROLACTIN: 362 mIU/L (86.00 - 324.00)

Thyroids, blood count, liver, kidney function etc all came back very good.


My T levels seem super low at 217 ng/dl.
I am not sure how to diagnose my E2 levels at 9 pg/ml - can anyone give some input?

I feel like I should get on TRT, but with high prolactin and low SHBG I am not sure if it would make any difference (from some quick googling).

I am not sure how bad my prolactin levels are as they seem just slightly over the range, and I don't know if my SHBG is low purely because my T is low (or my E2 levels).

Would going on TRT immediately be a good or bad idea (in a hypothetical sense)?

Hope someone can help as I am very confused by these results, and I wont be able to see my doctor for another week .. would love to have some follow up questions for him by then!

Thanks

 

[CoastWatcher]

Hi all,

I have never cycled or used steroids etc before and was suffering from Low T symptoms so decided to get some bloods done:

Results (31 year old male):

TESTOSTERONE: 7.53 nmol/L (7.60 - 31.40)
FREE-TESTOSTERONE(CALCULATED): 0.225 nmol/L (0.30 - 1.00)
BETA OESTRADIOL: 33.4 pmol/L (0.00 - 191.99)
SEX HORMONE BINDING GLOB: 12.5 nmol/L (16.00 - 55.00)
PROLACTIN: 362 mIU/L (86.00 - 324.00)

Thyroids, blood count, liver, kidney function etc all came back very good.


My T levels seem super low at 217 ng/dl.
I am not sure how to diagnose my E2 levels at 9 pg/ml - can anyone give some input?

I feel like I should get on TRT, but with high prolactin and low SHBG I am not sure if it would make any difference (from some quick googling).

I am not sure how bad my prolactin levels are as they seem just slightly over the range, and I don't know if my SHBG is low purely because my T is low (or my E2 levels).

Would going on TRT immediately be a good or bad idea (in a hypothetical sense)?

Hope someone can help as I am very confused by these results, and I wont be able to see my doctor for another week .. would love to have some follow up questions for him by then!

Thanks

Welcome to Excelmale. You are missing some key tests. It is important to have LH and FSH measured to determine if your hypogonadism is primary or secondary in nature, a PSA should be captured for baseline purposes, and your thyroid - which thyroid tests were performed? DHT along with a CBC and a CMP are important, too.

One can have low testosterone with low SHBG, high SHBG, or SHBG sitting in the desired spot. The SHBG value becomes a factor in designing a proper protocol, low SHBG usually means smaller more frequent doses over the course of a week, but low SHBG certainly doesn't mean TRT isn't possible. The elevated prolactin should be further investigated. It can also be treated, and is hardly a bar to TRT.

Your estradiol is low because your testosterone is low. E follows T as night follows the day.

You are young, it is possible that your LH and FSH results would suggest a Clomid protocol as part of an attempted restart effort. What medications and supplements are you taking? Do you have a history of head or testicular injury? How do you sleep? Snore much?

 

[teep]

Welcome to Excelmale. You are missing some key tests. It is important to have LH and FSH measured to determine if your hypogonadism is primary or secondary in nature, a PSA should be captured for baseline purposes, and your thyroid - which thyroid tests were performed? DHT along with a CBC and a CMP are important, too.

One can have low testosterone with low SHBG, high SHBG, or SHBG sitting in the desired spot. The SHBG value becomes a factor in designing a proper protocol, low SHBG usually means smaller more frequent doses over the course of a week, but low SHBG certainly doesn't mean TRT isn't possible. The elevated prolactin should be further investigated. It can also be treated, and is hardly a bar to TRT.

Your estradiol is low because your testosterone is low. E follows T as night follows the day.

You are young, it is possible that your LH and FSH results would suggest a Clomid protocol as part of an attempted restart effort. What medications and supplements are you taking? Do you have a history of head or testicular injury? How do you sleep? Snore much?

Hey thanks for the info!

Thyroid:
THYROID STIMULATING HORMONE: 1.8 mIU/L (0.27 - 4.20)
FREE THYROXINE: 20.4 pmol/L (12.00 - 22.00)
FREE T3: 4.76 pmol/L (3.10 - 6.80)

Prostate:
PROSTATE SPECIFIC AG(TOTAL): 1.14 ug/L (0.00 - 1.40)

Kidney/Liver/Proteins/Iron/Cholesterol all came back good.

I have booked in for an LH and FSH test and I'll post them as soon as I get the results back in a few days.

What medications and supplements are you taking? Do you have a history of head or testicular injury? How do you sleep? Snore much?

-No medication.
-No supplements apart from the odd multi vitamin and vit D (haven't been taking them as much recently)
-No head or testicular injuries.
-Sleep isn't amazing - I wake up still feeling fatigued most of the time. Get about 5-6 hours solid sleep but still feel exhausted throughout the day (maybe the low T).
- I don't think I snore much! Can;t be sure.

TRT:
I was actually going to self prescribe and it was one of the reasons I took the blood tests into my own hands (takes months through the doctors here to get anywhere). The plan was 100mg Test-E per week to start with and re-evaluate after 6 weeks.

Would going down this route be extremely careless now, or is there a chance it could make it better?

Could you please explain what would happen if my LH/FSH comes back low or normal too? I don't fully understand it.

Thank you again for the great info and taking the time to help!

 

[CoastWatcher]

Hey thanks for the info!

Thyroid:
THYROID STIMULATING HORMONE: 1.8 mIU/L (0.27 - 4.20)
FREE THYROXINE: 20.4 pmol/L (12.00 - 22.00)
FREE T3: 4.76 pmol/L (3.10 - 6.80)

Prostate:
PROSTATE SPECIFIC AG(TOTAL): 1.14 ug/L (0.00 - 1.40)

Kidney/Liver/Proteins/Iron/Cholesterol all came back good.

I have booked in for an LH and FSH test and I'll post them as soon as I get the results back in a few days.



-No medication.
-No supplements apart from the odd multi vitamin and vit D (haven't been taking them as much recently)
-No head or testicular injuries.
-Sleep isn't amazing - I wake up still feeling fatigued most of the time. Get about 5-6 hours solid sleep but still feel exhausted throughout the day (maybe the low T).
- I don't think I snore much! Can;t be sure.

TRT:
I was actually going to self prescribe and it was one of the reasons I took the blood tests into my own hands (takes months through the doctors here to get anywhere). The plan was 100mg Test-E per week to start with and re-evaluate after 6 weeks.

Would going down this route be extremely careless now, or is there a chance it could make it better?

Could you please explain what would happen if my LH/FSH comes back low or normal too? I don't fully understand it.

Thank you again for the great info and taking the time to help!

You're considering a self-designed TRT protocol on the basis of tests you don't understand? A serious hormonal intervention that by its very nature disrupts the endocrine system (that's true of both successful and unsuccessful protocols)? You have no idea what you're doing and don't yet understand what state your body is in.

A few quick examples. Is your hypogonadism primary or secondary in nature? That's what the LH and FSH tests can tell you. If the former, your problem is testicular; if the latter, the pituitary is implicated. If you are secondary, given your age, a Clomid restart should be considered. Your prolactin is high; do you have a prolactinoma, a non-cancerous adenoma in the pituitary? Unlikely, but further investigation is called for. What about your cortisol?

TRT is more than a shot or two of testosterone every week. Given your confusion about some of the basic points of this treatment, and all of us started with more questions than answers, I'm not criticizing you, it would be foolish to self-prescribe. If you can afford private care, we can offer the name of a fine doctor in Dorset.

 

[teep]

You're considering a self-designed TRT protocol on the basis of tests you don't understand?

This is why I decided to post here and find out a bit more first. I don't want to be one of those guys who injects for the sake of injecting, so I really appreciate your help and input!

The plan was to go on TRT assuming my bloods came back normal (apart from low T), but the high prolactin and low SHBG threw a wrench in the works and put me off / got me worried and I now appreciate how complicated a process the whole thing really is.

Many thanks for the examples, very interesting and a lot of things to think about. Can't wait to get those blood tests back and now and figure out what is going on. Will ofcourse be holding off on the TRT (and feeing better about it now) and I'll post again when I get my results for the other tests.

Is a cortisol test also a must-do?

 

[teep]

Got my LH / FSH results in:


FSH: (1.50 - 12.40) 1.39 IU/L
LH: (1.70 - 8.60) 7.62 IU/L

Doesn't look good.. and I can't see an endo for atleast 3 months because of the waiting times here. Unfortunately there is nowhere private I can go either.

What does this mean and would are my options? I really don't want to have to wait for so long to see an endo

 

[CoastWatcher]

Where do you live?

 

[teep]

Small town in the UK, would need to fly out somewhere to find a private clinic

 

[CoastWatcher]

Dr. Roner Stevens, a friend of Nelson's, is the director of this clinic in Dorset, if that is of any