Blood work - Do I need TRT/Whats next?

[lennylevino]

For the few years I have had low libido generally, bad erection quality and almost never waking up with a boner. I have also noticed reduced/slowed facial hair growth and increased balding. Although I will say that I don't often get a full 8 hours of sleep and I do not exercise much (if at all).

Here are my test results from a couple of days ago (blood taken at 10am on a fasted stomach). I am 33 years old.

Hormones:
- Total Testosterone: 97 ng/dl (range: 250 - 840)
- Free Testosterone: 27 pg/ml (lab range: 15 - 50 - *although when googling it says that normal reference range is 50-200 pg/ml)
- LH: 4.12 (range: 1.7 - 8.6)
- FSH: 1.8 (range: 1.5 - 12.4)

Thyroid and Prostate:
- PSA: 1.04 (range: <1.4)
- TSH: 1.9 (range: 0.27 - 4.2)
- T3 Total: 1.23 (range: 0.8 - 2.0)
- T3 Free: 3.36 (range: 2.0 - 4.4)
- T4 Total: 12.1 (range: 4.5 - 12.0)
- T4 Free: 1.77 (range: 0.93 - 1.7)

Seems like the lab forgot to include SHBG and Estradiol (E2). Do I need to check these as well? What should my next step be here? Do another test to confirm the low numbers and then get on injections?

Thing is I used a MAO-inhibitor called Tranylcypromine (Parnate) as an antidepressant and stopped taking it about 3 months ago. I also took this in the past and got similar symptoms to what I have now after quitting. When I started taking it again it felt like I had a return of libido, drive etc (although it only lasted for a couple of months before it vanished again). Last time I was off this medication for over 2 years with no improvement in symptoms.

 

[Systemlord]

It’s possible Tranylcypromine is to blame for your suppressed testosterone levels and perhaps when you were on it, the LH and FSH were elevated while testosterone suppressed.

Now that you’re off it, testosterone parameters haven’t recovered. Some SSRI’s do decrease testosterone, sometimes permanently.

Effect of Tranylcypromine Drug on LH, FSH, Testosterone Hormones Concentration and Testicular Tissue Changes in Adult Male Rat

Background:Tranylcypromine is a monoamine oxidase inhibitor (MAOI)-it is a nonselective and irreversible inhibitor of the enzyme monoamine oxidase (MAO). It is used as an antidepressant and anxuolytic agent in the clinical treatment of mood and anciety disorders, respectively. In this research...

aums.abzums.ac.ir

Results: The results showed that 21 days consumption of maximum doses of Tranylcypromine, significantly increases concentrations of LH and FSH hormones and significantly reduce testosterone concentration in maximum doses and leydig cells in all three experimental groups (P≥0.05). In addition, no significant effect was observed in the body weight, testicular weight as well as Sertoli cells. Moreover, testicular tissue study indicates that 21 days of Tranylcypromine consumption significantly reduces spermatogony,spermatid , spermatocyte and thus, affects spermatogenesis.

 

[lennylevino]

It’s possible Tranylcypromine is to blame for your suppressed testosterone levels and perhaps when you were on it, the LH and FSH were elevated while testosterone suppressed.

Now that you’re off it, testosterone parameters haven’t recovered. Some SSRI’s do decrease testosterone, sometimes permanently.

Effect of Tranylcypromine Drug on LH, FSH, Testosterone Hormones Concentration and Testicular Tissue Changes in Adult Male Rat

Background:Tranylcypromine is a monoamine oxidase inhibitor (MAOI)-it is a nonselective and irreversible inhibitor of the enzyme monoamine oxidase (MAO). It is used as an antidepressant and anxuolytic agent in the clinical treatment of mood and anciety disorders, respectively. In this research...

aums.abzums.ac.ir

Oh, interesting. How crazy I have never seen that study before. Thank you for linking it. The doses these animals received were quite huge though, and as far as I understand it serotonin gets significantly more affected the higher of a dose you take. At my dose (50-60mg per day) I found I had a good balance between serotonin and dopamine. If I were to take the same dose as these animals, I'd be taking 800-3200 mg per day.

Nonetheless, very interesting study.

I have personal experience with SSRIs and lowered testosterone levels. 10 years ago while taking Sertraline I was cruising around 300 ng/dl. After stopping the SSRI my levels bounced back to over 800 ng/dl within 3 months.

Last time I took a test I was also at nearly 800 ng/dl. This was about two and half years ago (and before getting on Tranylcypromine). I may have to give this another couple of months then to see if I can bounce back naturally, before starting injections.

Right now I am taking Vyvanse instead. Hopefully that won't affect the test production too much.

 

[Systemlord]

After stopping the SSRI my levels bounced back to over 800 ng/dl within 3 months.

Here’s the thing though, sometimes damage occurs and you don’t start to see problems until later. Take abusing steroids for an example, sometime 10 years down the road after stopping AAS, the hormones decline earlier in life instead of later in life.

You only have to weaken the HPTA to start the process earlier. A lot of guys are getting low-T in their 40‘s and 50’s, you got it earlier because of medicines that directly interfered with your reproductive system.

Another example is finasteride, sometimes the problems don’t start until after you stop taking it, months or years down the road. I’ve seen it time and time again.

 

[Systemlord]

now I am taking Vyvanse instead. Hopefully that won't affect the test production too much.

I got hypersexuality on Vyvanse. I didn’t like firing on all cylinders, 24/7 though. I felt speedy all the time. My test levels were unaffected by Vyvanse.

 

[Nelson Vergel]

I am not sure if this is a mistake, but you have high testosterone.

 

[Systemlord]

View attachment 28612

I am not sure if this is a mistake, but you have high testosterone.

Good catch Nelson! I didn't even look at the actual lab report because his other thread didn't include it and went off the typed in units.

This would put FT about mid-range. This is a slippery slope as this is subpar for some men and not that bad for others.

I feel like dogs*** at these FT levels, low energy, ED and low libido.

 

[lennylevino]

Here’s the thing though, sometimes damage occurs and you don’t start to see problems until later. Take abusing steroids for an example, sometime 10 years down the road after stopping AAS, the hormones decline earlier in life instead of later in life.

You only have to weaken the HPTA to start the process earlier. A lot of guys are getting low-T in their 40‘s and 50’s, you got it earlier because of medicines that directly interfered with your reproductive system.

Another example is finasteride, sometimes the problems don’t start until after you stop taking it, months or years down the road. I’ve seen it time and time again.

Good point and interesting take on it. I am going to go for another test soon to confirm the results.

 

[lennylevino]

View attachment 28612

I am not sure if this is a mistake, but you have high testosterone.

Oh, wow! What a mistake by me. So I actually have a very decent level of total testosterone. That is a relief for sure.

Good catch Nelson! I didn't even look at the actual lab report because his other thread didn't include it and went off the typed in units.

This would put FT about mid-range. This is a slippery slope as this is subpar for some men and not that bad for others.

I feel like dogs*** at these FT levels, low energy, ED and low libido.

Converting 28 pg/ml to ng/dl and I get 2.8. According to multiple sources I just looked up, it seems that the reference range for FT is 8.0-60 ng/dl. So I would be well under the minimum value on the reference range. Am I correct in this or am I misunderstanding this too?

 

[Nelson Vergel]

So I would be well under the minimum value on the reference range. Am I correct in this or am I misunderstanding this too?

It depends on the lab company

Free Testosterone Lab Test Range: Quest vs LabCorp Results

I was looking through some labs and feeling like I'm comparing apples to oranges and if so, how to interpret things. On a pre-TRT lab from Quest, the "Free Testosterone" reading is 51.3 pg/ml (range 35.0-155.0 pg/ml) On a post-TRT follow up lab from LabCorp, the "Free Tesosterone (Direct)"...

www.excelmale.com

What is a Normal Blood Level of Testosterone? What Do Guidelines Say?

Normal values may vary from lab to lab depending on what reference range they use. Depending on the country, ranges are in nanograms per deciliter (usually in the United States) or nanomoles per liter (Europe and other countries). The conversion factor is: Click here: What’s a “Normal”...

www.excelmale.com

144980: Testosterone, Free, Direct | Labcorp

Labcorp test details for Testosterone, Free, Direct

www.labcorp.com

Quest Diagnostics: Test Directory

testdirectory.questdiagnostics.com

 

[tareload]

Total Testosterone: 97 ng/dl

Nope. 970 ng/dl.

 

[tareload]

See this thread and this post.

Calculate Free Testosterone with TruT by FPT

The idea of SHBG as a sponge that sucks up large amounts of testosterone and leaves your free T low doesn't seem to be how it really works. The way I understand it, high SHBG makes your meager production (revealed by the free T) look like it's normal or even high when it isn't. The SHBG is...

www.excelmale.com

Calculate Free Testosterone with TruT by FPT

The idea of SHBG as a sponge that sucks up large amounts of testosterone and leaves your free T low doesn't seem to be how it really works. The way I understand it, high SHBG makes your meager production (revealed by the free T) look like it's normal or even high when it isn't. The SHBG is...

www.excelmale.com

All you want and more.

 

[Deleted member 42882]

See this thread and this post.

Calculate Free Testosterone with TruT by FPT

The idea of SHBG as a sponge that sucks up large amounts of testosterone and leaves your free T low doesn't seem to be how it really works. The way I understand it, high SHBG makes your meager production (revealed by the free T) look like it's normal or even high when it isn't. The SHBG is...

www.excelmale.com

Calculate Free Testosterone with TruT by FPT

The idea of SHBG as a sponge that sucks up large amounts of testosterone and leaves your free T low doesn't seem to be how it really works. The way I understand it, high SHBG makes your meager production (revealed by the free T) look like it's normal or even high when it isn't. The SHBG is...

www.excelmale.com

All you want and more.

I thought you're #TeamVermeulen

 

[tareload]

I thought you're #TeamVermeulen

Yes that is the gist of those posts.

 

[Deleted member 42882]

Yes that is the gist of those posts.

Ah yes. I had only looked at the titles.

 

[tareload]

Ah yes. I had only looked at the titles.

Yes the titles and descriptions thar carry over on the previews can be very deceiving. I've brought this up to MGMT that this may be a reason no one bothers to read the material behind the links.