Help and Advice Needed Pleaseeee !

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AussieMan1963

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Hi BM's

Firstly let me say this is a really informative website. Secondly I am all new to this TRT stuff so sorry if I sound a bit "dumb".

Here is my story..I am 50yrs old,6ft1 and 100kgs( was 115kg) I have had no libido,sex drive or erections ( without Viagra) for a few years now. I cannot remember the last time I had a morning wood. I had my bloods done last week and yesterday received my results as follows... Here in Australia we have a different measurement unit so I have given you what it is in NMOL AND PMOL...http://www.mens-hormonal-health.com/normal-testosterone-levels-in-men.html

Total T = 18.2 ( 525 ) Range (8.3-30.2)
Free T = 306 (8.8 ) (Range 225-725)
SHBG = 47 (nmol) (Range 13-71)
Serum Prolactin = 109 (Range 45-375)
PSA 1.1 (Range 0.00-3.5)
Chol / HDL ratio = 4.3 (Range < 5.0 )
Serum Glucose ( fasting ) = 5.2 nmol (Range 45-375)
Free T4 = 16.8 ( Range 10.0-19.0)
TSH = 0.37 (Range 0.50-4.00 )

My doctor said all my bloods are in range and he will NOT prescribe me TRT which does not help me with my problems. I have been told by other trt patients to also get my E2 tested ??? Do you think if I started trt this would help or will it stuff up my body ? I am ready to buy some treatment but would like to get other peoples opinion ? And finally my friend said Proviron with Primoteston would give me a boost ?

Once again thanks for a informative website...

Cheers AussieMan 1963
 
Last edited:
Defy Medical TRT clinic doctor
Your 50 years old and exhibiting all the symptoms of low testosterone levels or other age related decline.

For your Doctor to just say you are in the normal range and completely dismiss your symptoms is sad to say the least.

Remember, being within range does not mean you are healthy or normal.

Can you add the lab ranges to what you posted above by using the "edit" button?

If you have any other blood work please post that as well.

E2 is very important to check as well as SHBG is any male hormonal work-up.
 
Gene Devine said:
Your 50 years old and exhibiting all the symptoms of low testosterone levels or other age related decline.

For your Doctor to just say you are in the normal range and completely dismiss your symptoms is sad to say the least.

Remember, being within range does not mean you are healthy or normal.

Can you add the lab ranges to what you posted above by using the "edit" button?

If you have any other blood work please post that as well.

E2 is very important to check as well as SHBG is any male hormonal work-up.
Click to expand...


You now have my ranges ..Thanks for your reply...going tomorrow to get my E2 done. All my liver and Kidney bloods are excellent. B12 IS 328 (Range 150-700 )
 
In my humble opinion, while you are "within range" of your labs you are lower quartile for both Total and Free Testosterone and probably a big reason why you feel like you do...classic age related androgen deficiency. You may need to find a Doctor who will treat your symptoms and how you feel because the Doctor you have now is not going to be of any help to you. Look for any medical Doctor in your area that specializes in anti aging medicine and you will most likely get the right and proper care.

Here's something I wrote some time ago about lab reference ranges:

“In Range” Does Not Mean “Normal”

One of the biggest and more frustrating problems you're likely to face is the problem of most Doctors believing that any blood test value that is "in range" is "normal" and therefore “fine”. I wish it was that simple and that goes for most if not all lab ranges.

Let's take a look at Testosterone values. The Total Testosterone reference range for Quest is 250-1100 ng/dL. But those values were formulated simply by looking at the values of everyone else who has a blood test for Testosterone&#8230;let me say that again: “everyone else.”

What's normal for a young guy is to be in the higher end of the reference range. What's normal for an older guy is to be in the lower end of the range&#8230;just normal biological processes.

So, while low Testosterone might be "normal" from a lab reference range perspective that doesn't mean it's good or healthy for that matter! I may be an older guy, but why should I be happy with lower Testosterone and elevated Estradiol levels simply because “it's in normal range for my age”?

All men of all ages should be in the higher end of the Testosterone reference range if they want to feel good, look good and perform athletically and sexually as men and grow old healthy!

The same holds true for Estradiol levels. The Access Medical Labs reference range for Estradiol Sensitive is 7.6-42.6 pg/ml but "normal" young men are at the low end of that reference range and that's where we all want to be as well.

Trust me, if your Testosterone serum levels is 250 ng/dl and your Estradiol is 52 pg/ml, you may be "in range" for both values, but you aren't going to feel good or have anywhere near the athletic and sexual performance that you would have if your Testosterone level was 800 ng/dl and your Estradiol level was 25 pg/ml.
 
Aussie, let's look a little closer at the thyroid. Your TSH is rather low, exhibiting what one might see with a hyperthyroid like condition. Your FT4, the storage hormone, is in about the right zone, however more information is needed. We need to see the Free T3 assay to compare and understand what is taking place after converting downstream, AND it would be good to compare ratios with a Reverse T3 lab.

Everything you are experiencing could be thyroid related just as easily. My suspicion is that your FT3 is going to be higher in % comparison to the FT4 value, and for a variety of reasons this can lead to pooling; basically a build-up of T3 in the bloodstream. With me saying this, I'm presuming that you're not on any desiccated thyroid medications?

Please look into the FT3, RT3 & Antibodies (TPO, *TSI) *Research this a little further with Graves Disease. If the thyroid hormone is not sufficiently reaching the receptors of the cells, then you basically have the "hypo" like symptoms. You can research how this effects the mitochondrial ADP/ATP ratio, and you will usually find a correlation with the adrenals, and/or iron/ferritin serum levels. Would really like to also see a CBC, lipid & metabolic panel.
 
Vettester Chris said:
Aussie, let's look a little closer at the thyroid. Your TSH is rather low, exhibiting what one might see with a hyperthyroid like condition. Your FT4, the storage hormone, is in about the right zone, however more information is needed. We need to see the Free T3 assay to compare and understand what is taking place after converting downstream, AND it would be good to compare ratios with a Reverse T3 lab.

Everything you are experiencing could be thyroid related just as easily. My suspicion is that your FT3 is going to be higher in % comparison to the FT4 value, and for a variety of reasons this can lead to pooling; basically a build-up of T3 in the bloodstream. With me saying this, I'm presuming that you're not on any desiccated thyroid medications?

Please look into the FT3, RT3 & Antibodies (TPO, *TSI) *Research this a little further with Graves Disease. If the thyroid hormone is not sufficiently reaching the receptors of the cells, then you basically have the "hypo" like symptoms. You can research how this effects the mitochondrial ADP/ATP ratio, and you will usually find a correlation with the adrenals, and/or iron/ferritin serum levels. Would really like to also see a CBC, lipid & metabolic panel.
Click to expand...


Thank you for your reply ...I did get my T3 done about 6 months ago so I will ask the doc tomorrow for a copy.
As for my current report my iron is ...
Ferritin 63 ( Range 20-300 )
Iron 9 ( Range 10-30)
Transferrin 3.1 ( Range 2.2-3.7 )
Transferrin Sat 12 ( Range 13-47 )

Tot Cholesterol 4.7 ( 0.00-5.5 )
Triglyceride 1.3 ( 0.5-2.0 )
HDL 1.1 (09-2.2)
LDL 3.0 (<3.4)
Chol/HDL Ratio 4.3 (<5.0 )
HB 15.6 (13-18)
Pcv 46.8% ( 40-54 )
Rcc 5.02 ( 4.50-6.50)
Mcv 93 (80-96)
Mch 31.1 (27-32)
Mchc 33.3 (32-36 )
Rdw 12.4% ( 11-16)
Platelets 216 ( 150-450 )
 
Gene Devine said:
In my humble opinion, while you are "within range" of your labs you are lower quartile for both Total and Free Testosterone and probably a big reason why you feel like you do...classic age related androgen deficiency. You may need to find a Doctor who will treat your symptoms and how you feel because the Doctor you have now is not going to be of any help to you. Look for any medical Doctor in your area that specializes in anti aging medicine and you will most likely get the right and proper care.

Here's something I wrote some time ago about lab reference ranges:

“In Range” Does Not Mean “Normal”

One of the biggest and more frustrating problems you're likely to face is the problem of most Doctors believing that any blood test value that is "in range" is "normal" and therefore “fine”. I wish it was that simple and that goes for most if not all lab ranges.

Let's take a look at Testosterone values. The Total Testosterone reference range for Quest is 250-1100 ng/dL. But those values were formulated simply by looking at the values of everyone else who has a blood test for Testosterone&#8230;let me say that again: “everyone else.”

What's normal for a young guy is to be in the higher end of the reference range. What's normal for an older guy is to be in the lower end of the range&#8230;just normal biological processes.

So, while low Testosterone might be "normal" from a lab reference range perspective that doesn't mean it's good or healthy for that matter! I may be an older guy, but why should I be happy with lower Testosterone and elevated Estradiol levels simply because “it's in normal range for my age”?

All men of all ages should be in the higher end of the Testosterone reference range if they want to feel good, look good and perform athletically and sexually as men and grow old healthy!

The same holds true for Estradiol levels. The Access Medical Labs reference range for Estradiol Sensitive is 7.6-42.6 pg/ml but "normal" young men are at the low end of that reference range and that's where we all want to be as well.

Trust me, if your Testosterone serum levels is 250 ng/dl and your Estradiol is 52 pg/ml, you may be "in range" for both values, but you aren't going to feel good or have anywhere near the athletic and sexual performance that you would have if your Testosterone level was 800 ng/dl and your Estradiol level was 25 pg/ml.
Click to expand...


In Australia we are a bit behind the times when it comes to Anti Ageing doctors.none in my area ...I am off to Thailand next week and willing to get some Bayer to start the ball rolling, what do you think ? I have a mate on TRT and he said start with Primoteston and Provirion ? ....
 
I think you still need to dig deeper into the thyroid, especially after seeing your iron (presuming blood serum) and Transferrin Saturation results. The stand alone Transferrin is essentially your TIBC, and it would be normal to see this elevated a bit with iron deficiency.

I'm even more interested at this point with your RT3 ratio, and as pointed out earlier, the correlation with the adrenals is usually a factor. I don't know your situation with having access with the needed labs, nor do I know if your physician will be able or willing to explore this. On the T3 lab, it's got to be the Free T3 (unbound available). A total T3 won't tell much, and a T3 uptake is useless. Let me know. Also, keep a steady stream of calcium and D3 going ... Just my .02
 
Actually, if you could get the Total T3 and FT3 (hoping with the same measurement system), I can get the RT3, but FT3 is ultimately needed.
Thanks
 
AussieMan1963 said:
I take Vitamin D3 400iu a day ..what bearing does it have on my problem ?
Click to expand...

It will help lower your shbg and thus raises your free T. I bet your e2 is up there like the others are suspecting. I am more interested in your thyroid as Chris is helping me on this issue as well.
 
In addition to what Bass said, D3 plays a big role in bone support, and in helping the receptors that receive T3 function correctly. Sorry to break it to you, but 400iu/day in most people doesn't even get the candle lit. I inject 15,000-20,000iu 2x per week, and I'm by no means a heavy hitter with it. Again, research it on your end a little deeper and you will find all sorts of information on it.
 
Update- Seen doctor a few hours ago ,got a different doctor...He gave me a copy of my Serum Thyroid Antibodies which where done late last year

Anti-Peroxidase 53 ( Range <60 )
Anti- Thyroglobulin 30 ( <60 )

This new doc is going to do all my bloods again relating to Testosterone and Thyroid, after speaking with him and looking at last weeks results ( see above ) he is thinking maybe thyroid related. He is also testing my E2 which has never been done before. Results will be back Monday ...

Cheers AM1963
 
AussieMan1963 said:
Update- Seen doctor a few hours ago ,got a different doctor...He gave me a copy of my Serum Thyroid Antibodies which where done late last year

Anti-Peroxidase 53 ( Range <60 )
Anti- Thyroglobulin 30 ( <60 )

This new doc is going to do all my bloods again relating to Testosterone and Thyroid, after speaking with him and looking at last weeks results ( see above ) he is thinking maybe thyroid related. He is also testing my E2 which has never been done before. Results will be back Monday ...

Cheers AM1963
Click to expand...

Glad you posted this. The Anti-Peroxidase is also known as the TPO test to check for Hashimotos. There are variances of opinions within the medical community, and in literature and forums that discuss thyroid matters about interpreting the labs. I'm of the opinion if you're >80% of the lab range (in this case above 48), it is evident that antibodies are going against the peroxidase enzyme. Like any disease or complication, the diagnosis can range from mild to severe. Possibly your physician might lean to believe that Hashimotos should be looked at just a little when factoring the diagnosis and treatment program.

AussieMan1963 said:
What do they mean by Biovailable Testosterone ?
I found this http://www.nebido.com/tools/index.php/en/default/index/free-calculator and it tells me mine is 7.3 nmol/L(40.5%) and my Free is 0.298nmol/L (1.65%)
Is these numbers any good ?
Click to expand...

Here's an analogy I use. Imagine a water well that you use for your daily water needs. You are allowed by measurement, let's say 2% of the well. So even though you have 100 gallons in the well, you are regulated 2 gallons for usage. If your well dropped to 50 gallons you would only get 1 gallon to drink and cook with. The body works the same way ... Total serum is the entire well. Bio/Free test is the amount available to you (unbound) for actual use, and it's regulated (bound) by SHBG and Albumin. 2% to 3% is pretty much in the optimal zone (IMO). So, regardless of serum level, your body is only going to pull a small amount. If your serum is low, then the % is relative.

So, free & bio is really the truth with what your body is getting. One guy at 500ng/dl test serum can actually be getting more actual test than the guy at 700ng/dl, simply if he is sitting with a 3% free test amount, and the other at 700ng is at 2%.
 
Last edited:
Here's an analogy I use. Imagine a water well that you use for your daily water needs. You are allowed by measurement, let's say 2% of the well. So even though you have 100 gallons in the well, you are regulated 2 gallons for usage. If your well dropped to 50 gallons you would only get 1 gallon to drink and cook with. The body works the same way ... Total serum is the entire well. Bio/Free test is the amount available to you (unbound) for actual use, and it's regulated (bound) by SHBG and Albumin. 2% to 3% is pretty much in the optimal zone (IMO). So, regardless of serum level, your body is only going to pull a small amount. If your serum is low, then the % is relative.

So, free & bio is really the truth with what your body is getting. One guy at 500ng/dl test serum can actually be getting more actual test than the guy at 700ng/dl, simply if he is sitting with a 3% free test amount, and the other at 700ng is at 2%.[/QUOTE]

So my numbers any good or any problems you can see ?
 
Talking from a testosterone standpoint, and just my opinion, I think your free/bio available test is a bit low, as it's just shy of 1.7%. Keep in mind what I said that 2% to 3% is the "zone" to think about. As I stated above, this portion of the equation is regulated by your SHBG (strongly) and albumin (weakly). If you look at your SHBG score that will confirm this statement. The good news is you can get SHBG lowered. In a lot of cases a good Vitamin D regiment could get you down in the low 30's, high 20's, and you would have your Free Testosterone elevated as a result thereof. I personally believe a free test level between 13pg/ml to 20pg/ml is a good place to be, but again, that's just strictly my opinion and my experiences with this over the years. So by this statement, having a total serum of 625ng/dl and free test of 2.45% would = 15.3pg/ml ... Do you see how that works?
 
Got my results back .....

FSH- 12iu ( Range 1-10 )
LH- 5 iu ( 1-10 )
E2 - 0
Prog - 0.6nmol ( 1.2 - 4.8 )

ATP - 34 ( <60 )
AT - 30 ( 60 )

Got a new doctor also, so after a lengthy consultation he feels with all my results coming back good to excellent, he feels that I have a vascular problem to my old fella so has put me on Cartia 1 tab every day for 3 months ...he guaranteed that it will improve my problem ( morning wood ) ...as for TRT no chance of getting on it
 
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