Help me Understand my Lab Results!

[TestTossAway]

Background: I'm a 28 year old male, 6'2, 170lbs (about 9-11% body fat) with a very healthy lifestyle and diet. Non-Smoker, Less than 2 alcoholic drinks/week. Work Long days (8a-6p) and train Muay Thai 1.5 hours/day 3-4x/week.

My primary physician requested blood-work to check liver function due to long-term adderall prescription. Over the past 2-3 years I noticed a drop in my "killer instinct" and Libido; so, I take advantage of this blood-work to run labs on my testosterone (out of curiosity at this point). My issues/symptoms are all signs of Low-T:
- Decreased sexual desire
- Tired/foggy - regardless of sleep/food/caffeine intake
- Not "Depressed" but rarely excited about much anymore
- I've been "on-edge"/irritable - not sure that has anything to do with it

Sure enough, the 1st round of blood-work showed Low Free Testosterone (tested 9/27/17). BOOM! Red Flag.

[TABLE="width: 593"]
[TR]
[TD]Report[/TD]
[TD]Units[/TD]
[TD]Result[/TD]
[TD]Refrence Range (low)[/TD]
[TD]Refrence Range (high)[/TD]
[/TR]
[TR]
[TD]Testosterone, Total, LC/MS[/TD]
[TD]ng/dL[/TD]
[TD]638.0[/TD]
[TD]264.0[/TD]
[TD]916.0[/TD]
[/TR]
[TR]
[TD]Free Testosterone (Direct)[/TD]
[TD]pg/ml[/TD]
[TD]7.8[/TD]
[TD]9.3[/TD]
[TD]26.5[/TD]
[/TR]
[/TABLE]

Up to that point, I thought my symptoms were due to a high-stress point in my career. But I deemed those results to warrant further testing and I need help "translating" my most recent Lab results. (See Results from Test dating 10/6/17)

[TABLE="width: 593"]
[TR]
[TD]Report[/TD]
[TD]Units[/TD]
[TD]Result[/TD]
[TD]Refrence Range (low)[/TD]
[TD]Refrence Range (high)[/TD]
[/TR]
[TR]
[TD]Testosterone, Total, LC/MS[/TD]
[TD]ng/dL[/TD]
[TD]763.6[/TD]
[TD]264.0[/TD]
[TD]916.0[/TD]
[/TR]
[TR]
[TD]Free Testosterone (Direct)[/TD]
[TD]pg/ml[/TD]
[TD]11.2[/TD]
[TD]9.3[/TD]
[TD]26.5[/TD]
[/TR]
[TR]
[TD]TSH[/TD]
[TD]uIU/mL[/TD]
[TD]2.510[/TD]
[TD]0.450[/TD]
[TD]4.500[/TD]
[/TR]
[TR]
[TD]T4, Free (Direct)[/TD]
[TD]ng/dL[/TD]
[TD]1.48[/TD]
[TD]0.82[/TD]
[TD]1.77[/TD]
[/TR]
[TR]
[TD]Cortisol -AM[/TD]
[TD]ug/dL[/TD]
[TD]13.4[/TD]
[TD]6.2[/TD]
[TD]19.4[/TD]
[/TR]
[TR]
[TD]DHEA-Sulfate, LCMS[/TD]
[TD]ud/dL[/TD]
[TD]196.0[/TD]
[TD]38.0[/TD]
[TD]523.0[/TD]
[/TR]
[TR]
[TD]Prolactin[/TD]
[TD]ng/mL[/TD]
[TD]10.8[/TD]
[TD]4.0[/TD]
[TD]15.2[/TD]
[/TR]
[TR]
[TD]Estradiol[/TD]
[TD]pg/ml[/TD]
[TD]16.9[/TD]
[TD]7.6[/TD]
[TD]42.6[/TD]
[/TR]
[TR]
[TD]Sex Horm. Binding Glob, Serum[/TD]
[TD]nmol/L[/TD]
[TD]65.2[/TD]
[TD]16.5[/TD]
[TD]55.9[/TD]
[/TR]
[TR]
[TD]LH[/TD]
[TD]mlU/mL[/TD]
[TD]7.0[/TD]
[TD]1.7[/TD]
[TD]8.6[/TD]
[/TR]
[TR]
[TD]FSH[/TD]
[TD]mlU/mL[/TD]
[TD]6.5[/TD]
[TD]1.5[/TD]
[TD]12.4[/TD]
[/TR]
[/TABLE]

My primary recommends I follow up with an endocrinologist and I intend to do so. Prior to that meeting, I wanted to come here for feedback on my results. I will be able to have a higher-level conversation with the endocrinologist if this community can help me better understand and question my readings.

My Questions are:
1. My Testosterone, Total and Free Testosterone was tested twice within 10-days is the variance in my results normal?
2. My SHBG is high. How significant is that? What can/does that mean?
3. While "WNL" My Prolactin and LH are still high, are these results something to be concerned with?
4. My Free Testosterone, while now "WNL" on my second test is still respectively low at 11.2 pg/ml. Would you agree?
5. Are there any other readings or results that I'm missing which I should be concerned with?

I appreciate you taking the time to read and respond -- it will be extremely helpful. Let me know if you need anymore information. Thanks Again!

 

[Nelson Vergel]

Your blood test results are great. I would look at non-hormone reasons for your decrease in "killer instinct". Sleep quality, stress, or having stopped Adderall (I assume) may be issues.

 

[TestTossAway]

Your blood test results are great. I would look at non-hormone reasons for your decrease in "killer instinct". Sleep quality, stress, or having stopped Adderall (I assume) may be issues.

Two details i should have added:

1. My first test was taken about a week after a weight cut. which i dropped from about 180lbs to 165lbs for a fight. (was still taking adderall at this point).

2. My second test was done 13 days after the weight cut and had stopped adderall use about 3-4 days prior.

No worries with my very high SHBG?
LH and FSH are high as well and my prolactin reading seems a bit odd...

 

[FeelingLost]

Two details i should have added:

1. My first test was taken about a week after a weight cut. which i dropped from about 180lbs to 165lbs for a fight. (was still taking adderall at this point).

2. My second test was done 13 days after the weight cut and had stopped adderall use about 3-4 days prior.

No worries with my very high SHBG?
LH and FSH are high as well and my prolactin reading seems a bit odd...

Have you thought about supplementing DHEA? At your age I would think it should be >350
Your SHGB is pretty dam high give this a look.

https://www.excelmale.com/forum/sho...adiol-and-Sex-Hormone-Binding-Globulin-in-Men