Help me understand my results(

[Snarky]

Hi all.
A little background- 36 year old male, history of head injuries (6+ concusions). During my mid to late 20s I entered what I would refer to as a funk- lower energy, singificantly decrease libido, sleep disturbances, I can count the # of times I've had morning wood on one hand in the past two years, brain fog, low confidence, etc. I wouldn't consider myself debilitated, but have felt held back.

Decided to get total and free test looked at (defy)
Testosterone,Free and Total


Testosterone, Serum 391 ng/dL (348 - 1197 01)
Free Testosterone(Direct) 6.0 Low pg/mL (8.7 - 25.1 02)

Saw I was low and decided to get the full panel and the numbers looked like this:

Testosterone, Serum 477 ng/dL (348 - 1197)
Free Testosterone(Direct) 9.4 pg/mL (8.7 - 25.1 )



DHEA-Sulfate 201.7 ug/dL (102.6 - 416.3)
TSH 1.190 uIU/mL (0.450 - 4.500)
LH 3.1 mIU/mL (1.7 - 8.6 )
Estradiol, Sensitive 25.2 pg/mL (8.0 - 35.0)

Anybody else here start similar to me? I'm not sure if I'd be a good candidate for TRT since my free was low only one of the two times I tested. Any other insight from my #s?

 

[Vettester Chris]

Your last labs are what I would call in the "Low Normal" range. It's not tanked, but not optimal either. Your LH is semi suppressed, which would explain the results of the total serum. Your free test is also low, which indicates your SHBG is probably elevated. You can verify that with getting a SHBG lab, then talk to the team at Defy for options on how to improve this. In many cases this can improve with optimal amounts of Vitamin D, possibly some Nettle root and/or other supplements.

TSH is decent, but that doesn't give us any actual thyroid numbers. Too many times the TSH is spot-on, but actual thyroid hormone numbers can be tanked. The feedback on the pituitary isn't always reliable on this subject. For this purpose look into Free T3, Free T4, Reverse T3 and antibodies (TPO & TgAb).

 

[Snarky]

Thanks for your input. Is it common for free T to swing as much as mine did? I've read that T can very by 20% over the course of the day, but my Free T is almost 60% higher. These were taken within a few weeks of each other, at the same time of day with no change in my lifestyle.

 

[Snarky]

Anybody else here get treatment for the "low normal" side of things? I'm just wondering if I should continue visiting a specialist or stick with over the counter methods.

 

[BuzzzardMarinePumper]

Your last labs are what I would call in the "Low Normal" range. It's not tanked, but not optimal either. Your LH is semi suppressed, which would explain the results of the total serum. Your free test is also low, which indicates your SHBG is probably elevated. You can verify that with getting a SHBG lab, then talk to the team at Defy for options on how to improve this. In many cases this can improve with optimal amounts of Vitamin D, possibly some Nettle root and/or other supplements.

TSH is decent, but that doesn't give us any actual thyroid numbers. Too many times the TSH is spot-on, but actual thyroid hormone numbers can be tanked. The feedback on the pituitary isn't always reliable on this subject. For this purpose look into Free T3, Free T4, Reverse T3 and antibodies (TPO & TgAb).

What he said in addition IMHO there are no over the counter supplement to actually cause a drastic rise in Test levels and the only remote compound you can get from my knowledge is HCG and that may be an option for you sine you are in range and you may be able to address your other not in range levels with a few over the counter supplements ! Even in 3 years you are the 1st man I have actually read about with Low Testosterone from and injury and I am very interested to see what actions you take and what works for you

Never give up help is out there !

 

[Snarky]

Thank you all for your input. I've got a follow up question that maybe one of you could clarify.

So, my most recent numbers are:

Testosterone, Serum 477 ng/dL (348 - 1197)
Free Testosterone(Direct) 9.4 pg/mL (8.7 - 25.1 )

My understanding is that Free T should be ~2% of total T. The numbers aren't adding up in my head and maybe I've got something wrong here. Since 1 pg/mL = 0.1 ng/dL- then my free T should be 0.94 ng/dL, which is 0.2% of total. However, by this logic a "good" 2 % of my total T would be 95.4 pg/mL- which is totally ridiculous. Am I missing something here?

 

[CoastWatcher]

Thank you all for your input. I've got a follow up question that maybe one of you could clarify.

So, my most recent numbers are:

Testosterone, Serum 477 ng/dL (348 - 1197)
Free Testosterone(Direct) 9.4 pg/mL (8.7 - 25.1 )

My understanding is that Free T should be ~2% of total T. The numbers aren't adding up in my head and maybe I've got something wrong here. Since 1 pg/mL = 0.1 ng/dL- then my free T should be 0.94 ng/dL, which is 0.2% of total. However, by this logic a "good" 2 % of my total T would be 95.4 pg/mL- which is totally ridiculous. Am I missing something here?

https://www.excelmale.com/forum/showthread.php?3588-Calculating-Free-Bioavailable-Testosterone

Here is the link to the calculator for free testosterone.

 

[Nelson Vergel]

Snarky

The reason for your confusion is the units used to report total and free T.

Total T is in ng/dL and free T is in pg/mL

So, 9.4/477 = 0.0197 (multiply by 100= 2 %)

 

[Snarky]

Thanks all. Just wanted to update. I spoke with Dr. Saya at Defy and he put me on a month long test using 50 mg of clomid daily, 0.25 mg of anastrazole and there DHEA supplement daily.

My theory is that I am secondary hypo so this should work pretty well. A day in I felt really great- super happy, tons of energy and drive. Probably placebo effect. Second day can't say I feel different or not.

Wonder how I'll feel in a month and how my test results will look.

 

[CoastWatcher]

Patience is the key to success in all of this. All the best!

 

[Snarky]

OK, checking back in after a month. I have my appointment with Dr. Saya next week, and I'm looking forward to it.

After a month on clomid, DHEA, and anastrazole I was re-tested and had some interesting results:

Total Testosterone 391 -> 1360 ng/mL (348 - 1197)
Free Testosterone 6.0 -> 30.4 pg/mL (8.7 - 25.1)

LH 3.1 -> 5.4 (1.7 - 8.6)
Estradiol 25.2 -> 33.0 pg/mL (8.0 - 35.0)
Prolactin (not measured) -> 6.6 ng/mL (4.0 - 15.2)
IGF-1 (not measureed ) -> 98 ng/mL (83 - 233)


So, it looks like my body really responded to the clomid. I felt pretty good during the month, nothing earth shattering but just like I wasn't walking against the wind anymore. I lost an inch from my waste and gained an 1/2 inch on my bicep (I have a rather minimal workout routine 3x a week with medicine balls). I didn't notice any change in libido, perhaps estradiol got too high. Other side effects were pretty minimal- skin was a bit more oily and I had a couple of break outs, but this seemed to be under control. I've been out of clomid for a week and have noticed myself feeling worse.

My guess is that Dr. Saya will tone down my clomid dose and bump up the anastrazole, but I'll be interested to here what he suggests.

Anybody have any insights on my other results? I assume prolactin was measured to check for negative side effects, but I'm not sure how to interpret the IGF-1 numbers. This seems low for someone my age. Any ideas?