Lab Results and Your Input

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Hey all,

First time poster here. I've suspected low T for a few years, but after finally convicing my Doc to test for it 3 years ago, he would only look at Total T and it came back at 6.6 (2.80 - 8.00), so he said "you're just stressed" and sent me on my way.

I've been in his office once per year since telling him I am feeling increasingly worse and begging for more tests. A few weeks ago, he finally obliged, and my latest lab results are as follows:

Total T: 3.3 (2.8 - 8.0)
Free T: 6.1 (8.7 - 25.1)
SHBG: 69 (16.5 - 55.9)
LH: 5.6 (1.7 - 8.6)
Estradiol: 19.6 (8.0 - 35)

My total T went from 6.6 to 3.3 in three years -- pretty big crash. As suspected, my Free T is really low. SHBG is high and E2 seems to be a bit on the low side (from what I have found somewhere more around 25 would be ideal for someone my age).

I have started the process with Defy Medical and have a consultation in a week with NP-C Christee (I was hoping to get in with Dr. Saya but was told he was very booked and I wanted to get things going as quickly as possible).

A little about me, I am 30, in good shape as I've lifted 3-4 times per week for the past 10 years and generally live an active lifestyle playing sports, hiking, etc.

My symptoms:

-Increasingly bad fatigue. To the point where I have barely made it through the day the past month, haven't had any energy to workout (something I used to LOVE), and often can't even muster up the energy to go for a walk with my kids or play with them in the backyard.

-Decreased sex drive -- I've never really had one anyway, but recently it's basically non-existent (and my wife is smoking hot, so that's definitely not any of the issue).

-Brain fog -- Don't know how to explain this, just know I have it. Concentration has become much more difficult, my creativity has disappeared in my writing and everything requiring mental effort seems almost impossible.

-Rapid decrease in strength/stamina. As I said, I like to workout, and even at 3 workouts for 30-45 minutes per week at moderate intensity, I've seen the weight I'm using on most of my lifts drop by 30-50 pounds. My stamina has also tanked -- a month ago I was out of breath during the WARM UP -- I've only worked out 1-2 times since as I just haven't had the gusto.

-Emotionless/indifference. It's almost like I can't feel (emotionally). It's weird to say, but sometimes even with my family, I am in situations where I want to feel, but there's just nothing there, like an indifference to everything.

My questions:

1. Is me 19.6 Estradiol a concern for being too low? Should I avoid/question an AI if it's presented as part of the treatment plan from Defy? It seems like I actually could benefit from this rising a bit more towards 25, so maybe the rise of E2 that comes from TRT would actually be a good thing in my case?

2. SHBG is high -- I've read a lot about this and haven't found a lot of promising solutions. Any guys on here having successful experiences with TRT despite have high SHBG? Should I be looking at any type of different treatment from Defy as someone with high SHBG? I've read some places where people say TRT wont' help someone with high SHBG because it will all still just end up being bound up and not make to Free T -- any thoughts on this?

Thanks guys, I appreciate it. I'm ready to get my life back and finally start feeling like the person I know is caged within. Ultimately I'm going to trust what I hear from Defy in a week, but I'm going crazy just sitting here waiting, so any input you all have is appreciated.

I've seen Dr. Saya on here, if he reads this and has any input to put me at ease, it would be incredibly welcomed and appreciated.
 
Defy Medical TRT clinic doctor
You state your SHBG is high, what's that number? And Whatever your E is now isnt going to be relevant after you get started, its fine to just know as a baseline though but won't really have any bearing on your treatment. I would absoultely question the inclusion of an AI at the start when it's included 'just because'. At 90 days when you have your follow and consult, an AI might have a more appropriate place in any discussion.
 
Your Total T is low but that explains why your FreeT is subterranean. SHBG should or may come down a bit with treatment, hard to say, it'll be something that you want to run consistently in all your labs for awhile. usually this would mean that you'll have to run pretty high Total T even in your trough to compensate for it. SHBG is what it is, you have to take it for where it's at and deal with it.
 
Thanks

Your Total T is low but that explains why your FreeT is subterranean. SHBG should or may come down a bit with treatment, hard to say, it'll be something that you want to run consistently in all your labs for awhile. usually this would mean that you'll have to run pretty high Total T even in your trough to compensate for it. SHBG is what it is, you have to take it for where it's at and deal with it.

Gotcha, thanks for your feedback.
 
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