Lab Work. Not On TRT. Low Free T? Low Prolactin? Always fatigued. Joint Pain.

[OldSoul]

Hi everyone,

I haven't felt good in years. I am 36. Not on TRT. Lift 2-5 days per week. 186 pounds. 5 foot 10. 15-18% bodyfat roughly.

I'm going to list my symptoms and a few things from past blood work that may be relevant. Does TRT sound like something that may help me? My Free T always seems to be on the low end, while my total T is all over the place.

Low energy.
Not nearly as interested in sex.
I don't get horny.
Very low penis sensitivity.
Difficult to orgasm. Sometimes I can't. Especially in AM.
Low semen volume.
Joint pain. Squatting is tough for me now. Even just bodyweight. My joints ache. Knees, hips mostly.
Very low energy and explosiveness when I box/hit the heavy bag. I've trained for years and my energy and explosiveness is just gone now. I get dead tired so quickly, and my body feels lethargic.
Low motivation to do anything active.
Testicles seem to ache mildly often times.
Testicles suck up really really tight most of the time. They rarely hang like they normally did.
My body seems to stay fatigued from working out for days. My strength and power is so low in the gym. I just don't have any energy.
Strength declining. Body getting softer.

THINGS TO NOTE: For several years I've had high lymphocytes.
My SHBG is always in the 45-50 range.
On the standard reference range of 8.7 pg/mL to 25.1 pg/mL over the past 3ish years, my Free T has come back at 13.2, 14.9, 15.6, 14.5, 11.2, 15.1, 13.2.


I had labs done by my GP, he didn't do my Free T even though I asked, so I had them done at Quest through DiscountLabs. I also had some other labs ran after doing some reading.
The labs in the spreadsheet are results from my doctor. Other labs are from DiscountLabs/Quest.

What do you all think?

Thanks for the help!

 

[madman]

Hi everyone,

I haven't felt good in years. I am 36. Not on TRT. Lift 2-5 days per week. 186 pounds. 5 foot 10. 15-18% bodyfat roughly.

I'm going to list my symptoms and a few things from past blood work that may be relevant. Does TRT sound like something that may help me? My Free T always seems to be on the low end, while my total T is all over the place.

Low energy.
Not nearly as interested in sex.
I don't get horny.
Very low penis sensitivity.
Difficult to orgasm. Sometimes I can't. Especially in AM.
Low semen volume.
Joint pain. Squatting is tough for me now. Even just bodyweight. My joints ache. Knees, hips mostly.
Very low energy and explosiveness when I box/hit the heavy bag. I've trained for years and my energy and explosiveness is just gone now. I get dead tired so quickly, and my body feels lethargic.
Low motivation to do anything active.
Testicles seem to ache mildly often times.
Testicles suck up really really tight most of the time. They rarely hang like they normally did.
My body seems to stay fatigued from working out for days. My strength and power is so low in the gym. I just don't have any energy.
Strength declining. Body getting softer.

THINGS TO NOTE: For several years I've had high lymphocytes.
My SHBG is always in the 45-50 range.
On the standard reference range of 8.7 pg/mL to 25.1 pg/mL over the past 3ish years, my Free T has come back at 13.2, 14.9, 15.6, 14.5, 11.2, 15.1, 13.2.


I had labs done by my GP, he didn't do my Free T even though I asked, so I had them done at Quest through DiscountLabs. I also had some other labs ran after doing some reading.
The labs in the spreadsheet are results from my doctor. Other labs are from DiscountLabs/Quest.

What do you all think?

Thanks for the help!

Definitely symptoms of sub-par FT levels.

As you can clearly see from labs posted that although your TT 724 ng/dL is robust your FT is sub-par (although not absurdly low) due to your high SHBG.

This was done using the most accurate assays TT (LC-MS/MS) and FT (Equilibrium Ultrafiltration).

 

[madman]

Here is your other set of labs and although you did not have FT tested it would definitely be lowish/low with a TT 589 ng/dL and SHBG 51 nmol/L.

 

[OldSoul]

Thank you, Madman!

I definitely always appear to be in the lower 1/4 or 1/3rd on the reference range for Free T. I know I feel like I am physically, that's for sure.

As I mentioned:
On the standard LabCorp reference range of 8.7 pg/mL to 25.1 pg/mL over the past 3ish years, my Free T has come back at 13.2, 14.9, 15.6, 14.5, 11.2, 15.1, 13.2.

Would those levels be low enough typically to cause my symptoms?

Thank you.

 

[madman]

Thank you, Madman!

I definitely always appear to be in the lower 1/4 or 1/3rd on the reference range for Free T.

As I mentioned:
On the standard LabCorp reference range of 8.7 pg/mL to 25.1 pg/mL over the past 3ish years, my Free T has come back at 13.2, 14.9, 15.6, 14.5, 11.2, 15.1, 13.2.

Would those levels be low enough typically to cause my symptoms?

Thank you.

The set of labs you had done on your own through Quest used the most accurate assays for TT/FT and your FT level is sub-par.

It is clear in your first post that your FT levels are far from optimal.


I haven't felt good in years. I am 36.

Low energy.
Not nearly as interested in sex.
I don't get horny.
Very low penis sensitivity.
Difficult to orgasm. Sometimes I can't. Especially in AM.
Low semen volume.
Joint pain.

Low motivation to do anything active.
Testicles seem to ache mildly often times.

My body seems to stay fatigued from working out for days. My strength and power is so low in the gym. I just don't have any energy.
Strength declining. Body getting softer.

 

[Systemlord]

Does TRT sound like something that may help me?

Yes, it would help you.

 

[sammmy]

Your tests do not show low testosterone so most probably boosting it with TRT will not improve most of the symptoms, except it will improve difficulty reaching orgasm.

For working out endurance, joint pains and aches: beta-ecdysterone extracts. It acts on beta estrogen receptor and has nothing to do with testosterone.

For energy, motivation, interest in sex: guarana powder. It's like coffee but with additional mood brightening and sexual benefits.

For easier orgasm: boosting free testosterone with injectable HCG, unless the guarana powder solves the problem before that.

 

[OldSoul]

Your tests do not show low testosterone so most probably boosting it with TRT will not improve most of the symptoms, except it will improve difficulty reaching orgasm.

For working out endurance, joint pains and aches: beta-ecdysterone extracts. It acts on beta estrogen receptor and has nothing to do with testosterone.

For energy, motivation, interest in sex: guarana powder. It's like coffee but with additional mood brightening and sexual benefits.

For easier orgasm: boosting free testosterone with injectable HCG, unless the guarana powder solves the problem before that.

Thank you.

Would you say my Free Testosterone is also not low?

I know my Total T is not low, although some tests do have it coming back in the 400-500s often times, it seems to fluctuate a lot.

My Free T though always seems to be on the low end of the reference range. Would boosting it significantly be unlikely to improve my symptoms?

Thank you!

 

[Systemlord]

When you're dealing with hormones whether it be thyroid or testosterone a lot of doctors think it's like an on-off switch or you're either low or you're not low.

Hormones are more like a dimmer switch, you raise the levels until there are no more symptoms. So while the OP Free T levels aren't low enough to cause severe symptoms, they're not optimal and therefore you won't to feel your best.

 

[Cataceous]

TRT is not something to be casual about. It is far more disruptive than most people realize, leading to suppression of at least four upstream hormones: kisspeptin, GnRH, LH and FSH. The negative long-term effects of this are not fully known. Consider some less dramatic options first, such as proposed by @sammmy. Next I would look into enclomiphene or Natesto. Both of these preserve HPTA function, with enclomiphene stimulating it, and Natesto only marginally suppressing it. Either of these options should increase free testosterone, allowing you to get a sense of whether higher amounts are helpful.

 

[OldSoul]

A few updated labs after trying Nutrigenix Test Booster. These were taken the next day. Didn't feel nay different. Highest SHBG result I've had yet.

Free T seems even lower, though I'm not totally sure with this unit of measurement. Any advice? Comments?

 

[sammmy]

Over the counter "testosterone boosters" do not work.

The only reliable ways of increasing free testosterone are:
anastrozole (but bad side effects on days you take it - fatigue, joint pain)
injectable HCG
TRT (topical, oral, nasal, or injectable).

For many people, even those do not resolve symptoms, because testosterone does not control everything in your body.

 

[Systemlord]

Nutrigenix

Test boosters are scams, you are buying a placebo. If test boosters really worked there would be no need for TRT.

 

[Nelson Vergel]

@OldSoul

I would check my ferritin if I was you.

Low ferritin on testosterone.