Low-normal levels and trt

[DaveJ]

I am new to the forum and was hoping to get some thoughts on trt with low-normal test levels. I turn 47 next month and have experienced some mild low-t symptoms over the past few years. I have had bloodwork done on a few occasions during that time. Some pertinent results (and reference ranges) from the latest from a few months back are as follows:

Total test: 430 ng/dl (250-1100)
Free test: 81 pg/ml (35-155)
LH: 6 mlU/ml (1.5 - 9.3)
FSH: 11 mlU/ml (1.6 - 8.0) HIGH
Estradiol: 31 pg/ml (<= 39)
Prolactin: 5.1 ng/ml (2 - 18)
TSH: 2.94 mIU/L (0.4 - 4.5) - note: i currently take synthroid: 75mcg/d
T4, free: 1.5 ng/dl (0.8 - 1.8)


Cholesterol levels and other health markers are very good and I am quite fit as I exercise regularly. Primary symptoms include reduced libido, lower quality erections, increased joint pain, and mood swings. Given that I do not appear to be hypogonadal based on the lab results, how significant should the symptoms be before considering hormone optimization? Thanks in advance for your input.

 

[Nelson Vergel]

Dave

I would not go on TRT unless you have explored all options. Your numbers are pretty good (not sure if your thyroid can be optimized better). I would get on 5 mg daily Cialis. Get your CPK tested if you are having muscle aches to see if it is over 500.

It would not be a bad idea to test for DHT, estradiol (sensitive), and DHEA.

 

[DaveJ]

Thanks for the feedback, Nelson. I really appreciate the advice and will certainly look into your suggestions. Would also appreciate any other points of view from members with similar issues. Thanks!

 

[Hammer]

I suggest you get a sleep study as a first step based on personal history. I lift rather heavy but also do cardio for 2hrs/wk. I would never have thought that I had sleep apnea without the test as I never caught myself gasping for air. Secondly, was your T3 level tested to insure proper conversion of T4 to T3. My TSH levels were in the normal range but I found that my body wasn't converting to T3 very efficiently. I also find that zinc and magnesium seem to boost libido. You might also try a nitric oxide booster such as L-Arginine with Citrilline. DHT and DHEA levels should also be checked. Glutamine may help you your muscle soreness till you get back on track and then use post workouts. I agree with Nelson's post that you should exhaust all avenues before embarking on the TRT trail.

 

[DaveJ]

I appreciate the feedback,Hammer, and will definitely heed your (and Nelson's) thoughtful advice. My endo typically doesn't order the T3 test and I have never had DHT or DHEA levels tested. I will suggest these tests on my next visit as well as research the sleep apnea issue and NO boosters.

One additional question: my prior labs a year earlier showed total test of 476 ng/dl (compared to 430 reported above on the current labs) While I realize that there can be fluctuation in these levels, are seemingly significant decreases such as this a cause for concern even if the absolute levels are in the "normal" range? Thanks again!

 

[CoastWatcher]

Dave, I would consider the possibility of self-testing. Many of us utilize the services of the organizations that provide direct access to the major commercial labs. I have been very pleased with Discountedlabs.com (I have no affiliation with them). I find it a good investment in my own health; I can monitor my progress in real-time. It cuts down on the inevitable delays between visits with doctors.

 

[Hammer]

T levels can fluctuate significantly throughout the day. Make sure you have your blood draws done early in the morning and schedule all subsequent blood work at the same time or as close as possible. Also, differences in hormone levels are evident if your sleep or fatigue patterns the night before were different. If you perform a lot of cardio the day before your blood test, your levels could test lower. Good luck.

 

[a_crossfitter]

Dave,

Go to discountedlabs and order ANY tests you feel your Dr 'doesn't deem needed at this time'.