Results of Bloodwork - Help Me Make Sense of Them

[Evilwhitey]

I'm 38yo, married, 4 kids, workout hard 6+ hours a week (weights & HIIT) with another 10+ hrs of activity (hiking, mnt biking, backpacking, etc). 5'6" 169lbs, 21% BF.

I could eat better but for the most part I eat fairly clean, avoiding processed carbs, eat plenty of beef/chicken/eggs, and protein shakes. I had my T tested in 2014 and it was 205 but I declined going on TRT and tried to clean up my life and do what I could to get levels up naturally.

Exercise and diet can and will improve. Sleep is bad, I just don't sleep well, probably averaging 5hrs a night but low quality. I have a sleep study ordered and suspect they will tell me I have sleep apnea. Most days I feel exhausted, and wake up feeling worse than when I went to sleep. I can't remember the last time I felt rested and full of energy. In general I feel fatigued, have suffered weight gain despite efforts to eat clean and exercise.

I just received the following labwork which still shows low T, but I'm trying to figure out the rest of the results and decide how to proceed.


Albumin 4.5 (3.5-5.2)

Sex Hormone Binding Globulin 19 (13-71)

Testosterone 307 (was 205 in 2014) (240-871)

Testosterone Free % 2.3 (1.1-2.7)

Testosterone Bioavailable 198.5 (115-407)

Testosterone Free 71.2 (37-147)

Chol/HDL 5.9 (<4.5)

Total Chol 219 (138-199)

HDL Chol 37 (40-63)

LDL Chol 165 (<100)

Non HDL Chol 182 (<130)

Triglycerides 84 (54-149)

VLDL 17 (11-29)

Hemoglobin AC1 5

Ferritin 378 (37-400)

Hct 45.4 (41-53)

Hemoglobin 16.2 (13.5-17.5)

Thyroid Stimulating Hormone with Reflex Free T4 1.68 (.52-6.25)

Luteinizing Hormone 1.9 (.6-12.1)

Vitamin D 50 (30-80)


Thoughts?

 

[Vince]

Your testosterone is low, getting good sleep does help. Have you tried low-dose melatonin? Since you're getting labs, make sure you get a complete thyroid panel just to check it at least once. Thyroid panel, TSH, FT4, FT3 reverse T3 and antibodies.

 

[Matt Leiser]

Your testosterone is low, getting good sleep does help. Have you tried low-dose melatonin? Since you're getting labs, make sure you get a complete thyroid panel just to check it at least once. Thyroid panel, TSH, FT4, FT3 reverse T3 and antibodies.

agree with Vince. Grab the thyroid tests. Hopefully you are also getting sensitive estradiol, serum iron and ferritin.

 

[CoastWatcher]

Would you provide reference ranges for all of your labs? Every lab establishes their own, and if we have the ranges to guide the discussion we can frequently understand some of the decisions you and your doctor will be called upon to make.

 

[Evilwhitey]

Would you provide reference ranges for all of your labs? Every lab establishes their own, and if we have the ranges to guide the discussion we can frequently understand some of the decisions you and your doctor will be called upon to make.

Updated everything that I've received back so far.

Thoughts?



Albumin 4.5 (3.5-5.2)

Sex Hormone Binding Globulin 19 (13-71)

Testosterone 307 (was 205 in 2014) (240-871)

Testosterone Free % 2.3 (1.1-2.7)

Testosterone Bioavailable 198.5 (115-407)

Testosterone Free 71.2 (37-147)

Chol/HDL 5.9 (<4.5)

Total Chol 219 (138-199)

HDL Chol 37 (40-63)

LDL Chol 165 (<100)

Non HDL Chol 182 (<130)

Triglycerides 84 (54-149)

VLDL 17 (11-29)

Hemoglobin AC1 5

Ferritin 378 (37-400)

Hct 45.4 (41-53)

Hemoglobin 16.2 (13.5-17.5)

Thyroid Stimulating Hormone with Reflex Free T4 1.68 (.52-6.25)

Luteinizing Hormone 1.9 (.6-12.1)

Vitamin D 50 (30-80)

 

[Evilwhitey]

Thoughts? Just curious how to proceed.

 

[Fizzypopcorn]

Thoughts? Just curious how to proceed.

i know the focus is on testosterone, however, has your cholesterol always been elevated? Your height/weight/bf% isn’t alarming but, the cholesterol is up. I know mine is partly due to genetics also partly to me currently being a fat a$$. Working hard on that which led me to get some bloodwork done. Posted them on here and was told to check thyroid, went for more tests and they came back kinda funky from what I can see (like an elevated free t3 serum from which what I’ve read could indicate a slow metabolism and possibly thyroid issues). My sleep sucks like yours. That always jacks stuff up too.

With all all of that being said, your testosterone numbers are fairly low and the weight gain with you working out as much as you are is a sign of something happening (or not happening) if your first isn’t too crazy. Who is ordering the tests for you and evaluating the results?

 

[CoastWatcher]

Updated everything that I've received back so far.

Thoughts?



Albumin 4.5 (3.5-5.2)

Sex Hormone Binding Globulin 19 (13-71)

Testosterone 307 (was 205 in 2014) (240-871)

Testosterone Free % 2.3 (1.1-2.7)

Testosterone Bioavailable 198.5 (115-407)

Testosterone Free 71.2 (37-147)

Chol/HDL 5.9 (<4.5)

Total Chol 219 (138-199)

HDL Chol 37 (40-63)

LDL Chol 165 (<100)

Non HDL Chol 182 (<130)

Triglycerides 84 (54-149)

VLDL 17 (11-29)

Hemoglobin AC1 5

Ferritin 378 (37-400)

Hct 45.4 (41-53)

Hemoglobin 16.2 (13.5-17.5)

Thyroid Stimulating Hormone with Reflex Free T4 1.68 (.52-6.25)

Luteinizing Hormone 1.9 (.6-12.1)

Vitamin D 50 (30-80)

You clearly are hypogonadal. All your androgen markers are low, as is your SHBG. Is TRT something you are considering? Wary of? Puzzled by? You certainly need to address the sleep apnea concerns before beginning a protocol, and it would be wise to pull a full thyroid picture, ft3, ft4, rt3, along with the four-point salviary cortisol test. If TRT becomes likely your PSA, DHT and DHEA should be captured.

 

[Kirk001]

Your lipids don't look too good, despite you having a pretty good diet / activity level. Improving T levels should help there. Looks to me like possible secondary hypogonadism... your LH is quite low. Your testicles aren't making enough T because the pituitary signal for them to make some (LH) is weak. Sure couldn't hurt to look into the possibility of sleep apnea... but you may also need hormone treatment. If you are secondary and you want more kids, you might start out with clomiphene instead of TRT. I hated it, but apparently it does work for some guys.

 

[Evilwhitey]

Your lipids don't look too good, despite you having a pretty good diet / activity level. Improving T levels should help there. Looks to me like possible secondary hypogonadism... your LH is quite low. Your testicles aren't making enough T because the pituitary signal for them to make some (LH) is weak. Sure couldn't hurt to look into the possibility of sleep apnea... but you may also need hormone treatment. If you are secondary and you want more kids, you might start out with clomiphene instead of TRT. I hated it, but apparently it does work for some guys.

I'm 38yo and have a 5yo, 4yo, 3yo and one due in December. I'm 100% ok with nuking the shit out of my reproductive capabilities and will be getting snipped and my wife will be getting her tubes tied. We're ridiculously fertile which is strange considering my health.

Both sides of my family have terrible lipids, everyone is obese, diabetes is common, low muscle mass, dementia starting in 60s, etc. Even my family members that are active like me and try to eat well look like shit and have poor health. I hate blaming it on genes, but after a ton of research, I've come to the conclusion I have shitty genes.

One exception to the shitty genes, nobody on either side of my family has had cancer and that family history goes back several generations.

 

[Evilwhitey]

You clearly are hypogonadal. All your androgen markers are low, as is your SHBG. Is TRT something you are considering? Wary of? Puzzled by? You certainly need to address the sleep apnea concerns before beginning a protocol, and it would be wise to pull a full thyroid picture, ft3, ft4, rt3, along with the four-point salviary cortisol test. If TRT becomes likely your PSA, DHT and DHEA should be captured.

Yes, TRT is absolutely on the table. I just want to make sure I'm educated and doing everything I can first before taking the plunge.

I'm still learning and if I do take the plunge want to make sure I'm on an appropriate protocol and the hassle, expense, dedication, etc is worth it and safe.

 

[Systemlord]

That's not terribly low, I'm @16-18 on any given day and I respond strongly to TRT injecting EOD. Low SHBG isn't a death sentence, diabetes and fat around the midsection can lower SHBG. My SHBG dropped from 18 to 16 because my A1C worsened.

You can turn this around.

 

[Evilwhitey]

That's not terribly low, I'm @16-18 on any given day and I respond strongly to TRT injecting EOD. Low SHBG isn't a death sentence, diabetes and fat around the midsection can lower SHBG. My SHBG dropped from 18 to 16 because my A1C worsened.

You can turn this around.

Thanks for the encouragement!

My family history has diabetes and while not technically pre-diabetic, I show all the symptoms of it and metabolic/insulin issues.

I'm assuming if I go on TRT and start an aggressive protocol of EOD but lean out and my health improves (hopefully my sleep will be dialed soon), that my SHBG could potentially rise and I could change the protocol to twice a week or less?

 

[Evilwhitey]

i know the focus is on testosterone, however, has your cholesterol always been elevated? Your height/weight/bf% isn't alarming but, the cholesterol is up. I know mine is partly due to genetics also partly to me currently being a fat a$$. Working hard on that which led me to get some bloodwork done. Posted them on here and was told to check thyroid, went for more tests and they came back kinda funky from what I can see (like an elevated free t3 serum from which what I've read could indicate a slow metabolism and possibly thyroid issues). My sleep sucks like yours. That always jacks stuff up too.

With all all of that being said, your testosterone numbers are fairly low and the weight gain with you working out as much as you are is a sign of something happening (or not happening) if your first isn't too crazy. Who is ordering the tests for you and evaluating the results?

The weight gain despite being fairly active, the low energy, the fatigue, the brain fog, etc has been what motivated me to see my family Dr. who ordered the labs and is looking at them. I'm holding off going to an endo until the sleep study is done and I have labwork done a few months after that.

I figure I'll do 100% of what's in may capacity and then evaluate from there. I suspect that my T-levels will at best increase just enough to not feel like garbage 24/7 but not enough to live the way I am used to/want to.

I have a long family history of terrible lipid profiles.

 

[Systemlord]

Thanks for the encouragement!

My family history has diabetes and while not technically pre-diabetic, I show all the symptoms of it and metabolic/insulin issues.

I'm assuming if I go on TRT and start an aggressive protocol of EOD but lean out and my health improves (hopefully my sleep will be dialed soon), that my SHBG could potentially rise and I could change the protocol to twice a week or less?

My father held off diabetes until age 80, that's when his physical activity faded. I suspect his low testosterone is to blame for his diabetes, as it is to blame for my diabetes. I wasn't a diabetic before my testosterone crash after withdrawing off Klonopin almost 3 years ago. Once you restore your hormones to youthful levels, your body will be more efficient in everything it does. When we are low in hormone we are like a broken violin, nothing works the way it's supposed to.

Your sleep should also improve, that's a testosterone killer.

 

[Kirk001]

My family history has diabetes and while not technically pre-diabetic, I show all the symptoms of it and metabolic/insulin issues.

Look into metformin... many benefits.

https://www.excelmale.com/forum/showthread.php?12305&p=84830#post84830

 

[Omar]

The weight gain despite being fairly active, the low energy, the fatigue, the brain fog, etc has been what motivated me to see my family Dr. who ordered the labs and is looking at them. I'm holding off going to an endo until the sleep study is done and I have labwork done a few months after that.
same reason i started trt was tired of feeling like sh!t im still trying to get my protocol dialed in after more then 2 years on trt

 

[Evilwhitey]

Same reason i started trt was tired of feeling like sh!t im still trying to get my protocol dialed in after more then 2 years on trt

How have your first two year been? Feeling better?

 

[Omar]

How have your first two year been? Feeling better?

Sry I couldn’t respond sooner something was going on with the website & wouldn’t let me reply.
But I feel way better now don’t feel like crying anymore whenever I see a puppy lol but I kno something still isn’t dialed in yet because my libido is still pretty bad

 

[GeauxBears]

Really encourage you to get that sleep study done and report back here with results. Sleep apnea can kill testosterone levels and libido as well. Please let us know!