TST blood test results

[Pablo]

Hello everone. I’m new here and I found that forum after looking for some info about TRT.

As I have a low libido and quite a problem with sleeping, so I decided to check testosterone and I done some blood tests.

PSA (prostatic specific antigen)

PSA Total 0.58 ng/Ml (0-4)

PSA Free 0.17 ng/ml (0-0.5)

PSA Ratio (free/total) 0.293


LH (Luteinising hormone)

LH 2.09 mlU/ml (0.57-12.07)

Testosterone

Total Testosterone 7.3 nmol/L (1.63-34.0)

SHGB 16 (low) mol/L (17.1-77.6)

Free Androgen Index 45.63 (20.4-81.2)

Free Testosterone 3.99 (low) pg/mL (4.81-22.42)



FSH (Follicle stimulating hormone)

FSH 3.17 mlU/ml 0.95-11.95


Prolactin

Prolactin 147.8 mlU/L (72.66-407.4)


can someone help me to analyze those results? Do you thing TRT would be good for my case? If so what protocol can you recommend?

 

[Systemlord]

Total Testosterone 7.3 nmol/L (1.63-34.0)

Free Androgen Index 45.63 (20.4-81.2)

Free Testosterone 3.99 (low) pg/mL (4.81-22.42)

It's not even a close call, these are disease state levels and further health problems await you if nothing is done to treat these results.

There's no standardization for hormone testing as far as reference ranges go, every lab range are vastly different, on one lab you are in range while at another lab you are below ranges.

TRT is typically offered to patients <300 or 12 nmol/L. That's not to say that someone can't experience low-T above these levels.

If so what protocol can you recommend?

A big or even moderate TRT dosage can and likely will hammer your low SHBG levels even lower, therefore small frequent dosing may be best.

Twice weekly shots at a minimum, more frequent dosing may be necessary. Nobody can tell you what's going to work best for you.

Also because of the low SHBG you may not need higher than midrange T levels to have adequate Free T.

As I have a low libido and quite a problem with sleeping

Too little or too much T can negatively impact libido.

Low-T can cause poor sleep, so fix that.

 

[Systemlord]

SHGB 16 (low) mol/L (17.1-77.6)

The low SHBG can be genetic, diabetes and/or thyroid related.

 

[Pablo]

Thank you for very informative answer.
Regarding SHBG, do I understand correctly that with low SHBG level not so much testosterone would bound to it, so the rest will be available for an organism as free testosterone.

Is low SHBG a bad thing than?

I did a comprehensive blood test last April and that included thyroid. It was fine with TSH on 3.65 mlU/L level.

 

[Pablo]

Doc (urologist) prescribed me Longjack (Tongcat Ali) for 3 months and eventually implement THT if there would be no improvement.

I wonder if herbs can increase level of testosterone to the normal level, as mine as quite low.

maybe I should find another doc…

 

[Systemlord]

I did a comprehensive blood test last April and that included thyroid. It was fine with TSH on 3.65 mlU/L level.

By comprehensive testing, you mean your doctor tested the Free T4 and Free T3, the latter being the active thyroid hormone?

TSH stimulates the thyroid gland, it's not a thyroid hormone. The T4, Free T4 and Free T3 are thyroid hormones.

 

[Systemlord]

I wonder if herbs can increase level of testosterone to the normal level, as mine as quite low.

It's very unlikely you would succeed at increasing your testosterone to a meaningful degree to where you don't need TRT.

With these testosterone levels you're in a diseased state backed up by your low LH.

 

[JA Battle]

That tsh is not anywhere near ideal. Thyroid is your first bet. I would get more thorough thyroid labs. Tsh, free t3, free t4, reverse t3, antibodies, also total t3 & t4.

Also it is important to get your estradiol tested. You need the sensitive assay, LC/ms

Low thyroid causes all of the problems your experiencing

 

[Pablo]

Based on your input I decided to find a better doctor, who instead of herbal treatment would at least check my thyroid.

 

[Pablo]

Doctor Herb repeated results and when saw that 10% (7.8 nmol/L 225 ng/dL) vs 211 initially announced success and recommend to continue to use Longjack (Tongcat Ali) .. I won’t see it again.

In the same time I started to talk to more competent doctor - endocrinologist from Cleveland clinic. After MRI, thyroid tests and other hormones check I started TRT.

1,000 mg of T undecanoate - Nebido, once per 2-3 months depends on the blood results.

 

[Systemlord]

Doctor Herb repeated results and when saw that 10% (7.8 nmol/L 225 ng/dL) vs 211 initially announced success and recommend to continue to use Longjack (Tongcat Ali) .. I won’t see it again.

Sorry but the slight increase can be explained as a natural daily fluctuation.

Here's a doctor getting an F in how the endcrine system functions.

 

[Systemlord]

1,000 mg of T undecanoate - Nebido, once per 2-3 months depends on the blood results.

Nebido has a low rate of success among men.

 

[Pablo]

Sorry but the slight increase can be explained as a natural daily fluctuation.

Here's a doctor getting an F in how the endcrine system functions.

You are absolutely right, that’s the reason why I won’t see him again and I have changed a doctor already.

Nebido has a low rate of success among men.

Can you please elaborate? Do you have some links/papers?

 

[Vince]

Shorter interval between testosterone undecanoate doses may boost levels in hypogonadism

Testosterone undecanoate injected at 8-week intervals for men with hypogonadism may reduce fluctuations and increase mean testosterone levels compared with a 10-week dose regimen, according to data from a modeling study. “The currently approved 10-week dose regimen of testosterone undecanoate...

www.healio.com

 

[Pablo]

Thank you for sharing the link. It explains that 8-week regimen is better compared with a 10-week regimen. However it says nothing that it has “low success rate” as mentioned in one of the previous post.

 

[Systemlord]

Can you please elaborate? Do you have some links/papers?

However it says nothing that it has “low success rate” as mentioned in one of the previous post.

It's common knowledge for anyone in the TRT world that nebido is the worst option out there for TRT, dozens of experiences from members and word of mouth by the doctors themselves.

Nebido regularly gets trashed on Youtube by leading world renowned TRT doctors.

Younger men have large fluctuations in testosterone, the longer esters such as Nebido create a flat hormone profile that more closely looks like a hormone profile of an old man which is very little difference in morning and evening testosterone levels.

This is thought to be the reason for is the efficiency rating of Nebido being lower than anything else out there.

The shorter esters are much preferred, such a cypionate which has a 5-7 days half-life, Nebido is more like 30 days.

 

[madman]

Hello everone. I’m new here and I found that forum after looking for some info about TRT.

As I have a low libido and quite a problem with sleeping, so I decided to check testosterone and I done some blood tests.

PSA (prostatic specific antigen)

PSA Total 0.58 ng/Ml (0-4)

PSA Free 0.17 ng/ml (0-0.5)

PSA Ratio (free/total) 0.293


LH (Luteinising hormone)

LH 2.09 mlU/ml (0.57-12.07)

Testosterone

Total Testosterone 7.3 nmol/L (1.63-34.0)

SHGB 16 (low) mol/L (17.1-77.6)

Free Androgen Index 45.63 (20.4-81.2)

Free Testosterone 3.99 (low) pg/mL (4.81-22.42)



FSH (Follicle stimulating hormone)

FSH 3.17 mlU/ml 0.95-11.95


Prolactin

Prolactin 147.8 mlU/L (72.66-407.4)


can someone help me to analyze those results? Do you thing TRT would be good for my case? If so what protocol can you recommend?

Although TT is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.

Highly doubtful your FT was even tested using an accurate assay.

The FAI let alone direct immunoassay should not be used.

FAI is considered overly simplistic and inaccurate when it comes to measuring free testosterone concentrations.

The piss poor direct analog immunoassay provides inaccurate estimates of FT and experts recommend against its use for measuring free testosterone.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as Equilibrium Dialysis or Ultrafiltration (next best) performed under standardized conditions.

Even then in your case, you would not even need to post your FT level let alone SHBG as it would be a given that your FT would be absurdly low with a horribly low TT 7.3 nmol/L (210 ng/dL).

Definitely not healthy running around with a horribly low TT/FT level.

 

[madman]

It's not even a close call, these are disease state levels and further health problems await you if nothing is done to treat these results.

There's no standardization for hormone testing as far as reference ranges go, every lab range are vastly different, on one lab you are in range while at another lab you are below ranges.

TRT is typically offered to patients <300 or 12 nmol/L. That's not to say that someone can't experience low-T above these levels.


A big or even moderate TRT dosage can and likely will hammer your low SHBG levels even lower, therefore small frequent dosing may be best.

Twice weekly shots at a minimum, more frequent dosing may be necessary. Nobody can tell you what's going to work best for you.

Also because of the low SHBG you may not need higher than midrange T levels to have adequate Free T.


Too little or too much T can negatively impact libido.

Low-T can cause poor sleep, so fix that.

Come again?

5 years in!

Are those gootube/bro forums you waste your time on still polluting your mind?

Total Testosterone anyone!

*These reference values can be used for all testosterone assays and laboratories that are certified by the CDC’s hormone standardization program for testosterone

The same will be said for Free Testosterone soon enough!

CDC STANDARDIZED TOTAL T and ESTRADIOL ASSAYS and soon to be FREE TESTOSTERONE!

Measurement of Free Testosterone in Serum Using Equilibrium Dialysis Coupled With ID-UHPLC-MS/MS: Comparison Between Equilibrium Devices (2021) Hui Zhou, Ph.D., Ashley Ribera, BS, Amonae Dabbs-Brown, BS, Uliana Danilenko, Ph.D., Hubert W. Vesper, Ph.D. Centers for Disease Control and...

www.excelmale.com

Harmonized reference ranges for Total and Free T levels

Accurate Measurement and Harmonized Reference Ranges for Total and Free Testosterone Levels (2022) Ravi Jasuja, Ph.D., Karol M. Pencina, Ph.D., Liming Peng, MSc, Shalender Bhasin, MB, BS* INTRODUCTION A central tenet of endocrinology is that the hormones secreted by the endocrine glands...

www.excelmale.com

Testosterone Deficiency in Men

Optimizing Diagnostic Accuracy and Treatment Decisions in Men With Testosterone Deficiency (2021) Shalender Bhasin, MB, BS *, Noelle Ozimek, MSc Abstract Objective: This narrative review offers a guideline-based approach for optimizing diagnostic evaluation and treatment decision-making in...

www.excelmale.com

*A harmonized reference range for total testosterone was generated based on analyses of data from 4 cohorts of community-dwelling men in the United States and Europe.44 The assays used in these 4 cohorts were cross-calibrated against a higher-order method by the CDC, and the values from each cohort were harmonized to the CDC-standardized measurements using Deming regression. The harmonized reference range for the total testosterone concentration in healthy non-obese men, aged 19 to 39 years, was 264 to 916 ng/dL using the 2.5th and 97.5th percentiles and 303 to 852 ng/dL using the 5th and 95th percentiles44; the age-specific 2.5th, 5th, 95th, and 97.5th percentile reference values are shown in Table 2.

*These reference values can be used for all testosterone assays and laboratories that are certified by the CDC’s hormone standardization program for testosterone

*The lack of standardization of the equilibrium dialysis procedures for the measurement of free testosterone has retarded efforts at generating harmonized reference ranges.35

*A reference range for free testosterone, using an ensemble allostery method that was validated against the equilibrium dialysis method using data from the Framingham Heart Study and the European Male Aging Study, has been published.36

 

[Pablo]

Nebido regularly gets trashed on Youtube by leading world renowned TRT doctors.

Younger men have large fluctuations in testosterone, the longer esters such as Nebido create a flat hormone profile that more closely looks like a hormone profile of an old man which is very little difference in morning and evening testosterone levels.

I found only that “review”, but as in comparison to different materials in which there were very elaborative, they just said “I hate, it’s crap”.
No justification whatsoever.

Neither some medical docs, nor patients reviews (e.g. in Reddit) are so strong with that opinion. What I see majority is saying it works for them.

I’m new hear I want to know and understand and chose the best option for me. You mentioned about large fluctuations, which my doctor mentioned as possible side effect comparing to differnt esters and injections once per 2 weeks (another option given to me).

Let’s assume I would not have dips … what is wrong with Nebido ?

 

[Pablo]

Even then in your case, you would not even need to post your FT level let alone SHBG as it would be a given that your FT would be absurdly low with a horribly low TT 7.3 nmol/L (210 ng/dL).

Definitely not healthy running around with a horribly low TT/FT level.

I posted FT in the initial message

Total Testosterone 7.3 nmol/L (1.63-34.0)
SHGB 16 (low) mol/L (17.1-77.6)
Free Androgen Index 45.63 (20.4-81.2)
Free Testosterone 3.99 (low) pg/mL (4.81-22.42)

Later on FT has been confirmed low with LC/MS-MA method, which seems be accurate.