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Author Topic: Low Testosterone Blood Test Results - What Should I Do?  (Read 3599 times)

yearofthehoneybee

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Low Testosterone Blood Test Results - What Should I Do?
« on: May 20, 2017, 05:59:47 pm »
I had a basic blood draw done here in Colorado through a health fair and had my testosterone tested for the first time.  Result was 238, after a little research I found this is extremely low.  As a follow-up I had a comprehensive male blood panel done through Life Extension and just got the results back.  Even worse this go round on testosterone with a result of 225.  Results pasted below.  Does this combination of results suggest anything to anyone as far as treatment or root causes?  I would like to not take medication, but from what I'm reading these results are really low and most likely the best treatment would be injecting testosterone directly?  225 pound male 38 years old, good health, no medications currently. 

Blood draw at Labcorp: 5-15-17 10:49 AM   

Testosterone, Free and Total            
Testosterone, Serum           225   ng/dL   348-1197   Low
Free Testosterone (Direct)   10.1   pg/mL   8.7-25.1   
Pregnenolone, MS                     42   ng/dL      
Dihydrotestosterone             18   ng/dL      Low
Thyroxine(T4) Free, Direct, S    1.5   ng/dL   0.82-1.77   
DHEA-Sulfate                         326.6 ug/dL   102.6-416.3   
Cortisol                                    8.2   ug/dL   6.2-19.4 - AM   
TSH                                      1.83   uIU/ml   .450-4.500   
Estradiol                                  10.9   pg/mL   7.6-42.6   
Prostate Specific Ag,, Serum   0.4   ng/mL   0.0-4.0   
Triiodothyronine, Free, Serum   3.8   pg/mL   2.0-4.4   
Sex Horm Bind Glob, Serum    22   nmol/L   16.5-55.9   

Glucose, serum                   99   mg/dL   65-99   
Uric Acid, Serum                   6.5   mg/dL   3.7-8.6   
BUN   11   mg/dL                  6-20   
Creatine, Serum                  0.7   mg/dL   .76-1.27   Low
eGFR                                  120   mL/min/1.73   >59   
Bun/Creatinine Ratio           16               9/20   
Sodium, Serum                140   mmol/L   134-144   
Potassium, Serum                 4.5   mmol/L   3.5-5.2   
Chloride, Serum                104   mmol/L   96-106   
Carbon Dioxide, Total          19   mmol/L   18-28   
Calcium, Serum                 9.8   mg/dL   8.7-10.2   
Protein, Total, Serum         7.1   g/dL   6.0-8.5   
Albumin, Serum                 4.7   g/dL   3.5-5.5   
Globulin, Total                         2.4   g/dL   1.5-4.5   
A/G Ratio   2                  1.2-2.2   
Bilirubin, Total                        0.7   mg/dL   0.0-1.2   
Alkaline Phophatase, S        43   IU/L   39-117   
            
LDH                                      156   IU/L   121-224   
AST (SGOT)                        27   IU/L   0-40   
ALT (SGPT                       41   IU/L   0-44   
Iron, Serum                      143   IU/L   38-169   
Cholesterol, Total              155   mg/dL   100-199   
Triglycerides                      210   mg/dL   0-149   High
HDL Cholesterol                43   mg/dL   >39   
VLDL Cholesterol Cal        42   mg/dL   5-40   High
LDL Cholesterol Cacl        70   mg/dL   0-99   
T. Chol/HDL Ratio               3.6              0.0-5.0   
            
Estimated CHD Risk   0.6   times avg.   0.0-1.0   
            
WBC                                      5.8   x10E3/ul   3.4-10.8   
RBC                                     5.59   x10E6/ul   4.14-5.80   
Hemoglobin                     17.3   g/dL           12.6-17.7   
Hematocrit                    49.5%                   37.5-51.0   
MCV                                       89   fL           79-97   
MCH                                      30.9   pg           26.6-33.0   
MCHC                             34.9   g/dL           31.5-35.7   
RDW                             13.8%                   12.3-15.4   
Platelets                             208   x10E3/ul   150-379   
Neutrophilis                      48%      
Lymphs                              42%      
Monocytes                        7%      
Eos                                        2%      
Basos                                1%      
Immature Cells            
Neutrophils                      2.8   x10E3/ul   1.4-7.0   
Lymphs                              2.4   x10E3/ul   0.7-3.1   
Moncytes                              0.4   x10E3/ul   0.1-0.9   
Eos                                      0.1   x10E3/ul   0.0-0.4   
Baso                              0.1   x10E3/ul   0.0-0.2   
            
Immature Granulocytes        0%      
Immature Grans (Abs)        0           x10E3/ul   0.0-0.1   
            

tenraja49

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Re: Low Testosterone Blood Test Results - What Should I Do?
« Reply #1 on: May 20, 2017, 06:13:53 pm »
With respect to testosterone I was like u about 12 years back (age 40). My total T was about 200. At that time I had sleep apnea, low energy. Then things start to improve and I did not take any TRT therapy.

Now after 12 years later I experienced brain fog, not interested in doing anything. My total T was 200 about 3 months back. Since I was low on Vit D I started taking 5000 IU/day. Now my Total T is above 250 and I feel better. Just started taking clomid (25mg). Will do another blood test for T this week.

So not sure whether you can have Total T of about 200 and still feel better.

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Re: Low Testosterone Blood Test Results - What Should I Do?
« Reply #1 on: May 20, 2017, 06:13:53 pm »


Boxcar

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Re: Low Testosterone Blood Test Results - What Should I Do?
« Reply #2 on: May 20, 2017, 06:34:16 pm »
Based on your SHBG (on the low side) you will need to inject testosterone  twice a week (maybe more, if TRT drives down your SHBG more), if you go for TRT. This therapy works pretty well for most people. Side effects are reduced fertility (possibly total loss), shrunken balls and unpleasant withdrawal if you ever stop. Taking HCG simultaneously will help mitigate these issues, by keeping your balls active. But this means more injections and expense.

Clomid is a pill that raises your natural testosterone levels. It can have estrogenic effects, so it is best to take this at the lowest possible dose. But for some guys, it works really well, and it is a simple pill.

How do you feel, any symptoms? Although your total testosterone is quite low, your free testosterone (which is what really counts) is more borderline.
« Last Edit: May 20, 2017, 06:55:50 pm by Boxcar »
Age: 36
178 lbs 5'8''

Current Treatment: 50 mg testosterone cypionate IM, twice a week
Low T Symptoms: Chronic pelvic pain, and other neuropathic pain.  Mild anxiety, low energy and low motivation
Meds: Amitriptyline (for pain, not depression), Clonidine (for sleep, not blood pressure)

yearofthehoneybee

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Re: Low Testosterone Blood Test Results - What Should I Do?
« Reply #3 on: May 20, 2017, 08:01:12 pm »
Thank you Boxcar!  I guess as far as symptoms go that's the funny thing, I feel like "myself". Thinking about it I have low energy, low ambition, low libido, brain fog, trouble concentrating, very introverted, minor anxiety at times. But the thing is, I have "always" felt that way. And have just powered through, I have a good managerial level job, family, life in general, finishing up my PhD dissertation defense next week. All this stuff is painful to get through because of the energy/brain fog, but I do it and do well. I'm 6'4" 225 so a bit overweight but don't look it too much. I've never really gotten muscular, but I am not super lanky by any means.
 
I could use more exercise, probably a little more sleep. Between the time I had the first blood test and the second I made sure to get at least 8 hours a night, rode my bike, started lifting weights (I mean, very little lifting) so was surprised my 2nd test was even worse. I eat pretty well, low carb, low sugar, lots of good fats and proteins.
 
I have a vitamin D result from the first lab from the health fair that I didn't include above: 28 on a reference range of 30-100 so low there too. A1C also, was 4.9 which is a good score.  I will look up Clomid, looks like an easy fix if it worked.  The injections are less appealing, but might be interested in taking a run at it to see what it changes in me.  I wouldn't be worried about fertility at this point, we just had our 2nd and last child so no worries there.  Wouldn't look forward to shrunken balls and withdrawal though.  Thanks again and do let me know if you think of anything else, I appreciate your ideas!

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Re: Low Testosterone Blood Test Results - What Should I Do?
« Reply #3 on: May 20, 2017, 08:01:12 pm »


ghce

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Re: Low Testosterone Blood Test Results - What Should I Do?
« Reply #4 on: May 20, 2017, 10:13:23 pm »
If you don't want to go the TRT route then you might consider supplementation, something which as my journey through low T has progressed I have gained a lot of respect for.
You might want to start taking Vit D3 5000iu, zinc 15mg, magnesium 500 mg. These 3 form the basis of my feel good supplements. In my case I noted improvements in all of the symptoms you quote.
Given your low D3 levels you are likely to see an increase in your T of potentially 30%.

From your description your weight probably is a little high and I am guessing your fat level is not helping your T levels at all, getting more lean will certainly see a marked increase in your overall T and feelings of well being.
I would explore the above and getting some better body fitness first before jumping into TRT even though TRT offers a very fast quick fix to your symptoms.
Age:60, Height 6' 3" weight 100KG
2014 Androderm Patches
2014-2016 Oral Andriol 160mg Daily
June 2016 Clomid/Serophene 12.5mg EOD
September 2016 no TRT all natural and supplements for the time being
February 2017 Testosterone cream 100mg daily

Sept 2016
Testosterone   8.2 nmol/l   9-38
Free Testosterone   239 pmol/l   L   250-800
SHBG:  14    nmol/L   9-60
Free Androgen index   586   >400
Oestradiol    112   pmol/L    <190
LH    2.6 IU/L Adult male   2 - 9 IU/L
FSH  1.4 IU/L Adult male L2 - 12 IU/L

22 November
T 6.8  nmol/L ( 9-38 ) L

March 2017
Testosterone:   45.0  nmol/L ( 9-38 ) H ( 1,323 ng/dl )
Free Testosterone:   1512  pmol/L ( 250-800 ) H
SHBG:   17  nmol/L ( 9-60 )
Plasma IGF-1:   227 ug/L ( 55-198 ) H
Plasma cortisol:   434 nmol/L ( 0600-1000 hrs 170-500 nmol/L )
HbA1c:   36 mmol/mol ( 20-40 )
LH:   <0.1 IU/L
FSH:   0.1 IU/L
DHT Plasma Dihydrotestosterone:   7455   pmol/L ( 223 ng/dl ) 
Reference Range Adult males  1000-6000 pmol/L

Cataceous

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Re: Low Testosterone Blood Test Results - What Should I Do?
« Reply #5 on: May 21, 2017, 03:00:46 am »
That estradiol is in bone-loss territory. Don't let it go indefinitely.
.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 60, Ht: 5'10", Wt: 154 lbs
Protocol: 3.2 mg TE subQ qd, 2.4 mg TP subQ qd, 20 mcg GnRH subQ 5.25x/d, 6.25 mg DHEA bid, 12.5 mg enclomiphene qod
Approximate levels (peak): TT: 700 ng/dL, E2: 30 pg/mL, DHEA-S: 300 ug/dL, SHBG: 30 nMol/L

Boxcar

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Re: Low Testosterone Blood Test Results - What Should I Do?
« Reply #6 on: May 21, 2017, 03:35:08 am »
Your vitamin  d level is not dramatically low, but supplementation could raise your testosterone. A low carb diet can lower testosterone. I would avoid sugar, but starchy carbs are good for testosterone. Olive oil (of all things) raised my testosterone. Saturated and monounsaturated fat are associated with higher testosterone. Very high protein or fiber intake might lower testosterone.

Losing fat can raise testosterone, but you would need to be obese for it to add up to a lot. And since the mechanism is lowering estrogen, your already low estradiol suggests that you would not see much (if any) change.

Also, crash dieting (with a significant caloric deficit) is a proven testosterone-killer. So slow and steady dieting is the way to go, for a guy who wants to lose weight with low T (and I am not saying that you should, I am just passing along info).
Age: 36
178 lbs 5'8''

Current Treatment: 50 mg testosterone cypionate IM, twice a week
Low T Symptoms: Chronic pelvic pain, and other neuropathic pain.  Mild anxiety, low energy and low motivation
Meds: Amitriptyline (for pain, not depression), Clonidine (for sleep, not blood pressure)

PeakT

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Re: Low Testosterone Blood Test Results - What Should I Do?
« Reply #7 on: May 21, 2017, 03:27:12 pm »
Thank you Boxcar!  I guess as far as symptoms go that's the funny thing, I feel like "myself". Thinking about it I have low energy, low ambition, low libido, brain fog, trouble concentrating, very introverted, minor anxiety at times. But the thing is, I have "always" felt that way. And have just powered through, I have a good managerial level job, family, life in general, finishing up my PhD dissertation defense next week. All this stuff is painful to get through because of the energy/brain fog, but I do it and do well. I'm 6'4" 225 so a bit overweight but don't look it too much. I've never really gotten muscular, but I am not super lanky by any means.
 
I could use more exercise, probably a little more sleep. Between the time I had the first blood test and the second I made sure to get at least 8 hours a night, rode my bike, started lifting weights (I mean, very little lifting) so was surprised my 2nd test was even worse. I eat pretty well, low carb, low sugar, lots of good fats and proteins.
 
I have a vitamin D result from the first lab from the health fair that I didn't include above: 28 on a reference range of 30-100 so low there too. A1C also, was 4.9 which is a good score.  I will look up Clomid, looks like an easy fix if it worked.  The injections are less appealing, but might be interested in taking a run at it to see what it changes in me.  I wouldn't be worried about fertility at this point, we just had our 2nd and last child so no worries there.  Wouldn't look forward to shrunken balls and withdrawal though.  Thanks again and do let me know if you think of anything else, I appreciate your ideas!

A few comments for you:

--I believe I was low testosterone my entire adult life.  Can't prove that, but I have certain lines of evidence that follow yours and I was instantly cured of serveral things that I had struggled with post puberty (mild depression, lack of morning erections) once I went on testosterone cypionate and raised my testosterone significantly.

--Here are the options out there to preserve fertility:

http://www.peaktestosterone.com/testosterone_fertility

--Here are things that can cause low testosterone:

http://www.peaktestosterone.com/Causes_Of_Low_Testosterone

--Your DHT is low which can lead to low libido, etc.

--Your estradiol is low.  This can definitely lead to bone loss.  Discuss with your doctor getting a bone scan imo.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

yearofthehoneybee

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Re: Low Testosterone Blood Test Results - What Should I Do?
« Reply #8 on: May 21, 2017, 04:10:12 pm »
Thank you all!  What a great community here!  Starting with ghce's comments: I agree on the supplementation and weight loss route.  I am starting that now.  Supplementing D3 liquid tabs, Zinc (through a multivitamin), and Magnesium via a powder drink We already have all this here, I just haven't been using it :-[.  Picking up with the working out and weightlifting as of yesterday too to take care of the easy stuff I can control.  Might as well rule these things out, and it can only help.  Keeping Boxcar's comments in mind though, no crash dieting or overdoing it with the workouts as that actually cause lower T.  I will keep up with the good eating and try to add in some olive oil.

I didn't realize the bone loss issue with Estradiol (thanks Cataceous and PeakT!).  I will have a bone density test done as it sounds like that is the easiest way to detect this?  I wasn't aware of the DHT low libido connection, I would definitely say I have low to no libido for the past year at least if not longer.

Looking at the causes of low testosterone that you linked to PeakT, I am fairly intrigued by the hemachromatosis connection.  I had some genetic testing done through 23andme several years ago and it returned that I do have genetic markers for hemachromatosis and this is something that affected my grandmother.  I have also seen in the past that my liver tests come in just slightly on the high side.  I wonder if I could be building up iron in my liver and testicles and that it may have hit a point where I have a primary failure where I'm not producing testosterone because of it.  Another anecdotal point of support for this possibility is that I usually feel awesome for the week after I donate blood.  Brain fog lifts, I feel confident and happy.  Maybe I am getting enough iron out to stimulate some natural T production during that time and need a more aggressive blood letting schedule to try to start using up some of the excess iron I am storing in my organs (this is all speculation but a possibility at least).  I am going to get an iron panel done and another testosterone with LH and FSH this time to see where this whole process is breaking down (primary or secondary failure).  It doesn't look like there is any good cause, so hopefully it's as simple as that and not a pituitary tumor or something worse. 

I need to find doctors now.  I haven't been the doctor basically ever in my adult life so will need a primary and then a good endocrinologist.  I guess going to the annual health fair for a basic blood test isn't the best medical plan.   ;D  I can bring these tests in and go from there I suppose.  Any tips on finding a good doctor?  I am guessing this is all obscure enough that the people on here probably have a better idea of what is going on then your average doctor.  Hopefully I find a good one and get this all sorted.  Thanks again everyone, do let me know if you have any other ideas or comments.  I really appreciate it.

PeakT

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Re: Low Testosterone Blood Test Results - What Should I Do?
« Reply #9 on: May 22, 2017, 04:18:35 pm »
Thank you all!  What a great community here!  Starting with ghce's comments: I agree on the supplementation and weight loss route.  I am starting that now.  Supplementing D3 liquid tabs, Zinc (through a multivitamin), and Magnesium via a powder drink We already have all this here, I just haven't been using it :-[.  Picking up with the working out and weightlifting as of yesterday too to take care of the easy stuff I can control.  Might as well rule these things out, and it can only help.  Keeping Boxcar's comments in mind though, no crash dieting or overdoing it with the workouts as that actually cause lower T.  I will keep up with the good eating and try to add in some olive oil.

I didn't realize the bone loss issue with Estradiol (thanks Cataceous and PeakT!).  I will have a bone density test done as it sounds like that is the easiest way to detect this?  I wasn't aware of the DHT low libido connection, I would definitely say I have low to no libido for the past year at least if not longer.

Looking at the causes of low testosterone that you linked to PeakT, I am fairly intrigued by the hemachromatosis connection.  I had some genetic testing done through 23andme several years ago and it returned that I do have genetic markers for hemachromatosis and this is something that affected my grandmother.  I have also seen in the past that my liver tests come in just slightly on the high side.  I wonder if I could be building up iron in my liver and testicles and that it may have hit a point where I have a primary failure where I'm not producing testosterone because of it.  Another anecdotal point of support for this possibility is that I usually feel awesome for the week after I donate blood.  Brain fog lifts, I feel confident and happy.  Maybe I am getting enough iron out to stimulate some natural T production during that time and need a more aggressive blood letting schedule to try to start using up some of the excess iron I am storing in my organs (this is all speculation but a possibility at least).  I am going to get an iron panel done and another testosterone with LH and FSH this time to see where this whole process is breaking down (primary or secondary failure).  It doesn't look like there is any good cause, so hopefully it's as simple as that and not a pituitary tumor or something worse. 

I need to find doctors now.  I haven't been the doctor basically ever in my adult life so will need a primary and then a good endocrinologist.  I guess going to the annual health fair for a basic blood test isn't the best medical plan.   ;D  I can bring these tests in and go from there I suppose.  Any tips on finding a good doctor?  I am guessing this is all obscure enough that the people on here probably have a better idea of what is going on then your average doctor.  Hopefully I find a good one and get this all sorted.  Thanks again everyone, do let me know if you have any other ideas or comments.  I really appreciate it.

Ironically, endocrinologists tend to be the most likely to give outdated protocols and testing methodologies in my opinion.  There are some good ones out there, but it's tough to find them.  Our site sponsors are excellent and fertility specialist tend to be quite knowledgeable as well.  You just have to ask around to find a physician who is passionate, knowledgeable and open-minded about men's health and hormones.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Peak Testosterone Forum

Re: Low Testosterone Blood Test Results - What Should I Do?
« Reply #9 on: May 22, 2017, 04:18:35 pm »