Lab results - opinions wanted
Hi,
I have tried to submit my lab results for the past couple of day, but keep receiving an error? So I hope its ok to submit some here as I am seeking some experienced opinions.
I am 45, have been weight training for 16yrs. Always found it difficult to add muscle mass. Was born with one testicle, but always had strong libido (two kids 4 & 2 yrs). I am nutritionist, and always into eating quality diet.
Been thinking about cycle for some time now and decided to have bloods done (thanks to this site) on my 45th b/day (I will keep trying to submit).
Everything came up well, complete blood test, liver, thyroid, glucose, PSA, CRP, VIT D, Electolytes, Iron. My hormone panel is here. My free test is really low, which was a surpise to me, as I didn't think I was experiencing any of the usual symptoms, but now that I got the results its got me thinking, I am very moody, and though my libido is reasonably healthy, it has lowered of late and I can't remember the last time I had a morning erection. And for the first time I have started to 'feel my age'...my mojo has dropped a couple of points! And maybe its been low for some time (hence the difficulty with putting on muscle)
My SHBG is high, binding a lot of my free test no doubt.
Lutropin 4.6 IU/L (1.5-9.3)
Follitropin 3.3 IU/L (1.4-18.0)
Oestradiol 118 pmol/L (<146)
Testosterone 16.3 nmol/L (8.0-26.0)
Free Testosterone 198 pmol/L (225-725)
Dihydrotestosterone 2.0 nmol/L (0.7-3.1)
SHBG 71 nmol/L (13-71)
DHEA 12.1 nmol/L (4.5-48)
At my age, there is no chance I am going to get my free test levels up to a more optimal level 500+ naturally (my diet is great, regular training, good sleep).
I am thinking of discussing TRT with my GP (although I don't think he is going to be into the idea, as he couldn't understand why I wanted by estrogen levels checked with my blood test!).
Or maybe try a basic test cycle first and see how things pan out?
Of course I would love to put on some muscle mass, which is why I wanted to try a cycle in the first place, but now with this low free test result, my first concern is to get these levels to optimal for my health.
Apologies for the long message, any thoughts greatly appreciated.
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Your total testosterone looks (Ok) but your free is definitely low. If your total testosterone was on the low side of normal (300 ng/dl or 10nmol/L) coupled with your low free testosterone it would probably be an easy sell for trt. Based on your low free testosterone you could likely get on trt if you also complain of the classic symptoms of low T (Loss of libido, poor erections, trouble concentrating etc.)
Don't deal with a GP concerning TRT. See a specialist such as a Urologist. That is probably who you will end up getting referred to anyway by your GP. Don't plan on any cycling until you have your trt dose dialed in. You will be getting fairly frequent testing to dial that number in and as was already mentioned, cycling is going to be impossible during that timeframe. And just to reiterate, it may take up to a year to get everything figured out. You will have to get those LH and FSH levels to differentiate between primary and secondary hypogonadism.
Just thinking out loud here now: since your total test is fairly normal, maybe using some proviron may be all you need to free up more test from your SHBG. If you go into see someone, I think that may be a valid question to ask.
Good luck.
thanks for the feedback. My FSH and LH levels are posted above (lutropin & follitropin)
I did think about Proviron, everything I have read about it seems to be on paper something that would help my levels. But sounds like I should take it one step at a time and get the doctors onto it.
From what I understand TRT is quite difficult to get approved in my country, but the GP is a friend of family, so I'll start with him and see where it leads. Got an appointment next Tuesday.
bhsc you DO NOT have hypogonadism with your serum testosterone levels. If it was primary(which indicates a testes problem) your LH and FSH levels would be elevated and above the reference range and your testosterone levels would be very low. If it was secondary ( which indicates a signaling problem)your LH and FSH would be normal or low but your testosterone levels would also be below the reference range or very low. You have a healthy level at 470ng/dl.(That's what your level is in US)
45 and testosterone at 470ng/ml is not bad at all. But that high 71 nmol/L SHBG is locking up and lowering your free test levels. What time did you take this test as there can be a15-20% difference in testosterone levels at your age depending of time taken. Testosterone levels are always highest from 7-10am and fall from there. Proviron at 50mgs(2x25mg) ED would lower your SHBG. Proviron (Mesterolone) has a very weak suppressive effect on gonadotropins and serum testosterone. Studies show that when given in moderate doses (150 mg per day or less),significant suppression of testosterone levels DOES NOT occur. In studies with higher doses (300 mg per day and above), the proviron strongly suppressed serum testosterone. There are several guys on this board doing Proviron 25-50mgs a day with zero suppression. I can think of one who does it yr round.That's a fact. This will also boost your libido.
http://www.ncbi.nlm.nih.gov/pubmed/6431212
http://www.ncbi.nlm.nih.gov/pubmed/420413
http://www.ncbi.nlm.nih.gov/pubmed/2892728
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2409169/?report=classic
thanks for your feedback, much appreciated. As you pointed out 45 at 470 with one testicle is not bad!
My tests were taken 9:30am.
How long would you suggest to run 50mgs (2x25) ED Proviron before having tests done again? Would this have any effect on DHT related side effects at this dose (I guess I know the answer, its an individual thing)
Since the half life of SHBG is 7 days I would run it for 3wks and retest. If you see a drop in SHBG and increase in free test then continue.The half life of proviron is 12hrs so I would do one 25mg tab twice a day. Proviron is a very mild DHT-based compound. At 50mgs a day you should not have any DHT sides such as prostrate enlargement are hair loss if that is what your asking. It is also not c17-alpha alkylated so liver toxicity is unlikely. Estrogen build up will also not be a problem. In a nut shell proviron is very mild. It will not build large muscles but it will drop those SHBG levels and increase Free test Which in turn will make you feel great. The morning wood will return.Libido will increase. It will get your mojo back.
Now I have a question, What were your Thyroid #'s. TSH level?
Thanks again Mega.
Lets say my SHBG drops and free test increases, would I have to keep on Proviron long term? Again I understand its individual, but from your experience? And once it is working, how regularly would I need to have bloods tested?
My TSH level - Thyrotropin 1.364 mU/L (0.300-4.000).
Same age and gearing up to self medicate, what country are you in?
Proviron Is not a bad idea to decrease SHBG. The problem is that it is suppressive. And it's going to bring his testosterone level even lower. Frequent dosing of testosterone will have a dramatic effect on lowering SHBG so for that reason I would recommend skipping the proviron.
What your saying about proviron being suppressive is misleading. Suppression is dose dependent. At 50mg ED which is a dose most use to lower SHBG and increase free test levels there is no suppression. Read the published med. links above. It will not lower testosterone levels at that dose or even at 75mg a day.
I always hear so many conflicting reports about provi being suppressive and not being suppressive. Bottom line is I think you are right to let the testosterone dosing take care of everything and probably just save the provi for blasting to help maximize the cycle. When I go in for my bloodwork in a couple of months I'll ask my urologist about provi. I was diagnosed with secondary hypogonadism, my SHBG is normal but I still think it would be an interesting topic to discuss with my urologist.
It will definitely be an interesting conversation with your urologist.
As far as SHBG you would be surprised how far you can suppress it with biweekly injections.
Is there a difference between weekly vs biweekly for suppression of SHBG?
Actually yes. The suppression of SHBG is more dependent on the frequency than the total amount ( WITHIN REASON)
You can have the same weekly TRT dose and based on the way that you dose it you could have Night and day differences in free testosterone. The other benefit of frequent dosing is a lower E2.
Very interesting info. So based upon this would everyday application of say Androgel have more suppression of SHBG since the frequency is everyday compared to a say a weekly IM injection?
In theory you would think so but in reality Androgel is horrible. It converts to estrogen way too much by going through the skin For it to be of any benefit in the situation. If I have to take a stab I would say that every other day would probably give the most suppression for SHBG.
You are definitely a prime candidate for TRT. But before we get into that. What are your LH and FSH?
And you should definitely sort out your health issues ( and yes low testosterone is a health issue) Before you jump on any kind of cycle. TRT is a trial and error process with bloodwork confirmation and a lot of people can take up to a year to Dial that in. Until you have It dialed in don't even think of doing a cycle. You will be asking for a whole slew of problems.
Thanks for your feedback. LH & FSH results listed above (lutropin & follitropin is what they are referred to in my country). They are in the 'normal' ranges.
Hey I am sorry I just noticed that. So you Have Primary Hypogonadism Which makes you a perfect candidate for TRT unless you want to try A restart. There's a good chance that at your age a restart would not work. So the decision is yours but you really should fix your condition. Once you figure out what direction you want to go in I'll be happy to give you my opinions on the best way about it
thanks again.
Primary hypogonadism, despite my levels being in the 'normal ranges'? FSH is on low end of normal. Obviously best to get it diagnosed, I have an appointment with GP next Tuesday.
Sorry, not familiar with what a restart is? Would really like to go to my GP loaded with as much info as possible.