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What Questions Should I Ask My Doctor About Testosterone Levels

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  • What Questions Should I Ask My Doctor About Testosterone Levels

    After my bloodwork from this year's physical, I have the note "Your free testosterone is low. If you think you wouild benefit from testosterone supplementation, please come in to discuss."

    Testosterone,Free+Weakly Bound 01 Jul 2013 05:45 AM
    - Testost., % Free+Weakly Bound: 7.5 % Reference Range: 9.0-46.0 Flag: L
    - Testosterone, Serum: 843 ng/dl Reference Range: 348-1197
    - Testost., F+W Bound: 63.2 ng/dl Reference Range: 40.0-250.0

    If anyone here has had similar results, could you share what you may have done to improve the numbers and what sorts of questions might be good to ask the GP.

    I'm a 45yo male, eat pretty strict paleo, CrossFit 3 times a week, lost 140 pounds in 2009/2010

    He also notes "Your cholesterol (LDL) has gone higher this year. You may want to ake a look at your diet to see could be improved." but I'm really not worried by the LDL numbers:

    VAP Cholesterol Profile 01 Jul 2013 05:45 AM

    - HDL-3 (Less Protective): 42 mg/dl Reference Range: >30

    - HDL-2 (Most Protective): 16 mg/dl Reference Range: >10

    - Cholesterol, Total: 235 mg/dl Reference Range: <200 Flag: H

    - LDL Cholesterol: 164 mg/dl Reference Range: <130 Flag: H

    - HDL Cholesterol: 58 mg/dl Reference Range: >=40

    - Lp(a) Cholesterol: 10.0 mg/dl Reference Range: <10 Flag: H

    - IDL Cholesterol: 11 mg/dl Reference Range: <20

    - LDL Density Pattern: A Reference Range: A

    - VLDL-3 (Small Remnant): 8 mg/dl Reference Range: <10

    - Triglycerides: 61 mg/dl Reference Range: <150

    - VLDL Cholesterol: 13 mg/dl Reference Range: <30

    - Non HDL Chol. (LDL+VLDL): 177 mg/dl Reference Range: <160 Flag: H

    - Probable Metabolic Syndrome: No Reference Range: No

    - Remnant Lipo. (IDL+VLDL3): 19 mg/dl Reference Range: <30

    - LDL1 Pattern A: 23.9 mg/dl

    - LDL2 Pattern A: 64.2 mg/dl

    - LDL3 Pattern B: 49.5 mg/dl

    - LDL4 Pattern B: 5.3 mg/dl

    - apoB100-calc: 114 mg/dl Reference Range: <109 Flag: H

    - LDL-R (Real)-C: 143 mg/dl Reference Range: <100 Flag: H
    Apathy is tyranny's greatest ally.

  • #2
    Well, it is my (limited) understanding that free test is the amount circulating and actually available at any given time and that total test is the amount that is potentially available. And that one of the potential problems is an excess of sex hormone binding globulin which locks up the total test, preventing it from circulating.

    As for treatments, anecdotally it looks like stinging nettles may lower shbg as well as there are prescription drugs that do the same. Though it may not be a problem if you are comfy with how much muscle you are putting on, staying lean and satisfied with performance in the bedroom. Did you by chance have any other sex hormone testing done?

    As a side note, that is a pretty impressive total test number (imho).
    turquoisepassion - I MUST KNOW ALL THE THINGS


    • #3
      You need a bioavailable testosterone and e2 (estradiol) test, at a minimum, before proceeding. Based on your high total T, you are not hypogonadal. Likely you are all good, perhaps ideal. How do you feel?


      • #4
        Thanks, I'll ask him about those tests. I'm not as lean as I'd like, and I could crush my WoDs more ... mainly my concern is getting lean enough to not have man boobs anymore, truth be told. I wanted to know if low T could contribute to that. Considering I topped the scales at over 320 for a while, I'm not sure what level of leanness is even possible.
        Apathy is tyranny's greatest ally.


        • #5
          Originally posted by KestrelSF View Post
          After my bloodwork from this year's physical, I have the note "Your free testosterone is low. If you think you wouild benefit from testosterone supplementation, please come in to discuss."
          Who wrote the note, and on what basis would they expect you to have any idea whether you would benefit? It sounds like a drug advertisement where they tell you to "ask your doctor" whether some drug is right for you without telling you what it is intended to treat.


          • #6
            Do you feel like you need testosterone? What would low T 'feel' like?
            Age 48
            Start date: 7-5-12
            GOAL: to live to be a healthy and active 100

            "In health there is freedom. Health is the first of all liberties."
            Henri Frederic Amiel


            • #7
              He put me on Testralin and liquid liposomal DHEA so lets see if that helps. I'm not feeling all that bad, it's probably more about I'm 45 and doing 3-4 CrossFit WoDs a week and its using up a bit of testosterone
              Apathy is tyranny's greatest ally.


              • #8
                looking at testosterone without looking at the rest of the hormone chain is like looking at a headache without an MRI. All you can do there is treat the symptoms.

                steroid hormone basics by jonathan

                the body makes one hormone that gets split three ways ( body, mind, spirit, damn that trinity again)
                Stress, Sex, Energy

                Cortisol, DHEA, progesterone

                if you want to know really know what is going on make certain you test

                DHT - is your body binding an overload?.
                Estrogens - is your body converting it to girly hormones
                DHEA - are you actually making any sex hormones at all
                Pregnenolone - are you making enough mother hormone
                Cortisol - is your stress curve correct or skewed
                Progesterone - does your body have what it needs to process rhythms and power consumption

                if you dont know where your first 4 are you cant know why your last 3 are out of whack
                Optimum Health powered by Actualized Self-Knowledge.

                Predator not Prey
                Paleo Ketogenic Lifestyle

                CW 315 | SW 506
                Current Jeans 46 | Starting Jeans 66

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                • #9
                  I am a physician, so I will give this my 2c:

                  The lipid side looks pretty good, overall. Your HDL and Pattern A are both strong, and the pattern B is very good. A lot of pattern B is being implicated a lot recently as the true driver of LDL's overall bad reputation. Also, I am a big hater on trigly numbers and I love any 2 digit number. This is my big indicator on whether there is metabolic syndrome going on.

                  As for as the T numbers, your overall production is not low so much as you are not converting enough of it, in all probability. There are a lot of endocrinologists that have a strong dislike of "bioavailability" measurements, because they feel that it will nearly always give an artificially high number. In other words, they have had highly symptomatic patients that show "all good" on that measure. I am in ophthalmology (eyes), so it's not my area per se. You can ask your PCP, and if I were you, I would request a consult to an endocrinologist. I deal with a lot of severe diabetics, and some of the endocrine people I refer to get very testy about a pt's PCP advising on hormone therapies.

                  In short, get an endo consult, ask about more testing after you have adjusted to the supplementation, and keep it up with the diet.
                  "The soul that does not attempt flight; does not notice its chains."