Blood Test Results for Testosterone Levels

My second visit to the clinic was on another Friday, a week after my first visit. It was at this appointment I would go over my lab results with the doctor and get recommendations (if any) for a course of treatment.

I'd done plenty of research in the meantime on testosterone and testosterone levels, so I had a preconception going in. From my research, it seemed that "normal" testosterone levels encompassed a pretty wide range. It was commonly accepted that testosterone declined as one aged, and that your age influenced your levels, in that a 20-year old should have higher levels than a 40-year old.

A "soft" lower limit to serum testosterone of 300 ng/dL was mentioned in more than one place.

The blood test was for a full panel, the most pertinent of course (in this case) are the testosterone (both serum and free), my LH (luteinizing hormone) and FSH (follicle stimulating hormone) and IGF-1 (insulin-like growth factor 1) and a bunch of other stuff I'm not going to cover.

First up the testosterone:

Test	Result	Reference
Serum Testosterone	239 ng/dL	348 - 1197
Free Testosterone	8.0 pg/mL	6.8 - 21.5

I was surprised at the results. As I mentioned, I kind of considered the whole TRT replacement/anti-aging clinic thing to be sort of a wink-wink-nudge-nudge-here's-your-prescription-steroids sort of thing. They had hinted that even if my testosterone levels came back in the "normal" range, if I was experiencing the mere symptoms of low testosterone, I would still be a candidate for therapy. I read that as: pay the money, get the goods.

But surprise, surprise, my serum testosterone was actually low. Considerably low in fact, being more than 100 points under the bottom of the "normal" range, a range not established by the clinic whose job it was to sell testosterone, but by the medical society at large. Ditto for my free testosterone, which, while not under the bottom of normal, was pretty close to it.

Wow.

Given my lifestyle of exercise and healthy eating, I was shocked. I mean, I honestly never expected my testosterone to be actually be low. I maintained a muscular appearance, I picked up heavy things and put them down, and although my recovery time was longer and gaining strength and mass (without fat to go along with it) was tough, I figured that was the normal price of being 47 years old.

To see that low number staring right at me was a harsh and tangible confirmation of my physical decline and ultimate mortality.

Ouch.

While I wrapped my head around that realization, the doc went on to talk about some of the other results:

Test	Result	Reference
IGF-1:	146 ng/dL	59 - 201
Estradiol:	7.4 pg/mL	7.6 - 42.6
Total Estrogens:	62 pg/mL	40 - 115
LH (luteinizing hormone):	2.2 mIU/mL	1.7 - 8.6
FSH:	2.8 mIU/mL	1.5 - 12.4

No issues with IGF-1, so I've got that going for me, which is nice....

My estradiol was low, probably as counterpoint to my testosterone being low, as they tend to be somewhat synched. Higher testosterone = higher estradiol. It's this increase that, for stronger androgens like steroids, makes Post Cycle Therapy a good idea.

'Cause it works like this: you take steroids, the steroids artificially raise your testosterone, your body reacts by 1) reducing its natural production of testosterone (because it sees there's plenty) and 2) increasing estradiol (to balance out what it sees as higher testosterone). Then,  when you stop taking the steroids, your testosterone drops rapidly (as your body isn't producing as much, or any, and your no longer artificially raising it) leaving you with excess estradiol.

It takes your body a while to realize this and get everything in balance again. Too much estradiol and not enough testosterone and suddenly your nipples get puffy and aching and maybe even leaking fluid. Welcome to gynecomastia my swole friend.

In any case, mine being low isn't an issue since my test is low too. One potential long term effect of low estradiol could be reduced bone density (osteoporosis). Hopefully all the weight training I do keeps my bone density up.

My LH (luteinizing hormone) is in the normal range. I'm giving a very top level summary here, but LH is released by the pituitary to stimulate the testes to produce testosterone. Low LH can be another effect of steroid use, as in your pituitary won't be making it if it sees enough testosterone there already. My LH being normal could be seen as anecdotal evidence that everything is working as it should and I just have naturally low test.

FSH (follicle stimulating hormone) luteinizing hormone (LH) act together reproduction, so it's also involved in the process your body uses to decide if it needs to make more testosterone. It's particularly related to telling your testes to make sperm.

So there you have. According to widely accepted standards, I have medically low testosterone, and the clinic was going to help me do something about it.