question from a user
55 year old male. 170 lbs, decent shape. Have been experiencing some anxiety/low mood and low energy for last year for first time. Been checked medically and done lots of labs. Libido ok and no ED. Been suggested that I should try TRT for energy and well being . Curious if you think based on my recent labs, if it would help. Also curious if I do, should I start something to regulate E2 from the start? My measurements Albumin 4.5 g/dl SHBG 60.3 nmol/L Testosterone 648 ng/dl Estradiol: 22.3 Calculated Free Testosterone 9.29 ng/dl Bioavailable Testosterone 227 ng/dl
AlphaMD's Answer
From your lab results alone with no other information or context, we'd say you look to be not immediately primary or secondary hypogonadal.
Taking into account your age & symptoms, it does sounds like you could be relative hypogonadal. The reason being for all relative patients, regardless of your current "okay" T levels numerically, they were clearly higher in the past because all T levels drop over time with age. Since you've had an onset for a set period of time & sofar nothing has improved it, it's probably your levels have reached a point where you can feel the difference now.
The reason why you may have many normal low Testosterone symptoms & have no libido or ED issues is that those are more impacted by DHT. With the amount of T you have, you may have a fine amount of DHT for your needs in that department.
Relative hypogonadal patients are harder to diagnosis, but we do work with them frequently. You should just expect a slightly higher starting T dose than someone who has numerically lower numbers, but you still deserve treatment if you have symptoms.
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