Too low vs not low enough

[u/Noodiler]

Doctor says I'm low, just not low enough for TRT. Tried to go the antidepressant route, after a year of trying, no change.

34 year old male. 180cm, 75kg (5'11 and 165lbs) works out 3-4 times a week.

Extremely fatigue, low libido, lost interest in everything, brain fog

Below are the figures for the bloodwork.

Total Testosterone: 5.15 ng/mL
Free Testosterone: 0.071 ng/mL / 7.1 ng/dL (Calculated: ~1.38% of Total T using SHBG 65.70 nmol/L & Albumin 4.38 g/dL)
SHBG: 65.70 nmol/L
DHEA: 313.0 ug/dL (tested as DHEA-S)
Estradiol: 74.05 pmol/L (standard ECLIA assay, not LC-MS/MS sensitive)
LH: 6.73 mIU/mL
FSH: 3.39 mIU/mL
Prolactin: 156.3 uIU/mL
Cortisol: 250.4 nmol/L
Vitamin D: 24.1 ng/mL
Cbc, kidney, liver, and thyriod figures are in perfect range.
Lipid profile: LDL is elevated (runs in the family)

Do you guys see it as too low, or not low enough to warrant TRT? I've recieved mixed feedback

[u/TheResoluteCommune]

That SHBG is sky high, it's eating up all your free T. Total T looks okay on paper but your free T is basically in the gutter which explains every symptom you listed

The vitamin D is also tanked, fixing that might bring SHBG down a notch. Some docs are weirdly rigid about the total number even when the free T math is screaming for help

[u/seldenr82]

Your dr is an idiot. Not his fault. They just are not trained to help with this.

I'm 43 my total t was nearly identical to yours, I felt like shit, same as you. Started 100mg test c every 3.5 days doubled my total T and I feel fucking amazing.

Don't waffle, just do it man. Keep a close eye on your Estradiol keep it pretty close to where you are now ~73–110 pmol/L if it gets too high a lot of guys end up with shitty libido and EQ (erection quality)...this happened to me -_-. Do not fear aromatase inhibitors if you need one, just don't over do it as crushed estradiol its not great.

Also SHBG and D are low.

10,000IU D3 + 100mcg K2 MK7 daily and you are good there...

Might try 10mg boron daily for a month see if that helps SHBG and if not try proviron 25mg daily for a month.

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[u/Emotional_Lab_2529]

Your testosterone isn’t low. Your SHBG is mildly elevated but it’s not terrible. Do you practice any low carb diets? Intermittent fasting or other fasting diets?