Welcome all,

I am 42 yr. old and here are my results. Please review and give advice.

Testosterone 10.6 nmol/L
SHGB 14 nmol/L
Free Andgrogen Index 75.7%
Calculated Free Testosterone 0.31 nmol/L**

Adult Male Testosterone SHGB FAI Calculated Free T
8.0-30.0 10-45 30-120 0.20-0.60 **

** Note : The Free Testosterone calculation assumes a serum/plasma albumin value of 44g/L. The reference interval i provisional.



DHEAS 5.2umol/L 2.5-13.0


The Thyroid Function Test

Free T4- 14.9 pmol/L (9.0-25.0)
TSH 1.55 mIU/L (0.50-5.00)
Free T3- 5.2 pmol/L (3.5-6.5)

This is something I read on Androgen Australia Web site about blood tests:


Blood tests

If the physical examination suggests that there may be testicular problems, androgen deficiency can be confirmed by measuring the amount of testosterone in the blood.

When testosterone is released into the blood stream from the testes, only 2% of it is free to act on various parts of the body. The rest of the testosterone is attached to carrier proteins in the blood.

The most important of these carrier proteins is called ‘sex-hormone binding globulin’ (SHBG) and the other is albumin. The amount of total testosterone (free testosterone, plus SHBG-bound testosterone, plus albumin bound testosterone) is usually used as the measure of the level of testosterone in the blood stream as it is difficult to estimate the amount of free testosterone. Mathematical calculations have been used to calculate the amount of this free testosterone.

Some laboratories use another indirect method of measuring free testosterone by measuring the free androgen index - FAI index (testosterone: SHBG ratio). Unfortunately this method is not scientifically valid and does not relate well to direct calculations of free testosterone in men and should NOT be used as a diagnostic test in males when testing for androgen deficiency.

When the diagnosis is not clear, your doctor may refer you to a clinical endocrinologist or specialist with experience in the diagnosis of androgen deficiency.

Should I have any more tests for T?

Your test results confirm your T level is too low. I assume you have symptoms of low T? The next step would be to run the following tests all at the same time and BEFORE you take any T replacement: total T, LH, FSH, prolactin, estradiol, total estrogen. These tests will help determine if you have primary hypogonadism (where the testicles can not make enough T) or secondary hypogonadism (where the brain fails to send enough LH telling the testicles to make more T). Most likely based on your age you have secondary. At that point if the other tests above do not show why you would need an MRI of the pituitary to rule out a pituitary adenoma and blood iron tests to rule out hemochromatosis.

Your thyroid numbers look fine. Your free T is low but that is no surprise since your total T is low also.

The best course to take for treatment will depend on the results of the above testing. I suggest you get the book The Testosterone Syndrome by Eugene Shippen. It's a little out of date but will still teach you a lot.

I do have some symptoms like sweating, low energy, mood changes, poor sleep quality or insomia which fits the low T, but sex drive is fine.
What is correct level of T at my age? SHGB is on the low side which is good.
Had MRI/MRA head and neck scan with contrast few days ago (tinnitus complaints) will find out results FRI. Would the see Pituitary Andenoma without looking for it?

One study I saw that had 148 men in your age category (40-44) said the mean was 20.7 nmol/l with a standard deviation of 6.7.

They would not likely see a pituitary adenoma without looking for it because they tend to be very small which can also make them very difficult to remove. They may be able to see it if you take the MRI to a neurologist however when you get an MRI of the pituitary it is probably going to have some images just of the pituitary which are larger. Maybe yours will have that anyway, I don't know.

You could also ask now that the radiologist look for that in the MRI I suppose if it's possible to do that in Australia.

Can I ask what they were looking for re the tinitis? I have this too but have never bothered to look into it.

Also, I agree you should keep an eye on insulin resistance since your SHBG is pretty low. Your thryoid numbers were good so that is not the issue most likely. Are your triglycerides high by any chance? These seem to go together. Watch your blood glucose level.

MRI/MRA/MRV scan is fine" no evidence of vascular malformation or vascular neoplasm to account for the current symptoms. Ventricular calibre is satisfactory. There is no focal cerebral lesion"
They were looking for acoustic neuroma in inner ear or any blood vessel disorders etc. While I was there today to pick up the scan I mentioned low T blood result and asked about pituitary gland, and he said it looks normal on the scan . I suffer from pulsatile tinnitus for few years now. Had many various tests, different specialist, and they got no idea whats causing this.
Glucose tolerance test and insuline resistance are normal had this tested three weeks ago.
Triglycerides are slightly up.