Patient's Query
Hi doctor,
I am a 28 year old male. My height is 5’10”, and weight is 280 lbs. Yes, I know that I am overweight and I am addressing the issue. I recently performed some blood work on myself, so I could have a baseline as I have started a new ketogenic diet. Before 15 days, I ordered a CBC with differential, TSH, lipids panel, CMP, and A1c. The results are as follows (please note that the number in parentheses are the reference range from the laboratory). Hemoglobin A1c - 5.3 (4.8-5.6), TSH - 2.070 (0.450 - 4.500), serum testosterone - 239 (348 - 1197), CBC normal, SED rate - 3 (0-15), Cholesterol total - 214 (100-199), triglycerides - 126 (0-149), HDL - 36 (>39), VLDL - 25 (5-40), LDL - 153 (0-99), CMP normal and serum glucose - 90 (65-99). After I had got these results, I noticed the testosterone was low. I do not have any trouble with erections, though I am not sexually active.
I decided to order additional tests, and the results are as follows. Free testosterone - 11.8 (9.3 - 26.5), total estrogen - 88 (40 - 115) and SHBG - 14.1 (16.5 - 55.9). As you can see, my free testosterone is borderline while my SHBG and serum testosterone are all low. My question is besides losing weight, what can I do to naturally and more efficiently to increase my testosterone? Also, are these results indicative of anything more severe?Thank you for your help. I look forward to reading your answer. It is also important to note that I am not concerned about the lipids as I have reviewed research showing that those on a ketogenic diet can have an initial spike in cholesterol, though long term results outweigh the short term spike.
Hi,
Welcome to icliniq.com.
I have reviewed your reports.
Your free testosterone is on the lower side and lipids are not much abnormal. Your problem is excessive fat in the body that converts testosterone to estrogen. You also may have fatty liver causing low SHBG (sex hormone-binding globulin). You may do an ultrasound of liver to see if it is fatty or not. The course of action for you is to lose weight by exercise, not vigorous but moderate. The activities like walking, cycling, and swimming are the best to reduce weight. Please do not take any nutritional supplements to increase testosterone.
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Answered byDr. Purushottam Sah
Medically reviewed byiCliniq medical review team
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