low testosterone

Hi all,

I am looking for advice. I am 32. At a recent annual physical, I asked my dr. to check my testosterone level as part of my blood work, mostly out of curiosity, but also because I have trouble building muscle mass and strength despite putting in my time at the gym. Other than that, I have no other common low t symptoms. I have a great sex drive, no problem getting an erection, plenty of energy, have had 2 children recently (so am fertile),in good physical shape etc. My first test came back at 168. He did 1 more and it came back at 160. I was referred to an endo, who did a more detailed work up and came back with the following:

TESTOSTERONE, FREE AND - 01/24/13
Results:
- TESTOSTERONE, TOTAL, LC/MS/MS: 180 Low
- FREE TESTOSTERONE: 43.7
THYROID STIMULATING HORMONE (TSH) - 01/24/13
Result:
- THYROID STIMULATING HORMONE: 2.6 Normal
SEX HORMONE BINDING GLOBULIN - 01/24/13
Result:
- SEX HORMONE BINDING GLOBULIN: 16
FOLLICLE-STIMULATING HORMONE (FSH) - 01/24/13
Result:
- FSH, SERUM: 1.9 Normal
PROLACTIN - 01/24/13
Result:
- PROLACTIN: 7 Normal
RENAL FUNCTION PANEL - 01/24/13
Results:
- SODIUM: 143 Normal
- POTASSIUM: 4.6 Normal
- CHLORIDE: 100 Normal
- CARBON DIOXIDE: 29 Normal
- GLUCOSE: 103 High
- BUN: 20 Normal
- CREATININE: 1.1 Normal
- BUN/CREATININE RATIO: 18 Normal
- GFR ESTIMATED (CKD-EPI): 89 Normal
- CALCIUM: 10.4 Normal
- PHOSPHORUS: 3.5 Normal
- ALBUMIN: 5.4 High
LUTEINIZING HORMONE (LH) - 01/24/13
Result:
- LUTEINIZING HORMONE SERUM: 1.6 Normal
T4 FREE - 01/24/13
Result:
- T4 FREE: 1.37 Normal

The endo also sent me for an MRI, which came back with nothing. He said that he has run out of options for finding the root cause and that I just have low t. He prescribed me androgel, which I started last week. I am on no other meds or supplements.

My questions are:
Any ideas what could be causing this?
If I have no major symptoms, do I need to be on androgel?
Any other tests I should have done?

[Dr. Kokil Mathur]

Hi!
After going through the lab list, the only associated factor which I can identify is high blood glucose and low total testosterone. It is very common for men with diabetes to have low free or total testosterone and vice versa. Hence, a complete diabetes profile should be done: fasting blood sugar, post prandial blood sugar (two hour after meal) and glucose tolerance test (GTT), and tests for insulin resistance. Please discuss with your endocrine specialist. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.