Can You Help Interpret My Blood Serum Tests?

Hi Wray,

Wondering if you can help me out. My latest blood serum testing came back as follows:

Estradiol - 52 pg/mL
Estrone - 32 pg/mL
(Range: Premenopausal 15 - 350 pg/mL)

Progesterone - 29.5 ng/mL
(Range: Luteal Phase 3.3 - 25.6 ng/mL)

Testosterone Free - .3 ng/dL
(Range: .3 - 1.9 ng/dL)

Testosterone Total - 20 ng/dL
(Range: 8 - 60 ng/dL)

DHEA-S - 150 mcg/dL
(Range: 18 - 244 mcg/dL)

Vitamin D level in the 60's (ng/mL)

I currently am on prescription bioidentical progesterone and the smallest amount of bioidentical estradiol gel available (so the ranges above take this into account).

The problem is my low testosterone. I have had it tested a few times in the past and it has always been on the low end. I have ZERO libido. I work out and still can't lose a layer of fat around my waist (everywhere else I am in great shape and have muscles - it is just in my stomach area). My bioidentical specialist suggested some compounded bioidentical testosterone cream to help with losing the body fat and increasing my sex drive. She does not want me to increase progesterone at this time (as she feels my level is where it needs to be). She really doesn't want to increase estradiol since I am feeling pretty good for the most part on the lowest dose. She thinks my testosterone could afford to be a little higher and this is what my body may be missing. She is happy with my Vitamin D3 levels (I supplement 5,000 iu daily).

Can I have your thoughts on this and what you think about my ratios overall? Do you think I would be a viable candidate for a trial of bioidentical testosterone (I believe she suggested a dosage of 2mg daily of the cream)?

Any comments are appreciated. Thank you Wray!

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Oct 10, 2013
Can You Help Interpret My Blood Serum Tests?
by: Wray

Hi there Your P:E2 ratio is good at 537:1. Your free testosterone to total testosterone is also good, it's 1.5%, it should be anywhere between 1-4%. Your testosterone is still within range, and not that low. The jury is still out on whether testosterone increases Libido. Dopamine is usually the driver of this. Yours could be low, or your Prolactin high, this inhibits dopamine. Interesting you have a layer of fat around your waist, this is usually caused by excess testosterone, see here and here. To my mind your vitamin D could be higher, in the 70-100ng/ml range. Vitamin D is also essential for a good libido, so too is progesterone. So it would be up to you if you wanted to try the testosterone. Although I would first look at dopamine. The precursor to this is tyrosine, you could try taking some and see if it helps. Take care Wray

Oct 31, 2013
One More Question, Wray
by: Anonymous

Hi Wray!

I am now wondering if this fat layer around my stomach may be due to insulin resistance. I had some more blood work done by my other physican who is a regular general internist (not my bioidentical doctor who just concentrates on my hormones). She ran a comprehensive blood panel and I noticed that my glucose was 98 mg/dL (range of 74 - 106). Even though I fall in a normal range, this scared me because doesn't this mean I am headed toward a prediabetic level? I try to eat clean but I do have some carbs/sugars (frozen berries, apples) and I also eat flourless (Ezekiel) bread as well as whole grain pasta, beans, nuts and seeds. I also drink whey protein shakes with almond milk. Would foods like that cause my glucose to go high? Should I give up the fruit? It's very hard for me because I do not eat alot of meat (no cow, no fish and no pig, but organic chicken once in a blue moon).

Would you be concerned about the 98 mg/dL for a fasting glucose number? Are there supplements I can use to try to make that number better (I do take many supplements, one of them being chromium picolinate, which I think is supposed to help with glucose insulin issues). Probably a vegetarian diet is not the best for someone with insulin resistance because I am not getting enough lean protein?? I've been so focused on my estrogen, progesterone and testosterone numbers but now I am wondering since those ratios are pretty good, maybe if I get my glucose down there's a chance the little layer of fat around my waist will disappear.

Thanks for your help.

Nov 04, 2013
One More Question, Wray
by: Wray

Hi there You could have Insulin Resistance, that does cause weight gain. The page gives a list of nutrients which help reverse it. We do have a page on Hormone Testing you could look through. It’s best if fasting glucose is <100mg/dL, so you are borderline high. All those carbs you eat can easily cause glucose to rise. Ezekiel bread is made from wheat, albeit sprouted, but it’s still wheat like any other bread. So is the pasta, beans are high in carbs, some nuts are high like cashews. So your diet is taylor made to increase your blood glucose. Please see what Dr Hyman has to say about wheat and sugars. I became a vegetarian for four years, and put on weight. I wasn’t getting enough protein, it comes bound with too many starchy carbs. Take care Wray

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