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20 Y/O. Bloodwork. Need Advice


#1

Greetings. I am 20 year old male (6 foot tall, 155 lbs) who has been experiencing wide variety of symptoms during the past few years. I have here some lab results that I’d like to hear some thoughts on.

I had low testosterone (300 ng/dl) on my lab test when I was around 18 y/o, I was offered TRT trial but only took 3 shots and quit due to side effects. That was dumb thing to do at all with one reading but didn’t know any better back then, just wanted my issues solved as fast as possible. I also tried some small dose arimidex for couple of months some months after my initial TRT trial but after coming off of it, my symptoms worsened.

Right now my symptoms are occasional night sweats, cold hands and feet, lack of libido, nipple itching w/ what I assume is mild gyno, fatigue, severe brainfog, scalp itching with some hairloss (this started after I ceased the arimidex), intolerance to any kind of stress, any small stressful things cause bad adrenaline type of rush in my body. My skin, especially on upper body feels hot/warm almost all the time.

I’ve been to doctor, right now I have prescription for Tamoxifen for the nipple itching/mild gyno, haven’t taken it yet. During my recent lab results my E2 was actually on the low side(4 months ago it was on the higher end??), also my DHT levels seem low, can low DHT cause gyno?

Here are my latest lab results, taken 8AM.

Fasting glucose 6.0 mmol/l (4-6) [?]
C-Reactive protein, sensitive: <0.12 mg/l (<5.00)

Potassium: 4.0 mmol/l (3.6-5.0)
Calcium: 2.40 mmol/l (2.15-2.51)
Magnesium: 0.97 mmol/l (0.71-0.94) HIGH

Total testosterone: 19.7 nmol/l (10-38)
SHBG: 31 nmol/l (14-69)
Calc. free. testosterone: 315 pmol/l (155-800)

Estradiol, E2: 0.04 nmol/l (<0.15) [this was 0.14 4 months ago. In other units my E2 right now is ~11 pg/ml when it was 38 pg/ml 4 months ago, wtf?]
DHT: 1.00 nmol/l (1.03-2.92) [Is my DHT low?]

Cortisol: 546 nmol/l (138-690)
ACTH: 56 ng/l (<45) HIGH

Any thoughts on these results? Seems really weird.

Below are my labs from just 4 months ago.

Glucose: 6 mmol/l (4-6) [?]
Homocysteine: 8.8 umol/l (5-15)
ALAT: 18 U/l (<50)
ASAT: 31 U/l (15-45)

Hemoglobin: 160 g/l (134-167)
Platelets: 149 (150-360) [this was the highest my platelets has been in the tests, lowest has been around 120]

Total Cholesterol: 6.7 mmol/l (<5.0) HIGH
HDL: 2.4 mmol/l (>1.0)
LDL: 3.9 mmol/l (<3.0) HIGH
Triglycerides: 0.89 mmol/l (<2)

LH: 3.54 IU/l (1.5-9.3)
SHBG: 42 nmol/l (17-66)
Total Testosterone: 20.2 nmol/l
Calculated free test: 286 pmol/l (155-800)

E2: 0.14 nmol/l (<0.15)
Prolactin: 177 mIU/l (53-360)
Progesterone: 2.59 nmol/l (<4.11)

TSH: 1.25 mIU/l (0.4-4.00)
fT4: 15.19 pmol/l (10-21)
fT3: 6.14 pmol/l (3.5-6.5)

Ferritin: 33 ug/l (30-400)
IGF-1: 36 nmol/l (14-70)


#2

All of that labwork was done fasting?

Thyroid: TSH and fT4 are OK, fT3 is oddly high.
Please evaluate overall thyroid function via last paragraph below.

Do you feel cold easily?
Are outer eyebrows sparse?
Generalized hair thinning can be a thyroid issue.
Dry skin?

Stress reactions: Please discuss how stress has shaped and punctuated your life story.

Gyno: I have seen E2 labs messed up before. So sometimes you have to suspect the lab results when they do not make any sense, but which one to suspect?

Tamoxifen/Nolvadex: Often prescribed doses are too high. 20mg every other day [EOD] can be enough. This will also increase LH/FSH and that can increase T, FT and E2 as FT–>E2. Yes, it will increase E2 and can be in a big way if dose is too high for you. Only way to reduce FT–>E2 aromatization is with an aromatase inhibitor [AI]. You should do these labs later to see what nolvadex is doing: TT, FT, E2, LH, FSH.

ATCH: Were you freaking out a bit for the blood draw?

RBC?
Hematocrit?

Ferritin is very low and can affect thyroid fT4–>fT3 conversion.
Is your diet strange?
Men are good at hording iron which makes this odd.
Any digestive issues or food sensitivities?

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.