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24 Year Old: Labs, Symptoms, etc. [Updated]


Hey guys, I've finally discovered this forum and am hopeful some of you can give me a hand with my current situation. I've been feeling fairly shitty the past two years, or so (details in the Symptoms section), and am really trying to get my act together to figure out what is going on with me. I've tried to be as thorough as I can in detailing my general info/symptoms/lab work, but if anything else is warranted please let me know.

Age: 24
Height/Weightt: 6' and 215lbs
Waist: 35 inches (around belly button)

Facial/Body Hair: Lebanese ancestry, so thick rug on chest, arms, legs; face doesn't fill in completely (not quite thick enough to grow beard/moustache) and cheeks are patchy at best.
Male Pattern Hair Loss: no

Fat gain: diet dependent, but I have noticed a tendency to pack it on more easily than I used to.
Fat storage: stomach, buttocks primarily
Gyno: no

Morning Temperature: hovers around 96.1 degrees, ranging from 95.9 - 96.3. Increases to around 98 as the day goes on.

-Don't typically feel cold when it isn't warranted (though I hadn't really thought about it until recently, and it IS the winter so who knows).
-No real "changes" in how I deal with stress (i.e., I don't feel particularly beat up or weak at the end of a stressful day).
-I drink a lot of coffee (around a pot a day). It is usually very tough to get going without it (despite sleeping 8 - 10 hours per night).
-Oftentimes, it is tough getting going in the morning and I crash in the early evening (making gym consistency difficult as that is when I am best able to go). I usually get my second wind after a few hours and occasionally this carries into the night - making it difficult to fall asleep.
-No unusual cravings for sugar, salt.
-Nails and hair are not brittle.
-No pain or aching in testes.
-No history of steroid use (including Deca)
-No history of stimulant use outside of coffee and the occasional Adderall for studying (not my prescription)

-Low sex drive. I fit the description of looking at beautiful women as "works of art" as opposed to objects of lust.
-Inconsistent and soft erections. If I hold off for a day or two I can get a decent one going, but once it's over I'm pretty toast for the next day or so. They also don't tend to pop up or stick around without manual stimulation (goodbye HS days of pleasantly uncomfortable, bumpy bus rides)
-No morning wood/nighttime erections (that I'm aware of - never woken suddenly to one)
-Not really "depressed", but I do not get excited easily and can't really remember the last time I was genuinely optimistic/enthusiastic about something (though that's not to say I am never in a good mood - I just haven't felt the far end of the positive emotional spectrum in some time). I'm not really â??sadâ??, just typically emotionally flat lined, more or less.
-Lacking motivation to work out; lack of "general" motivation
-Trouble falling asleep and waking up
-Social withdrawal (I WANT to be able to go out, but whenever I actually do it seems I can hardly wait to just get it over with)
-Overly lethargic without a caffeine boost despite sleeping 8 - 10 hours per night.

It all seemed to start with erection issues (prompted by a shitty relationship). At first, I assumed it was in my head and that it would resolve itself; however, it didn't seem to for months. Saw my doc who "confirmed" my suspicion that it was a psychological issue and suggested I just relax over it (admittedly, probably not the worst advice for a 20-something, but in retrospect I wish I was more assertive/he was more thorough; but then, I wasn't exactly enthusiastic over discussing the issue). He offered me a prescription for Viagra to help me through it but I declined.

Over time, the listed symptoms manifested themselves until I woke up one day and said to myself, "Shit, I gotta get this figured out."

While I wouldn't have a problem seeing a professional on this matter, I am aiming to hopefully get some valuable input from the respected forumites here; I'd rather not fly blind into a doctor's office given some of the things I have read on this forum. So, for at least a preliminary inspection, I am hopeful that some here can point to any potential issues indicated by the lab work and my symptoms so I can do more than just nod my head robotically if I see a professional. I am in the process of educating myself on the topics addressed in this forum, but it seems a pretty overwhelming task at the moment and for now I'd rather defer to the forum experts than jump to conclusions on my own.


Blood Test Results

Miscellaneous - while there were a lot more things tested, I decided to only include those either outside of the normal ranges or things I feel might be relevant (so as not to turn this into a novel including normal levels of albumin, GGT, BUN, etc)... of course, I am no expert and can post the tests in their entirety if necessary.

Glucose, Serum: 90mg/dL [65-99] -> included only because it's a little higher than I would like.
Chloride, Serum: 96mmol/L [97-108] [b]LOW[/b]
Iron, Serum: 217ug/dL [40-155] [b]HIGH[/b]

The serum iron value was surprising, as I do not take any supplements that include iron. Plugging my typical daily diet into FitDay shows an estimated 23mg of iron (287% RDA) per day. Curious as to the implications of this and am amenable to dietary changes if necessary.

Cholesterol, Total: 170mg/dL [100-199]
Triglycerides: 108mg/dL [0-149]
HDL: 47mg/dL [>39]
T. Chol/HDL Ratio: 3.6 ratio units [0.0-5.0]
LDL Cholesterol Calc: 101mg/dL 0-99 HIGH -> though not entirely surprising as I am bulking and my diet isn't always as clean as I'd like
Estimated CHD Risk: 0.6 times avg. [0.0-1.0]

->As far as glucose/cholesterol is concerned, I am bulking so occasionally my calories need to come from wherever I can get them as opposed to more healthful choices. I'll quit the soda and fast food intake, perhaps throw in some cardio I've admittedly been slacking on, and see how those numbers change in a few months.

Vitamin B12: 1310pg/mL [211-946] [b]HIGH[/b]
Folate (Folic Acid), Serum: 15.3ng/mL [>3.0]
Ferritin, Serum: 135ng/mL [30-400]

Testosterone, Serum: 566ng/dL [280-800]
Free Testosterone(Direct): 22.8pg/mL [9.3-26.5]
Estradiol: 39.4pg/mL [7.6-42.6] [b]HIGH[/b]
DHEA-Sulfate: 200.1ug/dL [211.0-492.0] [b]LOW[/b]
LH: 3.1mIU/mL [1.7-8.6]
FSH: 1.7 mIU/mL [1.5-12.4]
Prolactin: 12.1ng/mL [4.0-15.2]
Progesterone: 0.6ng/mL [0.2-1.4]

Vitamin D, 25-Hydroxy: 70.5ng/mL [32.0-100.0]

TSH: 6.910uIU/mL [0.450-4.500] [b]WTF HIGH[/b]
[i]A follow-up blood test conducted about a week later showed the following:[/i]

TSH: 4.120uIU/mL [0.450-4.500] [b]maybe the initial value was a lab error?[/b]
Thyroxine (T4): 7.1ug/Dl [4.5-12.0]
T4,Free(Direct): 1.61ng/dL [0.82-1.77]
Triiodothyronine,Free,Serum: 3.5pg/mL [2.0-4.4]

FWIW, first lab test was taken about an hour after I woke up (and ~12 hours fasted); the second was after maybe three hours (without fasting).


Current Supplement List (brand omitted out of respect for T-Nation)
-Two-Per-Day multivitamin
-Vitamin D3 with Sea-Iodine, 5,000 IU (provides 1mg of iodine per serving)
-Super Omega-3 EPA/DHA with Sesame Lignans & Olive Fruit Extract
-Mega Green Tea Extract (Lightly Caffeinated)
-Optimized Resveratrol with Synergistic Grape-Berry Actives
-Protein powder


Your body temps and TSH suggest a functional hypothyroidism and your fT4, fT3 labs contradict this. There is a possibility that you have elevated rT3 which is depressing body temp. You also have to determine that the thermometer is accurate, perhaps someone else can get a 89.6 reading.

Your TSH and fT3, fT4 also seem to be in conflict.

rT3 can a result of low cortisol, which can be low for a variety of reasons, one extreme diet/starvation.

Your TT, FT levels are not horrible. FT is never conclusive. FSH indicates secondary hypogonadism. Again, your labs are a bit perplexing.

Start taking DHEA, 25 or 50mg per day.

What is your hematocrit level?

Do you use iodized salt?

Is your thyroid gland normal size, symetrical and free of lumps?


Thanks for chiming in, KSman. I was hoping to hear from you about this.

The thermometer I'm using is digital (most sites I've read state that a traditional glass mercury one is better, but I had already purchased the digital one). It was brand new when I started using it, making it about a week old now, but I will check to see what it reads for a few of my family members.

Hematocrit is 49.0% [36.0-50.0].

Have never done an extreme diet/starvation.

I typically never add salt to anything; however, my D3 supplement (taken daily) provides 1mg of iodine (I tried posting my supplement list earlier as I figured you'd ask this, but I guess one of the mods didn't approve).

The rest of my stash includes fish oil, a two-per-day multi, resveratrol, ZMA and green tea extract.

As far as I can tell. I paid out of pocket for these tests (LabCorp via LEF), so there was no physical exam by a professional. But, I am not sporting an abnormally sized thyroid as far as I can tell.


I'll purchase some DHEA to see if I can improve those numbers. The LEF Disease Prevention and Treatment book (which I finally found a use for) considers the optimal range to be 400 - 560 ug/dL ... do you feel this is the ballpark I should be shooting for?

Also, should I look into lowering my estradiol levels? While it is "in range" (barely) as far as the listed values are concerned, it is still higher than I see recommended around this forum. Supplemental DHEA might adversely affect this level, too, right?


LEF DHEA ranges might be idea from some points of view, but I expect that they were not looking at the big picture and how some will get increased E2. You seem to have the game figured out.

Lowering E2 should be your priority. Given your T levels, you can start with 1.0mg/week in EOD dosing. You can test E2 with LEF. Then adjust dose to get near E2=22pg/ml. This make make big improvements. Yes, DHEA may shift things.

If you take 1.0mg/week anastrozole and you end up with E2=27, the new dose will be 1.0 * 27/22 = simple.

test rT3, something is wrong

1mg iodine would be more than enough

what does LEF mean by "natural iodine" - I do not know. A mineral is a mineral.


Sounds like a plan. How long would you recommend waiting before retesting DHEA-S/E2 levels? LEF recommends 3-6 weeks for DHEA (haven't seen anything for E2 retesting just yet). Since (I believe) using anastrozole should adjust E2 levels quicker than DHEA supplementation will affect DHEA-S, I'm thinking maybe 3-4 weeks from starting the therapy? I can always tweak the anastrazole if I crash from the initial dosage.

Or maybe just get them tested separately, if that would be better - the drive to LabCorp isn't all that bad and the phlebotomist is a nice lady.

I'll get rT3 tested with those.

As far as LEF's 'natural iodine': it looks like they are just playing up the fact that they derive the iodine from several "natural" sources (two types of Kelp and two types of algae). I guess a mineral is a mineral only when you aren't marketing a mineral supplement.

I'm heading home tonight so I will edit this post later with an update on my thermometer.

Thanks, again.


Thermometer works fine - at least, both of my brothers scored at around 98.6 while I was at 97.8 for the evening.

DHEA is arriving today and the anastrozole should be here tomorrow or Thursday.

I will most likely be making an appointment with an endo in the near future. It never hurts to have a second set of eyes on my thyroid and it certainly doesn't hurt that my insurance will cover any further testing I need done (I'm already ~700 in the hole for the initial labs and supplements and at this point). If I'm lucky, he/she will agree that my E2 is higher than optimal and will monitor that and DHEA-S for me, as well, but even at worst I can still attempt to snag a little more thyroid work out of the deal.

Not much more I can do for now other than start my self-medication, continue educating myself and wait for further tests.


You're a bright guy and I'm happy to see you around these parts, sir. Plus you're from Mass, so I figure you must be at least a bit of a Bruins fan.


Thanks, man. I guess that finding this sort of stuff interesting helps with the fact I need to deal with it and, hopefully, keeps me from coming off as an idiot.

Gotta tell ya, though - more of a Celtics fan, myself, but I root for the Bruins on general principle.


(fairly long) Update

Over the past two months I have been working to get my DHEA and E2 to favorable ranges, starting off my 'treatment' with 25mg DHEA QD and 1mg/week anastrozole. While the anastrozole was originally every other day, I split the dosage further and moved it to every day as I (mentally) preferred that type of routine.

After one month, I tested DHEA and E2 via LabCorp:

Results - 1/24/11
DHEA-S: 268.6ug/dL [211.0-492.0]
Estradiol: 20.7pg/mL [7.6-42.6]

So, after one month of the initial dosages, my values were being normalized. I wanted to bump up my DHEA dosage further, so I decided not to tweak my anastrozole dosage per KSman's formula (wasn't going to sweat a 1.3pg/mL difference right away and figured the planned bump in DHEA might boost it a tad anyhow).

Note that despite the (positive) changes in these hormones, there were no changes in any of the symptoms listed in my OP.

Keeping my anastrozole dosage the same, I increased my DHEA to 50mg QD. After a week or so, no changes in symptoms were forthcoming. It was around this time I was browsing Dr. Crisler's forum and read one poster mention he didn't feel anything from 'normal' dosages, but felt a glow similar to hCg at around 100mg. While I don't know how hCg feeels, I was at the point where I didn't want to wait another few months tapering upwards 25mg/day trying to find a 'sweet spot'. Thinking I'd take a shortcut and bump to 100mg/day and decrease if there were any adverse effects, I increased my DHEA dosage an additional 50mg.

One month later, I got some more labs:

Results - 3/09/11
DHEA-S: 898.5ug/dL [211.0-492.0] [b]Quite high[/b]
Estradiol: 23.9pg/mL [7.6-42.6]

25mg increased DHEA-S levels by only 68.6, so this reading was quite a surprise for me. However, it should be noted that several days after starting 100mg DHEA supplementation, my morning fatigue just... went away. Just like that, I was clear headed when waking up in the morning after 8 hours of sleep - whereas I used to be such a zombie after 10+ hours that not even an entire pot of coffee could get me going. Since then I not only do not have a problem waking up in the morning, I also do not need to drink coffee for a boost (though I still have a cup or two since I like the taste). I fear I may have actually become a "morning person".

A slight boost in my general mood and libido was also noted, though the latter may very well be what caused the former. I am also not crashing later in the evening.

While I consider my DHEA dosage to have been a good move, my understanding of DHEA supplementation is that high dosages tend to increase E2 in men. While this isn't a huge concern to me right now due to the anastrozole, it is something to keep in mind and watch out for. I also need to do some reading on the implications of DHEA levels that high above and beyond potential E2 increases.


Update - Part II

I also had another thyroid panel done, results being:

TSH: 3.45uIU/mL [0.450-4.500]
Thyroxine (T4): 7.0ug/dL [4.5-12.0]
T4,Free(Direct): 1.60ng/dL [0.82-1.77]
Triiodothyronine,Free,Serum: 3.3pg/mL [2.0-4.4]
Reverse T3: 303pg/mL [90-350]

I was pleased to see my TSH is within the lab ranges, at least, though it it still higher than what many suggest is optimal. Other thyroid values are consistent with my past lab works.

rT3 seems high, as suggested by KSman. I will need to start reading up on the implications of this and what needs to/should be done.

Pregnenolone was also tested out of curiosity (as many people on Crisler's forum are big on TD preg usage). Results came back as 142ng/dL [<151], so that seems in order.

I have also added buffered vitamin C powder (~5g/day) and a 3x/day, high potency B vitamin complex to my supplement regime. I dropped the green tea extract as I prefer simply drinking the stuff.


rT3 suggests low cortisol levels. But your feeling better with high DHEA might be from improving cortisol levels. If so, rT3 would resolve.

Some men convert DHEA to E2 at high levels, most not. Some men absorb DHEA well some very poorly. So you really can't state that any dose is high or low, only lab work counts.


Good points and I shouldn't have spoken in absolutes like that regarding DHEA supplementation. I was running off of things I've seen mentioned on Crisler's forum. As long as it's making a positive difference, I'm not going to meddle with it.

What's strange though is that I have read in various places that it is HIGH cortisol that leads to increased rT3... and then I go and read other people saying that it is low cortisol that is the culprit, though I think low cortisol would better explain the morning fatigue I used to experience.

I figure I will just stay the course for right now and see if things continue to improve over the next month or so. The LEF blood sale is around the corner so I will wait until then to order a followup male panel.



No real changes in any symptoms the past several months. I had a Male Weight Loss Panel drawn by LEF this past Monday and just received the results.

Cholesterol, Total: 240mg/dL [100 - 199] [b]HIGH[/b]
Triglycerides: 114mg/dL [0 - 149]
HDL Cholesterol: 57mg/dL [>39]
VLDL Cholesterol Cal: 23mg/dL [5 - 40]
LDL Cholesterol Calc: 160mg/dL [0 - 99] [b]HIGH[/b]

Some big boosts in total cholesterol and LDL with a 10 point jump in HDL... I had just finished trying out a high fat/low carb/moderate protein diet about a week before so this might have had something to do with it. I find higher carb/lower fat diets to work better for me.

DHEA-S: 245.8ug/dL [211.0-492.0]
Estradiol: 17.4pg/mL [7.6-42.6]

Will reduce the anastrozole dosage a tad, I believe I left it more or less where it was when dropping from the 100mg DHEA pills to the 50mg, so that could explain the lowish estradiol values.

Testosterone, Serum: 600ng/dL [249-836] [i]slight increase[/i]
Free Testosterone(Direct): 12.9pg/mL [9.3-26.5] [i]significant drop[/i]
Insulin: 2.8 uIU/mL [0-24.9]
SHBG: 41.6nmol/L [14.5-48.4] [i]not a 'hormone', but relevant to this section[/i]

My understanding is that there isn't much one can do to directly influence SHBG levels outside of controlling E2, which makes this reading kind of a bummer.

Vitamin D, 25-Hydroxy: 78.1ng/mL [32.0-100.0]

TSH: 6.46uIU/mL [.450-4.5] [b]HIGH[/b]
T4,Free(Direct): 1.34ng/dL [0.82-1.77]
T3, Free, Serum: 3.2pg/mL [2.0-4.4]
Reverse T3: 209pg/mL [90-350] [i]an improvement over the 303 I had a couple months ago, though this didn't end up helping my FT3/TSH values[/i]

My WBC count was also low, 3.3 [4.0-10.5] with a low Neutrophil (Absolute) reading 1.7 [1.8-7.8]. Absolute monocytes and Eos were at the very bottom of the ranges, as well. I'll need to do some reading to see what this might mean, though I included it in the event someone might find it relevant.

While I am currently satisfied with my DHEA and D3 levels (couple less things to bother tweaking) and my E2 will be an easy adjustment, I am disheartened to see me Free T levels to be as low as the are, particularly when compared to my last readings. I wouldn't have guessed this would have changed for the negative, as I haven't noticed any negative changes these past few months.

I was hopeful that my improved rT3 would benefit my TSH and FT3 levels, but I guess not.

The problems with receiving these things in the middle of the work day is I don't have much time to sit and digest the information. I figured I'd throw this update up here and see if there is any input by later tonight.

This one was a definite bummer. Very curious, indeed.


with your fluctuating TSH levels you really should have your thyroid antibodies checked + 8am Cortisol.

have you ever tested or confirmed your hemocrit and hemoglobin levels? With your high iron, they could be above range which puts you at increased risk for a number of problems (can't name any, I just know that there are some).

high E2 with regular T indicates cortisol issues as well.


Thanks for the input, PureChance.

Latest hematocrit is 47.7% [36-50] and hemoglobin is 16.2g/dL [12.5-17]. Iron was still measured above range for this lab, as well (226ug/dL [40-155])... maybe it's time to start making some regular donations.

I will definitely look into getting some thyroid antibody and cortisol tests done. It's looking like I am going to have to resume the hunt for a doctor to help this process, too, since it's not going to be as simple a fix as I hoped.



New labs came in, results are as follows:

Glucose: 85 [65 - 99]
Total Cholesterol: 149 [100 - 199]
HDL Cholesterol: 57 [>39]
LDL Cholesterol: 82 [0 - 99]
VLDL Cholesterol: 10 [5 - 40]
Triglycerides: 51 [0 - 149]

Total Testosterone: 471 [249 - 836]
Free Testosterone: 10.1 [9.3 - 26.5]
DHEA-S: 337.3 [160 - 449]
Estradiol: 16.5 [7.6 - 42.6]
SHBG: 50.5 [14.5 - 48.4]

Pregnenolone: 247 [<151]
Progesterone: 1.4 [0.2 - 1.4]

Vitamin D3: 90.6 [32 - 100]]

TSH: 1.23 [0.45 - 4.5]
FT4: 1.17 [.82 - 1.77]
FT3: 3.8 [2.0 - 4.4]
rT3: 205 [90 - 350]
rt3 ratio: 18.5 [>20]


The above is the result of the following protocol for the past 6 weeks, or so:

1.5gr Nature-throid (1gr in the morning, .5gr in the evening)
100mg pregnenolone
100mg DHEA
Vitamin D3 5000IU + 1mg iodine
Two-per-day multivitamin

Huge improvement in the cholesterol category since the last time I had it looked at. It's actually looking like my cholesterol might be TOO LOW... but I just started working lots of red meat back into my diet so I'm gonna wait to see where that goes.

The 100mg preg is paying off: I don't have trouble getting up in the mornings (STILL not a morning person, but not overwhelmingly fatigued) and don't crash in the evenings, either. I was worried about oral supplementation since the wisdom on Crisler's board is that it is worthless for just about everyone. Maybe I just got lucky, but we can see that the increased preg has flown nicely to increased progesterone (don't want prog getting any higher, I think) and, given the relief of some symptoms, has made its way to cortisol.

I can probably get away with 50mg pregnenolone, but I'll leave as is for the time being since I haven't noticed anything negative.

Thyroid numbers are looking decent, I think, despite the still-high rT3. I'm going to see if I can't throw in some more selenium (only at 200mcg/day now) to get that down a little. FT3 is looking nice, though, and I've read an article on Crisler's site that raises the question of whether or not rT3 actually "clogs" the receptors, so I'm not sure how much it might really help things.

Really, my only main concern is the FT, TT and SHBG (the rest are just small tweaks). I was working under chilln's theory that, given my age, balancing adrenals and thyroid will lead to a boost in my T. Doesn't appear to be working -- both test values are at their lowest measured yet.

Will probably get LH/FSH measured to see what's going on there. This is an area I haven't done much thinking on since I had bought into the theory that it would sort itself out as things progressed, so I'll need to crack a few books open. Any thoughts here would be much appreciated.

Definitely wishing I had SHBG measured last December when my FT was at 22.8... which was decent despite the high estradiol I was sporting at the time (glad E2 is managing itself without the need for an AI now, at least).


Those lab ranges don't look right. Are you listing some sort of optimal range that you'd like to see? Have a hard time believing a lab sets Total T at 650-850.

Agree that your overall CHOL is a bit on the low side, but HDL and LDL look great, so I wouldn't sweat it.