T Nation

24 YO - Test at 426 ng/dL

Age/Height/Weight/BF% Stats:
24yrs old
230 lbs
~30% BF

Brief Medical History
In Jan of 2009 I began to have chest pains and excessive fatigue after returning from Iraq. I ended up going to the ER on Jan 31 for chest pains and my resting heart rate was 32 bpm and sustained that rate for several hours before they just said it was fine for me to return. By the end of Feb 2009 my weight went from 180 lbs to 215lbs, and this was with me doing brazilian jujitsu for 3-5 hours a day 6 days a week. My 3 mile run had dropped from 20:30 to 30:00+ in this month time frame as well. A 3 year long medical history shoved into a few more sentences, I have done every form of non invasive cardiology test multiple times and have always passed them with no abnormalities other than the low heart rate. I have been cleared by 4 different cardiologist at 3 different hospitals in 2 different states. I have also had my thyroid tested with no abnormalities

Recent Medical Information
After researching my symptoms online I started to believe that is could be low testosterone levels. After being denied by 4 different doctors at the VA, I finally convinced one to order the blood test. I just got the results back and did some research on it. From what I have been able to find online, my testosterone levels of 426 ng/dL is the equivalent of that of an average 75-80 yr old man.

Blood work since Oct-Dec:
Here is all of the blood work I have had in the pass 3 months. Ive included everything on the reports and I hope it provides you all the info to help educate me more.

Specimen Collection Date: Nov 29, 2012 @ 09:44
Test Name Result Units Ref. Range
(CRC) TESTOSTERONE, TOTAL 426 ng/dL 225-971

Specimen Collection Date: Nov 29, 2012 @ 09:44
Test Name Result Units Ref. Range
Vitamin D 1,25-DIHYDROXY 54.8 pg/mL 10.0-75.0

Specimen Collection Date: Oct 17, 2012 @13:38
Test Name Result Units Ref. Range
TSH (LAB) 1.55 IU/mL 0.35-5.50

FREE T4 (LAB) 1.05 ng/dL 0.93-1.71

Specimen Collection Date: Oct 1, 2012 @13:23
Test Name Result Units Ref. Range
POC TROPONIN 0.00 ng/dL 0.00-0.40

Specimen Collection Date: Oct 1, 2012 @13:41
Test Name Result Units Ref. Range
ABSOLUTE EOSIN 0.14 K/uL 0.00-0.50
ABSOLUTE BASO 0.02 K/uL 0.00-0.20
AB-IMGR 0.01 K/uL none
ABSOLUTE LYMPH COUNT 2.03 K/cmm 1.50-4.00
NEUTROPHIL % 56.3 % 40.0-74.0
LYMPH % 32.0 % 19.6-52.7
MONO % 9.0 % 3.4-10.0
EOSINOPHIL % 2.2 % 0.0-7.0
BASOPHIL % 0.3 % 0.0-2.0
ABSOLUTE MONO COUNT 0.57 K/uL 0.30-0.90

Specimen Collection Date: Oct 1, 2012 @ 13:05
Test Name Result Units Ref. Range
PTT 28.6 second(s)23.0-34.6

PROTHROMBIN 13.3 second(s)11.7-14.2
INR 1.05 none 0.89-1.13

CKMB-MASS 1.07 ng/mL 0.00-5.00

CPK 60 IU/l 55-170

L-CHOLESTEROL 136 mg/dL <=200
TRIGLYCERIDE 210 H mg/dL 30-170
HDL 31 mg/dL 30-70
VLDL 42 H mg/dL 6-34
CHOL/ HDL RATION 4.4 none none

PROTEIN TOTAL 6.6 g/dL 6.5-8.0
ALBUMIN 4.1 g/dL 3.6-5.0
TOT. BILIRUBIN 1.2 H mg/dL 0.1-1.0
DIR. BILIRUBIN 0.2 mg/dL 0.0-0.4
AST 22 IU/mL 15-46
ALT 34 IU/mL 13-69

EGFR-AA >60 mL/min/1.73 >=60
EGFR-NAA >60 mL/min/1.73 >=60
UREA NITROGEN 12 mg/dL 8-22
SODIUM 144 mmol/L 135-145
POTASSIUM 4.1 mmol/L 3.5-5.0
CHLORIDE 105 mmol/L 98-110
CO2 27.0 mmol/L 23.0-32.0
CREATININE 1.0 mg/dL 0.5-1.3
GLUCOSE 77 mg/dL 70-110
ANION GAP 16 mEq/L 3-16
CALCIUM 8.9 mg/dL 8.4-10.7

WBC 6.3 K/cmm 5.0-10.0
RBC 5.07 M/uL 4.70-6.10
HGB 14.8 g/dL 14.0-18.0
HCT 41.4 L % 42.0-52.0
PLT 175 K/cmm 140-440
MCV 81.7 fL 80.0-94.0
MCH 29.2 none 27.0-35.0
MCHC 35.7 g/dL 31.5-36.5
RDW 12.6 % 11.5-14.5
MPV 10.9 fL 7.2-11.1

Questions/Concerns/What I hope to get out of this post:
After seeing that my testosterone levels are in the 75-80 yr old average range, my immediate reaction was that I need to be put on some type of testosterone replacement therapy. I just want to verify whether these concerns are appropriate or not. If they are, what points should I bring up to the doctor that I will be seeing on the 31st. I feel like if my concerns are correct that I will have to fight with the VA doctor to get the testosterone replacement therapy. How should I state my case to the doctor and what information from the bloodwork do I need to use to justify my concerns.

Big mistake. You need to deal with the cause of your low T. Low T is the symptom, not the cause. Old men so not have your T levels, you are then basing a need for TRT on that.

Total cholesterol is 136? That is a pathology. Ideal would be 180. Level at and below 160 are associated with increased all-cause morality. Why is your cholesterol that low? What can you do about that. [Using statin drugs?] Cholesterol is vital to heath. You just do not want it getting past the arterial endothelium and parking inside the arterial walls.

Are you eating beef? Only chicken and tuna? High tuna intake exposes you to potential mercury issues.

HDL is horrible. Suggest:

  • fish oil and other EFA’s [nuts, flax etc]
  • high potency B complex vits with iodine
  • CoQ10 as ubiquinol 50mg
  • antioxidants, vit-E, vit-C
  • DHEA 25mg may be needed, depends on DHEA-S lab work

List all Rx and OTC drugs, supplements etc?

Read the advice for new guys sticky, carefully, and come back with more info. Do not assume that things there do not apply to you

fT4 is low, should be near the middle of the range. TSH suggests possibilities. As per the sticky, reply to issues there concerning iodine, iodized salt, feeling cold, and check/post body temperatures.

Under a lot of stress? Body reacts badly to stress? How has that changed?

Over training? Can wreck hormones.

Discuss your past exposure to chemicals, metals and fire retardants.

Any blows to the head? What illnesses and fevers. What took place prior to Jan of 2009. No problems before that? What burns/injuries? Any PTSD

Your labs do not have LH/FSH. You need that to determine if your testes are at fault or pituitary is not getting the job done.

Action items:

You may need to get labs on your own and out of pocket.