T Nation

26, Got Labwork. Suggestions for Next Steps?


#1

I’m 26 years old, 5’7 height, 87 kgs currently. I was 100kg last year and have been lifting (5hrs/week) and working on improving my diet to lose weight and I feel like I have changed myself immensely and there is still a lot of room for improvement. After reading on the internet the importance of healthy testosterone levels and benefits of it, I got some tests done on my own. Now before going to an endocrinologist, who will be very very very passive about this sort of stuff, I’d like to see what you guys have to say about my levels and what should be my next steps so I can call BS on some stuff that I will hear from the Doctor.

I couldn’t find any lab who would do an estradiol sensitive test so I got a normal version. I’ll keep looking and my Free T test is still pending.

Cortisol (AM) 15.7ug/dL (3.7-19.4)

Total Testosterone (Serum) 4.68ng/mL (1.2-10.19)

Free Testosterone (Serum) 18.17pg/ml (1.0 - 28.28)

Estradiol (Serum) 44pg/mL (10-50)

Free T3 2.60pg/mL (1.71-3.71)

Free T4 1.16ng/dL (0.7-1.48)

TSH 1.9670uIU/ml (0.35-4.95)

Total T3 104.45ng/dL (70-204)

Total T4 7.93ug/dL (4.6-10.5)

Vitamin-D 20.8 ng/ml (30-100)

HbA1C 5.0% (4.0-5.6)

Cholesterol 157mg/dL (<200)

Triglycerides 94mg/dL (<150)

HDL (Cholesterol) 34mg/dL (>40)

LDL (Cholesterol) 107mg/dL (<130)

Non-HDL (Cholesterol) 123mg/dL (<160)


#2

You need to post lab ranges, example: Vitamin-D 20.8 ng/ml (30-100 ng-ml).


#3

Added in brackets. :slight_smile:


#4

E2 [estradiol] is way too high, many labs have ranges that have much lower upper limits.

High E2 is negative feedback reducing LH & FSH and T goes down.

E2 can be reduced with 1/4mg anastrozole twice a week, do reading…

FT not tested, typical for UK.
If SHBG tested, calculated FT can be provided.

FT–>E2 rates are proportional to FT levels.
Assuming that FT is lower, your high E2 implies low E2 clearance rates in the liver. Labs for AST, ALT, CK would be useful.
Some medications, Rx and OTC can interfere with E2 clearance by competing for the responsible enzyme pathways.

Many in UK are iodine deficient and in UK, you are expected to get most of your iodine from dairy foods and sea food. Your low cholesterol levels suggest low dairy intake. Iodized salt is available there, but most shops do not have it.

Low HDL suggests low B vitamins.

Your Vit-D is low and a serous problem. Vit-D3 is slowly converted to Vit-D25 that is a true and essential hormone.

Find high potency B-complex multi-vits that have trace elements including 150mcg iodine and 150-200mcg selenium.

Take 5,000iu Vit-D3 every day, 25,000iu for first 5 days.
Take with a meal that has more fats and low fiber.
Look for tiny oil filled gel caps. We find 5,000iu easily in USA.

Let your total cholesterol increase, 180 is ideal. Cholesterol is the foundation for creating all of your steroid hormones.

TSH should be closer to 1.0
fT3 appears low to me, but ~OK with the range used there.
fT4 same as above
Ranges may be lower there reflecting lower iodine status in UK population.

Check overall thyroid function via oral body temps, see below.
This is very important. Purchase a thermometer if needed.

With a low fat diet, you may be EFA deficient. Fish oil, nuts, flax seed meal/oil can address that. Do not take these with high fiber meals!

Action list:

  • EFAs and health fats as needed
  • increase cholesterol
  • multi-vit as specified above
  • Vit-D3 as specified above
  • iodized salt
  • liver specific labs and medication review
  • anastrozole as above to lower E2 if you can get that, then E2 labs in 4 weeks

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.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#5

Whopper response. Good work KSman


#6

@KSman I eat like 5 eggs in breakfast. Does that help with Selenium. Apparently, one medium egg has like 146 mcg of Selenium?


#7

More like 15-30mcg per egg.
Depends on what is in the feed.
Selenium is used in feeds to improve poultry health and yields.
Selenium in eggs depends on what the producer feeds the hens.


#8

@KSman Ok. I have a supplement which contains Vitamin B and Selenium in it. https://www.rainbowlight.com/our-product/mens-health/mens-one-multivitamin.html

I believe that will help.

I have started another Vit-D supplement (drops) which contains coconut oil.

Also, an important note, I am still on a caloric deficit to lose body fat. I am still at around 28-30% bodyfat.


#9

@KSman My FT lab report is pending and I’ll get back to you when I get it.


#10

Vitamin does not have iodine.

5000iu Vit-D3?


#11

Yeah, I need to find iodine supplement and Vit-D supplement I took today was 12000IU which I can increase to 25000IU from tomorrow for the next 5 days.


#12

Also Anastrozole is available where I live. I might need a Dr prescription for it.


#13

@KSman Thank you the amazing reply. Lots of reading to do!

I’ll get to it.


#14

@KSman body tempeature after waking up (5.5-6 hrs of sleep) was 97.1 F

Late afternoon tempeature: 98.24 F


#15

Just got my free testosterone result and added to the top.

Free Testosterone (Serum) 18.17pg/ml (1.0 - 28.28)

@KSman any input to the update?


#16

Body temps are low as I expected.

Iodine intake assumed low.

Your comments re consumption of sea food and dairy?
Your supplement does not have iodine…


#17
  1. Arranging iodine supplement. Not available locally so importing from US.
  2. Sea food, very rarely. It’s been a while (about 7 months) since I’ve ate any sea food. I do take about 1280mg of fish oil everyday. Does that help?
  3. For dairy, I have tried to avoid it. I do drink a protein shake of whey protein once in a while but that’s essentially not dairy anymore and it’s mixed with almond milk. I will start adding real milk to it.

EFAs and health fats as needed
I am going to add about 30-40 almonds to my diet everyday to consume good fats. All my food is cooked in light olive oil and salads are topped with extra virgin olive oil. Not too much!

Vit-D3 as specified above

Supplementing Vit-D3 now. About 25000 IU per day since today.

iodized salt

See point 1.

liver specific labs and medication review

I didn’t take any liver specific tests and don’t take any medication of any kind.

anastrozole as above to lower E2 if you can get that, then E2 labs in 4 weeks

What is the verdict on anastrozole now that my Free Testosterone lab result is here?


#18

@KSman My 5 days temps. Definitely need iodine. I will have it delivered by next week. :slight_smile:

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