T Nation

31yrs Old, Low Test, Normal LH, FSH, Thyroid


#1

Hey guys, joining some of these forums since I have read some amazing replied by extremely intelligent people. Isn't a shame doctors don't know as much ad they think they do? At least that goes for some of them.

So here we go. Test was done at 5pm. Don't drink alcohol, etc. Tough time getting to bed at night, tough waking up. Feel brain fogged. Drink coffee every day. Start feeling better around 4-6pm every day.

T4 Free 1.13 (.8 - 1.8 ng/dL)
T3 Total 99 (60-181)
T3-Uptake 35.1 (22.5 - 37%)
Thyroxine 8.1 (4.5 - 10.9)
FTI 2.8 (1.5-3.9)
TSH 3rd Gen .63 (.4-4.5 uIU/mL)

Test Total 330 (300-1100)
Test Free 64 (47-244)
Test Percent Free 1.9% (1.6-2.9%)
SHBG 29 (11 -80 nmol/L)

FSH 4.2 (1.4-18.1)
LH 4.3 (1.5 - 9.3)
Albumin 5.2 (3.6 -5.3)
Calcium 10.2 (8.6-10.4)
Potassium 3.9 (3.5 -5.5)
Cortisol 11.8 (3-22.4)
Vit D 35 (30-100)

Cholesterol 182 (125 - 200)

Perhaps a serious deficiency or adrenal fatigue? I have about 2 days to add a couple more tests so I guess the obvious are estradiol, prolactin, dheas. Zinc? Iodine? Iron/ferritin? I cannot add many but will be getting retested next Friday.

Thanks guys, it means a lot.


KSman is Here
#2

Did I post this in the wrong spot?


#3

Testing at 5 pm is useless…get a test done around 8 am and then post results.


#4

Getting a test around 9:45am, earliest I could get in. I usually wke up around 10am since I work late.


#5

Estradiol 24.4 (<39.8)

Prolactin 5.2 (2.1-17.7)

I was expecting something different. Even though this was pulled at 5pm, wouldn’t these be out of whack?

Does this look like some kind of deficiency somewhere nutritionally?


#6

What?


#7

“I have read some amazing replied by extremely intelligent people.”

You must set the bar really low =)

First off, how old are you? That info is slightly helpful.

Testosterone levels can vary WILDLY between morning and evening. Although your score of 330ng/dL is low, it could be that your AM score is well within the healthy range.

“Tough time getting to bed at night, tough waking up. Feel brain fogged. Drink coffee every day. Start feeling better around 4-6pm every day.”

This is kind of self-answering. You have a hard time sleeping, so you have a hard time being forced to wake up in the morning. Coffee keeps you going throughout the day, and you “get over” your sleepiness in the early evening. Then, I’m guessing that, since you’re more awake in the evening, you’re more active in the evening/night time. Since your brain is being stimulated, it’s keeping you from falling asleep. Lather, Rinse, Repeat. A lot of that is guesswork on my part, but aside from the caffeine consumption I could have written the same thing about myself.

Have you had a sleep study done to rule out apnea or other things that could be making your sleep less restful? Have you ever been seen/treated for insomnia? Do you ever “binge sleep”, like after several days of having little/no/really shitty sleep do you sleep for an insane amount of hours if the situation permits?

Just an FYI, insomnia can cause low testosterone.

“Perhaps a serious deficiency or adrenal fatigue?”

Your cortisol looks fine, but I don’t know what the result should be since it wasn’t the 8am test. The 8am test is a specific test, not a general “you should test it sometime in the AM” type thing. There is a non-8am test, which I’m guessing is what they did for you, but I know so little about it I won’t comment other than to say that you’re smack in the middle of the range, so it’s really unlikely you’re having adrenal issues.

For your other labs, don’t kill yourself to get up early and get them tested, but do try to get them done as early as possible. I don’t see 9:45am being a problem.

You should get your ferritin levels checked since this can cause fatigue issues as well. Getting B-12 done too would be good.

You probably want to bring your D3 up. I don’t get a ton of sunlight so I take 5k IU a day. Wouldn’t hurt to start with that dose and see where you are in a month. Opinions will vary, but getting it between 60 and 100 is a good goal.

Aside from that your labs look good. Why is your doctor adding another round of tests? Just would be good to clarify you and him/her are digging at. You’re going to want to retest everything you had above if possible, just so you can get your morning “peak” values.

Good luck! Hope I didn’t answer this too late/past the cut-off.


#8

[quote]ctastrophe wrote:
How old are you? That info is slightly helpful.
[/quote]

I appreciate your response; however, it bewilders me that you responded without reading the subject.

You raise some great points - I know sleep depravation definitely has something to do with what is going on.


#9

Jesus! Durrrrr. Sorry about that. Goes hand in hand with:

[quote]ctastrophe wrote:

[quote] TheJackDaniels wrote:
I have read some amazing replied by extremely intelligent people.
[/quote]
You must set the bar really low =)
[/quote]

Were/Are you able to get the extra labs done?


#10

[quote]TheJackDaniels wrote:

[quote]ctastrophe wrote:
How old are you? That info is slightly helpful.
[/quote]

I appreciate your response; however, it bewilders me that you responded without reading the subject.

You raise some great points - I know sleep depravation definitely has something to do with what is going on.

[/quote]

The guy is a noob and feels HRT/TRT is his private island since he lost one nut and thinks unless you have done the same you are just looking for legal steroids. Dude needs help.


#11

You need to stop following me around, and stop obsessing about my testicle. I gave you the chance to bow out of this respectfully and you didn’t take it. If you don’t have something to contribute to the conversation you need to leave. This isn’t your personal shit-talking site, and this guy is looking for input on his actual TRT issues.

I don’t care what you have against me, but don’t impose your hatred of me on others. Feel free to blow up my inbox, but quit wasting space on someone else’s thread.


#12

OP, you want your blood work done prior to 9am if possible.


#13

[quote]
Your cortisol looks fine, but I don’t know what the result should be since it wasn’t the 8am test. [/quote]

I’m not an endocrinologist, but I do have a master’s degree in exercise physiology…

Your cortisol is actually quite low. A good, strong morning fasting cortisol level is around 17. In the late afternoon is becomes slightly elevated above this baseline (depending on your nutrition and exercise that day) then drops off after dinner and until bed. Then, as you go through REM sleep in the early morning hours it comes back online to wake you up.

The term “adrenal fatigue” is actually a misnomer. A better term is “central neurologic fatigue”. I don’t know anything about you or your lifestyle, but it is possible that living a high stress, low sleep, bad circadian rhythm pattern is what is kicking your butt. The low testosterone is more than likely a side effect / indicator of a deeper problem in your stress mechanism.

First and foremost, I would restore my sleep patterns to a predictable daily routine (even if it means using a sleeping pill and melatonin). Then, I would closely look at my nutrition, and limit my caffeine intake to 1 or 2 cups of coffee in the morning (coffee is actually a beneficial supplement for jump starting the circadian rhythm). Also, your Vitamin D is quite low too. I would start supplementing that ASAP. There are new studies showing that Vitamin D is roughly 12 times MORE anabolic than Testosterone (not exaggerating here). Vitamin D is a critical hormone that messages with multiple organ systems, and promotes lean body mass by regulating calcium metabolism for bone accrual and muscle contraction. Your TSH looks excellent… This indicates that baseline nutrition is most likely intact (eating disorders / malnutrition can wipe out Cortisol and T, and can show up as low TSH, along with other markers).

Second, what type of exercise are you doing? If it is the classic american male pattern of “lifting heavy weight, that’s it, that’s all”, then that too can be a problem on the stress mechanism. Or, on the flip side, if you do long, exhaustive endurance work, that too can be just as unhelpful. If you are indeed (and as I said, can’t be sure) in a state where your sympathetic nervous system is just wiped out, getting lower intensity consistent exercise can be of huge therapeutic benefit. Regarding the circadian rhythm, exercise is a critical component to regulating the release of hormones at the correct times. We also have a culture of sedentarism, and many of the people in that category can show low T and low Cortisol. For them, regular exercise is all they need.

I’m also discussing the cortisol component because you mentioned the term “adrenal fatigue”. Intuition is probably the most powerful tool you have (even more than labs). If you in fact feel that your adrenal hormones aren’t working properly, you’re probably correct. There is a situation in which a mammal can go into adrenal collapse, and thus define the term “adrenal” fatigue, but as I mentioned it is statistically more probable that your brain is exhausted. I think you also mentioned that you work night shifts, and this too can be the culprit.

Anyway, hope some of that helps. Quality of life is everything! Good luck!


#14

That’s why I put the “I don’t know what the result should be” part. I’ve only dealt with 8am test scores.

Do you have a source for this?

I ask because this: http://www.nlm.nih.gov/medlineplus/ency/article/003693.htm

Says, “Normally, cortisol levels rise and fall during the day, repeating on a 24-hour cycle (diurnal variation). Highest levels are at about 6 - 8 a.m. and lowest levels are at about midnight.”

And this: http://en.wikipedia.org/wiki/Cortisol_awakening_response

Says this, “Normally, the highest cortisol secretion happens in the second half of the night with peak cortisol production occurring in the early morning.”

And this: http://chipur.com/2011/05/05/cortisol-what-you-need-to-know-and-why/

Says, “Wonderfully, blood cortisol levels fluctuate throughout the day. Peak time is around 8 a.m., and levels bottom-out sometime between midnight and 4 a.m.”

I’ve never heard of Cortisol levels being higher in the evening than they are at the peak in the morning. Any info you can pass my way would be greatly appreciated. Always eager to learn more.

EDIT: Hey also, what are your thoughts on urine vs saliva testing when doing the 24 hour test? I’ve heard that 24hr-urine is best for testing total output of cortisol, and 24hr-saliva is only good for capturing “still shots” of what is going on the moment you collect the sample and since levels can vary from minute to minute this isn’t too helpful when figuring out hyper/hypo. I’ve only ever had the 8am test, and have been reading up on this and considering doing a 24hr test. Which test would you think would be best for TheJackDaniels given his last test’s testing time and results?


#15

[quote]ctastrophe wrote:
That’s why I put the “I don’t know what the result should be” part. I’ve only dealt with 8am test scores.

Do you have a source for this?

I ask because this: http://www.nlm.nih.gov/medlineplus/ency/article/003693.htm

Says, “Normally, cortisol levels rise and fall during the day, repeating on a 24-hour cycle (diurnal variation). Highest levels are at about 6 - 8 a.m. and lowest levels are at about midnight.”

And this: http://en.wikipedia.org/wiki/Cortisol_awakening_response

Says this, “Normally, the highest cortisol secretion happens in the second half of the night with peak cortisol production occurring in the early morning.”

And this: http://chipur.com/2011/05/05/cortisol-what-you-need-to-know-and-why/

Says, “Wonderfully, blood cortisol levels fluctuate throughout the day. Peak time is around 8 a.m., and levels bottom-out sometime between midnight and 4 a.m.”

I’ve never heard of Cortisol levels being higher in the evening than they are at the peak in the morning. Any info you can pass my way would be greatly appreciated. Always eager to learn more.

[/quote]

x2

BMX’s post also does not jive with established lab ranges for the 4x saliva tests, which are always the highest in the morning and taper off throughout the day. I do not think previously posted information was correct.


#16

[quote]ctastrophe wrote:
Jesus! Durrrrr. Sorry about that. Goes hand in hand with:

[quote]ctastrophe wrote:

[quote] TheJackDaniels wrote:
I have read some amazing replied by extremely intelligent people.
[/quote]
You must set the bar really low =)
[/quote]

Were/Are you able to get the extra labs done?
[/quote]

I do not believe it goes hand in hand with that - there are some people on here that do know what they are talking about.

I haven’t pulled new labs yet - waiting to speak with doc.


#17

I was saying that me missing your age in the Subject Line goes hand-in-hand with me saying that you set the bar low for intelligence, and I was poking fun at myself. Sorry if you didn’t see the humor in that.

Are you implying I don’t know what I’m talking about? Because I wouldn’t want to waste either of our time if you don’t want my input.


#18

[quote]ctastrophe wrote:
I was saying that me missing your age in the Subject Line goes hand-in-hand with me saying that you set the bar low for intelligence, and I was poking fun at myself. Sorry if you didn’t see the humor in that.

Are you implying I don’t know what I’m talking about? Because I wouldn’t want to waste either of our time if you don’t want my input.[/quote]

LOL - after I posted my response I thought to myself that you may have meant it that way. For some reason I thought the fact that you did not catch my age in the subject went hand in hand with me saying some of the people are intelligent on here LOL.

No - I am not implying that. I actually agree with your thoughts on cortisol as well and have read a number of the documents you posted.

Gotta love forum-based misunderstandings :slight_smile:


#19

I only love forum misunderstandings when they turn out to actually be misunderstandings, and not exactly what either party thought was going on. Glad we cleared that up!


#20

UPDATE: My DHT finally came back - borderline LOW. 24 is the number but only spoke to the doc over the phone real quick and did not get range or measurement units.

I will get this information - but does this coincide with the cortisol and low testosterone?