T Nation

38 YO Looking for Advice

KSman

Got script from Dr for LH/FSH and rT3 as well as rest of hormone and thyroid panel.

Does draw timing matter? First thing in morning correct.

Also do you know of a Dr that is on point in the NJ area? If you do not want to post you could email me at acfbob at comcast dot net

Probably no reason to do first thing in AM.
Exceptions:

  • AM cortisol should be 8AM
  • fasting cholesterol and glucose, you need to do the labs so you can eat!
  • T labs for guys not on TRT, some docs want to see your T AM peak
    – older guys have less pronounced AM peaks

Ping me at the KSman is here thread when you get results.

Here is my most recent set of blood with rT3 having been checked. This is a Quest Diagnostic so it reads different than all my others. I typed the results below and also uploaded the actual results to this file. Pretty sure I transcribed them perfectly but the link may be most accurate.

LH - 3.74 (Range mIU/mL 0.7 -7.9)

Prolactin - 9.3 (Range ng/mL 2.1-17.7)

TSH - 3.01 (Range mIU/L 0.40-4.50)

T4, Free - 1.3 (Range ng/dL 0.8-1.8)

T3, Free - 3.5 (Range pg/mL 2.3-4.2)

T3 Reverse, LC/MS/MS 15 (Range 8-25 ng/dL)

Thyroid Peroxidase AB - 41H OUT OF RANGE (Range <9 IU/mL)

Thyroglobulin Antibodies <1 (Range < OR + 1 IU/mL)

Cortisol, A.M. 12.4 (Range 4.0-22.0 mcg/dL)

DHEA Sulfate 142 (Range 106-464 mcg/dL)

Homocysteine 8.2 Range <11.4 MICROmol/L)

Vitamin D, 25-OH, Total 73 (Range 30-100 ng/mL)

Vitamin D, 25-OH, D3 73 (Range ng/mL)

Vitamin D, 25-OH, D2 <4 (range ng/mL)

Estrogen, Total, Serum 171 H OUT OF RANGE (Range 130 or less pg/mL)

Testosterone,Free,Bio/Tot Testosterone,Total,LCMSMS 650 (Range 250-1100ng/dL)

Testosterone Free 55.0 (Range 46.0-224.0 pg/mL)

Testosterone Bioavalable 132.2 (Range 110.0-575.0ng/dL)

SHBG 56H OUT OF RANGE (Range 10-50 nmol/L)

Albumin, Serum 5.3H OUT OF RANGE (Range 3.6-5.1 g/dL)

Estrodiol,LC/MS/MS 27 (Range < or = 29 pg/mL)

Dihydrotestosteron, LCMSMS 26 (Range 16-79 ng/dL)

Thyroid Peroxidase AB - 41H OUT OF RANGE (Range <9 IU/mL)
TSH - 3.01 (Range mIU/L 0.40-4.50)

The above labs are a problem.

The following labs are good!
T4, Free - 1.3 (Range ng/dL 0.8-1.8)

T3, Free - 3.5 (Range pg/mL 2.3-4.2)

T3 Reverse, LC/MS/MS 15 (Range 8-25 ng/dL)

Are your body temperatures good at the moment?

Your total estrogens are very high and liver is not the problem, AST/ALT are good.

The only interventions that I can suggest for estrogens are:

  • anastrozole as suggested in post above
  • probiotics for one month

My multi pack has:
Selenium (as selenium aspartate and selenomethionine) 140 mcg 200%

  • HOW LONG HAVE YOU TAKEN THIS?

Have you changed anything?

[quote]KSman wrote:
Thyroid Peroxidase AB - 41H OUT OF RANGE (Range <9 IU/mL)
TSH - 3.01 (Range mIU/L 0.40-4.50)

The above labs are a problem.

The following labs are good!
T4, Free - 1.3 (Range ng/dL 0.8-1.8)

T3, Free - 3.5 (Range pg/mL 2.3-4.2)

T3 Reverse, LC/MS/MS 15 (Range 8-25 ng/dL)

Are your body temperatures good at the moment?

Your total estrogens are very high and liver is not the problem, AST/ALT are good.

The only interventions that I can suggest for estrogens are:

  • anastrozole as suggested in post above
  • probiotics for one month

My multi pack has:
Selenium (as selenium aspartate and selenomethionine) 140 mcg 200%

  • HOW LONG HAVE YOU TAKEN THIS?

Have you changed anything?

[/quote]

My morning temps are consistently around 97.2. I do warm up as the day goes on. Afternoon temps are 98.4 - 98.6

I take a daily probiotic and have for about one month.

I have been taking the multi pack with Selenium for at least 6 months.

I go back to this Dr tomorrow. Prior to my visit he had talked of Anastrozole to lower E2. Hopefully he will give me a script. Do I need T Replacement as well?

As far as any changing - back on my September blood sraw when I had better Test/Estro numbers I was on a different over the counter test booster for the previous few months. My old neuropath switched me to a different one in October and the numbers have definitely not improved. They seem to have gotten slightly worse.

My inclination is to think that your T levels and tyroid-temperature issues are connected. If you do TRT, its for life. If you do TRT, your thyroid and temperature issues are not resolved. You could do tyroid hormones, for life and dose to get better AM body temps, not attractive. But the Thyroid Peroxidase is not going away and you have your mom’s experience as a guide.

This is a difficult case.

Your FT4 has improved a lot, any ideas why?

I have little faith in testosterone boosters. I think that your total estrogens are responsible for your low T levels and fixing the estrogen problem would be idea.

I have gone to about 90% gluten free since I started this thread. Very rarely do I eat it and when I do it is in very small tastes just to satisfy a craving. I was under the impression that was only to help TPO. Could that have improved FT4? I can’t think of anything else that would have helped that aside from living a much healthier life and losing about 10 pounds over the last year.

(EDIT) I just looked back. My FT4 is higher on this most recent lab but I think it may have to do with the Quest ranges. I am 1.3 at Quest but the range is .8 - 1.8. I had been bouncing around 1.03 - .82 on the AccuReference reports but their range is .61 - 1.12

My previous Dr said I was a very difficult case. He was not an MD though and could not prescribe. The man I am seeing today is very young, an MD and also a functional/integrative doctor. He specializes in thyroid. I will let you know what he says.

Thanks again for helping to educate me.

KSman. I had been staying the course with my new Dr and not seeing much changes. He suggested I start NatureThroid at a 32.5 dose. Been on for a couple days and feel better. Will continue this for the next 28 days and have blood checked.

Next week I am going to text temps throughout the day to see where I am at.

Glad to hear that you are feeling a bit better. You can watch to see if body temps change at all.

I am not aware of gluten thyroid issues. But anything that kicks up the immune system may make any autoimmune issues worse.