T Nation

43Yr Old, Symptons w/ Lab Results

I am a 43 year old male within the past few months have developed the below symptoms

-Brain fog, lethargic
-Social withdrawal - “I would rather not go out”
-Constant dulling Headaches
-It is up, now it’s gone.
-“morning wood” ? I used to have it every day, now about 20 % of the time
-really stressful situations leave me feeling physically beat up.
-can not focus, feel anxious
-I use to sleep like a rock,now I have disruptive sleep,waking up thru-out the night
-Loss of motivation in the gym, I’m looking to leave after 20 minutes,strength diminishing

I eat a fairly clean diet, been eating a vegan diet for the past 3 years ,lots of veggies and raw foods- not the processed soy crap

I already had standard yearly blood work done- cholesterol levels are in range and I requested to have my testosterone level;s checked soon.So I am planning to have the following done:

-LH and FSH [LH/FSH]
-FT or bio-T
-Prolactin [optional in most cases]
-DHT [sort of a waist of time and blood if your testosterone levels are low]
-DRE: the dreaded digital rectal exam

So I recently had some lab work done from LabCorp

NMR Lipo-profile
LDL-P 1200 nmol/L
LDL-C 127 mg/dl
HDL-C 72 mg/dl
Triglycerides 45 mg/dl
Cholesterol total 208 mg/dl
HDL-P total 33.1 umol/L
Small LDL-P 274 nmol/L
LDL Size 22.1 nm
LP-IR Score 8
B12 1356 pg/ml
Folate Serum 11.9 ng/ml
Cortisol 21.9 ug/dl
Testosterone Serum 430 ng/dl
Vitamin D 25 Hydroxy 20.9 ng/ml
TSH 2.42 uIU/mL

Please provide in-sight on what my next steps should be


This may be just a weird coincidence, but I’ve lately heard of several different cases where guys went vegan and had low-T issues show up a year or two later. Anyone know of a link supported by (or alternatively, refuted by) research?

add TSH and 8am Cortisol blood test
Vitamin D25-OH can also be helpful.

I had some labs done, see original post- My primary care DR commented that my T levels are normal, and that i should supplement vit D. Should I request additional test, if so what would be helpful ?

TSH is high.

please read stopthethyroidmadness.com/things-we-have-learned/

you need more tests including FT4, FT3, RT3, 8am cortisol, ferritin.

yes on the Vitamin D3. 6000iu daily is pretty standard I believe.

yes, your T is low, but does not look like it is in the gutter like most here. it could still be causing you problems.

you also really need to check estradiol.

what time was the blood draw? if it was anytime except around 8am, then you may have too much cortisol.

My blood was drawn at 8 am - thanks for your input.I will look to have additional test performed

In doing some of your suggested reading, Vit D can effect TSH levels, and my symptoms are possibly those of a hypothyroid issue

[quote]stormer wrote:
My blood was drawn at 8 am - thanks for your input.I will look to have additional test performed

In doing some of your suggested reading, Vit D can effect TSH levels, and my symptoms are possibly those of a hypothyroid issue[/quote]

Before implementing HRT in any one you should always examine other factors such as thyroid, adrenals, and nutritional components such as vitamin D and ferritin, b-12, ect.

Raising vitamin D can increase testosterone as well as affect the thyroid function in some people.

so I had more labs done the results are below, I have been taking my early morning temperature and it swings between 96.8 - 97.2 _ i requested FT3 , FT4 , and RT3 - but it seems that was not performed

Again any input on what should be done next is appreciated, currently I do feel like I have a lot of symptoms pointing to hypothyroid

LDL-P 1211 nmol/L range <1000 nmol/L
LDL-C 136 mg/dL range <100mg/dL
HDL-C 72 60 mg/dL range >=40 mg/dL
Triglycerides 50 mg/dL range <150 mg/dL
Cholesterol total 206 mg/dL range <200 mg/dL
HDL-P total 31.9 umol/L range >=30.5 umol/L
Small LDL-P <90 nmol/L range <=527 nmol/L
LDL Size 22.1 nm range >20.5 nm
LP-IR Score 6 range <=45
B12 1195 pg/mL range 211-946 pg/mL
Folate Serum 11.4 ng/mL range >3.0 ng/mL
8 am Cortisol 18.5 ug/dL range 2.3-19.4 ug?dL
Testosterone Serum 370 ng/dL range 348-1197 ng/dL
Vitamin D 25 Hydroxy 36.7 ng/mL range 30.0-100.0 ng/mL
TSH 2.46 uIU/mL range 0.450-4.500 uIU/mL
Triiodothyronine ,Free,Serum 3.3 pg/mL range 2.0-4.4 pg/mL
Thyroxine (T4) 7.3 ug/dL range 4.5-12.0 ug/mL
Ferritin 89 ng/mL range 30-4000 ng/mL


Vitamin D is still low. Were you supplementing at the time?

TSH is still high. Free T3 looks pretty good. did they ever test the Thyroid Antibodies? you also need to confirm RT3 - your 8am cortisol levels look good, but with the high TSH and symptoms you may want to ask for a 4x daily saliva cortisol test.

ferritin is low, but not horribly so (I think >150 is ideal for men)

I have been taking 5000 iu of D3 for the past 60 days - should I increase to 10000 iu ? They never tested Thyroid antibodies
I am looking to find a new doc, probably and Endo- my current doc is not open minded about my request,it is always a struggle to convince him of my request for specific labs - and to boot he claims all my levels are normal

How about my T4 - is that an ideal number ?

Also how about iodine ? Should I supplement and test that as well ? Should I omit consumption of Kale,spinach,and broccoli as it has been mentioned that those types of veggies can create issues with Thyroid function

So an ideal target for TSH is < 2.0 - correct ?

From memory here. Not a thyroid expert, these just seem to come up often. Not sure if there are more or more important.

Support for production of T4 (this is where you want to start with high TSH and/or low T4)
B Vitamins. Forget which ones. B6 for sure.
Vit C

Support for T4 to T3
Progesterone (healthy cortisol levels)

You should take as much Vit D as it takes to get to the top of the range. Read somewhere that boron can help make vit D supplementation more effective.

I have been consulting with a functional medicine doctor over the past year.The suggestion was to regulate blood sugar levels with steady food intake.Incorporating organic foods as much as possible,lots of fruits and veggies along with gelatin and bone broths.I have been eating animal products again as well.My current situation is that I still have most my symptoms listed at the top of this post,I do get to sleep quicker at night but seem to awake between 5:30 - 6:30 am every morning by high cortisol.

Are there any recommendations to take to assist with addressing my symptoms ?

TSH 2.42 uIU/mL

You have good cholesterol levels, low levels can hurt steroid hormone systems.

There is a new sticky: thyroid basics.

  • please come back with iodine intake data and temperatures
  • if temps are low and iodine intake low, assume iodine deficient and replenish
  • if not iodine deficient or after replenishment, and temps [still] low, suspect rT3 and adrenal fatigue


  • at the drug store, find a 5mg time release melatonin product. MUST BE time release.
  • if that does not work, get a Rx for 150mg trazodone, start with 50mg. This is a cheap Rx, $10 for 90 days

I have been checking temps
awakening temps are 96.8 - 97.2
mid-afternoon temps do get to 98.4 - it seems that potatoes help with temps
night temps 96.7 - 97.4 range

I have been salting everything over the past year,but have avoided it for years as being instructed by doctors that it may contribute to high blood pressure

So I will order some lodoral iodine along with the time released melatonin, and see what effect they have

Salt and BP:

Sale does not cause BP. BP is a mechanical situation where the arteries cannot accept normal flood flow from the heart. Reduced salt diets reduce blood volumes and help with this flow problem when the arteries are bad.

Why are arteries bad? Often from estrogen dominance that damages the endothelial cells, one cell layer thick that separates the blood from the blood vessel walls. Endothelial dysfunction allows cholesterol to enter the blood vessels walls where inflammatory processes cause scarring and worse.

Lab work: homocysteine is a inflammatory marker specific to processes that damage the arteries.

You want cholesterol numbers in the 180-200 range if possible and higher HDL


  • fish oil, nuts, flax seed meal or oil for EFA’s
  • DHEA, 25mg or as required to get into upper range of DHEA-S

-really stressful situations leave me feeling physically beat up.
-can not focus, feel anxious

  • sounds like adrenal fatigue. Google/read Wilson’s book on adrenal fatigue.
  • high potency B complex multi vits with trace minerals and iodine
  • anti oxidants, vit-C, natural source vit-E
  • CoQ10, Ubiquinol type.
  • mini aspirin
  • vit-D, 5000iu mini oil based caps

TRT can lower BP as it counters estrogen dominance and corrects problems with muscle tone of the arterial walls muscles. Estrogen maintenance is important.

Are you using a statin drug?

Thyroid problems have many symptoms in common with hypogonadism.

Regarding DHEA ;

Should I take 7-Keto or a regular DHEA supplement ?
Also , I have read about pregnenolone cream , should I consider this as well ?

I just started taking the iodine 2 days ago, going to try consuming 50mg for two weeks and verify temps.Just received Wilsons book as well

How much aspirin should I consume ? Should I also take vit K if consuming aspirin ?

No, I am not taking any statin drugs