44 YO Blood Test, Need Help Interpreting Results

Pharma / TRT Testosterone Replacement
1

-44, 5’5, 170 lbs. 34 waist.

-Body hair is fairly thick, hasn’t changed.

-Body fat stored primarily around my lower waist, never can get rid of that roll, even when dieting down to 150 lbs. 2 years ago.

-Only health condition is high blood pressure which I inherited, take an ACE inhibitor and diuretic daily for it since I was 18.

BLOOD TEST results from 7/11/11 (I left out CBC and metabolic panel for brevity)

Lipid Panel
Cholesterol, Total, 222 mg/dL (100-199)
Triglycerides, 87 mg/dL (0-149)
HDL Cholesterol, 79 mg/dL (>39)
VLDL Cholesterol, 17 mg/dL (5-40)
LDL Cholesterol, 126 mg/dL (0-99)

Thyroid Panel With TSH
TSH, 4.440 uIU/mL (0.450-4.500)
Thyroxine (T4), 8.7 ug/dL (4.5-12.0)
T3 Uptake, 33% (24-39)
Free Thyroxine Index, 2.9 (1.2-4.9)

Testosterone, Free/Tot Equilib
Testosterone, Serum, 357 ng/dL (249-836)
Testosterone, Free, 8.21 ng/dL (5.00-21.00)
% Free Testosterone, 2.30% (1.50-4.20)

PSA, 1.0 ng/mL (0.0-4.0)

IGF-1, 214 ng/mL (101-267)

Estradiol, Sensitive, 9 pg/mL (3-70)

LH, 1.3 mIU/mL (1.7-8.6)
FSH, 4.3 mIU/mL (1.5-12.4)

-My diet consists of chicken breast, lean burger, lean pork, fish, whole eggs, fresh fruits and vegetables, nuts, lots of water, etc. averaging 3600 cals a day.

-Training four days a week, one bodypart a day, primarily compounds. I train all-out balls to the wall in the gym 45 min. to an hour. Take a deload week every two months or so. I do experience frequent joint pain in my knees and shoulders.

-My libido has been the driving force behind seeking answers. In the last year or so I’ve had difficulty at times finishing, and often just don’t feel like having sex (despite having a hot wife). This bothers me the most.

-Besides libido I have found myself increasingly irritated and frustrated at work and don’t feel like being there half the time. I thought I was just burned out, but the other symptoms make me wonder.

The blood test results that stood out were LH (low), TSH (high), E2 (low), test and free test (low). From reading several other posts I’m thinking I may have hypothyroid problems which could be depressing my test levels. I’ve read about people using Armour to bring up thyroid levels, but from the latest information it seems Armour has changed the formulation and it may not be as effective.

I have visited stopthethyroidmadness and am planning to start taking morning temps. Any other advice or blood tests that I should be aware of?

Thanks in advance for any assistance.

2

I think you are on the right track…your high TSH almost certainly points to a thyroid issue…

Do you take Vit D3 and Fish Oils? If not, I would start both of these ASAP…this will help you heal yourself, but it looks like you will certainly need more medical intervention to really get straightened out…

It sounds like you eat very low carb…some people believe this can cause thyroid problems–I tend to disagree based on the admittedly flimsy “paleo principle” but it is what it is…so something to consider…

3

In addition to what VTBalla said (any TSH above 3.0 is hypothyroid, Armour is worth a try), I also recommend:

B-complex in morning (for histamine, for orgasm)

Zinc before bed (for testosterone)

Also, you may not need more carbs so much as more fat. Everything is “lean”, the only sources of fat you mention are eggs and nuts. Other (preferably organic) animal fats and some fruit fat (olive and coconut) might help. You need a certain amount of dietary fat to make T. [not sure where 3600 cals per day is coming from if you are both low fat and low carb aka “rabbit starvation”…]

4

[quote]SuperFast wrote:
Also, you may not need more carbs so much as more fat. Everything is “lean”, the only sources of fat you mention are eggs and nuts. Other (preferably organic) animal fats and some fruit fat (olive and coconut) might help. You need a certain amount of dietary fat to make T. [not sure where 3600 cals per day is coming from if you are both low fat and low carb aka “rabbit starvation”…]

[/quote]

This too…I meant to mention it but got sidetracked with the no carbs…fats are essential for hormone production…

5

Since Cholesterol is the primary precursor for all adrogen hormones, would his high levels of cholesterol (222 mg/dL) suggest that he is sufficient on that aspect?

[quote]VTBalla34 wrote:

[quote]SuperFast wrote:
Also, you may not need more carbs so much as more fat. Everything is “lean”, the only sources of fat you mention are eggs and nuts. Other (preferably organic) animal fats and some fruit fat (olive and coconut) might help. You need a certain amount of dietary fat to make T. [not sure where 3600 cals per day is coming from if you are both low fat and low carb aka “rabbit starvation”…]

[/quote]

This too…I meant to mention it but got sidetracked with the no carbs…fats are essential for hormone production…
[/quote]

6

[quote]B WS6 wrote:
Since Cholesterol is the primary precursor for all adrogen hormones, would his high levels of cholesterol (222 mg/dL) suggest that he is sufficient on that aspect?
[/quote]

Yes it would appear so…

OP: Its very rare that we see someone with low E2 naturally…are you taking any supplements or meds? List all.

7

VT: I take high blood pressure medication every day which consists of:

Hydrochlorothiazide Tab, 25mg (diuretic to reduce sodium)
Amlodipine/benazepril Caps, 10/20 mg (ACE inhibitor to dilate blood vessels)

I also take a multivitamin every morning. That is all I take in addition to my diet.

I do eat low carb through the week, though my wife tends to make some kind of potato dish for evening dinner which I usually eat. I also eat whole grain toast every morning, along with 5 eggs scrambled in olive oil plus a couple strips of bacon.

The bulk of the 3600 calories comes from protein and fat. I incorrectly wrote “lean” burger, in fact I grill up ground chuck which is 80/20 and have that almost daily. Every Saturday is a cheat/refeed day as well, so I get carbs at that time.

I just wiki’ed ACE inhibitors and read that the drug works by blocking the conversion of angiotensin I to angiotensin II. Angiotensin II is responsible for messaging the adrenal glands to produce andosterone, among other functions. So far I haven’t found any medical articles that might support a decrease in andosterone leading to a drop in estradiol, but I know these hormones are all inter-related.

Obviously I have to control my inherited high blood pressure, but I wonder if the ACE inhibitor is behind my low e2? My joint pain could certainly be explained by such a low level.

Just had a “light bulb” moment with researching the medicine I take, it’s always just been something I took for granted!

8

[quote]Vicar Philip wrote:
VT: I take high blood pressure medication every day which consists of:

Hydrochlorothiazide Tab, 25mg (diuretic to reduce sodium)
Amlodipine/benazepril Caps, 10/20 mg (ACE inhibitor to dilate blood vessels)

I also take a multivitamin every morning. That is all I take in addition to my diet.

I do eat low carb through the week, though my wife tends to make some kind of potato dish for evening dinner which I usually eat. I also eat whole grain toast every morning, along with 5 eggs scrambled in olive oil plus a couple strips of bacon.

The bulk of the 3600 calories comes from protein and fat. I incorrectly wrote “lean” burger, in fact I grill up ground chuck which is 80/20 and have that almost daily. Every Saturday is a cheat/refeed day as well, so I get carbs at that time.

I just wiki’ed ACE inhibitors and read that the drug works by blocking the conversion of angiotensin I to angiotensin II. Angiotensin II is responsible for messaging the adrenal glands to produce andosterone, among other functions. So far I haven’t found any medical articles that might support a decrease in andosterone leading to a drop in estradiol, but I know these hormones are all inter-related.

Obviously I have to control my inherited high blood pressure, but I wonder if the ACE inhibitor is behind my low e2? My joint pain could certainly be explained by such a low level.

Just had a “light bulb” moment with researching the medicine I take, it’s always just been something I took for granted![/quote]

Although you are eating mostly low carb, some more high-potassium foods in addition to the potato - orange (NOT juice!), carrot, banana - might help the blood pressure. Also a magnesium supplement (before bed).

9

Sounds good SF, I like eating real foods instead of always relying on supplements.

I’ve decided to go to my regular doctor as soon as possible, he’s backed up with appointments until Sep. 29. How on earth do these guys keep all their patients straight, let alone remember details about each individual? Broken health care system, hello?

I have my expectations set low for his approach to my case, I’ll hope for the best. I appreciate all the support.