T Nation

47 Y/O New Blood Work w/Multiple Issues?


-47 yo male. Lift 3-4 x week consistent. Some form of LISS Cardio 5-6 x week.
-9 years Special Operations after college
**Had 2 x significant Heat Casualty incidents during this time. Massive Core Temp, Thermometer in the ace, ice bags bath to get temp down (possible culprit??)

-5’-11" 202 lbs, 33-34" waist

  • body hair growth - on and in ears increasing
    -2000-2200 cal +/- daily with little to no sugar.
    -Alcohol is a rarity
    -No meds or Rx
    -ON Pre-workout, Surge Workout Fuel, Mag-10 on lifting days
    -get cold easy

Labcorp bloodwork done last week and results are from today. I have little to no energy from late morning onward regardless of diet and sleep. Very difficult to get my feet under me for work and to complete home remodel which has become unacceptable. I’m tired of feeling worn-out every day. My research both here wth @KSman , DeFranco’s podcasts on Functional Medicine, and through Stan Efferding’s rants on YT pointed me to Labcorp and issues I’ve long suspected. All of my excess fat is around my stomach. I’m eating at a large caloric deficit for my weight but the scale stays at 203#. If I add food calories(clean food at that), it visibly goes straight to my stomach - but the scale doesn’t move. Top 2 abs are still visible. The quality of my workouts are completely up to using a pre-workout mixed with my Surge or not. Over the last 2 months, I’ve completely removed all other stimulants (no coffee, no energy drinks for even longer period ~2 years maybe?) and really minimized red meat.

The Gist:
I suspect issues with my thyroid and not sure if possibly linked to heat casualty damage mentioned above. I can remember being tired to the point of rubbernecking in the afternoons since those incidents.

I suspect issues with my adrenals. I’ve read the adrenal fatigue book mentioned in the sticky, have done the temp readings in the past, supplemented with iodine but never could get temp up to 98.6. Low at start was 95.7, highest after iodine was 98.2 after 2 weeks. Temps taken with old school oral thermometer unfortunately. It is definitely time to get back on supplementation consistently again, and for good.

Inflammation attacks. Recently, when my immune system is weakened, my body has been attacked by some type of heavy inflammation. I had a shoulder reconstruction and old hardware removal in shoulder done almost 2 years ago. The surgeon diagnosed me with pseudo-gout after finding crystals in my shoulder fluid when I had nearly frozen shoulder on the table. A short time later (3 weeks maybe), my whole body was racked with an inflammation attack in nearly every joint. My hand opposite of shoulder repair swelled significantly, I couldn’t raise my arms above 90 degrees (repaired shoulder obviously), and it felt like I had broken glass in my knees, back, shoulders, and elbows. Every arthritic type bloodtest came back negative (to include RA, gout, and pseudo-gout levels/indicators).
Two months ago, I came down with pneumonia, oddly overnight. Once I came of my meds, my whole body broke out in hive-like rash and worsened if I moved. Double dose steroid dose pack Rx was done for both.

I’m not sure how many of these are linked, associated with aging, or are simply dumb luck…but here I am.

Test Results: unfortunately, this test bundle didn’t have a cortisol test included. High LDL was a big surprise. @KSman what do you see?

Here we go:

CBC With Differential/Platelet
WBC 4.4 3.4-10.8 x10E3/uL
RBC 4.88 4.14-5.80 x10E6/uL
Hemoglobin 14.4 12.6-17.7 g/dL
Hematocrit 43.1 37.5-51.0 %

Comp. Metabolic Panel (14)
Glucose, Serum 84 65-99 mg/dL
BUN 21 6-24 mg/dL
Creatinine, Serum 1.06 0.76-1.27 mg/dL
BUN/Creatinine Ratio 20 9-20
Sodium, Serum 142 134-144 mmol/L
Potassium, Serum 4.3 3.5-5.2 mmol/L
Chloride, Serum 105 96-106 mmol/L
Carbon Dioxide, Total 22 18-29 mmol/L
Calcium, Serum 9.3 8.7-10.2 mg/dL
Protein, Total, Serum 6.7 6.0-8.5 g/dL
Albumin, Serum 4.2 3.5-5.5 g/dL
Globulin, Total 2.5 1.5-4.5 g/dL
A/G Ratio 1.7 1.2-2.2
Bilirubin, Total 0.5 0.0-1.2 mg/dL
Alkaline Phosphatase, S 65 39-117 IU/L
AST (SGOT) 18 0-40 IU/L
ALT (SGPT) 15 0-44 IU/L

Lipid Panel
Cholesterol, Total 174 100-199 mg/dL
Triglycerides 85 0-149 mg/dL
HDL Cholesterol 51 >39 mg/dL
VLDL Cholesterol Cal 17 5-40 mg/dL
LDL Cholesterol Calc 106 HIGH 0-99 mg/dL
Iron and TIBC
Iron Bind.Cap.(TIBC) 281 250-450 ug/dL
UIBC 191 111-343 ug/dL
Iron, Serum 90 38-169 ug/dL
Iron Saturation 32 15-55 %
Testosterone,Free and Total
Testosterone, Serum 411 348-1197 ng/dL
Free Testosterone(Direct) 7.3 6.8-21.5 pg/mL

Hemoglobin A1c
Hemoglobin A1c 5.4 4.8-5.6 %

Thyroxine (T4) Free, Direct, S
T4,Free(Direct) 1.12 0.82-1.77 ng/dL
DHEA-Sulfate 113.0 71.6-375.4 ug/dL
TSH 5.140 HIGH 0.450-4.500 uIU/mL
Luteinizing Hormone(LH), S
LH 5.3 1.7-8.6 mIU/mL
FSH, Serum
FSH 2.9 1.5-12.4 mIU/mL
Prolactin 15.7 HIGH 4.0-15.2 ng/mL
Vitamin D, 25-Hydroxy
Vitamin D, 25-Hydroxy 28.0 LOW 30.0-100.0 ng/mL

C-Reactive Protein, Cardiac
C-Reactive Protein, Cardiac 0.86 0.00-3.00 mg/L

Estradiol, Sensitive 19.2 8.0-35.0 pg/mL

GGT 12 0-65 IU/L
Magnesium, Serum
Magnesium, Serum 1.9 1.6-2.3 mg/dL
Progesterone 0.1 0.0-0.5 ng/mL
Insulin 4.6 .6-24.9 uIU/mL
Ferritin, Serum
Ferritin, Serum 190 30-400 ng/mL

Triiodothyronine,Free,Serum 2.8 2.0-4.4 pg/mL

Sex Horm Binding Glob, Serum
Sex Horm Binding Glob, Serum 40.8 16.5-55.9 nmol/L

@KSman’s work here is nothing short of outstanding and of major help. Any feedback on my health history and labs is extremely appreciated as well. Please let me know if there is any additional information to provide to help shed light on what I may be experiencing.

Thank you to all for your time!

TSH is way too high. Were you using iodine supplements recently? That can increase TSH.

Please get current body temps to go with this lab set.

What has been your selenium source over time? Did you get selenium when taking iodine?

fT3 is below mid-range, so is fT4.

Might need thyroid autoimmune panel.
Thyroid checked by doctor? Do not get thyroid palpated then proceed to thyroid lab work.

CRP not indicating much re inflammation.

Do you take?
fish oil
vitamin D - nope, take 5000iu per day, 25,000iu first 5 days
DHEA, take 25mg per day
natural source Vit-E
All of the above need to be taken with low fiber meals with more fats and oils to facility absorption
selenium 200mcg in a high potency B-complex multi-vit, iron free, trace elements including 150mcg iodine 200mcg selenium

Are labs indicating that you were dehydrated for your fasting lab work?

FT is quite low and elevated SHBG might be par of this, also elevating TT.
FSH indicating secondary hypogonadism.
How many blows to the head have you suffered and severe?
Has your pituitary been MRI’d?
Prolactin may be indicating a pituitary adinoma. Get a follow up prolactin lab avoiding for a few days prior: orgasm, cuddling { babies | puppies | kittens } which can release prolactin.

What toxins are you getting exposed to with the home renovation work?

@KSman - your response is much appreciated. Thank you again.

This morning’s temp was 96.9 (taken twice, same result). Mid day yesterday was 97.4 when I started my temp log.

I’ll try and respond to all your questions in order:

I’ve been negligent on my consistent supplementation for quite awhile now and I’m paying for it, so NO iodine supplements have been taken recently prior to labs.

My selenium source would be from a Thyroid Complex I have from the Vitamin Shoppe. 1 capsule has B1, B2, B6, an B12 vitamins. 150 mcg iodine, 100 mg magnesium, 3 mg zinc, 70 mcg of selenium. Again, haven’t been taking it for a long while prior to labs.

Do you recommend thyroid autoimmune panel prior to restarting heavy supplementation and IR? Thyroid has been suspect by doc in past physicals, but labs weren’t this bad on last physical 2 years ago, hence no action Rx’d. Those labs aren’t as complete as these are. I ordered these myself if I didn’t point that out in my original post.

CRP not indicating inflammation? Is CRP a typo or am I missing which entry to look at?

I have access to (but haven’t taken consistently in a long while):
fish oil - Biotest Flameout - I never have been able to figure out a good dosing plan with these.
Vitamin D3 is ordered and will be here today
DHEA is ordered and will be here today
I have a Vit E to take. 400iU gells.

I also have on hand:
Biotest ZMA,
Rhodiola, and Curcumin.
ZMA and Z-12 are when I’m feeling my recovery really lagging and I take before bed. 2 ZMAs give me crazy dreams and sit heavy in my stomach, hence the Z-12 gets taken instead more often. But again, not in awhile prior to labs.
Astaxanthin - 4mg tabs

Labs didn’t say anything about potential dehydration. Blood draw went quick, easy stick and flowed well; UA was on demand as usual with no issue filling sample. My urine was yellow, which did surprise me. I expected lighter.

Blows to the head - I played HS and College football prior to the military. My last significant head blow was a concussion on an airborne operation in 1993 timeframe. Rough exit, parachute riser came under my helmet rim and tore my helmet away, tearing the metal buckle apart in the process. Rung my bell pretty good. I can’t recall any others since then.

Pituitary - no MRI and has not been suspect by docs or myself until now. After rereading your stickies and researching my lab results, it would appear the upstream source of many problems could very well be my pituitary. So much so, it has me wondering if this was the actual source of my heat injuries in the 90s due to poor temp regulation ability from a long time condition I haven’t been directly aware off. TSH, prolactin, and FSH from my pituitary would seem to be throwing off my thyroid, adrenals/test production according to this lab set.

Toxins on remodel are your standard you get with older homes. Anything in a range from heavy dust to lead paint, fuel oil heating systems, to I’m sure materials containing asbestos in some trace amounts. My remodeling is not an everyday thing, and more of an inconsistent hobby on weekends. The majority off the above has been hounding me long before any projects began, but I do see your logic in the question.

Today I’ll start IR again, 50mg Iodoral. Along with 25mg DHEA and 25K iUs of D3 when they get delivered as you RXd above. It looks like the thyroid complex doesn’t have enough selenium, so I should look for that as well. Do you have dosing suggestions on the Flameout and Vitamin E?

Vit-D3, DHEA, Vit-E and flameout absorb better with meals that have more fats and less fiber.

Vit-E 400 is probably not natural source that contains a spectrum.

Do not be dehydrated for your labs as it reduces blood volumes and then affects all lab results that are by volume. Drink water when fasting for labs.

Do not start Iodoral without selenium.

Leg or foot cramps? Can contract muscles to lock them up? - magnesium deficiency. Just take it and your body should find a new balance.