T Nation

A Little Help Interpreting Blood Tests?


#1

I had a few tests done and I would love to get some feedback on my results, particularly relating to my TSH and E2 levels. Results are as follows:

FT3 - 2.75 (2.02 - 4.03)
FT4 - 1.55 (0.93 - 1.71)
TSH - 3.10 (0.25 - 5.0)

Total T - 985
E2 - 32

First, I would like to know if I should be doing anything to get my TSH down, it seems high if my desire is optimal performance.

Also, I’m wondering if I would notice much difference if I got my E2 down to around 20?

I’m a 38 year old guy and been training steady the last couple years. I’m about 12% bodyfat and seem to have hit a wall with further fat loss (I’ve lost about 20 lbs of fat over the last year).

That’s the reason I got the blood work…

I’m wondering if my hindered fat loss is metabolism related (thyroid issue?) and/or elevated E2 that is telling body to hold on to stubborn body fat (lower abdomen, back, and love handles)?

Any input/feedback is much appreciated.


#2

E2 near E2=22pg/ml would allow for better fat profiling. You could try Arimidex/anastrozole 0.5mg/week in divided doses. But what doctor would Rx that?

Also need free testosterone tested as TT can sometimes be misleading.

TSH should be closer to 1.0
T3, T4, fT3, fT3 should be mid-range or a bit higher.
fT3 is the active hormone and is low.
Thyroid function can be low from not using iodized salt - long term.
Check overall thyroid function by checking oral body temperatures as per the thyroid basics sticky found here: About the T Replacement Category

TSH=3.1 is a big issue.

Are your outer eyebrows sparse?
Feeling cold easier?

As long as you are seeking to be optimal, take 5,000iu Vit-D3 and take a multi-vit that has iodine+selenium as well as other trace elements.


#3

Actually, I did get a script from a doc when I was in Kenya and currently have some Arimidex. I started taking .25 gram twice a week just recently. Nice to hear that my estimated dosage is on par.

Yea, outer eyebrows a bit thinner and at times I have a sensitivity to cold. I had Malaria last week and I was really feeling cold then, lol.

I will start taking my body temp and re post on here.

Thanks for feedback!


#4

I’ve been taking my temperatures and I generally have wake up temperatures, first thing in the morning, around 97.1 - 97.4.

Throughout the day, my temperature is usually between 97.7 - 98.2. Occasionally, I have seen it get up to 98.6 but it does not stay there long.

I do take a multi vitamin from GNC which has
200 mcg of Selenium and 150 mcg of iodine.

It seems my temps are low and indicate a less than optimal thyroid function.

Should I check blood work for an iron deficiency?
Could that be a cause?
Maybe cortisol is too high and affecting T3?

Any advice would be greatly appreciated.


#5

Are you cooking with iodized salt?
Iodized salt on the table?
Do you use it?

Why guess what high cortisol might do when you do not know cortisol level?

Iron low?
Post CBC and hematocrit.
Males do not need added iron unless blood loss from a GI bleed.


#6

K Sman,

Yes, I am using iodized salt.

I just got some new blood work done. Here are the results. Also, this was done at a different lab than my first test so I don’t know if “total estrogens” is the same as E2 like I had tested before. If it is the same, it has gone up significantly. My TSH is higher than before as well.

The things that I have changed since my first blood test is that I started taking low daily dose of Finasteride at 0.62 mg and a dose of Arimidex twice a week of 0.25 mg per dose. I was expecting the Estrogen to come down but I guess with the suppression of DHT conversion from the finasteride, there is more testosterone to convert to E2. I am planning on upping the Arimidex to two doses a week at 0.5 mg per dose. (I am taking the Finasteride to halt male pattern baldnes).

TSH - 3.51
Total Estrogens - 78 (40-115)
Free Testosterone - 15.2 (8.7 - 25.1)
Total Testosterone - 946.7 (348-1197)
Folate (Folic Acid), Serum - 12.6 (>3.0)
Vitamin B12 - 1007 (211-946)

Metabolic Panel
A/G Ratio - 1.8 (1.1-2.5)
Albumin, Serum 4.1 (3.5-5.5)
Alkaline Phosphatase, S - 51 (39-117)
ALT (SGPT) - 24 (0-44)
AST (SGOT) - 18 (0-40)
Bilirubin, Total - 0.3 (0.0-1.2)
BUN - 23 (6-20)
BUN/Creatinine ratio - 19 (8-19)
Calcium, Serum - 9.1 (8.7-10.2)
Carbon Dioxide, Total - 24 (18-29)
Chloride, Serum - 103 (97-108)
Creatinine, Serum - 1.23 (0.76-1.27)
eGFR If Africn Am - 86 (>59)
eGFR If NonAfricn Am - 74 (>59)
Globulin, Total - 2.3 (1.5-4.5)
Potassium, Serum - 4.6 (3.5-5.2)
Protein, Total, Serum - 6.4 (6.0-8.5)
Sodium, Serum - 142 (134-144)

CBC with Differential/Platelet
Baso (Absolute) - 0.0 (0.0-0.2)
Basos - 1
Eos - 3
Eos (Absolute) - 0.2 (0.0-0.4)
Hematocrit - 39.3 (37.5-51.0)
Hemoglobin - 12.7 (12.6-17.7)
Immature Grans (Abs) - 0.0 (0.0-0.1)
Immature Granulocytes - 0
Lymphs - 37
Lymphs (Absolute) - 1.9 (0.7-3.1)
MCH - 29.5 (26.6 - 33)
MCHC - 32.3 (31.5 - 35.7)
MCV - 91 (79-97)
Monocytes - 7
Monocytes (Absolute) - 0.4 (0.1-0.9)
Neutrophils - 52
Neutrophils (Absolute) - 2.6 (1.4-7.0)
Platelets - 262 (150-379)
RBC - 4.3 (4.14 - 5.80)
RDW - 12.8 (12.3 - 15.4)
WBC - 5.1 (3.4-10.8)

My GP tells me that my “blood labs look good”. I find it funny when I talked to her beforehand about my previous TSH of 3.1, she agreed with me about it being high… but when the new tests came back, she says everything looks good… sigh.

My BUN and B12 are out of the range and I have some readings that are on the far end of the range like the BUN/Creatine ratio;Calcium, Serum; Creatinine, Serum; Protein Total, Serum; Sodium, Serum; Hematocrit; Hemoglobin; and RDW.

I think my TSH is far from optimal, I have continued to take morning temperatures and they have consistently been under 97.0.F I definitely feel sluggish at times and I have been gaining weight even though my diet is good and am exercising regularly.

I also think I should be trying to get my E2 down under 30.

Please feel free to give me any advice or insight. Obviously, my GP isn’t going to be any more help to me so you are my best chance right now when it comes to making some sense of this blood work.

The only good news is that my insurance did pay for all this blood work, bad news is that I will be paying for any further tests since my labs “came back good”.

I thank you very much for the time and effort you have already put into my case, your expertise is very much appreciated.


#7

HTC=39 is way too low VS your T levels.
Raises the possibility of a GI blood loss and you can request an occult blood test to see if there is any blood in your poop. Total protein sometimes is lower with a GI bleed or low T which you do not have.

You can try more iodine but MUST have selenium.

If a GI bleed, less iron. RBC was a bit low, but expected with low HTC.

Doctors and normal … sigh

From your earlier E2 test, comments re anastrozole still stand.


#8

Thanks for reply.

That’s interesting that low HTC points to possible GI problems (bleeding). I have been feeling like I have some sort of problem with my digestion for a while now. My GP just diagnosed me with IBS but she admitted that all that really means is that we don’t know exactly what is causing you intestinal distress. At times I am overly bloated and have mild pain in abdomen. I do have an appointment to see a GI specialist soon so hopefully he can come up with something conclusive.

On a side note, I had an ultrasound done on my bladder and prostate and it showed that I have a abnormally enlarged bladder wall yet my urine test didn’t show any infection. I have an appointment to see a urologist as well.

Concerning Iodine and Selenium…

What would be good amounts to aim for?

-1 oz of Brazil nuts has appx. 542 micrograms of Selenium.
-A Kelp supplement by NOW.
Green Superfood 325 mcg of Natural Iodine Supports Thyroid Function* With 150 mg of Dulse A Dietary Supplement Vegetarian Formula Kelp

Does that look like a good daily regiment? 1 oz of Brazil nuts with a serving of that Kelp supplement from NOW?

Thanks again.


#9

That looks ample!

Glucosamine is good for intestinal health and healing.

Ask for that occult blood test.


#10

Update…

I have been taking 12mg of Iodoral daily with 200 mcg of Selenium. I have been noticing my wake up temps slightly rising.

My day time temp was rarely getting above 98 F so I have been trying the temp reset protocol listed here…
http://www.fixlowbodytemp.com/papers/LowTemp.htm

The reset protocol is 20% down the page under
"The Day of Reprogramming".

I have been able to get my temp up to 98.6 without supplementing T4 or T3. I just add clothes and consume caffeine, cayenne pepper, ginger root, and coconut oil.

My question is regarding my temp when I am exercising. I brought a thermometer with me to the gym today. I did a medium intense workout with 2 - 3 min rests between sets. I felt like crap after 45 min and stopped. I immediately took my temp and it was 95.3. ??? I would think that your body temp would rise when exercising.

Do you know if it means anything in particular if your body temp drops when exercising?

I think my next step is to get some 25 mcg Cytomel and try 12 mcg/day. I hope the stuff by Abdi Ibrahim is legit.

Thanks again for any feedback.


#11

When exercising with heavy breathing you may be cooling down your mouth and throat.

Good news with body temperature recovery with iodine.
Are you getting selenium? - YES

You feel more alert, better mood and energy?


#12

I think you’re right about the breathing making my oral temp go down. I tested temp the ‘other’ way after a workout and it was over 99 F.

I have to admit, I actually am feeling different. I have an energy level that is continuing through the day that I have not had in a long time. I think when I felt like crap during my workout the other day, it could just have been some of the toxins affecting me from my current Iodoral supplementation. I read that sometimes people can feell a bit ill when starting iodine supplementation because the iodine is actually helping to flush some the toxins out (I think they said bromins or halides or something like that).

I know my metabolism has been running low up to now and I am hoping that this increased energy is a sign that my metabolism is getting ramped up again. It was really hard to lose fat before and I’ve actually gained about 10 lbs while staying under 2500 cal/day in the last couple months with weightlifting and some cardio 3-5 times a week (I’m 190 lbs now and 5’11" and 38 yrs old). Hopefully that will start to change.

I saw this post of yours in another place…

These improve insulin sensitivity: improving cell wall permeability and mitochondrial metabolic rate
TRT
lower E2
fish oil
CoQ10 - ubiquinol type please
r-lipoic acid
cetyl-l-carnatine
natural source vit-E
vitamin C
vit-D3 5,000iu
chromium picolinate
B-complex multi-vits with trace elements and anti-oxidants including iodine and selenium

I’m currently taking most of these but would you mind telling me what the dosing/timing for the following should be?

Ubiquinol Coq10
r-lipoic acid
acetyl-l-carnitine
and the total EPA and DHA amounts of fish oil that I should be taking for maximal metabolic function.

I can’t even begin to express how great it feels to finally be coming out of this lethargy and actually having a solid reason for what my problem was (iodine and selenium deficiency).

Thanks a million. You have been an amazing help.

If I lived in Kansas, I would offer to come and cut your lawn a few times or fix something on your house for you!


#13

I just got some blood work done and I thought I’d post my results as an ongoing update to this discussion…

Testosterone, Total, LC/MS 839.0 ng/dL (348.0 - 1197.0)
Adult male reference interval is based on a population of lean males
up to 40 years old.

Free Testosterone(Direct) 12.9 pg/mL (8.7 - 25.1)

Dihydrotestosterone 27 ng/dL
Reference Range: Adult Male: 30 - 85

T4,Free(Direct) 1.47 ng/dL (0.82 - 1.77)
TSH 4.860 uIU/mL (0.450 - 4.500 03)
Triiodothyronine,Free,Serum 2.5 pg/mL (2.0 - 4.4)

Estradiol, Sensitive 11.4 pg/mL (8.0 - 35.0)

I think my DHT is about where I want it. It’s not dead but pretty low. I am assuming that with it low, I would eventually see my male pattern baldness decline.

However, I think my free T is lower than I want, from a bodybuilding perspective.

E2 is probably a bit too low. I will probably space my A-dex doses out a bit more. I have been taking 0.5mg and then taking 2 full days off and then taking another 0.5mg. I think my E2 target should be around 22 so I will start taking 3 full days between doses…

KSman, does that dosage adjustment make sense to you?

I also thought I’d ask if you have heard of people’s TSH going up after starting iodine supplementation?

My TSH was 3.5 a couple months ago and is now at 4.5. Not what I was hoping for. The strange part is that since starting taking iodine, I do have more energy, body temps have been up, and I have seen results in fat loss around abdomen. I had been stalled out before with my fat loss and I have lost fat without changing much of anything in diet or exercise other than starting taking Iodoral daily.

I read this on another site…

"It is well known, or should be well known, that iodine is transported into the cell by a transport molecule known as sodium-iodide symporter (NIS). NIS is stimulated by TSH. Therefore, when iodine supplementation is begun, one of the first effects seen is a slight elevation of TSH as the body is trying to produce transport molecules (NIS) to move iodine into the cell. After iodine supplementation begins, it is normal and expected for TSH to elevate slightly."
http://drdavidbrownstein.blogspot.com/2012_01_01_archive.html

Does that theory make sense to you?

Here are a couple pics that are only about 1 month apart since taking Iodoral.

Any feedback is appreciated.


#14

Just an update. I had iron levels tested and they came in at the very low end of the range. I have high fT4 and low fT3. I think my low iron is affecting my ability to convert T4 to T3. I’ve started taking some iron supp and low dose of T3. I think my iron is low because of poor absorption due to my high consumption of calcium rich foods and constantly drinking coffee/tea.

We’ll see how things change in the future.


#15

Auditing old threads.

fT3 is the active thyroid hormone and I expect that your body temperatures would then be low.

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

Serum iron is highly variable, depends on recent meals. One should not make changes based on that alone. At times I have been low and sometimes high. You need to be looking at RBC, hematocrit, hemoglobin and perhaps ferritin. If T levels are strong and blood appears thin, do an occult blood test to see if there is blood in your stool. Men should not need added iron and often need to avoid iron fortified foods/supplements.

HTC was low. I suggested occult blood test.
RBC was of interest too.

Low ferritin can impede T4–>T3. Ferritin >~80 is considered adequate, less is not.

Absorption can be poor from anti heartburn meds.