T Nation

Abnormal Bloodwork. Feel Awful. Looking for Some Insight


#1

Hey guys, First time posting and been browsing the forums the last few days. I have some abnormal blood work and im hoping this is the cause for why ive been feeling awful the last 3 months. I’ll explain briefly.
3 months ago had a what i imagine, a panic attack out of nowhere at dinner. I’ve never been an anxious person or had an attack before. My life was going in a great direction so i was not stressed. That was 3 months ago and i haven’t felt right since. I am not on any medicine at the moment or being treated for TRT. I was taking adderall at the time but have stopped since.
Labs 8 months ago when i felt normal besides fatigue
Test total 499 (348-1197)
Free T 18 (9.3-26.5)
Estradiol 14.3 (7.6-42.6)

Current Labs:
Test Total: 327 (264-916 normal)
Free T: 9.7 (9.3-26.5)
Prolactin: 27.9 (4-15/2) Tested several times the last 3 months. Were also 38, 24,19,13.
Estradiol 9.5 (7.6-42.6)
IGF-1 333 (115-355)
FT3: 3.65 (2.5-3.9)
T4: 1.04 (0.58-1.20)
FSH: 1.5 (1.5-12.4)
LH: 4.9 (1.7-8.6)
TSH 1.32 (0.34-5.60) Was 2.26 1 month ago
ACTH 22.9 (7.2-63.3) Was 26.3 1 month ago
Aldosterone 5.0 (0.0-30.0)
cortisol (urine): 117 & 98 (range 0-50) Tested twice
Cortisol Saliva normal
Cortisol AM blood Normal
Cortisol PM blood 11.5 (<10)
I have some other bloods, so if im missing something feel free to remind me and ill post it.

MRI of my brain showed a 3mm-4mm Rathke Cleft Cyst in my pituitary. First endo i saw was not helpful and didn’t know what to think of it.

My current endo doc has been great so far and is ordering all the bloods and isn’t ruling out my pituitary being the issue for this. I have a follow up next week. i guess what im getting at is, could my bloods and symptoms be why i feel like complete shit and out of nowhere?
24 year old male, clean diet 5’11 190lbs. I used to lift 6 days a week but now i hardly lift 3 days a week because im so fatigued and feel awful.
Symptoms:
Severe brain fog/lethargy
Anxiety and occasional panic out of nowhere
appetite not great alot of days
trouble sleeping
confusion
trouble processing things
loss of libido
orgasms aren’t as good
gaining fat around my lower stomach
and im sure a few other things.

I feel like my world did a complete 180 the last 3 months and i can hardly function. Does my blood work make sense for why i feel so crappy? Now were trying to find the cause, but i just want to know WHY i feel this way. My Blood pressure has also spiked pretty high sometimes but goes back to normal. Could be because of anxiety or another issue. Doc also did an MRI of my adrenal and carotid Artery to rule out Pheo as i had all the symptoms. My catacholamines bloods were normal. waiting on 2nd batch to come back.

Thank you for reading and sorry for the long post.


#2

Your low estrogen is the cause of your panic attack, estrogen is important for mood stability and typically when estrogen plummets men have a difficult time where you may seem emotionless, yet irritable and anxious. Prolactin is a concern, also your missing the most important lab test, SHBG tells us how well you hold onto your testosterone.

Any doctor who doesn’t understand it’s important may not be able to come up with an effective treatment plan. TSH is rather useless without Free T3, Free T4, Reverse T3 and antibodies as all of these creates the bigger picture, run half of these labs and you only get half the picture possibly missing an important disagnosment that may go undiagnosed for decades.

If it weren’t for your elevated prolactin I would say you look like to have primary hypogonadism.
The fact that your doctor missed SHBG is troubling as it’s the gold standard for sex hormone testing and evaluation and any doctor who thinks it’s not necessary will be unable to assist you going forward if TRT is needed.

You must educate yourself because the majority of endo’s prescribe some of the worse protocols to men that has to do with the fact doctors actually have no training in proper TRT protocol, there is no standard of care model for TRT. SHBG levels will determine dosing and injection frequency.

Most healthy 24 years are scoring in the 800-1000 ranges so your way below average, men with high normal testosterone have a 30% less likely chance of cardiac events than those in the 500 ranges, men scoring in your ranges have a higher mortality rate.


#3

I really appreciate your response, thank you.
I also thought my panic was due to my low estrogen after reading more about it. I’m assuming this also ties in with how I’ve been feeling as a whole. I think I have those other lab results. I will dig those up and post them here within the hour.


#4

You’re welcome,
You can also test thyroid function by measuring morning and afternoon oral body temperatures, need to be 97.7 upon waking and 98.6 by 2 pm. If body temperatures are even slightly lower and Free T3 levels are good, elevated Reverse T3 is suspected.


#5

I do not appear to have SHGB unfortunately. my
T3 is 3.65 (2.5-3.9)
T4 1.04 (0.58-1.20)
Thyroglobulin 9.2 (1.4-29.2)
thyrglobRIA N/A

i will check my temps tomorrow.
thank you


#6

@physioLojik Would you mind giving your opinion on this please? If my symptoms make sense according to my bloodwork? Thank you for your time.


#7

@albert9000 Hey man. Has your new endo scheduled a follow up MRI? That cyst is small but could become problematic. They can compress the pituitary and cause loads of drama. Drainage is preferable over excision these says. Super easy.


#8

Hey buddy, Thanks a lot for your response. You know your stuff so im glad i could get your opinion. I’m meeting with my endo this coming week and i believe shes going to get another MRI done.

I’ve always heard prolactin would be super high and mine is not. However it’s fluctuating from high normal to 38 (4-15) (but what the hell do i know lol) From what you’ve seen, Is it safe to assume my symptoms line up with my low e2 and prolactin?


#9

YI think low e but also high prolactin means low dopamine. Try tyrosine to raise it up a tick and you’ll feel better :slight_smile:


#10

Thank! ill give that a shot until i get this sorted out.


#11

Doc ended up putting me on 0.5 caber per week and going to watch the cyst. Going to see if the caber helps my T levels/e2 go up. I was told my “E2 is a female hormone and its good thats its low” next step will be trt.


#12

Sure hope you don’t plan on using this guy for TRT, men would be a eunuch without estrogen.


#13

Absolutely not. I don’t think that endo would even treat my low T, because it’s “slightly low” and doesnt think any of the problems im having are related. I am happy they are treating my slightly elevated prolactin but i’ve already contacted Defy and a local clinic for TRT. @systemlord Is there private message on here? wanted to pick your ear for a second through PM but didn’t see the option.


#14

No PMs here.


#15

Yea that’s stupid. lol. I’m glad they Rx caber and not bromocriptine :slight_smile:


#16

Low E gave me terrible anxiety and a few panic attacks. Worst feeling ever.


#17

do you remember what your E2 was tested at?


#18

Less than 10 usually for severe anxiety but I felt different and more anxious even in the teens. Once I tested at 2 all estrogen sensitive.


#19

I had my SHBG tested 30.5 (16.5-55.9 nmol/L)
how would this correlate to my other labs?