T Nation

Blood Draw Questions

Background: 26, 27 in a week
Hairy legs, hairy arms, thick head of hair, PATCHY beard, but covers most of jaw line with a couple gaps.
Wrestled in high school and have a decent mesomorph build
185 lbs as of writing this (let myself go, was 230 lbs 10 months ago)

Diagnosed with panic disorder at 17 which turned into agoraphobia
Got onto SSRIS (Paxil) and overcame agoraphobia
Used the gym as an outlet and got tight thick solid 170 lbs 5’9 natty
Let myself go during relationship to 226 lbs peak, back down to 186

Was in a relationship for 4 years, recently broke up and obviously my constant battle with my anxiety/depression issue took its toll in the relationship with my constant lethargy, lack of motivation etc (when i met her i was motivated, and driven)
I always coined it up to her as “its my meds, they make me tired” which is 60% the truth according to my assumption, because the things I was avoiding I naturally loved but lost desire to do it.
Also ED/low libido ever since starting my Paxil, low sex drive, I was the one saying no. Went from 2-4x a week during the honeymoon phase, to once a week (my choice) during the last 2 years of “complacency phase”

I also coined up all these issues to my paxil (which for now I CANNOT get off of, but I do plan to in the future) I’ve been on them for 9 years and they have helped me as a mental safety net even if its just a placebo and I’m really the one just pushing through my shit.

Anyway, Thoughts?

Component Your Value Standard Range
TSH 1.98 uIU/mL 0.33 - 4.70 uIU/mL
FREE T4 (REF) 1.11 ng/dL 0.89 - 1.76 ng/dL

VITAMIN B-12 905 pg/mL 211 - 911 pg/mL

Vitamin D, 25 Hydroxy 34.8 ng/mL 30.0 - 100.0 ng/mL

I have an APT with a TRT clinic, these blood labs were done by my GP, idk why he didn’t check est levels, but he is a gp so.

Your levels are low for your age, SHBG is low and dictates your TRT protocol to 10-14mg ED or 25mg EOD injections using 27-29 gauge insulin syringes.

TRT will lower your SHBG making frequent injections important, be warned some if these TRT clinics force weekly office visits for you injection for profit.

There’s another reason for very frequent injections, those prone to anxiety injecting moderate to large doses can get anxiety from the T spikes from Test cypionate.

T-creams (applied to testicles) may be useful in these cases where Test cypionate causes anxiety and/or panic attacks.

Thyroid labs are incomplete, Free T3 (not TSH or Free T4) increases metabolism and provides energy to every cell in your body. Usually TSH <2.5 is alright.

You do not really have enough labs to be undertaking TRT, we need to know there are no mineral deficiencies many of which could cause anxiety.

I started TRT with an iron and vitamin D deficiency and TRT added vitamin C and potassium to the list of deficiencies.

What should I ask them to test for next time?

Component Your Value Standard Range
Na 141 mmol/L 135 - 144 mmol/L
K 4.0 mmol/L 3.7 - 5.5 mmol/L
Cl 105 mmol/L 99 - 110 mmol/L
CO2 26 mmol/L 20 - 31 mmol/L
Anion Gap 10 4 - 13
Glucose 93 mg/dL 65 - 99 mg/dL
Diagnostic Categories (per ADA):

< 100 mg/dL = Normal
100 to 125 mg/dL = IFG (Impaired Fasting Glucose)

/= 126 mg/dL = Diagnosis of Diabetes.*

2 Hr OGTT:
< 140 mg/dL = Normal
140 to 199 mg/dL = IGT (Impaired Glucose Tolerance)

/= 200 mg/dL = Diagnosis of Diabetes.*

  • In the absence of unequivocal hyperglycemia, results should be confirmed by repeat testing.

In Pediatric patients, type 1 diabetes is more common and may warrant more immediate attention.|
|BUN|18 mg/dL|6 - 23 mg/dL|
|Creatinine|1.03 mg/dL|0.60 - 1.30 mg/dL|
|Bun/Creatinine|17.5|5.0 - 28.0|
|Ca|9.4 mg/dL|8.3 - 10.4 mg/dL|
|Alkaline Phosphatase|68 IU/L|32 - 110 IU/L|
|Bilirubin Total|0.8 mg/dL|0.2 - 1.2 mg/dL|
|AST|18 IU/L|11 - 39 IU/L|
|ALT|15 IU/L|6 - 42 IU/L|
|Total Protein|6.7 g/dL|5.9 - 8.2 g/dL|
|Albumin|4.7 g/dL|3.0 - 5.0 g/dL|
|Globulin|2.0 g/dL|1.6 - 4.0 g/dL|
|Albumin/Globulin Ratio|2.4|0.6 - 2.8|

Go to discountlabs (dot) com and search pre trt panel. It will show a list of labs to get. Then search full thyroid panel and add reverse T3 to that list. Take those to your doc and ask him to run those labs in addition to a full CBC and metabolic panels. That’s a good place to start. When he says some bullshit excuse for not running any of them place your foot on his groin and say “this is Sparta”.

*when you search for those panels it will say towards the bottom “you may want to add ___”. Add those to your list.

**You may also want to add a full iron panel including ferritin & folate.