T Nation

Blood Work, 33 Years Old


#1

height: 5,7

weight: 199 lbs

No facial hair/baby face

Mesomorph type of body

Supplements:
Zinc
magnesium
fish oil
Vitamin D
Kelp (iodine)


Total Testosterone : 6.3 ( 6.1-27.1) nmol/L

Free T : 196 ( 110-660) pmol/L

Bio-available T : 4.4 ( 2.8-15.5) nmol/L

SHBG: 11 ( 13-84) nmol/L

Estradiol : 78 (40-160) pmol/L

FSH: 2.1 ( 1.0-19.0) IU/L

LH: 2 ( 1.0-9.0) IU/L

DHEAS : 7.7 (2,9-12.6) uml/L

Free T3: 5.4 (3.3-6.0) pmol/L

T4: 11.9 ( 9.0-19.1) pmol/L

Prolactin: 8 (3-13.) ug/L

Progesterone: 4 (0.5-6.6) nmol/L


Glucose fasting: 6 ( 3.8-6.0) mmol/L

ALT: 56 ( 10-50) u/L

ALP: 106 ( 40-110) u/L

Albumin: 48 ( 36-48) g/L


Cholesterol: 4.6 ( 3.5-5.2) mmol/L

HDL: 1.6 (1-10) mmol/L

LDL: 2.3 ( 0.00-3.5) mmol/L

Triglycerides: 1.3 ( 0.00-1.7) mmol/L


Ferritin: 381 ( 24-336) Ug/L

Hemoglobin: 150 (130-175) g/L

Hematocrit: 0.435 ( 0.410-0.510) L/L

WBC: 4( 4.0-11)

RBC: 5.2 ( 4.5-6)


Symptoms:

Low energy

No libido

No motivation

anxiety

Easily gain fat around waist

Depression

Any input would be appreciated?


KSman is Here
#2

Any feedback would be appreciated…


#3

How old are you?
Suggest you see a competent endocrinologists like Eugene Shippen


#4

Im 33 and not in the US.

What can you tell from my blood work?

Possible protocol?


#5

@Ksman can you give me any feed back on blood work? I would really appreciated


#6

Avoid any foods with added iron.

Read the advice for new guys sticky.

What Rx or over the counter [OTC] medications?

ALT: 56 ( 10-50) u/L
ALP: 106 ( 40-110) u/L

  • are elevated, can be medications, or alcohol as simple causes

Free T3: 5.4 (3.3-6.0) pmol/L
T4: 11.9 ( 9.0-19.1) pmol/L
T4 is a bit low, better if closer to 15

  • do you use iodized salt?

Best measure of thyroid function is checking your body temperatures, see the thyroid basics sticky.

You have secondary hypogonadism. Prolactin is not the cause. E2 is quite high relative to your T levels making you estrogen dominant.

SHBG is low, a symptom of diabetes and fasting glucose is high border line. A test called A1C would be definitive.
TRT improves insulin sensitivity.


Low SHBG levels increase the probability of Type 2 Diabetes. [not cause but likelihood]

From what you describe, your hormones have never been right and you were never properly virilized.

HDL is low. These can help:
high potency B-complex multi vitamin with trance elements, including selenium and iodine
fish oil
anti oxidants, including natural source vitamin E and vitamin C

There are two stickies above for suggested reading.
Come back with body temperatures and iodized salt use.

Other labs:
IGF-1
fT3
fT4
TSH

What are your medical options there?


#7

[quote]KSman wrote:
Avoid any foods with added iron.

Read the advice for new guys sticky.

What Rx or over the counter [OTC] medications?

ALT: 56 ( 10-50) u/L
ALP: 106 ( 40-110) u/L

  • are elevated, can be medications, or alcohol as simple causes

Free T3: 5.4 (3.3-6.0) pmol/L
T4: 11.9 ( 9.0-19.1) pmol/L
T4 is a bit low, better if closer to 15

  • do you use iodized salt?

Best measure of thyroid function is checking your body temperatures, see the thyroid basics sticky.

You have secondary hypogonadism. Prolactin is not the cause. E2 is quite high relative to your T levels making you estrogen dominant.

SHBG is low, a symptom of diabetes and fasting glucose is high border line. A test called A1C would be definitive.
TRT improves insulin sensitivity.


Low SHBG levels increase the probability of Type 2 Diabetes. [not cause but likelihood]

From what you describe, your hormones have never been right and you were never properly virilized.

HDL is low. These can help:
high potency B-complex multi vitamin with trance elements, including selenium and iodine
fish oil
anti oxidants, including natural source vitamin E and vitamin C

There are two stickies above for suggested reading.
Come back with body temperatures and iodized salt use.

Other labs:
IGF-1
fT3
fT4
TSH

What are your medical options there?

[/quote]

Hey KSman,

My unsatisfactory ALT/ALP numbers may be cause by PAST alcohol abuse in college.( I don’t drink anymore). That or the fact that I take natural supplements on a daily basis?

  • I dont take RX medication.

As for my body temperature:

Mornings: 96.7

Evenings: 97.5

My feet get cold easily and last summer I had to wear two pair of socks at the same time. ( even in hot summer nights lol ).

As you see my temperature is low. I will be supplementing with Iodine salt/supplement and selenium as describe in sticky.

Is Sea kelp a good source for iodine?


Also my TSH levels are :

TSH: 1.3 ( . 3 5 - 4 . 9 4) mIU/L

My TSH and T3 is decent but T4 not much ?


" What are my options? "

I have access to a TRT clinic. The doctor presently has me on 25mg Clomid for one month then we will retest blood. So far after 2 weeks of Clomid I do not feel any better and perhaps more “depress”. I am aware that Novaldex is a better option for SERMs but in my case my doctor is going for Clomid for now to try to simulate LH/FSH.

I am on a good plan for now? Thoughts?

Thanks again KSman.


#8

Nolvadex has the same actions as Clomid, but without the side effects that some experience. The medical community is in a mental rut.

With your higher fT3 and low body temperatures, you should test rT3. See the sticky and review references to stress, rT3, adrenal fatigue, Wilson’s book.

Your low T4 does suggest a lack of iodine.

Better to use iodized salt. Were you using none? The amount of iodine in kelp is quite variable. One can find capsules that are typical 0.5mg; which is OK for maintenance, but not sufficient for IR.

What dose of Clomid? Often is dosed too high.
If doc wants to see if you an make your own T after Clomid, you must be tapering slowly off of Clomid. Do not stop SERM suddenly. Chances of working are reduced if E2 and/or LH becomes high. SERMs can lead to a lot of E2 if dosed too high.

Labs while on SERM: Please insist on all
TT
FT
E2 -could be very high
LH/FSH

Other labs:
IGF-1
fT4
A1C

You seem to be deeply hypothyroid. Labs sometimes do not describe the situation.
Are your outer eyebrows sparse?
Dry skin?
Changes to complexion?

Read those stickies!!!


#9

[quote]KSman wrote:
Nolvadex has the same actions as Clomid, but without the side effects that some experience. The medical community is in a mental rut.

With your higher fT3 and low body temperatures, you should test rT3. See the sticky and review references to stress, rT3, adrenal fatigue, Wilson’s book.

Your low T4 does suggest a lack of iodine.

Better to use iodized salt. Were you using none? The amount of iodine in kelp is quite variable. One can find capsules that are typical 0.5mg; which is OK for maintenance, but not sufficient for IR.

What dose of Clomid? Often is dosed too high.
If doc wants to see if you an make your own T after Clomid, you must be tapering slowly off of Clomid. Do not stop SERM suddenly. Chances of working are reduced if E2 and/or LH becomes high. SERMs can lead to a lot of E2 if dosed too high.

Labs while on SERM: Please insist on all
TT
FT
E2 -could be very high
LH/FSH

Other labs:
IGF-1
fT4
A1C

You seem to be deeply hypothyroid. Labs sometimes do not describe the situation.
Are your outer eyebrows sparse?
Dry skin?
Changes to complexion?

Read those stickies!!!

[/quote]

Hey Ksman this is a follow up. What do you think? Am I on the way of healing?

25mg clomid / daily

4 weeks in

Total Testosterone : 16.4 ( 6.1-27.1) nmol/L

Free T : 489 ( 110-660) pmol/L

Bio-available T : 11.5 ( 2.8-15.5) nmol/L

SHBG: 15 ( 13-84) nmol/L

Estradiol : 124 (40-160) pmol/L ( 33pg )

FSH: 3.4 ( 1.0-19.0) IU/L

LH: 4 ( 1.0-9.0) IU/L


Pre-clomid ( February)

Total Testosterone : 6.5 ( 6.1-27.1) nmol/L

Free T : 194 ( 110-660) pmol/L

Bio-available T : 4.5 ( 2.8-15.5) nmol/L

SHBG: 12 ( 13-84) nmol/L

Estradiol : 77 (40-160) pmol/L

FSH: 2 ( 1.0-19.0) IU/L

LH: 2 ( 1.0-9.0) IU/L


I dont feel anything yet and im really bloated. No option to take Novaldex.

I use iodine salt.

Could you give me any feedback? please

Should I continue with this treatment?


#10

Bloat is probably from E2=124, better closer to 80pmol/L
You can lower E2 with 1mg/week anastrozole in divided doses, if you can get it.

E2 may be high as a result of too much clomid as explained in the advice for new guys sticky. Many get good results with 25mg EOD, but every case is different. Your LH/FSH levels are nice and don’t appear to be too high.

FT is good because SHBG is low, but that will probably increase from E2 and FT will decrease.


#11

Ok good thanks for the feedback. I could not get Anastrozol but I got a hold of Aromasin. I will be taking 12.5mg twice a week and get blood work in a month to see how it goes.

Thanks a bunch.


#12

[quote]KSman wrote:
Bloat is probably from E2=124, better closer to 80pmol/L
You can lower E2 with 1mg/week anastrozole in divided doses, if you can get it.

E2 may be high as a result of too much clomid as explained in the advice for new guys sticky. Many get good results with 25mg EOD, but every case is different. Your LH/FSH levels are nice and don’t appear to be too high.

FT is good because SHBG is low, but that will probably increase from E2 and FT will decrease.

[/quote]

Hey Ksman,

I added Aromasin 2 weeks ago at 12.5 twice a week with the same 25mg Clomid daily. I still do not feel anything but the same side effects. Bloating and starting to gain fat…

Total of 46 days on Clomid but do not feel any benefit.

What do you suggests:

  1. Taper off Clomid and get on Novaldex ?

  2. Stay on protocol Clomid + Aromasin but lower Clomid to EOD instead of ED ?

  3. Any other suggestions?

I appreciated the feedback.


#13

Can anyone give me a feedback? Please I would really appreciated given that Ksman is out for while.