T Nation

Blood Work Results


#1

I have been lurking here for quite sometime. Even though I am only 33, I have taken an interest in the hormone threads. It's been pretty obvious to me that I have had issues in this dept for quite some time. Symptoms for years have been depression, zero libeto, +20lbs carried around my waist, no energy, ect.

I was really sick of the meds for depression and not dealing with the other symptoms, so I went and had some blood work done.

Creatine - 1.2 (.4 - 1.3)

Glucose - 99 (60-100) - not sure what this means

Liver
ALT - 57 (4-55) - not sure what this means. I enjoy the occasional scotch, but no reason my liver should be out of whack.

Test - 224 (225-825) - ouch

Thyroid
TSH - 1.81 (.2 - 4.5) - would I rather be on the high side or low side here? I have read that low TSH usually equals higher T4.

I also had some sort of Hematology tests that all seem normal, but I don't know much about that stuff.

My doc doesn't seem all that bright when it comes to this stuff, so I am debating my course of action here. Should I schedule a visit with an endochronologist or is there some other obvious message I am missing in these results. I was planning to re-up my supply of Z-12 and even do a sleep study to see what my blood work looked like after a few months of really good sleep. I did not expect the results I got and am now thinking I should just start with the HRT route. Thoughts?

The HRT route is also interesting becuase I actually don't have issues putting on muscle or making gains in strength. Getting my T on the high side of normal may produce some really interesting gains.


#2

—At least get your LH and FSH checked. You may have a completely reversible condition and you do not necessarily need a lifetime of shots.
—Recheck your fasting labs, including lipid panel (occasional rises in AST and ALT are due to lipid disorders)
—Take absolutely nothing until you have a real diagnosis; yes–a diagnosis. You are about to get a lot of advice which will come from well-meaning amateurs. They will not take responsibility for their advice. A good doctor will do so.


#3

[quote]DrSkeptix wrote:
—At least get your LH and FSH checked. You may have a completely reversible condition and you do not necessarily need a lifetime of shots.
[/quote]
I would rather not do shots or even regular visits. I travel quite a bit, so regular appointments of any nature are a pain in the ass.

I’ve had one recently. It was horseshit. I wish I could find the results.

Should I be asking my GP about this or seeking a more specialized opinion?


#4

What is your GP’s reaction to the labs?

TSH number does not indicate a thryoid problem, but does not rule that out either. Unfortunately, many symptoms of low T are the same as thyroid problems.

Get Eugene Shippen’s book. You will probably learn more that you need here or on your own than from a doctor who may very well not know what he is doing. You will most likely need to know more that your doctor[s] to get the care that you need.


#5

[quote]KSman wrote:
What is your GP’s reaction to the labs?

TSH number does not indicate a thryoid problem, but does not rule that out either. Unfortunately, many symptoms of low T are the same as thyroid problems.

Get Eugene Shippen’s book. You will probably learn more that you need here or on your own than from a doctor who may very well not know what he is doing. You will most likely need to know more that your doctor[s] to get the care that you need.[/quote]

He really hasn’t had any reaction. He thinks changes in diet and a sleep study would be the next step. I am ok with taking these steps, but am concerned about wasting time and feeling like shit for longer than I have to.

Sleep - probably worth looking into. Like I mentioned before, I need to reorder some z-12. I feel like I get better sleep when taking 2 before bed. While on it, I was losing some weight. Since being off it i have gained some back without any real changes to diet and a workout plan more conducive to weight loss. This may be coincidense.

Diet - My diet is probably the average American diet, so not that great. Generally, I prefer lean meats and don’t load up on carbs. The wife buys organic and reasonable healthy food. I know that there is room for improvement here, especially while traveling for work.

Stress - Probably contributing as well. I am in sales and sales are very low right now.

I need to address these anyway, and if my T was close to 400 I would probably stop here. My concern is addressing these and nothing else for a few months, only to find out additional action is needed anyway.

I am willing to take a month to clean some things up and get re-tested. I am going to start taking z-12 and ZMA again. I have some superfood that I need to start taking again. I am going to make more of an effort to clean up my diet a bit more, especially while on the road. Somehow I am doubtful this will bring my T up 400 points or so, I am open to trying before doing anything else.

We do have an endo clinic near by that seems to be well regarded. Maybe this is the first step. At least to get more thorough testing and evaluation.

I’ll check out the book, thanks.

edit - Also worth mentioning a few other stats:

Soon to be 34
5’10"
250lbs

I really have no business being over 220-230. I do carry a fair bit of muscle but not 250lbs worth. I was going to start competing in some local powerlifting events, but recently decided to address my weight and general health first. Most access weight is carried around my midsecion.

I would rather compete at 220 anyway. I have recently made changes in my workout to do this. Mostly just switching to circuit training, complexes, short rest intervals, etc. I have my main sessions sorted and just need to make some tweaks to what I do while on the road.


#6

Found my blood lipids results

Cholesterol - 261 (<200)

Triglyceride Fats - 236 (0-149)

Chol/HDL Ratio - 6.1
HDL Cholesterol - 43 (<40)
LDL Cholesterol - 171 (1-130)

Obviously not good. This was 3 months ago. I have made changes to my diet but not really lost any weight. Maybe 7lbs since this test. I still eat a lot, just not as bad.

I still haven’t been back to the doctor. I think I am going to get through another month of better sleep/diet and retest everything, as well as requesting tests of LH and FSH.


#7

TRT typically lowers total cholesterol to acceptable ranges.


#8

Updated results from endo

Test
Total Test - 327 (250-1100) - Was 224 - Tested Quest both times. This time LCMSMS method. no idea last time
Free Test - 79.3 (35-155) - not tested last time.
% Free Test - 2.43 (1.5-2.3)
FSH - 2.4 (1.6-8) - not tested before
LH - 5.6 (1.5-9.3) - not tested before
Prolactin - 5 (2-18)

I thought they were going to test for E as well. I asked him about this specifically. He said that they only do this if he detects breast tissue. He said my titties were all fat.

Thyroid
hTSH II - 1.655 (.32-5) - was 1.81
Total T4 - 6.53 (5-11)
T-uptake - .78 (.72-1.24)
FTI - 8.37
T4 index - 8.37 (5-11)

Lipid
Trig - 143 (<150) - was 236
Chol Total - 267 (125-200) - was 261
HDL - 49 (<40) - was 43
LDL - 189 (<130) - was 171
Chol/HDL Ratio - 5.4 (<5) - was 6.4

There was a bunch of other shit on this test, but not sure that it’s relavent. Unless the testing was different, my test is up 100pts so I have that going for me. I kleened up my diet slightly (more salads) and went back on Z-12 and ZMA for sleep. Trig looks a lot better as well.

The endo said I should just lose some weight and that he did not recommend any treatment. Symtoms are still present. Despite working out more and a slightly better diet, I have gained 30lbs in the last couple of years. I am off my meds, so depression is back. No libido. Serious crash after working out or at about 4-5pm at night. I mean almost impossible to stay awake.

Other than losing weight and continuing to clean up my diet, I am not sure what to do next. I would certainly like to be on higher end of the scale, but not sure a lifetime of TRT will be worth it. The endo has no interest in raising T levels. I could go the pro-hormone route and see if it helps i guess. If it did make me feel substantially better, I could look around for someone willing to work with me.


#9

Test E2 on your own and pay out of pocket. LEF.org uses Labcorp. If your E2 is elevated, use anastrozole to lower it to around 22pg/ml. Improving T:E ratio can make what T you have work better, and can also increase T if E2 was repressing your HPTA. With lower E2, loosing weight should be possible.

http://www.lef.org/Vitamins-Supplements/ItemLC004515/Estradiol-Blood-Test.html

Take 25mg DHEA and see if that is helpful, then later see if 50mg improves anything. If DHEA is low, that can rate limit T production to some extent. If you test, must test for DHEA-S [the sulfate]. Taking DHEA when it is not low should have a trivial effect. Absorbs better with food and better with fats or oils.

At your age, TRT is coming down the road at some point anyways.

Take some action. Your endo only knows how to care for someone who has low lab numbers. He does not care about your QOL or symptoms. Find a compounding pharmacy and ask for referrals. Tell them about your situation. Pay for things out of pocket if you have to. First try the E2 labs, anastrozole and DHEA. Find out what your age management options are.


#10

It sounds like your main problem is your depression, not a hormones. Your symptoms are consistent with depression. Many, if not most depressed people will have no libido. A likely reason why you never had one when you were on meds is because many of the antidepressants kill sex drive as well. Have you tried different ones to see how you respond?

You could possibly have elevated estrogen from excess bodyfat, but I doubt that alone would be a cause of all your issues. My suggestion would be to get the depression worked on, lose some bodyfat, and fix the LDL with a cleaner diet.

[quote]dhickey wrote:
Updated results from endo

Test
Total Test - 327 (250-1100) - Was 224 - Tested Quest both times. This time LCMSMS method. no idea last time
Free Test - 79.3 (35-155) - not tested last time.
% Free Test - 2.43 (1.5-2.3)
FSH - 2.4 (1.6-8) - not tested before
LH - 5.6 (1.5-9.3) - not tested before
Prolactin - 5 (2-18)

I thought they were going to test for E as well. I asked him about this specifically. He said that they only do this if he detects breast tissue. He said my titties were all fat.

Thyroid
hTSH II - 1.655 (.32-5) - was 1.81
Total T4 - 6.53 (5-11)
T-uptake - .78 (.72-1.24)
FTI - 8.37
T4 index - 8.37 (5-11)

Lipid
Trig - 143 (<150) - was 236
Chol Total - 267 (125-200) - was 261
HDL - 49 (<40) - was 43
LDL - 189 (<130) - was 171
Chol/HDL Ratio - 5.4 (<5) - was 6.4

There was a bunch of other shit on this test, but not sure that it’s relavent. Unless the testing was different, my test is up 100pts so I have that going for me. I kleened up my diet slightly (more salads) and went back on Z-12 and ZMA for sleep. Trig looks a lot better as well.

The endo said I should just lose some weight and that he did not recommend any treatment. Symtoms are still present. Despite working out more and a slightly better diet, I have gained 30lbs in the last couple of years. I am off my meds, so depression is back. No libido. Serious crash after working out or at about 4-5pm at night. I mean almost impossible to stay awake.

Other than losing weight and continuing to clean up my diet, I am not sure what to do next. I would certainly like to be on higher end of the scale, but not sure a lifetime of TRT will be worth it. The endo has no interest in raising T levels. I could go the pro-hormone route and see if it helps i guess. If it did make me feel substantially better, I could look around for someone willing to work with me. [/quote]


#11

[quote]drew1021 wrote:
It sounds like your main problem is your depression, not a hormones. Your symptoms are consistent with depression. Many, if not most depressed people will have no libido. A likely reason why you never had one when you were on meds is because many of the antidepressants kill sex drive as well. Have you tried different ones to see how you respond?

You could possibly have elevated estrogen from excess bodyfat, but I doubt that alone would be a cause of all your issues. My suggestion would be to get the depression worked on, lose some bodyfat, and fix the LDL with a cleaner diet.
[/quote]
Was on Lexapro for probably 7 years. Getting off of that was a huge pain in the ass. Figured libido was effected by that, even though it didn’t happen for a few years into it and after I reduced my doseage. Went on Buproprian(sp?) as well. I hated the way I felt on just Lexapro and the Buproprian made a bit of differense, but not in the area I had hoped.

I had asked about different meds while seeing different doctors over the years, and they all said Lexapro was the best in that familiy of drugs. Lexapro deffinately hit the right receptors, or whatever they do.

That was absolutly the right family of drug for my depression/anxiety. It turned me from a ranging emotional asshole to a complete robot. This was cool at first, but I started to hate the way I felt on it. I didn’t really give a shit about anything. Handy when dealing with stressful situations, not that great for familiy life and motivation at work.

All of the symtoms but depression came long after I started meds. My first T test was really a shot in the dark. I was actaully excited to see low numbers, as it gave me something to work with. I am not going back on meds, so hopefully I can tinker with my hormone levels and see some improvement. I absolutly need to clean up my diet and lose weight. I am sure this will help.


#12

[quote]KSman wrote:
Test E2 on your own and pay out of pocket. LEF.org uses Labcorp. If your E2 is elevated, use anastrozole to lower it to around 22pg/ml. Improving T:E ratio can make what T you have work better, and can also increase T if E2 was repressing your HPTA. With lower E2, loosing weight should be possible.

http://www.lef.org/Vitamins-Supplements/ItemLC004515/Estradiol-Blood-Test.html

Take 25mg DHEA and see if that is helpful, then later see if 50mg improves anything. If DHEA is low, that can rate limit T production to some extent. If you test, must test for DHEA-S [the sulfate]. Taking DHEA when it is not low should have a trivial effect. Absorbs better with food and better with fats or oils.

At your age, TRT is coming down the road at some point anyways.

Take some action. Your endo only knows how to care for someone who has low lab numbers. He does not care about your QOL or symptoms. Find a compounding pharmacy and ask for referrals. Tell them about your situation. Pay for things out of pocket if you have to. First try the E2 labs, anastrozole and DHEA. Find out what your age management options are.

[/quote]

Thanks for the response. This is exactly what I will do. I have no problem paying OOP and doing some things on my own. With my travel schedule, getting a doctor appt is a pain. Scheduling, showing up, being dissappointed, finding a different doctor could take an incredible amount of time. If I can try some simple things on my own, I am going that route.


#13

Compounding pharmacies can be of great help. Some of them are national in scope and yet may still be able to refer you to doctor who is accessible.


#14

I recently had the same group of tests, and only my thyroid was a concern. It was 5 on the scale of (.5 to 5.0)

My doctor told me to start drinking distilled water as it does not contain flouride. Evidently there is some new research indicating that flouride can, in some people, impair thyroid function. A 5 on that scale indicates an underactive thyroid. My doctor is as good as they get. Never had a better doctor than this guy. He told me to retest after 3 months on distilled water and flouride free toothpaste. Funny thing is that this underactive thyroid thing of mine is asymptomatic. I have no ill effects and he was quite surprised by the findings.

At 1.81 or 1.65, your thyroid function is normal.

Another thing is that you want high HDL chol. The preferred range is > 40 not < 40. As you know, your triglycerides and your LDL are high. I am surprised your doctor did not recommend cholesterol lowering medication. He does sound pretty clueless.


#15

[quote]eric_lacrosse wrote:
I recently had the same group of tests, and only my thyroid was a concern. It was 5 on the scale of (.5 to 5.0)

My doctor told me to start drinking distilled water as it does not contain flouride. Evidently there is some new research indicating that flouride can, in some people, impair thyroid function. A 5 on that scale indicates an underactive thyroid. My doctor is as good as they get. Never had a better doctor than this guy. He told me to retest after 3 months on distilled water and flouride free toothpaste. Funny thing is that this underactive thyroid thing of mine is asymptomatic. I have no ill effects and he was quite surprised by the findings.

At 1.81 or 1.65, your thyroid function is normal.

Another thing is that you want high HDL chol. The preferred range is > 40 not < 40. As you know, your triglycerides and your LDL are high. I am surprised your doctor did not recommend cholesterol lowering medication. He does sound pretty clueless.[/quote]

Sorry, typo. two docs have suggested chol meds. I declined for now. I need to clean up my diet and lose some weight. I don’t have a history of high chol. Just the last year or two. In the same time frame, I have gone from 230 to 260(ouch).

I also noticed that under my metabolic panel, my ALT was high. It was 70 (9-60). I just wish I knew what ALT was?

Also, my Creatine Kinase total was high at 198 (44-196). Seems slight and I not sure what this would indicate.


#16

[quote]eric_lacrosse wrote:
I recently had the same group of tests, and only my thyroid was a concern. It was 5 on the scale of (.5 to 5.0)

My doctor told me to start drinking distilled water as it does not contain flouride. Evidently there is some new research indicating that flouride can, in some people, impair thyroid function. A 5 on that scale indicates an underactive thyroid. My doctor is as good as they get. Never had a better doctor than this guy. He told me to retest after 3 months on distilled water and flouride free toothpaste. Funny thing is that this underactive thyroid thing of mine is asymptomatic. I have no ill effects and he was quite surprised by the findings.

At 1.81 or 1.65, your thyroid function is normal.

Another thing is that you want high HDL chol. The preferred range is > 40 not < 40. As you know, your triglycerides and your LDL are high. I am surprised your doctor did not recommend cholesterol lowering medication. He does sound pretty clueless.[/quote]

Do you use iodized salt or [un-iodized] sea salt?
Is your thyroid enlarged?


#17

Got my Estradiol text results back from LifeExtention. Just went in for the blood draw yesterday, so that was fast.

41 pg/ml - (0-53)

I guess I can’t say that I am suprised. I ordered DHEA at the same time as the test to see what type of effect it may have on T. I have been taking 50mg/day for a few weeks now and haven’t felt any difference. Probably because of the results above.

Anticipating poor E2 results, I ordered some RevZ and just started taking it today. I am going to order another Est test in few weeks to see if it does anything for me. These are only $30, so not afraid to tinker around and retest. Any other non-perscription recommendations?

I also ordered some Alpha Male and TRIBEX Gold. My plan was cycle these (DHEA,AM, an TG) and see if any made a noticable difference. If one appeared to work better than the others, I would continue use and get another blood workup to see what the numbers look like.

I guess I am a little anxious to start the TG and AM but I am wondering if I should hold off on this while I get my E2 under control. Comments?

I have also been taking ZMA/Z-12 for sleep and Flameout for quite some time. Since the fist test.


#18

Update

Last test was with better diet, Z-12, ZMA, and Flameout. This test was after a month of adex (3 drops ED) and Alpha Male(2 x twice a day). I ran out of ZMA and Flameout about a week before hand.

Total Test - 531 ng/dl - was 327, started at 224
Free Test - 23 ng/dl - was 7.9

E2 - 18 pg/ml - was 41

DHEAs - 335 ug/dl (120-520) not tested before. Going to start taking DHEA again.

I don’t know why I didn’t request FSH and LH. Last time FSH was low (2.4) and LH was in the mid-range (5.6). Would have been interesting to see how these reacted to AM.

This has been huge for me. Previously I would crash hard in the afternoon. This no longer happens. I have also lost ~10lbs (30 to go) while not changing anything else. Chol has been slowly but consistantly improving as well. My overall mood is much better. I had been on anti-Ds for years, am no longer on them, and no longer need to be. Libedo is still non-existant and haven’t had MW in years.

Alpha Male is a little expensive to only be at 500. I should have done a test with just the adex but I wanted to try the AM. I think this is the ammo I need to convince someone to put me on TRT. Lowering E and increasing T has made a significant improvement in QoL and I now have some proof.

Another couple hundred points and my sex drive may actually come back. I would also expect to lose weight at an increased rate and my chol to further improve.


#19

LH and FSH levels will track T levels and are really not of much interest right now. These are more of interest in a diagnostic differentiation between testicular failure and pituitary insufficiency. The LH and FSH levels in your case will be mid-low normal.

Please respond to earlier Q’s re thyroid and iodine. You should try a lower dose Armour thyroid to see how your mind/mood and body respond. If you feel better, that is the way to go.


#20

[quote]KSman wrote:
LH and FSH levels will track T levels and are really not of much interest right now. These are more of interest in a diagnostic differentiation between testicular failure and pituitary insufficiency. The LH and FSH levels in your case will be mid-low normal.

Please respond to earlier Q’s re thyroid and iodine. You should try a lower dose Armour thyroid to see how your mind/mood and body respond. If you feel better, that is the way to go.[/quote]

I do use a fair amount of table salt. When at home I use sea salt, but when on the road I eat chicken breast salads at Subway 3-4 times a day. I have them put salt, pepper, vinigar, and oil on it. Should probably skip the salt and pepper.

Thyroid tests in July.

hTSH_II - 1.655 uIU/mL (.320-5)
Total T4 - 6.53 uG/dL (5-11)
T-Uptake - .78 (.72-1.24)
FTI - .37

I have not done much homework on this part of my bloodwork. I was focused on T and E. I did buy some liquid T3 at the same time as my liquiDex. I have not taken it as I haven’t found any recommendations on dosage and translating that to a number drops.

I’ll check out Armour Thyroid but anything requiring a script puts me in the same spot I am now, trying to find a doc willing to prescribe me anything. Going to have to do a bit of research in order to make a case for doing anything.

I can get T4 and T3 as research chems. Not sure how I know if it is natural or synthetic, or if it matters. Need to understand what happens if i happen to go off it. Need to understand dosage recommendations and how this translates to drops.