T Nation

Bloodwork Results. Tiredness and Sex Drive Affected


#1

I am 34, in good physical shape and have been having problems with tiredness and ability to maintain erections during sex, I read the “Lab work, blood testing and symptoms post” on this site as well as a number of other sites which seemed to give similar data. I produced a list of tests I would like run and managed to get a doctor to agree to testing my androgens. This was something my normal doctor wouldn’t do as they felt a basic TSH test was enough. Both doctors thought these symptoms could be the result of depression and this is a possibility as I have been treated for depression and only recently came off Pristiq which is an antidepressant a month before my tests and the symptoms I have have not really changed, I want to have sex but physically have issues doing this I have been on antidepressants for 15 years so have no base to assume what normal is. I find that if I take my vitamins morning erections are stronger, if I don’t sometimes they are not there.

Details
age: 34
height: 5 foot 9 inches
waist: 31 inches
weight: 80 kg or 175 pounds
body and facial hair: hair on chest, little hair n back, full beard
where you carry fat and how changed:relatively lean most fat stored around mid section and some around lower back though not noticeable
health conditions, symptoms: Pernicious anaemia take B12 injections, depression and OCD for 15 years
Rx and OTC drugs: SSRI
diet: varies but does not change the symptoms
describe training: train 3-4 times per week, weights

Symptoms
-Brain fog- Yes
-Social withdrawal- Yes
-Why do I have boobs- No
-Why am I a moody bitch- Yes
-Can’t get it up- Depending on vitamin intake
-It is up, now it’s gone- Yes this is what caused me to get help
-My penis is numb -your nerves love T too- not really
-My testes are softer and smaller- not sure
-My testes ache 24x7- no
-My scrotum is up-tight, gives “how are they hanging” a whole new meaning- no
-“morning wood” -things are working- Occasionally
-Why do really hot looking women and girls now look like art instead of lust?- No
-I felt great when I started TRT, where did that go? Neural transmitters rule your life- Have not been on TRT.
-My TRT seems ineffective or never was. Things that crash in the night.- Not on TRT
-On TRT and still do not feel right, something else is wrong.- Not on TRT
-Loss of hair on lower legs, skin below the knees is smooth and shiny.- No
-Why do I feel cold easily or all of the time?- Occasionally
-Why do really stressful situations leave me feeling physically beat up. Adrenal fatigue.- Possible
-Dry skin, brittle hair and nails- No
-Skin on the back of hand is thin, crinkly. Pinched skin does not recover- Not a problem
-Gum disease, the ugly killer- No
-Why do I have a chronic cough [when taking a statin drug]- No
-I have visual field disturbances such as reduced peripheral vision- No
-My joints have started to ache- Occasional
-TRT and now leg cramps- Not on TRT
-TRT and wife says I am snoring more- Not On TRT
-I am not depressed, I just don’t care about anything, no joy, no motivation, no reward- Yes
-Skin does not heal quickly if broken- Yes
-testes ache, ever, with a fever- No

I asked about adrenal fatigue and the doctor says they would not diagnose that. I also asked if circulation and arteries could be the issue and was told it was not likely.

Test conditions:
I normally take the below as they help with my depression and ability to think
No multivitamins the day before- http://www.allmaxnutrition.com/products-type/vitaform/
Stopped calcium and vitamin D 2 days before
Stopped Inositol 2 days before
Fasted
test at 7:57 am

I received the below test results and the doctor said it was normal due to the ranges stated but that is not an answer.

Results- High levels in Bold

Total testosterone: 13.3nmol/L Ref. range(10 - 35)
SHBG: 28nmol/L Ref. range (13 - 71)
Calculated free test: 295pmol/L Ref. rang (225 - 725)

Vitamin B12: 629 pmol/L Ref. range (150 - 700)
TSH: 1.50 mIU/L Ref. range (0.50 - 4)
PSA: 0.10ug/L and Ref. range (0.0 - 2.5)
Sodium: 140mmol/L Ref. range (136 - 146)
Potassium: 5.1 mmol/L Ref. range (3.5 - 5)
Chloride: 104mmol/L Ref. Range (95 - 110)
Total Bilirubin: 10umol/L Ref. Range (<20)
Bicarbonate: 33mmol/L Ref. range (22 - 31)
Total Protein: 70g/L Ref. range (65 - 85)
Urea: 8mmol/L Ref. range (2.3 - 7.6)
ALT: 24 U/L Ref. range (<55)
AST: 18 U/L Ref. range (<40)
ALP: 74U/L Ref. range (35 -110)
Gamma Glutamyl Trans: 17U/L Ref. range (<40)
Est. GFR (mL/min): >90 per 1.73 sqm Ref. range (>60)
Globulin: 29g/L Ref. range (22 - 40)
Albumin: 41g/L Ref. range (36-49)
Creatinine: 85umol/L Ref. range (60 -110)
Serum glucose 6.3mmol/L Ref. range (4 - 7.8) I was fasting so range is (4 - 6)

Full Blood Examination
HB: 154g/L Ref. range (130 - 180)
RCC: 5.32x10^12/L Ref. range (4.5 - 6.5)
MCV 86fL Ref. range (80 - 96)
PCV: 0.46 L/L Ref. range (0.4 - 0.54)
MCH: 29pg Ref. range (27 -32)
MCHC: 336 g/L Ref. Range (320 - 360)
RDW: 12.6% Ref. range (11 - 16)
White cell count: 5.8x10^9/L Ref. range (4.0 - 11)
Neutrophils: 60% 3.5 Ref. range (2.0 - 8)
Lymphocytes: 29% 1.7 ref. Range (1.0 - 4)
Basophils: 1% 0.1Ref. range (0.0 - 0.2)
Monocytes: 8% 0.5 Ref. range (0.0 - 1.0)
Eosinophils: 2% 0.1 with Ref. range (0.0 - 0.5)
Platelets: 196 Ref. range (150- 450)
Ferritin: 150uG/L Ref. range (20-300)

Does anyone have any possible explanation for the symptoms based on the results?

If it is a hormone issue, is there a doctor in Melbourne, Australia who would be able to help? Is Clomid a way to solve this? I ask as I have read the restart protocol.

Thanks.


#2

Attempt two: My lengthy reply vanished. Very rare issue.

B12: Do you have heart burn and use any antacids?

You are in-range and many docs there will be dismissive, it is the system and mind-set of health care there.

Test LH and FSH, please not LH only, discuss with doctor. This will determine if problem is pituitary or testes. If LH/FSH are the problem, test E2 and prolactin to see if these HPTA negative feedback hormones are the problem.

Liver looks good, AST/AL, so we do not expect that liver has reduced E2 clearance increasing E2 in that manner. SHBG is good, also a positive indicator for the liver.

TSH better near 1.0, please see last paragraph in this post to self-evaluate overall thyroid function. Many there do not have enough iodine in their diets. Do your vitamins list iodine and selenium? How much?

Were you holding your breath for blood draw?
Were you dehydrated for your fasting lab work?

SSRI’s do have a reputation for altering hormones and often absolutely interfere with sexual function.

TSH has very little to do with androgens.

Melbourne? Search the forum for that!

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

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.


#3

I was really interested in hearing your ideas as you’ve been helpful to others on the forum.

I don’t have heat burn or take antacids. I have been taking iodine tablets for the last month and have logged data you requested. My temperature has been quite low and I haven’t been able to test the thermometer on anyone else. Before starting on iodine, I take 12.5-25g per day, my temperature was below 36.4 degrees Celsius or 97.5 for you. Some days I did peak higher in the afternoon. I recently took my temperature in the morning and it was 35.9 degrees Celsius after 1 month of Iodine.

In terms of morning erection quality is slightly better but that may be attributed to the multivitamin and vitamin D tablets also. I have noticed that when I take iodine there is no soreness in my muscles at the start of the workout, this was an issue before.

I went to some other doctors and found one that would order bloodwork that could help figure out the problem.

Results are below.
I had the test at 7.15am and was fasting.

ACTH: 8.5 pmol/L Ref. range (less than 20 pmol/L)
Sensitive Oestriadol: 61pmol/L Ref. range (50-150)
Total testosterone: 16.9nmol/L Ref. range(10 - 35)
SHBG: 22nmol/L Ref. range (13 - 71)
Calculated free test: 436pmol/L Ref. range (225 - 725)
Cortisol: 325nmol/L Ref. Range (145 - 619)
Serum C-reactive Protein: <1mg/L Ref. range (0-10)
HB: 150g/L Ref. range (130 - 180)
PCV: 0.43 L/L Ref. range (0.4 - 0.54)
RDW: 12.8% Ref. range (11 - 16)
RCC: 5.09x10^12/L Ref. range (4.5 - 6.5)
MCV 85fL Ref. range (80 - 96)
MCH: 30pg Ref. range (27 -32)
MCHC: 349 g/L Ref. Range (320 - 360)
White cell count: 6.5x10^9/L Ref. range (4.0 - 11)
Neutrophils: 53% 3.4 Ref. range (2.0 - 8)
Lymphocytes: 36% 2.3 ref. Range (1.0 - 4)
Basophils: 1% 0.1 Ref. range (0.0 - 0.2)
Monocytes: 8% 0.5 Ref. range (0.0 - 1.0)
Eosinophils: 2% 0.1 with Ref. range (0.0 - 0.5)
Platelets: 180 Ref. range (150- 450)
Vitamin B12: 592 pmol/L Ref. range (150 - 700)
Ferritin: 107G/L Ref. range (20-300)

FSH: 5 IU/L Ref. Range (1-10)
LH: IU/L Ref. Range (1-10)

Total Chol: 3.7 mmol/L should be less than 4
Triglyceride: 1.4 mmol/L should be less than 2
HDL- C: 1.2 mmol/L shold be greater than 1
Non HDL-C: 2.5 mmol/L should be less than 2.5
LDL-C: 1.9 mmol/L should be less than 2
Chol/HDL: 3.1
Sodium: 144mmol/L Ref. range (136 - 146)
Potassium: 5.5 mmol/L Ref. range (3.5 - 5)
Chloride: 106 mmol/L Ref. Range (95 - 110)
ALT: 21 U/L Ref. range (<55)
AST: 15 U/L Ref. range (<40)
ALP: 69 U/L Ref. range (35 -110)
Bicarbonate: 34mmol/L Ref. range (22 - 31)
Total Bilirubin: 10 umol/L Ref. Range (<20)
Total Protein: 68g/L Ref. range (65 - 85)
Urea: 7.5 mmol/L Ref. range (2.3 - 7.6)
Gamma Glutamyl Trans: 17 U/L Ref. range (<40)
Est. GFR (mL/min): >90 per 1.73 sqm Ref. range (>60)
Albumin: 41 g/L Ref. range (36-49)
Globulin: 27 g/L Ref. range (22 - 40)
Creatinine: 86 umol/L Ref. range (60 -110)

Serum PSA: 0.08 ug/L and Ref. range (0.0 - 2.5)
TSH: 2.12 mIU/L Ref. range (0.50 - 4)

Hydroxy Vitamin D: 35nmol/L Ref. Range (>50)

HbA1c: 30 mmol/mol Ref. Range (<54)
HBA1C: 4.9% Ref. range (<7.1 percent)

I did not have any water for 8 hours and did not hold my breath during blood draw.

My symptoms have not changed from the first post in this thread.

Thanks.


#4

TRT can take MONTHS to begin feeling better, I started TRT around the same time you did and I only just began to feel small changes in the way that I feel.


#5

Vit-D lacking. Take 5000iu Vit-D3.

Please do not be dehydrated for lab work, fasting for lab work means no food, drink water to not be thirsty.

FSH:LH ratio is high, typically we see a 1:1 ratio, but that is a rough relationship.

LH=1 does not make sense VS calculated FT. However E2=61 pmol/L suggests free T much lower than 436pmol/L

TSH=2.12 is high. But taking large amounts of iodine does increase TSH and then TSH results are not of much use. Your oral body temperatures are showing you are hypo and lack of energy makes sense with that. AM cortisol seems good, so problem may not be there.

Selenium may be part of this and I asked about selenium in your vitamins. Taking large dose iodine with a selenium deficiency is dangerous.

Blood work looks good, good iron status. Blood is a bit thin but makes good sense VS your T levels. Same for total proteins.

Insulin sensitivity is good.

The puzzle is LH=1 which may not be representative. LH is released in pulses with a short half-life. So there is great uncertainty at times. Getting repeat tests with NHS may be a problem.


#6

Thanks for your comment, I haven’t started TRT and I don’t want to, I’m trying to see what I can do naturally.


#8

The blood was taken before I started taking Iodine so TSH is high for another reason. The LH=3, I should have checked. Does that change your opinion?

I have been taking a multivitamin for a month which has 200mcg of Selenium and the recommended Vitamin D.

With the information I have given you and also the list of symptoms can you think of a problem? What can I do to alleviate the symptoms and the problem?

Thanks.


#9

Does anyone have any ideas? I am planning on seeing the doctor regarding these results but some ideas about what it could be and what to expect would be appreciated.

Thanks.