T Nation

Can Somebody Help Me Interpreting This?


#1

Disclaimer I do not intend to get or suspect to need TRT, but this was the section with the closest topic/subject, ie. endocrinology.
UPDATE 02/11/2018 I should have added the information a sticky by KSman asked for from the very beginning.
-Age: 18
-Height: 5 foot 9 inches
-Waist: 31 inches
-Weight: 145 lbs
-Describe facial and body hair: I got a slightly receding hairline on the sides of my forehead…Slightly–I am not bald. Hairy legs, especially below my knees, and not as hairy arms. My midsection has little to know hair; there is some in “trail to happiness” but not a lot, just enough to be noticed. I got some hair between-and-above my pecs and directly around my nipples. Hair on my eyebrows is thick and then fades, slightly.

-Describe where you carry fat and how it changed: Most of the little fat I carry is on the lower abdominal area. It is very little, like I said
.
-Health conditions and symptoms [history]
I use glasses. I also have bradycardia, but I have played soccer since I was 12, and in that time I was able to a very solid aerobic and anaerobic base; and now, despite having a PCL grade II injury recovering for over 6 months, I am still “fit”, perhaps because of side aerobic and anaerobic work I can do, like swimming intervals and recently some jogging. I guess I have some degree of social anxiety and at some times I have felt depressed-like, not sure if enough to be called **depression (?)**but definitely asking myself what was the sense of live and getting to the answer that there was none. Also, constipated (I go three or 4 times a week) and a lot of farts–a lot-- and they odor is very unpleasant.

-Rx and OTC drugs or any hair loss drugs or prostate drugs
I used to take magnesium citrate from november to december. I ran out of it, so I do not take it anymore. I also have 50mg of zinc and 5mg of melatonin every day before going to bed. Other than those, nothing.
-Lab results with ranges
See below.
-Describe diet
I do intermittent fasting. I used to do fast for close to 18h for a year or so; last month I cut it to 16h because it is increasingly hard to get the +2000 calories in, on some ocassions 3k calories. I eat 0.82g/lb of protein per day, which amounts for about 115-120 for me. Main sources of protein include 6 whole eggs a day and 100-150g of any lean meat, which as of recently has been liver because of my anemic-like blood results. The rest of the protein comes in the grains and cereals I eat, plus in some fats I eat like peanut butter. Fat: I have about 0.5g/lb of bodyweight, so I shoot for at least 75g per day, but that has been the past month. I used to not do these and I am sure threre was a very long period of time, about a year, where my fat intake was often below 60g per day and several times less than 50g. Just want to especifically point that out. Also, I have noticed I do not eat too many saturated fats, most of the times less than 15g a day, and that was probably a lot less during the one year period I just mentioned where I did not consume too much fat overall. I do supplement with about 1.5 EPA/DHA. About carbs, I eat more than a kilogram of veggies a day; about 8-10 servings. I also have one or two servings of fruit a day, mostly guavas or apples. The rest of carbs are “natural” grains and legumes, some bread here and there, sometimes pasta, etc.

I have crash dieted with 1200, 1600, 1800, calories, and on some occasions thrown in 600-800 calorie days.

-Describe training: I used to do 3 times a a week calisthenics full body routine. I now do 4 times a week push/pull, which is about the same volume. The full body routine took about 50 minutes and the push/pull takes a little more than half an hour. I used to play soccer (cardio) 4 or 5 times a week 2 hours per session, plus an additional light day were I just juggle the ball and do some skills, but I injured my PCL so I had to stop and started doing the only the skill work about 1 hour six times a week, now I am only doing 15 minutes of skill work six times a week to try discard (or confirm) it is overtraining.

-Testes ache, ever, with a fever? Never.

-How have morning wood and nocturnal erections changed? I had morning wood sometimes. Currently, every day. I never had many wet dreams and I still do not.

-Get cold easily? Changes? People at school would sometimes touch my hand and tell me it was very cold…Was it the bradycardia? Was it the caloric intake? I do not know. Sometimes I felt cold, but a lot of times when they told me this I WAS NOT feeling cold at all and I would not say I felt cold when other people did not. Also, my hands are kind of reddish/gingerish and I did not notice but people did. Could this be something related to bradycardia and blood? Or perhaps the pigments in the veggies–carotenemia? That is about it.

-Use iodized salt? I use lots of salt and yes, it is iodized.
-Eat much sea food? No, not much. Occasionally, we will have hake fillets at home or shrimp, but that is once every couple of weeks.
-Exposure to chemicals? No, I don’t think so.
-General energy levels? They are low. I make an effort to be a bit more energetic at school. Afternoon, I often feel tired and sometimes sleepy.
-Difficulty gaining muscle / recent muscle loss It is hard to say I have difficulty gaining muscle because during last year, I simply was trying to get stronger slow and steady, plus I did the soccer cardio. But two months ago, I stalled on the amount of reps for ALL my calisthenics exercises and about a month ago I started regressing while feeling lots of muscle soreness after every workout. I have now reduced all volume to half, and sometimes it still get sore I do one or two extra reps.
-Weight gain (difficulty losing weight) Yes, on December when I last crash dieted, I lost 0.65kg overall during two weeks were I ate 1900 calories per day. I lost all that weight on the first week, on the second I only lost 0.02 kg. That is not a lot considering I was on a daily 700 calorie deficit.

-Chest size/gyno/chest sensitivity: 36 inches. None of those symptoms/disease.
-Normal sleep patterns: Slept 6/6.5 hours for a very long time but current sleep between 7.5/8.5. Recently, I have started waking up in the middle if the night at 3 AM and then got back to sleep. I pee once or twice per night.

I will see the doctor tomorrow and want to get a first opinion, especially since I am sure he wont solve anything.

I am 18 years old, male, play soccer regularly and also calisthenics. The last couple of months my hands have been getting a slightly orange-ish tone, I am always cold,no libido, I feel fatigued, I am recurrently constipated, fart a lot, and during the last three weeks, my gym numbers have stalled and have even regressed, plus I have felt sore after every workout, something that never happened to me. The stall could be in part because I also resumed playing soccer after an injury without upping my calories accordingly, but I suspect the major cause is that I have been undereating.

Very importantly, I did some crash dieting mistakes back in november and december, consuming 1600 calories some days and even 800 calories once or twice, trying to get to 10% from 11% BF. To exacerbate the problem, I do intermittent fasting so perhaps I was undereating even when not dieting, before I tracked my maintenance calories

My stats: 65kg, 10% BF, 5´9´´

So, here are the results, this was all I could get tested for (I translated this the best I could from spanish btw):
DATE 23/01/2018
Chemical profile:

Serum creatinine: 0.85mg/dl (0.67-1.17)

Glycemia: 92.90 mg/dl (70-100)

Serum ureic nitrogen: 21.80 mg/dl (6.0-20.0)

ALAT-TGP: 18.00 I/U (0-41)

ASAT-TGO: 24.00 I/U (0-38)

Lipidic profile:

Total cholesterol: 187.80 mg/dl (Optimum: less than 200mg/dl, intermediate/high: 200-239 mg/dl, high: greater than or equal to 240 mg/dl)

HDL; 56.56 mg/dl (low: less than 40mg/dl, high: greater than or equal to 60 mg/dl)

LDL: 117.92 (optimum: less than 100 mg/dl, almost optimum; 100-129 mg/dl, medium/high: 130-159, high 160-189, very high: equal or greater than 190 mg/dl)

**Triglycerides:**66.90 mg/dl (normal: less than 150, intermediate high: 150-199, high 200-499, very high; greater than or equal to 500)

Differentiated Billirubin profile:
Total: 0.32 mg/dl (0.0-1.0)
Direct: 0.13 mg/dl (0.0-0.3)
Indirect: 0.19 mg/dl

Hematologic profile:
RBC: 4.32 x 10P6/U (4.50-6.20)
Hematocrit: 40.40% (40-52)
Hemoglobin: 13.50 g/dl (14-17.50)
Medium corpuscular volume: 93.50 fl (80-100)
Medium corpuscular hemoglobin: 31.30 pg (28-33)
Medium corpuscular hemoglobin concentration: 33.40 mg/dl (33-36)
RDW-Width Erythrocyte distribution: 11.8% (11.5-14.5)
Leukocyte total recount:4.95 x 10P3/ul (4.5-11.3)
Neutrophils: 2.68 x 10P3/ul (2.25-8.48)
Lymphocytes: 1.56 x 10P3/ul (0.9-4.52)
Monocytes: 0.47 x 10P3/ul (0-1.24)
Eosinophils: 0.16 x 10P3/ul (0.09-0.45)
Basophils: 0.07 x 10P3/ul (0-0.11)
Neutrophils % 54.20 (50-75)
Lymphocytes % 31.50 (20-40)
Atypic lymphocytes: 0%
Monocytes%: 9.50 (0-11)
Eosinophils%: 3.2 (2-4)
Basophils%: 1.40 (0-1)
Platelet count: 220 x 10P3/ul (150-450)
Platelet volume: 11 fl

Immunology I profile;

TSH: 3.19 uUI/ml (0.27-4.2)
Free T4: 0.98 ng/dl (0.98-1.63 for those between 18-20 years old)
Vitamin D-25 hidroxi: 29.60 ng/ml (insufficient: less than 20, mild insufficiency: 21-29, optimum: 30-100, toxic: more than 150)

The substances in emphasized text were “suggested to be especially taken into account given the patients symptoms” by the lab to the doctor.

Update Got my new lab results; I fu**ed up and didn’t include FREE T3 or FREE T4, only TOTALS for both, although FREE T4 appeared on my first lab a week ago. From the little knowledge I have acquired, even with total T3 (rather than free T3) as a reference, it seems rather contundent that I have some type of hypothyroidism. Again, any opinions are immensely appreciated. And by the way, look at how my TSH is higher now than before when it was kinda high already.

DATE:27/01/2018

TSH 3.95 uUI/ml (0.27-4.20)

Total T4 5.20 ug/dl (4.74-14.60)

Total T3 75.00 ng/dl (91-218)

Antiperoxidase Antibodies 14.18 UI/ml (0-34)

Tyroglobulinic Thyroid Antibodies 10.00 UI/ml (0-115)

Hepatitis B Surface Antigen 0.32 (non reactive: less than 1; reactive: 1 or more)

Estradiol 11.91 pg/ml (25.8-60.7)

LH 2.02 mUI/ml (1.7-8.6)

Total T 3.77 ng/ml (1.02-10.10)

Free T result pending, will be ready on monday

Free T 8.11 pg/ml (4-30)

The substances in emphasized text were “suggested to be especially taken into account given the patients symptoms” by the lab to the doctor.

Update
More lab results have been added.
DATE: 02/02/2018

Calcium 9.85 mg/dl (8.4-10.2)

CPK 76 U/l (0-170)

Phosphorus 4.57 mg/dl (3-5.2)

Serum Potassium 4.82 mE/l (3.3-5.1)

Serum Sodium 141 mEq/l (136-145)

Sedimentation Speed 3mm/hour (0-15)

AM Cortisol 14.88 ug/dl (6.24-18)

4 PM Cortisol 9.72 ug/dl (2.69-10.4)

TSH 3.28 uUI/ml (0.27-4.2)

Free T4 0.96 ng/dl (0.98-1.63)

FSH 2.78 mUI/ml (1.5-12.4)

LH 1.9 mUI/ml (1.7-8.6)

Basal Prolactin 6.32 ng/ml (4.04-15.2)

Total T 3.84 ng/ml (1.02-10.1)

ACTH 33.1 pg/ml (7.2-63.3)

Parathyroid Hormone 22.47 pg/ml (15-65)

Vitamin D-25 Hidroxi 38.3 ng/ml (insufficient: less than 20, mildly insufficient: 21-29, optimal: 30-100, toxic: 150 or more)

IGF-I 264.6 ng/ml (137-461)

UPDATE 12/2/2018
New lab from 10/02

TSH 2.33 uUI/ml (0.4-4)
T4 5.25 ug/dl (4.5-12.5)
fT4 1.11 ng/dl (0.89-1.76)
T3 0.55 ng/ml (0.6-1.81)
fT3 2.81 pg/ml (1.5-4.1)
rT3 pending


Metabolic Damage From Dieting
#2

it look like your just training to much and not enought food to recover from ! you should eat more, train less frequency ! rest is more important than anything


#3

Excessively reducing calories is dangerous for your health and will only work against you. Your thyroid is a mess, don’t let any doctor tell you it’s normal, most progressive doctors act when thyroid is above 2.5 uUI/ml instead of waiting for disease status. Read sticky threads, there’s a lot of clueless doctors out there and you need to be able to spot BS when you hear it.

You need fT3 and reverse T3 tested, fT3 is the active thyroid hormone and correlates to how you feel and drives metabolic rate. fT4 can be low while fT3 can be higher, not everyone properly converts T4–>fT3. More testing to find out why TSH is high.

Body temperatures are the best indication of thyroid function, take oral temperature upon waking before you get out of bed and at noon using mercury thermometer, optimal upon waking 97.7 and 98.6 at noon shows a properly functioning thyroid.

fT3 = body temperatures.


#4

Crash diets or low calorie diets also increase your SHBG, lowering your free testosterone.


#5

and you dont think this is due to lack of food and too much training ?


#6

Based on this, what can I do? Cut soccer (cardio)? I was playing between 45 to 70 minutes 6 days a week. Maybe I can top it at 20 minutes daily? Do I keep doing calisthenics to preserve muscle mass? Do I decrease the volume there too?

In regards to my food, what should I do? When I noticed that I probably had a problem I started eating 2800 calories per day instead of 2600; this week I was planning to keep excercise the same way but upping calories even further to 3100. What do you think?


#7

Thanks by the way… hugely appreciate the in depth answer


#8

Start like this, increase your calorie, reduce the volume and the intensity of your workout/ soccer practice.

Take some day off, 1-2 or 3 per week for a few month to see if you get better !

on your day off, go walk, do some stretching ! nothing big


#9

Your body needs rest and you need to eat plentiful, otherwise you will not recover.


#10

From 1 to 10, how bad is this? I mean, based on the available information. Also, take into account my strength started plateauing a month ago and regressing a week ago. Thanks man


#11

TSH is effectively yelling at your thyroid to produce thyroid hormones which might not even be getting the signal, if thyroid doesn’t get the message TSH will continue to rise until there is damage, if this is the case at 18 is cause for concern.

Your weight that you’re trying to lose is tied to your thyroid, get thyroid hormones optimal and TSH closer to 1.0 and weight should be easier to lose. You need full thyroid panel will reveal how bad, you’re young so perhaps you could bounce back quicker than say a 40 year old.

Don’t let that go to your head though.


#12

Gotcha man… will post as soon as I get the panel done. My doctor is not really to blame; I had never had a blood panel that included this hormones and the only reason I tested for them now is because I was feeling like shit.

A question: if I take synthetic T4 and/or T3 while eating more and excercising as I used to, can I effectively solve the problem and resume my life just like before and simply start to gradually stop taking the synthetic hormones until I am cured?


#13

Also, what would dictate if it is T4 or T3 what I should take?


#14

We’re you on thyroid medication and simply decided to stop it? It sounds like a doctor prescribed thyroid meds and you thought you could just stop meds and go natural, no it doesn’t work like that, if you were put on thyroid meds then you will likely have to take it for the rest of your natural life.

The same thing would happen to me if I stop my testosterone treatment, my testosterone levels would plummet to pre trt levels and stay there indefinitely until such time I started injecting testosterone again.

You cannot stop the treatment and expect everything to go back to the way it used to be.


#15

I was not on treatment before, but I get what you mean.I just want to know how will this most likely get solved. Btw, how is it living on TRT?


#16

Well testosterone is a natural hormone and having you T levels optimised feels fantastic, at 46 I feel like a 20 years old and want to have sex several times a day. TRT isn’t like medication, if done right there are zero side effects.

Been on medications my whole life up until now, TRT has done more for me than all medications combined. I’ve always had one of my testicles slightly pulled upwards and wonder if I had been low my whole life.

I’ve never been more happier in my life.


#17

Here are the hormones I will be now testing for on my new panel:

-T4
-T3
-TSH
-Total T
-Free T
-Estrogen
-SHBG
-TRH
-Thyroperoxidase
-LH

Unfortunately, I couldn’t test for rT3; I now think cortisol and iodine test might have been helpful too, but hopefully this is enough.


#18

Wow. That is really amazing. Seems like it was the difference between hell and heaven for you.
Hopefully, I will get this solved soon.


#19

Update: today, as soon as I woke up, I grabbed the thermometer from my night stand and got an oral reading; 96.08°F. I then got an armpit reading, just to double check: 95.72°F.
I will update later today to post my afternoon T°.

What does this all mean? It confirms the hypothyroidism theory, right?


Metabolic Damage From Dieting
#20

Do not take temps in armpit, just stick it under the tung. You should be 97.7 upon waking.