T Nation

Got My Test Today. Guidance/Suggestions?


#1

Hello guys ,
A little background iam 42years old male ,having no kids yet . I was actively involved in strength training before 2-3 years and was good in shape . now past 6 months I have put on quite a lot of weight mainly on the mid section . I under the influence of my trainer in 2007 had done a tren , winstrol ,primobolan , anavar cycle for 8 weeks . had taken hcg and novladex during cycle and had done pct with hcg and novladex . second cycle was winstrol and anavar and followed the same routine . i know as first cycles they were not appropriate ones . after that i have been completely drug free rill date .

Since 2009 I started feeling a lump under my right breast nipple which used to hurt too . the sensitivity used to increase when I used to go on diet to lose weight . i just ignored all that . now I see decided to meet a endocrinologist regarding this topic and also because I started facing some ED issues and low libido and difficulty in losing fat . I don't have any other symptoms like loss of mood or well being or depression or anything of that sort .

Mainly concern was ED , loss of libido and this lump in the breast .
The endocrinologist asked to perform number of test .
One thing I need to mention is 3 months back I had done vitamin D test and it was extremely low it was 9 ref range 30-60ng/ml. After that i started supplementing with vit D3 tablets .

Here are my test results now which i received today .

Vit D

29.4 ref range - 30-60ng/ ml .

Vitamin B 12

981.0 ref range - 187-883

Folic acid

More then 20.0
Ref range - 3- 17 ng/ml

Thyroid test

Parathyroid hormone ( intact PTH)
73.9

Ref range - 15-68.3 lg/ NL

Free T3 - 2.37
Euthyroid range - 1.71 - 3.71 pg/mL

Free T4- 1.0
Euthyroid range - 0.7-1.48 ng/dl

Ultra sensitive
T.S.H-2.4484
Ref range - 0.2-5.0,normal .

Glycosylated haemoglobin - hba1c - 5.7
Normal values - 4.27-6.07%

Mean plasma glucose level for last 3 months - 117 .

Testosterone levels

L.h - 3.23

Ref range-1.14- 8.75mIU/ml

F.S.H - 2.71
Ref range-0.95-11.95mIU/ml

Serum testosterone-6.64ng/ml

Ref range-3.0-10.6ng/ml.

Free testosterone-4.8pg/ml

Ref range -4.25-30.37pg/ml.

Estradiol(e2)-27.0
Ref range-11-44 pg/ml

Serum Prolactin - 8.81
Ref range-3.46-19.4ng/ml.

CBC - is all normal .

Lipid profile

Serum cholesterol- 248
Report - high

Serum triglycerides- 363
Report- border line high .

Serum h.d.l -35.0
Report -< 40 low .

Total cholesterol/ hdl ratio - 7.09
Normal- below 5.1

Serum V.l.d.l-72.60
Report - border line high.

L.d.l -140.40
Report- borderline high .

Serum Cortisol ( 8.00am)
7.0

Ref range - morning before 10am- 3.7- 19.4ug/dl.

I was told to do sodium , potassium , chloride, creatinine , serum s.g.o.t and s.g.p.t levels and all are in normal range .

Can Ksman and other knowledgeable members guide and interpret my lab results . my appointment with the endocrinologist is on the 8th Jan so if I could know before what you guys think about my test results I can be much prepared for the appointment and can judge what kind if response he gives to the test results and what treatment he decides .

I would like to give all information in case you guys need any more information .

I will be grateful to one and all who would interpret the above results for me and guide and suggest me a course of action .

Thanx a millions in advance .


#2

Also check AM cortisol, do labs at 8AM.

Your cholesterol should improve if you get other hormones fixed, do not start statin drugs now.

Your E2=27 and low FT make you estrogen dominant.

Your PCT was probably done incorrectly and you could use nolvadex then PCT out of that and see what happens.

Your TSH is too high, should be closer to 1.0 and fT3, fT4 are low relative to mid range. I suspect that this is contributing to all of your other issues. Your body temperatures are probably low. If you are iodine deficient, your thyroid function might be restored with iodine replenishment.


note calcium and vit-D

Are you taking 5,000iu vit-D3 per day?

Refer to these stickies:

  • advice for new guys [find suggestions for vitamins re cardiovascular health and HDL]
  • thyroid basics

Do not do TRT now.
Suggest that you address thyroid/iodine issues first.
Do nolvadex then PCT properly this time, using anastrozole during and after PCT. Find my writing on HPTA restart via search here or google.


#3

[quote]KSman wrote:
Also check AM cortisol, do labs at 8AM.

Your cholesterol should improve if you get other hormones fixed, do not start statin drugs now.

Your E2=27 and low FT make you estrogen dominant.

Your PCT was probably done incorrectly and you could use nolvadex then PCT out of that and see what happens.

Your TSH is too high, should be closer to 1.0 and fT3, fT4 are low relative to mid range. I suspect that this is contributing to all of your other issues. Your body temperatures are probably low. If you are iodine deficient, your thyroid function might be restored with iodine replenishment.


note calcium and vit-D

Are you taking 5,000iu vit-D3 per day?

Refer to these stickies:

  • advice for new guys [find suggestions for vitamins re cardiovascular health and HDL]
  • thyroid basics

Do not do TRT now.
Suggest that you address thyroid/iodine issues first.
Do nolvadex then PCT properly this time, using anastrozole during and after PCT. Find my writing on HPTA restart via search here or google.

[/quote]
Thanx a million ksman.

I will reply you as per your points mentioned .

Cortisol test and all this test were done at 8:30 am in morning .

Regarding thyroid do you think that is the reason of my low t and can that be cured ? Are this thyroid figures suggestive for my ED , and in ability to lose weight ?

And regarding htpa , the last cycle and wrong pct I did was in 2007 march , do you think a restart now in 2015 can be done ?

And can my free T can be increased without going the TRT route ?

And iam talking vitamin d3 4000iu everyday .

I generally follow low carb diet .

And what you think about my high parathyroid levels are they anyway contributing in this situation of mine .

And if iam estrogen dominant so you think that can be reversed without going TRT way ?

And thanx for the links I will go through them in detail .

Looking at the test results what you see do I have primary or secondary hypogondisim .?

Thanx a lot for your response .


#4

parathyroid: We rarely see that reported here. You will have to go off of the link I provided.

Sometimes thyroid issues are linked to low T and we have seen T levels improve when thyroid conditions are fixed, but you have to wait and see as is might happen.

Estrogen dominance. First you need to deal with an HPTA restart and you will be cruising on 0.5mg anastrozole per week where we are avoiding estrogen rebound and shutdown.

Your HPTA is working, so a restart might work.

You are not primary or secondary. Need to see where you are after getting thyroid improved. Low thyroid does seem to undermine any HPTA restart efforts.

If you get decent FSH, LH and T when doing labs while on nolvadex, your prospects are good. If nolvadex is dosed too high, E2 can be out of control and cannot be manged with anastrozole and you do not want high LH as the testes should not be exposed to high LH then dropped onto a post restart with lower LH levels as that is the wrong signal.

With my TRT doc, cortisol=10 at 8AM is considered acceptable and lower is not good enough. May be shifted by improved thyroid function.

Are you iodine deficient? Body temperatures?


#5

Ksman and experts ,

I have a update now .

Well I had a meeting with my endocrinologist and he said everything is normal , and must adjust my diet for the high triglycerides levels .
Rest said your testosterone levels and all are fine and good .
And for the breast lump near the right nipple he said to take tamxoifien 10 mg every day .
When I asked him about ED he said your reports are normal just lose weight and you will be fine .
I also pointed him towards the free test report he said its on lower side but after losing weight you must be fine .
Guys what you think ? Shall I see a second opinion .?


#6

What is your waist size and weight?

Weight issues are partly a result of low thyroid function. Weight is also a result of low T. So you are stuck.

See the finding a TRT doc sticky.

You never responded to:
Your TSH is too high, should be closer to 1.0 and fT3, fT4 are low relative to mid range. I suspect that this is contributing to all of your other issues. Your body temperatures are probably low. If you are iodine deficient, your thyroid function might be restored with iodine replenishment.

And you ignored:
Are you iodine deficient? Body temperatures?

Please read the thyroid basics sticky.


#7

Ksman and experts

Sorry dint reply about the iodine thing . I don’t know if iam iodine deficient or not , is there any test I need to do ?
Iam in India so TRT is not much famous here . Although there is a anti aging doctor who is also a endo so I have taken his appointment for the coming Tuesdays to check his opinion too .

My weight is 102 kgs and waist is around 40inches .

Iam confused a bit because the doctor said that my test levels are normal and it’s just a indication because test levels can vary a lot thought the day .

Regarding thyroid he said it’s also ok .

According to you what problem are you seeing here ? I have a serious thyroid issue ? A serious low testosterone issue ? Or both ? The reason iam asking this again is because I can put the points across the anti aging doctor in case he tries to take me for a ride .

And do you suggest I start the 10mg nolva tablet everyday as suggested by the endo for a month and then increase it to 20mg every day as a standalone protocol ? .

Btw my urologist had suggested me " enlarge forte " a powder made of l arginine , pine bark extract and safed musli . Which I have bought .

And also I am getting morning erections again since I started supplementing with zinc sulphate 40mg , vitamin d3 .


#8

Are you iodine deficient? Body temperatures?

Please read the thyroid basics sticky.

If you do not use iodized salt, you are iodine deficient.

Check your body temperatures, read the sticky.


#9

The history of iodized salt in India is messed up with the social issues with salt, salt tax and getting the British out. It was not until 2005 that iodized salt became fully mandated. Even then, there are distribution problems in some regions.