T Nation

Got Some Bloodwork Before Seeing Urologist. What Else to Ask?

Hey everyone,

Pretty new to this subject and still reading a lot to better understand everything.
(Btw, that sticky post is completely empty for me. Is that normal?!)

I am under constant surveillance for thyroid issues (had Hashimoto diagnosed a couple years back). Used to take L-Thyrox 150 for about two years before getting off about 1.5 years ago.
Blood results for fT3 and fT4 have recovered by themselves and are now in normal range. TSH is still a bit too high.

Still having trouble with a couple things, I asked my doc to test for TT when we did my last thyroid blood work and it came back quite low for my age (34).

Now I asked him today to run more tests next week in order to get the full picture on my Test situation.
We’re going to do TT, FT and SHGB. Now I read here that E2, FSH and LH are also important. Are all those definitely necessary to get a solid overview? Anything else?

He’s going to send me to an Urologist afterwards, but apparently it takes about 6-7 months to get an appointment with those specialists here. Should I maybe ask him to get me an appointment with an endocrinologist as well, or would the Urologist be sufficient in order to figure this out? I can’t just go there myself, they only give out appointments to my doc.

Those are the results from the last lab test:

Values without a range are age dependent, that’s why they don’t show them. But if the value doesn’t have a (+) or (-) indication it’s within range.
I’m already taking D3 5.000 IU/d to get it up.

All input is very welcome. Thanks!

I went back and got new labs done.
My total test came back a lot higher than last time. (They still only took one blood sample instead of the advised three samples; is that a problem?)
These are the results.

TT = 5.35 ng/mL
LH = 4.4 mU/mL (range 1.7 - 8.6)
FSH = 6.6 mU/mL (range 1.5 - 12.4)
E2 = 5.7 pg/mL (range 8 - 43) <- Low
SHGB = 29.9 nmol/L
FT = 114 ng/L

They also did Free Adrogenic Index, which came back with 62.1 (no unit).

Any thoughts on those labs?

There are no guarantees, sex hormones are an area of medicine that seems to be where docs fall short in knowledge. It can be hit and miss a lot of the time as far as finding a doc well versed in sex hormones.

I noticed you don’t have any Reverse T3 testing, if elevated would mean you are converting excess amounts of T3 to Reverse T3, then T4 only medicine is inappropriate and T3 medicine is needed.

This is really bad, low estrogen can cause a lot of mental and physical symptoms (fatigue, anxiety, ED, low libido) and if you don’t get this value to a healthy level you are looking at osteoporosis. If you have had these low E2 levels for a long time you may already have osteoporosis.

You may lack the aromatase enzymes needed to convert testosterone to estrogen and I have seen members with this problem before. If you were on TRT I would simply tell you to increase your T dosage to increase estrogen.

A healthy estrogen level is over 20 preferably closer to 35 (naturally) and have seen members with osteoporosis in the mid teens.

I edited the units above as he sent me the original labs.
FT seems to be in normal range?!
He also gave me a transfer to an endo. Now have to find one and get an appointment.
We will also check on E2 again in 2 weeks and see if the last result was maybe a one-off thing.

Especially with osteoporosis I want this to get checked. I do have some trouble with my spine since my teens, which is probably growth related. But on the other hand never had a broken bone in my life.