T Nation

Help. Doctors, Anyone? No One Will Give Me a Blood Test

Absolutely Wrong: While SHBG+E2 is weakly bound and considered bio-availalbe and also described as a transport method; SHBT+T it tightly bound and not bio-available. SHBT+T heads to the liver for garbage collection. I have seen this idea repeated by people and institutions that should be ashamed for repeating such crap when the definition of Bio-T excludes SHBG+T. If SHBG+T was bio-available, lab tests for TT and Bio-T would be the same thing.

The problem, is that SHBG+E2 makes people think that SHBG is a steroid hormone carrier or distribution vehicle. Not generally true.

Albumin+T is weakly bound and increased albumin helps increase Bio-T.

Alright here are the results (If I am missing something you would like to know please let me know and I’ll check the list, otherwise I’ll just post the Thyroid, Sex hormone, test, and so on)

They took a CBC with differential/platelet test for WBC RBC, Hemoglobin, Etc as well, those were all in the middle or upper range of the tests. Interval range was based on a population of lean males up to 40 years old.

Severe outliers are bolded.

Thyroid Panel with TSH:
TSH 1.100 Scale 0.45- 4.5
Thyroxine (T4) 6.6 Scale 4.5-12
T3 Uptake 36% Scale 24-39
Free Thyroxine Index 2.4 Scale 1.2- 4.9

Testosterone, Serum
Testosterone, Serum 352ng/dL Scale 348 - 1197

Sex Hormone Binding Glob, Serum 18.5nmol/L 16.5 - 55.9

TSH is good, like to see TSH near 1.0
T4=6.6 is well below midrange 8.25
Your oral body temps as per the thyroid basics sticky will provide a better indication than those labs.
Have you been getting iodine from iodized salt or vitamins that list iodine+selenium?

Best to test fT3, fT4
Thyroid uptake and indexes are obsolete.

TT to low to live with
SHBG is low, suggesting that FT, TT–>E2 and E2 are low.

Expect that hematocrit is near 42

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Thanks for your input, truly. You are helping give me advice that I would wait months for… if that info I wait for is even correct…

Body temps are always 95-97. However I have not measured when waking up. I will buy a oral thermometer tomorrow and start tracking this. My mother suffers from hypthoidism so perhaps I have that middle case, or nothing at all. I’ll post back my temperature results.

As far as Iodine salt or vitamins, no I don’t take them… table salt is the closest. I figure you should follow the label on those supplements.

Meanwhile I plan to find a endocrinologist that can see me more quickly than a month or two…

Thanks again for following this threat KSman. I truly appreciate this feedback. It was a a mini-miracle today when I got my lab results back, confirming my conspicions… and no parents/doctors/brain surgeons, neurologists wanted to do them!!! Pieces of crap doctors… if anything it’s money they are wasting.

Anyone heard of lowtcenter.com?

They were able to get me in for a secondary blood test this coming monday, while a “legitimate” sounding endo is taking appointments months out.

Either way maybeb i should keep the blood test appointment… it’s 20 bucks.

I’ll try to test for fT3 and fT4, as well as fT, TT–E2, and E2… and hematocrit

Many clinics of this nature are not looking at your overall health or situation.

They may not check LH/FSH or prolactin. Not doing a diagnostic to see if the condition can be fixed.

We have had reports of some stupid things been done, so you still need to be active in what it happening.

Yeah that’s what it looked like from what ive read. GUH, I just called the endos my doctors referred me to." Your levels are within range" they said and rejected me t to further review…

I need to buy some books, re-read the stickies…

My blood test is Monday morning and they trouble without a referral, so this place is a little sketchy already…

For 20 bucks though I’m getting blood drawn. I’m compiling a list of things I want tested and why do I have reason.

So far I have


Those types of centers usually use cookie cutter protocols. KSman is correct in that they are not interested in your health only your money. I went to a similar place and realized I was getting sub par treatment at a very high cost ($299.00 per month). I did my research and now my treatment costs about $80.00 a month managed by a very knowledgeable doctor.
If you are paying out of pocket I suggest looking elsewhere. There are better options.

Ok… Morning body temps with oral thermometer:

day 1. 96.7- 97.0
Day 2. 96.5- 97.0
Day 3. 96.3- 96.5
Day 4. 96.0 - 96.4
I posted rangesbecause my competency with placement of thermometer in toungue is variable, coldest spot is directly under, heat pockets are to the side.

Hypothyroidism runs in family.

Blood test today:

Doing the following, or at least pushing to:


For LH FSH Prolactin, Iwill really push to make sure these are tested, this is because these 3 tests will be a good diagnostic tool to see if my problem is fixable , and not just treatable.

Also I just wanted to clarify that i want these problems fixed for mental health and not more muscle and performance

Edit: WOW The nurse thought fT4 and fT3 WERE TESTOSTERONE. They said they would test them though. Along with all others listed above… free testosterone came back at 248. Since it is below range, my insurance will now cover treatment. I also received a call from my General physician and they found me an endocrinologist in the area. Sounds like I have a possible thyroid issue as well as low test.

What can I do before my next blood test to lower testosterone? If I lower it, I have excellent insurance that will do everything for me for 20 bucks. If I can’t lower it below range, insurance won’t cover. I need two tests to begin treatment with any of these endos.

I cannot see that you have responded to my question re history of using iodized salt.

You have a thyroid problem or iodine problem?

We never are optimistic when an endocrinologist is involved. They do and say stupid things.

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@KSman I had to do a bit of researching to figure out iodine part. Other than a few fish, almost daily yogurt, and cranberry juics here and there I do not get any iodine, which from what I read could be a sign of why my body temp is low in the morning. Also why you have been stressing this, Thank you!

However I just bought a nice daily vitamin containing both iodine and selenium. The iodine is 150mcg per serving and the selenium is 200mcg per serving… is that enough? I read in another thread I should take more than that for the first couple weeks if I’m deficient.

For the sake of the near upcoming blood tests and my thyroid issue or testosterone and being seen by a decent endo, should I hold off on taking these vitamins for a few weeks so they don’t alter with my blood results?

My insurance won’t accept me because I am within range on the TT Test. And I’m literally Four Points above the bottom of the range.


The lowtcenter has turned me down because of my age. They told me my thyroid levels were normal, I have not seen results yet. They are referring me to a urologist for further investigation on a varicose vein in my testicle as well as forwarding my lab results to my physician and endocrinologist

Edit: They didn’t test for my requested data but.
TSH is at 2.35 now

Can you post all lab work together in list format with ranges?

Insurance should not be refusing a 24YO for that level.

TT may be inflated by elevated SHBG and E2 may be a problem.

Can’t play the game with half a deck of cards.

I stress thyroid because many come here with low-T and have thyroid issues. If TT, FT and E2 are perfect, many can feel like shit with elevated TSH and low body temperatures. Everyone needs selenium. Increasing T intake with low selenium has known risks for thyroid - which few know about.

TSH=2.35 is a problem. Lab ranges say your normal, body temperatures are a mess. You have two choices, iodine deficiency or developing thyroid auto-immune disease, which selenium can prevent or sometimes reduce. You do have the family history. You need to read all of the thyroid basics sticky.

Did your mom avoid salt or not use iodized salt?

Are outer eyebrows sparse?
Do you feel cold easily?
Is neck thick where thyroid is?

Alright here is an update with LH, FSH, and Proleactin results, as well as an overall summary of my thread to date: I am 24 years old and have never cycled steroids that would affect these hormones.

First blood work:
Thyroid Panel with TSH:
TSH 1.100 Scale 0.45- 4.5
Thyroxine (T4) 6.6 Scale 4.5-12
T3 Uptake 36% Scale 24-39
Free Thyroxine Index 2.4 Scale 1.2- 4.9

Testosterone, Serum
Testosterone, Serum 352ng/dL Scale 348 - 1197

Sex Hormone Binding Glob, Serum 18.5nmol/L 16.5 - 55.9


Test: 370ng/dL
LH: 9.9 HIGH, range 1.7-8.6 (This is not a good sign if I’ve read stickies correctly. Could it also mean my pituitary is just puting in double time cause something else is wrong? )
FSH: 2.6 mIU/ml range (1.5-12.4) this seems low
T4 (free): 1.36ng/dL
Prolactin: 9.3 ng/dL
Hematocrit: 45.9% @KSman, you called this level earlier in thethread to be 42% nice work.

day 1. 96.7- 97.0
Day 2. 96.5- 97.0
Day 3. 96.3- 96.5
Day 4. 96.0 - 96.4

Other outliers, head trauma 6 months ago and hypothyroidism runs in family on mother’s side.

I do not supplement iodine, I do not know my iodine level, however I am starting today and I have another blood test this coming tuesday, so I hope my new iodine supplementation will be reflected by the tests

With this high ofLH andlow FSH, does that automatically mean my condition is not fixable and that something may be wrong with my laydig cells in the testicles? I have hope still I can treat this with hcg, but from what I’ve read hcg is used only whenLH is low. Can someone confirm this? Really, really hoping hcg would benefit me somehow, I’ve read numerous research articles on how it can be used to finish a adolescents sexual maturation in patients with hypogonadism. I think I have had hypogonadism or low testosterone for most of my puberty… Thank goodness I grew a bit but I don’t think anyone will say no to a bigger unit…

High LH and low T typically means that the testes are a problem and such problems can only be surgically fixed if there is a correctable vascular problem. Doctor can check for that. Any ache in your testes.

Another problem that cannot be surgically corrected is testicular cancer and that is a young mans disease. There can be FSH secreting testicular cancers your low FSH rules that out.

Typically, FSH and LH levels are similar, so your high LH and low FSH seems quite odd, so that needs consideration.

When LH is high and T is low, hCG which acts like LH will not work any better.

I would retest LH/FSH to see if this pattern still holds before taking any other action. LH is pulsatile, so it can change by the hour. FSH is typically the better indicator of LH status than LH itself, but you may be an exception to that.

LH secreting pituitary adinomas are rare, but still happen.

HCG secreting tumors can easily be detected in males as background levels of hCG are typically undetectable.

If LH levels are high and constant, that can turn the LH receptor pathways off.

The above is a brain dump may be useful to know if you get into any complicated diagnostics.

T4 is well below mid-range.
uptake and indexes are basically obsolete now that fT3 and fT4 labs are available.

TSH looks great, body temps are low.
As fT3 is the active thyroid hormone that is part of the body’s temperature regulation control loop and T4 is low, I expect that fT3 is below mid-range. Note that T4 is a reservoir for fT4–>fT3 generation.

Head trauma can damage the pituitary, but the result would be expected to be lower LH and FSH, not high LH, low FSH and low TT.

Taking higher amounts of iodine increases TSH. More to the point, please observe changes to mood, energy and body temperature. You are mostly on your own with these things as everything is “normal”.

When iodine has been low for a long time in the past, high TSH can lead to thyroid nodules that start making thyroid hormones independently of TSH control, thyroid levels improve and TSH starts to go down and as things progress to hyper, TSH will pass through the 1.0 zone, looking perfect, later on TSH gets very low. So there can be complexities that most doctors will not consider until things get abnormal. Again, this is a brain dump that might not have any bearing on your case.

You have not had FT tested and that may be abnormal. Diagnostics need to consider symptoms and other things. As SHBG was not high, your TT is probably not inflated by a disproportionate amount of T+SHBG.

If you want to nudge your T levels down, try taking OTC Tagamet /Cimetidine. It can interfere with E2 clearance, increasing E2, which would normally decrease LH and T to some extent. But with your high LH and low FSH with low T, all bets are off.

You stated that after talking to nurse, that fT3, fT4 would be tested. What happened?

Thanks… not good news. The nurse did say that and I double checked… turns out they only tested what they wanted to.

Luckily my chiropractor found me a clinic to see that is reputable. They are an integrative health place and look for patients like me. I’ll see them in a week and I’ll take note of how I change mentalyy and physically with the new iodine, as well as body temperature in the morning

Also, my neurosurgeon evaluated my pituitary on a brain scan and did not see anything , told me it looked good… not sure how in depth he evaluated it, but there are no growths or physical abnormalities.

I noticed my testosterone level increased from 352 to 370. I’ll have to see how much th e testosterone can fluctuate l, but it would be nice to see it even higher the next Time I test.

Could my LH be high because a thyroid issue is decreasing my testosterone, causing pituitary to secrete more LH? I don’t believe the doctors have thoroughly evaluated my thyroid hormones to rule out a thyroid issue.

No aches in my testes, have had a varicose veine ruled as OK by a urologist. He did not do any other tests besides visual inspection.

I’ll haveLH and FSHretested

Have a endo appointment theb21st and a urologist appointment beginning of april, the uro is pushing clomid.

From what I’ve read clomid may help in that it will increase fertility and fsh levels. I’m also looking into nolvadex, I heard it was better than clomid.

Clomid and Nolvadex do the same thing. Clomid was the first born and was used to determine how it increases LH/FSH and T. When Nolvadex came along there was no point in doing the same thing all over again and publishing papers, so the medical community has a mindset that is hard to change.

In some males, Clomid makes them feel horrible. Nolvadex does not do that. So I recommend Nolvadex to avoid some guys feeling like shit. Clomid affects me that way. IO tried it twice. [I have had no need of a SERM, but tried both to have some first hand feeling about what is does.]

Having said that:

You should not take any SERM. Your LH is already high and T is low and needs to be investigated. Using a SERM to make LH even higher is insane. Good luck trying to talk sense into that doctor. Deductive reasoning and critical thought is not part of med school.

Ok so I have been put on clomid 25mg every day for 2 months. then bloodwork after 8weeks… Seems like such a long time for more bloodwork. Anyways, The first 3 days I felt nothing, but then for 4 days I felt zero of my bad side effects in the mornings (depression, anxiety, fatigue, etc), and i would slowly gain them back in the afternoon. Felt fantastic, I felt so confident that I tried to come off my meds. But then that feeling went away and I felt like crap again. Balls are definitely more firm and slightly larger. Thyroid results came out good, still taking the iodine and selenium.

From my bloodwork i found I have a huge vitamin D deficiency, so ive been taking D, a K supplement, and Zinc, recommended to me by my “integrative health doctor”. I believe this could help depression symptoms also caused by Low T.

Is it possible the clomid worked for a few days but started acting differently towards estrogen in my system? I have gained some weight, been on it for 5 weeks now.

Also, 5 weeks ago my Testosterone level came back as 455, it was originally tested at 352ng/dL, I know test levels fluctuate by up to 30% but that is a good sign regardless Id like to think.

Any input is greatly appreciated… Seems I should try to switch to HcG injections 3x a week so I might ask the doc for that if you guys think that will benefit me at all or even stay the same as the clomid.

Something also worth mentioning, I found my doctor 2 hours away in Winsten Salem, NC. They are an integrative health place that accepts multiple insurances.