T Nation

Help Interpret Blood Test. Dr is an Idiot


#1

Firstly, I am a Male 32 years old. Only supplements I take are creatine, protein shakes, zinc/magnesium and cod liver oil capsules.

I got my blood test results today and my GP told me 'everything is normal'. Everything I asked about received the reply 'Don't worry that's normal'. When I queried results that were outside of the 'normal' range, he said 'that's normal'. Please help me interpret these results. I will only include results that worry me or seem unusual/relevant.

Lipids and HDL whilst fasting:

Cholesterol: 2.6 mmol/L - 'normal' range is supposed to be 3.9 - 5.5
Triglycerides: 0.4 mmol/L - 'normal' range is supposed to be 0.5 - 1.7
HDL Cholesterol: 0.9 mmol/L - 'normal' range is supposed to be 0.9 - 1.5
LDL Cholesterol: 1.7 mmol/L - 'normal' range is supposed to be 1.7 - 3.5

  • Am I getting enough cholesterol? I'm a noob trying to lose fat and gain strength/muscle. I take cod liver oil capsules and eat loads of salmon and tuna, almonds, olives and avocado. Do I need more cholesterol and if so how should I get it without adding too many calories to my diet?

Cortisol collected at 8:45AM whislt fasting:

Cortisol: 497 nmol/L - 'normal' range is supposed to be 138-650

Is my corisol too high?

Reproductive Hormones tested using Roche method:

Oestradiol: 166 pmol/L - 'normal' level is supposed to be below 160
Testosterone: 25.6 nmol/L - 'normal' range is supposed to be 11.5 - 32
DHEAS: 10.4 umol/L - 'normal' range is supposed to be 2.5 - 13

Obviously my estrogen is too high. But my Doctor doesn't seem to think so. As my estrogen is outside of the 'normal' range, shouldn't my Doctor prescribe me anti-estrogens? I suspect that the 'normal' range is way too high to begin with and I'm over it.

I really need some advice from someone who has experience/understanding of these things. I already do everything I know about to lower estrogen. I don't drink water from plastic bottles, I don't eat soy based products, I don't ever drink alcohol.


#2

I'll let one of the more "pro" guys comment, but you do look estrogen-dominant to me.

Are you experiencing any sides? What brought about getting the blood work done?


#3

The first thing to remember here are that all of these tests have an inherent degree of inaccuracy, so a value lying just outwith the "normal range" is not necessarily abnormal. This is also related to how figures for the normal range are determined. I do not have the figures to hand, but it normally works like this: a hundred people are selected, and the spread of their values is plotted out, which should reveal a normal distribution. The extremes of measurements are knocked off the end, and the resultant figures should relate to around 95% of the population in health. One thing you might notice is that if you went to a doctor or hospital in another area, the normal ranges might appear different - this just represents a slightly different population selected as normal. As far as your lipids are concerned, no real problems there - you don't want to try to increase your LDL cholesterol just to fit into "normal". Cortisol is a stress hormone, so can be influenced by a variety of external and internal stresses (that is why there is such a huge range) - it appears "normal" so no worries there. The oestrogen thing comes down to what I said about test values etc, so isn't really something to worry about. Besides, prescription anti-oestrogen medication is expensive, and not without undesirable side effects. In other words, your doctor is right, he just might not know why. Best way forward is to continue with what you are doing and enjoy that fact that there is nothing wrong! All the best.


#4

You have no idea what you are talking about from a health optimiziation standpoint--are you a doctor? Because you sure sound like a standard endo who only keeps patients from dying in his office.

Do you think if you take 100 people, 95 of those people are going to be at optimal health? I'd love to see the area where you find that sort of population--sign me up to move there.

If he is feeling side effects form too high of estrogen, then his estrogen is too high!!!! The fact that is is OVER the normal range should be worrisome. Unfortunately for OP, I think getting Adex in Australia is akin to pulling teeth from a slumbering grizzly bear. If someone has evidence to the contrary, I haven't seen it on this board.

Cholesterol being too low can also cause issues--but of course you don't realize that because you have been brainwashed by Big Pharma pushing their lipid lowering statins onto the market. Did you know that these drug makers successfully petitioned all major labs to set their cholesterol set point to a standardized number? That means that for cholesterol, the ranges do not indicate a normal population distribution--it hsa been set by drug companies who use studies they have funded that shows that should be the limit. In the US, I rarely even see a "TOO LOW" range for lipids--that should show you how great their influence is.

Cholesterol is required to produce hormones--if its too low, it doesnt take a genius to realize that hormones might have trouble being produced.

That being said, it looks like DHEA is good and cortisol appears good too. To me, this indicates that he is incredibly efficient at converting hormones from raw cholesterol. But the low CHOL values also indicate that his body is fighting his current "good" hormone levels (whether it be test, cortisol, thyroid, etc.). The dumping of T to E2 is further proof of this.

Something is out of whack. I would look at liver clearance issues with the E2, as well as thyroid.

OP: Did you get a thyroid panel done? And most importantly: WHAT ARE YOUR SYMPTOMS? Why did you go to the doctor in the first place? If your erections are fine, you are able to concentrate, you see results in the gym, and you aren't feeling ill, then there's nothing to see here. Monitor your hormones yearly if possible, but don't try to fix something that ain't broke.


#5

I have no intention of suggesting to this any random 100 people are those you would wish to emulate. This was merely a (perhaps too basic) description of how the "normal ranges" are constructed - i.e. if your values are outwith the "normal" there is not necessarily anything wrong. Although I am not saying this is or is not the case, there was no mention of side effects in the original post.

As far as cholesterol is concerned, your body has the capacity to make it from other lipids - you do not need to eat loads to make up for a "deficit" - this is indicated by the fact he seems perfectly able to make hormones (oestradiol and testosterone). Maybe his HDL could do with being a little higher, but attention seems to being paid to that already (eating plenty of healthy fats etc).

All I was trying to communicate is that numbers not quite adding up on paper does not necessarily equate to anything going wrong - we are all subject to natural variation. Interpret things as you will, but I didn't think this guy had much to worry about. If you don't agree, then fine, and I had no intention of trying to lord over anyone. Cheers.


#6

The problem is that the normal range is only what is 'normally' found in a/the sample population. The sample population includes people who are not healthy at the extremes of the ranges. I wish that the ranges were not named "normal", perhaps "typical". Docs start to equate lab normal with absence of any associated pathologies. Many here are seeking to get optimal levels.


#7

anyone who has ever been told that his cholesteral was to high by a dr. should really check out "the cholesteral myth" just google it sometime. it basically states that the entire cholesteral hysteria is a big hoax. good cholesteral bad cholesteral, again all crap. cholesteral is cholesteral. ask yourself this. why is it that over 70% of people that have heart attacks have so called normal cholesteral levels. hmmmmm. why is that.

its called getting rich off of selling statins to lower cholesteral levels. big med. comps make billions with these.


#8

I really don't want anyone to feel that I am suggesting that medics/big pharma etc are always right. I do appreciate the desire to achieve better - to optimise hormone levels etc. However, drugs are most likely not the best way forward with this, given their potential for side effects etc, and to knock other aspects of your health out of their optimal level.

As far as the cholesterol issue goes - cholesterol in itself is just cholesterol, its the proteins that are expressed to carry it to different places that are the issue (LDL and HDL). A very good point about high/normal values and heart attacks - cholesterol is only one risk factor for vascular disease - just because blood levels are normal does not mean arterial plaques will not develop.

Your best bet as far as statins is concerned (should you "need" them) is to go for the older, off-patent ones - big pharma companies do NOT make lots of money from them (which is why they try to ply you with newer, more expensive ones), and they are pretty much as effective. Anyhoo - I am going to have some eggs!


#9

Source please? I am anti-establishment as they come, and this shocked even me.


#10

same here, i want to know the source as well. those figures sound really bogus, as my father had really
high colesterol levels and that lead to blocked ateries more than 90% and required emergency surgery to save
his life.


#11

Because there is a lot more people with normal cholesterol levels then people with high cholesterol levels???

If 40 million people have normal cholesterol levels and only 1 million have high cholesterol levels, the vast majority of heart attacks will still come from the population with "normal cholesterol levels". This does not change the fact that the risk of suffering from a heart attack is greater if you have high cholesterol levels...


#12

Basically the reasons I got the test done are:

  1. I've been an overweight slob since I was a teenager and never seen a doctor for anything other than the occasional cold/flu. I wanted to know about my insulin tolerance and liver/kidney function as well as hormone levels.

  2. My fat has always accumulated at my hips and breast area. I never considered gyne because I thought guys with gyne actually had swollen, enlarged glands behind their nipples whereas I just have a bit of fat. I thought it would go away as I lost bodyfat(it has been actually). More recently I have heard gyne described as just fat accumulation at the breast area so this concerned me.

  3. I am gaining strength but I feel tired a lot of the time and tend to skip cardio often. Sex drive is probably a bit below 'average' but I don't have erectile problems though.

RE Thyroid Function results:

TSH: 0.81 mU/L - 'normal' range 0.40-3.50

From my understanding and reading mens' estrogen levels have been rising so dramatically over the last 50 years that some scientists are prediciting mass infertility in the general male population. This is also why I don't consider the 'normal' estrogen level to be normal at all. I'm aware that estrogen is an important hormone for men as well as women and is closely related to calcium absorbtion and therefore bone density amongst other things. I would just like to lower mine to reasonable levels. I'm going to see an endo but I'm sceptical about whether he will help me lower it. And as I said, I'm already doing everything that I know of to lower it naturally.


#13

Because there is a lot more people with normal cholesterol levels then people with high cholesterol levels???

If 40 million people have normal cholesterol levels and only 1 million have high cholesterol levels, the vast majority of heart attacks will still come from the population with "normal cholesterol levels". This does not change the fact that the risk of suffering from a heart attack is greater if you have high cholesterol levels...


#14

HaveIronWillLift: good for you. Hope all is well when you go for your appointment, but hopefully continued hard work and proper nutrition will set you right!


#15

Bump? Anti-estrogens, endos, Australia, chances? 32 year old.

166 pmol/L - Australian 'normal' level for men is supposed to be less than 160pmol/L.


#16

It's my understanding that getting an AI in Australia is very difficult.

Read the "FINDING A DOCTOR" stickey which well tell you to google a compounding pharmacist near you, and go ask them to point you towards a doctor that has filled AI scripts through them in the past.


#17

Cholesterol: LEF.org aka LEF.com has some good data re many with high cholesterol not having heart attacks and many with low cholesterol having heart attacks. CRP lab results can address CV disease risks, however is not specific to arterial inflammation and CRP can be increased by any chronic inflammation, which can include gum disease that does increase CV death rates. Homocysteine is CV specific and low HDL has a positive correlation, a negative thing, and high potency B-vits, Vit-D, fish oil, anti-oxidants, youthful T levels and optimal T levels can lower homocysteine and reverse or halt the fundamental problem, endothelial dysfunction. If you do not know that that is, Google does! [Chronic use of ibuprofen can also increase homocysteine.]

The CoQ10 deficiencies caused by statin drugs are a huge issue that you might want to research. I have a friend who was taking 40mg Lipitor who had signs of an induced state of congestive heart failure. I put him on 100mg LEF Ubiquinol CoQ10 and that fixed that [and his chronic elbow pain]. A year later he was not doing as well on CoQ10, same description from a local vit shop. Ordered a year supply from LEF and he states that he is feeling much better from that. He learned something from that and is willing to pay for the good stuff now.

There are lots of complex stories like this. You cannot fundamentally understand them all, you can only pick up on some of these things. Myself, after reading about such things for many years, I have a context into which I can keep inserting new information, like a jigsaw puzzle where things need to fit in just right. A single jig saw puzzle piece does not make much sense if you do not have a place to put it. So you may need to take some things in faith when you have current needs. Myself, I had the good fortune to be in great health for many decades and the [inexplicable] motivation to be reading about such things. Now that intractable activity is paying off in many ways. If I could cash in on promised beers, I would be a rich man!

Why? As a Engineer with great design and problem solving skills, it all seemed natural. My work doing failure analysis is also part of my compulsive studies of these small areas of medical concern. As long as I am babbling tonight... my Age Management Doc, that I have taught very well, asked me to get a PA and become part of his practice, opening a office in my town. I was not interested in 5-6 year of work to start on that after retirement age. So I do this for self satisfaction.

end of babble


#18

Thanks guys. I also get obsessively interested in things and read a lot but this is an area where I have very little knowledge(I'm a linguistics/philosophy/history post grad.) I intend to read the Chol studies you mention and try to understand the rest of your first paragraph. But I get the idea. Basically I need to raise my HDL levels. I'm also interested in the relationship between arterial plaque formation and LDL plasma levels as I have relatives who have died of heart attacks attributed to high Chol.

Also, I've never taken statin drugs in my life. I take cod liver oil caps daily and eat heaps of olives/olive oil, avocado, wild salmon etc. I take 2000iu of vit D daily but I have read that you really need to have your vit D levels checked to tell how much you should take. I would've thought I get enough B vits from my food but I should get my vitamin levels checked. I suspect my Doc will start to think I'm a hypochondriac but then again, I think he's an idiot.