Help Interpreting Bloodwork Results

Pharma / TRT Testosterone Replacement
1

New to the boards. Just received my bloodwork posted by Labcorp and played phone tag with the doctor’s office to discuss my results and obtain a recommendation. Any thoughts on what I should be researching in preparation to speaking with the doctor tomorrow?

Latest Test Results

Testosterone, Serum 222ng/dL (264 - 916)
Luteinizing Hormone(LH) 2.6 mIU/mL (1.7 - 8.6)
Prolactin 12.8 ng/mL (4.0 - 15.2)
Free Testosterone Direct 8.6 pg/mL (6.8 - 21.5)
SHGB 19.9 nmol/L (16.5 - 55.9)

Initial Bloodwork

Hematocrit 46.9 % (37.5 - 51.0)
Glucose, Serum 94 mg/dL (65 - 99)
Protein, Total, Serum 6.7 g/dL (6.0 - 8.5)
Albumin, Serum 4.2 g/dL (3.5 - 5.5)
Cholesterol, Total 196 mg/dL (100 - 199)
Triglycerides 145 mg/dL (0 - 149)
HDL Cholesterol 37 mg/dL (>39)
VLDL Cholesterol Cal 29 mg/dL (5 - 40)
LDL Cholesterol Calc 130 mg/dL (0 - 99)
PSA Serum 0.7 ng/mL (0.0 - 4.0)
PSA, Free 0.16 ng/mL N/A
% Free PSA 22.9 %
Testosterone, Serum 289 ng/dL (264 - 916)
Free Testosterone(Direct) 7.1 pg/mL (6.8 - 21.5)
Hemoglobin A1c 5.2 % (4.8 - 5.6)
TSH 3.390 uIU/mL (0.450 - 4.500)
Prolactin 9.5 ng/mL (4.0 - 15.2)

Age: 43
Height: 6’2"
Weight: 305
BP 120/70
Temperature 98.7 (ear)
Fertility is not an issue. Three kids already and no plans for a fourth.

2

You need to edit and post ranges with your results.

Short answer though is: your test it way too low, andyour TSH is too high

3

Advice needs to be specific to your age and need to preserve fertility.

Your location can be helpful in getting specific advise or sympathies.

TSH should be near 1.0
Your doc is not concerned because stupid lab ranges make you “normal”

The above is a real problem. The cause could be not using iodized salt and the results of iodine deficiency can be what you are experiencing.

Low thyroid function symptoms:

  • low energy
  • mood and libido problems
  • fat gain
  • feeling cold easily
  • dry skin
  • sparse outer eyebrows

Most symptoms are the same as low-T so you have double problems.

Please post all available labs with ranges. Do not skip because results are normal.

Get oral body temperatures posted ASAP - see below

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

4

I updated my tests with ranges. Seeing the second reply now I should have included sodium results.

Sodium, Serum 141 mmol/L (134 - 144)

5

Please obtain oral body temperatures first thing in the morning and mid afternoon. Your infrared thermometer may not be accurate enough.

Do not expect doctor to have concerns re thyroid. The lab ranges mean that almost doctors are blinded.

With lower SHBG there is less non-bioavailable SHBG+T inflating your TT and TT=222 is understating your T status.

You do need TRT.
Your body weight fat may be partly the result of thyroid issues.
A1C is good and TRT and working your thyroid can only make this better.

With TSH=3.39 you may not be able to effectively absorb T gels or creams and self-injected T is your best option.

With low FT we then assume/expect FT–>E2 to be low and E2 lab results are then expected to not be high. Thus your low LH cannot be expected to be attributed to the effects of E2 or prolactin.

Discuss your history of iodized salt use. If not in the house everyone there is affected.

Read the advice for new guys and protocol for injections stickies before you see the doctor. Write down what you want to do and hand it to him/her.

  • Self-inject 50mg T twice a week.
  • 250iu hCG subq EOD to preserve testes [if you care]
  • 0.5mg anastrozole at time of injections, adjust after E2 labs to get near E2=22pg/ml

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

6

Thanks for the responses thus far. It looks like you guys are pointing me in the right direction. I am at work at the moment so I will use tonight to read up on the suggested stickies to educate myself.

Didn’t think there was a problem with my TSH level. I was initially concerned with LH and I was not clear what SHBG meant.

Still haven’t heard back from my doctor’s office. I went to Penn Medicine Urology (1 hour away) instead of using local urologists in the hope they are more thorough. I figured they would be more apt to catch underlying issues instead of simplying writing a script. The downsides I suppose is that it may take longer for a response.

Regarding iodine, I will have to take a look at the salt brand we use at home. It’s seat salt variety and I don’t add salt to my meals. I eat how they were seasoned by my wife/restaurant/etc.

7

Based on my own personal experience and reading this forum, hypothyroidism seems to go hand in hand with low testosterone. You need to be holistic in your approach and make sure the doctor is looking at everything. Its all tied together.

I personally take Armour thyroid, which is desiccated pig thyroid gland. It closely resembles human thyroid hormone and contains both T3 and T4. Some people have trouble converting T4 into the more-active T3.