T Nation

Help Reading Labs - Newbie


#1

40 year old male, 5'9", 210 lbs. Testicular cancer at age 25 resulting in removal. Been noticing a pretty sharp decline in libido along with an increase in mood swings in the past year. Also, even with regular intense exercise and whole foods high protein/fats and very low carb (no sugar) diet, finding it very difficult to gain and maintain any muscle, and equally difficult to lose and fat. Here are the results from labs order by an Endo.

Component Your Value Standard Range
Testosterone: 513 ng/dL (350-1200 ng/dL)
SHBG: 21 nmol/L (13-90 nmol/L)
Albumin: 4.1 g/dL (3.5-5.0 g/dL)
Calc Free Testos: 487 pmol/L (>225 pmol/L)
Estradiol: 22 pg/mL (Male: 7-43 pg/mL)

TSH : 1.62 uIU/mL (0.30-4.50 uIU/mL)
LH: 11 IU/L (2-6 IU/L)
FSH : 10 IU/L (1-15 IU/L)
Hematocrit: 44.6 % (41.0-51.0 %)
Prolactin: 8 ng/mL (2-15 ng/mL)

Cholesterol, Total: 131 mg/dL (130-200 mg/dL)
Triglycerides: 91 mg/dL (52-150 mg/dL)
HDL Cholesterol: 36 mg/dL (40-65 mg/dL)
LDL Cholesterol: 77 mg/dL (<130 mg/dL)
Non-HDL Cholesterol: 95 mg/dL (<190 mg/dL)
Chol/HDL Ratio: 3.6 (2.0-5.0)

Any help gleaning anything useful from these results would be greatly appreciated. I do not have high confidence in the Endo I met with explaining too much of this as she basically laughed when I requested to have a hormone panel run. Nothing jumps out to me (not surprisingly) and I'm also not too confident in how I converted the Free test from pmol/L to ng/dL. Thanks in advance for any thoughts/comments!


#2

The biggest problem is the doctors, most are idiots and uninformed at best. Endos are as a group the worst, when it should the the opposite.

Please read these stickies found here: https://forums.t-nation.com/t/about-the-t-replacement-category/38/2?u=ksman
* advice for new guys
* things that damage your hormones
* protocol for injections
* finding a TRT doc

Your cholesterol is way too low! 160 and below are associated with increased all-cause mortality.

Other labs:
pregnenolone
DHEA-S
AM cortisol - at 8AM please

HDL cholesterol is low:
high potency B-complex multi-vit with trace elements including iodine+selenium
fish oil
DHEA if needed
health fats
Vit-C, natural source Vit-E

Hi LH/FSH: What history of hot flashes?
[TRT will lower or zero out LH/FSH]

So you have one testicle , TT is mid-range and FT range is not shown, only a minimum.
I could look for FT ranges, but these vary wildly from one lab to another, so go back to the source for that. You are getting into primary hypogonadism and your LH/FSH levels are high to compensate. Your pituitary may not play that game forever.

Cortisol is made from progesterone in the adrenals. Can be a problem if progesterone is low. Progesterone cascades from pregnenolone. Males normally produce a significant amount of pregnenolone in their testes.

FT status remains a big unknown and because it is pulsatile, even a lab range may not paint the who picture. As SHBG is low, FT may be moderate and not low.

Symptoms of low thyroid function are mostly the same as low T. Having both is a double hit.
Make sure that you get iodine from iodized salt.
TSH would be better closer to 1.0
Check oral body temperatures as per the thyroid basics sticky as this is the best measure of overall thyroid function.

You may need more health fats in your diet.
How are you getting essential fatty acids?


#3

Thank you for the reply KSMan!
I do not get much iodized salt so i will start to rectify that immediately. Do not really supplement with anything at the moment so i went out and got:
Omega-3 fatty acid supp (1100mg fish oil, 500mg epa & dha)
Iodine from Kelp 225 mcg (I will add to this with iodized salt, as this is a lot lower than your 500-700 mg recommendation in the thyroid sticky)
b complex vit
I do eat lots of eggs and avocado;s and coconut oil if that helps.

As far as hot flashes, it's hard to tell since i run pretty hot (unless its all one big hotflash :slight_smile: ). almost any exertion will cause me to sweat profusely regardless of the ambient temperature. I've always been like that so probably not symptomatic of anything, but i will take the Oral Temperature challenge to see how i fare. I do feel like i could have other symptoms of thyroid issues like dry skin and hair year round, easily cold extremities

Do you think i should consider seeking out additional help or advice? or should i try increased fatty acids/iodine for a time and retest with a true FT reading? I'm loathe to seek reach out to the endo or my primary for, well, pretty much any reason.

Thanks again for the reply. Just trying to feel better if i can.


#4

You can do your own labs out of pocket, quite affordable.

Roll with what I posted above and we can work through labs and issues.

You can ping me at the KSman is here thread, please put a link there to this thread.


#5

Will Do. I live in Massachusetts, i think there may be some restrictions on ordering your own hormone tests, but I will investigate that further, and figure out something.
thank you.