T Nation

Help Understanding Blood Work


#1

Hi,

I am a 25 Year old. I sensed low T due to symptoms such as low libido, no morning wood and occasional depression. Got the below panel done,

Cortisol : 12.64 ug/dl Range : 6.02 - 18.4 μg/dl
E2 : 46 .08 pg/ml Range : 0 - 39.8 pg/ml
FSH : 3.1 mIU/ml Range : 1.4-18.1
LH : 5.31 mIU/ml Range : 1.5 - 9.3
Prolactin : 13.71 ng/ml Range : 2.1 - 17.7
Testosterone : 404.82 ng/dl Range : 241 - 827
TSH : 1.88 μIU/ml Range : 0.3-5.5

LH looks okay but FSH seems low. Can you guys help me understand what could be driving the Low T here.

Help is much needed and would be highly appreciated.

Thank You


#2

High E2 is acting on your HPTA reducing LH/FSH so TT is low.

High E2 should be increasing SHBG production in the liver, creating lots of SHBG+T, which is not bio-available, inflating TT and lowering FT.

Get FT tested and if not available test SHBG.

FSH is often a better indicator of LH status than LH itself because LH is released in pulses and has a short half-life.

Get AST/ALT tested to eval liver function, E2 clearance is impaired. Some medications, Rx and OTC can do this.

TSH a bit high, ranges are stupid. Should be closer to 1.0
Please eval overall thyroid function via last paragraph in this post.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • 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.


#3

Thanks KSman,

I will be getting other tests done soon. Meanwhile I checked my body temp as described in the sticky. I was surprised to get a reading of 96.6 F straight out of bed, which is pretty low. I should mention that my family has a history of hypothyroidism. My mom has it and her mom has it. I’ve always consumed iodised salt though. Have always carried very soft fat tissue around my belly and thighs but have a good muscle mass. I am planning to get the below panel done, should I be adding anything to it in light of possible thyroid issues?,

FT3, FT4, ALT, AST, SHBG

In case low thyroid numbers do showup, how does one address them and does fixing thyroid help ramp up testosterone?

Thanks again,

J Turey


#4

I have seen that happen, but rarely.
I do not know what to make of the fact that so many guys who come here have low thyroid function. Does that ratio reflect the frequency of such problems in the general population? Or is secondary hypogonadism promoted by these low level thyroid problems? No way to know.

Check body temps for a while to see what seems to be going on. Any one reading might not represent the situation. Also need to see mid-afternoon temps to see what your body warms up to. Some people who have low AM temps do get to 98.6F later in the day.

If you sore, oral cavity can be cooled.

Do you also cook with iodized salt? Do not count on getting iodine from prepared foods or restaurant meals.

You seem to be thinking that your use of iodized salt means that there is no need for iodine replenishment. That may be true. There is a possibility that rT3 is an issue, read the sticky re stress and adrenal fatigue. We have seen where bromines can be in a guy’s body, displacing iodine. But only one clear cut case. Bromines are been or have been phased out of citrus flavored beverages were bromated vege oils were used to keep citrus oil flavorants dispersed.

Do read the first two suggested stickies completely.


#5

KSman - So I got the below labs done (In addition to the ones above),

FREE TRIIODOTHYRONINE (FT3) 3.5 pg/ml 1.7-4.2

FREE THYROXINE (FT4) 1.29 ng/dl 0.7-1.8

FASTING BLOOD SUGAR 103.41 mg/dL 70-105

TOTAL CHOLESTEROL 195 mg/dl 125-200

HDL CHOLESTEROL 45 mg/dl 35-80

TRIGLYCERIDES 145 mg/dl 25-200

LDL CHOLESTEROL 110 mg/dl 85-130

VLDL CHOLESTEROL 29 mg/dl 5 - 40

TC/ HDL CHOLESTEROL RATIO 4.3 Ratio 3 - 5

LDL / HDL RATIO 2.4 Ratio 1.5-3.5

NON-HDL CHOLESTEROL 149.8 mg/dl < 160

BILIRUBIN - TOTAL 0.66 mg/dl 0.3-1.2

BILIRUBIN -DIRECT 0.21 mg/dl < 0.3

BILIRUBIN (INDIRECT) 0.46 mg/dl 0-0.9

ASPARTATE AMINOTRANSFERASE (SGOT ) 19 U/l < 37

ALANINE TRANSAMINASE (SGPT) 17 U/l 13-40

ALKALINE PHOSPHATASE 69 U/l 53 - 128

GAMMA GLUTAMYL TRANSFERASE (GGT) 11 U/l < 55

PROTEIN - TOTAL 7.4 gm/dl 5.7-8.2

ALBUMIN - SERUM 4.7 gm/dl 3.2-4.8

SERUM GLOBULIN 2.7 gm/dL 2.5-3.4

SERUM ALBUMIN/GLOBULIN RATIO 1.74 0.9 - 2

I’ve been taking continuous body temp reading over last couple of days. My temperature shoots up to a max of 97.8 F around afternoon and drops to a min of 96.2 F around early morning. Inbetween this range it keeps fluctuating a lot throughout the day, sometime within a span of 10-20 minutes.

Since FT3 and FT4 look okay I wonder what is causing my low body temp. Could it be a low metabolism due to low Testosterone?

FBS is indicative of a lower end pre-diabetes especially since my family has a history of being diabetic but I don’t happen to have any symptoms yet (except for maybe low temp?)

I’ve started taking Anastrozole 0.75 mg/week by splitting the tablet in it’s solid form, in hope that the AI would help ramp up Test. What would be your suggestions/advices? Any particular thing I should take note of in light of the results?

Greatly appreciate your help. Thanks,

J Turey


#6

fT3 is the active hormone, T4 is a reservoir for T4–>T3

fT3 and fT4 are above mid-range which is good. But thyroid is complex. TSH indicates that you are having trouble making thyroid hormones [not] or your body is not ‘seeing’ the effect of your fT3 [yes]. Your good fT3 and low body temps suggests either low CoQ10 from statin drugs [not too young for that] or rT3 [reverse T3] is interfering with fT3 at T3 receptors.

rT3 can be elevated by stress, stress events, starvation diets etc. In the thyroid basics sticky, look for: stress, rT3, adrenal fatigue.

Typically, there are exceptions, FSH is a better indicator of LH status than LH itself. FSH has a longer half-life and steadier serum levels. LH has a short half-life and is released in pulses.

Please respond to points and questions in my prior post.
Iodized salt?
AST/ALT?
Any issues as per the first two suggested stickies?

Also re thyroid:
Energy levels low?
Are you training or exercising?
Outer eyebrows sparse?
respond re stress issues
Do you feel cold easier now?
What is your history of your complaints?