T Nation

Help Understanding Bloodwork?


#1

Hi all. I've felt pretty low libido wise for a long time, put fat on easily in ladylike places, etc. So, I got some bloodwork done by my GP and my testosterone was 310. I went to an endo but first decided to see how tamoxifen would make me feel. 20mg/day for 6 days and then 9 days later got bloodwork done through my endo. This time came back differently:

K, so this bloodwork was done after 6 days of 20mg tamoxifen daily and a 9 day cessation of the tamoxifen before the bloodwork was done.

Testosterone total : 600 (went up, not bad)
Free testosterone : 1.1%, range: 1.5-3.2
Free testosterone: 66, range 52-280
cortisol: 19 ug/dL range: 8-19
igf-1 204 range: 155-432
prolactin: 8.9 range:3-18
t4, free: 1.50 range 0.82-1.77
TSH: 3.180
LH: 5.6 range 1.7-8.6
FSH 1.2LOW range 1.5-12.4
Thyroxine 8.3 range 4.5-12.0

To my understanding tamoxifen has a half life of 7 days and its prodrug a halflife of 14 days. I don't feel any better on the tamoxifen, but that could very well be from the side effects of it.

If anyone could put in their 2 pennies it'd be greatly appreciated. My endo wants to do bloodwork again in 2 months and I noticed on the bloodwork sheet he put down 257.2, hypogonadism.


#2

you should post details of any bloodwork done before tamoxifen.

TSH looks like shit. No idea if tamoxifen has anything to do with that, but worth some further investigation/testing.

should probably test SHBG and E2.


#3

The FSH worries me more than the TSH, I'm sure I'll end up with thyroid problems at some point in my life, my entire family has a thyroid problem except for me (aside from higher TSH than one would like). I don't see anything on tamoxifen effecting TSH.

The doc said my insurance won't cover SHBG and E2 right now but maybe after another set of bloodwork they would.


#4

You should be orders of magnitude more worried about TSH and thyroid issues. This might be a slight exaggeration if you are trying to have children at the moment.

E2 and SHBG are pretty inexpensive tests. Sounds like some bullshit from a doc that wants to bill your insurance company for few more office visits. You could pay out of pocket via your doctor or order them on online if you have a near-by testing facility. Best pricing I've seen if from Life Extension. I think they are in the $50 range.


#5

As long as I don't get ED or any issues along those lines, I couldn't care less about children. Wanted a vasectomy anyhow. I'll look into it more, it's nice to have my insurance pay for everything instead of out of pocket though


#6

the thyroid tests they ordered don't give you enough information. to truly know what is going on you need
FT4
FT3
RT3
and
8am Cortisol

(ferritin can be helpful)


#7

I have free t4 and total thyroxine and a 9am cortisol listed if that's of any use. All of them are on the high end?


#8

What's the interest in ferritin? I see that come up often. I understand what it does. Just wondering if you want it in range, high end of the range, and what you would do if it was low.


#9

yeah free T4 and total T3 don't really help as you can't compare the two. FT4 vs FT3 is helpful. FT3 vs RT3 is helpful.

9am cortisol looks really good at 19 (you typically want it in the top 75% of the range first thing am)

ferritin is critical for thyroid functioning - at least according to stopthethyroidmadness.com and thyroid-rt3.com

you can take iron supplements to try and boost it - but that hasn't helped me too much. Ideal is suppose to be >150. I have levels around 60 I think.


#10

Thanks. I need to go back an visit that site. It's been awhile since I'v sniffed around. I gathered that ferritin was kind of like a speculator for Iron. Holds it when it plentiful and releases it when it's needed. Just wasn't sure that supplementing iron would increase it.


#11

I'll investigate the thyroid more, but I'm much more concerned with a free testosterone of 60s when I had been on tamoxifen and my low FSH


#12

thyroid/cortisol/testosteron/estradiol - they are all connected and all have an impact on one another. if two are 'off' then trying to fix just one won't get you very far for the typical hard-to-fix male. for others, they do just great on a simple patch or weekly shot.