T Nation

Help with Lab Results - Fatigue, Lethargy, and Brain Fog

Hey folks. I’ve been reading on here for quite a while but have found myself a bit confused. Over the last 6-9 months I’ve found myself super fatigued, really low energy, no sex drive at all and have a general brain fog most of the time. I’ve got some test results back but don’t know what to make of them after seeing my GP. She wasn’t a lot of help and basically said not to worry about anything. I’d love a little advice about what you think might be going on.

The readers digest from the results is:

  • Low iodine
  • Low Vitamin D (it’s summer here if that makes a difference?)
  • High SHGB

I’m reasonably active and healthy. I do 2 strength training sessions each week, 3 gym classes for fitness and ride a bike once a week for about 35km’s. I don’t eat crap. I eat mainly veggies, chicken, eggs and avocado 90% of the time. I will add in a protein shake and creatine most days and have a protein bar on most of the days I workout. I don’t drink much, maybe once a week I’ll have a bottle of wine but I’ve even pulled back on that lately as well. The only weird thing I do is I’ve taken 100mg of Modafinil 4-5 times a week for the past few years. I’ve stopped taking that in the past week thinking that may be contributing?

Anyone have any insights into what might be going on or what I could do to fix it? Let me know if there’s more info that’s needed!

Test results are below.

Low iodine and vitamin D could certainly be causing these kind of symptoms. Grab some iodised salt and take 8000iu of vitamin D a day. Make sure it’s vitamin D3 (softgels are best).

Do NOT start trying to fuck around with your SHGB.

I just saw what you said about modafinil. Is it doctor prescribed? Did your doctor tell you to come off?

Thanks @Yogi1! I’ve got some vitamin D3 and read that combining that with vitamin K2 was recommended so I have that as well. Is 8000iu high? I was starting with 5000iu’s but happy to go higher if there are no downsides.

So you wouldn’t try and lower the SHGB? I haven’t found much online that seems to help to lower that anyway.

No, the modafinil wasn’t doctor prescribed. I started taking it a while ago to help with a challenging job I was in and thought it best to stop using it now given how I was feeling. I definitely want to keep taking it because it does help me concentrate but I’d rather get to the bottom of how I’m feeling now.

It’s my understanding that the most recent research says 8000iu is the sweet spot for most. You’re right about the K2. You should also take it all with a meal that contains fat.

Man modafinil is kinda mild but it’s still a drug and there can always be some kind of dependence, withdrawl or whatever. I’d not fuck around with it any more.

I just don’t like the current culture of fucking with your hormones before you know for a fact they’re actually causing your problems. Dudes are always trying to raise their testosterone or lower their oestrogen or whatever in the total absence of any actual symptoms or medical guidance.

1 Like

Interesting. Yeah I’m off Modafinil for good now. I liked how it made me feel for a while but if it’s causing any issues I’m not reliant on it so I’ll put that aside. This current feeling doesn’t seem to line up with starting or stopping it though but best to be sure.

WIth SHGB do you think the test results that show elevation isn’t enough to think I need to lower it though? I totally get what you’re saying and haven’t ever done any testosterone or similar drugs but am concerned about the higher levels of SHGB so thought it’d be worthwhile trying to lower and see if that makes a difference.

I’ll up the vitamin D and make sure to have it around lunch time with my meal. This may be a stupid question but does the amount of fat matter? Should I try for a high fat meal or just make sure there’s some fat in there?

Thanks again for the guidance!

I dunno, man. I’m no doctor but I’ve seen dozens of forum posts about guys doing stupid shit chasing perfect bloodwork numbers so I’m against it in principle, but obviously I have no way of knowing if it’d help in your circumstances. Stinging nettle root can lower it a little so if you were looking for an over the counter supp you could give it a try. I certainly wouldn’t start fucking around with pharmaceuticals unless a doctor tells you to. You don’t know what’s causing your issues yet so throwing random medications into the mix might make things worse.

I’m not sure it really matters all that much, and I’d expect that if you’re not deliberately eating very low fats then any meal will probably be sufficient.

Legend! Thanks! I’ll focus on the diet and vitamin D for now and see if that helps things along. I guess with how long this has been going on I was sort of hopeful that something would show up on the results so I’d have a definitive idea of what’s causing it. I’m not knowledgable enough to know if there’s anything there that’s obviously wrong though so this is a helpful start. Really appreciate it!

Are you eating carbs? How many grams/day? Are you eating the same few foods over and over?

Yeah I typically eat the same few things over and over. I’m sure I’m no different to most people but I’m pretty flat out with work at the moment so the eating the same thing tends to make life a little simpler.

I guess I don’t get a ton of carbs outside of small amounts with vegetables. I haven’t counted calories/macros much over the years because I’ve managed to maintain a fairly stable weight and perform really well in sport eating what I’m eating now. I haven’t really changed my diet over the years much because it’s generally made me feel really energetic and perform well so I didn’t think that was the main issue here. I’m obviously sensing I could be wrong on that but I didn’t change my diet when I started feeling this way so didn’t think that would be the problem.

I’ve always performed fairly well with lower carbs and reasonably high protein but I’m guessing that may be part of the overall problem?

Hate to say this but your symptoms matchup with your low Free t level. You have good total t serum, but less is turning into free t because you have higher SHBG. I’m guessing your pretty young

Nobody knows how to lower SHBG. I would try to find blood work from earlier in life to see if it was high years ago. Is it genetic?

Also be clear with your time line. When did this start and what was going on in your life before and during. Did you start any new meds. Did you change diet. Maybe you started this medicine (you spoke of sbove) before these issues arose. Maybe this is causing your shbg to increase?

Again I haven’t heard of any solutions that increase shbg, this area of hormones is not clear. So there is a possibility that fixing your intake of meds might get you back to a lower level: it’s worth a try. Maybe your diet is lacking. Maybe vitamin d will help.

Atleast you know your body is creating plenty of testosterone. It’s just not converting into free t which dictates energy, mood, well being, mental health and etc…

You will experience all these sides while your free t stays at the low end. Normally an older man in there 50 to 70s would fall at the low end of free t lab ranges.

I had to start TRT because I was even lower than you at 40. 3.5 free t with range of 9-25… total was 185… I had low vitamin d as well… I had every side x 10 that you have. I didn’t check till it was too late.

Do not take T boosters they will make it worse and potentially damage you permanently. They are also very temporary and not a permanent fix for increased t. Stay far away brother.

Also don’t start TRT. Once started your stuck and your system will never recover. Stick with finding a holistic solution. If all else fails you have a final option of trt.

Your welcome to post in the T replacement category and I’m sure the folks there (more experienced than I) will reiterate what I just explained.

Maybe someone there can tell you if the meds and diet are causing this issue.

Damn this is an awesome post. Thanks! I’m 36 so relatively young for this by the sounds of it. Unfortunately I’ve tried to get hold of previous blood work and haven’t been able to get my hands on anything so that’s a bit disappointing.

As for the timeline really it’s gotten this way about 6-9 months ago as far as I can tell. Before that I was stressed and fatigued but not to this same degree. The lower libido was definitely not there then either so it makes me think this is really an issue that’s come from the last 6-9 months.

I’ve started to supplement with Vitamin D and K2 as well as iodine to get those back to normal. I’m not sure what the time frame is for those but I’ve been doing that for about 11 days now. Hoping that might help with some of this.

I definitely don’t plan on doing much around my hormones for now to make sure I don’t stuff anything else up. I’m starting to feel like the higher SHBG is what’s causing me the issues though so hopefully there’s some connection with the other deficiencies and that lowers normally.

I’ve read as much as I can about lowering SHBG but like you, haven’t found much that seems to work. I have read that perhaps Boron supplements and something called Avena Sativa could block or lower it but I’d be curious about your thoughts on that before I head down that path.

I guess I’m just frustrated at the moment because I feel so lousy and want a fix but find it difficult to see anything that might lower SHBG without drastic measures.

Thanks! I might post there as well and see what they recommend.

Glad it made sense my friend. focus on simply removing any toxins, medications, environmental factors that might cause any issues. No matter how small. Usually men don’t feel symptoms with t dropping until they hit a threshold. So I might go from 50 free t to 35 and not feel much different, and then after 35 I do start feeling. However it started dropping at 50 maybe 2 years ago. Who knows. Make sense?

I would get off that medication your on. Also realize it could be genetic. I think it’s ficable. Just don’t start messing with other hormones to lower this hormone.

Dont take iodine your thyroid is fine. At most take the recommended daily dose that’s under 1mg.

Yes post there . Men with years of experience can guide you.

8000 D3 is totally safe and sometimes when people have low D3, doctors recommend an extra large dose for a few days to bump up levels since D3 hangs around for a while (like 30,000 for 3-5 days). You also don’t need D3 every day-you can take a double dose every other day for example. Low D3 can lower testosterone, and also can negatively impact sleep which can further affect testosterone. Chronic low D3 also may tend to lead to insulin resistance, but your fasting basal insulin levels are not high and your fasting glucose is fine (4.1 which is 74 mg/dL).

In fact, morning fasting glucose levels in the 70s CAN indicate that you could use more fat in your diet since most people’s fasting blood sugar will be rise a little to between 80-90 if they get enough fat-especially saturated fat (on maintenance calories). Also your vitamin B might be a little low so in addition to D3, you might be able to use a serving of red meat with some fat instead of your chicken, or adding a B vitamin. Your total cholesterol of 5.1 would equate to about 197 which is not too low. It looks like you eat a low carb, higher fat diet, but don’t get much saturated fat.

The only thing I have read about that can raise SHBG is a high protein diet.

It’s interesting you say don’t take Iodine. That’s one thing that was low and I was recommended to supplement with. I’ve got an Iodine spray but I’ll check how much is in it and be a little cautious. Thanks again! It’s really helpful.

Yes I thought you were taking it for the thyroid. Missed your iodine’s low. I simply wanted to pass alone not to take too much :slight_smile: I hve an employee who has thyroid issues and didn’t want you to head in that direction. It’s scary. Very scary.

Ok that’s good to know! Thyroid issues sounds nasty so I’m glad I’m not going down that path.

1 Like

I agree with what YOGI told u and what he mentioned to take. But i would rather want to add vitamin b12. Take a B12 tab every day as deficency of b12 also cause such things. Adding a ZMA will also be beneficial.