T Nation

Help with the Next Step

35yo male. Former collegiate athlete, longtime weightllfter and aspiring pro powerlifter (I hope one day). 5’9 205 (down a few pounds due to an injury) and estimating about 15%bf (can still see some upper abs). No AAS use ever. Have taken 1 bottle of Alpha Male and some Daa.

I work a very stressful job and had been been feeling very tired and sluggish of late. Noticed a decrease in libido and an inability to heal from injuries. I also started having problems sleeping and feeling rested afterwards if I did sleep well.

So, I made an appointment with a hormone specialist at my compound pharmacy and made an appointment with a Doc that he feels most comfortable working with after our meeting.

I had the bloodwork done in the morning since test would be at it’s highest. I fasted as well. Lastly, all tests are LabCorp so the ranges are consistent with what most of you have as well. I don’t know the difference in some of these tests but will list them nonetheless. All ranges to the right side:

Test , Serum (Total) {L} 259 ng/dl 348-1197

Bioavailable Test , S 144 ng/dl 128-430

Bioavailable Test % 55.5%

Test , Free, Direct [L] 5.3 pg/ml 8.7-25.1

Test , Serum [L] 187ng/dl 348-1197

TSH 3.590 uIU/ml 0.450-4.500

Luteinizing Hormone (LH) 1.2 mIU/ml 1.7-8.6

Prolactin 6.1 ng/ml 4.0-15.2

Estradiol 9.7 pg/ml 7.6-42.6

PSA 0.9 ng/ml 0.0-4.0

Thyroxine (T4) 9.3 ug/dl 4.5-12.0

T3 Uptake 35% 24-39

Free Thyroxine Index 3.3 1.2-4.9

Dihydrotestosterone {L} 16 ng/dl

DHEA-Sulfate, Serum 252 ug/dl 33-416

IGF -1 233 ng/ml 115-307

IGF -BP3 4.8 mg/L 3.5-7.0

Growth Hormone , Serum <0.1 ng/ml 0.0-2.9 (Am I not producing an GH?!?!)

SHBG, Serum 18.4 nmol/L 16.5-55.9

This is all in terms of hormones. I’m not sure which test level to go by (259 or 187?). Either way I was shocked it was that low. Kind of an ego blow to be honest, I’m getting older. Thought I was gonna feel unstoppable forever lol.

My lipid panel has my cholesterol at 226 and Triglycerides at 108. Cholesterol could be related to low test as well. My kidney and liver function were just slightly elevated due to lifting/soreness and most likely too many vitamins and a high healthy fats/protein diet . Everything else is normal.

Follow up appointment is next Tuesday and I wanted to have my ducks in a row when I go back. Thanks for any and all help!!

As someone who suffered from untreated hypothyroidism, your TSH stands out to me.

Sorry Pangloss I had to correct the range level. I had it punched in 1000uiu too low.

your TSH is horrible, and you really need to test FT4, FT3, RT3, 8am COrtisol, and ferritin at a minimum. your FT4 results don’t tell you anything without a reference point of FT3, and RT3 is needed in reference to FT3.

please check out stopthethyroidmadness.com/things-we-have-learned

odd that your E2 is so low. typically we see the reverse, low T with high E2.

looks like your entire system is crashing around you. more tests may be needed before you jump into treatment.

typically you want to support/fix your adrenals first (cortisol), then thyroid, then hormones.

Cortisol is 13.5 ug/dl 2.3-19.4

Cortisol am 6.2-19.4
Corisol pm 2.3-11.9

Do you compete as a 198 or 181?

198 or 220. 198 suits me better.

Ok just making sure you weren’t cutting across two classes to make weight–that could potentially shed some info on whether or not you have thyroid issues.

Everyone else before me here pretty much nailed it

[quote]Dr. Pangloss wrote:
As someone who suffered from untreated hypothyroidism, your TSH stands out to me.[/quote]

Its not primary hypothyroidism most likely, but secondary due to possible adrenal insufficiency. I see this case scenerio witd Dr’s I consult all the time. They would be use to giving Thyroid meds, but through proper guidence they have learned you need to check adrenal , ferritin and other parameters. Dr giving you thyroid is this instance is premature and can result ending up in a worse scenerio.

I been on both sides of the table knowing first hand how the body will respond. Look for factors which are peripheral and not directly related to thyroid. After learning about dealing with imbalnace in GI tract and liver a lot of people are in the process of discontining or reducing thyroid meds in general. Integrative approaches is to look at the root cause as the same time support the symptoms.

I am not against HRT or thyroid replacement. It only needs when properly needed. HRT is a great way to make a person feel good using it as bridge in certain situations unti lfurther evaluation can be investigated.