T Nation

High Test, Is This Too Much for Life?


#1

This question is for a friend.
He is 5'6" weighs 170 Lbs,about 14% bf. He lifts and runs 4-5 days a week, 48 years old and work 2 jobs 72 hours a week. This is his numbers.
Hemoglobin 17.4 high
Platelets 165
Creatinine,serum 1.03
sodium,serum 140
Cholesterol 183
Triglycerides 150 high
HDL 34 low
VLDL 30
LDL 119 high
LDL/HDL Ratio 3.5
Testosterone, serum 896 high
Test Free 27.9 high
TSH (throid) 4.20
PSA 1.2
estrogen did not come back

He takes procardio for High BP, Synthroid for Throid, a multi-vit, Vit-C, and 12-15 fish oil caps a day. He was taking hcg but it gave him a high heart rate so he quit using. He inject's 3 times a week for a total of 160mg. he feels great but so many people are dying of heart attacks, he wants to make sure he is on the right path.

Thank you


#2

You need to increase HDL. Take folic acid, niacin, B-12 and B-6 as part of a higher dose vitamin B multivitamin and mineral supplement.

What is your iodine intake? Are you using iodized salt and eating sea food? Lower iodine levels are associated with breast cancers in women. There is no data re such effects in men, but the effects will be there.

Your TSH says that you have hypothyroidism. If your dose of T4 was effective, your TSH would be lower.

Are you taking high dose vit-D?

Are you taking DHEA? At 48 years old your levels are dropping. If on TRT without hCG, pregnenolone levels will be lower, further dropping DHEA. Suggest 50mg/day.

The “high” flags for T are simply the result of the ranges been age adjusted. When I turned 60 my T lab ranges dropped a lot.

Heart attacks and strokes: You need to test CPR and homocysteine. These are markers for the inflammation of arterial disease and endothelial dysfunction. TRT is protective. So are increased DHEA-S levels. Fish oils are protective. The large amount of fish oil will decrease clotting times and bleeding. You will have to stop taking fish oils for some time before you have any elective surgery. How long to stop before surgery… I do not know, probably depends on the amount of fish oil taken. High BP suggests some arterial damage. Some of that is reversible. You need broad spectrum antioxidants to protect from oxidized cholesterol. Vitamin E with Mixed Tocopherols, vitamin C and others…


#3

iodine was not the test results, but as far as salt goes there is none in the house and don’t eat seafood. About the vit-D, Nope. When I read about DHEA,it scared me so I never took it. Should have the test results for the estrogen back today, they didn’t test the first time so had more blood drawn.

I forgot to add been on T for 3 years now, The wife takes a Super B-Complex and it has all of the described items, would it be better to take one or two a day?

As always KSman thank you very much for your time and wisdom

G


#4

[quote]uwacop wrote:
This question is for a friend.
He is 5’6" weighs 170 Lbs,about 14% bf. He lifts and runs 4-5 days a week, 48 years old and work 2 jobs 72 hours a week. This is his numbers.
Hemoglobin 17.4 high
Platelets 165
Creatinine,serum 1.03
sodium,serum 140
Cholesterol 183
Triglycerides 150 high
HDL 34 low
VLDL 30
LDL 119 high
LDL/HDL Ratio 3.5
Testosterone, serum 896 high
Test Free 27.9 high
TSH (throid) 4.20
PSA 1.2
estrogen did not come back

He takes procardio for High BP, Synthroid for Throid, a multi-vit, Vit-C, and 12-15 fish oil caps a day. He was taking hcg but it gave him a high heart rate so he quit using. He inject’s 3 times a week for a total of 160mg. he feels great but so many people are dying of heart attacks, he wants to make sure he is on the right path.

Thank you[/quote]

Hemoglobin 17.4 high

Check for iron overload.

do all three tests recommended here:

http://www.ironoverload.org/diagnosis.html

May need phlebotomy.

Consider this blood test and goals below:

1 --------- Comprehensive Metabolic Panel w/EGFR
2 --------- Hepatic Function Panel
3 --------- VAP TM Cholesterol Test
4 --------- CBC w/ diff/PLT
5 --------- Iodine
6 --------- iodide
7 --------- Selenium
8 --------- Copper, serum
9 --------- Zinc
10 --------- Magnesium
11 --------- Phosphate
12 --------- C-Reactive Protein (CRP), Highly Sensitive, CSF
13 --------- Fibrinogen
14 --------- Homocysteine, cardio
15 --------- Lipoprotein (A) Lp(A)
16 --------- Iron and Iron Binding Capacity
17 --------- Iron, Total
18 --------- Ferritin
19 --------- Transferrin
20 --------- Folate, RBC & Hematocrit
21 --------- Hemoglobin A1c
22 --------- Hemoglobin, Plasma
23 --------- VITAMIN A, E, B3, B12
24 --------- Vitamin D, 25-Hydroxy
25 --------- T3, Total
26 --------- T4, Total
27 --------- T3, Free
28 --------- T4,Free
29 --------- T3, Reverse
30 --------- Ultrasensitive TSH
31 --------- Thyroid Peroxidase and Thyroglobulin Antibodies
32 --------- Insuline, serum
33 --------- IGF Binding protein-3
34 --------- IGF-1
35 --------- DHEA Sulfate
36 --------- Aldosterone
37 --------- ACTH, Plasma
38 --------- Cortisol Binding Globulin (Transcortin)
39 --------- 8AM/4PM/10PM—Cortisol, Free and Total
40 --------- Prolactin
41 --------- Progesterone
42 --------- Pregnenolone
43 --------- Androstenedione
44 --------- Estradiol, sensitive
45 --------- Estrone
46 --------- Total Testosterone
47 --------- SHBG
48 --------- Albumin
49 --------- Dihydrotestosterone
50 --------- Ceruloplasmin
51 --------- Coenzyme Q10

244.9 ----- 257.2 ----- 780.79
250.00 ----- 272.4 ----- 788.41
250.01 ----- 601.9 ----- 253.3
255.4 ----- 780.4 ----- 255.8
783.9 ----- -------------------------------------------------

===========
My own Goals
DHEAs(500-640)mcg/dL(13.55-17.34)µmol/L------------------major player, 95% time overlooked
Progesterone(0.9-1.2)ng/mL
Pregnenolone(> 100ng/dL)
Estradiol, Ultrasensitive(25-29)pg/mL
Estrone, LC/MS/MS (23244X)
do not use Anastrozole if possible or minimize its use
BATest(342, 460-575)ng/dL------------stay around 342 if you need more than 1.5mg/week Anastrozole to control E2
DHT(60-90)ng/dL (I am active when it gets over or under this range)
RT3(0.12-0.32)nmol/L=(7.8-20.8)ng/dL
TotalT3 in upper 1/3 range (June09 LEF magazine)
FreeT3~400pg/dL or higher if TotalT3 goal not reached, but not higher than 450
TotalT4>bottom of range
FreeT4 rather low, do not know (yet) how low
Oral temperature (36.25 - 36.80)C = (97.25 - 98.24)F (no sinus or oral infections)
Ferritin(100-150)


#5

Also, his hemoglobin is too high. I would possibly lower the T - dose which could be driving up the HG. You could lower the dose to 125 and see if it brings free T to upper normal levels and he still feels good. If he insists on same dosage of T start donating blood every 2 months and retest to see if RBC goes down. Also could retest to see if maybe he was just dehydrated on blood test. This can cause false positives.


#6

Thanks, he gave blood and they told him his Iron was high,


#7

[quote]uwacop wrote:
Thanks, he gave blood and they told him his Iron was high, [/quote]

I would look to rule out hemochromatosis with ferritin levels, iron saturation, TIBC.
Your thyroid is taking a real beating tsh >2 is indicator of subclincal hypothyroidism.

With hypothyroidism and DHEA this is going to open up doors to potential cancer die to low 2/16 hydroxy ratio so people with hypothyoidism using DHEA with out testing metabolites are askng for potential problems down the road. Iodoral will help this as well reseveratrol.

If RBC indices are high look for sleep apnea to rule this out. Over 30% of test listed in previous post are a waste because nutrients can not be measured in serum accurately.


#8

[quote]uwacop wrote:
iodine was not the test results, but as far as salt goes there is none in the house and don’t eat seafood. About the vit-D, Nope. When I read about DHEA,it scared me so I never took it. Should have the test results for the estrogen back today, they didn’t test the first time so had more blood drawn.

I forgot to add been on T for 3 years now, The wife takes a Super B-Complex and it has all of the described items, would it be better to take one or two a day?

As always KSman thank you very much for your time and wisdom

G[/quote]

B vits, depends on what is in them.

Take 4-6000 iu Vit-D ED, look for 2000iu oil caps.
50mg DHEA ED

You are probably iodine deficient, perhaps a lot. You TSH says that your thyroid is not working right. Get some iodine supplements for you and everyone in the house.


#9

There is nothing high about your T levels. The lab is showing age adjusted ranges for your age group. You do not want to be in the T ranges of that age group. You levels could be higher. Focus on FT levels not TT.


#10
  1. You could give blood for the high hemoglobin…the Hematocrit was probably about 52 or so,…this is therapeutic phelebotomy…

  2. I would check your fish oil supplements too…I use Meg certified fish Oil ( cheapo Spring Valley at Walmart)…they are purified and tested for heavy metals like mercury.

  3. I am scared of Vit E supplementation due to the supposed increased stroke risk.

  4. Hemochromatosis is a good thing to check for …but…SLEEP APNEA also can cause high hematocrits as well as decreased testosterone levels… and we all know that testosterone use also raises HCT/Hgb.

  5. Niacin…Be careful…niacinamide or inositol hexanicotinate OTC does Nothing for lipid modification…
    I would get an Rx for Niaspan it will raise your HDL and lower ldl and trigs…need your liver
    functions monitored with its use…

  6. I would cut out any excess alcohol…might help lower trigs and iron…

  7. the point of care testing for blood donation are not the most accurate screening for iron levels… I would base nothing on them…I would have a proper lab test…I have used point of care t esting in my job alot and have gotten many erroneous test.


#11

“”
3) I am scared of Vit E supplementation due to the supposed increased stroke risk. “”"

Wrong form of vitamin E. Search and read at LEF.org


#12

I know many attack the Helsinki research as only causing strokes in the male smoker population. They also demonstrated Vitamin E supplements may increase pneumonia with smokers They studied both alpha-tocopherol and beta-carotene separately.The ATBC Study showed that men who took the beta-carotene supplement had 16 percent more cases of lung cancer and 14 percent more lung cancer deaths than those who did not take beta-carotene.

The Physicians’ Health Study II Randomized Controlled Trial used beta carotene and synthetic Vit E. Neither vitamin E nor vitamin C reduced total MI, total stroke, cardiovascular death, congestive heart failure, total mortality, angina, or coronary revascularization. They did find an increase in hemorrhagic stroke with vitamin E use.

I can find flaws in every study done on Vit E… My personal choice would be to not take high doses of a fat soluble vitamin…unless a blood test confirmed my level…like Vitamin D…


#13

lol.of course I do not know my Vit E level… my Vit D level was 24 pre-tx …my wife was 8!!!