My uncle is always complaining about being tired lack of motivation and to me seems to not be able to loss belly fat but muscle has definitely declined over the years. He is over weight, diabetic and about 67 years old. I told him to have labs ran these are the results. Opinions?
Estradiol by TMS: 37.5 pg/mL
(Ref Interval: 10.0-42.0)
SHBG 40 nmol/L range 17-125
Free Test 58 pg/ml range 38-311
Total Test 329 ng/dL range 175-781
% free test 2.3% range 1.6-2.9
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FSH 10.7 mlu/ml range 1.6-8.0
LH 7 mlu/ml range 1.6-15.2
TSH 3.52 ulu/ml range .47-4.68
FT3 3.23 pg/ml range 2.77-5.27
FRT4 1.24 ng/dl range .78-2.19
Prolactin 12.4 ng/ml range 2-18
Vitamin D 22.10 ng/ml range 30-100
Type 1 or Type 2? He needs to spend some time outside and exercise, at a guess. Is he on Metformin? Injections? What’s his diet? Does he drink stuff like Coke Zero?
Some doctors prescribe TRT and Metformin for people with diabetes. TSH is indicating the pituitary gland is unhappy with the amount of thyroid hormones, any TSH >2.5 indicating a problem, a sick care doctor would never treat the thyroid with those numbers and so seek a private doctor in anti-aging.
Testosterone is low, but again is not low enough for insurance to approve treatment, again seek a private doctor who doesn’t take insurance. Your uncle is at high risk for developing cardiovascular disease with these testosterone levels. Your uncles testicles seem to be functioning poorly which is probably do to age, LH is healthy, yet testosterone is low.
FSH is above ranges suggesting testicles are just not responding well to either LH or FSH stimulation. Men with low testosterone live shorter lives and tend to have cardiovascular, heart problems and more aggressive prostate cancer.
Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men
These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction.
Reference ranges for TSH and thyroid hormones
First of all the distribution of TSH reference range is not normal, with median values (also depending on population iodine intake) usually between 1-1.5 mU/L. On the other hand, upper TSH reference limit is (assay-dependent) usually around 4.2-4.5 mU/L. There is also an argument that significant number of patients (up to 30%) with TSH above 3.0 mU/L have an occult autoimmune thyroid disease
The evidence for a narrower thyrotropin reference range
It has become clear that previously accepted reference ranges are no longer valid as a result of both the development of more highly sensitive TSH assays and the appreciation that reference populations previously considered normal were contaminated with individuals with various degrees of thyroid dysfunction that served to increase mean TSH levels for the group. Recent laboratory guidelines from the National Academy of Clinical Biochemistry indicate that more than 95% of normal individuals have TSH levels below 2.5 mU/liter. The remainder with higher values are outliers, most of whom are likely to have underlying Hashimoto thyroiditis.
Type 2 tresiba injections and Metformin. Diet and exercise is shit. What do you think about his estrogen? His doctor prescribed him 200mg test injections EOW yes I know weekly is a better recommendation.
Some people who have type 2 diabetes who go on TRT will no longer require insulin because low testosterone is a reason for high insulin levels, very common for men in their 40’s to have low testosterone and Type 2 diabetes.
You need healthy testosterone levels in order to drive glucose into muscle tissue or else it backs up in the bloodstream and insulin levels become elevated. TRT can improve insulin within days, but full effects on glycemic control become evident only after 3–12 months.
Do not start TRT under this family doctor or else your uncles condition will likely worsen. Most doctors have no training or knowledge in this area of medicine and almost always get it wrong. The guidelines instruct doctors to prescribe protocols that only cause suffering as these every 2 week injections simply do not work out well most of the time.
Most men inject once or more times per week, once weekly will see T levels fluctuate more than twice weekly.
Testosterone level and risk of type 2 diabetes in men: a systematic review and meta-analysis
This meta-analysis suggests that higher testosterone level can significantly decrease the risk of type 2 diabetes in men. Therefore, combined with previous researches, the findings above suggest a reverse-causality scenario in the relation between testosterone deficiency and risk of type 2 diabetes in men.
I am not diabetic. My father, all of his brothers and their father, type 2 diabetes starting in middle age. Diet has a big effect. Big. If he is like my relatives, he thinks it’s fine to have pie and ice cream , just take a little bit extra of a shot beforehand. He could do the TRT, but every two weeks is stupid. He injects now, he could handle the T injections himself. He’d frankly be better off getting outside and improving his diet.