T Nation

Lab Help Please....

I had some labs done on 7/16/10. As follows:

Total test 404 ref 241-827 ng/dl
Free test 1.79 .95-4.3 ng/dl
FSH 4 1.6-9.7 mIU/ml
LH 2 <15 mIu/ml
Prolactin 9 0-20 ng/ml
T4 free 1.05 0.65-1.4 ng/dl
TSH 1.42 0.46-4.68 mIU/ml
Vit D25 31.6 30.1-100 ng/dl

Doc wanted retest on test on 7/26/10

Total test 338
free test 1.21

At this point I started 5g (1 tube)Testim per day. Retest on 8/26/10

Total test 281
free test .98

He then doubled my dose to 10g Testim per day. I’m 39yo and take 9mg Entocort/day for Crohn’s.
I felt better initially, but feel like I’ve regressed.

He sent me a lab sheet to test again, but only has the testosterone labs on it. Could some one please give me an idea of what I should be tested for at this point. Thanks for the help!

1 - welcome onboard
2 - please read all of the sticky posts at the top
3 - what are your symptoms?
4 - start taking 6000iu Vitamin D3
5 - doesn’t seem like testim is working for you. myabe talk to doctor about T-Cyp injection E3D

There are some good stickies. Read them all. [Two are a mess from getting hijacked.]

As explained in the ‘protocol for injections’ sticky: Some do not absorb transdermal T very well. Often when that happens we find an underlying case of hypothyroidism. The thyroid labs that you have now look good, but there could still be a functional hypo situation if rT3 is high and/or ferritin is low. With your gut problems, you should check your ferritin level.

Some never absorb, some do for week or two then stop. When there is poor absorption, the T can convert to a lot of E2, making one feel worse than before they started transdermal TRT.

E2 monitoring is important and most need E2 management for an optimal response and quality of life. You need to test TT, FT and E2. Also test DHEA-S.

If 40 or older, you need to track CRP and should have a pre-TRT baseline. And a DRE before TRT, then at 6 months and once a year after that.

Entocort can have systemic effects for some even though it is well targeted for action mostly in the gut. Do you have any side effects? Skin changes or changes to body shape?

When do you think your T levels started to decline?
What else happened at that time or preceded? Accident or blows to the head?
Any reduction in peripheral vision?
Why were the T tests done?
Do you get cold easily?
Are you using iodized salt?
Taking fish oil?
What other Rx or OTC drugs? -these can affect hormones?
How do you cope with major stress situations and how has that changed?
Testes ache now? Ever had a fever where your testes ached?

Use the search function to find other posts that involve Crohn’s

Thanks for the replies. I’ve read the stickied threads, but am suffering paralysis by analysis. So, I’ll test, TT FT, E2, rT3, DHEA-S and ferritin. I’m guessing I should still do CRP and DRE, even though I already started TRT. On the Entocort, I’m actually down to 6mg ED. I noticed weight gain and water retention after starting it.

36" waist
I really think the low T started in High School. I was always in a fog, had bad short term memory, mood swings, etc… Junior year I was in a bad mountain bike accident. Lost memory for two days either side of accident.
Peripheral vision is fine.

Had the tests done because of,
loss of libido
depression that wasn’t corrected by meds
lack of interest in day to day life
mood swings
always tired, especially after dinner
lack of self esteem

I do get cold easily. I’ll track my temp on rising to see where it’s at.
Just started iodized salt last month. I hadn’t used it for several years.
I take 1T cod liver oil ED, but I do miss days.
No other meds.
No problems with testes, but I never thought they were low enough. Maybe being overly critical :slight_smile:
On stressful situations, at work (FF/EMT) I do great under pressure. Chronic stress breaks me down pretty well, though. I can get kind of defeatist.

Oh, and I’m taking 6,000IU Vit D3 along with the D in the cod liver oil.
Also taking 2,000 mg B12 and Centrum silver multi. Thanks again for the help. -Ian

Should I test T3 also?

Your multivitamin Sucks which is putting you at nutient defieincy which can also have a huge impact on hormonal function. I usually look at supplementation of my clients to see where better recommendation can be made so they can have a high absorbable mineral/vitamin. It is a known fact that low levels of zinc reduce LH and response to LH at the receptor level. Always look at the simpliest things first then move into the more complex issues such as hormones, thyroid, ect. I am a firm believer in creating a strong nutrient base so you body has the building blocks to make hormones and response act the receptor level. This is where I would begin first before anything.

Nothing to add if you will not respond to my questions.

I answered every question. Not sure what your talking about.

OK, sorry, my fault.

You stated: "I really think the low T started in High School. I was always in a fog, had bad short term memory, mood swings, etc… Junior year I was in a bad mountain bike accident. Lost memory for two days either side of accident. Peripheral vision is fine. "

If the bike crash and memory loss preceded the brain fog and other symptoms, the effects might have included physical damage to the pituitary. This is best determined by a brain MRI. A CT scan will not be good enough.

A growth on the pituitary, adinoma, can cause hormone problems and the growth can press on the optic nerves and create a reduction of peripheral vision. You do not observe that.

With young men when age related T decline cannot be the issue, MRI’s are often done to determine if the cause is an adinoma that can have other serious consequences.

At your age, if the problem is from physical damage to the pituitary, nothing can be done about that and the only recourse is TRT.

If you cannot absorb T effectively through your skin, you will need to inject.

Could you give me a recommendation on an acceptable multi mineral/vitamin? Thanks

Brought a list of labs to my GP. Waiting to hear back from him or receive the new lab test order. Thanks for the help.

Okay, got the lab results back. The lab screwed up and forgot the RT3 and coronary panel. I’m havinf these redone tomarrow.


E2 29 ref 0-60

Ferritin 34 ref 20-522

FSH 1.9 ref 1.6-9.7

LH 1 ref <15

PSA 0.59 ref 0-4

T3 free 2.97 ref 2.77-5.27

T3 total 1.3 ref 0.97-1.69

Test total 272 ref 132-813

Test free 13.4 ref 8.7-25.1

Pregnenolone 62 ref 13-208

VitD3 25.2 ref 30.1-100

DHEA-S 88 ref 120-520

8:00 AM <50 ref 7-9AM 100-750, 3-5PM <401, 11PM-12AM <100
1:30 PM <50
7:30 PM <50
12:30 AM <50

I was taking 10g ED Testim and 6-8000IU D3 at the time of these labs.

I switched to 8000IU liquid D3 after receiving these results. I also have an appointment tomorrow with a new doctor. She will hopefully get me off the Testim, as it’s not working and I feel worse than when I started on HRT. Looking at these labs, everything looks out of wack. Any ideas on what the hells wrong with me?

cortisol says you should be basically dead… (which means your RT3 should be through the roof) you need to double check with a 8am Cortisol blood test - to see how accurate the saliva test is for you.

Free T3 is in the toilet - severe deficiency.

Testosterone is also in the toilet - non-absorption is common for those with thyroid issues.

D3 non-existent - I have to take 17,000iu to get my blood levels up to the 60-70s.

Iron/Ferritin is also in the toilet. man, these numbers all just plain suck, but at least you can get an action plan started now.

start elemental iron, increase D3, start supplementing your Thyroid and Cortisol, and switch to injections every third day or so.

I would also ask for Magnesium the next time you get tested.


Saw the new doc today. It was a complete waste of time. Her best idea was to reduce the testim to EOD. WTF? I have an appointment later today with an endocrinologist. We’ll see what happens. If KSMAN, Hardasnails, or anyone else can help interpret my last labs, I would appreciate it. Thanks again, Ian

You can start taking DHEA today. Low DHEA can undermine downstream hormones. Start with 25 or 50mg. 50mg might be best -if your body processes it normally.

I wish that some of your cortisol numbers were not <50 to rule out a lab failure. You need to do more work to confirm these results or, based on symptoms, start taking Cortef. If you start taking Cortef and then feel a lot better, that is diagnostic. I suspect that your progesterone is very low too. Cholesterol is the raw material, we need your coronary panel as low cholesterol can lower all steroid hormones.

Low DHEA and cortisol indicate adrenal problems. Read this and see if some things in the book fit your life:

Pregnenolone can be from low testicular function, but all pregnenolone is made by mitochondria and that has nothing to do with the pituitary or any other feed back governed process. Fish oil, anti-oxidants, CoQ10 can be helpful, among other things. Low T3 is probably making a bad situation worse.

Saw the endo Dr. Told me I should go off all T since my initial levels were normal. Says my T level now is fine and my symptoms going back to shit after a short time on 10mg Testim was placebo effect. Another waste of time. I have an apt. with my GP again next Wednesday. We’ll see what he will do. Otherwise I really need the name of a good Dr. in Michigan. Thanks guys, Ian

Coronary panel came back:

Cholesterol 176 ref 120-200
Triglycerides 218 ref 30-149
HDL 48 ref 40-59
LDL 84 ref 0-99
Colesterol/HDL 3.7

Still waiting on the RT3

Looks good, should not be lower. Many consider 180 to be optimal. B-vits, testosterone [good], E2 [bad if elevated or not opposed by T], fish oil or other EFA’s are important factors in how cholesterol interacts with your arterial walls [endothelial function/dysfunction].