T Nation

Lab Result Help Would Be Much Appreciated

Hi guys, new to the forums but love the site and been reading for a few years. Im a 24 YO guy and been dealing with some issues for a long time coming but been trying to figure them out on my own to no avail. During my undergraduate schooling I was training very frequently on top of my sport training and definitely not eating enough as well as found myself following a low carb diet (stupidly) while playing which messed with my performance greatly as well. Currently in graduate school for physical therapy and finishing up my last year and the issues I was facing have gotten slightly better but I still don’t feel right.

Symptoms: dry skin around nose, tired/brain fog, very cold hands and feet, libido isn’t low but refractory period after sex is long, carry weight around lower abdomen and low back more than other areas.

Diet is well balanced and for the most part I put good things in my body with the occasional meal for enjoyment and social activities.

Recent Lab Work:
Sodium- 140mmol/L (135-146mmol/L)
Potassium- 4.3mmol/L (3.5-5.3mmol/L)
Urea Nitrogen- 26mg/dL (7-25mg/dL) H
Calcium- 9.9mg/dL (8.6-10.3)
Creatinine- 1.05mg/dL (0.60-1.35mg/dL)
BUN/Creatinine ratio- 25 (this was high per Quest calculation)
Protein,Total- 7.1g/dL (6.1-8.1g/dL)
Albumin- 4.6g/dL (3.6-5.1g/dL)
Globulin- 2.5g/dL (1.9-3.7g/dL)
Bilirubin- 0.3mg/dL (0.2-1.2mg/dL)
AST- 35U/L (10-40U/L)
ALT- 36U/L (9-46U/L)
Hemoglobin A1C- 5.8 (<5.7%) H
TSH- 1.09mIU/L (0.40-4.50mIU/L)
T4,Free- 0.9 ng/dL (0.8-1.8ng/dL)
T3,Free- 2.7pg/dL (2.3-4.2pg/dL)
T3,Reverse- 9ng/dL (8-25ng/dL)
Glucose,fasting- 95mg/dL (65-99mg/dL)
FSH-7.7mIU/mL (1.6-8.0mIU/mL)
LH- 2.8mIU/mL (1.5-9.3mIU/mL)
Prolactin - 11.0ng/mL (2.0-18.0ng/mL)
Cortisol AM - 18.4mcg/dL (4.0-22.0mcg/dL)
DHEA-S - 121 mcg/dL (85-690mcg/dL)
Test Total - 448ng/dL (250-1100ng/dL)
Test Free - 85.7pg/mL (46.0-224pg/mL)
Test bio- 183.7ng/dL (110-575ng/dL)
SHBG - 20nmol/L (10-50nmol/L)
Albumin Serum - 4.7g/dL (3.6-5.1g/dL)
Cortisol AM - 18.4 (4.0-22.4mcg/dL)

Any and all help would be much appreciated guys

Thanks for posting the labs. Please use the edit function icon below your post above and add the lab ranges.

TSH looks ideal, but fT3 and fT4 are below midrange.
Please post oral body temperatures as per the thyroid basics sticky?
What is your history of using iodized salt?
Do you get cold easily now?
Are outer eyebrows sparse?

See these stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • thyroid basics - check body temperatures

havent tested my oral body temperatures in a while but ill recheck them. Over the summer the coldness wasn’t really an issue but once the temperatures started to drop recently my hands and feet began to get cold again. My outer eyebrows are a little sparse but thick hair in the eyebrow elsewhere. I had done alot of reading on the thyroid sticky a long time ago and began specifically implementing iodized salt into my diet but as to the exact amount I cannot say.

Your DHEA-S is low!
Please get 25mg DHEA in vitamins shelves if in USA. Take with a meal that has more oils/fats and avoiding high fiber. Take fish oil and Vit-D3 the same way.

A1C is a problem. Diet should avoid all simple carbs such as subars, bread, rice, potatoes etc. You could try 500mg metformin per day. Very inexpensive, $40 per year at USA Walmart and others.

Is there selenium in your vitamins?

A1C affected by overall metabolic rate and AM cortisol should also be checked.

FSH is quite high relative to LH.
If/when you go on TRT, check LH/FSH one time then. Both should track near zero. If FSH does not, that could be from a FSH secreting testicular cancer.

rT3 looks very good, so we can remove that as a factor in your metabolism.

Prolactin does not seem to be a factor in low LH, TT, FT.
E2 was not tested and it can suppress LH, TT, FT.
However, SHBG is low and that normally suggests that E2 would be low, but we also know that diabetes can lower SHBG and your A1C indicates a problem.

A1C suggests metabolic problems. Would be good to also test AM Cortisol and Vit-D25. But take 5,000iu Vit-D3 per day and test to see where Vit-D25 is later.

With low DHEA-S, we are concerned with what else is going on in the adrenals is important. With good rT3 we do not expect to see adrenal fatigue.

I added the AM cortisol measure that I had done but forgot to put in and I also did a salivary cortisol test a few months ago which the numbers appeared to come back in range but I can add those in if you think they would give a better picture of what may be going on. I took my oral body temperatures today upon waking and in the afternoon. Morning temperature was 97.2 and the afternoon was 97.8. I currently don’t take any specific vitamins or minerals, mostly eat as much vegetables as possible but i do take fish oil. I can start up on vitamin D3 as i used to take it but my levels tend be fine without it when i’ve had them tested previously. I can buy selenium and DHEA no problem as i’m in the US my only question is if there is a specific form of these I may have to buy. As an aside, I don’t really eat any simple carbs, my carbohydrate source is mostly sweet potatoes and if I eat bread its typically Ezekiel bread the only thing might have on occasion are some gluten free pretzels so ill cut those out.

AM cortisol is good.

Get an male [iron free] B-complex milti-vit that lists iodine+selenium.

5,000iu Vit-D3, tiny oil based caps
Do not take oils with high fiber foods!

Selenium will protect thyroid and you reintroduce iodine.

There is something wrong with thyroid and body temperatures. You can try introducing iodine as per the thyroid basics sticky and see if you get warmer with more energy and alertness.

Alright thank you for your help KSman, ill give all those a go and see what happens