T Nation

Lab Results and Doctor Visit, Need Help


#1

I’m a 30yr male “powerlifter”. I lift about 5-6 times a week. I’m 196lb about 13-14% body fat. I started to have very bad recovery over the last 2 years so I finally went to LabCorp and got my T checked. The results and questions are below. Thank you so much for the help and resources you guys provide because you keep me sane reading this stuff.

I got my lab results and went to the doctor about low testosterone and now I’m slightly worried.

Comp. Metabolic Panel (14)
Glucose, Serum 78 65-99 mg/dL 01
BUN 21 HIGH 6-20 mg/dL 01
Creatinine, Serum 1.33 HIGH 0.76-1.27 mg/dL 01
AST (SGOT) 32 0-40 IU/L 01
ALT (SGPT) 96 HIGH 0-44 IU/L 01
Testosterone, Serum
Testosterone, Serum 268 LOW 348-1197 ng/dL 01
Luteinizing Hormone(LH), S
LH 2.1 1.7-8.6 mIU/mL 01
FSH, Serum
FSH 1.5 1.5-12.4 mIU/mL 01
1 of 2
Estradiol
Estradiol 18.4 7.6-42.6 pg/mL 01

Based on these results and my Dr. Google degree I appear to suffer from secondary hypogonadism. I feel like I have very low FSH and LH which could mean pituitary issues which cause my low T. I went to the doctor today and was told I do have low testosterone but not alarmingly low and that I will have to do another blood test before we decide about any trt or hrt. The thing I’m worried about is my FSH and LH being so low. Should I be concerned about a tumor or other pituitary issue or is that not low enough to warrant the concern? I currently suffer from extreme fatigue, headaches, and increased stress.

Thanks


#2

I think it’s premature to have major alarm about a tumor. There are many possible reasons your pituitary could be malfunctioning. When you get your next blood test, ask for a TSH reading. I bet it’s high.


#3

Thanks! we are checking out my thyroid on the next tests next Tuesday. Hopefully we get somewhere. If I end up at 350 test aka low normal I’m probably going to cry.


#4

I had tests at 305 and 360 - my doctor still put me on treatment (Clomid). If your doctor is resistant to helping you because of his erroneous interpretation of the lab ranges, you will be able to find another doctor who is more committed to quality of life.

268 TT for a 30 year old who participates in the sport that is MOST conducive to promoting T levels is going to raise red flags for doctors with even a rough understanding of this stuff.


#5

He seemed resistant to the idea. He told me he didn’t want me to get prostate cancer from trt. I asked him if my active lifestyle is what was keeping it up at 260 and he basically said no.


#6

Get your next round of blood work, go back and talk to him. Emphasize the symptoms - especially those dealing with your mental health (fatigue and stress) - rather than just the numbers. Be careful about mentioning the sports too much. My doctor didn’t care that I compete in a sport, but I know that some doctors think that they’re somehow aiding and abetting cheaters by helping people with pituitary problems.

If he’s worried about reactions to TRT, ask him about SERMS. Clomid/Nolva will raise your numbers, energy level, and you WILL notice the increased T during workouts. I saw a roughly 5% improvement in my sport within 3 weeks.

If he’s unwilling to help, go to the “How to find a TRT doctor” thread and get to work on finding a new one.


#7

I would recommend trying to fix whatever is causing the Low T, whether it’s pituitary, thyroid, or whatever. But, 268 is cause for concern, in my opinion. If you can fix it, great, if not, go TRT.


#8

So what are potentially the causes? It sounds like pituitary to me but I don’t really know what else to point my doctor at. He seems more of the lead to where you want him kind of doctor as opposed to the figure it out himself kind.


#9

Wait for KSMan to weigh in and he will give you some guidance. Remember it’s the hypothalamic pituitary testicular axis, so there are a few moving parts. TRT will fix the T part, but fixing one of the other ones may fix the T part as well.


#10

Thanks for the help guys


#11

How long do doctors typically wait between blood screening?


#12

Testosterone DOES NOT cause prostate cancer! That he believes that shit should be your first red flag.


#13

Please follow these links found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Thyroid:
Please get these labs,
TSH
fT3
fT4 [not T3, T4]

Labs: - you have some now
TT
FT
E2
LH/FSH
prolactin !!!
CBC
hematocrit
AST/ALT
fasting cholesterol [ can be tool low]
fasting glucose
AM cortisol [at 8AM please]

Thyroid function can be low if you have not been using iodized salt.
Outer eyebrows can be sparse
Get cold easy/easier
Dry skin

Has width of peripheral vision become reduced?


#14

Peripheral vision hasn’t changed as far as I can tell,. I went to the optometrist couple weeks ago he didn’t mention it. I’ll get the rest to you after blood work on Tuesday. I work 2nd shift so morning is a different time for me. My 8 hour mark usually gets me up around 9. My current blood work was at 11 am and new one is scheduled for 930.

Can those 2 hours from waking to blood work effect it much? I’m honestly terrified that I’m going to get tests back normal and not have a solution in sight. I’ve been so tired and run down and unable to recover from workouts that I feel like I’m grasping for any fix.

My work out is dup
Squats bench deads about 5-6 days a week different rep ranges And one accessory day.


#15

Cortisol peaks in AM then drops. Try to do labs 1 hour after waking.


#16

I feel like I got hoodwinked on these labs. I told him what I was concerned with and now after these labs he says we can check prolactin…

Testosterone 252.90 ng/dL 300.00 - 890.00 ng/dL

Component

Sodium 139 mEq/L 135 - 145 mEq/L
Potassium 3.8 mEq/L 3.5 - 5.1 mEq/L
Chloride 103 mEq/L 96 - 112 mEq/L
CO2 33 mEq/L 19 - 32 mEq/L
Glucose 96 mg/dL 70 - 99 mg/dL
BUN 20 mg/dL 6 - 23 mg/dL
Creatinine 1.25 mg/dL 0.40 - 1.50 mg/dL
Total Bilirubin 1.0 mg/dL 0.2 - 1.2 mg/dL
Alkaline Phosphatase 56 U/L 39 - 117 U/L
AST 24 U/L 0 - 37 U/L
ALT 28 U/L 0 - 53 U/L
Total Protein 6.6 g/dL 6.0 - 8.3 g/dL
Albumin 4.3 g/dL 3.5 - 5.2 g/dL
Calcium 9.3 mg/dL 8.4 - 10.5 mg/dL
GFR 71.84 mL/min >60.00 mL/min

TSH 1.60 uIU/mL 0.35 - 4.50 uIU/mL

So my tsh looks good. My test is obviously still low. My peripheral vision hasn’t changed. The only thing I have noticed is headaches, tiredness, and lack of recovery from working out. The doctor basically asked if I want to get an MRI because I asked him about potential for a pituitary issue. I said I would prefer to have more labs first because mri is about $800. What do you guys think?


#17

I wouldn’t personally have an MRI if you don’t have a prolactin test indicating that a scan is needed.

TSH is slightly high, are you supplementing iodine?


#18

if you get an mri make sure its with contrast or it will be pointless, small pituitary adenoma’s will only show up if contrast is used and will be missed otherwise.


#19

I’m not supplementing anything. I eat my macros lift heavy and that’s about it. Prolactin is the next item on the menu for testing but I don’t understand why it wasn’t checked last time.

He will talk to me on MyChart which is basically a messaging service. He seems like a nice guy but not really educated on this particular topic. If anyone has a suggestion that I could request from him such as trt protocol I should ask for,more tests, or anything else I’d be much obliged


#20

We checked my prolactin and it was in range. The next step doc wants to pursue is mri for my pituitary due to 1.5 fsh. If no adenoma, no thyroid issue, and no indication of testicle issue what else could be causing my low t?

I still feel like shit every day. I basically have daily headaches now, slight dizzyness with headache occasionally, really fatigued legs like they are overworked but I have been out of the gym for 2 weeks feeling bummed about this t and the headaches.

The doc doesn’t feel any more blood works are warranted. Should I just pay to get some labs done myself? Thanks