T Nation

Lab Results Came Back Low - Now What


#1

Long time/first time here.

I started seeing the normal symptoms of Low T / Adrenal fatigue about 6 months ago, and finally started the process of getting tested.

Went to a naturopath instead of Low T doc/endo, etc… We did baseline blood panels and she gave me an at home urine test through Dutch Test.

Dutch Test reports significant symptoms of androgen deficiency. My T levels came back way lower than anticipated… 12.9 out of a 25 - 100 range. Instead of jumping right into TRT, she wants to supplement me with Ashwaganda, Indoplex, and Trizinc, and is open to injections once my metabolic system is more in balance.

I asked to go straight to TRT. She was a bit hesitant, but asked me to take a serum draw first. (results should be back in a day or two). Her approach is holistic first, and bring out the “big guns” as she put it, later.

Questions/Concerns:

-I don’t want to invest the next 6mo to a year with a holistic approach, when TRT would likely provide all around improvements much, much faster.

-Is it plausible to raise my T levels by taking the supplements she is prescribing, and focusing on more sleep, reducing stress, lowering my cholesterol (within range), or is my T level way too low for someone at my age to bring the levels up holistically?

  • What I would really like to do is get on a TRT protocol consisting of Test Cyp, HCG, and Arimidex. How do I bring up/introduce HCG if she only plans to prescribe T and Adex?

-What do I do if she only prescribes T injections 2x a month at 200mg per injection?

-The last thing that I want to do is find a new doc who will insist on taking the same tests that I’ve already taken, costing me anther $500 just to prove again that I have low T.

Thanks for reading, I appreciate your thoughts and comments.
Nathan

-age - 33
-height - 6’0
-waist - 34
-weight - 208
-describe body and facial hair - Facial hair is dark and thick, moderately hairy back chest, legs, arms, etc.
-describe where you carry fat and how changed - Bodyfat carried around my waist, in my face, and thighs.
-health conditions, symptoms [history] High cholesterol 2015, Vitamin d and b deficient.

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
Current OTC supplements:
Vitamin B complex, Vit D3&K2, L-5-methlytetrahydrofolate, trace minerals, Glucose optimizer, citrus bergamot, berberine, and meriva 500

-lab results with ranges

SHBG: 47.1
IGF -1: 162

Labs:
TT 12.9 Range 25 - 100 (Dutchtest Urine test, not serum) Serum results pending
FT Awaiting results
E2: 1.9 - Range 0.5 - 1.6
LH/FSH - must be before TRT N/A
prolactin
CBC w hematocrit N/A
DHEA: 158 - Range 60 -2000

Thyroid
THS - 1.46
T4 - 6.8
T3 Free - 3.5
T4 Free - 1.25
TGB - 13

AM cortisol [at 8 AM] 82.4 (Range 17-50)
fasting cholesterol - 273
fasting glucose N/A

-describe diet [some create substantial damage with starvation diets]
Avg day
6/7am: Butter/Bulletproof Coffee
9am: 3 Eggs, kale, bell peppers
12pm Chicken salad, spin, tomato, pickle 4-5oz chix breast
3: Handful almonds, handful cranberries.
6/7pm 5-8 oz chix/fish/beef and veggies
9pm: Serving dark chocolate

-describe training [some ruin there hormones by over training]
BJJ 3-5x per week
5x5 Strength training 3x per week
3 hour hike 1x per week

-testes ache, ever, with a fever? - I had an aching problem within the last 30 days. Lasted for 1-2 days, never before.

-how have morning wood and nocturnal erections changed: I rarely have natural morning wood. Occasionally supplement Cia, that gives extremely strong am erections.


#2

Labs:
TT
FT
E2
LH/FSH - must be before TRT
prolactin
CBC w hematocrit
DHEA-S
TSH, fT3, fT4
AM cortisol [at 8 AM]
fasting cholesterol
fasting glucose

At your age, its important to look for causes of low T, low T is the symptom

E2 is high and high SHBG would be a consequence.

check your oral body temps as per the thyroid basics sticky.
you may have problems from over-training
do you use iodized salt
iodine+selenium in your vitamins

please use [edit] in lower RH corner above and add lab ranges to thyroid panel.
Were these a blood test?

IGF-1 is sub optimal


#3

Thank you,

Updated OP as much as possible…

Will look at oral temps tonight.

Iodized salt is not a regular pard of my diet.
There is 200 mcg Selenium in my trace mineral supplement.

Yes on the blood test. Sex hormone labs provided came from a dry urine test.

I’m about to dive in on IGF1… Any advice or articles you can throw my way?


#4

IGF-1 is made in the liver in response to GH. IGF-1 is a better indicator of GH status than GH itself.
We have interest pituitary hormone levels. GH replacement is very costly.

Not seeing range for thyroid panel.

T4 should be closer to 8 and this is probably low from lack of iodine.

High AM cortisol is odd.

Does this seem to fit:
“Adrenal Fatigue sufferers in the early stages of their condition tend to be under significant stress, and therefore their adrenaline and cortisol levels are high. This interrupts the natural 24-hour cycle of cortisol levels, leading to a state of permanent alertness that prevents restful sleep.”

DHEA might be a bit low. DHEA levels change a lot. Serum DHEA-S [sulphate] is the best test as the levels of this metabolite do not change much and is a better indicator of DHEA status than DHEA itself.

Did your body react oddly to the blood draw?

There is merit in looking at all of your hormone systems, not just T. You will see a focus here on T, E2, cortisol and thyroid. There is a lot more going on that affect your quality of live other than T.


#5

[quote]KSman wrote:
IGF-1 is made in the liver in response to GH. IGF-1 is a better indicator of GH status than GH itself.
We have interest pituitary hormone levels. GH replacement is very costly.

Not seeing range for thyroid panel.

T4 should be closer to 8 and this is probably low from lack of iodine.

High AM cortisol is odd.

Does this seem to fit:
“Adrenal Fatigue sufferers in the early stages of their condition tend to be under significant stress, and therefore their adrenaline and cortisol levels are high. This interrupts the natural 24-hour cycle of cortisol levels, leading to a state of permanent alertness that prevents restful sleep.”

DHEA might be a bit low. DHEA levels change a lot. Serum DHEA-S [sulphate] is the best test as the levels of this metabolite do not change much and is a better indicator of DHEA status than DHEA itself.

Did your body react oddly to the blood draw?

There is merit in looking at all of your hormone systems, not just T. You will see a focus here on T, E2, cortisol and thyroid. There is a lot more going on that affect your quality of live other than T.[/quote]

Not 100% sure what your’e asking for on the thyroid, so here is everything on the sheet…
TSH: 1.460 (.358 - 3.74)
T4Total: 6.8 ( 4.5 - 12.5)
T3Free: 3.5 (2.2 - 4.0)
T4Free: 1.25 (.75 - 1.46)
Anti TPO Ab: <10.0 (0.0 - 35.0)
Anti Thryroglobulin Ab: <20.0 ( ND - 40)
Thyroglobulin: 24 ( <= 55)
Thyroxine-binding globulin, TBG: 13 (14 - 31)
Reverse T3: pending ( 9.0 - 27.0)

As for the stress, I’m self employed, and am always working on a project of some type. I don’t often feel overwhelmed, or like I’m about to have an anxiety attack, but I could have adapted over the years, and this level of stress is a “new normal”. I seem to sleep okay. Don’t have a hard time falling asleep, don’t wake up during the night. My melatonin levels are super low too… Melatonin: 2.4 (Range 10.0 - 50.0) Should I be supplementing this? My doc didn’t seem to phased by the low number.

I didn’t react oddly at all to a blood draw, unless you are asking about something other than physically.

I’ve attached a page from the Dutchtest, unfortunately, I can only upload one image at a time, and not all seven pages at once from a doc.

Thanks for your help, and input!


#6

Looks like your high progesterone may be driving your high cortisol.

Melatonin is the mechanism for falling and staying asleep. You did not get tested while sleeping. If you fall asleep and stay asleep, I would assume melatonin is OK. When taking as a supplement, should be a time release product because as it wears off, that can wake you up as that is the mechanism of waking up. Light in your eyes causes melatonin to drop.

Looks like a lack of iodine so far. Your body temperatures should be good unless rT3 is blocking fT3.