T Nation

Lab Results, Need Help Understanding Them

Hi guys,

31 year old male, feel like crap all the time, low sex drive, low energy, aches and pains, fatigue, depression. Don’t sleep that well. I try to eat extremely healthy and I lift 4-5 times a week. Don’t drink that often.

Just got these blood labs back and need help interpreting them. If you guys could let me know what you think my next steps should be, I would really appreciate it. I’m sick of feeling like this. Thanks.

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You are hypo thyroid. Elevated TSH means your brain is not happy with your thyroid levels and trying to get more from the thyroid. Your fT3 is in the lower end of the range (better if closer to 4.4) but, on top of that you have a conversion issue and reverse T3 is high, especially relative to your fT3.

Your pituitary hormones which drive testosterone and spermatogenesis (FSH and LH) are low and your total testosterone is in the lower range. I started TRT at age 59 with a total T of 335, you’re 31! Sex Hormone Binding Globulin of 38, while mid range, is binding up what little test you have, so free test (which is what actually does the test work) is low.

You have options. I’d look for a local doctor that does TRT, and by that I mean only anti-aging, TRT, hormones, etc. TRT, hCG (married, kids?), thyroid, DHEA all options. I’d start with TRT and go from there. Good luck, no reason to continue to suffer.

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Your typical endocrinologist or urologist may not be the best choice to manage your TRT protocol, they typically offer one type of protocol for everyone (200mg every 2 weeks) and don’t tailor your TRT to your specific biomarkers. The aforementioned protocol will make you quite miserable.

Most men do well on two or more injections per week depending on where your estrogen levels sit. TSH suggestions you have some type of thyroid dysfunction (autoimmune disease) going on that may not always show up on labs, fT3 can be fine at the time of your blood draw and decrease later in the day, thyroid problems are often erratic and therefore labs miss it completely because labs are only a snapshot in time.

TSH has a story to tell.

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Thanks for your feedback guys. I really appreciate it.

Based on the research I’ve done on my own, it seems that getting my Test levels back up to optimal levels with TRT could also correct the hypothyroidism. And it seems the vice versa is also true – meaning, if I were to fix the hypothyroidism with dessicated thyroid medication or whatever, it could also end up getting my T levels back up. So two birds one stone either way. Is that fair to say? Which scenario is more likely?

Or should I try to fix both at the same time (TRT + thyroid medication concomitantly)? I’d obviously much rather get on TRT and reap all the other benefits that come with it, but I also don’t want to do anything unnecessary. Like if just popping a thyroid pill everyday could do both, then why go with TRT? I guess the question is how much would my Test levels actually go up if at all if I were to just take a thyroid medication and nothing else. Either way feeling like shit sucks and I need to fix this ASAP.

I guess I need to find the right TRT doc who also knows about thyroid issues so he can address this thoughtfully

The answer to your question is no, we are talking about two separate glands, hypothyroidism doesn’t cause hypogonadism. If anything thyroid meds will increase SHBG therefore decreasing Free T.

Find a doctor we versed in both thyroid and TRT, well that’s not going to be easy unless you go for a telemedicine clinic like Defy Medical.