T Nation

Lab Results - Need Interpretation


#1

Hey all, need some interpretation with lab results. My regimen is 50mg 2x/week Test E and 250iu hcg EOD. I’d like to increase my T dosage, but are the other hormone levels ok? I’m not really familiar with this kind of thing.

Labs:

TT: 356 ng/dL (200-800)
E2: 18 pg/mL (<54)
LH: 0.5 mIU/ML
FSH: 0.3 mIU/ML
prolactin: 5.8 ng/mL (2.6-13.1)
Hemoglobin: 17.7 g/dL (13-17.5)
Hematocrit: 49.6% (38-50%)
Cortisol (8AM): 15.2 ug/dL (5-25)
TSH: 1.49 uIU/ML (0.4-4)
fT4: 0.8 ng/dL (0.7-1.5)

I know there are some lab results missing that I still need. So far, I’ve donated blood to lower hematocrit. How does everything else look? Prolactin? Cortisol? TSH / fT4?

To me, fT4 seems a bit low, but my TSH looks pretty ok. My temperature upon waking up is 96.5 though, which can show something is wrong, right?

Thanks everybody


#2

When was the sample taken after injections? Was it in the middle of the two injections? if so, T is not good. You may need higher dosing if it’s not something related to the lab timing. How do you feel?

Thyroid: Are you hitting 98.6 in the afternoon or evening? your fT4 seems on the lower side, but TSH is not bad. fT4 could be causing low body temps.


#3

Sample was taken on a trough day. I dose Sunday and Thursday and this was taken Thursday morning. I feel terrible, I still have all the symptoms of low T.

I hit nearly 98.6 in the afternoon. I get to about 98.1 or so, from what I’ve checked. If I get to optimal T levels and still feel like garbage, I want to look more into thyroid. What do you think?


#4

98.1 or 98.6? There’s a huge gap. I think if you can only hit 98.1, there’s definitely a thyroid issue and needs to be taken care of.
I am not sure about the timing artifacts your lab timing is creating. Someone like @KSman will be able to give a better answer. But if it’s not playing a big role, T dose needs to be higher. This is not good.


#5

Yep, T dose needs to be higher regardless and my doctor simply won’t play along due to the hematocrit levels. I’ve taken it upon myself to donate blood, though, and see if I can convince him now.

98.1 is a problem indicator? Really, now? I had just assumed it was close enough. And my doctor keeps telling me that basal body temperature varies greatly among different people. I’m so fed up with all of this misinformation.

Thank you for your replies, by the way.


#6

The whole point of this body temperatures and thyroid thread they have on here is for people to understand how things work and what’s a problem indicator and what is not. I do not know more than a doctor at all, i am learning from my own problems and reading. 98.6 is the average temperature of a healthy person without any thyroid issues. 98.1 in the afternoon/evening is not close to 98.6, neither is 96.5 to 97.6. I agree about how basal temperatures vary among individuals but if you were reaching 98.4-98.6 while only being at 97.3-97.4 in the morning with your labs being midrange, i wouldn’t advise thyroid issues at all.

I, in fact, think that the thyroid frenzy is a bit much here for what it’s worth, but that does not mean no one has thyroid problems here.


#7

Thyroid hormone T3 is what gets the job done and fT3 should be tested. fT3 regulates body temperature by regulating mitochondrial metabolic rates. Mitochondria product ATP, the universal currency of cellular energy. Body temperatures are a very important indicator.

We have histories of guys here who have had lower body temps who were iodine deficient who improved energy levels and body temperatures by taking iodine. If someone does need Rx thyroid meds, great improvements are achieved.

I did ask you to read thyroid basics explained in one of your other threads and also asked about your intake of iodized salt.

If you keep spreading your history across multiple threads, you will not get the best assistance.

Doctors are not very expert at these things and never seem to really want to understand the issues. Iodine deficiency is quite common and I have never seen a report of a doctor asking about iodized salt intake. They will tell people with high blood pressure to not use salt and then they induce iodine deficiencies. Do not take doctors as authoritative in any of this.


#8

Fair enough. I will just use this thread as an “update” thread and post as necessary. I’ll be sure to get the rest of the tests you recommended too and post the results.

I’ve ordered iodine supplements. In your thread, you mention that .75g is the necessary amount of iodine. Is this universal? Should I load with 50mg iodine every day and then measure temperatures? Are there any negative side effects I should worry about?


#9

That has been discussed to death several times. Some disagree with the high doses, but they work well for some people. Could the same people get results with less? Unknown as no one has reported.

I do suggest something that is done in two weeks. If 50mg causes GI discomfort, use less because the iodine is killing off gut bacteria and that can cause digestive issues.

If you smell horrible, like fish, that can be from bromine in your body that high dose iodine flushes out. Low dose iodine may not be able to do that. Bromine gets into cells where iodine should be and causes problems. Bromated vegetable oils are been phased out of citrus drinks. Some meds contain bromines. There are no absolute answers.

Watch body temps and be watchful for improved energy and alertness.


#10

Use Selenium when using iodine. Iodine can accelerate underlying autoimmune thyroid disease. Selenium is pivotal to avoid inflammation.


#11

Ok, gotcha. Any sort of ratio you recommend for this?


#12

A standard 200mcg supplement would be okay.


#13

Even with 50mg of iodine? Only 200mcg will suffice?


#14

Thanks for the answer. I ordered some mega potent iodine stuff (along with selenium). Do you recommend I just go head first with the 50mg / day? And 200mcg of selenium each day as well is enough?

I really want to start this now because my TSH is 1.49 (seems ok), but have symptoms of hypothyroid. Went to the doctor today and my temperature was 97.7! So it probably is not just inaccuracies from my thermometer at home.


#15

Selenium and other trace elements are catalytic reaction sites in enzymes. All you need is enough for the enzymes to work. In this case, selenium is needed for an enzyme that takes care of free radicals produced as part of normal thyroid function. If that does not happen, you get inflammation and an opportunity for the immune system to misinterpret the cellular wreckage as foreign. When that happens, the immune system does not forget very easily. A lack of selenium can cause the problem.


#16

Interesting. Good for my wallet though. So you DO recommend starting with the 50mg a day then? Other sites are recommending to build up to it, but as long as it isn’t dangerous, I’d take your word for it.

Thank you for the answers. Both of you.


#17

One more thing, @KSman, if you don’t mind: after reading through your thyroid basics thread, I’ve learned that adrenal fatigue, thyroid problems, and testosterone are all strongly comorbid.

My cortisol at 8AM is 15.2mcg/dL (5-25mcg/dL) - is this indicative of adrenal problems? 15 seems to fall right in the middle of the scale. Also, my TSH, 1.49ulU/ML (0.4-4) seems to be pretty ok as well. My current plan of action is to do the IR and see what happens from there.

Do you think this is ok?


#18

At this point, your body temperatures are more useful than labs and any observations about energy, mood and alertness. Taking iodine will exaggerate TSH so TSH labs are meaningless at that time. Many tolerate 50mg and if guts get unsettled, try 25. I had to do that. There is nothing cast in stone other than needing selenium.

AM cortisol 15.2 is quite good. Down around 10 is a problem.

You have made a good observation of “comorbid”. Nice way to put it but the working would be lost on most guys here. We do see all three in some guys, but not so many cases lately. Maybe because we are out of the recession and its effects.


#19

I’ve been struggling for years, so it still makes sense. 5 years now maybe (sheesh). I have some important things I need to be functional for in the next few days, so I’ll wait on the IR for about a week or so, just in case.

I will be sure to update with results, temperatures, etc. More important lab results to follow in the next few weeks as well.


#20

FINAL QUESTION @KSman and I know you must be tired of me by now… but are there any dangerous side effects that could happen with the IR schedule you mentioned? Like, hypothetically, if I turned out to be hyperthyroid or have hashimoto’s or something. Or if I had a heart condition. Anything before I try it?

And when you say my cortisol is quite good, is that an indicator that I do NOT have adrenal fatigue? Wondering if I should do some research into that. Any links for me to start? Or anything you want to share on the subject?