T Nation

Lab Results

Hi all, This is my first post on here but i am looking for help. First a little backround info,

I am a 28 year old male.
6’2" tall and currently 218 lbs
I have always been a skinny dude, hardly any muscle mass but the weight that i have gained is all around my waist (38 inch waist now)

About 3 years ago i started noticing anxiety and had my first panic attack, I finally went in for help a year ago and was put on SSRI’s for it, which has helped. Over the same time frame i noticed it being incresingly easy to gain weight, however my high activity level has been able to compensate for it (for the most part)

7 Months ago i had shoulder surgury to repair a torn labrum. This obviously caused my activity level to drop and i gained weight quickly, almost 30lbs in 4 months.

My activity level is now back to normal however my energy levels are terrible. Im exhausted all the time now. have difficulty staying awake while driving, constantly late for work, and honestly my care factor or motivation is at zero.

I went to the Doc about this about 6 weeks ago and he tested my vit D levels along with T levels. My results are as follows

Vit D, 25-Hydroxy = 13.3 ng/mL (<20 ng/mL = deficient)

Testosterone ========================371 ng/dL Ref: 250-1100
Testosterone Free ================== 96.8 pg/mL Ref: 46-224
Testosterone Free and weekly bound = 211.6 ng/dL Ref: 110-575
Sex hormone binding globulin ======= 11 nmol/L Ref: 10-50
Albumin ============================ 4.8 gm/dL Ref: 3.6-5.1

The Doc told me everything was fine. After a little research on my own though, i became conserned that they might be to low. I asked for a second opinion, they retested me earlier in the morning, but this time they only tested total Testosterone, which was at 377.

The Doc insists that im still fine, however she did prescribe me a vit D supplement.

any thoughts on my levels for my age? I have another appointment tomorrow and am going to ask to be referred to a specialist, but any ammunition i can bring with me would be helpful. Thanks!

(edit)

Also, I have very thick head of hair, pretty hariy, specially on my lower back. My Left testicle does ache every now and then. Mostly when im running

Bump, any info would be helpful.

Have doc check for a hernia for that aching teste and check the teste as well. Feels different [sensation] from the other when you inspect?

You need a proper male panel. See the blood work sticky. LEF has this one:

http://www.lef.org/Vitamins-Supplements/ItemLC100010/Male-Comprehensive-Hormone-Panel-Blood-Test.html
plus and very important
http://www.lef.org/Vitamins-Supplements/ItemLC028480/FSH-and-LH-Blood-Test.html

Others may suggest other places where you can get and pay for your own labs.

Where are you located?

That will take time+$

Right now, you can check your body temperatures and post, along with iodine intake, iodized salt etc, as per the advice for new guys sticky. Do you get cold easily?

And post your current/past Rx and OTC drug use and other things mentioned in that sticky. And read that sticky carefully, not just looking for what you think that you need to be concerned with.

We often see docs and guys tunnel visioned on low T, not looking for the causes of low T.

Your body hair suggests that you were highly virilized by higher T levels years ago. That been the case you would suffer more at a lower T level than a guy who never was a higher T type. The lab ranges do not in any way reflect the needs of an individual. Hence, individualized medicine.

Any other lab results that you can post? Cholesterol and glucose? What other health issues/changes? Heartburn? Changed sleep patterns? Need to eat something 1.5-3 hours after dinner?

I am currently in the military so anything i do has to go thru my primary health care provider on base. I have an appointment today and will request a referal to a specialist. With that being said,

Hemoglobin A1c was at 5.2%
estimated avg Glucose at 102.5 mg/dL I did NOT fast prior to that test though.
Thyrotropin Sensitive was at 1.63 micro international units/mL (ref .36-3.74)
Thyroxine Free was at .87 ng/dL (ref .76-1.46)

they also did a comprohensive metabolic panel, but im not sure if it pertains to anything, so i will post the results anyways

Albumin 4.2 gm/dL
Bilirubin .38 mg/dL
Calcium 9.0 g/dL
Carbon Dioxide 26 mmol/L
Chloride 103 mmol/L
Creatinine 1.06 mg/dL
Glucose 100 mg/dL
Alkaline Phosphatase 94 units/L
potassium 4.3 mmol/L
Protein 8 gm/dL
sodium 140 mmol/L
Alanine Aminotransferase 68 Units/L (ref 30-65…high)
Aspartate Aminotransferase 47 units/L (ref 15-37…High)
Urea Nitrogen 12 mg/dL
Anion Gap 14.9 mmol/L
Osmolality calculated 279 mOsm/kg
Urea nitrogen/creatinine 11.3 (ref 12-20…Low)
Globulin 3.8 gm/dL
Albumin/globulin 1.1 ratio

Sorry if alot of that is useless. i really dont know what alot of it is. but thanks for your help. For RX’s im on Luvox CR(SSRI) (200 mg/day) and Klonopin for anxiety. No recent heartburn but i did get it before being treated for anxiety. Sleep paterns have been more inconsistant. i used to get a solid 7 1/2 hours of sleep, but now dispite being exhausted, i have a hard time going to bed at a decent time. Lately its been closer to 6-7 hours of sleep. lately even when i do go to bed at a normal time, i end up waking up an hour earlier then i would like. as for eating, alittle over a year ago, i got really bad cravings about 1-2 hours after dinner for something like icecream. these cravings have just subsided recently but i do feel the need to eat until i feel full, and not just satisfied. I do know diet is something i need to focus more on though.

Also, I wouldnt say i get cold easily, i Really dont know about iodine intake, last few times i went to the doc, my body temp was around 97.8 Morning erections rarely happen now, but my sex drive has overall been lowered since being put on Luvox. maybe TMI but i am not currently sexually active.

I have also noticed that over the past year or so, while going to the bathroom, its been harder to completly empty my bladder, (dispite shaking it once it goes in the pants there tends to be a few more drips) I should probably bring this up with the Doc today. i never really thought much of it before though

You need to take your oral temperatures when not talking, eating, drinking training for a while, doc wanted to see if you had a fever.

Benzodiazepines inhibit cold-induced thyroid stimulating hormone (also known as TSH or thyrotropin) release.

You are too young for BPH, need to consider prostatitis. http://en.wikipedia.org/wiki/Prostatitis

You cannot use Klonopin type drugs long term, they WILL mess you up. Hopefully you can resolve causes and get off of that crap.

SSRIs mess with sexual function and increase E2 and lower T. If Wellbutrin would work for you, it does not have negative effects. Sometimes SSRI+wellbutrin is used to reduce the sexual problems of SSRI’s.

Iodine intake:
You do not know if there in any iodine in your vitamins?
You do not know if you use iodized salt?

Can you do better?
Any other lab results that you can post? Cholesterol and glucose? What other health issues/changes? Heartburn? Changed sleep patterns? Need to eat something 1.5-3 hours after dinner?

I will get a thermometer and start tracking temps. I will look on my vitamin pack for iodine, i was taking mega mens green vitapacks but my doc told me to stop for a few weeks while i take the precription vit D supp. Im working on getting off of klonopin and only take 1mg at night time to help get me ready for sleep.

when i was put on luvox i didnt notice anything mention it causeing lower testosterone, but i guess it does make sence if its lowering my sex drive. You recommend welbutrin over Luvox? i was put on Luvox because the cause of my anxiety tended to be me worring about things and not being able to forget about them.

All in all, you think its my meds that i should be more worried about or do you think my lower T numbers are still an issue that needs to be addressed.

Honestly i was hoping that my anxiety may be caused by my lower T levels and that i can eventually get my T up and get off of the brain meds all togeather. any thoughts? Thanks again for your help!

Wellbutrin may not address the AD requirements that you have. But it has no negative sexual sides and does not rewire your brain or castrate your emotions. It is now a cheap generic.

Sleep: Suggest 5mg TIME RELEASE melatonin. Must be time release. And 50-100mg trazodone is very effective. You should start at 25mg and increase later as your body accommodates. When properly dosed is has no carry over effects in the morning. The listed side effects are from its high dose use as an AD med and it is rarely used for AD now. I have used both for years.

You can take high dose vit-D3 and your vitamins. What is your Rx dose of vit-D3? Vit-D3 in an oil cap works best. Best absorbed with a higher fat/oil meal and less absorbed with a high fiber such as oat meal.

Do not know where you are. We can get 5,000iu vit-D3 oil caps in the USA very inexpensively. One can take high amounts of vit-D3 and much is stored in the body for later conversion to vit-D25. In a UK study, participants were given 300,000 iu single doses 4 times per year.

We need more lab data before we take aim in any particular direction.

Sorry, I am in the US, just outside of Salt Lake City. the vitimin that i was put on was Drisdol 50,000 units, taking 1 capsule a week.

The first doc that i saw who told me my T was normal, suggested i switch to welbutrin but when i went to my psyciatrist, he said that ive been on Luvox for a year now and have responded well to it, so he didnt think it was the cause of my fatigue/loss of motivation/just feeling like crap. I may look into switching though just because it is more readilly availible, (i have to special order my Luvox most of the time) Im about to go in today and will request the suggested labs.

The Supplement that i was taking did have Iodine (as Potassium Iodide & Kelp) 150 mcg 100% per day

http://www.gnc.com/product/index.jsp?productId=11978947 this is what im taking.

Is iodine good or bad in this case?

You can get a bottle of tiny 5,000iu vikt-D3 oil caps at Walmart, very inexpensive, and take a number of those.

I use fast acting generic wellbutrin for mood support and dopamine and most of the time I promote it for mood, not so much for serious depression. For that, doses will be higher and the time release would work better.

That level of iodine 150 mcg [microgram] is enough to tread water and will not replenish iodine [IR] stores if one is iodine deficient [ID]. People store 1.0 1.5 GRAMS of iodine, mostly in their thyroid. If one need IR, the RDA=150 will take forever, try some math.

Your iodine stores are a balance of years of intake and losses. So how long have you used that vitamin? And what is your history of using iodized salt. Do not count on getting any iodine in prepared foods or restaurant foods. Most people are iodine deficient and getting less and less as time goes by. Many are using sea salt or forms of rock salt that have no useful amounts of iodine.

!!! What other health issues/changes? Heartburn? Changed sleep patterns? Need to eat something 1.5-3 hours after dinner?

I cover a lot of ground, try to do the same. :wink:

I do use sea salt… and ive only been taking supplements for about 3 weeks. Once i saw i had a vitamin D deficiency and before they prescribed me the actual vit D sups, i started looking at vitapacks. Again health issues have been weight gain around the waist. Just total lack of energy. battle falling asleep after lunch every day.

I also seem to not care, which sucks cause its starting to affect my job performance. Again, no real hearturn, when i did have it i think it was from the anxiety, ive been falling asleep right after work for an hour or so, which makes it harder to fall asleep at night.

Just got back from the Doc, She did a testicuar exam and didnt find anything. Also did a prostate exam (awkward) and she said it felt slightly enlarged but it was symmetrical. she drew blood and urin samples for a PSA? test.

She also refered me to an endo. And said thats where ill get the rest of the tests done

Endo’s often do a bad job of TRT and fail to understand that E2 is mission critical or any concern at all. Good luck with that.

Vit-D3 absorbs best with a meal that has higher fat content. Worst would be with oat meal or cheerios.

Sea salt has no iodine. You have 150 mcg [micro grams] of iodine in those vitamins, but that is not significant if you have not used them steady for a long time. That is 0.054 grams per years. People can store 1.0-1.5 grams of iodine. So you can see that the 150 mcg maintenance dose is not going to address a deficiency.

You can look for an iodized sea salt product, some do exist.