T Nation

Lab Reviews / Advice

Hello everyone. I’m 32/M, 5’10" 210lbs. About a year ago I had thyroiditis. They did a radio active iodine uptake scan. Radiologist said it was some kind of viral infection of my thyroid. It cycled as they predicted. A few months of overactive then a few months over active. Then it cycled back to “normal” per my tsh levels. was around a 8 month process. I went back to to doctor a few weeks ago to have it checked again. I’m tired all the time, don’t sleep well, weight gain, mood swings, exc. He speculated that it was due to stress, but he did do some lab work:

Testosterone 217.8
Free t 49
TSH 2.6

He said my thyroid is fine and had me retake testosterone labs on

Testosterone 241.7
Free T 57

He called me today and wants me to start androgel. I’m not sure of the dosage I haven’t picked it up yet. I have been reading all the stickies and will have more info at a later date but I have a few questions.

It seems weird to me that I would have several hormone problems. Does anyone have any thought on that?

Should I ask for a full thyroid panel?

I’m really hesitant at my age to start trt if I don’t need to. Is it possible something else is wrong or are my numbers low enough that I really need to start the androgel?

I’m also concerned about having kids. I still planned on having them.

I think it is odd the doctor would want to start me on trt replacement without looking for any other possible solution, all over the phone. I’m trying to get in to see him tomorrow. If not it will be soon.

Thank you for any guidance.

Ive never known anyone to recover from 217 ng/dL, that’s severe hypogonadism. Your pituitary gland is already showing it’s weak hand otherwise your T would be optimal. Forget the gels and demand injectibles.

Please post oral body temps to eval overall thyroid function.

Thyroid lab ranges are mostly useless as well a doctors stating “normal”. TSH better near 1.0

You should test LH/FSH and prolactin prior to TRT.

Many thyroid issues involve iodine deficiency from not using iodized salt and/or vitamins listing iodine+selenium.

We see that guys with thyroid problems have a pattern of not absorbing transdermal T, self injected is the solution.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

My doctor ordered a full range of lab work on Monday. The results are being mailed but they called me and stated the following:

LH/FSH are normal (Not sure of the number or reference yet)
Prolactin - 21.5 Lab range males 4-15
E2 - 14.9 lab range males (27-52)

The have ordered a MRI on my pituitary gland, and are sending me to a endocrinologist.

@KSman I will post oral body temps, all lab numbers, and other info as soon as I have them.

If LH and FSH are normal than your testes are damaged, you are primary hypogonadism.

According to my doctor, they were expecting my LH and FSH to be high for primary hypogonadism. With them being normal and my prolactin levels being elevated it indicates secondary hypogonadism.

Is this information incorrect?

Normal doesn’t mean much, normal could mean high but in range. What’s normal for you isn’t normal for someone else. Sounds like these doctor’s are fixated on labs rather than paying attention to the symptoms, this is how you spot a doctor who Medical degree isn’t worth the paper it’s printed on.

Elevated prolactin can lead to low LH/FSH and some of that can be from the physical adinoma. Recent sex or hugging babies, kittens or puppies can elevate prolactin for a while. Given costs of MRI, herhaps a second prolactin test might be wise. Prolactin secreting adinomas are typically managed well with 0.5mg/week dostinex/cabergoline.