T Nation

Merry Christmas - ***New Labs***

Im clueless guys… I read for hours but nothing seems to jive with my situation. I would appreciate any input. I will keep it short and just post my labs. Doc just wants to throw Test at me but wanted to just make sure I know what I am getting into. Prepare yourself though… My blood work is horrible… Just like I feel. Again, any input would be great.
And BTW - Im 35 6’ 250 LBS.

Glucose 104 65-99
Uric Acid 7.1 3.7-8.6
Bun 14 6-20
Creatine .79 .76-1.27
Egfr 118 >59
Bun/Creatine Ratio 18 8-19
Sodium 140 134-144
Potassium 4.1 3.5-5.2
Chloride 103 97-108
Carbon Dioxide 18 19-28 LOW
Calcium 9.9 8.7-10.2
Phosphorus 3.3 2.5-4.5
Protein 7.5 6.0-8.5
Albumin 5.0 3.5-5.5
A/G Ratio 2.0 1.1-2.5
Bilirubin 0.3 0.0-1.2
Alkaline Phosphates 72 39-117
LDH 144 0-225
AST 24 0-40
ALT 33 0-44
Cholesterol 242 100-199 HIGH
Triglycerides 600 0-149 HIGH
HDL Cholesterol 36 >39 LOW
TSH 2.27 0.450-4.5
Thyroxine 7.3 4.5-12
T3 29 24-39
Free Thyroxine 2.1 1.2-4.9
WBC 7.1 3.4-10.8
RBC 4.78 4.14-5.8
Hemoglobin 15.2 12.6-17.7
Hematocrit 43.5 37.9-51
MCV 91 79-97
MCH 31.8 26.6-33
MCHC 34.9 31.5-35.7
RDW 13.4 12.3-15.4
Platelets 212 155-379
Neutrophils 61 40-74
Lymphs 25 14-6
Monocytes 11 4-12
EOS 3 0-5
Basos 0 0-3
Immature Granulocytes 0 0-2
Immature Grans 0 0-.1
B12 477 211-946
Folate 11.3 >3.0
Hemoglobine A1c 5.4 4.8-5.6
T4 Free 1.04 .82-1.77
Testosterone 185 348-1197 LOW
Prolactin 8.4 4.0-15.2
Triiodothyronine 3.0 2.0-4.4
Estradiol <5.1 7.6-42.6 LOW

I have dedicated the past 18 months working out 4 days a week. I have given up. Doesn’t matter if I work out or not I cant lose weight. My diet is clean as well but almost which is why this is all so frustrating. I am balding yet full of body hair and strangely enough I CAN get good wood with the wifey. So again, any “ideas” im all ears. My doc is nice enough guy and willing to help but like most just not experienced.

I am by no means an expert but you labs are similar to some of my own. I would read the thyroid stickie and keep track of your body temps. Your TSH is elevated compared to optimal but most Docs would not think anything of it. Was your Doc concerned with the lipid profile? Cholesterol and triglycerides need work, I have found fish oil to be a big help in this area for me. Alcohol will affect triglycerides and cholesterol it may not affect overall feeling but for overall health you want to work on getting those under control. You did not list any meds or supplements are you taking any? Hopefully some of the more experienced guys will chime in a wealth of knowledge here. Good luck !

Thanks for the response. Actually for the last 3 weeks I have not taken one single supplement. I was doing fish oil and a multi vit but my lipid panels were not much better even then. I do have several glassesof wine a week so i do drink (heck i have to when you feel this bad lol) So I still believe its one hormones imbalance which is disrupting the rest of me. I will start recording my body temps and go from there. Thanks again for the feedback.

Just updating again…Im starting in the morning with temperature tracking. I also wanted to mention I hold all my fat in my torso. I still have decently in shape legs and arms. Ten years ago I had veins in my stomach. I know however am just like most americans I suppose with a family, hi stress job, and just hustling all the time.

I am experimenting now going wheat free as I seem to respond well when I go low on the carbs. Anyways, if anybody has similar experience please post up. Im wanting so badly to be pointed in a good direction with all this. Tired of mood swings and everything else and with all the great research I have found here I now know I could take all the test in the world and feel just as bad if its not the underlying problem.

And thats exactly what my doctor wants to do. So Im trying to play safe. Anyways have a great weekend everyone.

Ok more updates… I’ve been checking my temperature for 36 hours. Never been above 97.6. Ever time I check it I have my wife check just for the heck of it and she is 98.6 on the money… Without fail… And as long as I can remember she has been hot in the morning and I’m always cold. Regardless of the time of year. Kind of funny to think about when she is 5’5" 115 -120 and I’m 6’ hairy and 250. Hormones are powerful and Im going to get mine right. Going to vitamin shoppe tomorrow to pick up some iodine. Just totally on the fence about starting the testosterone therapy. Please any guidance would be appreciated.

Couple more things keep in mind. I did not see a cortisol test. You may consider a that as it will tell you the state of your adrenal system. You may be suffering from poor thyroid and adrenal fatigue. Are you under a lot of stress? Job, death, financial,extreme weight loss can all tank your adrenal system. Hang in there things will get better unfortunately getting dialed in is a marathon and not a sprint. I wished I would have paused and sought more advice prior to starting TRT.

Took me almost two years to dial in as I was also fighting adrenal and Thyroid issues while adding T to the equation. You are doing the right thing examine the other variables first and then add T if needed. Be patient but persistent and keep a good journal of you supplements , weight and overall feeling as you try things.

You need to do more labs:

  • LH/FSH is very important to determine if primary or secondary hypogonadism, !!! must do before starting TRT!!!
  • DHEA-S [not DHEA]
  • AM Cortisol - do this at 8AM [as suggested above]
  • rT3
  • CRP to detect general inflammation [not cardio specific]
  • homocysteine to detect cardio specific inflammation
  • report your blood pressure

If LH/FSH are high, your testes are not working and you will need to start TRT, unless there is a blood flow problem that can be surgically corrected. If LH/FSH are low, you might be able to restart your HPTA. We need the lab work.

If you do not have a long history of using iodized salt, you are probably iodine deficient [ID]. That would be the good news as you can fix that. See the thyroid basics sticky for info re iodine replenishment [IR].

You have to start learning and understanding so you can actively manage your own health care. You cannot be passive.

Were you fasting for your lab work? Glucose is a problem if you were fasting.

Your body temperature is low, so you have functional hypothyroidism. Your thyroid hormones should all be mid range or a little higher and you are low across the board. You need optimal levels, docs will think that you are just fine. But they understand disease management, not health management. TSH should be near 1.0, TSH=2.27 is a major problem. Docs will think you are OK because they are idiots and the reference range is stupid. Note that “normal” does not mean healthy!

Thyroid hormones control your body temperature by regulating mitochondrial energy production. When temperatures are low, everything is effected. If your mitochondria are down regulated, you are not burning calories or blood born fats/lipids.

With thyroid problems, it is easy to gain fat and difficult or impossible to loose fat. If T levels are low, all the worse.

If you have adrenal fatigue, rT3 can be elevated and that can block the action of rT3, so things can be worse than a normal thyroid panel might indicate.

Iodine deficiency can typically affect a family if iodized salt is not been used.
Does your wife take vitamins that list iodine?
Do you avoid salt?
Does she avoid salt?

If you fix thyroid/iodine issues [including any rT3 issues, and fix your HPTA or get on TRT, your cholesterol levels should come down.

To increase HDL

  • fish oil, flax seed meal/oil, nuts [essential fatty acids EFA’s]
  • olive oil and other health fats
  • high potency B complex multi-vits with trace elements and iodine
  • DHEA 25mg
  • 50mg Ubiquinol form of CoQ10 [vital for mitochondria]

Do your testes ache, ever?
Testes smaller mushy?
Testes hanging normal or up tight?
What drugs do you use? Rx and OTC
Digestive problems?
Allergies?
When did this problem start?
Any blows to the head prior to that?
Ever use hair loss drugs?
Ever use steroid or “testosterone boosters” of any sort?
Provide a medical history.

Do not do extreme low fat or extreme low Calorie diets. Both are harmful.

Get the new lab data then we can explore your options.

See the advice for new guys sticky for medical terms, that sticky is something that you need to understand.

Wow not sure where to start with my response. I guess first with some updates… Ive read Wilsons book and I do not believe I have adrenal issues. Actually quite the opposite believe it or not… I am wired most of the time and highly motivated. Stressed out? Yes tremendously but I guess in some what of a good way because it keeps me moving.

I have not once been over 97.6 degrees… 9-10 times I take my temp its been 97.1. I have both a liquid gauge and digital. Both the same and backed up with wifes temp. She is 98.6 ALL THE TIME its sick. Anyways, I have avoided salt my whole life and my wife always uses it. No serious injuries or blows to the head. And just like you said with my thyroid jacked up I simply cannot burn fat. No matter what. I have even done a 2 week fast to try and “re-boot” everything.

Do your testes ache, ever? No never
Testes smaller mushy? No Never
Testes hanging normal or up tight? Yes sometimes they hang nice and low and sometime they disappear.
What drugs do you use? Rx and OTC ? No drugs.
Digestive problems? No Never
Allergies? Yes in the spring… Sneezed 25 times in row once
When did this problem start? Ive been feeling like shit for 5 years
Any blows to the head prior to that? No sir
Ever use hair loss drugs? No sir
Ever use steroid or “testosterone boosters” of any sort? No sir
Provide a medical history. - Healthy other than depression/anxiety that I suffer with over the past 5 years coinciding with these hormonal issues.

So I will schedule the new blood work tomorrow first thing. Thanks so much guys. Yall are amazing.

With this new info, you really sound like you have problems stemming from iodine deficiency. So read up on the IR issues in the thyroid basics sticky. Start with 6.25 mg and fly that for a while before increasing dose. This sounds like it will be a drastic change for you.

So why don’t docs ask about iodized salt?

  • because the drug rep is not selling it!

Good stuff guys. Blood work is scheduled and in the meantime I am going to start the iodine. My temp simply doesn’t budge of 97.1. Talk soon.

Additional lab work as follows:

You need to do more labs:

  • LH= 6.0 (1.7-8.6)
    -FSH= 2.5 (1.5-12.4)
  • DHEA-S= 265.9 (138.5-475.2)
  • AM Cortisol - 6.9 (6.2-19.4)
  • rT3 = Still Waiting
  • CRP= 1.72 (.10-.50)
  • homocysteine = Still Waiting
  • report your blood pressure = 120/80 - 130/80

Still recording low temps. Constant 97.1 it seems. I received my I iodine in the mail and started yesterday @ 3.125 MG to start with and go up from there. So thanks folks for any feedback. Merry Christmas.

Also, a little more medical history from a few years ago that might be of use. I should have said this earlier but I just didn’t think it was related but now I think otherwise. I went through some pretty bad depression and anxiety. Went and had all heart tests done and paid for them OUT OF POCKET because my doc wouldnt prescribe them because he thought nothing was wrong. Had pet CT scan done with contrast and the works. Turns out heart is fine… Had calcium score of 0. However these tests did find inflamed/swollen lymph nodes in my chest. Had them biopsied to check for lymphoma. In short everything was normal or negative yet my lymphatic system is inflamed for some reason. Sorry to throw this all in the mix but I just wanted to make sure everything was on the table in case it makes a difference. Thanks again my fine friends. I wish you all a very Merry Christmas and enjoy every second with your family.

Sup friends… Santa bring yall Some good toys?

I’ve now bummed the iodine to 6.25 and will let it ride for a while and see what’s up. I feel ok I suppose. I do feel tired a lot. Temps are still low though. I will give it some time though as I know this is not a race. Please comment on my updated labs if possible. If I need to throw the test on board it’s ready to but I’m still hesitant.

Your CRPh is elevated more than normal…have you been sick recently or something? The range at my lab is 0-6.0. However, most people are below 1.0…It is a inflammation marker…could be a lot of things that cause it to elevate. a lot of times they use it to see how auto immune patients are doing…like Rheumatoid Arthritis and such. Also, don’t know if it means anything or not, but usually you see FSH higher or equal to LH…with one reading it probably means nothing though…

Your inflamed lymphs and CRP are self consistent. You may have a chronic infection. If so, will go with rT3 is that is elevated.

Any tick bites in the past?

Your CBC should be reviewed looking for signs of chronic infection.

10 is the lowest AM cortisol where on might function properly. Consistent with adrenal fatigue which can also drive elevated rT3.

Is your thyroid enlarged or sore?

LH quite high relative to TT, suggests a degree of primary hypogonadism. Testes ever ache? Examined for physical problems such as vascular abnormalities?

FSH is more consistent with your low T and FSH is generally a better indicator of average LH status than LH itself as LH has a short half live and it very pulsatile. So some confusion and I do not know how to resolve.

Geez now Im even more confused. Not sure I know what to do or even where to turn now. Are you asking about tick bites for lyme disease? My docs have tunnel vision and see low T and just say you have low T so take some. I agree there seems to be something deeper but Im just lost at this point. I do, however, have some additional labs to report in the meantime. And I am still waiting on the RT3 which seems like something you still would like to see. I really appreciate the input my friends.

WBC = 7.1 (4.0-10.0)
RBC = 4.58 (4.2-5.8)
Hemoglobin = 14.2 (13.0-16.8)
Hematocrit = 41.4 (40-50)
MCV = 90.4 (82-98)
MCH = 31.1 (27-33)
MCHC = 34.4 (32-36)
RDW = 12.4 (12-15)
Platelets = 207 (150-430)
MPV = 8.4 (6.5-10.5)
nRBC = 0 (0-100)
Neutrophils Relative = 63 (45-80)
Lymphocytes Relative = 27 (12-45)
Monocytes Relative = 6 (0-13)
Eosinophils Relative = 3 (0-5)
Basophils Relative = 0 (0-2)
Neutrophils Absolute = 4.4 (1.8-8)
Lymphocytes Absolute = 1.9 (1.48-4.50)
Monocytes Absolute = .4 (0-1.4)
Eosinophils Absolute = .2 (0-.5)
Basophils Absolute = 0 (0-.2)

Total Protein = 7.8 (6-8.5)
Albumin = 4.6 (3.5-5)
Alkaline Phosphatase = 75 (30-115)
Total Bilirubin = .5 (.1-1.2)
Sodium = 143 (135-148)
Potassium = 4.1 (3.5-5.5)
Chloride = 103 (98-106)
CO2 = 26 (24-32)
BUN = 16 (10-26)
Creatine = 1.06 (.5 - 1.2)
Glucose = 101 (70-110)
AST = 28 (5-40)
ALT = 36 (5-50)
EGFR = 80 No range given??
ACE Serum = 26 (9-67)

Thanks again champs.

Got the RT3 back

rT3 = 12.0 (9.2 - 24.1)

Your labs are fantastic…can’t ask for better than that. I don’t know about the rT3 though…wait for Ksman on that one. Why didn’t they order a CRP this time???

I have bumped the iodine now to 12.5 mg daily. Back on the fish oil as well and feel somewhat better. Body temps still struggling and hanging right around 97.0-97.5. I’m also going to see a HRT doctor next week and go from there. I really hope they take all the bodies systems in consideration not just the T. Anyways I wish everyone an awesome new year.