T Nation

My Labs. What Do You Think?


#1

Hello,

I started looking and researching about Testosterone after feeling like crap for awhile.

Jan 2010 My PCP did a TT check which came out at 323 ng/dl range (241-827)
I drank pretty heavy for a couple of years and had just quit 3 months before. I figured I would abstain from alcohol, exercise, and eat healthier.

Dec. 2011 TT 415 same range as above. I went to a Urologist and he gave me labs for free test, LH, Estradiol, and Vitamin D.

Jan 2012
Free T = 46pg/mL range = (47-244)
Estradiol 14pg/mL range = (10-52)
LH 2.0 range = (1.5-9.3)
Vitamin D25-Hydroxy = 31 range = (30-80)

Also had T4,T3,TSH done in Dec 2011 from PCP
T4 free 1.10ng/dL range = .89-1.76
T3 free 3.28Pg/ML range = 2.30-4.00
TSH .786mIU/L range = .350-4.00

Tryglycerides--been struggling with them for years now 787
Cholesterol 120
HDL 27
LDL --- elevated tryglycerides invalidates the LDL calculation.

Doc got the lab results and called me over the phone. Was talking everything but the Testosterone value. He said I needed to take 3000 units of D3. I asked him about the free test and he said, your only "1 point below normal." I argued with him a little about this and asked about a trial run of some kind of T product.

He said he would have the nurse call me back (this was in the morning) to set up an appointment. Didn't receive a call, so the next day I called to talk to the nurse. I voiced my opinions about seeing him for a possible trial (how I've been feeling like crap for two - three years). She said, "she would talk to the doc." She called me a little later and got me an appointment for next week.

I called a BhRT place and they suggested some more labs. So, I'm going to ask about Prolactin, Ferritin, AM Cortisol, FSH, DHT, and IGF-1 and CBC.

I thought about writin a letter with these requests and dropping it off at his office tomorrow. I think I'll wait till my meeting next week, and request if after I feel him out on the trial. I didn't want to start TRT in the beginning because I'm 33 and I figured with abstinence from alcohol etc... these problems would resolved.

Now, I'm gung-ho almost impatient, b/c I believe there is a good chance I will feel better soon. The doc said if I was 50 he would say "sure." But since I was 33 he didn't want to put me on a life long course of TRT. I agree. What about TRT for 4-12 months to help improve my body/get healthy and then stopping and restarting HPTA naturally or with help?

What do you think of my labs? Free T low, LH low-normal? Estradiol-low normal -or good?

I would appreciate any advice. I'm 33yrs old 6 foot, diabetic - was able to maintain a1C of 5% without meds by diet and exercise. I was out in the sun a lot from March - October. I haven't been in the sun that much this winter. I drink a glass or two of milk a day. I eat eggs, fish, and greens a lot. Would Vitamin D raise my levels that much?

I used prohormones in my early 20's around 4 times (for 8 weeks each). How should I approach the Doc? Last time I talked with him he was talking about vitamin D, zinc, magnesium, and the paleo diet.

I avoided alcohol for 15 months. I quit drinking soda's before I found out I was diabetic around 2-1/2 years ago. I cut down sweets a lot. I still probably eat too many carbs, around 150grams or less. As a diabetic my PCP suggest around 150(preferrably)-210(max. I haven't been having A1C issues, I haven't been taking any diabetic drugs. Although, since the last visit in early Dec. I've been taking metformin 500mg b.i.d. b/c Doc suggested it to lower tryglycerides. I've been taking lipitor for about 1/2 year.

Anyway, that's a little snapshot of what's going on with me right now. I appreciate your help, advice, etc.. Thanks!


#2

More to add later when I’m on a computer but:

TRIG =787??? No typo? Wow

LB is low could be from pro hormone use. How did your pro hormone use correspond to the timing of your diabetes diagnosis and other health problems?

YOU NEED VIT D!!! 3k iu per day is too low for you. Go at 15-20k/day for a couple weeks then drop down to 6k iu or so per day for maintenance. U want this at top of range.

If on statins you also need CoQ10 to help mitochondrial function


#3

Thanks for your advice VTBalla

That isn’t a typo. The first time I saw it elevated (300ish) was in 2004/2005. Doc (my former) said it wasn’t a big deal. I did the prohormones 3-4 times between 19yrs of age and 23. I wasn’t diagnosed diabetic until December 2009. Who knows what did what. I’m sure I was insulin resistant or borderline for awhile before 2009.

At the height of my alcohol abuse and being fat 6’ around 280, I would sweat real easy (short walks, sometimes just sitting if it wasn’t in AC). Until recently, I have either had a very high carb diet or abused alcohol or both. Haven’t had a drink in 15 months. I’ve cut the carbs down significantly, but now I’m really going to try and keep the carbs under at least 100grams.

I just started taking Qunol Ultral CoQ10. The only study I found that showed Vitamin D raising Test levels showed a slight increase. --10% Which every little bit is good, but it concerned me that my Dr. was basically pointing to the D level as the reason my free T was low. He wanted to wait another 3 months.

I want to start now, even if it’s a trial run for 3-6 months and then get back off and see how I respond after optimally Vit D levels, another 6 months away from alcohol, exercise, and improved diet. I don’t want to have to be on it forever, I would like to use it as a bride. Does low Vitamin D lower LH?


#4

Hello,

Mr. VTBalla or anyone.

What do you think of my above post.^^^^^^^^ I appreciate your help.

I might have the option of starting a trial run of T next week. Should I wait and just supplement Vit. D? I can’t find any research that shows it raising T significantly. What if it raise my levels 20% and then I’m in the low but “normal reference.”

Plus, I’m already diabetic (managed pretty good). But still probably some kind of insulin resistance going on.
Going by symptoms I’ve probably been low for 3-4yrs. Would it be beneficially to go ahead and do a trial run for 3-6months and then get off and try to restart HPTA to get the benefit of the T my body has been deficient in for awhile. Also, I think my E2 is a little low, I have achy joints in the hands, feet, and ankles (lock/pop) pretty bad.

Thanks for any advice. This would be my first time and I’m kind of nervous for a variety of reasons.


#5

If I were you, I would supplement the Vit D and see if that helps. Vit D is crucial for hormone functioning. I would give it a month. If at that point, your LH is still low, you should try a SERM restart to see if your pituitary and testes can function again. Exogenous T is a bit premature IMO


#6

Thanks for the advice VTBall34.

I’m going to push the Doc for more labs. Prolactin, AM Cortisol, DHT, Ferritin, FSH. Hopefully, to rule out hemochromatosis or other endocrine stuff. I might ask him for a Vitamin D shot, unless the Vitamin D will get in my system just as fast taking mega doses orally.

I’ve been doing some reading about SERM’s, b/c I was thinking that would be a possible option. SERM’s are contraindicated in women with hypertriglyceremia. SERM’s can shoot up some people’s triglycerides. I’d have to get mine at least below 300 before I could do a SERM restart. I’m assuming it would be contraindicated in guys with hypertriglyceremia but I can’t find any information on guys - SERM’s-triglyceride’s.

I’m working on reducing my carbs. I’ve been reading the nutrition board. I’m going to go as low carb-high fat -medium protein as I can.

Thanks again. Will Doctor’s do Serm restart’s? Or is it even harder to find a Dr to understand that as it is TRT?


#7

Very difficult to find one…if you decide to go that route, you will have to do some searching…guys often do it on their own using UGL sourced SERMs.

You can bring your d levels up quickly using a good bioavailable brand. I use Biotics Emuslified Drops, which I bought on Amazon. 6-8k iu/day keeps my levels at the very top of the range…I loaded up at 30k iu/day or so for the first week I think…


#8

With Trigs so high you could try taking Apple Cider Vinegar (tablespoon) after every meal. Not saying it will definitely help but absolutely worth the try.


#9

Cool, I’m going to the health store this morning. I’ll probably get my first set of Vitamin D at the store. I don’t won’t to wait, even a couple of days to start loading up on the Vit D.

I’ll do some research about Apple Cider Vinegar. I guess it can’t hurt.

Thanks, again. I see the Dr. in a few days. I’ll post what happens.


#10

Labs update:

Last time at the Urologist’s office, I asked for more labs. He ordered: a CBC, Cortisol, Ferritin, Prolactin, Vitamin B12/Folate, CRP, high sensitivity, Homocysteine -Total, and DHEA (I asked about DHEAS and he didn’t know about it).

CBC - everything is normal.

Cortisol = 6 range 6-29 (7-9A.M.) I woke at 05:30 and took it @08:30.

Ferritin=144 range=22-322NG/ML

Prolactin=2.9 range=2.1-17.7NG/ML

Vitamin B12=795 range=211-911PG/ML

Folate=17.9 range>5.0 NG/ML

CRP, High Sensitivity=0.23 MG/L

Lowest risk (lowest tertile) <1.0 mg/L
Average risk (middle tertile) 1.0-3.0 mg/L
Highest risk (highest tertile) >3.0 mg/L

Homocysteine, Total 11.3 range=3.7-13.9umol/L

DHEA=129 range for a male>19yrs of age=31-701

So, do these results, specifically the low cortisol and low normal DHEA but low normal prolactin (which I’m assuming is good), combined with the earlier low freeT, low normal total T and low normal LH mean anything to anyone?

Thanks for your help.


#11

Cortisol is absolutely abysmal–one of the lowest I remember seeing. Indicates adrenal fatigue (I hate that term but easiest way to describe hypoadrenia). All pituitary hormones look low. I would recommend one of the three, depending on which direction you want to go (i’ve listed them in order from my perspective):

-Pituitary MRI to see if you may have a pituitary suppressing andenoma
-ACTH stimulation test to see if your body is capable of producing cortisol. If not, look into treatments for adrenal fatigue. Hydro-cortisone at 20 mg or so per day (ramping up) for a period of a few months, then discontinuing to see if your cortisol maintains.
-SERM restart/Clomid Challenge to see if your body is capable of producing LH/FSH and T.

You are going to be very difficult and my require a combination of 2 & 3 (most likely) until your body is back in balance again. Not sure how your high triglycerides play in, but they certainly do. Indicative of metabolic syndrome.


#12

Thanks, for your help. I have a Dr’s appt. in two weeks with my PCP. I will see if I can move it up sooner. I thought the Cortisol was just low normal but not necessarily bad. I do feel like I’m more fatigued than I should be at 33 yrs old, but I thought that was from Low T. I was diagnosed with metabolic syndrome. I’ve lost like 45-50lbs. I’m now 6’ 230 and my 38" jeans are starting to get loose. My blood pressure is fine. My HDL is low, my LDL is fine. I’ve been doing this primal or low carb diet for the last couple of weeks and been taking vitamin D.

I have a bad feeling that isn’t going to be enough.

I walked about 6 miles on a flat trail yesterday. I wasn’t overly wiped out afterwards. My hip joints and knee’s were aching though. They ached more than I figure they should for being 33 and not having my hip joints ache like that before. (including biking about 10miles 3 days a week during the spring and summer.)

I have a bad feeling that isn’t going to be enough.


#13

aching joints = possible aldosterone issues (can also be partially assumed because of low cortisol results)

Any water retention/excess sweating/higher blood pressure/higher resting heart rate/freq urination?


#14

No, I don’t have any of those symptoms. I use to sweat real easy, when I was 50lbs heavier and was drinking alcohol. Actually, my joints feel better the last week. A week to two weeks ago I started cutting out a lot of carbs, “going primal or stoneage.” A lot of people say to cut out dairy products too. Cutting out cheese on my grassfed burgers and salads would probably be harder than going low carb. – flavor.
I started taking Vitamin D, B12. Also, I quit taking lipitor even though I have high triglycerides. I don’t think it was doing much anyways considering my last lab result.

While resting, my joints feel better. I was just surprised my hip joints were aching after walking 6 miles because that hasn’t happened before. I just graduated school in December and have been pretty much sitting around, so, I hope it had more to do with that. I don’t know.

Thanks, for looking at my thread. I appreciate your input.


#15

I just briefly looked at your first post and a couple problems/suggestions I noticed instantly where

  1. you failed to mention the appropriate measurements for your D status ng/mL or nmol/L. (assuming ng/mL) the target should be at least 60 ng/mL
  2. Total Cholesterol is completely useless.
  3. your high Triglycerides are mostly due to being highly deficient in Omega-3’s
  4. “elevated tryglycerides invalidates the LDL calculation” <----WTF does that mean…high triglycerides encourages abnormal lipoproteins (not a good thing). IMO this is the most important take away from a lipid panel, to be able to differentiate between the various LDL’s.
  5. Niacin in the form of “nictionic Acid” will improve your HDL’s dramatically, but it will take awhile like all great things.

just my initial thoughts.