T Nation

My Story and Labs

Hey guys Iâ??m pretty new here but would like to hear your input. Iâ??ll try to keep this as short as I can. Iâ??m 23, 5â??10, and 165-170ish

Currently my symptoms are as follows:

-Low libido/slight impotence (spontaneous erections are non-existent, morning erections are non-existent or weak)
-Fatigue during the day
-Trouble focusing/concentrating at work
-Little facial/body hair growth
-Slight depression at times (I think due primarily to my low libido/impotence)
-Poor fertility

Medical History

-Grade II Varicocele left side since I was 14-15 (now 23; conventional surgery done on 2/11/10)
-2 extremely small micro adenomas on pituitary gland (so small MRI couldnâ??t specify if they were in fact micro adenomas or not but I will assume they are)

Labs prevalent to symptoms (these are all from May 2010 or newer)

-Prolactin 12.6 & 13 & 11.4 (1.8-14.4)
-TT 543 & 532 (280-800)
-Free T 14.5 & 15.5 (9.3-26.5)
-Hemoglobin 13.9 (12.1-17.)
-Cortisol 22.5 (4.3-22.4) High
-Estradiol 35 (10-52)
-SHBG 21 (no scale given)
-DHT 22 (30-85) Low
-Vit D 25.8 (32-100) Low
-IGF-1 312 (116-358)
-FSH 10 (0.9-15)
-LH 5.3 (1.5-9.3)

So basically the last couple months have been a runaround with various doctors getting nowhere. Got in touch with a well known member here and what a relief. My meeting with him and his colleague went very well.

We uncovered that my college years put an enormous stress load on my hormones and body in general. Like most college students I didnâ??t take the best care of my body; eating crap, drinking all the time, smoking occasionally, poor sleep, staying up late, overtraining at the gym, and class work load all put stress on my system. Additionally I lost a very close friend during my time in college which may have been the straw that broke the camelâ??s back.
Currently they think my problem lies in my adrenals or thyroid. Adrenal fatigue or reverse T3 syndrome make the most sense at this point. They think my hormone system crashed in college and never fully recovered.

They recommended 10,000iu/daily of liquid vitamin D drops, replaced my GNC Mega Men multi vitamins with better absorbing ones, and recommended I eat more greens until our next meeting. I cant seem to get enough greens in my diet so Iâ??m supplementing with green vibrance.

So here are the new labs Iâ??m getting done but I donâ??t have the results yet. (blood, urine, and saliva)

DHEA-S
Progesterone
Thyroxine Free, Direct, Serum
Triiodothyronine Free, Serum
Thyroxin (T4)
Thyroid Peroxidase Ab (TPO)
Antithyroglobulin Ab
TSH 3rd Generation
Reverse T3
Prealbumin
Cortisol, AM Total and Free
ACTH Serum
Ceruloplasmin
CBC with Diff/Platelet
CMP with Liver Panel
Ferritin, Serum
Homocysteine
C-Reactive Protein Quant.
Lipoprotein Subfract (AKA VAP)
Hemoglobin
Iodine Random Spot Urine 10mL (LC not found)
Allergen Profile, Basic Food
Celiac Disease Panel
Antigliadin Abs, IgG
Fractional Catecholamines, Serum
DHEA, Total, 24 hour Urine (LC not found)
Prolactin

Thanks

it looks like they are doing a complete workup and that you are moving in the right direction.

The only extra tests I can think of would be for B12 and Pregnenolone.

post your test results when you get them.

Best of luck.

Fish oil caps
Acetyl-l-carnitine
r-lipoic acid

cholesterol lab results?

PureChance: Just looked through all of my bloodwork and couldnt find those labs. I will see if i can get them added to my next blood test whenever that may be. And yes Ill post the results here when I receive them.

KSman: cholesterol is 151. Ill bring those three items up at my next appointment as I am not familiar with them, what benefits will they offer? Currently im on 10,000iu vit d drops (3 drops morning 2 drops afternoon), multivitamins (4 pills with breakfast 4 pills with dinner), green vibrance (once a day), and uni-liver(3 tablets per meal). Switching to beverly international ultra 40 after uni-liver runs out.

Thanks

Total cholesterol that low can be a problem and low cholesterol can lower hormone levels. Are you doing anything extreme with your diet?

Fish oil?

KSman I am not doing anything extreme to my diet. Additionally I am not taking any of the 3 items you listed above. Got my labs in gonna post in a second message here in a sec but there is a more detailed cholesterol panel listed

Got my labs today and there are a lot of them. I got the bloodwork done on Thursday July 29th at 7:30am. Any input would be greatly appreciated.

VAP Cholesterol Profile
LDL Cholesterol 70 (<130)
HDL Cholesterol 46 (>=40)
VLDL Cholesterol 22 (<30)
Cholesterol, Total 138 (<200)
Triglycerides 154 (<150) HIGH
Non HDL Chol. (LDL+VLDL) 92 (<160)
apoB100-calc 72 (<109)
LDL-R (Real)-C 52 (<100)
Lp (a) Cholesterol 10 (<10) HIGH
IDL Cholesterol 7 (<20)
Remnant Lipo. (IDL+VLDL3) 19 (<30)
Clinical Consideration Probable Metabolic Syndrome (Flag=Abnormal)

Sub-Class Information
HDL-2 (Most Protective) 10 (>10) LOW
HDL-3 (Less Protective) 36 (>30)
VLDL-3 (Small Remnant) 12 (<10) HIGH
LDL1 Pattern A 5.2 (no range)
LDL2 Pattern A 2.0 (no range)
LDL3 Pattern B 26.4 (no range)
LDL4 Pattern B 18.8 (no range)
LDL Density Pattern Abnormal

Celiac Disease Complete Panel
Immunoglobulin A, Qn, Serum 242 (70-400)
Deamidated Gliadin Abs, IgA 3.1 (0.0-10)
Deamidated Gliadin Abs, IgG 1.0 (0.0-10)
t-Transglutaminase (tTG) IgA 1 (0-3)
t-Transglutaminase (tTG IgG 1 (0-5)

CBC w/ Differential/Platelet
WBC 5.5 (4.0-10.5)
RBC 5.08 (4.10-5.60)
Hemoglobin 14.1 (12.5-17)
Hematocrit 42.6 (36-50)
MCV 84 (80-98)
MCH 27.8 (27-34)
MCHC 33.1 (32-36)
RDW 13.6 (11.7-15)
Platelets 192 (140-415)
Neutrophils 54 (40-74)
Lymphs 34 (14-46)
Monocytes 10 (4-13)
Eos 2 (0-7)
Basos 0 (0-3)
Neutrophils (Absolute) 2.9 (1.8-7.8)
Lymphs (Absolute) 1.9 (0.7-4.5)
Monocytes (Absolute) 0.6 (0.1-1)
Eos (Absolute) 0.1 (0.0-0.4)
Baso (Absolute) 0.0 (0.0-0.2)
Immature Granulocytes 0 (0-1)
Immature Grans (Abs) 0 (0.0-0.1)

Comp. Metabolic Panel (14)
Glucose, Serum 91 (65-99)
BUN 18 (5-26)
Creatinine, Serum 1.05 (0.76-1.27)
eGFR >59 (>59)
eGFR African American >59 (>59)
BUN/Creatinine Ratio 17 (8-27)
Sodium, Serum 141 (135-145)
Potassium, Serum 4.3 (3.5-5.2)
Chloride, Serum 102 (97-108)
Carbon Dioxide, Total 27 (20-32)
Calcium, Serum 9.6 (8.7-10.2)
Protein, Total, Serum 7.2 (60.-8.5)
Albumin, Serum 4.6 (3.5-5.5)
Globulin, Total 2.6 (1.5-4.5)
A/G Ratio 1.8 (1.1-2.5)
Bilirubin, Total 0.6 (0.0-1.2)
Alkaline Phosphatase, S 76 (25-150)
AST (SGOT) 19 (0-40)
ALT (SGPT) 14 (0-55)

Allergen Profile, Basic Food
Levels
Class 0: <0.05 (Negative)
Class 0/I: 0.05-0.07 (Equivocal)
Class I: 0.08-0.15 (Increasing)
Class II: 0.16-0.50
Not going to list the rest of the classes I donâ??t fall into those categories

Milk (Cow) <0.05 Class 0
Wheat <0.05 Class 0
Corn 0.08 Class I Abnormal
Peanut <0.05 Class 0
Soybean <0.05 Class 0
Pork <0.05 Class 0
Beef <0.05 Class 0
Fish/Shell Mix <0.05 Class 0
Egg, Whole <0.05 Class0
Chocolate, Cocoa <0.05 Class 0

Catecholamines, Plasma
Catecholamine Frac, P
Norepinephrine, P1 266 (0-874)
Epinephrine, P1 28 (0-62)
Dopamine, P1 18 (0-48)

Iodine, Urine
Iodine, Urine 420 (no reference given)

Dehydroepiandrosterone Sulfate
DHEA-Sulfate 299.3 (211-492)

Thyroxin (T4) Free, Direct, S
T4, Free (Direct) 1.29 (0.82-1.77)
TSH 3.600 (0.450-4.500)

ACTH, Plasma
ACTH, Plasma 35.1 (7.2-63.3)

Hemoglobin Alc
Hemoglobin Alc 5.6 (4.8-5.6) Some warnings about diabetes here
It says â??Increased risk for diabetes: 5.7-6.4â??

Homocyst(e)ine, Plasma
Homocyst(e)ine, Plasma 6.6 (0.0-15)

Prolactin
Prolactin 13.6 (4.0-15.2)
This blood draw was on a Thursday morning and I did not engage in sexual activity since the Saturday before (6 days)

Thyroxin (T4) 6.8 (4.5-12)
Ceruloplasmin 17.7 (16.2-35.6)
Thyroid Peroxides (TPO) Ab 6 (0-34)
Reverse T3 261 (90-350)
Triiodothyronine, Free, Serum 2.9 (2.0-4.4)
Progesterone 1 (0.2-1.4)
Ferritin, Serum 132 (30-400)
Prealbumin 34 (20-40)
C-Reactive Protein, Quant 0.4 (0.0-4.9)
Antithyroglobulin Ab <20 (0-40)
Cortisol-AM 27.7 (6.2-19.4) HIGH

One would expect a cortisol that high to result in whacky rT3. One would also expect a much lower ACTH.

Were you on finasteride?

[quote]JLWilson wrote:
One would expect a cortisol that high to result in whacky rT3. One would also expect a much lower ACTH.

Were you on finasteride?[/quote]

no was never on that. i was never on anything except multi-vitamins and now vitamin d drops

Thyroid is a mixed bag. T4 could be higher and TSH is getting high. You need to read and ID symptoms of hypogonadism to discuss with your doc. Get some waking body temps before you get out of bed.

Prolactin is a problem. Most docs will ignore.

You need to increase your cholesterol levels.

Improve your metabolism with the items that I suggested. Use a good multi-vit + trace elements that has a high vit-D potency. Add anti-oxidants. CoQ10 may be useful.

I do not know how to interpret your iodine lab number. You use iodized salt?

[quote]KSman wrote:
Thyroid is a mixed bag. T4 could be higher and TSH is getting high. You need to read and ID symptoms of hypogonadism to discuss with your doc. Get some waking body temps before you get out of bed.

Prolactin is a problem. Most docs will ignore.

You need to increase your cholesterol levels.

Improve your metabolism with the items that I suggested. Use a good multi-vit + trace elements that has a high vit-D potency. Add anti-oxidants. CoQ10 may be useful.

I do not know how to interpret your iodine lab number. You use iodized salt?

[/quote]

My current doctor is not ignoring prolactin but this lab confirms it is a problem. Especially that I didnâ??t have sexual activity for 6 days before this blood draw so itâ??s not like it was falsely elevated. This was my fourth prolactin test since may and all in the 11-13 range. I have no idea how my doctor is going to want to approach this problem. Perhaps vitex, b-6, or cabergoline.

How can I safely raise cholesterol levels. And what range would be optimal?

I do put salt on my food unsure if itâ??s iodized though…

Hemoglobin Alc 5.6 = high avg blood sugar levels.

high cortisol & high Rt3 - RT3 should be 33% the value of (Free T3 * 100). You are at 90%.

I have no experience with or knowledge about high cortisol.
I have no idea how to read those CHOL values - I haven’t done research in that area yet.

maybe a short term use of T3-only medication to get your Thyroid back in line. low cortisol normally results in high RT3.

what is your doctor advising?

eat more eggs (omega-3 variety I think are best) to raise CHOL.

[quote]PureChance wrote:
Hemoglobin Alc 5.6 = high avg blood sugar levels.

high cortisol & high Rt3 - RT3 should be 33% the value of (Free T3 * 100). You are at 90%.

I have no experience with or knowledge about high cortisol.
I have no idea how to read those CHOL values - I haven’t done research in that area yet.

maybe a short term use of T3-only medication to get your Thyroid back in line. low cortisol normally results in high RT3.

what is your doctor advising?[/quote]

Thanks for the input. I meet with my doc in two weeks so not sure yet. Just wanted to post results and get as much input as I can beforehand

[quote]southpaw41 wrote:
Thanks for the input. I meet with my doc in two weeks so not sure yet. Just wanted to post results and get as much input as I can beforehand[/quote]

no problem. I do the exact same thing. Best to be prepared. Just keep us posted on what the doctor does say eventually.

Check the salt package, will or will not state iodized. Sea salt does not contain iodine unless added. Iodine is lost during crystallization. Kosher salt has no iodine.

Low cholesterol levels can easily limit hormone production as cholesterol is the base that all steroid hormones are made from. Low cholesterol is associated with higher all cause mortality - affects everything.

Review my other comments above.

Some docs are brainwashed and will think that low cholesterol is good.

[quote]KSman wrote:
Check the salt package, will or will not state iodized. Sea salt does not contain iodine unless added. Iodine is lost during crystallization. Kosher salt has no iodine.

Low cholesterol levels can easily limit hormone production as cholesterol is the base that all steroid hormones are made from. Low cholesterol is associated with higher all cause mortality - affects everything.

Review my other comments above.

Some docs are brainwashed and will think that low cholesterol is good.

[/quote]

Just checked I do in fact use iodized salt. Should I continue using iodized salt or switch to something else?

I forgot to mention above that the only thing Im doing differently to my diet is eating lower GI foods. Perhaps this is lowering my cholesterol. I will try to get more eggs in my diet.

You are ok with that salt. The point is to make sure that you do not have an iodine deficiency from using the wrong product.

[quote]KSman wrote:
Thyroid is a mixed bag. T4 could be higher and TSH is getting high. You need to read and ID symptoms of hypogonadism to discuss with your doc. Get some waking body temps before you get out of bed.

Prolactin is a problem. Most docs will ignore.

You need to increase your cholesterol levels.

Improve your metabolism with the items that I suggested. Use a good multi-vit + trace elements that has a high vit-D potency. Add anti-oxidants. CoQ10 may be useful.

I do not know how to interpret your iodine lab number. You use iodized salt?

[/quote]
Since all his parameters are in check I suspecting low cortisol levels are not causing the thyroid to be pushed into the cell since the ferritin is good that variable is rulled out. Correcting the adrenals will probably show the true hidden hypothyroidism when the thyroid levels in the blood drop. We also see this alot in people with food allergies as we well which he has some as well as potential hidden infections that are lowering the cortiosol production. Secondary hypothyroidism due to adrenal insufficeny is what I am looking to potential cause.

[quote]Hardasnails wrote:
Since all his parameters are in check I suspecting low cortisol levels are not causing the thyroid to be pushed into the cell since the ferritin is good that variable is rulled out. Correcting the adrenals will probably show the true hidden hypothyroidism when the thyroid levels in the blood drop. We also see this alot in people with food allergies as we well which he has some as well as potential hidden infections that are lowering the cortiosol production. Secondary hypothyroidism due to adrenal insufficeny is what I am looking to potential cause. [/quote]

So HAN, if low adrenals are the cause, how do you strengthen them so they will produce more cortisol?

Also, is it not true that the increased metabolism due to TRT can further tax the already weakened adrenals?