T Nation

MY Testing Labs

I know KSman posted some labs to be done before starting TRT, but here is what my doctor wants me to test one week prior to our next appointment. I will be out of town one week prior to the next appointment. Would it be okay if I test it a day before, or two weeks before the next appointment? Is this even a concern? I have been arguing with my PCP for over a year about having this done and she finially referred me to a endo that is a TRT specialist. Is there any other testing that I should have done that my doctor did not think of? Below is the list of labs that the doctor is requesting me to have completed.

TESP-Testosterone free and total
CORTR-Cortisol
PROL-Prolactin
B12-Vitamin B12
FERR-Ferritin
T3F-T3 Free
TSH
LH
SHGB
FSH
FT4- T4 Free

DHEA-Sulfate

Here are my recent labs. If I can get some feedback I will be very appreciative.

PinnacleHealth

TESTOSTERONE FREE: 03/07/2014 08:16
Result
TESTOSTERONE FREE: 53.8
TOTAL TESTOSTERONE: 208

Comments:
TESTOSTERONE FREE: TESTOSTERONE FREE Reference range: 50.0 to 210.0
TESTOSTERONE FREE Unit: pg/mL
TESTOSTERONE FREE (Note)
TESTOSTERONE FREE: Free Testosterone reference ranges are from Tietz Clinical
TESTOSTERONE FREE Guide
TESTOSTERONE FREE to Laboratory Tests; A.H. B Wu, 2006. P1012.
TESTOSTERONE FREE Test performed by Central Pa Alliance Labs, LLC
TOTAL TESTOSTERONE: TOTAL TESTOSTERONE Unit: ng/dL
TOTAL TESTOSTERONE (Note)
TOTAL TESTOSTERONE Effective 12/13/2010: reference ranges changed
TOTAL TESTOSTERONE due to restandardization to WHO IRP 95/560.
TOTAL TESTOSTERONE Testosterone Interpretive Data:
TOTAL TESTOSTERONE Males:
TOTAL TESTOSTERONE 20 to 49 yrs: 160 to 726 ng/dL
TOTAL TESTOSTERONE >=50 yrs: 129 to 767 ng/dL

SEX HORMONE BINDING GLOB: 03/07/2014 08:16
Result
SEX HORMONE BINDING GLOB: 10

Comments:
SEX HORMONE BINDING GLOB: SEX HORMONE BINDING GLOB Reference range: 10 to 50
SEX HORMONE BINDING GLOB Unit: nmol/L
SEX HORMONE BINDING GLOB (Note)
SEX HORMONE BINDING GLOB Test Performed by Quest, Chantilly,
SEX HORMONE BINDING GLOB Quest Diagnostics Nichols Institute,
SEX HORMONE BINDING GLOB 14225 Newbrook Drive, Chantilly, VA 20151
SEX HORMONE BINDING GLOB Kenneth Sisco, M.D., Ph. D., Director of Laboratories
SEX HORMONE BINDING GLOB: Test performed by Nichols Institute Quest Diagnostics

VITAMIN B12
Result
VITAMIN B12: 284
Comments:
VITAMIN B12: VITAMIN B12 Unit : pg/mL
VITAMIN B12 (Note)
VITAMIN B12 Low: <146 pg/mL
VITAMIN B12 Indeterminate: 146 to 180 pg/mL
VITAMIN B12 Normal: 181 to 1500 pg/mL
VITAMIN B12 Test performed by Central PA Alliance Labs, LLC

CORTISOL, SERUM: 03/07/2014 08:16
Result
CORTISOL, SERUM: 8.3

Comments:
CORTISOL, SERUM: CORTISOL, SERUM Unit: mcg/dL
CORTISOL, SERUM (Note)
CORTISOL, SERUM Expected ranges:
CORTISOL, SERUM 8:00 AM: 10.0 to 25.0 mcg/dL
CORTISOL, SERUM 4:00 PM: 2.0 to 15.0 mcg/dL
CORTISOL, SERUM Test performed by Central PA Alliance Labs, LLC

LUTEINIZING HORMONE: 03/07/2014 08:16
Result
LUTEINIZING HORMONE: 7.40

Comments:
LUTEINIZING HORMONE: LUTEINIZING HORMONE (Note)
LUTEINIZING HORMONE Normal Ranges
LUTEINIZING HORMONE
LUTEINIZING HORMONE Males; 1.24-8.62 mIU/ml

FSH: 03/07/2041 08:16
Result
FSH: 4.90

Comments:
FSH: FSH (Note)
FSH Normal Ranges
FSH
FSH Males: 1.27-19.26 mIU/ml

TSH: 03/07/2014 08:16
Result Flags Range
TSH: 6.720 H 0.35-5.50

PROLACTIN: 03/07/2014 08:16

            Result

PROLACTIN: 8.40

Comments:
PROLACTIN: PROLACTIN (Note)
PROLACTIN Normal Range
PROLACTIN
PROLACTIN Males: 2.64-13.13 ng/ml

FERRITIN: 03/07/2014 08:16
Result Flags Range
FERRITIN: 235.0 24.0-336

T4, FREE: 03/07/2014 08:16
Result Flags Range
T4, FREE: 1.00 0.56-1.64

T3, FREE: 03/07/2014 08:16
Result Flags Range
T3, FREE: 3.4 2.5-3.6

Comments:
T3 FREE: T3 FREE NOTE NEW NORMAL RANGE EFFECTIVE 6/12/2013

With my TSH coming back as Hypo, the Doctor wants to try and treat that first saying my low test is a possible direct result of my TSH Levels. She wants to run more tests to see what else might be the problem. Also because of my CORTISOL, SERUM levels coming back low she wants me to do the ACTH Simulation test with Cortisol. I have not a single clue about this test, I just know it takes an hour to do. The more labs she wants me to do now is:
ACTH Simulation Test with Cortisol
TSH
FETIB; Iron and Tibc
FE; Iron
AMCR; Anti-tpo (Microsomal) AB (AMCR)
IGF1; IGF-1
LIVR; Hepatic Function Panel

I don’t even know if these tests are even necessary, and I don’t want to take what my idiot has to say at face value either. Please help with your feedback. I also got my lipds test the day before these last panels, but I haven’t seen the results yet. Sorry I don’t have them. Also my diet is very very very clean. I know most people say that, but I have been a Performance Trainer for over 8 years now. My Macro’s are 45% carbs 33% pro and 22% fat on a 2800 calorie per day diet. I weight 181 lbs and I don’t know what my body fat percent is right now.

That’s an interesting set of labs. You’re TSH and T4 are pretty shitty, but your T3 looks pretty damn good.

I’m not a doc and never treated anyone but myself, but I’m not sure I’d go into full on thyroid treatment. Might want to read the stuff on iodine deficiency KSman has posted.

You’re cortisol is really low and definitely worth looking into. Been there. Good luck with the ACTH test. Most docs don’t have a fucking clue how interpret results. If you fail, they say your adrenals are shot and treat. If you pass, you’re perfectly fine. They never question why your levels are low and your body isn’t sending sufficient ACTH on its own. idiots. Decent article with some stuff you can try http://www.T-Nation.com/free_online_article/sports_body_training_performance_nutrition/the_truth_about_adrenal_fatigue

Quite frankly, I don’t think any of these are going to make much of a difference until you get T into a reasonable range. Good luck with your doc, but I would start looking for an endo, urologist or anti-aging clinic that will put you on a decent trt protocol. I’m not one to recommend TRT off the jump, but I can certainly understand how you’re feeling with that BW. I had similar levels of T and cortisol and felt like absolute shit. TRT was life changing. I’m now figuring I can do without it, but it was a life preserver I desperately needed. If your average doc weren’t mostly useless in this area, you might be able to work from the ground up, but that’s not the world most of us live in.

[quote]dhickey wrote:
That’s an interesting set of labs. You’re TSH and T4 are pretty shitty, but your T3 looks pretty damn good.

I’m not a doc and never treated anyone but myself, but I’m not sure I’d go into full on thyroid treatment. Might want to read the stuff on iodine deficiency KSman has posted.

You’re cortisol is really low and definitely worth looking into. Been there. Good luck with the ACTH test. Most docs don’t have a fucking clue how interpret results. If you fail, they say your adrenals are shot and treat. If you pass, you’re perfectly fine. They never question why your levels are low and your body isn’t sending sufficient ACTH on its own. idiots. Decent article with some stuff you can try http://www.T-Nation.com/free_online_article/sports_body_training_performance_nutrition/the_truth_about_adrenal_fatigue

Quite frankly, I don’t think any of these are going to make much of a difference until you get T into a reasonable range. Good luck with your doc, but I would start looking for an endo, urologist or anti-aging clinic that will put you on a decent trt protocol. I’m not one to recommend TRT off the jump, but I can certainly understand how you’re feeling with that BW. I had similar levels of T and cortisol and felt like absolute shit. TRT was life changing. I’m now figuring I can do without it, but it was a life preserver I desperately needed. If your average doc weren’t mostly useless in this area, you might be able to work from the ground up, but that’s not the world most of us live in.[/quote]

Thank you for your feedback. Sometimes I feel like I’m going crazy, because my Doctors tell me I’m Fine when I know I am not. I feel like I cannot think, almost like a really bad hangover, plus the feeling of being drunk and weak.