T Nation

Need Help with Bloodwork Results


Hello Everyone,

I've had my bloodwork done 4 times and I am going to post the latest below. I am 35 5'10 about 17% BF and weigh 200 pounds. I work out heavy 3 times a week and do cardio the other 3 days. Each time I have been tested my testosterone shows on the far low end with this latest test being the highest and my lowest was 210.

I would please like some opinions from other men that have been through this and maybe some suggestions on how I should proceed. The cost is not an issue but my wife and I do want to have one more child. Here are the results:

LH mlU/mL 7.1 Range 1.7-8.6
FSH 3.7 Range 1.5 - 12.4 (mlU/mL)
Testosterone: 323 Range 249 - 836 (ng/dL)
Free Testosterone (Direct) 10.1 Range 8.7 - 25.1 (pg/ml)
TSH, 3rd Generation 2.750 Range 0.450 - 4.500 (mlU/mL)
Estradiol 28.4 Range 7.6 - 42.6 (pg/mL)

The only symptoms I have noticed is a general feeling of fatigue, depression, and lack of interest in most things including sex. Strength in the gym seems fine for the most part. I also have anxiety issues and take Lexapro each day.

Thanks so much for any help or advice you can provide.


Your testosterone is a bit low, and your TSH levels are elevated. Without further testing, I'd say that this looks like a possible hypothyroidism issue. Your symptoms fit this possibility very well.

Free T3, reverse T3, free T4 tests would be useful in diagnosing hypothyroidism. Cortisol AM or 24-hour saliva cortisol are useful, as well, as low adrenal function is a common side effect of hypothyroidism, and you will want to supplement cortisol before starting hypothyroidism treatment (assuming you have a thyroid condition).

Fixing a hypothyroidism issue could help bring your testosterone back to an acceptable level. At your age, TT/FT at 323/10.1 is definitely low.


ditto what Akaji said

check out stopthethyroidmadness.com/things-we-have-learned

they have lots of good information on thyroid issues.


Thanks guys. My doc supposedly did some tests at one of my earlier labs and my thyroid seemed normal
However, both my parents have had their thyroid removed and I have issues with an unexplained elevated heart rate at odd times which my doc claims is due to my anxiety issues. When it doesn't speed up for no reason it is around 59 to 65 BPM. All the sudden sometimes it will jump to 100 to 115. Had EKG done and all looks totally normal. Is there something specific I could have him check or is that all listed on the website?


Your thyroid is almost definitely not normal with a TSH of 2.75. Hypothyroidism is sometimes associated with bradycardia (heart rate below 60 BPM), but not usually tachycardia (heart rate above 100 BPM). Fitness is also correlated with bradycardia (fitness tends to lower resting heart rate; bradycardia with heart enlargement is sometimes called "Athlete's heart", which is typically benign). I find it unlikely that your fits of tachycardia (possibly atrial fibrillation, but unlikely; anxiety seems a likely explanation, though I don't know your medical history well enough to say) are related to your testosterone or thyroid issues (since you certainly don't have hyperthyroidism); have you seen a cardiologist about it?


"Normal" is a curse word here.

Normal does not equal Ideal.
+ most doctor's wouldn't know normal if it slapped them upside the head.

please get your results in your hands and post here. we can help dissect them. or check out the blood test sticky. There are some ideal ranges posted there.


Once again thanks for the help. I am going to see if I can get my thyroid tests and post them in this thread. If I can't I will get tested again and post the results. Can hypothyroidism be treated?


Yes! Most doctors will treat with something like Levothyroxine (e.g. Synthroid, Levoxyl, etc.). Some people (e.g. Stop the Thyroid Madness) have found that dessicated thyroid (literally dried and powdered thyroid, usually from a pig) is significantly more helpful as it contains a greater variety of thyroid components (i.e. contains T3 in addition to T4, while Levothyroxine only contains T4).


If I get the panel recommended by STTM would that be enough to determine if there is a Hypothyroidism issue or is there anything else I need to look into?


It depends on who you ask. STTM recommends getting the panel done, but that you treat based on symptoms - i.e. if you have a lot of hypothyroidism symptoms, you try treatment (after making sure your cortisol levels are solid) and see if that improves those symptoms. If it does, you probably have hypothyroidism, and you should continue treatment; if it does not, then you probably do not.

Most doctors will state that the TSH test is sufficient, but they will also tell you that a level below 3 (or below 5 for some doctors) is fine, and that you don't have hypothyroidism - which certainly doesn't seem to be the case for some people who have TSH <= 3 and have started treatment, and found that the treatment greatly improves their lives.

What the panel provides is the potential to show undeniable hypothyroidism, not the potential to rule out hypothyroidism (ostensibly).


I will go ahead and look into this now. First thing is to get access to my charts so I can see what has already been tested. I don't enjoy giving blood enough to do it for the lulz. Since I am clueless would treatment for Hypothyroidism be simpler than pursuing a testosterone replacement program? I am somewhat scared of any treatment but I am tired of being depressed, tired, and "flat". I tend to fall asleep when I hit the couch after work and sometimes have trouble staying awake while driving. On a somewhat embarrassing note my lack of interest is upsetting to both my wife and me.

I would always prefer to pursue natural methods but sometimes that just isn't enough.

Thank you all once again.

PS - I have not seen a cardiologist but I have had x-rays, EKG and all seems totally normal. I also workout very intensely with no chest pain or any other issues.


yes, treating your thyroid is much simpler than HRT.


One thing I forgot to mention is that my normal body temp is 97.1. I don't know if that is relevant but it has been that way for years.


One thing I forgot to mention is that my normal body temp is 97.1. I don't know if that is relevant but it has been that way for years.


upon waking or daily avg?

97.2 - 97.8 is a good waking temp
98.6 is a good avg daily temp

any lower and you have more symptoms pointing to possible thyroid issues that need to be treated.


It is 97.1 pretty much anytime I check my temp.


Im far from an expert on anything here but I am dealing with almost the exact same issues as you. I went for blood work and found out I have Lymes Disease. Within a few days of being on antibiotics my racing heart and "hot flash" problems have largely diminished. I dont know if you live in an area that Lymes is prevalent but it may be worth looking into.


Dr. Rind's site might be a little confusing, but he has some good information about thyroid/cortisol and body temperature.

chronic low body temp avg (under 98.6) = hypothyroidism
constantly fluctuating body temps = problems with cortisol levels



Well I finally got access to my charts and if there was a Thyroid test done then I don't see it anywhere. The only things I see are Metabolic Panels. Everything is in range as far as those are concerned. There was also a CBC test done that was also in line with the averages.

I sent a letter to my Doc asking about the possibility of Hypothyroidism so I will see what he has to say.

On the subject of Lyme disease. I was bit by a tick about 13 years ago and it made a red rash in the area. Don't remember if it was a bullseye or not. Never had any symptoms at the time. I suppose it could be a possibility if it was dormant all this time.


Kruxx - did you check your results vs the ideal ranges posted in the blood test sticky? Normal range does NOT equal Ideal range.

I would be willing to wager $5 that your doctor responds that he doubts you have a thyroid issue and doesn't see a need to run the test, but that he will feel your thyroid on your next appointment and go from there. Assuming he even reads the letter in the first place. (hopefully I am wrong and your doctor is one of the very rare ones who actually listens to their patients concerns and symptoms)