T Nation

Please Evaluate My Lab Report


#1

Hello,
Age: 40 5'11 197lbs. Treadmill 3 times a week per 30 min. No drugs, no smoking, casual drinking.
So I went to the Urologist a week ago bc since 3 months I was feeling very weird, DOWN and depressed, very low libido, ED. I had NEVER heard of low testosterone and never had a problem. I get my results back and did some research, and I think I have Secondary Hypogonadism.

Why the HELL do I have SUCH low numbers for LH, FSH , total and free test?
How severe is my Secondary Hypogonadism? (I'm freaking out)
What are my treatment options?

REPORT:
Out of Range (1)

LH    0.9    Low In Range High 1.5-9.3 mIU/mL

Additional Results (7)

FSH 1.7 Low In Range High 1.6-8.0 mIU/mL

TESTOSTERONE, TOTAL, LC/MS/MS
335 ng/dL

FREE TESTOSTERONE
61.3 pg/mL

NEUTROPHILS
50.7 %

LYMPHOCYTES
40.3 %

MONOCYTES
7.8 %

EOSINOPHILS
0.6 %

BASOPHILS
0.6 %

In Range (35)

GLUCOSE
84
Low In Range High
65-99 mg/dL

       Fasting reference interval

UREA NIT...
16
Low In Range High
7-25 mg/dL

CREATININE
1.08
Low In Range High
0.60-1.35 mg/dL

eGFR NON...
85
Low In Range
> OR = 60 mL/min/1.73m2

eGFR AFR...
99
Low In Range
> OR = 60 mL/min/1.73m2

BUN/CREA...
N/A

SODIUM
138
Low In Range High
135-146 mmol/L

POTASSIUM
4.6
Low In Range High
3.5-5.3 mmol/L

CHLORIDE
105
Low In Range High
98-110 mmol/L

CARBON D...
25
Low In Range High
19-30 mmol/L

CALCIUM
9.5
Low In Range High
8.6-10.3 mg/dL

PROTEIN,...
8.0
Low In Range High
6.1-8.1 g/dL

ALBUMIN
4.7
Low In Range High
3.6-5.1 g/dL

GLOBULIN
3.3
Low In Range High
1.9-3.7 g/dL (calc)

ALBUMIN/...
1.4
Low In Range High
1.0-2.5 (calc)

BILIRUBI...
0.7
Low In Range High
0.2-1.2 mg/dL

ALKALINE...
65
Low In Range High
40-115 U/L

AST
28
Low In Range High
10-40 U/L

ALT
22
Low In Range High
9-46 U/L

WHITE BL...
5.2
Low In Range High
3.8-10.8 Thousand/uL

RED BLOO...
4.66
Low In Range High
4.20-5.80 Million/uL

HEMOGLOBIN
14.5
Low In Range High
13.2-17.1 g/dL

HEMATOCRIT
42.5
Low In Range High
38.5-50.0 %

MCV
91.3
Low In Range High
80.0-100.0 fL

MCH
31.1
Low In Range High
27.0-33.0 pg

MCHC
34.1
Low In Range High
32.0-36.0 g/dL

RDW
13.3
Low In Range High
11.0-15.0 %

PLATELET...
198
Low In Range High
140-400 Thousand/uL

ABSOLUTE...
2636
Low In Range High
1500-7800 cells/uL

ABSOLUTE...
2096
Low In Range High
850-3900 cells/uL

ABSOLUTE...
406
Low In Range High
200-950 cells/uL

ABSOLUTE...
31
Low In Range High
15-500 cells/uL

ABSOLUTE...
31
In Range High
0-200 cells/uL


PSA, TOTAL
0.9
In Range High
< OR = 4.0 ng/mL

This test was performed using the Siemens
chemiluminescent method. Values obtained from
different assay methods cannot be used
interchangeably. PSA levels, regardless of
value, should not be interpreted as absolute
evidence of the presence or absence of disease.


#2

The only thing that at a glance looks severe is the LH, but in actuality a single lab result of this does not mean much, as levels fluctuate greatly even within a space of minutes. It's luck as to whether a test happens to be at a momentarily high point, a momentarily low point, or somewhere inbetween.

Your free test is certainly not genuinely good, but by most standards would not be severely bad. Total test follows from free test and SHBG; it will be fine once free test is fine.

I would go back and check estradiol level.

It may be that this is relatively high, and if it is, that could be the cause of all this, and is eminently fixable.


#3

thanks.
are low libido and ED typical/common with these kind of numbers?


#4

We need lab ranges. Especially for FT [free testosterone]

Meanwhile, read these stickies:
- advice for new guys - need more info about you
- things that damage your hormones

Labs:
E2
prolactin
TSH
fT3
fT4 [not T3, T4]

Have you been using iodized salt continuously for years - or are iodine deficient?

Treatment:
Self injecting is best and least cost. Big pharma has a host of other costly products. If you have thyroid problems, you probably will not be able to absorb transdermal products. Biggest problem is that most doctors are rather ignorant and/or stupid about these things. We have a sticky for finding a TRT doc too.

When did problems seem to start? Any blows to the head prior to that?
What is your waist size?


#5

According to Quest Diagnostics
Age Total Test-a Free Test-b Free/Bioav test-c
(years) (ng/ml) (ng/ml) Free (pg/mL) Bioavailable (ng/dL)
18-69 250-1100 35-155 46-224 110-575
70-89 250-1100 30-135 6.0-73 15-150

a Test codes 15983, 36170, 14966.
b Test code 36170.
c Test code 14966.


Have you been using iodized salt continuously for years - or are iodine deficient? YES.

"
Treatment:
Self injecting is best and least cost. Big pharma has a host of other costly products. If you have thyroid problems, you probably will not be able to absorb transdermal products. Biggest problem is that most doctors are rather ignorant and/or stupid about these things. We have a sticky for finding a TRT doc too."
TRT is NOT for people with Secondary Hypogonadism. It's for Primary Hypogonadism.

When did problems seem to start?
Problems with libido and ED like 6-8 months ago, and became severe 3 months ago.
Any blows to the head prior to that?
Never
What is your waist size?
34 inches


#6

yes ...using iodized salt for years.
are low libido and ED typical/common with these kind of numbers?


#7

Your sexual symptoms, mood and energy are consistent with your lab results.

At your age, TRT is what is needed for your secondary hypogonadism unless labs disclose a correctable cause. I suggested labs. The acute onset makes the quest to find the cause more urgent. Both because the cause may be on-going or worsening and also because it might be correctable as it could be non age related.

Who told you this?
"TRT is NOT for people with Secondary Hypogonadism. It's for Primary Hypogonadism. "

You should not have any problems getting TRT. But its always a problem finding a knowledgeable and caring doctor. We have a sticky for that.


#8

ok. i have an appointment on tuesday. we will see.
thnaks


#9

i read that trt is not for secondary hypogonadism since it will shut down my natural production mechanism. since lh and fsh are low, indicates some problem with the hypothalamus or pituitary gland, and that the problem is not testicular (primary hypogonadism)


#10

If you are secondary and cant find a reason and fix it, there is no other option to TRT.

All TRT shuts down pituitary secretion of LH/FSH and the testes then shrink if you don't inject hCG. Some can use a SERM, but that is not preferred and may not work with some secondary cases.

Some young guys can do hCG alone [mon0-therapy], but does not work with old guys.

Your understanding is confused. If you are primary or secondary, your T production is shutdown. Primary cannot be fixed. Sometimes secondary can be.

197# seems heavy for a 34: waist.
What time line for weight gain VS sexual issues?
Please see all points in my prior post and REQUIRED reading.


#11

weight 190-205 last 10 years. not fat, some minor love handles. look average to thin appearance.
sexual problems: 1.5 years ago to 8 months ago had some decent libido + 1-2mg cialis = great response.
4-5 months ago noticed some decline , needed more like 3mg cialis.
about 3 months ago i drank like 4 shots of that illegal moonshine. i did not know it was illegal and bad for u. maybe that messed up the hpt axis somehow.

3 months ago to now felt like crap physically/mentally down, no energy, 5-8mg cialis needed.
but right now i dont feel physically/mentally down. i even play softball for 3 hours on sundays, 1.5 hours on weds, and 30 min 3 times a week treadmill with no energy problems.
i feel like my body is recovering except for the low libido and ed for now


#12

Went to the Urologist but end it up seeing the NP.
He said I'm fine and I do NOT have a problem.
Told me to buy Stinging Nettle, and that should make more Bio available testosterone.
In 5 months, To get tested for TSH, t3, t4, estrogen, SHBG and total/free testosterone.
Why not get tested NOW and then in 5 months and compare?
In 6 months, another appointment.
Asked him about low libido and ed and I needed Cialis in the meantime. TOLD ME I WAS FINE. I told him based on those low numbers, those are typical problems. (Which he knew from before and should know from lab results), and TOLD ME I WAS FINE... implying I don't need it, like I was making it up. WTF?
I insisted and Gave me 2 samples of 30 day Cialis 5mg.
These f...ing Drs, NPs in the medical field don't give a shit and/or are incompetent.


#13

You can order lab tests yourself. I would test estradiol and thyroid panel including free T3 as the next thing, as apparently none of this has been done.


#14

Can I just go to quest diagnostic and request them with no lab order?
Please tell me all the tests that I need To get all done at once. Don't eat to keep going bac
k


#15

I haven't personally tried that at Quest, but I don't think so. Some of the testing chains have some tests which a customer can self-order, but for most tests a prescription is required.

I get mine through the LEF . org website.

Others have posted recommendations of alternates.

If not wanting to go back and forth, I'd test everything mentioned above by either KSman or myself.


#16

Thanks, will do all mentioned tests on my own.
what do u think of progene daily complex?
will it help temporarily and mess me up if I stop taking it?
What do u think of the np's comments and diagnosis and treatment option?


#17

I didn't find anything hopeful in the ingredient list.

I'd expect starting and stopping to make no difference. If you particularly pick up the effect of taking B vitamins, you could notice that difference. Some will notice a difference in how they feel with 50 mg/day DHEA, but most don't, and starting and stopping will not be a problem.

The naturopath was a one-man frikkin' idiots convention.


#18

Thanks.
Besides the "Stinging Nettle", Zinc and fish oil,
I read DHEA causes testicles to shrink... WHY? I would not want that. boldness, etc.
I read about Tongkat Ali, Opinions?
What else can I take that will help me naturally and NOT mess me up or create dependency as a result of taking?


#19

Tongkat Ali when properly standardized and dosed has some effectiveness as a prosexual agent but has become a very expensive raw material. Even then, I don't think it's an answer to actual deficiency.

50 mg/day DHEA won't cause testicles to shrink. But it also won't do much at all of any kind.

There really is no herbal solution to actual testosterone deficiency.

A thing to consider trying for a person who is able to do so is to try HCG, at for example 500 IU 3x/week. If that puts testosterone to high normal, or sometimes even above the normal range, then there is no problem with the testes. It also might prove a suitable long term therapy, though if possible I'd rather have natural LH production restored.

We still don't have your estradiol test results, so that would be jumping ahead. If for example your estradiol level is too high, that could explain your condition, and all that would be needed would be an anti-aromatase (again, unfortunately no effective herbal remedy.)


#20

will report back in 2-4 weeks with lab results, gonna use ur lab.
people in this forum are great source of knowledge.
thanks for responding