T Nation

Received Blood Work - Advice?


#1

Hello.

A little background of myself:

29 years old
200 lbs
roughly 8% body fat
full beard - but not super thick
body hair is on the light side, younger brother is very similar to me with this

I just had my blood work done and my doctor did not go over the results as clearly as I wish he had. I have always felt as though I exhibited low-t but am confused by the below results.

The test was taken at 9:00 AM and I ate my typical breakfast prior to the blood draw.

Some additional notes on the blood work;

Cholesterol: 177
HDL: 41
Triclycerides: 130
LDL: 117
VLDL: 26

WBC: 5.2
RBS: 5.47
Hemoglobin: 16.8
Hematocrit: 49.8
MCV: 91
MCH: 30.7
RDW: 13.1
Platelet count: 177
Polys: 51.5
Lymphs: 34.8
Monos: 8.9
EOS: 2.5
Basos: 2.1

Currently on a high protein, fat diet with minimal carbs. Typical day includes foods such as, lean ground turkey, whole eggs, nuts, PB, ezekial bread, cheese.

Supplements: ZMA, whey or vegan protein powder, vitamin D.

Any help deciphering these results would be greatly appreciated.


#2

Are you currently on TRT?

Your DHEA-S is running a bit on the low side. TSH is a bit elevated (optimally should be between 1 and 2), and free T4 is slightly low (should be mid range at least).

If I were you, I would read the Thyroid sticky, take and post your body temps, and then get your RT3 (Reverse T3) tested. If it is high, then you may have adrenal fatigue.

Don’t start TRT until you get adrenals rested and healed, and your thyroid tests improve.


#3

I am not on TRT.

I just read the Thyroid sticky and adrenal fatigue and or thyroid issues do seem plausible. I am definitely going to take my temperature in the morning and see if IR can assist with my numbers.

Is asking for an RT3/T3 test common? Would that be something I can easily ask my doctor?


#4

fT3 is what gets the job done, so that should be tested
rT3 blocks fT3
We sometimes see great thyroid numbers with low temperatures and then fT3 is suspected. When numbers are off, testing rT3 is speculative. If you have a lot of stress in your life, test rT3 and AM cortisol at 8AM.

You need to be fasting for cholesterol and glucose testing.

Hematocrit is rather high given your T status. You may have trouble with TRT.

You have read the advice for new guys sticky?

IR needs to be in the the context of your iodine intake history over several months or years.

Try 25mg DHEA ED, take with fatty meal. Note DHEA–>T inside your testes.

Also need to see if you can get 98.6 during mid afternoon. We often see both low, but sometimes only one or the other.

Your diet may be EFA deficient; fish oil, nuts or flax seed meal/oil.

Get much sun exposure? Vit-D3 4000iu - 6000iu?

Prolactin or E2 do not seem to be a cause of your low T and liver seems OK too.

Is that a high fat diet? What fats?

When did this start?

See other Q’s in advice for new guys sticky.

Only simple fix that I can see would be a correctable thyroid issue. We sometimes see low thyroid levels pulling down T levels.


#5

KSman - thank you so much for the reply.

Fats in my diet come from: cheese, nuts, PB, olive oil, coconut oil, whole eggs.

I work in an office so I get minimal sun exposure during the week. I just started supplementing with 2000 IU’s of Vit-D but can easily increase that.

I cook all my meals using pink sea salt - have been doing this for years. I can almost guarantee I get zero iodine in my diet. This is why I was thinking of starting the IR protocol which you wrote up on.

I still need to read the advice for new guy’s sticky - and I will certainly look into DHEA. Sounds promising.

How does one test rT3 and cortisol levels - is this blood work?


#6

How does one test rT3 and cortisol levels - is this blood work? -yes, lab work

So you are iodine deficient. Your thyroid may be enlarged, asymmetric or lumpy. You can look in the mirror and feel around.
Feel cold easy? Dry skin or nails?

When you do IR, you will shift everything and the prior labs are not so useful then. So may not make sense to spend time and $$$ on labs now. However IW will suggest thyroid antibody testing first.

Suggest that you slowly work up to your IR dose and not jump right in.


#7

I don’t get cold easily, and my skin does not get dry.

I do see other signs such as low energy, slight depression, and some concentration issues. I often get swollen lymph nodes, not sure if this is tied to thyroid issues at all.

I did purchase DHEA and began taking the suggested 25mg and day, and now I will be taking additional vitamin D. Do you feel it would be safe to start slow with the IR while monitoring my temperature?

Thanks


#8

Quick update:

8/27 - temp at night 96.5
8/28 - temp in the morning 97.1 (A/C was not on)
temp in afternoon 96.8


#9

I really don’t think testosterone is the major problem here. TT 500 is pretty good and with proper supplementation you’ll probably be able to get that up to 600-650 or maybe even 700. Though FT is what really matters. Estrogen looks good here.

Thyroid is a problem. Your really want your TSH around 1 and your fT4 to be in the upper quartile. Also need to check for fT3 to see if that is up in the upper end.

Your doctor did not check cortisol or DHEA-S. Best to have 4 x cortisol saliva test to see where your cortisol is at. If adrenal function is bad, improving that will improve both the thyroid and HPTA axis, leading you with higher testosterone as well as higher thyroid function.


#10

KSman - do you recommend reading Dr. David Brownsteins book on iodine?

Also, I have read about supplementing with selenium when taking iodine. I began taking iodrol which has no selenium in it. I am on day 2 and actually felt somewhat better today even though my morning temperature was at 96.8.

If taking selenium is a necessary component to take with iodine (I believe this is to combat toxicity) what amount would you need to take in context with a typical iodrol 12.5mg tab.

Thanks again!