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Test Results Back - Very LOW T

First off, a little background info on myself.

-age 31
-height 5’11"
-waist 32"
-weight 160
-describe body and facial hair: average facial hair, shave everyday but it’s not all that thick. Normal hair on arms and legs, below average on chest/stomach
-describe where you carry fat and how changed: I have a fairly skinny/athletic body type. Body fat before I started working out was just over 14%, carried mostly in the stomach area
-health conditions, symptoms: My main symptoms are irritability and decreased moods. I also feel like I have trouble concentrating at times and my brain feels like it’s running slow at times - I guess that’s what people here refer to as “brain fog.”
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: No Rx drugs. I take a multivitamin and fish oil
-lab results with ranges: See below
-describe diet: My diet is very clean since I started getting into nutrition over a year ago. Right now I shoot for around 3000 calories a day as I’m trying to gain mass. I’ve always had trouble putting on weight and muscle mass.
-describe training: Currently workouts are short but intense. Typically around 40 minutes, 5-6x a week
-testes ache, ever, with a fever? No issues here
-how have morning wood and nocturnal erections changed: Occasional morning wood. Not near as much as I used to but I’m not thinking about getting laid 24/7 like I was when I was 18! No troubles getting an erection when needed.

I went to get tested for the first time this week and just received my results. I ordered a basic hormone panel from Life Extension as cost is a concern for me. I have insurance but it’s a high deductable plan so I pay 100% until I get up to a few grand.

So here are my results:

Test, Serum 166 (348-1197) Flagged as low
Free Test(Direct) 3.3 (8.7-25.1) Flagged as low
DHEA Sulfate 383.4 (160-449)
Estradiol <6.0 (7.6-42.6) Flagged as low
PSA, Serum 0.6 (0-4.0)

My plan is to call a local compounding pharmacy and get a recommendation for a doc (Kansas City area). What are the most cost effective treatments? From what I’ve read it seems injections are more effective than gels. Again, cost is a factor, but I am willing to spend some money to feel better.

Don’t rush in to TRT. You need more lab work, to try and find the root of the problem.

The crucial ones

Complete thyroid panel free t3 free t4 antibodies
Cortisol prolactin E2 aka Estradiol
LH and FSH to determine if primary or secondary

Check b-12 ferretin vit D and get a full CBC if possible.

You have no insurance, or a high deductible package.

Additional to Tunapancake’s post above; please go back to the sticky and note items concerning thyroid, iodine and body temperature. Post your iodine intake and temperatures.

No Rx drugs, what about OTC? Cimetidine?

Please post HDL, LDL and triglycerides.

Ask at Midwest Compounders, Troy is the pharmacist.

This looks interesting: http://www.mwcpharmacy.com/consultations.htm

I do have insurance but deductible is around $2700. After that I pay 10% of costs.

Not taking any OTC drugs.

Thanks for the heads up on Midwest Compounders. The consultation sounds interesting.

For now I’m going to order more tests.

Stay tuned…

I have the same type plan plus a HSA plan with a debit/credit card that pays for these things with pre-tax dollars.

Least cost:

Self injected testosterone cypionate, cheapest from Costco or Sam’s Club with a business membership.

hCG from midwest

anastrozole, now generic, but still not cheap, some get research chems.

Ok, received my lab results today for the additional tests recommended above. The only items flagged were Iron as high and Vitamin D as low.

I also tracked my waking body temp for 3 days:
Day 1: 97.1
Day 2: 96.7
Day 3: 96.8

Temp throughout the day ranged from 97.4 - 98.4.

Lab Results:

CMP14+LP+4AC+CBC/D/Plt
Glucose, Serum 90 mg/dL (65-99)
Uric Acid, Serum 5.4 mg/dL (3.7-8.6)
BUN 18 mg/dL (6-20)
Creatinine, Serum 1.12 mg/dL (0.76-1.27)
eGFR If NonAfricn Am 87 mL/min/1.73 ( >59)
eGFR If Africn Am 101 mL/min/1.73 ( >59)
BUN/Creatinine Ratio 16 (8-19)
Sodium, Serum 141 mmol/L (134-144)
Potassium, Serum 4.4 mmol/L (3.5-5.2)
Chloride, Serum 103 mmol/L (97-108)
Carbon Dioxide, Total 27 mmol/L (20-32)
Calcium, Serum 9.7 mg/dL (8.7-10.2)
Phosphorus, Serum 3.4 mg/dL (2.5-4.5)
Protein, Total, Serum 7.0 g/dL (6.0-8.5)
Albumin, Serum 4.6 g/dL (3.5-5.5)
Globulin, Total 2.4 g/dL (1.5-4.5)
A/G Ratio 1.9 (1.1-2.5)
Bilirubin, Total 0.8 mg/dL (0.0-1.2)
Alkaline Phosphatase, S 63 IU/L (25-150)
LDH 128 IU/L (0-225)
AST (SGOT) 22 IU/L (0-40)
ALT (SGPT) 24 IU/L (0-44)
Iron, Serum 230 HIGH ug/dL (40-155)
Cholesterol, Total 149 mg/dL (100-199)
Triglycerides 102 mg/dL (0-149)
HDL Cholesterol 60 mg/dL ( >39)
VLDL Cholesterol Cal 20 mg/dL (5-40)
LDL Cholesterol Calc 69 mg/dL (0-99)
T. Chol/HDL Ratio 2.5 ratio units (0.0-5.0)
Estimated CHD Risk < 0.5 times avg. (0.0-1.0)
WBC 4.9 x10E3/uL (4.0-10.5)
RBC 5.89 High x10E6/uL (4.14-5.80)
Hemoglobin 16.4 g/dL (12.6-17.7)
Hematocrit 49.7 % (37.5-51.0)
MCV 84 fL (79-97)
MCH 27.8 pg (26.6-33.0)
MCHC 33.0 g/dL (31.5-35.7)
RDW 13.2 % (12.3-15.4)
Platelets 221 x10E3/uL (140-415)
Neutrophils 59 % (40-74)
Lymphs 29 % (14-46)
Monocytes 7 % (4-13)
Eos 4 % (0-7)
Basos 1 % (0-3)
Immature Cells
Neutrophils (Absolute) 2.9 x10E3/uL (1.8-7.8)
Lymphs (Absolute) 1.4 x10E3/uL (0.7-4.5)
Monocytes(Absolute) 0.3 x10E3/uL (0.1-1.0)
Eos (Absolute) 0.2 x10E3/uL (0.0-0.4)
Baso (Absolute) 0.0 x10E3/uL (0.0-0.2)
Immature Granulocytes 0 % (0-2)
Immature Grans (Abs) 0.0 x10E3/uL (0.0-0.1)

TSH+T4+T3F
TSH 3.440 uIU/mL (0.450-4.500)
Thyroxine (T4) 9.9 ug/dL (4.5-12.0)
Triiodothyronine,Free,Serum 3.0 pg/mL (2.0-4.4)

Vitamin B12 and Folate
Vitamin B12 806 pg/mL (211-946)
Folate (Folic Acid), Serum >19.9 ng/mL ( >3.0)

FSH and LH
LH 3.7 mIU/mL (1.7-8.6)
FSH 4.3 mIU/mL (1.5-12.4)

Thyroxine (T4) Free, Direct, S
T4,Free(Direct) 1.38 ng/dL (0.82-1.77)

Cortisol
Cortisol 14.6 ug/dL (2.3-19.4)

Prolactin
Prolactin 8.8 ng/mL (4.0-15.2)

Vitamin D, 25-Hydroxy
Vitamin D, 25-Hydroxy 23.7 LOW ng/mL (30.0-100.0)

Ferritin, Serum
Ferritin, Serum 220 ng/mL (30-400)

Thoughts on these results?

Total Cholesterol is too low, dietary issue. Cholesterol is used to make all of your steroid hormones AND vitamin D.

Get 5000iu tiny vit-D3 oil caps at Walmart. Take one per day on-going. Double that for the first two weeks. Do not take this or other oils [fish oil], with high fiber meals!

Do you get much sun exposure to create vit-D3?

fT3 is a wee bit low, but good. Other thyroid numbers are good. But your thyroid needs to be flogged with TSH to get you there. Suggesting possibility of iodine deficiency.

I have had serum iron numbers high and low, your ferritin suggests that things are OK.

I don’t get much sun exposure in the winter. I do get a fair amount in the summer from golfing and going to the pool occasionally.

Not sure exactly what you mean by this quote. Can you clarify?
“But your thyroid needs to be flogged with TSH to get you there.”

Also, can we rule out hypothyroidism at this point or is that too premature?

I will plan on picking up some vit d3 caps. Do you recommend taking those for a while before looking into TRT? If so how long would you recommend before I check vit d levels again?

Thanks for all your help!

Your waking body temps seem too low. Your T3 and T4 seem OK, but your body has increased TSH up to push [flog] your thyroid to achieve those levels. That is an expected result of iodine deficiency.

So, what are your sources of iodine?
“”"
please go back to the sticky and note items concerning thyroid, iodine and body temperature. Post your iodine intake and temperatures.
“”"

Vit-D levels are build up and stored in the summer and depleted in seasons where you are not getting much sun light.

Been taking vitamin D supplement for about 4 weeks now. Took 2 of the 5000iu capsules daily for the first 2 weeks and have been taking 1 capsule everyday since.

Temperatures have been in the same range as those I posted earlier. Waking temps are still low, but do get up to 98-98.5 range.

We use iodized salt at our house but I don’t put a lot of salt on my food. Not real sure how to track my iodine intake. I use a food tracker online to track my calories, protein, carbs and fat, but it does not track iodine. Thoughts on this would be appreciated.

Thoughts on what steps to take next?

Waking at 97.7 or higher is good. Also need to get to 98.6 mid afternoon.

Only things to track for iodine intake is any iodine in vitamins and some iodized salt use.

See the “Thyroid Basics” post/sticky

I read the Thyroid sticky. Very good information. It sounds like my issues are very similar to what you were experiencing with low body temps but normal thyroid lab results.

I take a multivitamin that doesn’t have iodine in it. That’s the only vitamin I have been taking other than the vitamin D.

I’m interested in trying IR. You said you saw results in 2-3 days from taking 50mg daily. Did you cut back after that or keep taking 50mg every day? Also, from what I’ve read it sounds like Iodine supplements can be hard to find now a day. Any recommendation on where to purchase?

Thanks

I have been on TRT for the last several years. At first I was on the shots, then the gel and now back on the shots. I feel much better taking the shots, but after a year on the gel I was feeling like hammered crap. Have an appointment next week with my DR. I hope my levels have come up. When I started they were 99.

https://www.google.com/search?q=iodoral

Ha. Thanks for the link. Guess I had that coming. As for my first question, how long did you take 50mg per day? Did you keep taking 50mg per day or did you cut it back after a certain amount of time? I’ve been looking around and have read about people taking 25 - 100mg a day.

Everyone will be different: http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/ksman_has_a_thryoid_problem