T Nation

To KSMAN: Lab Results In... Need Advice

Since KSMAN is so knowledgeable I was hoping for his help. But anyone who knows their shit can help. I’m 42 and started TRT. These lab results are from BEFORE I started TRT.

I’m always tired. I wake up with my entire body stiff and in pain. I always have brain fog, depression, and severe anxiety.

Here Are My Results:
Date: 6/21/2017
Age: 42


Testosterone Free Total -Out of Range 315.0 L
SHBG -Out of Range 26.9
Testosterone Free -Out of Range 6.5 L

T3 Reverse, LC/MS/MS. 10 ng/dL Normal Range: 8-25
TSH 3.48
Free T4 0.94
Free T3 3.6
TPO Antibodies 13.80

Occult Blood -Out of Range. Moderate
RBC -Out of Range. 26-50

CBC with differential
RBC -Out of Range. 5.76 H 3.80-5.60
Hematocrit -Out of Range. 53.10 H 35.00-47.00
Cholesterol Total 268.0 H
LDL 179.0 H
Triglycerides 185.0 H
Non-HDL-C 216 H
VLDL 37.0 H
Creatinine 1.2
Microalbumin/Creatinine Ratio 31.2 H (Shows some issue with kidneys…I have hematuria…could this be why these values are off?))
Microalbumin 34.6 H. (Shows some issue with kidneys)

wrong forum

Sorry,where should I post it?

You’re good, @cipher7836. Your thread has been moved to the T Replacement forum.

Problem with the kidneys or simple bleed from a kidney stone. Radiology to resolve that.

You need to avoid iron fortified:
vitamins, bread, pasta, cereals, rice

  • read labels

Donate blood if you are able, otherwise have it removed.
Mini aspirin and fish oil to improve blood flow.

I still do not memorized lab ranges, which can vary from lab to lab. Please directly edit to add in your above post.

TSH is way too high.
rT3 is good
more with lab ranges

Urine and CBC sections are mixed.

Taking Vit-D3

Ever tested AM cortisol?

Do you get leg/food cramps? - magnesium deficiency that otherwise affects muscle tone.

Anything else I need to know?
TRT protocol etc?

Thanks,KSman. I’ll repost the labs with the reference ranges. I just reposted the hormone specific information where N = The Lab Reference Range.

Testosterone, T = 315.0 L N = 348.0 - 1197.0 ng/dL
SHBG = 26.9 N = 16.5 - 55.9 nmol/L
Testosterone, F = 6.5 L N = 9.0 - 30.0 ng/dL:

T3 Reverse, LC/MS/MS. = 10 ng/dL N = 8 - 25 ng/dL
TSH, 3rd Generation = 3.48 N = 0.400 - 4.500 uIU/mL
Free T4 = 0.94 N = 0.89 - 1.76 ng/dL
Free T3 = 3.6 N = 1.8 - 4.2 pg/mL

As for TRT Protocol I’m on Androgel 2 squirts a day at: 1.62% So according to the bottle I’m getting 40.5 mg.

I do get where my toes lock up if I flex them too much. I also get some cramps in them.

I’m taking a sleep study because I have sleep apnea. Sometimes I wake up gasping.
The doc told me that he could give me tons of T but without proper sleep it won’t help me much. I also read where sleep apnea can cause an elevation in the red blood cells.

I noticed that cortisol wasn’t checked. There’s also no entry for LSH, FSH, or E2.

A magnesium supplement will help with cramps and perhaps sleep to some extent. This site’s Biotest store sells ‘ZMA’. The amounts of magnesium needed are very large and usefully can’t be part of a multi-vit.

TSH should be nearer to 1.0, 3.48 is a major problem.
Thyroid lab ranges are mostly useless.
fT4 is below mid-range, possible iodine deficiency.
fT3, the active hormone is above mid-range, sort of odd.

Really need your oral body temperatures and history of using iodized salt.

Your high TSH and strong fT3 do not make sense when rT3 is low. Your case is not fitting a well known pattern so far.

No lab results on TRT? Too late now to check LH/FSH, they–>zero.

With thyroid problems we see many who simply cannot absorb transdermal T products. With your thyroid profile so far, could swing either day.

Transdermals are highest cost and absorption is unpredictable and variable, also having the highest T–>E2 potential. Self-injected T is least cost and 100% absorbed. Most need an aromatase inhibitor [AI] to manage E2 at an optimal level. Injected hCG prevents the testes from, shrinking and a possible low level 24x7 ache.

Please to the reading and reread my posts to see what you missed drinking from the fire hose.

“No lab results on TRT?” -Do you mean what the labs are after TRT? I just started back on Androgel ten or eleven days before. So these labs reflect what my blood was BEFORE starting TRT. Is that what you mean?

As for temp…my body temp has always been 97.7. After reading one of your posts a while back I started using iodized salt. However, my wife went shopping two months ago and I noticed yesterday that the salt had no iodine in it!

My wife got wrong salt years ago and that was the start of my thyroid issues. Toss it out.

My big fear is that I’m still going to be chronically tired and brain fogged forever. It’s been years like this for me. I’ve lost jobs because of it. I used to be in awesome shape and strong as hell…now I hardly work out because I feel so damned drained.

My current doc isn’t a hormone specialist. Even the ones that supposedly are don’t know shit. I doubt my doc would let me use injectables, an AI, and HCG shots.

I’ve seen tons of different docs for years, and here I am no better. I feel like my youth has been eaten up. I feel like a little, old man.

I forgot to add that my wounds heal slowly. I have a mosquito bite I scratched that still hasn’t healed after 5 months! Last year I did three sets of squats. The next day I woke up with fatigue and an upset stomach. I missed two days of work. Whenever I work out too hard the same thing happens.