T Nation

Trying to Feel Better


Hey guys, I just got my labs back from the doctor. I'm not on TRT, but considering it as an option if it would help. For several years now I've had severe joint pain, fatigue, brain fog, and just generally felt shitty. I usually wake up feeling like a one-hundred year old man.
I'm hoping I can get some advice about what my results mean before I talk to the doctor. It looks to me like I'm slightly dehydrated, although I drink a good deal of water. I plan on adding iodine per the stickies, and am in the middle of Wilson's book.

My TT looks fine, but I'm unsure where a FT of 10.2 puts me. Some thing I read suggest anything under 15 for my age range is low, where as others suggest low is in the 6 range. My estradiol is low as well, which I've read can cause joint pain and body fatigue. I'll post the lab and sticky information below.

-age - 29
-height 5' 6''
-waist 36 inches
-weight 185
-describe body and facial hair
-describe where you carry fat and how changed - hips, stomach, general middle area, always been like this.
-health conditions, symptoms
joint pain that shifts and moves around (back is the worst)
brain fog, difficulty concentrating
fatigue (some days much worse than others, but rarley good)
anxiety, social withdrawl (again, some days worse than others)
libdo is still decent, althoguh not the same as it used to be.

-Supps - glutamine, creatine, 4g fish oils, multi vitamin, glucosamin, Vit D.
-describe diet - 1600 off days (lower carbs). 1900 on days- 50-60g fat a day.
-training - 4 day split, a little cardio if I have the energy
-testes ache, ever, with a fever? no
-how have morning wood and nocturnal erections changed - still have

Glucose 70-100 mg/dL 88
BUN 6-22 mg/dL 23
Creatinine 0.80-1.30 mg/dl 0.98
BUN/Creatinine Ratio 15.0-20. 23.5
Sodium 135-145 meq/L 139
Potassium 3.5-5.3 meq/L 4.3
Chloride 99-110 meq/L 100
CO2 23-32 meq/L 29
Anion Gap with K 6-20 meq/L 14
Calcium 8.5-10.2 mg/dL 9.7
Protein Total 5.5-8.2 g/dL 7.7
Albumin 3.5-5.0 g/dL 4.9
Alkaline Phosphatase 30-125 U/L 61
AST - SGOT 0-33 U/L 33
ALT - SGPT 0-36 U/L 43
Bilirubin Total 0.2-1.2 mg/dL 0.9
Age 29
eGFR Non-African American >=60 mL/min/1.73m2 90
eGFR African American >=60 mL/min/1.73m2 >90
Fasting Yes, No, Unknown No

T4 Free 0.7-1.5 ng/dL 1.0
T3 Free 1.7-3.7 pg/mL 2.4
TSH 0.40-5.00 uIU/mL 1.59

Estradiol 25-50 pg/mL 20
Testosterone 240-871 ng/dL 707
Testosterone Free 46.0-224.0 pg/mL 102.6


Yes, your thyroid levels are consistent with ?mild? iodine deficiency. Were you not using iodized salt?

Your typical symptoms are also easily explained by low thyroid function. - but not joint pain
Including your weight+waist

Please check your oral body temperatures:

  • when you first wake up, should be 97.7-98,8 and higher is also good, 97.3 is a problem
  • can you get 98.6 mid-afternoon?

You need selenium with your added iodine, found in many multi-vits, look for iodine+selenium

E2=20 does not explain joint pain
Could you have had a tick bite and have Lyme disease?
Any exposure to tropical diseases or malaria?

Any testicular aches or pains? Testicular cancer is a young man’s disease. There can also be vascular abnormalities that typically are corrected by surgery.

You could test LH/FSH, but will be in a normal range that will not help. But LH/FSH should always be done prior to TRT.
If LH/FSH is low, then one checks prolactin with younger males as a possible HPTA depressant.

AST/ALT suggest some liver issues and might relate to the unknown cause of joint pain.
Some here have cholesterol that is too low, so can be tested. If <160, there can be issues.

Muscle cramps? If so, get a magnesium supplement.
This product works well for me: https://Biotest.T-Nation.com/products/all?utf8=✓&search_text=zma&commit=

For now; look at iodine + body temperatures and also consider that joint pain and liver enzymes might be pointing to different problems. So you appear to have multiple issues. We can eliminate AST/ALT as an issue if your had sore muscles from training at time of blood draw.

Any unexplained weight loss or rashes?


Thanks, I really appreciate the response.
I’ll edit with my temps in the next day or two. I’m definitely cold throughout the day, and then usually by the time I have my last meal in the evening I feel almost hot. I used iodized salt in the past, but haven’t for a while, and never really focused on it as a problem.
As far as I know I’ve never had a tick bite, nothing with the tropics ect.
No weight loss per se, although my weight does fluctuate pretty considerably depending on my sodium intake, which Iâ??m reading in wilsonâ??s book is often a problem with adrenal fatigue.
No rashes of any kind.
No testicular pain, however I do get some upper groin area pain from time to time. Itâ??s possible I have kidney or gull stones, and might mention this to my doc.
I trained heavy all week prior to the tests so that most likely explains the ALT/AST; I’ve also had a liver ultrasound a couple years prior for just that reason, and everything came back fine.
As you suggest Ill focus on the iodine and body temps, and see how that effects my energy levels during the next few weeks. I ordered some lodoral supplements, and Iâ??ll start adding iodized salt as well.


The pain that you describe could be a hernia.
These are relatively common: https://en.wikipedia.org/wiki/Inguinal_hernia
Doctor can poke around and determine or rule out in a couple of minutes.
If so, heavy lifting where you are holding your breath, grunting and straining can make that worse.
Doc can detect vascular abnormalities in the testes at the same time.