Unexpected Lab Results (Part II) and Condensed

Was on Sertraline at the time these labs but have since gone off successfully so far.

My primary complaint is fatigue, exhaustion and lack of desire to do anything including fun including sex.

No Keto, IF, finasteride or Accutane

Testosterone: 1995 ng/dL (0.320-1100)
Free Testosterone: 133.7 (35.0-155.0)
SHBG: 146 nmol/L (10-50)
Prolactin: 17.4 ng/ml (Not listed)
THS: 3.871 ilU.L (0.320-5.550)
Estradoil: 50pg/ml (Not listed) BUT flagged as “High”
DHEA: 217 us.dL (Not listed)
FSH: 7.4miU/ml (Not listed)
LH: 8.3mIU/ml (Not listed)

T3F 2.79 (2.3-4.2)
T4F 1.40 (.50 -2.50)
T3, reverse 22 (8 - 25)

Testicular ultrasound negative, BetaHtcgtm negative,

HERE IS MY ENDOCRINOLOGIST’S FINDINGS She had nothing to say about my thyroid or sertaline being a problem

As we reviewed today:
->your total testosterone is elevated but this is because SHBG (sex hormone binding globulin) the carrier protein for testosterone is elevated (in fact the free testosterone is normal)
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->other hormone testing is also normal with the exception of estradiol being slightly elevated = which is likely the culprit for the elevated SHBG testing
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->in terms of the etiology for the slightly elevated estradiol=your testicular ultrasound and HCG testing is normal so this is not coming from the testicles per se. I recommend a CT scan of the adrenal glands to verify that there is no abnormality in the adrenal glands (which is another source of estradiol precursors so can potentially cause elevated estradiol). In the end if all the additional testing is normal, then by diagnosis of exclusion the elevated estradiol is coming from increased extraglandular aromatase activity. That said, for a few years I will recommend your primary care doctor continue to assess your hormone levels periodically
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->unfortunately this doesn’t explain why you are felling unwell which is why you sought medical attention in the first place, I recommend some 8-9 am fasting blood work (additional testing to rule out contributing factors that could be implicated in your fatigue symptoms)
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->I recommend you have a sleep study to rule out potential sleep apnea,

She ordered cortisol, Kidney function B12 and Vit D also ordered a CT of my adrenals and brainstem.

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