T Nation

Weird Lab Results


#1

Hey guys, 1st time poster long time lurker here. I'll try to keep this as brief as possible as I'm currently at work. Did my 1st cycle of AAS over the summer. 10 weeks of Test E, started at 325mg a week and upped it to 400 (not the smartest I know) With 50 mg of Tbol from week 6-10. Started pct 2.5 weeks after last shot, with a clomd 100/50/25/25 protocol as well as .5 Adex EOD.

Long story short, got nice strength gains, moderate size gains which seemed more from the Tbol. Overall I'd say my results were 6/10. Fast forward to late November 2014, and I start noticing something "off" downstairs. During intercourse (with or without a partner) my ejaculate volumes started decreasing. Eventually it got to a point where just a tad of fluid would dribble out and would literally feel like I was blowing hot air out my member. At this point my strength and size gains started to subside as well.

Went to get my labs from Direct labs. Didn't really suspect much was up and was basically looking for my baseline T levels at this point (Didn't get blood work before cycle, stupid of course) 2 days later and Holy Sh**. Total T at 105ng/dl Reference range- 348-1197 with free T at 3.5 pg/ml reference range 9.3-26.5 pg/ml. After some research, I follow a 6 week clomid restart. 4 weeks at 25mg ed with 2 weeks 25 mg eod and .25 adex e3d. 3 weeks in got my labs done this time with LH and FSH. Total T- 618ng/dl Free T 16.3 pg/ml. LH was through the roof at 11.5 MIU/ML Reference-1.5-9.3 and Fsh 11.9 reference- 1.5-12.4 MIU/ML.

Got my 3rd set of labs done 2 days ago, a full 6 weeks after my last dose of clomid. At this point all my lifts besides bench are back to levels while on cycle and even added 20lbs to my deadlift. Nice sex drive, morning wood, and though I yawn a bit more than I used to, I put that off to my new job and 50+ hr work weeks. Well today I read the results and was pretty floored. Total T down to 93!! Yet, Free T at 20.1. LH came down obviously but still in normal range at 4.7 and FSH at 7.3. Obviously, a full set of tests would be better, but I'm currently between insurances and on a budget. How could my Total T be fatally low yet my free T is 6x higher than it was at the start??

Sorry, this turned out to be a bit longer than expected. I'm just well worried and upset with these results. I understand dealing with AAS can be a crap shoot, especially if you don't plan everything out to a "T" While I'm definitely guilty of this, I made sure to run proper pct, get adequate rest and nutrition, etc. At the age of 27 I'd rather not be on TRT for the rest of my life. As I said my lifts are decent if unspectacular (Bench-290, Deadlift 480, Squat 350 at 6'2 220), I never have a problem getting it up, and I'm overall pretty happy though slightly apathetic at times. Does this sound like primary hypogonadism here? Perhaps (hopefully) a screw up at the lab. Any and all advice is much appreciated.


#2

Abnormally low estradiol, low thyroid, and/or high insulin levels all can work towards lowering SHBG.

Your lab screwup theory is also a quite reasonable possibility. When results are screwy, this very often is the cause. I’d do a retest.

I would not have used Arimidex in your PCT unless estradiol testing showed it was needed. That said, any such error shouldn’t have permanent consequence.

I’d test for estradiol level while doing the retest.

As for possible cause if this is true, abnormally low estradiol or thryoid levels or high insulin act towards driving SHBG down, with abnormally low estradiol having the largest effect of these.

I would not have used Arimidex along with the Clomid without blood testing showing it was needed, but if your use was in error, that won’t have permanent consequence.


#3

SERM doses were too high and LH would have been high creating a high T–>E2 production rate inside the testes where anastrozole does not work.

When you finish PCT, its stupid to expect the testes to work right when you have engineered a huge drop in LH.

High LH levels are also thought to desensitized the LH receptors [LH resistance], obviously a wrong outcome. Your LH/FSH is not suggestive of some degree of primary.

SERM’s increase E2 and advice to not use an AI is wrong.

I expect that your body is still changing and labs will be shifting. LH is released in pulses with a short half life. FSH is often a better indicator of LH than LH itself. Your FSH suggests some degree of primary or ‘LH resistance’.

Your labs suggest that PCT worked and the top end of your HPTA is working, but the testes are not working well.

These drugs alter gene expression. Testosterone is a natural hormone in the body and T esters do not seem to cause any problems. We do see some guys who have damage from synthetics that mess with gene expression and sometime permanently. You can add the pro-hormones to the list of offenders. The 5-alpha reductase inhibitor hair loss drugs are also xeno-steroids that ruin the lives of the few who are vulnerable.

There are 7 stickies in this forum, start with ‘advice for new guys’.


#4

Thanks for the responses guys. Forgot to mention both my 1st and 3rd tests were taken approximately 230 in the afternoon, after a rather strenuous workout. I suppose my levels would have been higher first thing in the a.m though not by a drastic amount. I plan to get new tests in the next week or so and also have a consultation with an ageless male director over the weekend. Worst case scenario, does this look like a case for future TRT or just my body slowly righting itself?


#5

There are 7 stickies in this forum, start with ‘advice for new guys’.
There are 7 stickies in this forum, start with ‘advice for new guys’.
There are 7 stickies in this forum, start with ‘advice for new guys’.


#6

[quote]laxtreme56 wrote:
Worst case scenario, does this look like a case for future TRT or just my body slowly righting itself?[/quote]
I think it unlikely that you have what must turn into that scenario.

All too commonly permanent HRT becomes necessary as a consequence of starting HRT while it was still unnecessary.

As for my advice to not use an anti-aromatase together with a SERM during PCT without estradiol test to support it, that is based on more than 16 years experience in very many instances. I lost count long ago, but well over 1000 individuals.

There are many instances in which, with no SERM, estradiol level does not rise to a level where an aromatase is beneficial, and where monitoring is done only after aromatase use has started, where aromatase use drives levels too low.

As for success rate, it’s extremely high not using an aromatase, when the cycle was planned properly in the first place and loss of testicular function did not occur. Both as documented medical fact and in a great number of cycles.

If you indeed have abnormally low SHBG (we dont’ know it, but it could be) abnormally low estradiol is the most likely culprit, and the anti-aromatase use would be relevant to that.

I don’t want to get into a “that advice is wrong” back and forth, but wish to present only the above. Each can judge for himself, and decide for himself whether it makes sense to use an antiaromatase while having no factual evidence of estradiol level needing correcting.


#7

Quick update here. Got some labs done yesterday. As expected, E2 was extremely low. <6 Range- 7.6-42.6, TSH at 3.80 Range-.450-4.5 uIU/ml. After reading the stickies I went out and picked up a thermometer. My morning temps have ranged from 95.9-96.5 with afternoon temps generally between 96.5-97.1. I have always been bit cold in the hands and feet may have been a bit out of whack for some time now. Might some iodine supplementation be smart at this stage, or should I just let my body try to find its homeostasis?

It’s been roughly 6 weeks since my last dosage of clomid. I know there is no concrete answer to this, but can I be expected to be back to “normal” in say 30 days? 60 days? Truth be told, it’s really just the lab results that have bothered me as I have been as close to asymptomatic as can be.

Since my cycle was relatively mild, and I showed no signs of gyno, can it be assumed my mistake was too much AI?


#8

You have strong symptoms of hypothyroidism.

“out of whack” for how long?

Have you always used iodized salt and/or long term use of vitamins listing iodine?
Thyroid is enlarged, asymmetrical, lumpy, sore, sometimes hard to swallow?
Dry skin, hair falling out, outer eyebrows sparse?

You could test:
TSH
fT3
fT4
thyroid antibodies

If you do iodine replenishment, you have to have an identified source of selenium.

The discussion of stress in the thyroid basics sticky applies to you?


#9

Can’t really say I’ve cooked much with Iodized salt. Honestly I’m not much of a cook, besides the basics. I do order out from Muscle Makers fairly often and know their food is saturated with salt, but don’t know if it’s iodized salt. I can’t exactly pinpoint how out of whack it’s been. I tend to wear socks around the house as my feet get cold pretty quickly. However, I also tend to sleep with a window open and even with my low body temps. I’ve never really felt too uncomfortable. As for eyebrows, no sir, I’ve got two hairy catepillars for eyebrows. Never had problems swallowing or lumps in throat, skin is rather oily and have been acne prone all my life, no hair falling out though a bit of a receding hairline the past 2 years or so.

I do take a 1 a day that lists 75% of the RDA for selenium. Could it be possible my adrenals are causing the tyroid deficiency. I did some reading that low, stable body temps =hypothoroid, while low, erratic temps = adrenal dysfunction. Any validity to this? I must also confess, I did a 3 week Bronkaid/Caffeine cycle beginning of Feb as I was becoming quite soft in the midsection. My strength keeps increasing week by week, just hit a PR on Squat and Deadlift the past week. Can’t really see any appreciable new muscle mass or get much of a pump but at least I’m getting stronger. I also forgot to mention in my original post, I was born with an undescended testicle. Got surgery right before my 6th birthday to drop the right testicle in it’s proper home. Because of this my left testicle has always been quite a bit larger than the right. However, I saw no shrinkage on cycle and the boys are still hanging as low as they’ve always been.


#10

Hey guys, update here. Shortly after my lackluster test results in the beginning of March I scheduled an appointment with a local urologist in the central NJ area. I told him my full history including AAS use as well as my undescended testicle for which I had surgery on before my 6th birthday. After examining my testicles, which he said looked full and healthy he wrote up a set of labs to be done with Labcorp. The doctor was very informative and although up there in age was more “new school” than old school. He pretty much brushed off the thought of TRT and said worst case scenario he’d send me to an endo and perhaps try another clomid restart.

Went for my blood work on Wednesday April 22. Tests were done shortly after 8 a.m, roughly 45 mins after waking. I made sure to get a solid 8 hours of sleep the night before. Well here are my results
FSH- 8.7 Range-1,6-8.0 MIU/ML High Final
LH- 7.3 Range- 1.5-9.3 mIU/ML Normal Final
Prolactin 18.3 Range- 2.0-18.0 ng/mL High Final!
Estradiol 21 Range <Or=39 pg/ml Normal Final
Testosterone, Free+total serum 428 Range-250-1100 ng/dl Normal Final
Testosterone, tot, LC/MS/MS- 102.7 Range- 35-150 mg/ml Normal Final
Thyroid Panel, Serum
T4, total- 6.7 Range-4.5-12 mcg/dl
T3 uptake 28 Range-22-35 percent
T4, Free, calculated- 1.9 Range- 1.9-3.8 Units

So let’s see. Test is increasing which is good, albeit low for a 27 year old male. Free test is in the upper 1/3. Not too sure if the Thyroid is optimal despite the “normal” range. Yet LH and FSH is way high for what is suboptimal testosterone. My temperatures are still all over the board. I can wake up anywhere from 96.3-97.4 degrees. Afternoon is also a crapshoot with anywhere as low as 96.9 up to 98.5. Have yet to achieve 98.6. The high prolactin is worrisome. I’ll admit I haven’t done much research into prolactin at the moment, might this entail some type of tumor in the pituitary?


#11

My mistake, these labs were done at Quest labs. The previous were done at Labcorp. I also visited a Men’s wellness clinic I found off Groupon in the middle of March. My Test levels came back at 217 ng/dl, with that test being done around 1030 in the morning. That doctor had echoed the sentiment on here, that my body was probably just slowly returning to normal.

He did not think I was a candidate for T-Replacement, which was refreshing since this is a guy who makes his living off just that. I’ve been supplementing with Ashwaganda, BCAA’s, 15,000 I/U of Vitamin D and a multivitamin as well as Lugols 2% Iodine solution for about the past month and a half. Beside the highish prolactin and still slightly lower test levels, does anything else on my results stand out?


#12

On your Lugol’s usage: I suggest reading my thyroid article which can be found on the Article tab under Diet and Fat Loss, with regard to the part on overdosing and the references that are provided, and/or reading various posts here discussing thyroid overdosing.

More is NOT better and you can get the reverse results of what you want.


#13

A little tardy with this, but here are my latest labs. Full hormone panel done by an endocrinologist in early May. Everything is in range, and optimal in some areas. However FSH is still elevated as well as low(ish) T and mid-range free T. Is it possible my Clomid restart caused a degree of Leydig cell desensitization which results in higher FSH and the testes being somewhat unresponsive? For the most part I’ve remained asymptomatic.

Strength gains are slow and steady in the gym while mass has been a bit eh. Body fat is now in the 18-20 range, would really like to get it in the 13-15% range. Anything here in these labs I might be missing out on? Perhaps I was always a lower T guy and this may be about as good as things get.

COMMENTS: FASTING
Test Name Results Reference Range Lab
COMP METAB PANEL TBR
GLUCOSE,FASTING 78 65-99 MG/DL
SODIUM 142 135-146 MMOL/L
POTASSIUM 4.3 3.5-5.3 MMOL/L
CHLORIDE 103 98-110 MMOL/L
CARBON DIOXIDE 27 19-30 MMOL/L
UREA NITROGEN 19 7-25 MG/DL
CREATININE 0.94 0.6-1.35 MG/DL
BUN/CREATININE RATIO NOTE 6-22
BUN/CREATININE RATIO IS NOT REPORTED WHEN THE BUN AND
CREATININE VALUES ARE WITHIN NORMAL LIMITS.
CALCIUM,PLASMA 9.3 8.6-10.3 MG/DL
PROTEIN, TOTAL, SERUM 7.4 6.1-8.1 G/DL
ALBUMIN 4.5 3.6-5.1 G/DL
GLOBULIN 2.9 1.9-3.7 G/DL
A/G RATIO 1.6 1-2.5
BILIRUBIN,TOTAL 0.5 0.2-1.2 MG/DL
ALKALINE PHOSPHATASE 54 40-115 U/L
AST 23 10-40 U/L
ALT 30 9-46 U/L
GFR ESTIMATED 111 >=60 ML/MIN/1.73M2
EGFR AFRICAN AMERICAN 128 >=60 ML/MIN/1.73M2
TSH 1.86 0.4-4.5 MIU/L TBR
T4,FREE 1.2 0.8-1.8 NG/DL TBR
CBC (INCLUDES DIFF/PLT) TBR
WBC 6.4 3.8-10.8 THOUS/MCL
RBC 5.57 4.2-5.8 MILL/MCL
HEMOGLOBIN 15.4 13.2-17.1 G/DL
HEMATOCRIT 47.8 38.5-50 %
MCV 85.8 80-100 FL
MCH 27.8 27-33 PG
MCHC 32.3 32-36 G/DL
RDW 14.2 11-15 %
PLATELET COUNT 248 140-400 THOUS/MCL
MPV 8.2 7.5-11.5 FL
PAGE 1 OF 4
Specimen: RC049370
DOB: 06/23/1987 AGE: Not Given Gender: M
Health ID: 8573013617403939
RARITAN BAY PHYSICIAN’S GROUP
Quest, Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics.
Test Name Results Reference Range Lab
TOTAL NEUTROPHILS,% 53.0 38-80 %
TOTAL LYMPHOCYTES,% 29.6 15-49 %
MONOCYTES,% 8.9 0-13 %
EOSINOPHILS,% 7.8 0-8 %
BASOPHILS,% 0.7 0-2 %
NEUTROPHILS,ABSOLUTE 3392 1500-7800 CELLS/MCL
LYMPHOCYTES,ABSOLUTE 1894 850-3900 CELLS/MCL
MONOCYTES,ABSOLUTE 570 200-950 CELLS/MCL
EOSINOPHILS,ABSOLUTE 499 15-500 CELLS/MCL
BASOPHILS,ABSOLUTE 45 0-200 CELLS/MCL
DIFFERENTIAL
AN INSTRUMENT DIFFERENTIAL WAS PERFORMED.
FSH 8.2 H 1.6-8 MIU/ML TBR
LH TBR
LH,PEDIATRICS 5.5 1.5-9.3 MIU/ML
PROLACTIN 10.2 2-18 NG/ML TBR
CORTISOL, TOTAL, SERUM TBR
CORTISOL,TOTAL,SERUM 13.5 MCG/DL
REFERENCE RANGE
CORTISOL AM 4.0 - 22.0 MCG/DL
CORTISOL PM 3.0 - 17.0 MCG/DL
PSA,TOTAL 0.5 <=4.0 NG/ML TBR
See Endnote 1
ACTH,PLASMA 17 6-50 PG/ML TBR
REFERENCE RANGE APPLIES ONLY TO SPECIMENS COLLECTED
BETWEEN 7-10 AM.
PROLACTIN,TOTAL,MONOMERIC See Endnote 2 QNI
PROLACTIN 9.8 2-18 NG/ML
FREE PROLACTIN 7.0 3.4-14.8 NG/ML
PATIENT SAMPLES WITH ELEVATED TOTAL PROLACTIN CONCENTRATIONS
ARE ROUTINELY TESTED FOR THE PRESENCE OF MACROPROLACTIN.
THIS ABNORMAL FORM OF PROLACTIN CROSSREACTS IN THE TOTAL
PROLACTIN ASSAY BUT IS CONSIDERED TO BE BIOLOGICALLY
INACTIVE.
FOLLOWING MACROPROLACTIN PRECIPITATION, MONOMERIC
(UNPRECIPITATED) PROLACTIN LEVELS ARE EXPECTED TO BE WITHIN
THE REFERENCE RANGE. A MONOMERIC PROLACTIN LEVEL GREATER
THAN THE UPPER LIMIT OF THE REFERENCE RANGE IS CONSISTENT
WITH HYPERPROLACTINEMIA.
IGF 1,LC/MS See Endnote 3 QNI
PAGE 2 OF 4
Specimen: RC049370
DOB: 06/23/1987 AGE: Not Given Gender: M
Health ID: 8573013617403939
RARITAN BAY PHYSICIAN’S GROUP
Quest, Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics.
Test Name Results Reference Range Lab
IGF-I 254 63-373 NG/ML
Z-SCORE (MALE) 1.0 2 SD
THIS TEST WAS DEVELOPED AND ITS PERFORMANCE CHARACTERISTICS
HAVE BEEN DETERMINED BY QUEST DIAGNOSTICS NICHOLS INSTITUTE,
SAN JUAN CAPISTRANO. PERFORMANCE CHARACTERISTICS REFER TO
THE ANALYTICAL PERFORMANCE OF THE TEST.
TESTOSTERONE,FR(DIAL)TOT See Endnote 4 AMD
TESTOSTERONE,T,MALE,ADULT 436 250-1100 NG/DL
FOR MORE INFORMATION ON THIS TEST, GO TO
HTTP://EDUCATION.QUESTDIAGNOSTICS.COM/FAQ/
TOTALTESTOSTERONELCMSMS
TESTOSTERONE,FREE 91.6 35-155 PG/ML
SEX HORMONE BINDING GLOBULIN 27 10-50 NMOL/L AMD
See Endnote 5
PROLACTIN,DILUTION STUDY See Endnote 6 TBR
PROLACTIN 9.7 2-18 NG/ML
PROLACTIN 2-18 NG/ML
RESULT CONFIRMED BY 1:100 DILUTION. NO HIGH-DOSE HOOK
EFFECT DETECTED.
Endnote 1 THIS TEST WAS PERFORMED USING THE SIEMENS (BAYER)
CHEMILUMINESCENT METHOD. VALUES OBTAINED FROM DIFFERENT
ASSAY METHODS CANNOT BE USED INTERCHANGEABLY. PSA LEVELS,
REGARDLESS OF VALUE, SHOULD NOT BE INTERPRETED AS ABSOLUTE
EVIDENCE OF THE PRESENCE OR ABSENCE OF DISEASE.
Endnote 2
TEST PERFORMED BY:
QUEST DIAGNOSTICS NICHOLS INSTITUTE
33608 ORTEGA HIGHWAY
SAN JUAN CAPISTRANO, CALIFORNIA 92690
Endnote 3
TEST PERFORMED BY:
QUEST DIAGNOSTICS NICHOLS INSTITUTE
33608 ORTEGA HIGHWAY
SAN JUAN CAPISTRANO, CALIFORNIA 92690
Endnote 4 THIS TEST WAS PERFORMED AT:
QUEST DIAGNOSTICS NICHOLS INSTITUTE CHANTILLY
14225 NEWBROOK DRIVE
CHANTILLY, VA 20151
Endnote 5 THIS TEST WAS PERFORMED AT:
QUEST DIAGNOSTICS NICHOLS INSTITUTE CHANTILLY
14225 NEWBROOK DRIVE
CHANTILLY, VA 20151
Endnote 6
PROLACTIN DILUTION STUDIES ARE DONE TO DETERMINE IF THERE