T Nation

Zdravo's Numbers


#1

After feeling super fatigued (above and beyond sleep apnea) and no motivation, I asked my doctor at the last physical for some labs. He referred me to an endo, who ordered more tests. I have had difficulty maintaining erection and climaxing during sex. Libido has decreased, as well as a desire to do anything that involves leaving home.

-age: 28
-height: 6'0
-waist: 38.5"
-weight: 185 lbs
-describe body and facial hair: Normal pubic and axillary hair growth, facial is patchy

-describe where you carry fat and how changed: Seems to be extremely concentrated around the navel, waistline has been growing steadily

-health conditions, symptoms: Obstruactive Sleep Apnea, Hypertension, Spondylitis
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: Rx Amlodidpine 2.5mg, Naproxen 500 mg bid

-lab results with ranges
TT 2.27 [2.41-8.27 ng/mL]
TT 260 [250-1100 ng/dL] 2nd test
FT 84.7 [35-155 pg/mL]
SHBG 11 [10-50 nmol/L]
FSH 3.2 [1.6-8.0 mIU/mL]
LH 4.9 [1.5-9.3 mIU/mL]
Prolactin 7.0 [2.1-17.7 ng/mL]
TSH 1.60 [0.36-3.74 uIU/mL]
Ferritin 72.3 [26-388 ng/mL]

-describe diet:
Generally home baked, chicken, steak, fish, mixed veggies/beans, fast food and energy drinks on weekends/busy days

-describe training: Almost none d/t fatigue. Running in place, push ups when feeling energetic.
-testes ache, ever, with a fever? Never.
-how have morning wood and nocturnal erections changed: Haven't been present for awhile; I attributed this to sleep apnea in the past.

Thanks for your responses and if I'm missing anything, let me know.


#2

Check E2. Free T could be better, but total T looks like shit.

Might want to try iodine or iodized salt to get TSH down a bit.

You probably need to deal with your sleep apnea first.


#3

I have been using CPAP for nearly two years.


#4

Get an E2 test.


#5

seems like primary hypogonadism, but I would also check cortisol levels (4x daily saliva test would be best given your sleep issues).

confirming CHOL, pregnenolone, DHEA-S, DHT, ferritin, D25-OH, B12 can also be very helpful.


#6

That worries me. What is it that points to primary? FSH and LH being high, or?

I have an appointment in two days, I will ask for the additional labs then. Had a lipid panel, CBC, and glucose in November, waiting on a copy of those results to come in the mail.


#7

You have LH and FSH signals but lowish testosterone levels. Meaning signals are there for your boys to produce but they are not coming to the party.

But you will still need to confirm/test if this is the case.


#8

Thanks.

HCT 44.2 [35-49%]

CHOL 147 [0-200 mg/dL]
HDL 44.0 [35-60 mg/dL]
CHOL/HDL RAT 3.34 [<5.60 ratio]
Calculated LDL 91 [<130 mg/dL]
VLDL 12 [0-40 mg/dL]
Triglycerides 58 [30-200 mg/dL]

Glucose 98.0 [70-110 mg/dL]


#9

low CHOL meaning under 150 indicates your body is not producing enough building blocks to feed into the hormone production chain.


#10

After waiting two months, he walked in and told me all of my labs were normal and that I needed to see my GP for any other causes of fatigue/malaise.

I told him this was a colossal waste of time, could there be any other cause? He then ordered a serum cortisol as a consolation prize, but told me endocrinology is ready to sign-off of this case.


#11

In other words, I don't know what the hell to do with you. Thanks for coming, you are fine now move along. The next patient might just need thyroid meds so I don't need the headache.


#12

CHOL converts to pregnenolone first. We can (possibly) assume low pregnenolone due to low CHOL. You could always try to start supplementing OTC Pregnenolone - starting very small at 5mg and then slowly increase.

it is best to work with docs and get full tests before supplementing, but most usually end up experimenting and self treating.


#13

Cortisol 15 [4.3 - 22.4]. Serum this am

Will be going Monday to speak with GP on remaining tests.


#14

Finally got these results back. Any thoughts about estrogen dominance and next steps? I've been megadosing Vitmin for a week already and feel better.

E2 34 (< 57 ) vs. T 260 (250-1100)
DHEA-S 356 (80-560)

D25 OH 29 (30-100)
B12. 1666 (254-1320)

Ferritin 56.9 (26-388)
Hct 41.8. (38-48)