27, Low TT and No FT. What is Going On?

Pharma TRT
1

So I recently got a private blood test done, I feel perfectly ‘normal’, strength normal and improving (pulled 600 for the first time recently) and basically wanted to establish a baseline blood panel to benchmark my ‘prime’ against for the rest of my life and basically there were no ‘symptoms’ triggering the test other than curiosity.

Well I get the results this morning and, shock horror, my Free T is off the chart. AT THE WRONG END!

Needless to say Im confused. Im young, lean, train regularly, eat healthily, probably drink less than 2 units a month lose weight when I put my mind to it and carry a reasonable level of muscle mass and am considered pretty strong by average measures.

Was hoping some of you pro’s could look over the results and let me know what I’m missing / help me understand what it means before I start panicking too much.

EDIT: Just read the sticky, updated Stats.
-age: 27
-height: 5"10
-waist: 32"
-weight: 193
-describe body and facial hair: Never had a torso hair in my life, regularly get asked if I shave my chest. Facial hair is light and relatively sparse, likewise with arms and legs.
-describe where you carry fat and how changed: Love handles and Lower back, am relatively lean most of the year though.
-health conditions, symptoms. No real conditions, non-coeliac gluten intolerance and dairy intolerant (basically triggers for IBS).
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: No RX drugs, occasionally an aspirin?
-lab results with ranges: See below
-describe diet: Currently in a calorie deficit of c. 400 cals / day. Always eat relatively high protein diet, currently standard 40:40:20 P:C:F diet though I am low carb higher fat most of the year, though rarely actually keto.
-describe training: 4 Day / week powerlifting split, detailed records in my training log.
-testes ache, ever, with a fever? Never noticed any aching.
-how have morning wood and nocturnal erections changed: Probably less frequent that when I was 18… Other than that prevalence has remained constant for the last 5-8 years.

Supplementation:
AM: Iodine, Selenium ACE, Creatine, Acetyl L-Carnitine.
PM: Vit d3, ZMA, 5-HTP, Omega 3

Of potential relevance, about 8-9 years ago I took an OTC cutting supplement called ‘Shredded Mass’ which is effectively a 30 day cycle of Epi at 30mg / day. No PED’s since.

Anything important I’ve left out just ask.

The results and ranges

ENDOCRINOLOGY

Thyroid Function
TSH *16.6 mIU/L (0.27 - 4.20)
FREE THYROXINE *11.6 pmol/L (12.00 - 22.00)

Hormones
FSH 3.08 IU/L (1.50 - 12.40)
Total T 7.89 nmol/L (7.60 - 31.40)
FREE-T(CALCULATED)* 0.176 nmol/L (0.30 - 1.00)
SHBG 24.6 nmol/L (16.00 - 55.00)
17-BETA OESTRADIOL <18.4 pmol/L (0.00 - 191.99)
LH 2.6 IU/L (1.70 - 8.60)

Other Labs that may / may not be relevant

HAEMATOLOGY
Red Blood Cells
HAEMOGLOBIN (G/L) *173 g/L 130.00 - 170.00
HCT 0.496 L/L 0.37 - 0.50
RED CELL COUNT 5.21 x10^12/L 4.40 - 5.80
MCV 95 fl 80.00 - 99.00
MCH 33.2 pg 26.00 - 33.50
MCHC (G/L) 349 g/L 300.00 - 350.00
RDW 12.4 % 11.50 - 15.00
White Blood Cells
WHITE CELL COUNT 6.1 x10^9/L 3.00 - 10.00
NEUTROPHILS 2.41 x10^9/L 2.00 - 7.50
LYMPHOCYTES 3.13 x10^9/L 1.20 - 3.65
MONOCYTES 0.39 x10^9/L 0.20 - 1.00
EOSINOPHILS 0.10 x10^9/L 0.00 - 0.40
BASOPHILS 0.10 x10^9/L 0.00 - 0.10
Clotting Status
PLATELET COUNT 160 x10^9/L 150.00 - 400.00
MPV 10.6 fl 7.00 - 13.00
BIOCHEMISTRY
Inflammation Marker
CRP - HIGH SENSITIVITY 0.0 mg/l 0.00 - 5.00
Kidney Function
SODIUM 142.6 mmol/L 135.00 - 145.00
UREA *9.5 mmol/L 1.70 - 8.30
CREATININE New sample required
Liver Function
ALKALINE PHOSPHATASE 85 IU/L 40.00 - 129.00
ALANINE TRANSFERASE *55.8 IU/L 10.00 - 50.00
CK *586 IU/L 38.00 - 204.00
GAMMA GT 13 IU/L 10.00 - 71.00
Proteins
TOTAL PROTEIN 68.7 g/L 63.00 - 83.00
ALBUMIN 44.1 g/L 34.00 - 50.00
GLOBULIN 24.6 g/L 19.00 - 35.00
Diabetes
HBA1C (MMOL/MOL) 28.78 mmol/mol 20.00 - 42.00
Iron Status
IRON 21.82 umol/L 10.60 - 28.30
FERRITIN *526 ug/L 30.00 - 400.00

KSman is Here
2

Um… is that TSH a typo?

3

I reeeealy wish it was.

A lot of Hashimotos in my family history so I’m less surprised by my thyroid being screwed than my T levels.

4

Am I right in interpreting that as meaning my body is working pretty damn hard to try and keep my Free Thy in range?

5

I’m not an expert at thyroid labs by any means. Maybe KSman will chime in. However its a major problem being that high and needs treated as your primary objective first. Hypothyroidism can reduce your T levels.

6

Fingers crossed. Thats why I’m here! Ha

Thanks for your input though bud.

7

Where are you located?

Those number are correct?
That would be very deep hypothyroidism.

How much iodine and selenium and for how long?
Note that high dose iodine can elevate TSH as expected and that makes the TSH results unactionable.

Thyroid has lumps, sore, visually large or asymmetrical?
Outer eyebrows sparse?
Dry skin?
General hair thinning?
Brittle nails?
Feel cold easily?
Low energy - can be from low-T as well.

Get thyroid auto-immune panel.
Also test: rT3 and fT3

What are your oral body temperatures - see below.
If body temps are good, you might be fine and then no thyroid labs needed.

Reduce iron intake. Iron fortified foods: flour, pasta, rice, breads, cereals.

ALT/AST can be elevated easily by training, sore/injured or none recovered muscles. Take a break before labs.

Other labs:
repeat LH/FST [both]
prolactin
DHEA-S [not DHEA]

What is going on with libido and sexual performance? How has this been in the past and trends?

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

8

Hi Ksman, thanks for checking in.

In the UK

Those are the correct results. No typo.

10mg iodine 15mg iodide 440mcg selenium daily for maybe 6 weeks.

No
No
Maybe
No
No
Only in a calorie deficit
Yes noticably

If im being honest then Libido is pretty low against my expectations for a guy my age, but has been at a constant level for as long as I can remember other than my teens.

And I do appreciate all the stickies, incredibly useful and a great resource on this forum.

Will look into getting those tests and temperature readings.

9

Just got a thermometer.
First temp readings.

12:30pm before lunch - 96.8
1:30pm 1 hour post lunch - 97.8
4:30pm 4 hours post lunch - 96.6

Will check again in the AM

10

Wife just scored 98.6 on the thermometer so not defective :grimacing:

11

You will find that this explains a lot. From here you can do more thyroid labs while keeping in mind the effects of higher dose iodine increasing TSH. At least you know what road will lead to better quality of life, even though you do not know what routes the road will cover.

12

Am Temp - 96.6

13

Thanks KSman.

Can the Iodine supplementation explain all of the high TSH? Meaning the low Free Thyroxine is the symptom to focus on?

Only a few temp readings so far but they certainly seem to indicate an issue?

Also can I interpret this to mean I need to focus on Thyroid first before tackling any T issues?

Thanks again.

14

Might want to be sure you don’t have hereditary hemochromatosis. It would explain the high ferretin, elevated liver enzyme, thyroid damage, and testicular damage.

15

Thanks for the heads up

16

Feb-1 - 96.9

17

Feb-2 - 96.4

18

Feb-3 - 96.4

19

Feb 5 - 96.9

20

Hey @KSman / @systemlord

Finally got a GP appointment for this weekend, based on the above temp readings, and the results I got above on my private bloods, what tests would I be reasonable in asking for?

Thanks again.