Blood Work Advice

Pharma TRT
41

New blood work ordered by my new Doc. This is everything except RT3, which I won’t get until I see the doc again. That particular test is done at a hospital that refuses to release info directly to patients.

B-Hb: 14.7 g/100 mL, 13.4 - 17
B-Leukocytes: 11.3* 10^9/L, 3.5 - 11
S-Ferritin: 181 ug/L, 20 - 300
P-Homocystein: 5.9 umol/L, 5 - 15
S-Kalium: 3.8 mmol/L, 3.6 - 5
S-Kalsium: 2.21 mmol/L, 2.15 - 2.51
S-Magnesium: 0.78 mmol/L, 0.71 - 0.94
S-Uric Acid: 325 umol/L, 230 - 480
S-ASAT: 19 U/L, <45
S-ALAT: 29 U/L, <70
S-CK: 260 U/L, <400
B-HbA1c: 5.5 %, <6.1
fS-Glukose: 5.5 mmol/L, 4 - 6
fS-Insulin: 79 pmol/L, 18 - 173
fS-C-peptid: 586 pmol/L, 270 - 480
fS-Triglyserider: 1.35 mmol/L, <2.6
S-Cholesterol: 4.9 mmol/L, 2.9 - 6.1
S-HDL-Cholesterol: 1.0 mmol/L, 0.8 - 2.1
S-Lp(a): 205 mg/L, <250
S-TSH: 3.0 mU/L, 0.2 - 4.0
S-Free T4: 16.3 pmol/L, 11 - 23
S-Free T3: 5.7 pmol/L, 3.5 - 6.5
S-Anti-TPO: 47 kU/L, <100
S-TRAS: <0.8 U/L, <1.0
S-Prolaktin: 316 mU/L, <700
S-Estradiol-17Beta: 0.07 nmol/L, <0.18
S-Testosterone: 14 nmol/L, 8 - 35
S-SHBG: 15 nmol/L, 8 - 60
Free Testosterone Index: 9.1, 2.3 - 9.9
S-hCG <5 U/L, <5
S-Cortisol morning: 835* nmol/L, 250 - 750
S-Vitamin D: 52 nmol/L, 50 - 150

  • Vitamin D3: 52, -
    S-Vitamin K: 0.3 ng/mL, 0.1 - 2.2
    S-Selen: 1.2 umol/L, 0.6 - 1.8
    S-Sinc: 13.6 umol/L, 9 - 17

The doctor said that homocystein test would show if I was deficient in any vitamin B, and its value is at the bottom of the range. As you can see Leukocytes and Cortisol is high. TSH has gone down to 3.0 all of a sudden. Vit D looks low.

I’ve been feeling better lately, with the warmer weather. + I’ve been forced to keep very busy, which is always good for mope heads like me.

Still waiting for the RT3 test, but it looks to me like I don’t really have a thyroid issue? Well maybe a “sluggish” thyroid, but that’s it.

42

Everything looks good from the range standpoint, some things on the lower scale, but nothing substantiality out of range.

…have you thought of looking into some different serologies… i.e. auto immune testing, viral panel etc?

43

I don’t know about those, I will look them up.

I know nothings out of range, but it does look like I should definitely be supping with vit B, vit D, and magnesium.

44

TSH varies throughout the day. TSH is of 3.0 is still high and probably was bounced down randomly.

My GP would treat any TSH over 2.0

My current well treated TSH is undetectable. Don’t take that TSH being slightly lower to mean anything.

You’re hypothyroid thats why you feel like shit. You need proper thyroid hormone supplementation.

Its also why you’re depressed, FYI.

EDIT: No reason not to start supplementing your vitamin D right now.

45

  1. I noticed your TSH units are not the typical US units, so I’d be careful comparing your actual value to those of us here. What matters is where you are in the reference range (too high).

  2. You had TPO checked, but to rule out hashi’s you also need ATA (Antithyrogloglobluin Antibodies)

  3. Your T4 is solid and your T3 is way right of optimal. Why is your body screaming for more thyroid? If it’s not high RT3 or hashimoto’s, I’m kinda stumped here. Actually your tests remind me of my first round of tests (TSH 3.6 [.5-5.0], mid-range FT4, mid/high-range FT3)… given that my case is still ongoing I can’t exactly say I know what’s up yet.

I don’t think you’re iodine deficient because your body seems to make plenty of t4/t3. Do you eat a lot of seafood?

46

[quote]scj119 wrote:

  1. I noticed your TSH units are not the typical US units, so I’d be careful comparing your actual value to those of us here. What matters is where you are in the reference range (too high).

  2. You had TPO checked, but to rule out hashi’s you also need ATA (Antithyrogloglobluin Antibodies)

  3. Your T4 is solid and your T3 is way right of optimal. Why is your body screaming for more thyroid? If it’s not high RT3 or hashimoto’s, I’m kinda stumped here. Actually your tests remind me of my first round of tests (TSH 3.6 [.5-5.0], mid-range FT4, mid/high-range FT3)… given that my case is still ongoing I can’t exactly say I know what’s up yet.

I don’t think you’re iodine deficient because your body seems to make plenty of t4/t3. Do you eat a lot of seafood?[/quote]

I responded before the last labwork.

I GUESS RT3
I don’t seee that on the lab results am I just missing it?

47

Still waiting on RT3, because the only lab in this city that DOES RT3 testing… does not release results directly to the patient. I’m trying to get a hold of the doc to find out the result. My next appointment isn’t until august 16th. (Yeah, must be great being the only doc in the country who knows his shit about thyroid issues)

I’ve started taking 10 000 IU of D3 a day, vitamin B complex, ZMA and Magnesium, and trying some Rhodiola for the high cortisol. Oh and 2-3000 mg of vit C.

I’m killing it in the gym again and eating AD style, I’ve moved to a different city, and I seem to be healing all 'round. Still, I have very high stress levels and some anxiety still, so have to be careful not to take anything for granted.

If it’s NOT an RT3 issue, I stop seeing this abhorrently expensive doctor. lol

Thank you to those taking an interest, I will update as I learn more.

48

I got the result of the RT3 test:

0.22 (0.14-0.55)

My total T3 was 2.3 (1.2-2.7)

My doc says the RT3 usually lies around 20% of total T3. As you can see my RT3 is less than 10% of my total T3. He didn’t want to get into it on the phone, because he is a greedy bastard. lol

I don’t get it. Why is my TSH so high?

49

I also don’t get why the doc says ferritin alone is enough to determine if there is an iron issue. I got this info on iron from a friend that self medicates with T3:

Being Hypothyroid leads to poor Iron Absorbtion & cannot hold onto Iron
Low Iron interferes with T4 to T3 conversion & likely to cause T4 to RT3
Need Iron & Cortisol to get the T3 into the Cells
Low Iron will also cause T3 to Pool
Low Iron can cause Low TSH
Low/High Cortisol will also cause RT3
Serum Iron needs to be at the Mid to Higher End of Range
Transferrin % Saturation needs to be 35% to 45%
TIBC needs to be at Mid to High end of Range
Hair Loss > Low Iron
Muscle Weakness > Low Iron
Total Iron Binding Capacity>
This shows the capacity of your body to absorb iron.
When it’s more toward midrange, you can take lots.
If near the bottom, means you cannot safely
absorb much iron at any one time.

50

Total T3 is useless but your FT3 is at the top of the range and your RT3 is leaning towards the lower end so it’s probably safe to say your FT3:RT3 is fine.

Ferritin is storage iron… useful though I don’t know if it’s the only thing that matters. I’ve always heard just iron isn’t enough, you need ferritin too… don’t know how the converse situation works.

Also, I initially skimmed over your body temps and figured I’d convert them to Fahrenheit after I finished the thread (but forgot to do so). I ran through them now and you have low body temp which is yet another sign of hypothyroid.

Next things to rule out: Hashi’s (you got TPO but you ALSO need ATA - Antithyroglobulin Antibodies), and chronic infection (could be the cause of your high cortisol, and can obviously cause fatigue etc.)

51

[quote]scj119 wrote:
Total T3 is useless but your FT3 is at the top of the range and your RT3 is leaning towards the lower end so it’s probably safe to say your FT3:RT3 is fine.

Ferritin is storage iron… useful though I don’t know if it’s the only thing that matters. I’ve always heard just iron isn’t enough, you need ferritin too… don’t know how the converse situation works.

Also, I initially skimmed over your body temps and figured I’d convert them to Fahrenheit after I finished the thread (but forgot to do so). I ran through them now and you have low body temp which is yet another sign of hypothyroid.

Next things to rule out: Hashi’s (you got TPO but you ALSO need ATA - Antithyroglobulin Antibodies), and chronic infection (could be the cause of your high cortisol, and can obviously cause fatigue etc.)[/quote]

According to the stopthethyroidmadness website, a healthy ratio of FT3 to RT3 is above 20. Mine is 25.9, so that does look ok.

I do have a lot of symptoms pointing towards hypothyroidism, and that’s why I’m so confused about all this.

I got most of my info off this website. You should check it out if you haven’t already.

Thanks for posting, I’ll make a note of that ATA and ask my doc to test for it.

52

All the info your friend gave you about Iron is basically true, but not really applicable to your situation. Your T4->T3 conversion is good, your RT3 is good, your cortisol is certainly high enough to achieve activation with thyroid at the receptors.

Your case really points to subclinical hypothyroidism. I don’t know how liberal the docs are with meds in Norway, but I would push hard for a clinical trial of T3. Dose conservatively at first (I would be surprised if you need a lot) and get bloodwork done when your symptoms disappear and waking body temps normalize. Obviously take temps in the meantime and track changes. Your TSH will probably drop and ft3 will be slightly above range.

6 weeks should be a good timeline to figure out if this will work for you.

If your doc isn’t onboard, there are other means…depends on your risk tolerance…

53

[quote]VTBalla34 wrote:
All the info your friend gave you about Iron is basically true, but not really applicable to your situation. Your T4->T3 conversion is good, your RT3 is good, your cortisol is certainly high enough to achieve activation with thyroid at the receptors.

Your case really points to subclinical hypothyroidism. I don’t know how liberal the docs are with meds in Norway, but I would push hard for a clinical trial of T3. Dose conservatively at first (I would be surprised if you need a lot) and get bloodwork done when your symptoms disappear and waking body temps normalize. Obviously take temps in the meantime and track changes. Your TSH will probably drop and ft3 will be slightly above range.

6 weeks should be a good timeline to figure out if this will work for you.

If your doc isn’t onboard, there are other means…depends on your risk tolerance…[/quote]

You make a lot of sense, as usual.

Doctors in Norway don’t know shit about thyroid treatment, but I have shelled out to see a specialist. He should be on board with doing a trial run of T3, he seems pretty much on the ball. Besides, it gives him the opportunity to milk me for more cash. lol

I can get T3 on my own if need be.

54

Does it make sense to take in more iodine in my case?

55

From what I read about subclinical hypothyroidism, it’s usually treated with T4, not T3. But then I do have plenty of T4. So the pituary gland is working overtime to make sure the thyroid produces enough hormones. In that case, wouldn’t Levo take care of it, or perhaps Armour thyroid?

One thing that seems weird to me is that hypo patients are usually feeling cold. With me it’s the other way around, I’m always sitting there in a t-shirt and complaining about the heat. lol

Also, dry scaly skin is supposed to be a symptom, but I have clammy skin with a bunch of these little red dots everywhere.

Most of the symptoms match, I just find the heat intolerance to be a little odd.

56

[quote]Quick Ben wrote:
From what I read about subclinical hypothyroidism, it’s usually treated with T4, not T3. But then I do have plenty of T4. So the pituary gland is working overtime to make sure the thyroid produces enough hormones. In that case, wouldn’t Levo take care of it, or perhaps Armour thyroid?

One thing that seems weird to me is that hypo patients are usually feeling cold. With me it’s the other way around, I’m always sitting there in a t-shirt and complaining about the heat. lol

Also, dry scaly skin is supposed to be a symptom, but I have clammy skin with a bunch of these little red dots everywhere.

Most of the symptoms match, I just find the heat intolerance to be a little odd.[/quote]

Symptoms will never match entirely. I thought I was hypothyroid (still unsure, but most likely not), yet I have heat intolerance and sweat profusely. I’m thinking it’s just my overly active adrenals but I haven’t figured that one out (I have a 5min walk to my docs office in 100deg weather, and I sweat through two layers of shirts despite my body temp being measured below 99deg when I first walk in). Also, keep in mind that you have low body temps, whether you FEEL cold or not.

As far as treatment… just because Thyroxin(T4) is the most common does not mean it is the best treatment. T4 only converts to two things: T3, and RT3. Obviously, you don’t want more RT3, so why give your body the option of deciding it has enough energy and increasing T4->RT3 conversion? T3-only meds skip the middle man. It may not make a difference… but why risk it.

This is not to say Synthroid or dessicated thyroid won’t work. T3-only is just better in most cases IMO.

Iodine: I skimmed through and didn’t see you mention whether you use iodized salt or eat a lot of seafood. It’s hard to imagine you are iodine deficient because your T4/T3 levels are actually good (iodine is used in the process of making T4 and again in the process of converting T4 to T3). That being said, your body seems to want more thyroid so iodine deficiency is possible.

57

I recommend T3 for the clinical trial because it is the type the body uses. You don’t KNOW at this point that its going to help, so its easiest to use the bioavailable form in order to more easily gauge the bodys response.

If offers an additional benefit in that it has a shorter half life (hours versus days). In your case, with already highish fT3 valuesm I expect the dose you actually need to be relatively minimal. If you overshoot with T3 it will clear your body quickly without need ancillaries. Overshooting T4 would leave you feeling like shit for days, and may require hydrocortisone to metabolize it more quickly.

Once you are at a level where symptoms disappear, you will have bloodwork done to establish your target numbers. You could either continue with T3, or have the option to switch to longer T4 (or a combo) and dose iteratively until you again achieve the target.

Re: heat intoleramce. I found a good discussion of the theory on this and wehy it applies to some hypo patientshypo patients. Ill see if I can find i t later when I’m on my CPU and not my mobile…

58

@scj: I don’t eat a lot of seafood, I stick to beef and eggs mostly. I don’t use iodinized salt. Hmm maybe I ought to try using iodine salt and see if it makes a difference.

@VT: With T3 having a shorter half life, I guess you’d have to take it several times a day?

I’ll be seeing my doc in a little more than two weeks, you guys are providing me with a lot to bring to the table.

59

[quote]Quick Ben wrote:
@scj: I don’t eat a lot of seafood, I stick to beef and eggs mostly. I don’t use iodinized salt. Hmm maybe I ought to try using iodine salt and see if it makes a difference.

@VT: With T3 having a shorter half life, I guess you’d have to take it several times a day?

I’ll be seeing my doc in a little more than two weeks, you guys are providing me with a lot to bring to the table.[/quote]

Iodine deficiency may be your problem. KSMan talks about this in every thread with hypothyroid symptoms. You might want to supplement Ioddoral (spelling?) to build some up in your system, then maintain with iodized salt afte rthat.

re: T3 - they make slow release T3, I believe the dosing with that is once per day.

60

There is a RT3_T3 message board on Yahoo, and that’s where I’m getting the opinion that I’m making the T3, but it’s not getting into the cells. My cortisol is high, but you need iron too. Hence the request for iron labs.

EDIT: And the resident guru over there feels that if you’re getting enough thyroid hormone, you won’t be needing additional Iodine.

Opinions to the left of me, opinions to the right. And then the doctor in the middle :slight_smile: