Bloodwork...Could Use Some Input

Pharma / TRT Testosterone Replacement
1

Quick facts:

  • 30 yr male
  • 6’ ~210
  • body fat unknown, est @ ~18%
  • gain fat and carry it like a woman (goes first to hips, ass/legs, obliques, then the rest of the body)
  • low body hair
  • libido is lowish but no performance issues
  • high stress in the last 6 months, and the diet to match (ie: diet has sucked)
  • strength gains and fat loss have always been snail slow compared to peers
  • suspected most of my adult life of having low T, confirmed in 2010, and still the case today (see linked spreadsheet for historical data)

Main panels of interest: http://i49.tinypic.com/2ibg3fr.png (red = their noted out of range. yellow = “normal” but still concerning)

Full workup, including prior two tests: http://dl.dropbox.com/u/281318/bloodwork.xls
(all labs done in 12 hour min fasted state and at 8-9am)

I’m also waiting on diurnal cortisol from ZRT. I fully expect the results to be low throughout the day, most notably in the morning, just as they were in 2010. I had done a 6 week cycle on E/C prior to both and felt the same after. Will post results when I have them.

Action steps taken in reponse to the results above:

  • DHEA 200mg
  • 7-Keto DHEA 200mg
  • raw thyroid 390mg
  • isocort, 3-2-1 morn-mid-evening
  • southland revamp
  • diet revamped as the glucose value blows. going forward it’s basically paleo-esque without intentionally being paleo. ~50% fat, 50% protein, carbs in the form of liberal servings of veggies and incidentals from fat & protein sources. I always felt better on low carb diets anyway.

My immediate concern is RT3. As you can see in the prior years’ panels, the value has always been high. I don’t know how to get that down and I’ve heard countless theories on getting it down. Hopefully, solving that would solve or at least improve other issues like low free test and low T. Given the fact that I’ve ALWAYS had trouble taking off fat (and even when I do, it’s usually a 1:1 ratio with fat:muscle loss, I suspect that is the source of my hypothyroid-esque symptoms)

Longterm concern is the low-normal T. I have yet to attempt to find a Doc for this because I know that the vast majority would turn me away in a request for an attempted restart or T supplementation and would simply call me normal. I’ve suspected low T since I was in my teens and I’m tired of it. I’m at the point where if I’m unable to resolve the issues “naturally” within the next 12 months, I’ll self-administer my own TRT

TIA for any assistance

2

[quote]flanktwo wrote:
Quick facts:

  • 30 yr male
  • 6’ ~210
  • body fat unknown, est @ ~18%
  • gain fat and carry it like a woman (goes first to hips, ass/legs, obliques, then the rest of the body)
  • low body hair
  • libido is lowish but no performance issues
  • high stress in the last 6 months, and the diet to match (ie: diet has sucked)
  • strength gains and fat loss have always been snail slow compared to peers
  • suspected most of my adult life of having low T, confirmed in 2010, and still the case today (see linked spreadsheet for historical data)

Main panels of interest: http://i49.tinypic.com/2ibg3fr.png (red = their noted out of range. yellow = “normal” but still concerning)

Full workup, including prior two tests: http://dl.dropbox.com/u/281318/bloodwork.xls
(all labs done in 12 hour min fasted state and at 8-9am)

I’m also waiting on diurnal cortisol from ZRT. I fully expect the results to be low throughout the day, most notably in the morning, just as they were in 2010. I had done a 6 week cycle on E/C prior to both and felt the same after. Will post results when I have them.

Action steps taken in reponse to the results above:

  • DHEA 200mg
  • 7-Keto DHEA 200mg
  • raw thyroid 390mg
  • isocort, 3-2-1 morn-mid-evening
  • southland revamp
  • diet revamped as the glucose value blows. going forward it’s basically paleo-esque without intentionally being paleo. ~50% fat, 50% protein, carbs in the form of liberal servings of veggies and incidentals from fat & protein sources. I always felt better on low carb diets anyway.

My immediate concern is RT3. As you can see in the prior years’ panels, the value has always been high. I don’t know how to get that down and I’ve heard countless theories on getting it down. Hopefully, solving that would solve or at least improve other issues like low free test and low T. Given the fact that I’ve ALWAYS had trouble taking off fat (and even when I do, it’s usually a 1:1 ratio with fat:muscle loss, I suspect that is the source of my hypothyroid-esque symptoms)

Longterm concern is the low-normal T. I have yet to attempt to find a Doc for this because I know that the vast majority would turn me away in a request for an attempted restart or T supplementation and would simply call me normal. I’ve suspected low T since I was in my teens and I’m tired of it. I’m at the point where if I’m unable to resolve the issues “naturally” within the next 12 months, I’ll self-administer my own TRT

TIA for any assistance[/quote]

In for Answers. Although I’ve never been tested (YET) for ReverseFT3, My blood panel looks very much like yours.

Good luck man

EDIT: Just looked at the excel sheet. Our blood panels are VERY close, even down to the low WBC. That should be looked at too.

Mine turned out to be Idiopathic and ‘fixed’ itself. Your Cholesterol levels are low, have you had a DHEA-S test? Eating carbs will help with the triglyceride end of things bringing up the CHOL a little bit. But If you’re like me, carbs make you fat and it’s a never ending cycle.

3

[quote]Darkane wrote:
In for Answers. Although I’ve never been tested (YET) for ReverseFT3, My blood panel looks very much like yours.

Good luck man

EDIT: Just looked at the excel sheet. Our blood panels are VERY close, even down to the low WBC. That should be looked at too.

Mine turned out to be Idiopathic and ‘fixed’ itself. Your Cholesterol levels are low, have you had a DHEA-S test? Eating carbs will help with the triglyceride end of things bringing up the CHOL a little bit. But If you’re like me, carbs make you fat and it’s a never ending cycle.

[/quote]
yeah WBC has been low…no idea why, and I experience no issues in terms of illness. Seriously I very rarely get sick and don’t remember the last time I was (it’s been a couple years). That combined with high lymphs and low neutrophils lead me to believe it’s further evidence of thyroid dysfunction.

My cholesterol values are fubared imo from the crappy diet. I haven’t been eating horribly as in fast food and stuff, but it’s been bad in that I know I wasn’t getting the required amounts of cals, macros were out of whack and I was doing shit that I hadn’t been doing for years, for example eating a big ass bowl of pasta with a glass of soda for dinner (which is why i think triglycerides are almost doubled). I honestly don’t expect cholesterol to be a problem going forward. I’ve been able to manipulate the numbers via diet alone in the past so I think I’m good to go in that respect.

DHEA-S is in the pic & spreadsheet…lowest one I’ve had in the last three years but mid-range I guess.

And agreed on carbs…never-ending cycle indeed.

4

[quote]flanktwo wrote:

[quote]Darkane wrote:
In for Answers. Although I’ve never been tested (YET) for ReverseFT3, My blood panel looks very much like yours.

Good luck man

EDIT: Just looked at the excel sheet. Our blood panels are VERY close, even down to the low WBC. That should be looked at too.

Mine turned out to be Idiopathic and ‘fixed’ itself. Your Cholesterol levels are low, have you had a DHEA-S test? Eating carbs will help with the triglyceride end of things bringing up the CHOL a little bit. But If you’re like me, carbs make you fat and it’s a never ending cycle.

[/quote]
yeah WBC has been low…no idea why, and I experience no issues in terms of illness. Seriously I very rarely get sick and don’t remember the last time I was (it’s been a couple years). That combined with high lymphs and low neutrophils lead me to believe it’s further evidence of thyroid dysfunction.

My cholesterol values are fubared imo from the crappy diet. I haven’t been eating horribly as in fast food and stuff, but it’s been bad in that I know I wasn’t getting the required amounts of cals, macros were out of whack and I was doing shit that I hadn’t been doing for years, for example eating a big ass bowl of pasta with a glass of soda for dinner (which is why i think triglycerides are almost doubled). I honestly don’t expect cholesterol to be a problem going forward. I’ve been able to manipulate the numbers via diet alone in the past so I think I’m good to go in that respect.

DHEA-S is in the pic & spreadsheet…lowest one I’ve had in the last three years but mid-range I guess.

And agreed on carbs…never-ending cycle indeed.[/quote]

Opps, I see the Dhea-S now. Thanks.

I found this for you, gives some pointers for sure!

What specifically are the reasons I, as a thyroid patient, make too much RT3? On top of the chronic stresses of your life, there are three common physiological reasons patients have noted, with the first two related to your adrenals (low cortisol, high cortisol), and the third related to your storage iron and serum saturation levels. Even low B12 and other chronic inflammation and other health issues can cause it.

When biological stress is excessive, such as being on the inadequate treatment of T4-only or being held hostage to the lousy TSH lab test (both which keep you underdosed or hypo), your adrenal glands produce high amounts of cortisol to help you cope with ongoing hypothyroidism and lingering symptoms and conditions. The excess cortisol inhibits the conversion of T4 to T3, and instead produces even larger amounts of RT3, creating an RT3 problem.

When biological stress is ongoing, your adrenals will eventually become fatigued, dropping from high cortisol to a mix of high and low, or all low, and those low levels put you into the problematic state of adrenal fatigue, which causes chronic anxiety, poor coping skills, paranoia, easy nausea, sensitivity to light or sounds, psychological issues, etc. When you donâ??t make enough cortisol, thyroid hormones can pool high in your blood. So your body responds by converting the T4 to excess RT3.

When ferritin, aka storage iron, is low, as can be your serum iron and saturation (which is quite common in thyroid patients), your red blood cells become less plentiful, and carrying thyroid hormones via your blood becomes inadequate, causing thyroid hormones to pool in your blood. The body responds by producing excessive amounts of RT3 to clear out the excess T4.

***Note that you can have either an iron problem, or a cortisol problem, or BOTH.

Tons of other info there too.

5

interesting…Rt3-ratio - Stop The Thyroid Madness
RT3 Ratio: 7
For healthy amounts of RT3, The ratio result should be 20 or larger. If lower, you may have a problem. Janie has noted that many patients without an excess RT3 issue have a result of 23 or 24.

I don’t think cortisol is an issue. Waiting on ZRT results but if they are like they were on the first test i took after an E/C cycle in 2010, then I’m expecting to be flatlined through the day. So maybe cortisol isn’t inhibiting conversion…Perhaps a ferritin issue. I’m in range but on the low end of the range. Maybe Iron supplementation is in order?

6

cortisol results came in. i’m pretty surprised that they’re apparently rather normal, even high in the afternoon…wasn’t expecting that.

7

bumping an old thread (and crossposting from another forum due to inactivity)…

background for the year:

basically floundered most of last year…stressed a lot and cheating on diet (more or less t-dawg 2.0). No real improvements in strength, body fat, or anything. Incidentally last year’s estimation of 18% body fat was off. It was more like 20%.

2013…jan/feb i try lyle mcdonald’s rapid fat loss program in conjunction with an attempt to clear reverse t3 that was high each of the last three years. i was on a ramp up (and down) T3 to about 75mcg. I say “about” because i was using liquid research chem. Lost some poundage but I never hit that hyperthyroid feeling indicating i’ve cleared rT3.

Came off in feb, did RFL off and on until saying screw it (it’s hard to stick to). April first i go back to RFL and couple it with low dose T3. ramp up and down on 12mcg with a few days of 25mcg. I hit hyperthyroid status about 2/3 through. high heart rate and itchy body. so i quickly stopped about april 25-30 (lost my logs to a hard drive crash). I assumed I was cleared once i felt hyper (which has since gone away). And I don’t know whether it was placebo or what but I started feeling pretty darn good. Mood was/is great vs the prior state of feeling slightly above average, if that makes sense. I still floundered with diet so at the beginning of May, I switched to paleo which made me feel even better and is a helluva lot easier to stick to…should have done it sooner :slight_smile: I’ve lost about 6 lbs just this month and as you can see in my blood work aside from thyroid, my testosterone is reflecting that I believe.

I thought the tests I got included reverse t3, so I’m going to get that done next week.

Bloodwork (note that some of the units are different than last year’s and I’ve converted…hope it’s right)

Test: 847 ng/dL (!!! 64% improvement??)
% Free & Weakly bound: 10.8% (9.0-46.0)
F+W bound: 91.5 ng/dl (40-250)
DHEA-S: 242.5 ug/dl (160-449)
Estradiol: 28.6pg/ml (7.6-42.6)

LH: 6.4 miu/ml (1.7-8.6)
FSH: 1.8 miu/ml (1.5-12.4)

TSH: 0.018 uiu/ml (0.450-4.500)

T4: 5.5 ug/dl (4.5-12)
T4, free 0.78 ng/dl (0.82-1.77)
free T4 index: 1.7 (1.2-4.9)

T3: 85 ng/dl (71-180)
T3, free serum: 2.6 pg/ml (2.0/4.4
T3 Uptake: 30% (24-39)

Also, since earlier this month i’ve been taking fasting glucose measurements (home electronic meter) every so often. i’m consistently at about 85.

Supplements of interest:

  • iodoral 12.5mg/day
  • 7-keto 200mg/day
  • now foods thyroid energy 2caps/day
  • natural sources raw thryoid 1-2 caps day (started at 2, now at 1 as of this week)
  • 1500mg 10% guggul

Should I stop the raw thyroid (or anything else for that matter)? It seems like TSH is still suppressed and from my understanding, people usually recover quite quickly so I’m thinking maybe the raw thyroid is suppressing it?? I also have tyrosine on hand…should i start that?

note: i’m confused as to the value of the serum T number vs what is reported as being bioavailable. i’m following up friday with a comprehensive check from LEF. will have everything including stuff like SHBG, reverse T3, etc