Bloodwork Tomorrow, Correct Tests?

Pharma / TRT Testosterone Replacement
1

Age: 32
Height: 6’3"
Weight: 260lbs
Waist: 40 approx
Fat is mostly around midsection, always seems to be there, upper body doesn’t look as fat.
Few years ago when I dieted down to single digit bf, I took low calories, around 2000. That seemed to be the only thing that worked for me.
I was on a cycle last year, I can’t remember if I took proper PCT when coming off. But I never feel any different if I do take it or don’t. My gf got pregnant a few months ago, on the second try, so I’m guessing it shouldn’t be too low (not sure if that’s even related).
I started running four days a week, and training, and I can’t drop a pound.
Sometimes I think I have depression, sometimes I don’t. I don’t know if I don’t, or if I have been depressed for so long, I’m just used to it. It’s not severe if I do have it. I can get out of bed, and function normally. But times I just don’t care, lack motivation, etc.

I told my doctor I’ve been feeling tired the past 1-2 years. I often have to take a nap during the day, where as in the past I could go through a day on 3-4 hours of sleep with zero problems, and wouldn’t be able to nap if I wanted to.
I’m also struggling to lose weight, I’m about 18% right now, and can’t drop a pound, where as I’ve been single digit BF before.

So I wanted my thryoid checked, and asked him to check my testosterone too.
I used testosterone about a year ago, along with cytomel, dropped a few pounds, but really couldn’t make good progress after several months.
I’m 32 years old now.

I have some symptoms of low test and/or low thyroid, but not others.

I feel tired.
Sometimes depression.
Can’t lose weight.
I read a symptom of low thyroid is plaque build up, and I’ve had issues with this the past couple years, even when brushing and flossing every day.
Sex drive seems fairly low.
But I don’t feel cold, have dry skin, brittle nails, etc.
I don’t get morning wood, it’s been years since I can say I have, unless I really have to go to the bathroom.

Anyways, my doctor has me going for blood work tomorrow.
He didn’t select “iron”, which I thought being tired often, he would, but I don’t really know if that’s relevant.

Under Endocrine he checked of TSH, and Testosterone (Total).
He did not check off Free T4, T3, Thyroid Ab, FSH, LH, Estradiol, Prolactin, Progesterone, B-hCG, Cortisol AM, PM, Cortisol (Random). He also did not check off PSA (total or free), CEA or Homocysteine.

Am I missing anything that should be tested that isn’t? My Dr isn’t the best, so I’m worried I’m missing important tests to properly check my thyroid and testosterone levels.

2

There is no reason to suspect any prostate problems at your age, therefore no PSA.

You can press for fT3, fT4. But perhaps you should read the thyroid basics sticky and check your waking body temp before you get out of bed. Then you might have evidence of a functional thyroid issue.

You need cortisol random as you have complaints of fatigue.

Have you been ,long term, iodized salt or taking vitamins that list iodine?

Low T result will be useless without LH/FSH. But if T is low, one can follow up with LH/FSH, FT, E2 as a diagnostic effort.

You doc may be focused on disease management instead of health management.

Do not do any thyroid lab work after doc palpates your thyroid, that can affect the lab numbers.

3

Hello
Thanks for the reply. I will read the thyroid basics thread.

I will try and get the cortisol random added.

I take Orange Triad that has 255mcg of Iodine in it, but I take 4 pills instaed of 6 so I get 170mcg of Iodine. I’ve been taking the multi for several months, it actually seemed to have helped with fatigue, or atleast it seems. I was needed to nap almost daily, but with multi, not as much.

" Do not do any thyroid lab work after doc palpates your thyroid, that can affect the lab numbers. "

Sorry, what do you mean by this?

4

If you squeeze the thyroid, you cause a surge in blood levels of the thyroid hormones. Doc will feel your thyroid gland. Google!

5

I checked my temp at night and was 96.5 before bed, at 1AM.
Woke up and it was 97.3. But thermometer wasn’t working so I’m not 100% sure it was accurate, but I assume it must have been atleast that temperature if I got that reading.

I got my bloodwork this morning, so I’ll wait for the results now.
Thanks for the help so far.

6

Hello

I got my test results in.
Testosterone is low. It’s 6.4 normal range 7.6-31.4
Everything else seems okay.
TSH 2.01 normal .35-5

ALT 27 Ref Range < 46
AST 23 Ref <37
BUN 7.2 Ref 2.5-8.1
Creatinine 117.6 ref 60-110

Glucose 4.5 ref 3.6-6

Lipids all god.
Only other borderline low is
WBC 4.6 REF 4.5-11
RBC 4.95 REF 4.4-5.9
HCT fr BLD .453 REF .4-.52

Iron is good, b12 is good.

I’ve dropped calories since I made my first post, and I’ve dropped around five pounds, so I started to think it wasn’t thyroid. Though my calories are pretty low for someone my size, so I still wasn’t sure.

Doctor gave me a prescription for Delatestryl aka enanthate. Not sure what dosage he wanted to go with, but he said every three weeks we’ll do injections.

Here is my question. I did a cycle last year, and I don’t think I did proper PCT. I may have just taken some nolvadex coming off, but no HCG, which is stupid because I have some sitting in my fridge. But my last injection was probably 12-14 months ago. Is it possible it’s still low from my cycle and I can bring it back naturally? Or after this long, is it a more serious problem and I should take the injections?

  1. WBC borderline low, is that a concern?

Thanks for the help.

7

TSH=2.0 is a problem, so are your body temperatures. Normal does not mean healthy or optima. In many cases it means that your doc will not do anything. Did you read that sticky?

You need to test LH/FSH and E2 before starting TRT.

You might consider a HPTA restart before you commit to TRT. If LH/FSH are low, you might be able to restart. If high, your testes are broken and TRT is only option unless a physical defect can be found and fixed with surgery [veins].

You are very overweight. Low thyroid can be a major factor.

Lipids are OK? Not if too low! We need data. Everything else looks OK may not be reality. You can edit your post above with more lab data.

Your situation looks like a train wreck waiting to happen, get on the right track, study the stickies. you are very uninformed! You need to be proactive about your health care, you cannot be passive; docs will kill you. Injections should be twice a week at least. Your doc is an idiot, most are.

8

I never saw E2 on the bloodwork form, so I don’t know what I tell my doc to test it.
I can go back and ask LH/FSH to be tested, but I’m not sure about E2.
I’ve also dropped calories to about 1800 now, and I’ve lost about 7 pounds in the last few weeks. About four the first week, then 1-1.5 the next two weeks.

9

Okay, I finally got results from my next test.
No one knew/knows what e2 is, both my doctor and the lab.
Here are results of what I got this time:

Estraiol (They assumed this was e2) 96 normal: under 157
FSH 5.3 Normal: 2-12
LH 2.5 Normal: 2-9

Does this mean a restart could work? If so, can someone give me a link to a proper restart?
I have some HCG here right now, 5000ius.

10

Bump

11

Please respond to thyroid issues.
Did you read the stickies?

12

I read the stickies.
I don’t know what else to do about thyroid? My multivitamin gives iodine, so I’m getting enough.
I’ve taken my temperature morning and night.
I’m sure my doctor won’t have a clue what rT3 is.

13

Please help.

14

Bump

15

bump

16

Please help

17

Op your doctor is attempting to treat some thing he obviously does not know how to treat. Fire him and look up a good hrt doc. That’s what I did.

18

Go read the stickies again about Thyroid, there are other things you can do. Learn more about the Thyroid. And for sure get another Doctor, he is an idiot.

19

My city is usually behind on these types of things. I don’t think there are any doctors that specialize in this.
I read the stickies. I know my Thyroid is not optimal, my low test is my biggest concern.

20

Please someone help me. It’s been six months since I started this thread. I don’t know what to do.