Got My Lab Results... High Ferritin?

Pharma / TRT Testosterone Replacement
1

Hi everyone,

I’ve joined this forum about a month ago and based on my research, decided to get my hormone levels tested. I just received my lab results and I am looking for a little help in interpreting them.

A little background first. I am 39 and did about 6 months of TRT 5 years ago but quit due to the fact that my primary symptom (low libido) didn’t improve (I did see improvements in muscle mass, bady fat levels, and lipids).

I am not currently on any TRT, but I have been exercising heavily and following an extremely clean diet (25% fat, 45% protein, 30% carb. Average 2,000 calories per day, with a mega-cheat day on Saturdays averaging maybe 5,000 calories). In December I weighed 214 lbs at 24% BF. I am now 196 lbs at 17.5% BF (I use electronic calipers). I look and feel 10x better now, but my libido has only improved a little (no problems performing, but normally little desire).

Supplements include fish oil, Vitamin D (I was deficient), Magnesium, ALA, Picolinate, Vitamin C, and Lysine. I can provide exact dosages if necessary, but I am not megadosing any of these. I finished up my first bottle of Sustain Alpha one day before the labs below were taken. Haven’t taken it since then because I didn’t really feel any difference from it.

Anyway, my lab results just came in:

Male Stuff:

Total Test: 440 (250-1100 ng/dL)
Free Test: 76.1 (35-1100 pg/mL)
Estradiol: 19 (13-54 pg/mL)
DHEA-S: 126 (110-370 mcg/dL)
FSH: 1.6 (1.6-8.0 mIU/mL)
LH: 1.3 (1.5-9.3 mIU/mL) - LOW

Thyroid Stuff:

T3 Uptake: 35 (22-35%)
T4, Total: 7.1 (4.5-12.0 mcg/dL)
Free T4 Index: 2.5 (1.4-3.8)

Other Stuff:

Ferritin: 367 (20-345 ng/ML) - HIGH

My doc is not a TRT specialist and doesn’t know how to interpret most of these numbers. I have a cousin with hemochromatosis so I’m going to get these ferritin levels checked out. I would really like to walk in there informed though, so any advice you guys can provide would be well appreciated!

Thanks,
OT

2

Was reading through a few more posts and thought I would add a little more info:

Height: 5’10"
Weight: 196
Waist: 36.5"

Rest of these numbers are about 6 weeks old… I lost 20 lbs since then, so they are probably vastly improved:

Total cholesterol: 232
LDL: 160
HDL: 48
Triglycerides: 122
Insulin: 6 (3-25 uU/mL)
Vitamin D: 20 (been supplementing with 6000 IUs/day since)

Note: my LDL pattern is type-A (large molecules) so this isn’t quite as bad as it seems.

Mood: fantastic! Highly energetic and upbeat all day.

Libido: low, but seems to be improving a little.

3

When did problems start?
Any blows to your head prior to that or car accidents?

36.5 waist and 17.5% BF, that really does not make any sense to me!

You need a high potency B-vit complex to try to improve HDL.

If eating any iron fortified foods, change that.

Take 25mg DHEA

free test range is bogus, you can edit that post via a function in the lower RH corner.

No TSH?
You need fT3, fT4, not what you have.

Check your waking body temp for a few days, write the numbers down and report here. If near 97F or lower, you have some degree of hypothyroidism. If near 97.8, you would seem to be OK.

Do you use iodized salt?

Your problems may be caused by or aggravated by over training. Starvation can lower cortisol and increase rT3. We have seen these cause low T and other problems.

Estradiol is in-line with expectations for your TT levels.

LH/FSH are low and E2 is not the cause of this repression.

Is your hematocrit or RBC count high? Numbers?

You need TSH, fT3, fT4, not what you have.

4

Libido started dropping around 10 years ago, very slowly over time.

No blows to the head that I’m aware of.

36.5" waist and 17.5% BF - I’m using a 3-site test (thigh, ab, chest). I have basically no fat on my legs so my reading there is a 7mm. That probably drives it down. The other readings are around 27 (ab) and 20 (chest). I don’t worry about it too much, as long as it’s going down. FWIW, I have one ab showing.

HDL - I’m all over my lipid numbers and expect my next test to show massive improvement. I am getting a Spectracell test soon and fully expect them to confirm your recommendation on the B-vitamins.

No iron fortified food. Diet is incredibly clean in fact. Organic meats, no flour, very little processed food (other than the occasional can of vegetables and whey protein).

DHEA - I will start this today.

Free Test - # is exactly off the sheet but the units are different. Looks like it equates to 1.7% free (which is about the same as it was 4 years ago). I’ll double check today to be sure though.

TSH - I have no clue why they didn’t run it, makes no sense to me. Isn’t T7 essentially a measure of circulating thyroxin? From what I’ve been reading, if you’re not on thyroid medicine, this is supposed to be a good measure of thyroid activity.

Body temp - I do this now. I am almost always at 97.5 when I wake up.

Iodized salt - I will have to check, but almost certainly yes. Is it possible to get salt without iodine these days? Good suggestion though.

Overtraining - definitely not the case with me. I just started training seriously again two weeks ago (prior to that was very light aerobic activity and weights maybe once a week). I feel fantastic, every levels are high as well.

I don’t have hematocrit or RBC counts right now. Sounds like this is something I should ask the doc for if he doesn’t suggest it? I was planning on getting some additional tests to check for hemachromatosis.

5

KSMan,

Thanks for your comments, much appreciated.

I’m going to bump this because I’m burrowing deeper into the rabbit hole and finding lots of old threads on this stuff, many of them conflicting. I have lots of questions and I’m wondering if you would be so kind as to enlighten me a bit more!

LH: this seems to me to cut to the heart of a lot of my issues. LH triggers the conversion of cholesterol to pregnenolone, right? When I was on TRT previously, the doc had me on HCG. My lipids immediately came under control. So how do I increase LH? I’d rather avoid the HCG route due to expense (the one doc I know who will prescribe is insanely expensive) and inconvenience.

Also, why causes low LH? I used to drink a lot in my 20’s (binge drink, not the every day type). That has tapered off quite a bit in the past decade, but I do like to have a glass of wine a few nights a week. Can alcohol cause this? Is it reversible?

DHEA: Started today, 50mg. I remember taking this five years ago on doc’s orders and my numbers jumped way up. Don’t know what effect I can attribute to it because the doc put me on a few things simultaneously.Can increasing DHEA levels result in higher T? Will E2 follow?

Iron - I could have hemachromatosis. Or maybe it’s the fact that I’ve been cooking a few steaks a week on a cast iron skillet. I’m betting the latter so I’m thinking I’ll cut that out and retest in a couple of months.

One more breadcrumb from my past TRT - I do not have primary hypogonadism. Testes are fine and respond very well to increased LH. Seems like LH is the problem.

6

LH hormone is made in research quantities and is not affordable. hCG gets the job done. Healthy functional testes make some pregnenolone. If the HPTA is shutdown, they will not unless one used hCG. Pregnenolone is a secondary effect of activation of LH receptors. HMG also works well, but is more costly than hCG. You can increase LH with a SERM if the top end of the HPTA is working. SERMs are not considered appropriate for long term use. There are issues that you will need to understand. hCG is not cheap, but a 10,000iu vial will last 80 days at 250iu EOD. The non obvious answer is to fix your HPTA, but that

What do you mean by T7? Typo?

Sea salt has no iodine unless labeled otherwise. Kosher salt has no iodine. Pickling salt… none I think. Salt used in prepared foods typically has no iodine. As we eat more prepared foods, societal iodine intake has dropped.

Is your hematocrit or RBC count high? Numbers?
Ferritin is high, the other above labs might confirm a need to loose some blood, blood donations if possible.

7

T7 is another name for the free T4 index. It’s generally considered to be a reliable indicator of thyroid function and I believe measures the amount of Thyroxine being delivered to the cells.

It turns out I have been using sea salt, but I generally used salt sparingly if at all even before that. I’ll switch back. Great to know!

I don’t have hematocrit of RBC counts. I think what I’ll do is continue supplementing with zinc and eliminate the red meat for two months and test again. I learned at serum ferritin can be falsely elevated by high cholesterol and viral infection, both of which I had when I was tested.

So back to increasing LH. I didn’t find the HCG to be expensive, but rather the doctor here who is willing to prescribe. It’s also mighty inconvenient.

You suggested fixing e HPTA but your post was cut off. What did you mean by that exactly? In my case, testes are working fine but LH and FSH are both near or below the bottom end of the range. I haven’t had anything else tested so I’m not sure where to go from here. Seems like DHEA is a good addition but it’s too far down the hormone chain to help…?

Appreciate the dialog, this is very helpful.

8

Most here simply work with fT4.

Injecting hCG would be inconvenient? Your current state is inconvenient. You get to choose a new devil instead of the one that you know.

cholesterol → pregnenolone → DHEA → Testosterone —is the chain, highly simplified.

Fixing ones HPTA is sometimes possible, if you can find a correctable problem that can be fixed.

Hemochromatosis Iron overload - Wikipedia
Can also be a factor.

You can do a SERM trial. If that does not increase T levels, then there is no reason to expect that the problem can be fixed unless a vein defect of the testes can be found and corrected. Typically that can ache.

9

Hey KSMan,

I have no idea why they didn’t give me the standard thyroid panel as I asked for it. Quest, go figure.

I’m not really interested in HCG right now. Needles were a major pain in the ass, especially with my travel schedule. It did increase my test from 440 to 960 but it more than doubled my estrogen. My doc at the time (2006) didn’t have any suggestions (which was the main reason I quit TRT - expensive and no improvement in symptoms).

I placed an order for Nolvadex. Seems like it’s exactly what I need. Figure I’ll try it for a month and see what effect it has on my LH. Thanks for the tip!

10

Not telling you what to do one way or the other. Here are some things to consider.

We should expect that the dose of nolvadex that creates the same LH receptor action as your [prior] dose of hCG will create the same amount of E2 by your testes and the resulting serum T levels will drive peripheral T–>E2 in a similar fashion. If a given dose of nolvadex creates less LH receptor action and E2 levels are lower, a smaller dose of hCG would do the same.

High levels of LH would be expected to degrade LH receptors in the same fashion as hCG. It is also known that constant levels of LH [non pulsatile] can shut the testes down. [I have never seen an explanation of why hCG with is vastly longer half life does not have such actions.]

With a SERM, LH will still be pulsatile and LH lab results will be in part determined by lab timing. So we still have FSH has the better indicator of gonadotropin release as FSH has a much longer half life. [Just at DHEA-S has more lab value than DHEA.]

Watch for ‘floaters’ in your vision and get off the the nolvadex if this develops.

[Repeating: It has been found that lesser doses of SERMs can be quite effective. That would also be expected to reduce side effects.]

11

Again KSMan, more excellent information. Thank you.

The Liquinolva arrived today. Took my first dose (1ml at a concentration of 25 mg/ml, so around 25mg of liquinolva, or around 17mg of Tamoxifen). I plan to take it in the evenings for the next month and get my blood drawn again.

Sadly, I have not been able to locate the actual copies of my blood work from 2006. I had written down most of the values but not the LH/FSH numbers because I didn’t understand them at the time. From what I recall, I was taking a minimal dosage of HCG and my test jumped from 400 to 960 in a short period of time. Testicle size increased commensurately as well.

DHEA update - morning wood has returned, but not every day. Seems like it was more last week than this one. Libido has increased a little, but not much. Been having more sexual dreams. I like the direction this is heading but want more.

I’ve also completed Spectracell testing and should get the results in another week.

Fat loss has slowed to about one lb per week. I am now down to 192 (from a starting weight of 214 lbs 60 days ago) and the calipers are showing me at 16.5%. I have more abdominal fat than I remember in the past … hopefully the Nolva will help with this.

12

I was about to turn off the computer but your comment about “floaters” just made me realize something.

Last year I noticed a floater that would appear whenever I looked at the computer screen too long. It was around for quite awhile (most of the year). I was chalking it up to aging and maybe too much screen time.

You just made me remember that. The floater is gone now … I don’t think I’ve seen it in at least a month, maybe longer.

13

KSMan,

Day 1 of Nolva: back acne and morning wood like I haven’t had in a long time.

Nice…

14

Update: I am now down to 189 lbs. I’ve lost an additional 7 lbs this month, which to me was particularly impressive as I had been stuck at a plateau for a few weeks. BF has dropped to 15.7% (I started at 24%) and my waist is down to 36".

I made a number of changes, some at KSMan’s suggestion.

  1. Nolvadex (20mg/day) - had a bit of acne at first but it went away. Started getting morning (and evening) wood much more frequently. Libido is much stronger now and I’m hard as a rock down there. Not back to 18 yo levels, but not a bad result.

  2. Switched my generic CKD diet to the Anabolic Diet. I feel great from it and the weight loss was fast and furious. Guess I’m carb sensitive. I am NOT looking forward to my next cholesterol test though.

  3. ECY stack - alternating E and Y to avoid stacking them together. Very effective.

  4. Increased calories to 2300/day (from 2,000).

expecting to get my spectracell test results back today… Will be interesting to see what it uncovers.

Oh, almost forgot. I also received my 23andme.com test results back as well. No major genetic issues and in fact, it identified my muscle type as primarily fast-twitch (sprinter). Guess that explains why I was so successful at boxing when I was younger! It’s quite motivating as well… Once I hit 10%, maybe I’ll try to build some serious muscle…

15

We seem to have a similar type of blood profile. I’m focusing on lowering my ferritin down to about 100. I think that is my core problem.