Help with Lab Results

Pharma / TRT Testosterone Replacement
1

Hi everyone. I just got my lab results back, and I am awaiting my initial consult. I wanted to get the read of some individuals who have some experience, so I can have some groundwork done going in. I am a 36yo male, been experiencing Low T symptoms for about a year and a half. Here is a portion of my lab results. If there are any other numbers you are interested in, let me know and I will be happy to provide. Thanks in advance for you time and help.

Comp. Metabolic Panel (14)
Glucose, Serum 93 mg/dL 65 - 99 01
BUN 11 mg/dL 6 - 20 01
Creatinine, Serum 0.99 mg/dL 0.76 - 1.27 01
1.00
eGFR If NonAfricn Am 98 mL/min/1.73 >59
eGFR If Africn Am 113 mL/min/1.73 >59
BUN/Creatinine Ratio 11 8 - 19
Sodium, Serum 140 mmol/L 134 - 144 01
Potassium, Serum 4.5 mmol/L 3.5 - 5.2 01
Chloride, Serum 98 mmol/L 97 - 108 01
Carbon Dioxide, Total 24 mmol/L 18 - 29 01
Calcium, Serum 9.8 mg/dL 8.7 - 10.2 01
Protein, Total, Serum 7.5 g/dL 6.0 - 8.5 01
Albumin, Serum 4.5 g/dL 3.5 - 5.5 01
Globulin, Total 3.0 g/dL 1.5 - 4.5
A/G Ratio 1.5 1.1 - 2.5
Bilirubin, Total 0.3 mg/dL 0.0 - 1.2 01
Alkaline Phosphatase, S 101 IU/L 39 - 117 01
AST (SGOT) 23 IU/L 0 - 40 01
ALT (SGPT) 24 IU/L 0 - 44 01
Lipid Panel w/ Chol/HDL Ratio
Cholesterol, Total 220 High mg/dL 100 - 199 01
Triglycerides 209 High mg/dL 0 - 149 01
HDL Cholesterol 51 mg/dL >39 01
Comment 01
According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a
negative risk factor for CHD.
VLDL Cholesterol Cal 42 High mg/dL 5 - 40
LDL Cholesterol Calc 127 High mg/dL 0 - 99
T. Chol/HDL Ratio 4.3 ratio units 0.0 - 5.0
Please Note: 01
T. Chol/HDL Ratio
Men Women
1/2 Avg.Risk 3.4 3.3
Avg.Risk 5.0 4.4
2X Avg.Risk 9.6 7.1
3X Avg.Risk 23.4 11.0
Testosterone,Free and Total
Testosterone, Serum 260 Low ng/dL 348 - 1197 01
Comment:
Adult male reference interval is based on a population of lean males
up to 40 years old.
Free Testosterone(Direct) 8.2 Low pg/mL 8.7 - 25.1 02
DHEA-Sulfate 433.3 High ug/dL 102.6 - 416.3 01
TSH 3.870 uIU/mL 0.450 - 4.500 01
1.00
Luteinizing Hormone(LH), S
LH 3.6 mIU/mL 1.7 - 8.6 01
Prostate-Specific Ag, Serum
Prostate Specific Ag, Serum 1.1 ng/mL 0.0 - 4.0 01
Roche ECLIA methodology.
According to the American Urological Association, Serum PSA should
decrease and remain at undetectable levels after radical
prostatectomy. The AUA defines biochemical recurrence as an initial
PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory
PSA value 0.2 ng/mL or greater.
Values obtained with different assay methods or kits cannot be used
interchangeably. Results cannot be interpreted as absolute evidence
of the presence or absence of malignant disease.
Estradiol, Sensitive 22.8 pg/mL 8.0 - 35.0 02
This test was developed and its performance characteristics
determined by LabCorp. It has not been cleared by the Food and
Drug Administration.
Methodology: Liquid chromatography tandem mass spectrometry(LC/MS/MS)
Progesterone 0.8 ng/mL 0.2 - 1.4 01

08/22/2016 Total Chol:HDL
Ratio
T. Chol/HDL Ratio Men Women 1/2 Avg.Risk 3.4 3.3 Avg.Risk 5.0 4.4 2X Avg.Risk 9.6 7.1 3X Avg.Risk 23.4
11.0
Mitchell S. Laks, PhD - Laboratory Director
Current Laboratory Results
Blood Draw Date: 08/22/2016 Date Received: 08/22/2016 Date Completed: 08/23/2016 Fasting: YES
Comp. Metabolic Panel (14)
ANALYTE REF. INTERVAL LOW HIGH RESULT
Glucose mg/dL 65-99 93
BUN mg/dL 6-20 11
Creatinine mg/dL 0.76-1.27 0.99
Sodium mmol/L 134-144 140
Potassium mmol/L 3.5-5.2 4.5
Chloride mmol/L 97-108 98
Carbon Dioxide mmol/L 18-29 24
Calcium mg/dL 8.7-10.2 9.8
Protein, Total, Serum g/dL 6.0-8.5 7.5
Albumin g/dL 3.5-5.5 4.5
Globulin, Total g/dL 1.5-4.5 3.0
A/G Ratio 1.1-2.5 1.5
Bilirubin, Total mg/dL 0.0-1.2 0.3
Alkaline Phosphatase, S IU/L 39-117 101
AST IU/L 0-40 23
ALT IU/L 0-44 24
BUN: Creatinine Ratio 8-19 11
Anion Gap mmol/L 8 - 14 18 H
estimated GFR
mL/min/1.73mE2

59 98
Albumin testing performed on the Roche Modular using the ALB PLUS assay.
Lipid Panel with Chol/HDL Ratio
ANALYTE REF. INTERVAL LOW HIGH RESULT
Total Cholesterol mg/dL 100-199 220 H
Triglyceride mg/dL 0-149 209 H
HDL-C mg/dL >39 51
VLDL mg/dL 5-40 42 H
LDL(calc) mg/dL 0-99 127 H
non-HDL cholesterol mg/dL 0 - 129 169 H
Total Chol:HDL Ratio ratio units 0.0-5.0 * 4.3
TSH
ANALYTE REF. INTERVAL LOW HIGH RESULT
TSH uIU/mL 0.450-4.500 3.870
L - Below Low Normal
H - Above High Normal
LL - Alert Low

2

please always post lab ranges, they are not the same from one company to another

use the edit icon below your post to edit

Thyroid:
TSH should be closer to 1,0
Thyroid lab ranges are rather useless
TSH could be high from not using iodized salt and/or vitamins that list iodine+selenium

What is your history of using iodized salt?

Thyroid is complex and TSH is only one part of the puzzle. The best overall measure of your thyroid function is to check your oral body temperatures as per the thyroid basics sticky.

You T is low, but at your age, low-T is a symptom and not the disease. You do not have a diagnosis.

Labs: - more that what you posted!
TT
FT
E2
LH/FSH - do not start TRT before getting this done
prolactin - if elevated, can lower LH/FSH and T
CBC
hematocrit
Vit-D25
fasting cholesterol
fasting glucose

Where are you located? - affects medical options

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

  • advice for new guys - provide more info about you
  • things that damage your hormones
  • protocol for injections
  • thyroid basics - check oral body temperatures
  • finding a TRT doc

You need to understand why your T is low - diagnostics, so the root cause can hopefully be corrected/managed.

Thyroid issues are very common with guys who come here. Many of the symptoms of low thyroid function are the same as low-T, so you have double problems and fixing T alone would still leave you feeling down. Take this seriously and do not have T-tunnel vision.

3

Updated labs, and I will check out the stickies and respond accordingly, thanks. To answer the quick questions, I have a loving relationship with iodized salt, have never avoided it , but couldn’t even remotely guess as to my intake, And I’m in Oklahoma. Thanks!

4

Thanks for the full set of labs.

LH suggests that your low T is secondary hypogonadism.
Not caused by elevated E2.

LH is released in pulses with a short half life, so one lab is a random sample of an unsteady signal. Labs should be LH and FSH as FSH has a longer half-life and provides a steadier signal that can be a better indicator of LH status than LH alone.

When you correct T levels and get thyroid resolved, your cholesterol should improve. And then get some exercise to lower triglycerides.

Signs of thyroid trouble:

  • sparse outer eyebrows
  • feeling cold easily
  • dry skin, brittle hair/nails
  • thyroid sore, enlarged, lumpy
  • fat gain and/or inability to loose fat
  • low energy
  • mood/depression problems
5

The last three items on your thyroid checklist above apply, but none of the others.

-age
36
-height
6’0"
-waist
35
-weight
215
-describe body and facial hair
never been hairy. cannot grow full beard.
-describe where you carry fat and how changed
have only ever carried in abdomen, “love handles.” This has increased by 20 lbs in last year.
-health conditions, symptoms [history]
none
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
no, no, and no
-lab results with ranges
posted
-describe diet [some create substantial damage with starvation diets]
Not ideal, not terrible. Example: English Muffin with peanut butter & 2% milk for breakfast, leftovers for lunch, jambalaya, garlic bread, and salad for dinner
-describe training [some ruin there hormones by over training]
none, but job is physical
-testes ache, ever, with a fever?
They have ached before, for maybe a day at a time, no fever. I do have an epididymal cyst, but was told it was nothing to worry about, and has never “bothered” me.
-how have morning wood and nocturnal erections changed
Rarely if ever. I’ll never get an erection without physical stimulation, and even then it is difficult to achieve, maintain, and complete, to varying degrees.

6

If testes were holding you back substantially, we would see elevated LH/FSH - in theory. But we can expect combined primary and secondary at times, so hard to generalize.

Try to get prolactin tested and get those oral body temperatures.

Give the above info, needed labs:
Vit-D25 - or take 5,000iu Vit-D3 ED and be done with it
prolactin
IGF-1 to eval GH status
TSH, fT3, fT3 -please not T3, T4
CBC
AM cortisol

In the time frame before you think that things became a problem:

  • any blows to the head or whiplash?
  • chronic or acute exposure to chemicals, fumes etc

If you tackle T and thyroid status, your life will be transformed
You will need a good TRT doc and a doc who is interested in thyroid optimal values and can see outside of the lab range normal box.

As you were never deeply virilized, your T levels were never very good and if there was some possibility of a HPTA restart, I expect that you would simply get back to inadequate.

So TRT should be pursued. Get up to speed with the stickies so you know what your are fighting for with the doctors. Doctors are the biggest problems as most are idiots when it comes to these issues. See the finding a TRT doc sticky for scouting suggestions. Note that many good TRT docs do not take insurance, because the insurance companies are not interested in getting guys on lifelong hormone treatment. A good enthusiastic GP is the best outcome, but hard to find. Urologists are terrible as a group and endos the worst. Now that I have pumped up your expectations … go forth and do battle.

I think that I found you on WWW, three sons? That is a handful. You will gain a lot more energy and tolerance with TRT and thyroid.

The next thing that you can get completed cheap and easy is those body temperatures.

7

Do you eat fish? Omega-3 fatty acids are very important to thyroid function, along with selenium, zinc and iodine.

Your tryglicerides are very high. Your trygliceride/HDL ratio is 3,7 which put you in very high risk for heart disease.

So, your thyroid seems “depressed” which could explain your symptoms and high cholesterol. In most casesm high cholesterol levels are not a disease, but a sign of a disease.

In your case, I guess that rT3 will be helpfull and important to understand what is happen with your thyroid, metabolism and testosterone levels.

8

None of the above.

Uh huh. And primary custody. :slight_smile:

On it. Thanks for all of your help.

Love fish, eat fish (and other seafood) several times a week. So I’m getting plenty of mercury as well. :skull:

I’ll work on getting these labs done. My whole life needs a turn around, and I am hoping that getting some of these levels straightened up will help me out, and the other levels, such cholesterol, etc., will fall in line as I become healthier in every facet of life.

9

If you choose the right seafood, you have no worry about mercury.

Both low thyroid and testosterone, may lead to high cholesterol levels. Thyroid helps to control LDL receptors, and testosterone is made of cholesterol. So, if your testicles shut down testosterone production, liver may trend to increase cholesterol production with an enzyme named HMG CoA reductase, to try to compensate the testicles to pruduce more testosterone.

So, In my opinion, your cholesterol levels are not so high. If you fix thyroid and testosterone, the cholesterol levels tend to lower.

But I’m quite worried about your tryglicerides levels.

10

These cholesterol levels do not worry me at all as the problem should resolve.

11

Hello can you please look at my last labs. I have a full panel. I want to go look at my test. I had my shot around midnight on Saturday so Sunday morning basically. And these where taking Thursday around 1052 am. 150mg shot. And I have been doing 170mg for a couple years before these labs. I feel great. No issues health wise i can upload the CBC also if you want to see.

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12

Cholesterol looks great. 180 is ideal, no need to be lower.
Never seen triglycerides that low.

TSH looking good.
Get those body temps!

Testosterone - good
Cholesterol - excellent
Thyroid - ???

Are you taking a statin drug to lower cholesterol?

Could there be a mix up of labs?

13

Hello. I don’t get labs for thyroid. Have not had any symptoms with it. I take a lot of fish and a lot of vitamins all plant based and organic. I do intermittent fasting. 12-16 hours a day of fasting. And diet is in check.

14

So my dosing of meds are still good to go.

15

Hello,

I sent you my labs from last year back in Sept you should still be able to see the picture. My provider is wanting me to lower my dose down from 150mg to 120 hopefully or maybe even 100mg a week. The results from the labs where on day 5 after a shot. Can you give me an idea on where I will be sitting and if I will even notice a change in the way I feel now on the lower dose?

16

Then check body temps to be certain.

Most of the symptoms of low thyroid function are the same as low-T, so how do you say that you have no symptoms? While that may be true, you cannot make that statement.

17

My body temp is 98.6 i did check it. Do you have a response to the ? from yesterday?

I sent you my labs from last year back in Sept you should still be able to see the picture. My provider is wanting me to lower my dose down from 150mg to 120 hopefully or maybe even 100mg a week. The results from the labs where on day 5 after a shot. Can you give me an idea on where I will be sitting and if I will even notice a change in the way I feel now on the lower dose?

18

Your labs were 4 days after injecting 160mg and you are requested to reduce by 20%.

Given your results, that may be a good outcome.

You have not tested E2 and not used any anastrozole. If E2 is elevated and you correct that, you may feel better than now.

E2 management often mission critical.

Have you read about using anastrozole in stickies or discussed with your doctor?
Also available google ‘research chem’

19

My E2 is 29