Lab Results

Hello everybody first time poster. Just got my labs from the doctor back and wanted some input. All labs were done by Labcorp

Total T 316 348-1197
LH 5.0 mIU/mL 1.7-8.6
FSH 4.7 mIU/mL 1.5-12.4
Prolactin 6.6 ng/mL 4.0-15.2
Estradiol 16.1 pg/mL 7.6-42.6

Cortisol-AM 6.3 ug/dL 6.2-19.4

Doctor called in a script of Testim without me talking to him first on what I want. Just curious about my Cortisol as it seem on the very low end of normal. I have been feeling extremely tired and was wondering if that had an effect. Thx for any input

Sorry i forgot to add…

39 year old male
5’ 11" 205 lbs

I would address cortisol before taking the testim. Might want to test pregnenolone and progesterone. If those are low, you’ll know how to make improvements in cortisol.

okay thanks. i will try and get my doc to run those 2 tests. If both of those are low what are my treatment options?

what time were your labs taken?

labs were taken at 8:30 a.m…

Very low cortisol for that time of the day…read up on Adrenal Fatigue (there is a good book by Dr. Wilson of that name on Amazon). Look for stressors that could be negatively impacting your hormones. Emotional obviously, but also physical (sickness, heavy metal toxicity, etc.)

Starting T treatment may be premature, IMO

yeah it seems like a lot of the symptoms of low t and adrenal fatigue overlap…i had a total testosterone check done by quest 3 weeks ago and it was at 254…but im wondering if my cortisol levels would improve would that help out my test and would raising my test help my cortiol levels…

yes, they are all connected

[quote]tkmoney wrote:
okay thanks. i will try and get my doc to run those 2 tests. If both of those are low what are my treatment options?[/quote]

If pregnenolone is low, I would supplement that first. If that’s in the high normal range and progesterone is still low, supplement progesterone. If both pregnenolone and progesterone are in the high normal range and cortisol is still low, you have other issues. Preg and prog are easy to fix with transdermals (lotions) you can find on amazon, that’s why I would start there.

ok thanks but my dr already prescribed me Androgel 1.62…are you saying I should even start testosterone at all right now?..also he started me on the maximum dose of 4 pumps (81g) a day…not sure why or if i should even start with the max…

got my free test results back and it was 11.3 (8.7 - 25.1) range

I’ll defer to one of the more experienced members here, but I don’t think exogenous Test is going to help your low cortisol.

It’s your body, but my guess is you could make some improvements without starting on the T gel. You start taking T now and it’s going to pretty tough to figure out what the underlying issue is. You LH and T numbers seem to point towards primary, but there are quite a few things you could test for and try to improve before jumping into full-on replacement. Just my 2 cents.

yeah i hear you…i have been working thru my primary care dr and so far he has been willing to listen to me and ordered the labs that i requested…i could ask him to run a prog and preg test and see where that takes me…

Ok so I have been on Androgel 1.62 for a month and just got my labs back today. I noticed I felt better right away but after a week it seem to have very little effect for me. I was taking 3 pumps a day. All results are from Labcorp…

Testosterone Total 332 (348-1197)
FSH 3.4 (1.5-12.4)
LH 3.5 (1.7-8.6)
Estradiol 24.6 (7.6-42.6)
Prolactin 3.8 (4.0-15.2)
Cortisol AM 5.8 (6.2-19.4)
Testosterone F W Bound 108.9 (40-250)

Doctor said he was worried about my pituitary gland with a possible tumor and wants me to come in and set up possible brain MRI. I was told my FSH and LH were low and that was a concern.

My question is wouldnt my LH go down due to me taking Androgel?. Also, I understand that im not absorbing well or they may be some other issues going on. Any comments or thoughts are welcome. Thx

What time of the day were your labs taken? Your non-existant cortisol means you are likely dead.

Did you address this as you were previously advised? Or do you insist on going down the androgel route? Clearly not working either.

Of course LH/FSH are suppressed–you are taking exogenous testosterone (though not enough of it is being absorbed).

Your doctor is not really grasping the fundamentals, and the fact he has not addressed your cortisol is a scary sign.

VT, labs were taken at 830 a.m…and yes I’m concerned with my cortisol and brought it to his attention several times…he wanted me to try the Androgel first and go from there…yes he is just a gp doc and I would love to switch but my insurance covers all labs and my androgel is only 10 bucks a month…

How much is your health worth? Here is on area that I might recommend actually going to an endo. You have documented hypoadrenia/hypocortisolism (whatever you want to call it). This isn’t a case where its not “optimized” you are below the range and aren’t producing it. Endos are actually good at these kinds of things, though I guess it might depend on how far below the range you were.

I recommend getting that fixed before attempting TRT (though TRT can be a useful bridge when done correctly and if you can tolerate it). Your TRT regimine, however, is not correct since you aren’t absorbing it. Could be related to the cortisol issues. Either way, those should be addressed and soon!

yeah thx VT, I actually went to another doc who is part of the anti-aging assoc and does take my health insurance. He was concerned with my cortisol and ordered a adrenal test and they just came back. Here is the results.

Cortisol Saliva 4.4 ng/ml 7:30 am (7-10)
2.5 ng/ml 12:30 pm (3-6)
1.4 ng/ml 5:30 pm (2-4)
1.7 ng/ml 10.30 pm (less than 1.5)

DHEA Saliva 1244.8 pg/ml (41-578)

I also had 12 Neurotransmitters tested and my Serotonin was low along with my 5-HIAA…Here is this doctors recommendation…

The most significant finding in your urine and saliva test is very low serotonin and 5-HIAA, one of its metabolites. There are also some imbalances in the adrenal functioning. My recommendation would be to start on 5-HTP 100 mg 2x daily and Rhodiola 1 cap 2x daily…

dunno anything about those meds…IMO, you would probably need hydrocortisone until you stabilize…those other things sound like supplements–you are way past the supplement stage…time for a medical intervention

yeah i think your right and I even mentioned that to him at my last appt and he said that was an option…i think those other meds are for my low serotonin…will find out more tomorrow…thx