Recent Bloodwork

Training Over 35 Lifter
1

…good morning, just looking for a little ‘board’ advice before I meet back with my doctor on the 20th. A quick history, my doctors have been chasing a low-test problem on/off for the past couple of years now. Back in 2003 we got as far as trying out a 5mg Androgel patch for a period of about 30days, it didn’t seem to be doing anything so I was advised to stop. Next thing I knew a different doctor started talked about depression and what not and somehow my treatment got redirected. Well after three years of experimenting with every other SSRI, SNRI, and/or anti-psychotic drug under the sun, we’re back full circle and looking this being a hormonal issue and not so much a mental disorder (as previously diagnosed).

One thing I should add, back in 2003 it was suspected that it could be a Pituitary problem. I was sent for an MRI and the hospital diagnosed a Pituitary Macro Adenoma (that’s around the time that I started the Androgel). About two months after the MRI I was sent to a ‘Pituitary Specialist’ in Toronto. He found the results to be inconclusive of a tumor, thought that the images could also be the result of a ‘swollen’ gland, told me stop the Andogel. A year later we re-tested. Same hospital concluded that yes, the tumor was still there, and there was no change in size. About two years later we went back and we did a third MRI, this time the results came back normal??? Yesterday I just had my fourth MRI (it’s been approx two years). The results will be back in about a week.

As for the bloodwork. Here’s my latest results, I’ll list the important stuff anyways. And I should add that I’m Canadian, so I’ll list the Cdn reading, the reference range in brackets (as listed on the reports), and then the correct US conversion (that’s if I have it).

AST - 34 (6-42 U/L)
ALK PHOSS - 68 (30-110 U/L)
GAMMA GT - 15 (5-50 U/L)
CREATININE - 96 (60-125 UMOL/L)
eGFR - 87 (above 90 mL/min/1.73m2 is considered normal)

CHOLESTEROL - 2.72 MMOL/L (optimal less than 4.14 mmol/L)
LDL - 0.81 mmol/L (optimal less than 2.5 mmol/L)
HDL - 1.80 mmol/L (desirable more than 1.56 mmol/L)
CHOLESTEROL/HDL Ratio - 1.5 to 1 (desireable less than 6 to 1)
TRIGLYCERIDES - 0.24 mmol/L (normal less than 1.7 mmol/L)

TSH - 1.88 (0.30-4.70 MU/L)
TOTAL TESTOSTERONE - 16.5 (7.3-23.5 nmol/L) or 475 ng/dL
FSH - 6 (2-8 IU/L)
ESTRADIOL-17 BETA - 123 (up to 206 pmol/L) or 33.5 pg/mL

Low (or borderline low) Tests:

*FREE TESTOSTERONE - 14.4 (19.0-94.0 PMOL/L) or 4.2 pg/mL
*DHEA-S - 1.7 (3.3-14.0 umol/L) or .49 ng/mL
*PROGESTERONE - <0.6 (0.9-2.9 nmol/L) or .189 ng/mL
*LH - 2 (2-6 IU/L)

These two have always been chronically low, and the Doc’s have never been able to figure it out?

*FERRITIN - 17 (22-322 UG/L)
*TOTAL PROTEIN - 54 (60-85 G/L)

IGF-1 - test declined due to cost ($95)
PSA - test declined due to cost ($40)

I think that’s it. Thanks in advance to any who respond…Hebs

2

How old are you? What symptoms are you presenting with? Do you have morning wood? How’s libido? Do you exercise? How’s your diet? What’s your body fat percentage?

Your estradiol to total T ratio is about 14:1 which isn’t so good. I didn’t start to feel normal until about 15:1 and knowing what I know now, I wouldn’t want to live day to day at anything under 20:1.

PSA declined (for any reason) makes me think you must be under 40 years old and these are not good numbers for someone that young.

The biggest problem most people face is finding a doctor who understands that simply being in range on all your tests doesn’t mean shit.

3

…sorry about that, I forgot to give you any personal info in the first post. I’m a 38 year-old male, 6’1" tall and currently weighing in around 182lbs with approx 12% BF. I’ve been symptomatic with signs of low test since way back into my mid to early 20s.

-Things like a slow, to my present, almost non-existent libido.
-I get morning wood maybe once every couple of months (at best).
-I suffer from a mild depression where I’m moody and tired all of the time it seems.
-At night I’m completely lethargic, I fall asleep early, but then struggle to stay asleep and tend to wake up every 30-45mins all night long.
-My body is, and always has been very prone to fat storage and wild weight swings. I’ve been as high as 235lbs, and then once dropped down as low as 155lbs.
-I would say that while I’m in better shape than the average Joe (I work very hard at it), I’ve always struggled with making any real ‘muscular’ gains in the gym.
-My recovery really sucks, muscles are constantly sore and achy.
-My diet is excellent, I pretty much follow a typical ‘Paleo’ type/style of eating and cook everything from scratch. The only grain that I’ll eat is my breakfast oatmeal once/day. Outside of that it’s lots of fruit & veggies, lean proteins and healthy fats, nuts and seeds, etc…
-I supplement my diet with approx 3-4mg of combined EPA/DHA (from fish oil) per day.
-As for exercise, I lift weights 3xweek (currently doing TBT), I do two to three 5km runs/week, two HIIT sessions/week, three Yoga/Pilates classes/week, and then I walk the dog anywhere from 5-10km/day. I seem to have two speeds, I’m either all out or I do nothing at all. A touch of an exercise-induced Bulimia perhaps?

That’s about it I guess…Hebs

4

Some comments and questions for you hebsie:

Your estradiol is up a bit from optimal (want low 20’s pg/mL).

Do you have any SHBG results?

Might you be overtraining? I’ve seens studies of distance runners showing a pattern of low T and raised E. If you don’t have much muscle on ya, you aren’t anabolic. And, if you run a lot, you are catabolic anyway.

About fish oils, did you mean 3-4 grams of EPA/DHA daily?

My unprofessional guess is that your situation is due to either disease, or that you do a heck of a lot of cardio. As great as that is, it’s not anabolic and does not support anabolism or androgenic expression.

I’m not a doctor.

5

[quote]bigdawg011 wrote:
Some comments and questions for you hebsie:

Your estradiol is up a bit from optimal (want low 20’s pg/mL).[/quote]

…it’s unfortunate that I only have one Estradiol test to compare to. That one was done about two weeks ago. I have about 30ml of liquid Letrozole here. Do you think that it would be worth trying out?

…I checked all of my recent blood work and there’s no sign of a SHBG test being done.

…this has always been a concern, yet the start of my ‘decline’ happened about five years prior to my ‘get healthy’ kick. I like to think that I don’t ‘overtrain’, I may just be more prone to ‘over-reaching’ than most folks.

When I say that I don’t have a lot of muscle, what I mean is that I am definitely not ‘thin’, and I am not the build of a long distance runner (I only run around 15km/week, and that’s only about six months of the year, I bore easily!). More of a Mesomorph I guess, but I can definitely eat my way into a ‘slightly-plump’ Endomorph too!

My body just seems to naturally want to maintain what it’s got and not really grow. It could just be a genetic thing too I guess?

…yes, on most days I take 4-5 1200mg concentrated capsule (so they’re a 400/200 split). Factor in some conversion form the flax over to EPA/DHA, a couple of Omega3 eggs, Salmon/Sardines, etc, I’d guess that I average around 4g of combined EPA/DHA per day. Too little?

[quote]My unprofessional guess is that your situation is due to either disease, or that you do a heck of a lot of cardio. As great as that is, it’s not anabolic and does not support anabolism or androgenic expression.

I’m not a doctor.[/quote]

…point well taken, thanks…Hebs

ps…what confuses me is the low LH, but the relatively normal total TEST, and then the low free TEST. And with the low DHEA (along with the low LH), would that not point back to the Pituitary gland, which should then have my total TEST low too?

6

The Low free test is why I suspect high SHBG (sex hormone binding globulin) and asked about that.

Based on what you said and on my own experience, you might want to ask your doctor to check adrenal function, ACTH stimulation, cortisol.

Are you living a stressful life?

7

…I had a 12hr fasted (taken at 8:05AM) Cortisol level of 514 (170-720 nmol/L). Stressful life, no not really - having no wife or kids helps (me)!

Does the adrenal test go by a specific name? I do have a bunch more test results here it’s just that I didn’t post them all…Hebs

8

ACTH Stimulation test. But, if you’re not stressed out, it’s probably irrelevant.

You might just have a low metabolism set point.