Blood Work - Help Needed

[BAB]

I am having some serious trouble receiving proper treatment and was wondering if anything can be inferred from the following statistics and blood work.

Age: 21
Height: 6'0
Weight - 194
bf % - fluctuates between 6-15% per year
Fat storage - Umbilical region - love handles
Hair - no hair on chest, very little on stomache and under armpits
Drug History - basically none, no Rx really, No rogaine, No Booze, just some nicotine in the form of swedish snus every now and then.

Symptoms - Chronic joint and tendon pain, depression, erectile dysfunction, loss of libido, extreme stress and anxiety. Occuring for approximately 1 year. Joint and tendon pain have been going on for about 5 years.

Lab Work
FSH - 1.7 ^2 mIU / ml Range 1.6 -9.7 mIU/ ml (i think labs difficult to read)
LH - 0^3 mIU/ ml Range - <15 mIU / ml (once again difficult to read )
Prolactin - 5 ng/ml Range - 0 -20 ng/ml
CRP - .8^1 ng/ ml Range - Range for inflammation 0.0 - 7.4
Total Test - 130 ng / dl Range - 241-827
Free Test - .55L ng / dl Range - .95-4.30
Free Test Percentage - .21 L ^2 Range .32-.51
Free T4 - 1.06 ng / dl Range - .65 - 1.40
TSH - 2.14 mIU / l - Range - .46 - 4.68
Glucose Serum 95 mg / dl Range - 74-106
Creatinine - 1.07 mg / dl Range .66 - 1.25
Bun / Creatinine ratio 21.50H Range 12.00 - 20.00
Bun 23 range mg / dl - Range 12-20.00
Cortisol - 20 Range - 1-21
ACTH - 60 Range (less than 46)
E2 (Estridol) - 18 Range (1-60)

So i guess what we are looking at is Low LH, FSH, Free and Total Test. With extremely elevated cortisol and ACTH.

The doctor was going to administer 100mg Test Cyp and i was going to get the AI and HcG myself. That is until the Cortisol and ACTH came back extremely elevated. I just got an MRI to check for a pituitary tumor. I have not yet got the results back ( which usually means negative, since i had the test over a week ago and did not receive a call).

Any ideas what could be causing the high cortisol? High ACTH? Low Test?

Very tricky situation and i currently cannot seek another doctor due to my situation as a student with very poor medical insurance.

[BJJ]

1. When did you take that blood work? I mean at what time during the day?
2. Are you living a tough moment of your life?
3. You did not check neither your liver nor your pancreas values, why?
4. Do you sleep deeply at night?
5. When you wake up, are you tired?
6. That level of cortisol is not "extremely elevated" as you mentioned but the ACTH is not good at all.
7. Pls clarify the values related to LH and FSH. If you have doubts, call the lab and ask for clarifications.
8. How can you fluctuate between 6 and 15% body fat within a year? Do you realize what that mean? How is your diet like?

[BAB]

1. When did you take that blood work? I mean at what time during the day?
2. Are you living a tough moment of your life?
3. You did not check neither your liver nor your pancreas values, why?
4. Do you sleep deeply at night?
5. When you wake up, are you tired?
6. That level of cortisol is not "extremely elevated" as you mentioned but the ACTH is not good at all.
7. Pls clarify the values related to LH and FSH. If you have doubts, call the lab and ask for clarifications.
8. How can you fluctuate between 6 and 15% body fat within a year? Do you realize what that mean? How is your diet like?

All of the blood work was between 8-9 am fasting

Definitely a tough moment, in college, cannot lift any weights barely due to joint pain, tons of shit going on with school stressors.

Which things do we check for in the liver and pancreas? I was just getting the testing the doctor would give me. I asked for SHBG and DHEA but he would not go for them yet.

So since the cortisol test was done in the AM it should be expected to be in the high range? i'm assuming i need the 24 hour cortisol test?

LH AND FSH values are both accurate after double checking
LH - 0 ^ 3 with a range of <15
FSH - 1.7 ^ 2 with a range of 1.6 - 9.7

I used to have problems getting to bed but once I removed caffiene i can usually fall asleep pretty well. Alot of times i can wake up right away and get going. I do sleep a little deep tho, sometimes sleeping through my alarm. I usually remain tired for awhile once i wakeup yes.

With the bodyfat, what i meant was that i used to be bigger last year about 15% bodyfat but after adopting precision nutrition and a high protein high fat, low carb dietary style i managed to drive my bodyfat percent very low last summer. I usually hang around 10% during the winter though. I would say right now i am at aboiut 10%.

My diet usually follows precision nutrition. Rarely starchy carbs and only around the workout window if i take them in. Otherwise tons of lean meat fruits and veggies. Healthy fats etc... I usually take in about 2400 cals a day when trying to stay lean and about 2000-2300 when trying to get really lean. When im not trying to cut or stay too lean i stick around 3200 cals. Out of these cals 20% is usually carbs and the rest is healthy fats and protein.