my blood work! Can you take a look and tell me why I am always fatigued?

[FRDave]

Hi guys, new here, long time lurker... So I have been feeling fatigued for the past couple years with all the typical symptoms of low test such as fatigue, loss of libidio, horrible memory, can't concentrate, anxiety, flushing and hot flashes, increased abdominal, chest and lower back fat, super slow muscle gains (been working out the hardest ever in my life for 2 years straight with my diet in check counting calories), etc.

I have the following blood labs in which my Dr. says I am fine and want's me to see a therapist

Can you tell me if anything looks off?

Thanks in advance,
Dave

[FRDave]

DHEA-S	250.7		ug/dL
PSA	0.32	< OR = 2.5	ng/mL
Pregnenolone, LC/MS/MS:	59		ng/dL
CALCIUM	9.4	8.5 - 10.7	mg/dL
PHOSPHORUS	4.1	2.7 - 4.5	mg/dL
REPORT	Vitamin D, 25-OH, Total: 35	30 - 100	ng/mL
VIT B12	702	200 - 910	pg/mL
TESTOSTERONE, TOTAL	327.0	249 - 836	ng/dL
SEXHORMONE BINDING GLOBULIN	27.81	14.5 - 48.4	nmol/L
CORTISOL, SERUM	14.2		ug/dL
TSH	2.46	0.35 - 4.00	uIU/mL
FSH	3.4		mIU/mL
LH	3.9		mIU/mL
TPO AB	<3.0	<5.6	IU/mL
ALBUMIN	5.0	3.3 - 4.8	gm/dL
ESTRADIOL	24.1		pg/mL
CHOLESTEROL	134	<200	mg/dL
TRIGLYCERIDE	126	<150	mg/dL
HDL	23	>/=40	mg/dL
LDL CALCULATED	86	<100	mg/dL
CHOLESTEROL/HIGH DENSITY LIPOPROTEIN	5.8	<5.0
GLUCOSE, FASTING	90	70 - 99	mg/dL
IRON	154	59 - 158	mcg/dL
TOTAL IRON BINDING CAPACITY	406	250 - 425	mcg/dL
IRON SAT	38	20 - 50	%
FERRITIN	166.8	25 - 336	ng/mL
BILIRUBIN, TOTAL	0.9	0.1 - 1.0	MG/DL
ALKALINE PHOSPHATASE	52	20 - 125	units/L
ALT	27	17 - 63	units/L
WBC'S AUTO	6.6	4.0 - 11.0	THOU/CUMM
RBC, AUTO	4.68	4.7 - 6.1	MIL/CUMM
HGB	15.2	14.0 - 18.0	G/DL
HCT, AUTO	43.9	42 - 52	%
MCV	94.0	80 - 94	FL
MCH	32.6	27 - 35	PG/CELL
MCHC	34.7	32 - 37	G/DL
RDW, BLOOD	13.4	11.5 - 14.5	%
PLATELETS, AUTOMATED COUNT	229	130 - 400	X1000/CUMM
MPV	8.2	7.4 - 10.4	FL
GGT	18	<63	units/L
PT INR	1.07	0.8 - 1.2
ESR, WESTERGREN	8	0 - 15	MM/HR
SODIUM	139	135 - 145	MEQ/L
POTASSIUM	4.0	3.5 - 5.0	MEQ/L
CHLORIDE	100	101 - 111	MEQ/L
CO2	30	21 - 31	MEQ/L

[FRDave]

***edited above table***

[MickeyKnox]

Good job bro. The pros in here will be with you shortly.

[Brohim]

Hi guys, new here, long time lurker... So I have been feeling fatigued for the past couple years with all the typical symptoms of low test such as fatigue, loss of libidio, horrible memory, can't concentrate, anxiety, flushing and hot flashes, increased abdominal, chest and lower back fat, super slow muscle gains (been working out the hardest ever in my life for 2 years straight with my diet in check counting calories), etc.

I have the following blood labs in which my Dr. says I am fine and want's me to see a therapist

What kind of therapist? You need to see a qualified HRT doc. Where are you from? Your test levels would be low according to Labcorp the lowest is 348 I believe. Do you have any more Thyroid bloodwork such as free T3? Your TSH number (Thyroid) is a little high which would warrant more bloodwork.

Can you tell me if anything looks off?

Thanks in advance,
Dave

What kind of therapist? You need to see a qualified HRT doc. Where are you from? Your test levels would be low according to Labcorp the lowest is 348 I believe. Do you have any more Thyroid bloodwork such as free T3? Your TSH number (Thyroid) is a little high which would warrant more bloodwork.

[FRDave]

What kind of therapist? You need to see a qualified HRT doc. Where are you from? Your test levels would be low according to Labcorp the lowest is 348 I believe. Do you have any more Thyroid bloodwork such as free T3? Your TSH number (Thyroid) is a little high which would warrant more bloodwork.

I forget what they call the therapist, but basically it's to make sure the loss of libidio, memory, etc. is not all in my head and/or me supressing something due to stress, etc. I have a very easy normal stress-free life and my girl is a hottie so I have pretty much wrote off the therapist as I don't feel it's needed and more of a money thing... I am from SoCal.

As for T3, no, the above is all I got along with a bunch of STD testing I did which all came back negative :-)

I do have previous TSH numbers as follows:

Name Standard range 2/18/2011 8/19/2011 2/19/2012
TSH 0.35-4.00 uIU/mL 1.76 1.91 2.46

[steroid.com 1]

First, welcome to the forum; good to see a guest finally join in!

Okay, you are missing some critical labs to make a solid assessment of your situation; that said there is enough here to warrant further testing.

Take a look at the sticky at the top of the forum called finding a TRT Doc, you will see a list of labs you need to evaluate your hormonal situation.

Can you tell us more about yourself like age, weight, BF, diet, medical history, drugs/meds or aas use, injuries to the head or pelvic area...all things like that.

Now, you have symptoms which is our first pass on evaluating your situation. Many of the symptoms you describe can be attributed to many things but for most guys here we look at things like sex hormone levels, Thyroid levels, cortisol levels, HPTA performance...you get the idea.

From what I see from your labs your Total Testosterone serum levels are near clinically low and may be why you feel like you do...but we want to know more like is it age related androgen deficiency or due to something else like Hypothyroidism...and we can't tell with the labs you have. Lab Corps reference range for Total Testosterone is 348-1197 ng/dl and with your Total of 327 and presenting with symptoms would highly suggest that you are Hypogonadal.

Your TSH assay is elevated here but previous labs the past two years has it in the normal range. TPO AB are your Thyroid antibodies and it looks fine at <3 IU/ml (this can impede conversion of T4 to T3 and you want it low) Nevertheless, I would want to rule out Hypothyroidism 100% so getting labs for Free T4 and Free T3are important as are Reverse T3...we want to make sure the Thyroid is functioning normally. Note, Hypothyroidism can and will cause Hypogonadism so undertanding Thyroid health is critical.

We also want to see Estradiol levels and the one that is important is the Estradiol Sensitive assay; I don't see a range for it here so I can't tell if it was a Sensitive assay or not. However, that being said, 24 pg/ml on most labs is about as ideal as you can get...which is a very good thing!

Cortisol (your stress hormone) is missing ranges as well so can't see if it's elevated or not. Adrenal fatigue can cause much of what you are describing.

SHBG is fine as well and a very good thing; it binds to Testosterone rendering it useless for a good time.

FSH and LH are missing ranges and we want these to be as high on the reference range as possible.

I would say this to you, and not knowing your age or histories, but you clearly would be a candidate for TRT if over the age of 35 and where it's age related decline. My Doc would have you on a complete TRT protocol the same day you saw him that I can say for sure!

I would look for a Physician who specializes in hormone replacement for men and take this to another level.

It's time for you to feel better and the quality of your life improved; trust me, most of us have been there, heard the same shit about seeing therapists and yet TRT has changed our lives in a very significant way.

Also, start reading and learning as much as you can on TRT for men; the educated man is a wise man in this business.

Peace.

gd

[kelkel]

Excellently covered GD, as always!
Op, fill in the missing ranges as requested. Next time you do blood work check your Vit D (25-Hydroxy) level as well. It relates to your free testosterone level as well as being literally in every cell in your body.

Quick good read for you: http://www.lef.org/magazine/mag2008/...ing-Men_01.htm

Welcome to the forum!

kel

[FRDave]

Thanks for the responses guys. A little about myself... I am 31 years old, 5'7" tall and currently 148.5 lbs as of today at about 17% body fat. Diet wise, I am currently eating about 2,000 calories, slowly adding calories every couple weeks based on weight increase. I eat 150g protein (mostly from protein shakes, chicken or steak), 185g carbs (slowly upping / mostly from oats and bananna's) and 65-70g fat (mostly from fish oil, milk and almond butter). I do not take any medications other than flo-nase for my allergies, but I do want to get a food allergy test. As for dr ugs, I don't do anything, nor do I drink or smoke. In my high school days I was a pot head (helped me concentrate - got straight A's all through high school), tried s h rooms and ac id once, and did a few inhalants a hand full of times. I was a heavy beer drinker up until a few years ago which is when it seems everything started going down hill (once I stopped drinking that is). As far as head injuries, I cracked my head open as a kid (fell off my big wheels and hit curb), ran into two poles and knocked myself out, got hit in head with a ball and had lump on forhead (all as a kid - under age of 10). I have also had a few bad crashed on my dirtbike and have been knocked unconscious a couple times. That's about all I can think of... I can not remember much at all of my child hood, nor do I remember people from high school that I hung out with all the time. When I use to smoke, I could remember my child hood suprisingly, so the memories are there...

Hope the above helps?

So I should request blood labs for Free T4 and Free T3 as well as Reverse T3? Also, I will try and find out what the reference range was for LH, FSH, Estradiol and Cortisol as it's not listed on my labs.

Thanks again and please let me know if any more questions,
Dave

[FRDave]

I'll take a look at the link, thanks Kel. As for Vitamin D, I must have forgot to post it but it was like 25 or 30, lowest end of the range. I have since been taking in close to 10k IU's between my multi vitamin and NOW brand D3 so it should be up. I have request new blood labs and will be going in within a week or two as well as getting updates on DHEA as I have been taking 100mg micronized LEF pregnenolone and 50mg micronized LEF DHEA once per day every morning with breakfast.

Dave

[xtitan1]

Good luck let us know when you get those new labs. Your symptoms definitely sound like low T symptoms and your total is not great, but really we need to see the additional labs.

[steroid.com 1]

Your DHEA-S of 250 ng/dl is extremely low compared to Lab Corps reference range of 348.0-1197.0 for adult males.

Your Pregnenolone of 59 ng/dl is very low compared to Lab Corps reference range of 27-199 for adult males.

Both of these hormones are the precursor hormones for everyother hormone in your body and must be in optimal range; if they are low everthing else will be low. Additionally, they vast majority of both are produced in the testes along with Testosterone which comes downstream.

The fact that all 3 are below or near clinical levels points to you being hypogonadal; that's a fact.

Your FSH of 3.4 mIU/mL is low compared to Lab Corps reference range of 1.5-12.4.

And not surprising your LH of 3.9 mIU/mL is low compared to Lab Corps reference range of 1.7-8.6.

Giving your good life style habits, that you had no recent injuries, that you take no meds/drugs and are otherwise healthy in every other way and the low labs above I am willing to bet you have age related (albeit accelerated) androgen deficiency and why you feel like you do.

Your current Doc won't help you as he couldn't even do the assessment I just did here. And if you been reading here for a while you will know that most Endos and Uros won't get it as well.

You need to find a specialist in the Finding a TRT sticky by using the search links.

Most of the expert help you will find won't take insurance but will provide the codes necessary for you to submit to your insurance assuming your insurance will cover such a medical protocol.

Nevertheless, you need help and you need to get on a well planned TRT protocol.

Where do you live?

[FRDave]

Thanks for the quick responses everyone, you guys are awesome! So ya, I have seen two Dr's and an Endo in which I requested most of the blood work you see based on the stickies and threads I read here on the forums. They just did the basics, and I never could get them to do free test, they just calculated it based on my other numbers above.

My new Dr. although he says I am fine, is willing to put me on TRT to see how I feel, at least he offered this last time. I just wanted to make sure there is nothing else that can be done prior to going this route? Like mentioned, I now supplement with 100mg of pregnenolone and 50mg of DHEA daily after reading about back filling the pathways, but I honeslty feel no difference and have tried 3 brands now, just starting the Life Extension brand a few days ago...

If I were to go with TRT, would this bring all these low numbers mentioned into range, thus, solving my issues? Or is there other issues I need to look into and treat as well?

By the way, I am out of Lancaster, CA. I could not find any TRT clinics in the sticky, but could be doing it wrong. My chiropractor did mention a TRT clinic one of his buddy runs, but I have yet to check it out. He is the one who got me researching TRT in the first place as he is into sports medicine and bodybuilding himself.

Thanks again,
Dave

[steroid.com 1]

It all depends upon the protocol the Doctor wants to put you on; if you've been here for a while you will know that most Docs who don't know what they are doing and attempt to put a man on a protocol screw it up royally.

If you can get to LA (even worth the drive from my point of view) and see Dr. Mark Gordon he will turn your life around my friend.

I'd see him in a heart beat if I wasn't so well cared for by my TRT Doc.

Do it, it's time to get better man!!!

[FRDave]

I'll have to google his name and make an appointment. LA is only about an hour away, so it would be worth the drive. But... Will he let me self administer or would I have to drive out there every week? Ideally I would like to get my script filled at costco (much cheaper) and inject test twice per week, once per week minimum. I also want to be place on HCG as I will be having a kid within a year, and my Dr. didn't seem like he was familiar with HCG or AI's, thus, the reason I didn't pull the trigger. Like you said, he would most likely have me shut down with high estrogen and feeling even worse...

I assume Dr. Mark Gordon is familiar with HCG, AI's, back filling pathways, etc?

Thanks again,
Dave

[FRDave]

Just did a search on Dr. Mark Gordon. This guy seems legit right here, im super excited, you don't even know. Going to call him first thing Monday morning. Even specializes in traumatic brain injury, so he may be able to figure out my memory loss.

Thanks again gdevine, you have made my night :-D

Dave

[steroid.com 1]

Dave - You are so welcome my brother!

Makes my day when I can help another man out here in our forum and put them on the path to unbelievable health.

Dr. Gordon is one of the top and leading medical authorities on TRT for men in the country and is on the cutting edge...trust me on that!!!

I referred another new member here to Dr. Gordon a few months ago and he had his concerns since he saw so many Docs all who could not help him and failed.

He PM'd me a few weeks ago and said that after seeing Dr. Gordon and following his protocols in less then a month his life turned 180 degrees.

Without getting into the details; he said to me both he and "his wife" wanted thanked me "personally" for referring him to Dr. Gordon as his life is better then it's ever been in over 10 years.

Mark Gordon is one of the top, if not the top, TRT Physicians for men in the country.

He will see you and you will be in the care of a great man who will turn your life around.

So happy for you bro you don't even know!

It's participation in threads just like this one that makes it so worth it for me!!!!

Of course, you're going to keep us posted on each step of the way here in this thread...right?

Peace.

gd

[FRDave]

Alright, so I called Dr. Mark Gordon's office and was given the basics over the phone and have submitted the online 'intake form' as requested, in which they will respond back with more details once received. Being that I do have TBI, she states the starting cost will be $1250 which includes labs, office visit, etc. Little pricier than I was hoping, but if I can self administer and fill my own scripts, this may make up the difference in cost vs the typical TRT clinics since they wont let you fill your own scripts and charge throught the roof for test and what not (based on what I have read).

In the mean time, do you have any other reputable suggestions that would accept Kaiser insureance?

Thanks again and I will keep everyone updated!

Dave

[FRDave]

Received some reference ranges today that were missing from above as follows:

- FSH 3.4 (range 1.4-18.1)
- LH 3.9 (range 1.5-9.3)
- Cortisol 14.2 at 10am (range 7-10am: 6.2-19.4 n=144)
- Estradiol 24.1 (range 7.63-42.6)

Does this tell me anything? I will be talking with a local a4m clinic as I could not afford to see Dr. Mark Gordon, but the more informed I am the better off I will feel going in for my consiltation.

Thanks in advance.

[bullshark99]

Forum is for opinions right, forgive me gd not trying to be disrespectful, I personally have reached out to you in the past, but why is a different Dr the "Cats Ass" every time I turn around?? Cristler was God, then Shippen not to mention a few others, Gaines, very good??? Maybe Im missing something, am a litle off today?

[bullshark99]

Maybe Im just having a bad day here, but help me see whats wrong here with these numbers???? Yes T Tes is low according to Laborp but NOT if u use quest. If symptoms persist, yes, can be Low T but also 100 other things! What else is significantly out of whack??? I do not question Dr Gordon one bit, dont know him but is this Low T?????? Truthfully, having a bit of an issue with people that have "red" titles holding themselves out as HRT specialists???? Really, Ever heard of Google????? Got ur name and location and even ur current Dr on this furum??? Specialist huh???? Again, I say that with respect becausre I beleive you to be the most knowledgerable person ( with KelKel and Vet) on here, but why would u want to take on the liability???? Hope I dont get sick listening to u?? Again, I not the most articulate man but unless u have ur head so far up Obamas ass, cant beleive what I read sometimes??? Sorry again, mean not to be disrespectful.

[TennTarheel]

Am I missing half of this story?

[steroid.com 1]

Forum is for opinions right, forgive me gd not trying to be disrespectful, I personally have reached out to you in the past, but why is a different Dr the "Cats Ass" every time I turn around?? Cristler was God, then Shippen not to mention a few others, Gaines, very good??? Maybe Im missing something, am a litle off today?

I am not even sure I understand your questions to be honest?

Are you questioning why we recommend a number of "Top TRT Doc's" here and not just one?

And every time "you turn around"...really???

Every Doc deals with different patients with different protocols and different outcomes and like any medical speciality field there are those whose work stands above the rest. There is a list going around in here of Docs all of who would qualify for being at the top of the HRT field.

It's good for members to be exposed to medical care options by providers who standout among the rest.

So what's your question???

[steroid.com 1]

Maybe Im just having a bad day here, but help me see whats wrong here with these numbers???? Yes T Tes is low according to Laborp but NOT if u use quest. If symptoms persist, yes, can be Low T but also 100 other things! What else is significantly out of whack??? I do not question Dr Gordon one bit, dont know him but is this Low T?????? Truthfully, having a bit of an issue with people that have "red" titles holding themselves out as HRT specialists???? Really, Ever heard of Google????? Got ur name and location and even ur current Dr on this furum??? Specialist huh???? Again, I say that with respect becausre I beleive you to be the most knowledgerable person ( with KelKel and Vet) on here, but why would u want to take on the liability???? Hope I dont get sick listening to u?? Again, I not the most articulate man but unless u have ur head so far up Obamas ass, cant beleive what I read sometimes??? Sorry again, mean not to be disrespectful.

edit: this diatribe is not worthy of my response.

[steroid.com 1]

Am I missing half of this story?

You know what I say; "Just grin and bear it!"

[FRDave]

Alright, so I was referred to a local anti aging clinic by my chiropractor (bodybuilder), and come to find out, he is right around the corner from my house and is a4m certifed per the link in the sticky.

I gave them a call today and spoke with the nurse who chatted it up with me for a good 20 min, going over the typical protocal, prices, etc. Suprisingly and thankfully he is fully aware of AI's (if needed), HCG, DHEA, etc. Allows for self administration and will write script to be filled by pharmacy of my choice. States they normally recommend a cream by a local compound pharmacy, but has no issues if I would rather go with injections, and will even allow me to come in and she will personally do the injections if I am not comfortable doing them myself. She states Dr. Raj is very up to date and does lots of re-search and attems many conferences, so he is very open if I recommend/request something that he does not offer/suggest, although they were fully aware of everything I asked/requested based on what I have learned here on the forums.

So ya, I have my consiltation on the 20th which is $150-$200 and then he will have me follow up around 6 weeks after 1st injection, then every 6 months after at $100 per visit.

Pretty excited right now so I thought I would post :-)

Thanks for all the help everyone,
Dave

[TennTarheel]

That's freakin awesome man. Where do you live?

[FRDave]

That's freakin awesome man. Where do you live?

I'm out here in the AV about an hour North of Los Angeles. I originally contacted Dr. Mark Gordon but it was going to be $3000 + per year which I just can't afford unfortunately :-/

Dave

[TennTarheel]

You'll probably do just as well having the scripts and doing your own due diligence with all the info and help here. I'd much rather save the 3k

[FRDave]

You'll probably do just as well having the scripts and doing your own due diligence with all the info and help here. I'd much rather save the 3k

With the research I have done here and the phone consiltation I received, I feel pretty confident all will work out well and much much cheaper. If any questions, I will just post blood labs here and get help from the pros :-)

[hoov]

FRDave, can let me know what Doctor you found as I live close to your area.

[FRDave]

FRDave, can let me know what Doctor you found as I live close to your area.

Here is the link to his info. on the a4m site: www dot a4m dot com/eugene-rajaratnam-lancaster-ca dot html <<<------------ replace dot with "." as I can't post links due to post count.

I will update this thread next tuesday after my consultation with Dr. Raj.

Hope this helps.

[kerplunk]

I hope this doc works out for you. I am in the SCV so maybe I will go see him too.

The price is right!!!!

Good Luck