Got the missing blood work done.

[wild_eye]

So I went to another doc; To set the tone I told him my previous doc never sent for the complete lab work needed and wanted to treat me before diagnosing the cause. He understood and had me get the lab work that was missing.
Below are the results.

Recap of basic stats: I am 41 years old, 5'10", 150 lbs and at about 13% bf.
My diet is good. I go to the gym at least 5 times a week and do cardio maybe 1 to 2 times a week (20-30 min).

First BW:



Missing BW:
TEST.............. Unit .............. Result .............. Range
------------------------------------------------------------------------------------
T4 ......................... ug/dL .............. 5.00 .............. 4.60 – 12.00
T3 UPTAKE .............. % .............. 37.62..............28.00 – 41.00
T3 UPTAKE .............. TBI .............. 0.93 ..............0.80 – 1.30
T7 ......................... ..................... 1.88 .............. 1.29 – 4.92
TSH 3rd gen............ mlU/L .............. 2.210 .............. 1.29 – 4.92
FSH ...................... MIU/ML .............. 5.38 .............. 1.4 – 18.1
LH ........................ MIU/ML .............. 4.62 .............. 1.5 – 9.3
Prolactin ................ NG/ML .............. 5.28 .............. 2 – 18
Cortisol .................. ug/dL .............. 8.80 .............. AM 6.2 – 29.0, PM 3.0 – 17.3

some of the labs from up top:
PSA ...................... NG/ML .............. 2.080.............. 0.000 - 4.400
Estradiol ............... PG/ML .............. 38.67.............. <=39
Testosterone .......... NG/DL .............. 292 .............. 220 - 950
Testosterone Free ... PG/ML .............. 2.804 .............. 3.84 - 34.17

Again, your help is greatly appreciated.

Thanks

[wild_eye]

From what I see everything seems to be in range except for the test. Simon1972 had noted in my previous post that my E is particularly high in relation to my T. Where do I go from here?
Any other bw/tests I should get done?

[Mr.BB]

Was this test taken first thing in the morning?

Your thyroid values are bit low, which can influence your testosterone , I would try supplementing iodine and selenium and retest after a month or so. Also, would be advisable to supplement vit d3 (which you should have tested in bw) and zinc (which is a mild antiestrogen).

Edit: only take iodine if you are sure you dont have hashimotos, theres a test for this also.

[wild_eye]

The tests were taken in the morning about 8am right after the gym (on empty stomach).
Could gym before lab have affected the results?

Thanks for the info on iodine, selenium, d3 and zinc, I'll go get them and check hashimotos.

[wild_eye]

I have a feeling the doc is going to want to start TRT when I go see him (if i get chance today).
So I should tell him that i do not want to start yet and that i want to pursue using selenium, d3, zinc iodine etc... To test in a month?

[Mr.BB]

Yes, you should do blood work first thing in the morning, not after workout.

Its your decision, not your docs, when you want to start trt. I would persue a more definite diagnostic, but like I said its up to you.

[wild_eye]

Ok, thanks for your help Mr.BB
It's much appreciated. I'll tell the doc to keep digging and ill wait to see what happens using items you mentioned and do bw again in a month.

[wild_eye]

Just got back from the doc today and told him about the thyroid values being low. He said they were perfectly fine and only thing wrong was low T. :/
He wanted to prescribe T but I told him i wanted to think about and get back to him.
I am going to do the 1 month of selenium, iodine etc to see what happens. Only worried that if that does nothing i cant go back to him since he says all is ok so guess id have to find a 3rd doc. Was really hoping he would have had more input. Also kind of dificult since docs tend to get a little offended when you me tion something "online" that conflicts with their eval.

[wild_eye]

Ok, I've been on selenium, iron, zinc and d3 for a month and a half. Got the labs done that my insurance will cover so soon. Here are my results:

Urinalysis
Test Name Result Units Range
Color .................... Yellow
Appearance ........... Clear
Specific Gravity ..... 1.030 ............................ 1.010 - 1.025
pH ....................... 6.0 .............................. 5.0 - 7.0
Protein ................. 15MG/DL ........ mg/dL ........... Negative
Glucose ................. Negative ....... mg/dL ........... Negative
Ketone .................. Negative ....... mg/dL ........... Negative
Bilirubin ............... Negative ............................ Negative
Blood .................. Trace .................................. Negative
Nitrite ................. Negative ............................ Negative
Urobilinogen ......... 0.2 MG/DL ....... EU/dl ........... 0.2 - 1.0
Leukocytes ........... Negative ............................ Negative

Microscopic
WBC ..................... 0-1 ............ per HPF ......... 0 - 3
RBC ...................... 0-3 ............ per HPF ......... 0 - 3
Bacteria ................. Few ............ per HPF ......... None Seen
Mucous Threads ....... Light .......... per HPF ......... None Seen
Crystals ................. Occasional ..... per HPF ......... None Seen
Crystal type ........... Negative ....... per HPF ......... None Seen

Lipid Panel
Cholesterol ............ 194.0 .......... mg/dL ........... 50.0 - 200
Triglycerides ........... 46.0 ........... mg/dL ........... 36.0 - 150
HDL Cholesterol ...... 50.0 ........... mg/dL ........... 34.0 - 59
LDL Cholesterol ...... 134.8 .......... mg/dL ........... 66.0 - 100 HIGH
VLDL ...... .............. 9.2 ............ mg/dL ........... 9.0 - 26.0

CBC
White Blood Count..... 5.09 ........... X10^3/uL ........ 4.60 - 10.20
Red Blood Count....... 4.55 ........... X10^3/uL ........ 4.20 - 6.30
Hemoglobin ........... 13.80 .......... g/dL ............ 12.00 - 16.00
Hematocrit ........... 42.30 .......... % ............... 38.00 - 54.00
MCV ..................... 93.00 .......... fL .............. 80.00 - 97.00
MCH .................... 30.30 .......... pg .............. 26.00 - 33.00
MCHC .................. 32.60 .......... g/dl ............ 31.00 - 36.00
RDW .................... 12.90 .......... % ............... 12.00 - 16.00
RDW-SD ............... 42.80 .......... fL .............. 35.10 - 46.30
Plateket Count ....... 255.00 ......... 10^3/uL ......... 150.0 - 450.00
MPV ..................... 11.60 .......... FL .............. 7.40 - 10.40 HIGH

Neut ................. 46.00 ........... % .............. 47.00 - 76.00 LOW
Lymph ............... 35.00 .......... % .............. 12.00 - 44.00
Mono ................. 9.00 ............ % .............. 2.00 - 12.00
EOS .................. 9.60 ............ % .............. 0.70 - 7.00 HIGH
BASO ................. 0.40 ........... % .............. 0.00 - 2.50
NEUT # ............. 2.34 .......... x10^3/uL ....... 1.50 - 7.10
Lymph # ............ 1.78 .......... X10^3/uL ....... 0.80 - 2.80
Mono # .............. 0.46 .......... X10^3/uL ....... 0.20 - 1.00
EOS # ................ 0.49 ........... X10^3/uL ....... 0.00 - 0.70
BASO # .............. 0.02 .......... X10^3/uL ....... 0.00 - 0.20


ESTRADIOL ............ 71.96 ........... PG/ML .......... <= 39 PG/ML
FSH ...................... 6.10 ............... MIU ............ 1.4 - 18.1
Testosterone .......... 335 ............. NG/DL .......... 175 - 781
Testosterone Free .... 3.896 ........... PG/ML .......... 3.84 - 34.173


Testosterone is still low (went up a bit from 292 to 335) and estradiol is higher... not sure what to attribute it to.
Don't know of this adds insight but I did forget to mention I had noticed testicular atrophy before all this began. Never suffered any trauma (besides getting kicked with a cup on in martial arts for a few years). No varicose veins from what I see.
As indicated in earlier thread looks like AI inhibitor might be needed based on estradiol
No recent lab but previous T4 was low before and doing more reading I see that has an effect on T so not sure if to pursue something else for that.

On a quick side note I took my mom to her spine doc and I decided to ask if he knew of a good doc to treat low T.
He asked if I had my labs (which I didnt since wasn't my appointment).
He said he himself uses treatment (pills) called Testoluten (for 10 days every 6 months). (Anyone use it?)
He said it makes the body produce test and raises his T to 700-800.
Of course I got excited and ordered it but have not used it.

So, not sure if to:
1 - keep trying to treat low T4 to see what happens
2 - treat the high estradiol
3 - start with the testoluten to see if it works
or a combination...?

Please help with my next steps
Thanks