Help Reading Recent Blood Work

[Berryman1981]

Hey Guys, Can one of you experienced members give me some advise if able on my results? I'm trying to fix the reason my shbg is so high before I commit to life long trt etc. Anybody reply and I'll reply with results here. -Thanks

[Berryman1981]

PDF Report1
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
See Attachment
SEX HORMONE BINDING GLOBULIN
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
SEX HORMONE BINDING GLOBULIN (nmol/L)
67
10-50
Comments: Above high normal
TESTOSTERONE , FREE
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
TESTOSTERONE, FREE (pg/mL)
63.7
46.0-224.0
TESTOSTERONE, TOTAL, MS
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
TESTOSTERONE, TOTAL, MS (ng/dL)
850
250-1100
HEMOGLOBIN A1c
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
HEMOGLOBIN A1c (% of total Hgb)
5.2
<5.7
Comments: Normal (applies to non-numeric results)
VITAMIN D,25-OH,TOTAL,IA
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
VITAMIN D,25-OH,TOTAL,IA (ng/mL)
43
30-100
Comments: Normal (applies to non-numeric results)
DHEA SULFATE
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
DHEA SULFATE (mcg/dL)
327
106-464
Comments: Normal (applies to non-numeric results)
TSH W/REFLEX TO FT4
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
TSH W/REFLEX TO FT4 (mIU/L)
1.02
0.40-4.50
Comments: Normal (applies to non-numeric results)
PSA, TOTAL
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
PSA, TOTAL (ng/mL)
0.9
< OR = 4.0
Comments: Normal (applies to non-numeric results)
CBC (INCLUDES DIFF/PLT)
MARTIN MILNER | 10/16/2019

Patient: Rollin R Berryman PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
WHITE BLOOD CELL COUNT (Thousand/uL)
6.7
3.8-10.8
Comments: Normal (applies to non-numeric results)
RED BLOOD CELL COUNT (Million/uL)
6.28
4.20-5.80
Comments: Above high normal
HEMOGLOBIN (g/dL)
17.7
13.2-17.1
Comments: Above high normal
HEMATOCRIT (%)
52.5
38.5-50.0
Comments: Above high normal
MCV (fL)
83.6
80.0-100.0
Comments: Normal (applies to non-numeric results)
MCH (pg)
28.2
27.0-33.0
Comments: Normal (applies to non-numeric results)
MCHC (g/dL)
33.7
32.0-36.0
Comments: Normal (applies to non-numeric results)
RDW (%)
13.1
11.0-15.0
Comments: Normal (applies to non-numeric results)
PLATELET COUNT (Thousand/uL)
273
140-400
Comments: Normal (applies to non-numeric results)
MPV (fL)
10.7
7.5-12.5
Comments: Normal (applies to non-numeric results)
ABSOLUTE NEUTROPHILS (cells/uL)
3779
1500-7800
Comments: Normal (applies to non-numeric results)
ABSOLUTE LYMPHOCYTES (cells/uL)
2238
850-3900
Comments: Normal (applies to non-numeric results)
ABSOLUTE MONOCYTES (cells/uL)
549
200-950
Comments: Normal (applies to non-numeric results)
ABSOLUTE EOSINOPHILS (cells/uL)
67
15-500
Comments: Normal (applies to non-numeric results)
ABSOLUTE BASOPHILS (cells/uL)
67
0-200
Comments: Normal (applies to non-numeric results)
NEUTROPHILS (%)
56.4
Comments: Normal (applies to non-numeric results)
LYMPHOCYTES (%)
33.4
Comments: Normal (applies to non-numeric results)
MONOCYTES (%)
8.2
Comments: Normal (applies to non-numeric results)
EOSINOPHILS (%)
1.0
Comments: Normal (applies to non-numeric results)
BASOPHILS (%)
1.0
Comments: Normal (applies to non-numeric results)
DIHYDROTESTOSTERONE
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
DIHYDROTESTOSTERONE, LC/MS/MS (ng/dL)
49
16-79
IGF 1, LC/MS
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
IGF 1, LC/MS (ng/mL)
158
53-331
Z SCORE (MALE) (SD)
0.2
-2.0 - +2.0
ESTROGEN, TOTAL, SERUM
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
ESTROGEN, TOTAL, SERUM (pg/mL)
157.8
60-190
COMPREHENSIVE METABOLIC PANEL
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
GLUCOSE (mg/dL)
102
65-99
Comments: Above high normal
UREA NITROGEN (BUN) (mg/dL)
14
7-25
Comments: Normal (applies to non-numeric results)
CREATININE (mg/dL)
1.08
0.60-1.35
Comments: Normal (applies to non-numeric results)
eGFR NON-AFR. AMERICAN (mL/min/1.73m2)
87
> OR = 60
Comments: Normal (applies to non-numeric results)
eGFR AFRICAN AMERICAN (mL/min/1.73m2)
100
> OR = 60
Comments: Normal (applies to non-numeric results)
BUN/CREATININE RATIO ((calc))
NOT APPLICABLE
6-22
SODIUM (mmol/L)
142
135-146
Comments: Normal (applies to non-numeric results)
POTASSIUM (mmol/L)
3.8
3.5-5.3
Comments: Normal (applies to non-numeric results)
CHLORIDE (mmol/L)
102
98-110
Comments: Normal (applies to non-numeric results)
CARBON DIOXIDE (mmol/L)
22
20-32
Comments: Normal (applies to non-numeric results)
CALCIUM (mg/dL)
10.2
8.6-10.3
Comments: Normal (applies to non-numeric results)
PROTEIN, TOTAL (g/dL)
7.7
6.1-8.1
Comments: Normal (applies to non-numeric results)
ALBUMIN (g/dL)
5.4
3.6-5.1
Comments: Above high normal
GLOBULIN (g/dL (calc))
2.3
1.9-3.7
Comments: Normal (applies to non-numeric results)
ALBUMIN/GLOBULIN RATIO ((calc))
2.3
1.0-2.5
Comments: Normal (applies to non-numeric results)
BILIRUBIN, TOTAL (mg/dL)
2.0
0.2-1.2
Comments: Above high normal
ALKALINE PHOSPHATASE (U/L)
78
40-115
Comments: Normal (applies to non-numeric results)
AST (U/L)
43
10-40
Comments: Above high normal
ALT (U/L)
154
9-46
Comments: Above high normal
LIPID PANEL, STANDARD
MARTIN MILNER | 10/16/2019

Patient: Rollin R PRN: BERRO001
Quest Diagnostics (QDRT)
Address not provided
Test component
Result
Standard Range
CHOLESTEROL, TOTAL (mg/dL)
223
<200
Comments: Above high normal
HDL CHOLESTEROL (mg/dL)
42
>40
Comments: Normal (applies to non-numeric results)
TRIGLYCERIDES (mg/dL)
118
<150
Comments: Normal (applies to non-numeric results)
LDL-CHOLESTEROL (mg/dL (calc))
157
Comments: Above high normal
CHOL/HDLC RATIO ((calc))
5.3
<5.0
Comments: Above high normal
NON HDL CHOLESTEROL (mg/dL (calc))
181
<130
Comments: Above high normal

[GearHeaded]

cyclon is on point in regards to looking into your diet as well as needing to exercise .. this imo is the problem.
I'm guessing that you consume alcohol, you eat a high carb diet, and you don't workout. this is why your SHBG is elevated.

you have high liver values (crappy diet)
you have high hematocrit (your dehydrated)
you have high SHBG (your fasted blood sugar was in pre diabetec range which tells me your insulin resistant, your pancreas is thus pumping out a lot of insulin, your high carb diet does not help, and all this insulin load is going to cause your SHBG to elevate)

easy fix. get on a clean and healthy diet thats low carb. workout 4 days per week with some weights as well as cardio


your "natural path" should have easily been able to of spot the issue with just a quick glance of your blood work like I did . if he/she doesn't know that insulin causes elevated SHBG, and your running high blood sugars (and thus insulin resistant) then they need to go back to school

[almostgone]

I'll move this to the TRT forum, but you may not get many replies. The way your panels are listed make it difficult to read.

Type out the panel, the value, and the reference range. Cut out all of the patient name information, and ordering physician stuff. It is very distracting.

For example:

SHBG 67 10-50 nmol/L

[almostgone]

Just at a glance, you could increase your Vitamin D intake, your lipids need some attention, your liver enzymes are elevated, your glucose is high,and your HCT and HGB are a little high. I didn't see a sensitive E2, only a serum esyrogen

Have you been on a cycle or self managing your TRT? If on a cycle, how long have you been off cycle?

[GearHeaded]

you may also want to supplement for the time being with some TUDCA, NAC, Chromium picolinate , and berberine (or a GDA that has that in it). possibly injectible glutathione if you have access to it.

you need to "detox" your liver and increase your insulin sensitivity and lower your blood sugars. again thats going to come mainly down to drastically improving your diet and exercise. but a few sups can help aide along the way

[Youthful55guy]

I reduced the labs down to what we need to know. All that other garbage just gets in the way.

[QUOTE
SEX HORMONE BINDING GLOBULIN (nmol/L)
67
10-50
Comments: Above high normal
Yes, it's a bit high. It tends to increase as we age. I don't see that you've provided your age. No matter, some guys are genetically programmed to produce higher amounts of SHBG. We add an extra sugar molecule to the protein and it about doubles the half life. This condition affects about 10% of men. I am one of them and have much higher SHBG than you do. You are just borderline high, but it may increase with age. There are ways to lower it with certain synthetic steroids but they also suppress natural T production, so they don't do much good without additional supplemental T. The best method I found to deal with high SEBG is TRT using reasonable doses to saturate the SHBG protein so that enough T spills over to keep Free T in range. If you go down the TRT route, you need to monitor Free T and base dosing decisions on it. For me a simple protocol of 40mg T-cyp every 3 days (E3D) is enough to do this.

TESTOSTERONE , FREE (pg/mL)
63.7
46.0-224.0
You are on the low end of normal. You may find it difficult to get a doc to treat you with these values. I suspect that Free T will decline as you age due to increasing SHBG. Eventually, you may end up below normal.

TESTOSTERONE, TOTAL, MS (ng/dL)
850
250-1100
The ironic thing about high SHBG is that it tends to artificially inflate Total T values. This is because SHBG binds and protects T from liver metabolism, so it pushes up the Total T value. At the same time, it only very slowly releases the T, so Free T is low. The bound SHBG-T cannot pass through the blood-brain barrier where you need the 9Free) T to feel normal. So, you may be swimming in high T levels, but feel like crap because little of it is getting into the brain.

HEMOGLOBIN A1c (% of total Hgb)
5.2
<5.7
Nothing to see here. It's just a measure of pre-diabetes. You are not pre-diabetic according to these results.

VITAMIN D,25-OH,TOTAL,IA (ng/mL)
43
30-100
You could beef this up a bit. I'd start with 5,000 IU of Vit D3 daily and retest in about 6 months.


DHEA SULFATE (mcg/dL)
327
106-464
Nothing to see here. Your levels are good.

TSH W/REFLEX TO FT4 (mIU/L)
1.02
0.40-4.50
This is only a screening test for thyroid function, but it does not indicate an overt problem. You need a full thyroid panel including Free T3 and Free T4 to get more a better picture of thyroid function.

PSA, TOTAL (ng/mL)
0.9
< OR = 4.0
Nothing to see here. Level is great. Prostate cancer is probably not in your near future.

HEMOGLOBIN (g/dL)
17.7
13.2-17.1
A bit on the high side. Not sure why if you are not on TRT. Your DHT level below is also normal, and DHT is the hormone that drives hemoglobin production while on TRT. Not sure why your hemoglobin is so high. Perhaps you were dehydrated when they drew the blood.

HEMATOCRIT (%)
52.5
38.5-50.0
Same response are hemoglobin. Perhaps this is a case of dehydration at the time of the blood draw.

DIHYDROTESTOSTERONE, LC/MS/MS (ng/dL)
49
16-79
Mid-range. Nothing to see here. Need to monitor and control it if you begin TRT.

IGF 1, LC/MS (ng/mL)
158
53-331
OK levels. Only you can decide if you want to muck around with GH or peptides.


ESTROGEN, TOTAL, SERUM (pg/mL)
157.8
60-190
Judging by the normal range they provide, this is the standard female test which is worthless for men. It will always tell you that you have high E. You need to throw out these tests and only conduct the sensitive assay designed for men.



ALKALINE PHOSPHATASE (U/L)
78
40-115
Liver function looks good by this test.

ALT (U/L)
154
9-46
Comments: Above high normal
Liver looks a bit stressed by this test. Could be a medication you are taking. Many common drugs put stress on the liver.

CHOLESTEROL, TOTAL (mg/dL)
223
<200
A bit high. Might want to consider a low dose statin, particularly if you start TRT.

[Berryman1981]

A few thoughts....

1 - You are right, these results ARE difficult to read. You may want to screen shot the results, that seems to work for most of us. Oh, and you probably ought to blank out your name and doctor's name.

2 - You will get much better responses if you move this to the HRT section.

3 - Clomid as HRT is typically used for those with Secondary Hypogonadism. Looking at your numbers (at least if I'm reading them right), your Total T is GREAT and Free T isn't bad either. Based on those numbers alone, Clomid is not a good choice, IMHO. If you insist on pursuing this as an option, pull your LH and FSH on next blood work before thinking about Clomid.

4 - Get your fasting blood sugar and cholesterol in order. Those numbers make me think your diet is less than stellar.

5 - You didn't say what your exercise is like, but I'm going to guess it's a little out of whack. Diet and exercise should be the first thing you address.

In short, yeah, it would be nice to bring down the SHBG some and increase Free T, but diet and exercise should be the first step for you, imho. I'm not sure that there are many non-suppressive ways to bring down SHBG, but maybe someone else will chime in on this.

----------------------Thanks Man! Yea, Im 38, have not exercised constantly ever. Been able to get by until now off of good genetics. To be honest, I probably have anorexia or some sort of eating disorder as the past 10 years I've rairly eaten my weight in protein/grams of protein. Problem is the knee joints are not feeling too good and I'm afraid the body is starting to break down due to not enough water, food/protein, exercise etc.. i guess the high range total t means that I don't have hyperthyroidism which is great. based on my numbers can i assume i dont have hyperthyroidism also? I obviously need to eat more, eat more protein and fat, weight train, drink more water, and take some boron/zinc or DIM etc to try and lower shbg and free up more testosterone as apposed to taking clomid i guess. --------------------------------

[Berryman1981]

yes my doctor is worthless but you guys are not. Just needed him to order the tests so i could get some answers here. Appreciate you guys confirming some things for me. I will follow these recommendations and re test in a couple months. They ordered another round of tests couple days ago so I can post the results here when they come in. you say I'm dehydrated. Any recommendation on how to absorb more water? You guys add electrolytes to water? in regards to cutting down on the carbs, im assuming you guys are not full keto or carnivore but if i cut out most carbs, wont that further dehydrate me once I loose all the water weight from cutting out the carbs making it harder to stay hydrated? (depleting electrolytes)

[almostgone]

In regards day to carbs, I'd start with ditching simple carbs and focus on fibrous veggies.
I would definitely be supplementing vitamin D. It's cheap and absorbs better with a fattier meal ( think avacado, steelhead trout, etc).
Your electrolytes look good, just drink water whenever you are thirsty.

[Berryman1981]

i will look into detoxing my liver as well as the other healthy changes in order to get the shbg down. Thanks for the advise