Advice on My Blood Work [Forum Archive]

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Advice on My Blood Work

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Posted by: m11

I had my blood work done and some red flags have come up. I'm a twenty one year old male.

TSH- 4.425 (Lab range 0.35 - 5.5; AACE range 0.3 - 3.0)

On the lab results at the office, it says that normal is 0.350-5.5...and therefore that particular physician says it's normal.

However,

"the American Association of Clinical Endocrinologists has revised these guidelines as of early 2003, narrowing the range to .3 to 3.0. Many labs and practitioners are not, however, aware of these revised guidelines"

Lipid Profile: Total Chol- 149 mg/dL(<200mg/dL)
Trigs-146mg/dL (<150mg/dL)
HDL - 19mg/dL (>40mg/dL)
LDL - 101mg/dL (<100mg/dL considered optimal)

Also, my testosterone results:

Total Testosterone: 381 ng/dl (300-1200 ng/dl; sometimes 400-1080 ng/dl)
Free Testosterone : 16 ng/dl (42-244 ng/dl)

I've sent these results to other physicians recently. From my brief research, it looks like I may therapy for both issues.

Thoughts?

Posted by: Built

Kindly put the units and reference ranges in here.

You are very likely in need of thyroid treatment. I don't know enough about the rest of your bloodwork, and you need more testing to be sure. At a minimum, you should have your free T4 and free T3 tested, as well as your total, free, and bioavailable free testosterone; also a full lipid panel.

Posted by: m11

Lipid Profile: Total Chol- 149 mg/dL(<200mg/dL)
Trigs-146mg/dL (<150mg/dL)
HDL - 19mg/dL (>40mg/dL)
LDL - 101mg/dL (<100mg/dL considered optimal)

Testosterone units are in ng/dl.

What is considered 'normal' varies. Most clinics use 300-1200 ng/dl as their range, while a narrower range that some clinics consider is 400-1080 ng/dl . Typical levels of free testosterone are around 42-244 ng/dl.

Is there anything else pertinent in regards to lab work that would be useful?

Posted by: Built

Okay, I edited those in.

You had your fasting blood sugar drawn? I'd be willing to bet money it's at least somewhat elevated.

Posted by: m11

Quote:

Originally Posted by Built

fasting blood sugar

GLUCOSE 95 (60 - 99 MG/DL)

Posted by: Built

Right up at the top, just as I expected.

Posted by: dg806

Did you recently take an oral ph or steroid?

Posted by: m11

No, I have no history of commercial ph or steroids. No DHEA or anything of that nature either. My supplements have been creatine monohydrate, protein powder, fish oil, and vitamins (vit C, K,Ca,Mg,multi).

Posted by: Prince

testosterone is definitely at low end of "normal", you may be a candidate for HRT.

Posted by: bandaidwoman

low thyroid levels, and I would say yours is definately on the lower side, can cause a increase in prolactin levels which negatively affects the testosterone level ( a negative feedback cycle). I would probably repeat the free testosterone after having the thyroid corrected.

Posted by: dg806

Also your HDL is very low which is a good indicator for heart disease. How long has it been that low? It should be above 40.
Oral Ph's or steroids can temp lower these levels....reason I asked.

Posted by: dg806

I would bet that with an HDL of 19, you have a family history of heart problems......genetics.
Do you know if this is the case?
I would take every supp I could that helps raise HDL and lower LDL.
Ex...Fish oil......Niacin
Molecular Nutrition makes something called Lipid Stabil that works very well.
Lipid Stabil (90 Capsules) By: Molecular Nutrition

Posted by: Built

Quote:

Originally Posted by bandaidwoman

low thyroid levels, and I would say yours is definately on the lower side, can cause a increase in prolactin levels which negatively affects the testosterone level ( a negative feedback cycle). I would probably repeat the free testosterone after having the thyroid corrected.

Interesting.

Quote:

Originally Posted by dg806

Also your HDL is very low which is a good indicator for heart disease. How long has it been that low? It should be above 40.
Oral Ph's or steroids can temp lower these levels....reason I asked.

Good call.

Quote:

Originally Posted by dg806

I would bet that with an HDL of 19, you have a family history of heart problems......genetics.
Do you know if this is the case?
I would take every supp I could that helps raise HDL and lower LDL.
Ex...Fish oil......Niacin
Molecular Nutrition makes something called Lipid Stabil that works very well.
Lipid Stabil (90 Capsules) By: Molecular Nutrition

Also a good call - although my strong feeling is that correction of the underlying subclinical hypothyroidism and clear hypogonadal status will elicit the desired improvement in M11's lipid profile.

These supplements of course can only help - probably everyone should be taking those.

Posted by: m11

Quote:

Originally Posted by dg806

Also your HDL is very low which is a good indicator for heart disease. How long has it been that low?

Now that you bring it up...

I had blood work done last year as part of a physical, and my HDL were normal. They certainly were not this low.

If that is the case, I think it provides for an interesting indicator of something else (i.e probably sub-clinical hypothyroidism). The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT Study -- Åsvold et al. 156 (2): 181 -- European Journal of Endocrinology

All in all, i'm not terribly worried about the low HDL values.

Quote:

Originally Posted by dg806

I would bet that with an HDL of 19, you have a family history of heart problems......genetics.
Do you know if this is the case?

Not sure on the family history regarding heart problems. My mother is on Synthroid though for her hypothyroidism.

Posted by: m11

Quote:

Originally Posted by m11

All in all, i'm not terribly worried about the low HDL values.

However, a more potentially worrisome issue is my very high C-Reactive Protein (CRP) levels. 1.0-3.0 is normal, anything above that is high. I came in at 6.1. The doctor attributed it to a recent gouty attack, but he wasn't certain.

Regarding heart disease, the vascular inflammation is really what sets things off. The cholesterol that ends up mucking things up will only muck things up if there is inflammation and platelets sticking to everything in the region etc.

Ultimately, he wasn't very concerned with the CRP readings. I felt that those values were more indicative of a potential issue than the low HDL. But then again, he was the one in the lab coat, and I was sitting there with my pants off.

Posted by: bandaidwoman

Quote:

Originally Posted by m11

The crp is an overly sensitive test. Make sure you had the hscrp or high sensitivity crp or cardiocrp. If it is high, it needs to be repeated fasting again, after a period when your body is not under inflammatory stress ( like the recent gout attack). The gout attack could have caused a false positive or high crp the day you measured it. What is interesting is that there is now a lot in the literature associating high uric acid levels to heart disease, not definative since some studies were contradictory but they are arguing in the literature wether uric acid is an independant risk factor for heart disease.

Posted by: Built

Also that GLUT9 are not only fructose transporters, but also urate transporters, and that high fructose consumption contributes to urate production.

Posted by: m11

My primary care physician got back to me...actually his assistant did. The assistant said that he doctor won't even comment on my blood work that I sent him until I make an appointment with him. Unfortunately, I live hundreds of miles away.

So that's one doctor down. I should be hearing back from another doctor that I visited recently tomorrow.

Posted by: hardasnails1973

Quote:

Originally Posted by m11

I had my blood work done and some red flags have come up. I'm a twenty one year old male.

TSH- 4.425 (Lab range 0.35 - 5.5; AACE range 0.3 - 3.0)

On the lab results at the office, it says that normal is 0.350-5.5...and therefore that particular physician says it's normal.

However,

"the American Association of Clinical Endocrinologists has revised these guidelines as of early 2003, narrowing the range to .3 to 3.0. Many labs and practitioners are not, however, aware of these revised guidelines"

Lipid Profile: Total Chol- 149 mg/dL(<200mg/dL)
Trigs-146mg/dL (<150mg/dL)
HDL - 19mg/dL (>40mg/dL)
LDL - 101mg/dL (<100mg/dL considered optimal)

Also, my testosterone results:

Total Testosterone: 381 ng/dl (300-1200 ng/dl; sometimes 400-1080 ng/dl)
Free Testosterone : 16 ng/dl (42-244 ng/dl)

I've sent these results to other physicians recently. From my brief research, it looks like I may therapy for both issues.

Thoughts?

After seeing thousands of blood results you are low thyroid, but you may also have low adrenal reseerves or what is commonly called adrenal insuffiency. Your low T could be due to over training or improper balanced die, poor lifestyle, sleep hygiene, emotional or hidden infections, ect.. We may eat healthy but we also eat unbalanced which can cause alteration in hormonal production. Your wonderful Dr neveer checked SHBG, DHEA, cortisol AM and FREE, as well as estrodial (4021 - quest or sensitive from labcorp) Again Drs have not freaken clue when it come to hormonal manipulation or identifying it. I have seen many patients that have been treated with Testosteone and when further examined never needed it in the first place. These Dr's do not explain to the patient that they have to be on this for rest of their life. At first it seems cool, but after a month you will get sick of it real fast. You have to monitor other hormones so they do not get out of balance. Guys that start feel great for 2 weeks then all hell breaks loose or have low thyroid and can not absorb the gel and it goes to DHT or e2. It one big vicious cycle because Dr's do not look for root cause, but treat symptoms. This also happens in women which are 10 times more complex then male hormones. Male hormones are a walk in the park compared to females. When I have a female patient i love a good challenge. Male patients get Boring because they are so easy to rebalance.

Posted by: m11

Just an update:

My primary care physician is open to the concept of HRT/thyroid treatment for me. I had more blood work done today.

He also referred me to a pharmacist at a compounding pharmacy. I spoke with him for a bit as well.

On September 29th, I'm going in for my follow up appointment with my PCP and we will go on from there.

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