Bloodwork: low test overall, high free test %. Confused.

[jarhead]

I got my complete results back and they show a test of 115 with a scale of 220-1000. The test free% was 4.1 with the scale being 0.5 - 3.2.
Last my testosterone free was 46.6 with a scale of 40 - 240. I'm confused how I could have a high free % with such a low total. I have an appointment with an endo thrusday. Any help on this?

 

[The Matrix]

I got my complete results back and they show a test of 115 with a scale of 220-1000. The test free% was 4.1 with the scale being 0.5 - 3.2.
Last my testosterone free was 46.6 with a scale of 40 - 240. I'm confused how I could have a high free % with such a low total. I have an appointment with an endo thrusday. Any help on this?

What where you taking when these labs where drawn HRT protocol?

 

[jarhead]

What where you taking when these labs where drawn HRT protocol?

No nothing at all. My last dose would have been a month and a half before 20.mgs of nolva. No aas for six months prior.

 

[The Matrix]

No nothing at all. My last dose would have been a month and a half before 20.mgs of nolva. No aas for six months prior.

Did they check LH and e2, SHBG probably not. Suggest another Dr. I know Dr in PA and also michagen who would help you.

 

[jarhead]

Did they check LH and e2, SHBG probably not. Suggest another Dr. I know Dr in PA and also michagen who would help you.

No my family doc did just a test, free test, free test% based on my symptoms. When the results came back he referred me to an endo, who I see this thurs and I will ask for that.. Is the better indicator the low total T or the high free T%? Does it just mean that of the T I do have, that it's mostly not bound, but I still have Low T overall?

 

[The Matrix]

No my family doc did just a test, free test, free test% based on my symptoms. When the results came back he referred me to an endo, who I see this thurs and I will ask for that.. Is the better indicator the low total T or the high free T%? Does it just mean that of the T I do have, that it's mostly not bound, but I still have Low T overall?

SHBG may be low which could be indicating low thyroid. Again one needs to evaluate the whole person not just hormones. One will not get the proper treatment if they do. The endocrine system works as an orchestra when one thing is out there is a whole chain reaction which can occur. The secret is to find the imbalances which caused it to occur in the first place. Your Dr needs to do more testing, and stop waisting your and his time dicing around with your health. The list which I give to Dr' are comprehensive, but they give the data they need to make the proper analysis. It makes difficult to find these Dr's but when you do they are a diamond in the ruff. The funny thing is that they are no big names who wrote books or have internet presence. Rather they are just humble medical professionals who love helping people and or open to new ways of trying things while staying with in medical guidelines.

 

[jarhead]

Thank you for your input. I had my thyroid tested with my bloodwork and it came back normal. I go tomorrow to the endo and I will let you know how that goes. I hope he is on the ball. I really don't want top walk out of there with just another follow up appointment, and left to feel like this another month or two.

 

[The Matrix]

Thank you for your input. I had my thyroid tested with my bloodwork and it came back normal. I go tomorrow to the endo and I will let you know how that goes. I hope he is on the ball. I really don't want top walk out of there with just another follow up appointment, and left to feel like this another month or two.

as with 90% of cases I deal with Drs directly everything looks normal until you start to break it down to the smaller levels at the same time keeping in mind the over all picture.

 

[jarhead]

Thanks again for the input. i see the endocrinologist in a couple of hours. This is my first visit. He has my bloodwork (metabolic panel, lipids, test) from my primary Doc. Any advice on what to ask him, what to look out for, or how to get the best treatment from him? Also is it inappropriate if none is offered, to ASK for some form of treatment rather than waiting months for a return visit if he just wants to do more tests. That is what worries mes. I am going to be working 80 hours a week and I am in the crapper. I don't want to continue struggling thru this feeling this way.

 

[The Matrix]

Thanks again for the input. i see the endocrinologist in a couple of hours. This is my first visit. He has my bloodwork (metabolic panel, lipids, test) from my primary Doc. Any advice on what to ask him, what to look out for, or how to get the best treatment from him? Also is it inappropriate if none is offered, to ASK for some form of treatment rather than waiting months for a return visit if he just wants to do more tests. That is what worries mes. I am going to be working 80 hours a week and I am in the crapper. I don't want to continue struggling thru this feeling this way.

Low T needs to be treated other wise you will no be able to work those hours with go productivity. As a result, I have seen people lose their jobs due to inappropiate treatments protocol. Wish you luck beacuse endo are not hormone Dr's, but rather diabetic.

My friend just went to his Dr. Dr told him "did you know testosterone can raise estrogen levels in men". He had to do everything to bite his tongue on it and not want to strangle her LOL. "Lets's not go there", pick up his stuff said thank you and out the door he went ..

 

[lboston]

Low T needs to be treated other wise you will no be able to work those hours with go productivity. As a result, I have seen people lose their jobs due to inappropiate treatments protocol. Wish you luck beacuse endo are not hormone Dr's, but rather diabetic.

My friend just went to his Dr. Dr told him "did you know testosterone can raise estrogen levels in men". He had to do everything to bite his tongue on it and not want to strangle her LOL. "Lets's not go there", pick up his stuff said thank you and out the door he went ..

Which in your opinion is better--endo or urologist? I've seen urologist, but have an appointment with an endo at the end of the month.

 

[The Matrix]

Which in your opinion is better--endo or urologist? I've seen urologist, but have an appointment with an endo at the end of the month.

Urologist are more open USUALLY..

 

[lboston]

Urologist are more open USUALLY..

Thanks-- appreciate it. I am just frustrated by mine as he answered no questions in regards to fertility.

 

[jarhead]

Ok just got back and I'm fairly happy. At first he questioned the test results and said that I appear very "virile" and gestured towards my arms. But he listened to me explain my symptoms etc. He ordered more bloodwork which i will have done. He ordered the following:
test free, thyroglobulin ab, microsomal ab bld, vitamin d25 hydroxy, vitamin b12 blood, free cort ur lcmsms, Luteinizing hormone, fsh bld, cortisol, ACTH bld, C-peptide bld. The ones in bold, i'm not sure why or what they are (haven't looked them up yet). He also ordered a sonogram of my liver for next week to check for a possible fatty liver. And he said possibly a MRI on my pituitary to make sure there are no lesions. Is the need for this based on the results of the blood work? Also he is having me collect my urine for 24 hours, and I'm not sure why. He made a follow up with me in march which made me freak a bit. Then he said don't worry, we will begin treatment if needed after the bloodwork and I will be consulting you by phone. We talked about types of treatment. He uses androgel everyday he said. I told him I prefer injections, explained why, and he was ok with it. He talked about self injecting, and I told him my mother in law is a nurse, she taught me how to give my wife depot shots, etc., he said that was perfect. Is there anything that I should address that with him that you see is missing? what is your opinion over all?

 

[The Matrix]

Ok just got back and I'm fairly happy. At first he questioned the test results and said that I appear very "virile" and gestured towards my arms. But he listened to me explain my symptoms etc. He ordered more bloodwork which i will have done. He ordered the following:
test free, thyroglobulin ab, microsomal ab bld, vitamin d25 hydroxy, vitamin b12 blood, free cort ur lcmsms, Luteinizing hormone, fsh bld, cortisol, ACTH bld, C-peptide bld. The ones in bold, i'm not sure why or what they are (haven't looked them up yet). He also ordered a sonogram of my liver for next week to check for a possible fatty liver. And he said possibly a MRI on my pituitary to make sure there are no lesions. Is the need for this based on the results of the blood work? Also he is having me collect my urine for 24 hours, and I'm not sure why. He made a follow up with me in march which made me freak a bit. Then he said don't worry, we will begin treatment if needed after the bloodwork and I will be consulting you by phone. We talked about types of treatment. He uses androgel everyday he said. I told him I prefer injections, explained why, and he was ok with it. He talked about self injecting, and I told him my mother in law is a nurse, she taught me how to give my wife depot shots, etc., he said that was perfect. Is there anything that I should address that with him that you see is missing? what is your opinion over all?

He never checked estodial, or FT3,ft4 , prolactin but its a start..

 

[jarhead]

He never checked estodial, or FT3,ft4 , prolactin but its a start..

I will ask for those. I already had prolactin. it was 12.9 on a scale of 2.0-14. Should I seek a different Dr. or do you think he's on the right track enough to treat me properly?

 

[The Matrix]

I will ask for those. I already had prolactin. it was 12.9 on a scale of 2.0-14. Should I seek a different Dr. or do you think he's on the right track enough to treat me properly?

Prolactin is high could interfer with LH..Need to find out why its high. Possible thyroid

 

[jarhead]

Had further bloodwork done. Results:
result/range

Thyroglobulin Ab

4.6

<14.4 -

Microsomal Antibody

<1.0

<5.6

Vitamin D 25 Hydroxy

37.6

31.0 - 80.0

Vitamin B-12

804

221 - 700

LH

1.7

1.0 - 7.0

FSH

1.7

1 - 10

C-Peptide

1.6

0.8 - 3.2

Cortisol16.4


Should I be concerned about the high b12? I have read that it can indicate liver disease, but is 804 with a scale of 200-700 high enough to indicate that ? My previous tests revealed slightly elevated liver enzymes, which you said could be from exercise. Is this related? Anything else stand out with my bloodwork?

 

[The Matrix]

Had further bloodwork done. Results:
result/range

Thyroglobulin Ab

4.6

<14.4 -

Microsomal Antibody

<1.0

<5.6

Vitamin D 25 Hydroxy

37.6

31.0 - 80.0

Vitamin B-12

804

221 - 700

LH

1.7

1.0 - 7.0

FSH

1.7

1 - 10

C-Peptide

1.6

0.8 - 3.2

Cortisol16.4


Should I be concerned about the high b12? I have read that it can indicate liver disease, but is 804 with a scale of 200-700 high enough to indicate that ? My previous tests revealed slightly elevated liver enzymes, which you said could be from exercise. Is this related? Anything else stand out with my bloodwork?

Possible secondary hypogonadism
vitamin D levels are low Raising vitamin D up to 60-70 ng/dl may help to increase LH
B-12 nothing of concern since you eat alot of meat,
Do not read into stuff too much ...

Still inconclusive labs to work from..

 

[jarhead]

Update: Had a phone consult with the doctor today. he said my test came back at 85! He also said he wanted to do an mri at my pituitary. Tomorrow, I have an ultrasound on my liver. Today he prescribed me testosterone injections. 200 milligrams every other week. After the fourth shot he wants to do the blood work again. everything that I've read says it's better to split the dose up multiple times a week to maintain more even levels. Do you find this to be true? Being that im so low to begin with, I would expect this dose to make a positive difference hopefully.

 

[The Matrix]

50 mg twice weekly will keep.levels more steady.
Still have other things ruled out.

 

[jarhead]

Aside from what I have done, what do I need to rule out?

 

[The Matrix]

Aside from what I have done, what do I need to rule out?

Thyroid, adrenals, other imbalance which I have listed on numerous threads..

 

[jarhead]

He already checked both of those. Everything has come back in normal range except b12 high and slightly elevated liver. However everything was the low or high end on the "range".(prolactin,fsh, lh). I have my liver ultrasound today and my pituitary mri next week. The only thing you've mentioned that he didn't run was estradiol, which I will get with my follow up bloodwork.

Unfortunately, I'm pretty sure I did this to myself. The Dr. said he's seeing it more in younger men these days due to things in our environment (stress, diet, etc.). Have you noticed this as well? For me personally though, I have to believe that years of aas use, even though it was moderate, has to be the main cause.

 

[The Matrix]

He already checked both of those. Everything has come back in normal range except b12 high and slightly elevated liver. However everything was the low or high end on the "range".(prolactin,fsh, lh). I have my liver ultrasound today and my pituitary mri next week. The only thing you've mentioned that he didn't run was estradiol, which I will get with my follow up bloodwork.

Unfortunately, I'm pretty sure I did this to myself. The Dr. said he's seeing it more in younger men these days due to things in our environment (stress, diet, etc.). Have you noticed this as well? For me personally though, I have to believe that years of aas use, even though it was moderate, has to be the main cause.

More so I am seeing it people our age due to the fact of long term exposure to smoke from when you used to go out in public. I can link alot of these issues to people who where bouncers, DJ, bartenders, at clubs back when we were 18-30 years old. People who went to bars and clubs weekend after weeked which had no ventilation being enclosed in an area where you breathing second hand smoke. When I asked this questions to people in their late 30's early 40's, a huge light bulk goes on. Typical response "I would have never thought of it" ..I told them no other medical professional would have even asked that question which is crucial to looking at potential pathology. It strange, when I do certain intracellular test it appears to be that profile of smoker...Its really kind of disturbing, but reality. The use of steroids, combined with toxins. Most of the old time bodybuilders rarelyt had issues with low testosterone. It was not untill the late 90's when the crap all started coming out. When properly evaluated I am sure there are other underlying issues, steroids did not help. Drs tried to pin the same BS on me when I had been clean for close to a year before getting sick. It was due my system was run down from contest prep, I ate contaminated food which triggered the stress response. My body could not fight it off, next months the systems shut down one at a time leaving me almost dead. This is why taking time to understand the pathology of the issue is most important factor for proper recovering.

 

[jarhead]

More so I am seeing it people our age due to the fact of long term exposure to smoke from when you used to go out in public. I can link alot of these issues to people who where bouncers, DJ, bartenders, at clubs back when we were 18-30 years old. People who went to bars and clubs weekend after weeked which had no ventilation being enclosed in an area where you breathing second hand smoke. When I asked this questions to people in their late 30's early 40's, a huge light bulk goes on. Typical response "I would have never thought of it" ..I told them no other medical professional would have even asked that question which is crucial to looking at potential pathology. It strange, when I do certain intracellular test it appears to be that profile of smoker...Its really kind of disturbing, but reality. The use of steroids, combined with toxins. Most of the old time bodybuilders rarelyt had issues with low testosterone. It was not untill the late 90's when the crap all started coming out. When properly evaluated I am sure there are other underlying issues, steroids did not help. Drs tried to pin the same BS on me when I had been clean for close to a year before getting sick. It was due my system was run down from contest prep, I ate contaminated food which triggered the stress response. My body could not fight it off, next months the systems shut down one at a time leaving me almost dead. This is why taking time to understand the pathology of the issue is most important factor for proper recovering.

That is really interesting-and funny thing is, I tended bar for 5 years in my twenties, before my states smoking ban! My ultrasound today revealed I have a fatty liver and a "Heterogeneous pancreas", and it was recommended I get a ct scan to look at it more closely. And next week, I'll get my mri on my pituitary. Thanks for all your input and I'll let you know what happens.

 

[The Matrix]

Update: Had a phone consult with the doctor today. he said my test came back at 85! He also said he wanted to do an mri at my pituitary. Tomorrow, I have an ultrasound on my liver. Today he prescribed me testosterone injections. 200 milligrams every other week. After the fourth shot he wants to do the blood work again. everything that I've read says it's better to split the dose up multiple times a week to maintain more even levels. Do you find this to be true? Being that im so low to begin with, I would expect this dose to make a positive difference hopefully.

These cases are always fun to work on because its interesting when you start to looking at hidden factors. Its amazing what factors can be found which go behind traditional medicine.

 

[lboston]

Jarhead--any updates?