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What do you think my blood work could indicate?

Mward97

New member
Here is a list of some of the symptoms I have been experiencing.
1). I cannot gain weight despite eating almost 7000 calories a day. It does not make me gain significant fat or significant strength or mass. I maybe gained albs then just ended up stalling out with zero further progress. My activity is minimal, no more than 45-60 minutes of lifting per day then resting all day studying(I am a college student).

2). I've gained virtually zero strength on my compound lifts in the last 15 months despite very good training(training with a couple IFBB pro's and some pro baseball and football players.

3). I often am tired feeling, but a little caffeine fixes it. This is despite having 8-12 hours of sleep every night and obviously eating plenty of food.

4). I NEVER and I mean NEVER get morning wood anymore when 7-10 months ago I did everyday.

5). I NEVER get erections anymore no matter how scantly clothed females are, unless they are literally on my lap and I seriously think I am going to get some(if this happens it seems to work fine, but not nearly as good as it used too).

6). More recently my muscles have seemed to be recovering very slowly from exercise, remaining sore for 2-4 days longer than they used too.

NOTE ABOUT MYSELF I am an asthmatic, when I was in 3rd grade with one lung functioning at only 13% of the normal lung volume, and the other at 10%. I have been on some form of corticosteroids for most of my life(12 years). I was on 60mg of prednisone daily for periods of 4-8 weeks at a time when I was younger. Currently I am on low dose inhaled corticosteroids only(Symbicort---steriod is called budesonide at 160mcg daily). I haven't taken oral corticosteroids for a few years(2-3). And even three years ago the dose I was taking was closer to 20mg daily or EOD only.

I have gone to an end and got my first bloodworm back. Some of the labs, including testosterone and a 24-hour urine analysis have not come back yet, they come back when I go back in for the first follow-up this Thursday.

Here are the labs I got back that I think are of interest because they are out of range or are close to out of range, or I just think they could be related.

ACTH = 11 Ref. Range <46
Cortisol P.M 6.2ug/dl Ref. 1/2 AM values. Morning Ref range is 5-25ug/dl
DHEA-S = 339ug/dl Ref. 80-560
Vitamin D 25-OH TOTAL(Abnormal-Low) = 27.4ng/dl Ref. 32-80
ABS EOS COUNT =60 Ref. 30-600
Urea Nitrogen(BUN)(Abnormally high) = 29mg/dl Ref 8-22mg/dl
Creatinine, Serum = 1.10mg/dl Ref 0.70-1.30
Total Protein, Serum = 7.9g/dl Ref 6.4-8.3
Albumin(Abnormally high) = 5.2 Ref. 3.5-5.0
Total bilrubin = 0.7mg/dl Ref 0.2-1.2
Alkaline Phosphatase = 181(Abn High) Ref. 61-146u/l
AST = 37 Ref. 10-40
ALT = 83(Abn High) Ref. 10-50u/L

eGFR >= 60 Ref. >=60

There is no glucose, blood, or protein in my urine. At-least not more than normal.

Free T4 = 1.23 Ref 0.80-1.76
Free T3 =3.4 Ref 2.3-5.0
TSH = 1.44 Ref 0.40-4.00
C-Peptide 1.0 Ref. 0.9-7.00
Hemoglobin A1c 5.1 Ref 4.0-5.6 is normal range

Serum LH = 5.83 Ref 0.80-7.60
FSH Serum = 4.2 Ref 0.7-11.1
Prolactin = 9.3 Ref. 1.9-25.00
IGF-1 = 378 Ref. 141-483
HGH = 3.47(Abnormally high) Reference range 0.00-1.00 ng/ml

Triglycerides = 51 Ref. Anything under 150 is "optimal"
Total Cholesterol = 133 Ref. Anything under 200 is "optimal"
HDL Cholesterol is = 56 Ref. <40 is low >60 is high
LDL Cholesterol is = 67 Ref. Optimal is less than 100
Cholesterol/HDL Ratio 2.38(Abnormally low) Ref. 2.8-6.6 Percentile 10.

Lastly, Yes I now for an absolute fact how much I was eating. I accurately record all my food. I was practically raised form birth to be a professional athlete.

Note that I am only about 194b at probably 15-16% bodyfat and I am 6ft tall. I cannot drop my body fat below
below what it is at. No matter what I do i just lose muscle and look fatter if I even drop my calories even a little bit.
With all that in mind, can anyone give me some insight into what might be causing my symptoms? The Endocrinologist immediately thought low testosterone when he first saw me. We will likely be running even more bloodworm this Thursday. Any ideas or suggestions for me?

Thanks much,
Matt

P.S. I'm 19.
 
This is something for your doctor to examine.

The one easy fix is your low vitamin D level. Most people are deficient in D, supplement with Vitamin D3 at 5000 IU per day.

The next thing I noticed is the low cholesterol and triglycerides. This may indicate you are on a low fat diet or not getting enough fats. Try increasing good fats like avocado, coconut oil and olive oil. You may want to post your macro amounts in here to get recommendations. Cholesterol is what your body uses to produce hormones:

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kenpoengineer do you know of any reasons metabolically why cholesterol and triglycerides could be so low? I truly am eating within a couple hundred calories of 7,000 daily and my daily fat intake is 160-200g. I also eat all kinds of fat other than hydrogenated..
 
I just noticed your liver values are high as well. It's going to be interesting to hear what your doctor says. I would add a good probiotic into your daily routine. What app are you using to track calories and macros? 7000 sounds like a tremendous amount of food to consume each day.
 
Some of your symptoms may be consistent with low testosterone, but I don't think that would account for everything. It seems at least possible that a 7000 calorie diet might produce some abnormal values, so it seems like you might want to review your macro intake with your doctor to see if could account for some of the results. (I know BUN values can be affected by a high protein diet, for example. I don't know about liver enzymes, but it seems at least plausible that a very high calorie might make the liver work "overtime" and potentially produce unusual lab work.)

The fact that you are not gaining/growing despite your high caloric diet and elevated HGH makes me think something is going on with your endocrine system. Maybe your doc will want to look at pituitary gland?
 
Thanks!! What were you thinking could be wrong with my pituitary? A tumor or something? Or just not functioning properly was your point?
 
I really don't know much, except that the pituitary is one thing that CAN influence HGH and ACTH level. Apparently there is a form of benign tumor that can result in secretion of increased amounts of HGH and/or other hormones, depending on where in the pituitary it is located. My guess is it would be a real long shot to think that is going on, but there must be something that explains your profile. Hopefully, you have a good doc who likes to solve puzzles.
 
kenpoengineer said:
The next thing I noticed is the low cholesterol and triglycerides. This may indicate you are on a low fat diet or not getting enough fats. Try increasing good fats like avocado, coconut oil and olive oil.
Click to expand...

Lipids can be a purely genetic thing as well. For example: I eat everything you mentioned, and daily, but my triglycerides are low and total cholesterol fairly low too. My background is mainly German and I've been told that German's tend to not have many problems with high cholesterol, and considering how Germans tend to eat traditionally (a lot of meat & potatoes and such, really greasy foods), it's pretty interesting.
 
Thanks. Yeah hopefully they can get that fixed. But do you have any suggestions to me on how to get the doctor to prescribe anything to Boost T(Clomid, hcg, TRT...whatever works) if even after the cortisol thing I cannot get my total test much over 450(currently 437) when reference is (350-1200). His nurse seemed to think that was very very low for 19 then proceeded to tell me there was nothing possible for us to do.
 
Oops. Not a reply.

No suggestions on dealing with your doctor, but I think you should try to get to the bottom of the diagnostic work first, as it may be related to how you're feeling.

I know your situation is frustrating/depressing (been there during a long struggle with low T), but I would not leap too quickly to old-school TRT which will alter/suppress natural T production on a long term basis. I know there are some nonsuppressive alternatives, but I wonder if altering your hormonal profiles now might mask what is going on and make it harder to get an accurate diagnosis. You can always see what your doctor thinks about starting something now.
 
I'm at-least going to ask him if he plans to support me, and if in 2-3 months we cannot clear up the underlying problem OR simply if solving the main issue doesn't push my testosterone up to near 1000ng/dl, if he will then support me hoping on something to improve my performance both athletically and sexually. I will also ask if he honestly thinks Barely elevated 24-hour cortisol is truly making my total testosterone about half of what it really should be, if he says probably not I will ask if we can talk about potential options of my test so i can atleast start feeling better while we resolve some other issues like the cortisol.

Lastly I was fasted when I had that reading, so id assume working out, eating carbs in general, but specifically sugar through the day(which I do around my workout) and the insulin elevation that accompanies that would push my total testosterone even further into the depths of hell. That 437ng/dl is probably close to my peak reading if I had to guess.
 
I'm not sure how much statistical power there is behind the T level breakdowns by age, but most of the numbers I have seen would put the mean for your age group around 690, and your current numbers would fall within the low end of the normal distribution for your age on some charts. Even age-adjusted ranges are pretty wide, so they don't seem helpful; however, it does mean you can probably expect resistance from a lot of docs -- especially about a 1000 target.
 
But I should not have to live with 25% lower than the average level if I don't want to. I am an adult I should be able to make adult decisions about what's important to me about my health.

Part of the Dexamethasone suppression labs came back. Cortisol did not come back yet. Hopefully today or tomorrow's the only abnormality so far was GH 572% higher than normal.
 
And actually unless I am not thinking clearly , if 690 was at the top of the bell curve; a bell curve's "normal" or "C grade" would be 25% on either side of that. I'm about 36.667% below the top of the bell curve. That's not in the "median statistical range" if 690 is the mean.
 
I hear you and don't necessarily disagree. My personal experience has been with a very conservative doctor, so I just know you could encounter some resistance, depending on your doc's philosophy. (I felt like I was pulling teeth to get my doc to authorize TRT when I my total T was around 220 and free T was also low.) You can always look for another doctor if you don't get satisfactory response from your current one.

Given your age, I assume any legitimate practitioner would want a TRT regimen that preserves long term fertility. Based on my age and other factors, that was not really a consideration for me, so I don't have any experience with things used to prevent long term suppression of natural T production, and I have no idea if they place any limits on how high the doc will boost your T. I'd bet there are plenty of folks here who know all about that, though.

Good luck. If you ever get an explanation for your various elevated values, I'd be curious to learn, if you feel like sharing it.
 
What supplements are you taking? Why are your ALT and AST values so high? Did you start taking vitamin D3 at 5000 IU per day?
 
I just started the vitamin D. This was before I started on vitamin D. No clue about any of it. Why is my GH 572% higher than normal another good question. Doc said AST ALT could be from hard excercise
 
Mesomorphin do you think claiming mild social anxiety I've never had before, just sporadically getting butterfly's and getting pretty nervous(confidence is severely diminished around females and or males I don't have any positive or negative emotions about(no feelings about then at all) on top of zero libido and ED should be able to get something considering my number is low...
 
I don't have a good feel for that. My guess is many docs would want to rule out some organic cause for your unusual labs and inability to put on weight despite a huge caloric intake before starting you on TRT. If your doc is not that concerned about the labs, then it probably comes down to his/her attitudes about TRT.

For some docs, zero libido and ED would probably be enough by themselves; other docs probably never prescribe TRT if you are ANYWHERE in the reference range, regardless of symptoms. My doc was in the latter camp -- and even when I was below the reference range, my doc really seemed to discount anything non-libido related as a "non-specific" symptom. (I had experienced some pretty strong "brain fog"/difficulty concentrating enough to follow complex discussions, some sleep pattern disruption, and even some weird peripheral vision/spatial perception problem that was starting to make me nervous about driving -- none of which seemed to make any difference to my doc, even though those things were driving me crazy.) My guess is that most docs who aren't motivated by the libido and ED issues might not change their views based on the social aspect you described. Probably no harm in bringing it up if it is a concern, but it may shift some focus to any stress/anxiety issues that might affect libido.
 
I have never had Clomid, so I not sure of side effects. My understanding is that it blocks receptors in the hypothalamus that would otherwise signal the body to stop producing FSH and LH, and the resulting increases in LH and FSH stimulate increased natural T production. I believe it can boost T toward the high end of the normal range. If so, it seems possible that it might lead to increased production of red blood cells, but that would be something you could easily control and monitor with periodic blood donations.
 
Thanks! I'm seeing like 6 weeks but do you have any idea how long till my serum testosterone levels will start to spike up? Seems like it would after dose even a little bit?
 
I don't know how quickly you should expect to feel changes with Clomid. The important thing is not the raw number but how you feel, and I suspect that is subject to individual variation.

I received exogenous T rather than something that attempted to boost my natural T production. Although I assume the outside T produced some effect on my T levels right away, I still had to go through a trial-and-error process to find an effective dose, and after a adjusting my dose, it was probably about two weeks before I could feel the difference.
 
Do you think if this dosage pushes me a little over the 1200 number the doctor will make me come off or reduce dosage, or if I tell him I feel incredible(which I already do) and my bloodwork isn't off he charts bad he might let me stay on that dosage? Especially since it's endogenous...dem gains doe
 
I'm confident my doc would ratchet me back well before 1200, but that doesn't mean yours will. If your doc let's you stay up there, I would definitely keep track of your red cell count. Even at much lower levels I experience a gradual buildup to abnormal levels if I don't make regular donations. (I used to just give platelets, but now I HAVE to add periodic whole blood donations for my own benefit.)
 
How old are you again if you don't mind me asking? The impression I got from my doctor was that if I'm feeling good I'm that's a good thing. How often would you recommend donating blood to keep hematocrit and rbc down?
 
I'm older than dirt -- 62. Feeling good is definitely a good thing. However, different docs have different views of risk and risk tolerance. There are a lot of practitioners who want to aim for the lowest level that resolves libido/ED. My guy, for example, once made a remark that suggested he was practically horrified hearing about a patient who had been boosted up to 900. On the other hand , there are some practitioners who aim for that kind of level.

I think how often you give blood is a matter of trial and error. If I were you, I'd probably make a donation relatively soon, just to get some baseline hematocrit information. I'd do a second one 8 weeks later to see how if it has gone up and by how much. That should help you gauge if you need to give and how often.

In my case, I can get by with a few times a year, but last year I neglected it, and got well into an abnormal range. Among other things, that can screw with your blood pressure, which in turn can make them reject you as a donor, so it is better to stay on top of it.
 
Alright great thanks. I'm not even getting bloodwork for androgens for 90+ days and I have Clomid in my possession to cover that and more. So I suppose it simply depends on if my hormones levels can continue to rise until 100 days from now. Maybe I'll hit that 1200 total
 
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