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In your opinion do my labs match up with my symptoms?
Symptoms: #1 is fatigue then anxiety and social (panic attacks), achy, moody, think vision is getting worse, i feel weaker in the gym. I have no motivation at all to do anything.

I been running labs every 8 weeks.. but these are a huge change from my previous labs just 8 weeks ago... Testosteonre increased was 900.. SHBG increased was 20, e2 increased was 20 (which is perfect)... I did switch thyroid meds

100mg TEST CYP (33.3mg 3x a week)
300iu HCG
130mg WP Thyroid


TESTOSTERONE, TOTAL, MALES (ADULT), IA - 1217 *High* (ng/dL 250-827_
SEX HORMONE BINDING GLOBULIN 32 (nmol/L 10-50)
ESTRADIOL, ULTRASENSITIVE LC/MS/MS - 39 *High* pg/mL < OR = 29 Final
PROGESTERONE <0.5 - ng/mL <1.4
PROLACTIN 7.1 (ng/mL 2.0-18.0)
IGF 1, LC/MS 225 (ng/mL 53-331)
Z SCORE (MALE) 1.0-SD -2.0 - +2.0
ANDROSTENEDIONE, LC/MS/MS 93 (ng/dL 40-190)
DIHYDROTESTOSTERONE, LC/MS/MS 39 (ng/dL 16-79)
PREGNENOLONE, LC/MS/MS - 15 *Low* (ng/dL 22-237)
DHEA SULFATE 170 (106-464 (mcg/dL)


IRON, TOTAL 105 - mcg/dL 50-180
IRON BINDING CAPACITY 331 -mcg/dL (calc) 250-425
% SATURATION 32 - % (calc) 15-60
FERRITIN 73 -ng/mL (20-345)






TSH 0.86 - mIU/L (0.40-4.50)
T4, FREE - 0.6 *Low*( ng/dL 0.8-1.8)
T3, FREE - 2.1 *Low* (pg/mL 2.3-4.2)
T3 REVERES 10 (ng/dL 8-25)


Cortisol Salvia (4x) 8.8 (3.7 - 9.5 ng/mL) morning
1.7 (1.2 - 3.0 ng/mL) noon
1.1 (0.6 - 1.9 ng/mL) evening
0.7 (0.4 - 1.0 ng/mL) night
Graph of cortisol is in picture below


VITAMIN D,25-OH,TOTAL,IA 38 (30-100 (ng/mL) ( BEEN GETTING LOT OF SUN LATELY)


ANTINUCLEAR ANTIBODIES TITER AND PATTERN
ANA SCREEN, IFA - POSITIVE
ANA TITER - 1:40 HIGH ( low anti range 1: 40 - 1:80 , high > 1:80 )


EPSTEIN BARR VIRUS ANTIBODY FULL PANEL - NEGATIVE
CYTOMEGALOVIRUS ANTIBODIES (IGG,IGM) - NEGATIVE
SED RATE BY MODIFIED WESTERGREN, MANUAL 2 ( < OR = 15 mm/h )
C-REACTIVE PROTEIN <0.10 ( <0.80 (mg/dL)
HELICOBACTER PYLORI, UREA BREATH TEST - NEGATIVE
C.ALBICANS IGG 0.9 REFERENCE RANGE: <1.0
C.ALBICANS IGA 0.2 REFERENCE RANGE: <1.0
C.ALBICANS IGM 0.7 REFERENCE RANGE: <1.0
METHYLENETETRAHYDROFOLATE REDUCTASE (MTHFR), DNA:: This individual is heterozygous for the C677T mutation and negative (normal) for the A1298C mutation in the MTHFR gene.


LYME DISEASE ANTIBODIES (IGG,IGM), IMMUNOBLOT - 23 KD IGM BAND REACTIVE ( ALL OTHER BANDS WERE NEGATIVE )


CONCENTRATION 1: No ova or parasites seen
TRICHROME 1: No ova or parasites seen


CONCENTRATION 2: No ova or parasites seen
TRICHROME 2: No ova or parasites seen


CONCENTRATION 3: No ova or parasites seen
TRICHROME 3: No ova or parasites seen




Glucose 94 mg/dl ( 65-99 )
UREA Nitrogen ( BUN ) 24 mg/dl ( 7 &#8211; 25 )
Creatinine 1.02 mg/dl ( .5 &#8211; 1.3)
eGFR Estimated 96 > OR = 60 ml/min/1.73m2>
BUN/Creatinine Ratio 15 (CALC) 6 &#8211; 22
SODIUM 139 mmol/L ( 135 &#8211; 146 )
Potassium 4.0 mmol/L ( 3.5 &#8211; 5.3 )
Chloride 101 mmol/L ( 98 &#8211; 110 )
Carbon Dioxide 24 mmol/L ( 21 &#8211; 33 )
Calcium 9.6 mg/dl ( 8.6 &#8211; 10.2 )
Protein, Total 7.9 g/dL ( 6.2 &#8211; 8.3)
ALBUMIN 4.8 g/dL ( 3.6 &#8211; 5.1)
Globulin 3.1 g/dL ( 2.1 &#8211; 3.7 )
Albumin / Globulin RATIO 1.5 (calc) ( 1.0 &#8211; 2.1 )
Total Bilirubin .6 mg/dl ( . 2 &#8211; 1 .2 )
Alkaline Phosphate 46 u/l (40 &#8211; 115 )
AST 19 u/l ( 10 &#8211; 41 )
ALT 17 u/l ( 9 &#8211; 60 )


CBC (includes Diff/Plt)


White Blood Cell Count 7.8thousand/ uL ( 3.8 &#8211; 10.8 )
Red Blood Cell Count 5.62 million/ uL ( 4.20 &#8211; 5.80 )
Hemoglobin 16.2 g/dL ( 13.2 - 17.1 )
Hematocrit 48.8 % (38.5 &#8211; 50.0 )
MCV 86.9 fL ( 80 &#8211; 100 )
MCH 28.8 pg ( 27 &#8211; 33 )
MCHC 33.2 g/dL ( 32 &#8211; 36 )
RDW 13.4 % ( 11 &#8211; 15 )
Platelet Count 284 thousand / uL ( 140 &#8211; 400 )


Absolute Neutrophils 5733 cells / ul ( 1500 &#8211; 7800 )
Absolute Lymphocytes 1498 cells / ul ( 850 &#8211; 3900 )
Absolute Monocytes 304 cells / ul ( 200 &#8211; 950 )
Absolute Eosinophils 242 cells / ul ( 15 &#8211; 500 ) &#61663; HIGH
Absolute Basophils 23 cells / ul ( 0 &#8211; 200 )


NEUTROPHILS 73.5%
LYMPHOCYTES 19.2%
MONOCYTES 3.9%
EOSINOPHILS 3.1%
BASOPHILS 0.3%
 
Defy Medical TRT clinic doctor
In your opinion do my labs match up with my symptoms?
Symptoms: #1 is fatigue then anxiety and social (panic attacks), achy, moody, think vision is getting worse, i feel weaker in the gym. I have no motivation at all to do anything.

I been running labs every 8 weeks.. but these are a huge change from my previous labs just 8 weeks ago... Testosteonre increased was 900.. SHBG increased was 20, e2 increased was 20 (which is perfect)... I did switch thyroid meds

100mg TEST CYP (33.3mg 3x a week)
300iu HCG
130mg WP Thyroid


TESTOSTERONE, TOTAL, MALES (ADULT), IA - 1217 *High* (ng/dL 250-827_
SEX HORMONE BINDING GLOBULIN 32 (nmol/L 10-50)
ESTRADIOL, ULTRASENSITIVE LC/MS/MS - 39 *High* pg/mL < OR = 29 Final
PROGESTERONE <0.5 - ng/mL <1.4
PROLACTIN 7.1 (ng/mL 2.0-18.0)
IGF 1, LC/MS 225 (ng/mL 53-331)
Z SCORE (MALE) 1.0-SD -2.0 - +2.0
ANDROSTENEDIONE, LC/MS/MS 93 (ng/dL 40-190)
DIHYDROTESTOSTERONE, LC/MS/MS 39 (ng/dL 16-79)
PREGNENOLONE, LC/MS/MS - 15 *Low* (ng/dL 22-237)
DHEA SULFATE 170 (106-464 (mcg/dL)


IRON, TOTAL 105 - mcg/dL 50-180
IRON BINDING CAPACITY 331 -mcg/dL (calc) 250-425
% SATURATION 32 - % (calc) 15-60
FERRITIN 73 -ng/mL (20-345)






TSH 0.86 - mIU/L (0.40-4.50)
T4, FREE - 0.6 *Low*( ng/dL 0.8-1.8)
T3, FREE - 2.1 *Low* (pg/mL 2.3-4.2)
T3 REVERES 10 (ng/dL 8-25)


Cortisol Salvia (4x) 8.8 (3.7 - 9.5 ng/mL) morning
1.7 (1.2 - 3.0 ng/mL) noon
1.1 (0.6 - 1.9 ng/mL) evening
0.7 (0.4 - 1.0 ng/mL) night
Graph of cortisol is in picture below


VITAMIN D,25-OH,TOTAL,IA 38 (30-100 (ng/mL) ( BEEN GETTING LOT OF SUN LATELY)


ANTINUCLEAR ANTIBODIES TITER AND PATTERN
ANA SCREEN, IFA - POSITIVE
ANA TITER - 1:40 HIGH ( low anti range 1: 40 - 1:80 , high > 1:80 )


EPSTEIN BARR VIRUS ANTIBODY FULL PANEL - NEGATIVE
CYTOMEGALOVIRUS ANTIBODIES (IGG,IGM) - NEGATIVE
SED RATE BY MODIFIED WESTERGREN, MANUAL 2 ( < OR = 15 mm/h )
C-REACTIVE PROTEIN <0.10 ( <0.80 (mg/dL)
HELICOBACTER PYLORI, UREA BREATH TEST - NEGATIVE
C.ALBICANS IGG 0.9 REFERENCE RANGE: <1.0
C.ALBICANS IGA 0.2 REFERENCE RANGE: <1.0
C.ALBICANS IGM 0.7 REFERENCE RANGE: <1.0
METHYLENETETRAHYDROFOLATE REDUCTASE (MTHFR), DNA:: This individual is heterozygous for the C677T mutation and negative (normal) for the A1298C mutation in the MTHFR gene.


LYME DISEASE ANTIBODIES (IGG,IGM), IMMUNOBLOT - 23 KD IGM BAND REACTIVE ( ALL OTHER BANDS WERE NEGATIVE )


CONCENTRATION 1: No ova or parasites seen
TRICHROME 1: No ova or parasites seen


CONCENTRATION 2: No ova or parasites seen
TRICHROME 2: No ova or parasites seen


CONCENTRATION 3: No ova or parasites seen
TRICHROME 3: No ova or parasites seen




Glucose 94 mg/dl ( 65-99 )
UREA Nitrogen ( BUN ) 24 mg/dl ( 7 – 25 )
Creatinine 1.02 mg/dl ( .5 – 1.3)
eGFR Estimated 96 > OR = 60 ml/min/1.73m2>
BUN/Creatinine Ratio 15 (CALC) 6 – 22
SODIUM 139 mmol/L ( 135 – 146 )
Potassium 4.0 mmol/L ( 3.5 – 5.3 )
Chloride 101 mmol/L ( 98 – 110 )
Carbon Dioxide 24 mmol/L ( 21 – 33 )
Calcium 9.6 mg/dl ( 8.6 – 10.2 )
Protein, Total 7.9 g/dL ( 6.2 – 8.3)
ALBUMIN 4.8 g/dL ( 3.6 – 5.1)
Globulin 3.1 g/dL ( 2.1 – 3.7 )
Albumin / Globulin RATIO 1.5 (calc) ( 1.0 – 2.1 )
Total Bilirubin .6 mg/dl ( . 2 – 1 .2 )
Alkaline Phosphate 46 u/l (40 – 115 )
AST 19 u/l ( 10 – 41 )
ALT 17 u/l ( 9 – 60 )


CBC (includes Diff/Plt)


White Blood Cell Count 7.8thousand/ uL ( 3.8 – 10.8 )
Red Blood Cell Count 5.62 million/ uL ( 4.20 – 5.80 )
Hemoglobin 16.2 g/dL ( 13.2 - 17.1 )
Hematocrit 48.8 % (38.5 – 50.0 )
MCV 86.9 fL ( 80 – 100 )
MCH 28.8 pg ( 27 – 33 )
MCHC 33.2 g/dL ( 32 – 36 )
RDW 13.4 % ( 11 – 15 )
Platelet Count 284 thousand / uL ( 140 – 400 )


Absolute Neutrophils 5733 cells / ul ( 1500 – 7800 )
Absolute Lymphocytes 1498 cells / ul ( 850 – 3900 )
Absolute Monocytes 304 cells / ul ( 200 – 950 )
Absolute Eosinophils 242 cells / ul ( 15 – 500 )  HIGH
Absolute Basophils 23 cells / ul ( 0 – 200 )


NEUTROPHILS 73.5%
LYMPHOCYTES 19.2%
MONOCYTES 3.9%
EOSINOPHILS 3.1%
BASOPHILS 0.3%

Those are really comprehensive. When were these taken relative to injection?

Several things are off, testosterone seems really high, which could be explained by testing at a different time relative to injection.

Thyroid is low for what seems like a high dose of thyroid medication, but I am no thyroid expert.

ANA being positive raises some questions, but again I don't know much about this test.

I think your low thyroid hormones would explain the fatigue.

Low pregnenolone is interesting, although hCG is purported to increase it, I never found much evidence of it doing so.
 
Even if you are getting a lot of sun, make sure to take around 6,000iu of Vitamin D3 per day to get your Vitamin D levels optimal. Also make sure to take Vitamin K2 along with the Vitamin D3. Anyone taking Vitamin D3 should always be taking K2 with it. Obviously you have to get your Free T3 and free T4 levels up. Estradiol I wouldn't worry about too much. And obviously address the low pregnenolone with your doctor as well.
 
I did my injection wednesday morning and tested labs friday morning...

I did noticed i been getting ED / low libido lately... I thought that was my e2... i do a bit better with low e2 20-25 range....
I figured my lab were going to be completely different just from how i felt... Before i needed sex every day, now i can go a few days without it
I may actually lower of my does of TRT.. to 30mg 3x a week (total of 90)

My low DHT could also cause the low libido, it was 75 a few months after i started my TRT but now i was surprised it fell by half, i guess this is at least good for hair?


I agree my thyroid is horrible...

So my plan is:
Reduce TRT or increase arimidex
switch back thyroid meds and increase
start a trandermal Preg/DHEA
 
Based on the very little I'm able to see from your first set of labs and this one you may want to ask your endo/doc for a bit more info on Hashimoto thyroiditis. I'm obviously looking at a very small snapshot here and am hardly a trained professional, but it may be the cause of some of the things you're currently going through. Another consideration would be switching to a synthetic thyroid medication that contains t4 and/or t3. I'm unsure if there are any true studies backing this up but I've at least heard a lot of anacdotal evidence regarding a negative interaction involving desiccated thyroid in hashimoto patients.
 
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