Help with blood test results

[zman22]

Looking for some advice/help on symptoms im having. Quick overview on what lead me to TRT: I have had three crashes in the past 3 years where i was under incredible stress and my body kind of gave out. What i mean by crashes are symptoms as follows:
-Extreme fatigue
-Insomnia
-Body pains
-Brain fog
-depression
-anxiety
- lack of sexual desire
-heighten anger
-severe constipation- hospitalized once thought my appendix was bursting
-heighten food sensitivity's
-easily got sick

Found out last year I have Hashimotos. Testosterone during last years crash was 250 not sure on free. This year when i crashed in May testosterone was the 252. I decided to do TRT this year and i was prescribed a dose of 125mg once a week. I now do 125mg but divided twice a week. Below are my labs from june 1st this year.


DHEA-Sulfate 138.5-475.2 249.3
Estradiol 7.6-42.6 16.7
Reverse T3 18.8
Serum Sex Horm Binding Glob 16.5-55.9 42.0
Testosterone, Serum 348-1197 255
Thyroglobulin Antibody 0.0-0.9 6.5
Thyroid Peroxidase (TPO) Ab 0-34 51
Thyroxine (T4) Free, Direct, S T4 0.82-1.77 1.33
Triiodothyronine,Free,Serum 2.0-4.4 2.8
TSH 0.450-4.500 2.270
Vitamin D, 25-Hydroxy 30.0-100.0 51.3

I switched doctors after 4 weeks. My new doctor added 1 grain (64mg) of nature thyroid for my hashimotos. He ran my labs again since it had been a month on TRT. Below are some of my labs. He didn't do any thyroid labs on this day.

Estrodial- 41
Teststrone - 1149
Free T- 264

He kept me on the same dose of T 125mg twice a week. He wants me to take anastzole only when i feel symptoms. Problem is after 7 weeks I still feel like crap. My other problem is when i take the thyroid medication I really feel like crap. I will say my overall health has improved since starting TRT. I have days where i feel really good and then the next I'm lethargic and moody to the point i hate life. I usually have major anxiety after doing a shot that sometimes lasts for two days. Most of the time its gone after a full day. So I tried to lower my T dose to 100mg a week and i was still having the same anxiety after the shots. Feels like my lymphodes in my neck swell up.

I have been wondering if TRT id right for me and if i made a mistake by going on it. I am at a total loss as to whether i should be taking thyroid medication based on how i feel on it. My doctor says I am taking a really low dose and it shouldn't be giving me a dull headache and anxious but i does. Sleep is another factor in this as i have a couple good nights sleep then a couple bad ones. Any thought advice?

 

[CoastWatcher]

Looking for some advice/help on symptoms im having. Quick overview on what lead me to TRT: I have had three crashes in the past 3 years where i was under incredible stress and my body kind of gave out. What i mean by crashes are symptoms as follows:
-Extreme fatigue
-Insomnia
-Body pains
-Brain fog
-depression
-anxiety
- lack of sexual desire
-heighten anger
-severe constipation- hospitalized once thought my appendix was bursting
-heighten food sensitivity's
-easily got sick

Found out last year I have Hashimotos. Testosterone during last years crash was 250 not sure on free. This year when i crashed in May testosterone was the 252. I decided to do TRT this year and i was prescribed a dose of 125mg once a week. I now do 125mg but divided twice a week. Below are my labs from june 1st this year.


DHEA-Sulfate 138.5-475.2 249.3
Estradiol 7.6-42.6 16.7
Reverse T3 18.8
Serum Sex Horm Binding Glob 16.5-55.9 42.0
Testosterone, Serum 348-1197 255
Thyroglobulin Antibody 0.0-0.9 6.5
Thyroid Peroxidase (TPO) Ab 0-34 51
Thyroxine (T4) Free, Direct, S T4 0.82-1.77 1.33
Triiodothyronine,Free,Serum 2.0-4.4 2.8
TSH 0.450-4.500 2.270
Vitamin D, 25-Hydroxy 30.0-100.0 51.3

I switched doctors after 4 weeks. My new doctor added 1 grain (64mg) of nature thyroid for my hashimotos. He ran my labs again since it had been a month on TRT. Below are some of my labs. He didn't do any thyroid labs on this day.

Estrodial- 41
Teststrone - 1149
Free T- 264

He kept me on the same dose of T 125mg twice a week. He wants me to take anastzole only when i feel symptoms. Problem is after 7 weeks I still feel like crap. My other problem is when i take the thyroid medication I really feel like crap. I will say my overall health has improved since starting TRT. I have days where i feel really good and then the next I'm lethargic and moody to the point i hate life. I usually have major anxiety after doing a shot that sometimes lasts for two days. Most of the time its gone after a full day. So I tried to lower my T dose to 100mg a week and i was still having the same anxiety after the shots. Feels like my lymphodes in my neck swell up.

I have been wondering if TRT id right for me and if i made a mistake by going on it. I am at a total loss as to whether i should be taking thyroid medication based on how i feel on it. My doctor says I am taking a really low dose and it shouldn't be giving me a dull headache and anxious but i does. Sleep is another factor in this as i have a couple good nights sleep then a couple bad ones. Any thought advice?

How old are you? Has your sleep been evaluated for apnea? As has been noted many times, sleep apnea is undiagnosed far too often and it can hammer hormones. Has adrenal function been evaluated? Your LH and FSH: are you dealing with primary or secondary hypogonadism? Are you overweight? Is diabetes a possibility? Your thyroid function, or, rather malfunction, has to be addressed to maximize the chances of TRT being successful.

Taking anastrozole based on how you feel is a ticket to frustration - and another frustrating thing is that, based on your lab reference ranges, you tested e2 with the incorrect test. Men need to measure estradiol with the sensitive, LC, MS/MS, lab test. The standard test is unreliable.

Was HCG discussed?

 

[Vince Carter]

To add to my friend CWs remarks, you also cannot use 100mg one week because you feel this that and the other...like he said with the Anastrozole. Hormones is about balance and consistency, over time; marathon and not a sprint.
many guys here present with ancillary problems...thyroid as mentioned which you're doing something about, and then there's anxiety which I seem to see that coming thru in your post. Some of these sorts of things just have to be dealt with outside of TRT it seems...most cases TRT isn't going to resolve anxiety or other medical matters though you can be diagnosed as Hypogonadal.
Given what you've presented here you have a lot going on between a serious Thyroid disease and TRT. It may be best to go solo on the Thyroid and reach a state where you are again healthy and stable in that regard and perhaps revisit TRT later.

 

[zman22]

How old are you? Has your sleep been evaluated for apnea? As has been noted many times, sleep apnea is undiagnosed far too often and it can hammer hormones. Has adrenal function been evaluated? Your LH and FSH: are you dealing with primary or secondary hypogonadism? Are you overweight? Is diabetes a possibility? Your thyroid function, or, rather malfunction, has to be addressed to maximize the chances of TRT being successful.

Taking anastrozole based on how you feel is a ticket to frustration - and another frustrating thing is that, based on your lab reference ranges, you tested e2 with the incorrect test. Men need to measure estradiol with the sensitive, LC, MS/MS, lab test. The standard test is unreliable.

Was HCG discussed?

I'm 34 years old. Not sure if it's secondary or primary hypogonadism. I would lean toward primary based on having a autoimmune thyroid disorder. Wish I had a testosterone lab when i feel normal. Although I am almost always on the tired side even away from a crash. Yes I have mild obstructive sleep apnea. I usually wear a oral appliance.

Yes HCG was discussed. I actually did this last year by itself but it don't offer much relief. Made me more interested in sex but that's about it. I have been contemplating HCG to help if I decide to stop TRT to get my nuts working good again.

I have no test on adrenal besides DHEA test. I don't know what to believe with adrenal fatigue but I do fit it almost to a T. I'll probably do a saliva test soon. The thing with my thyroid I'm unsure about is my labs are in a good range so not sure if I'm hurting myself by taking thyroid meds.

 

[CoastWatcher]

I'm 34 years old. Not sure if it's secondary or primary hypogonadism. I would lean toward primary based on having a autoimmune thyroid disorder. Wish I had a testosterone lab when i feel normal. Although I am almost always on the tired side even away from a crash. Yes I have mild obstructive sleep apnea. I usually wear a oral appliance.

Yes HCG was discussed. I actually did this last year by itself but it don't offer much relief. Made me more interested in sex but that's about it. I have been contemplating HCG to help if I decide to stop TRT to get my nuts working good again.

I have no test on adrenal besides DHEA test. I don't know what to believe with adrenal fatigue but I do fit it almost to a T. I'll probably do a saliva test soon. The thing with my thyroid I'm unsure about is my labs are in a good range so not sure if I'm hurting myself by taking thyroid meds.

Primary hypogonadism results from a testicular issue, I'm not sure how you moved from a thyroid problem to a primary diagnosis. Post your LH and FSH results and it should be clear. How well managed is your apnea? Is the appliance you're wearing permitting a night of restful sleep? If it's not, you'll never turn your hormonal problems around.

No one is asking you to believe in adrenal fatigue, only to get tested. When the results arrive you can determine what course of action may - or may not - be necessary.

Your relationship with your doctor doesn't seem to inspire much confidence in your efforts to sort out the complicated issues you're dealing with. Is your physician a true partner who you can work with?

 

[zman22]

Primary hypogonadism results from a testicular issue, I'm not sure how you moved from a thyroid problem to a primary diagnosis. Post your LH and FSH results and it should be clear. How well managed is your apnea? Is the appliance you're wearing permitting a night of restful sleep? If it's not, you'll never turn your hormonal problems around.

No one is asking you to believe in adrenal fatigue, only to get tested. When the results arrive you can determine what course of action may - or may not - be necessary.

Your relationship with your doctor doesn't seem to inspire much confidence in your efforts to sort out the complicated issues you're dealing with. Is your physician a true partner who you can work with?

Yeah I'm a complicated case I would say.
LH- 2.6
They didn't do a FSH test on me.
I could do another sleep study to see if my sleep appliance is doing it's job. Thanks for the info. No I'm not super confident in my doc but he's better than the first one I had. Maybe I'll look into defy more.