Lab Results - How did I do?

[illinoisguy]

I just received all my tests results:

CBC Tests - All within normal range
CMP Panel - All within normal range with exception of Total Billirubin which was 1.3 mg/dL. Normal test range on the test said 0.1 - 2.0 mg/dL but discountlabs.com say 0.0-1.0 mg/dl. Is this too high?
Ferritin - 19.8 ng/mL - Low but addressed in another post.
Iron, Serum - 84 ug/dL - Range 65 - 175 ug/dL
Choloestrol Levels - All within range.
Free T3 - 2.81 pg/mL - Test range is 2.40 - 4.20 pg/mL but I read somewhere else that it is low if below 3.7. Is it low?
Free T4 - 0.9 ng/dL - Range 0.358 - 3.740 mIU/mL
25-Hydroxyvitamin D (Total) - 39.4 ng/mL - Range 30.0 - 100.0 ng/mL
DHEA Sulfate, Serum - 110 ug/dL - Range 95 - 530 ug/dL
Prostate Specific Antigen Screen - 0.49 ng/mL - Range <=4.00 ng/mL
LH - 4.4 mIU/mL - Range 1.2 - 10.6 mIU/mL
FSH - 3.3 mIU/mL - Range 0.7 - 10.8 mIU/mL
Testosterone, Free, Calc - 140 pg/mL - Range 47 - 244 pg/mL. Test results back in October 2015 were 119.0 pg/mL.
Percent Free Testosterone - 1.40% Test range is 1.6 - 2.9 % but doctor didn't seem concerned. Is this low?
Testosterone, Adult Male -983 ng/dL - Range 300 - 890 ng/dL. Test results back in October was 781.0 ng/dL.
Testosterone, Bioavailable - 407 ng/dL - Range 131 - 682 ng/dL
Sex Hormone Binding Globulin - 61 nmol/L - Range 11 - 80 nmol/L
IGF-1 (Insulin-Like Growth I) - 184 ng/mL - Range 76 - 230 ng/mL
IGF 1 Z Score Calculation - 1.0 - Range -2.0 and +2.0
Prolactin - 6.0 ng/mL - Range 2.5 - 17.4 ng/mL
Cortisol - 15.0 ug/dL -Range 5.27-22.45 µg/dL
Pregnenolone By MS/MS, Serum - 87 ng/dL - Range 23 - 173 ng/dL
Estadiol - 41.0 pg/mL - Was 42.1 pg/mL back in October 2015. I asked for the "Sensitive" version in both instances but test results don't specify that (just "Estradiol"). Does this seem high? Original test range back in 2015 was 0.0 - 39.8 pg/mL so general doctor sent me to a endocrinologist who didn't seem overly concerned and didn't really do much. This time the test range was 11.0 - 52.5 pg/mL so my general doctor didn't even mention it. I do think I might have some gynecomastia, and do suffer from slight fatigue and head fog. Should I do anything further?


Did I miss any tests? Anything concerning? Any further tests? Any advice is appreciated! For references, I am 44 male, overall good health, 215lbs, 6'2", in decent shape, lift weights sometimes, never been on any testosterone therapy and only major medical issues are acid reflux and I lost my spleen about 15 years ago.

Thanks in advance!

 

[Vince Carter]

We need lab ranges here...different labs have different ranges.

 

[illinoisguy]

I added ranges. Sorry about that.

 

[Vince Carter]

Did you run TSH/THyroid Stim Hormone? FT3 should be lcloser to as ytou say 3.7 or the upper ranges like that, FT4 is pretty common to see on the low side so that's not a cause for concern. If this is all you had it's incomplete:

TSH
FT3
FT4
Antibodies
Reverse T3

I'd delve in to those and see that that is squared away before anything else. and the probiotics from your Ferritin thread

 

[illinoisguy]

Thanks Vince! I forgot to post the TSH:

TSH - 1.410 mIU/mL - Range 0.358 - 3.740 mIU/mL

 

[Systemlord]

If you are not using Equilibrium Dialysis or Ultrafiltration lab testing methods and are using the Direct Immunoassay your results may be inaccurate by up to 40%. I'm seeing conflicting results on FT levels, the FT percentage is low and the directly measured levels are showing almost midrange or better levels which suggest you are using the Direct Immunoassay.

The Tru-T calculator when TT and SHBG is accounted for shows FT at 31.70 (16-31 ng/dL) which is excellent! You're getting these levels with an LH of 4.4, whoa!

The TSH score is excellent as well, maybe your body operates well at a lower fT3.

 

[illinoisguy]

Systemlord....can you please explain further? I have no idea what "Equilibrium Dialysis", "Ultrafiltration lab testing methods" and "Direct Immunoassay" is (I am new here). Do I need to have something retested? I am attaching a copy of the test for you reference.

 

[Vince Carter]

Thanks Vince! I forgot to post the TSH:

TSH - 1.410 mIU/mL - Range 0.358 - 3.740 mIU/mL

If at some point you retest anything please do those those 5. Your FT3 is just OK, could be much better in that 3.7+ range. Reverse T3 would tell us if that T3 is "pooling" and not making it in to your cells to be used. Though I think at this point you could move on from Thyroid being a primary cause of anything for you at this time.

 

[illinoisguy]

Thanks! Would it be okay to start taking Ashwagandha? From what I have read it helps increase T3 and also reduces anxiety (which I think I suffer from sometimes).

 

[Systemlord]

Systemlord....can you please explain further? I have no idea what "Equilibrium Dialysis", "Ultrafiltration lab testing methods" and "Direct Immunoassay" is (I am new here). Do I need to have something retested? I am attaching a copy of the test for you reference.

Why TruT™

Current methods for measuring free testosterone (fT) are technically challenging and not accurate. The widely used direct immunoassay and tracer analog techniques for measuring fT have been shown to be inaccurate. Equilibrium dialysis, the reference method against which other methods are compared, is labor-intensive and cumbersome, and therefore has had limited clinical adoption. Recently, Endocrine Society’s Expert Panel acknowledged the experimental problems in fT measurements and concluded that "...the calculation of free testosterone is the most useful estimate of free testosterone in plasma..." For this reason they advocate for indirect "calculator" based methods, where free testosterone can be computed from the total testosterone, SHBG, and albumin concentrations.

However, we have demonstrated that even the calculated fT values derived from the prevailing equations, based on linear law-of-mass action models or empiric equations, differ systematically from free testosterone measured by equilibrium dialysis by as much as 40%.

 

[illinoisguy]

Thanks Systemlord! So it sounds like I don't need any further tests at this time? Any thoughts on my Estradiol levels? This is the one I am most concerned about.

Test results from 10-23-19:

Test results from 10-29-15:

 

[DragonBits]

I just received all my tests results:

LH - 4.4 mIU/mL - Range 1.2 - 10.6 mIU/mL
FSH - 3.3 mIU/mL - Range 0.7 - 10.8 mIU/mL
Testosterone, Adult Male -983 ng/dL - Range 300 - 890 ng/dL. Thanks in advance!

This is very odd, are you on TRT? Are you taking testosterone in some form?

Lh/FSH are typically close to zero on TRT.

 

[illinoisguy]

No. I have never taken any TRT/testosterone in my life.

 

[Systemlord]

The thing that bothers me is the LH at 4.4, it's ok but not spectacular, TT is excellent and FT percentage is below normal. I see a lot of men on these forums with high TT, low FT and high SHBG.

You haven't mentioned any low testosterone symptoms though.

 

[illinoisguy]

So what would you suggest I do? This is all new to me so I'm not sure how to proceed.

 

[fifty]

What are you looking for? Are you feeling bad currently?

 

[Vince Carter]

So what would you suggest I do? This is all new to me so I'm not sure how to proceed.

The real problem is that with these numbers no one is going to treat you, treatment is based on Total Test and that cufoff is usually is I think 250 now and you're way over that. Beyond some reflux which has been addressed and needing to rethink Thyroid testing...there's no viable need for TRT.
The Estradiol is not a problem per se but note that the two tests are both different tests, see the difference in the lab range each time...different tests. Not withstanding that either one is the wrong test anyway.

 

[illinoisguy]

Thanks guys. Ideally I am just looking to improve my overall health. Health issues include acid reflux (have been taking Omeprazole when it flares up but just started taking Zenwise Health Digestive Enzymes Plus Prebiotics & Probiotics), minor fatigue, minor head fog, and anxiety. The fatigue and head fog could just be part of getting older.