latest lab results - what to do?

[wham]

Hi,
I suffer from debilitating insomnia, fatigue, and cognitive impairment. I just got my labs. Does anyone have any insights? The lab ranges follow each value in brackets.


TSH 0.944 [0.550-4.780 ulU/mL]
Free T4 1.38 [0.89-1.76 ng/dL]
Free T3 3.2 [2.3-4.2 pg/mL]

Total T 287.0 [129.0-767.0 ng/dL]
Free T 48.44 [30.0-150.00 pg/mL] (1.69% of Total T)
SHBG 42 [10-57 nmol/L]

FSH 9.0 [1.4-18.1 mlU/ml]
LH 4.7 [1.5-9.3 mlU/mL]

PSA total 2.23 [<4.10 ng/mL]

DHEA-S 234 [80-560 ug/dL]

Estradiol 21.06 [<39.90 pg/mL]

Progesterone 0.58 [0.28 - 1.22 ng/mL]



Thank you!

 

[PAUL-E]

I'm not a doctor but to me it looks like you have low testosterone and id look into adrenal function and maybe cortisol. are you in the US? how old are you?

 

[Weasel]

Hi,
I suffer from debilitating insomnia, fatigue, and cognitive impairment. I just got my labs. Does anyone have any insights? The lab ranges follow each value in brackets.


TSH 0.944 [0.550-4.780 ulU/mL]
Free T4 1.38 [0.89-1.76 ng/dL]
Free T3 3.2 [2.3-4.2 pg/mL]

Total T 287.0 [129.0-767.0 ng/dL]
Free T 48.44 [30.0-150.00 pg/mL] (1.69% of Total T)
SHBG 42 [10-57 nmol/L]

FSH 9.0 [1.4-18.1 mlU/ml]
LH 4.7 [1.5-9.3 mlU/mL]

PSA total 2.23 [<4.10 ng/mL]

DHEA-S 234 [80-560 ug/dL]

Estradiol 21.06 [<39.90 pg/mL]

Progesterone 0.58 [0.28 - 1.22 ng/mL]



Thank you!

SHBG is higher than ideal. Which can make your TT lower. Those 2 stand out to me.

 

[wham]

I am 41 and in the US.

Any hints on how to lower SHBG?

 

[PAUL-E]

I am 41 and in the US.

Any hints on how to lower SHBG?

1st have you done a sleep study for sleep apnea since you have insomnia because that can reek havoc on your hormones as well.

Well anabolics lower SHBG so starting trt should lower it but you seem like secondary hypogonadism to me so I would explore a clomid restart before that.

 

[CoastWatcher]

I seem to remember you are on a TRT protocol; are you using topicals? Ot were you on a protocol?

 

[wham]

Paul-E, I had a sleep study done and do not have apnea.

You said it seems like I have secondary hypgonadism, but aren't my LH and FSH right in the middle of the ranges and not low, thereby indicating primary hypogonadism? Would Clomid still be appropriate for me?

 

[wham]

CoastWatcher, I previously took cream containing 50 mg/day of T for about a month. I stopped using it when I found out that if I kept using it I would need to take it for the rest of my life, that there were risks to my fertility, and that I would also need to inject HCG. I wanted to do some research before making that commitment.

While I was taking T my mood was improved and I was more functional (although I was still nowhere near normal). I was also trying other treatments at the time that made it hard to know exactly what was helping, but I strongly suspect the T.

The labs were done about a month after stopping T.

 

[PAUL-E]

I had a sleep study done and do not have apnea.

You said it seems like I have secondary hypgonadism, but aren't my LH and FSH right in the middle of the ranges and not low, thereby indicating primary hypogonadism?
Would Clomid still be appropriate for me?

to me primary hypogonadism is were LH/FSH are at the top if not a little over screaming at your testicles to produce and there not. your LH/FSH is middle range and your testosterone looks low so to me its like your brain isn't yelling loud enough. I think clomid would be worth asking an experienced HRT/TRT doctor about.

 

[PAUL-E]

CoastWatcher, I previously took cream containing 50 mg/day of T for about a month. I stopped using it when I found out that if I kept using it I would need to take it for the rest of my life, that there were risks to my fertility, and that I would also need to inject HCG. I wanted to do some research before making that commitment.

While I was taking T my mood was improved and I was more functional (although I was still nowhere near normal). I was also trying other treatments at the time that made it hard to know exactly what was helping, but I strongly suspect the T.

The labs were done about a month after stopping T.

Can you post your original pre TRT labs?

 

[CoastWatcher]

It isn't surprising that your symptoms were only partially resolved while you used topical testosterone. For many men, I was one of them, topicals simply don't absorb. Sad, but true. Yes, you are right, TRT is typically for life, and - when run properly - can be an enormous life enhancer. That said, if Clomid and a restart are a possibility, by all means look into it. I echo what Paul-E wrote: an experienced doctor specializing in androgen therapy is critical.

 

[wham]

I don't have pre-TRT labs (it is hard for me to do things right with my fatigue).

 

[PAUL-E]

I don't have pre-TRT labs (it is hard for me to do things right with my fatigue).

were they not run?
I would look into a clomid restart with an experienced HRT/TRT doctor but if that is not an option or doesn't workout for you consider TRT I know the life long commitment sucks but your better off with it than without, injections seem to be the most effective and cost effective option and if you use the right syringes and protocol its not so bad I would encourage you to think about HCG also check this out as an example

 

[trt4me]

Question could also be what came first, bad sleep or low hormones?
Maybe try resolving sleep first to see if other areas improve. There are a lot of natural Remedys that can help like;
"Sleepy time" tea.
Chamomile tea.
Valerian root
Melatonin.
Magnesium

Also something like aniexty can interrupt sleep because your nervous system is in overdrive.

 

[PAUL-E]

Question could also be what came first, bad sleep or low hormones?
Maybe try resolving sleep first to see if other areas improve. There are a lot of natural Remedys that can help like;
"Sleepy time" tea.
Chamomile tea.
Valerian root
Melatonin.
Magnesium

Also something like aniexty can interrupt sleep because your nervous system is in overdrive.

I agree with this also try limiting your exposer to artificial light at least an hour before bed and EMF's in your room(tv, computer, etc..)

 

[wham]

The initial labs that I had done before starting T were saliva labs. Testosterone and Free T3 were low normal, prompting a trial of testosterone and thyroid hormone.

Those would be considered my “pre” labs, but since they were saliva and not blood they are apples to oranges with respect to my latest labs.

I switched to blood testing after I found out that most of the research has been done with blood.

 

[wham]

I forgot to post one of my latest blood results:

pregnenolone 10 [13-208 ng/dL]

 

[wham]

In the past years I have tried everything imaginable for sleep. I don't know if my hormones were low before my sleep problems started because they had never been tested.

 

[wham]

The Clomid option sounds attractive, but I found this post where Nelson wrote:

I have never met anyone who feels great on Clomid (clomiphene) monotherapy.
https://www.excelmale.com/forum/sho...omid-not-working&p=42380&viewfull=1#post42380

Are you guys therefore recommending something different than monotherapy?

 

[trt4me]

I would fix the sleep as it can and usually does affect your hormones just like stress does. I've been down that road.
Do you have trouble falling asleep?
Staying asleep?
Vivid dreams ?
Repetitive dreams?