29 YO...help with labs

[Stewie]

Two things jump out from your lab results: your Testosterone level is way too low for someone your age and 2) your LDL is also too high (needs to be under 100).

Don't be surprised if your endo does not want to do anything. They typically look at ranges – without consideration of the persons age – so even though you may have a current testosterone level of an 80-year-old man, that's fine with them. You may want to consider seeing a doctor that specializes in male health.

Regarding LDL - see a cardiologist. All heart disease is LDL - driven and you are setting yourself up for plaque when you are in your 50's. Diet is only 10-20% of Cholesterol so don't believe the bullshit that you can eat right to getting in check. Most docs look at ratios of LDL and HDL which is 30 year old outdated way to do this. Most progressive Cardiologists will put you on a low dose statin to fix that issue before it manifests itself later in life.

Before you do anything – you should have other tests done – perhaps even two more – because values, especially testosterone, can fluctuate extremely. I raised my own testosterone level about 200 points by just supplementing with D3 since it turned out I had a deficiency.

The bottom line is – most healthcare professionals are extremely ill equipped, and inexperienced to deal with the multitude of factors dealing with optimal health – so best to do your research – and get several opinions


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The cholesterol hypothesis, is just that, an hypothesis.

 

[Bigunitny]

The TSH needs to be addressed. Your TSH is hitting the upper limit , a solid endocrinologist would address or at least monitor a TSH of 3.42 with the symptoms you are describing. This has a lot to do with genetics and diet in my opinion. I DO NOT THINK YOUR STEROID USE HAS ANYTHING TO DO WITH THIS.

 

[grizz007]

alright....heres my #'s from my second set of labs

Total T -589
Free T- 87.2
LH- 1.5
Prolaction- 4.8
T4, free- .9
T3, free- 2.9
TSH- 2.9

Vitamin D- 27

I think these are all the important #'s

After seeing these results, I dont know what to think. How'd my test go up 200ng's? and why do I still feel like shit?

 

[grizz007]

Forgot estrogen 36pg/ml

 

[JimGainz]

alright....heres my #'s from my second set of labs



Total T -589

Free T- 87.2

LH- 1.5

Prolaction- 4.8

T4, free- .9

T3, free- 2.9

TSH- 2.9



Vitamin D- 27



I think these are all the important #'s



After seeing these results, I dont know what to think. How'd my test go up 200ng's? and why do I still feel like shit?

Labs look good. Test levels change dramatically- which is why docs want to check multiple times before prescribing gel. Cortisol can explain low T and why you are tired. Check out the book Men's Hormones Made Easy - it's by a wellness doc and explains the interrelation of hormones on men's health and what to do about them


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[JimGainz]

The office finally called me back with results. The only thing that they told me is that I was low on vitamin D3 and that I should take a supplement 2x day. They said the doc will go over my results with me at my next apt (which is 8 weeks away).



Not thrilled to hear this, debating on going to a clinic.



Any thoughts or opinions on what to do next?

Yes. You will notice a HuGE difference when you get D in check. It is actually a hormone that regulates numerous body functions - Testosterone being one.


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[JimGainz]

The cholesterol hypothesis, is just that, an hypothesis.

True but the current evidence is that high LDL (over 100) is the single largest risk factor in heart disease.


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[Stewie]

True but the current evidence is that high LDL (over 100) is the single largest risk factor in heart disease.


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Citation, if you don't mind.

 

[RamboStallone]

Address the low vit d. Supplement with vit c as well. I like vit c for it's immune system support and to lower cortisol. Also, a slight diuretic and pain reliever.

 

[grizz007]

Yes. You will notice a HuGE difference when you get D in check. It is actually a hormone that regulates numerous body functions - Testosterone being one.


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How is vitamin D a hormone?

 

[grizz007]

Anyone have any input on t4/t3 from my labs?

Also, isn't LH low? And wouldn't this mean that the signal to produce test is low?

 

[JimGainz]

How is vitamin D a hormone?

From the society of endocrinology:

**broken link removed**

"Vitamin D is actually a hormone rather than a vitamin"



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[JimGainz]

Citation, if you don't mind.

I was just passing on what my cardiologist buddy told me based on all his research. It actually gets more complicated than that - involving specific particle sizes of LDL and HDL and there is another test to determine how "Sticky" the LDL particles are. If you check out Berkley Heart Lab or Boston Heart Lab it will give you an idea about some of the genetic markers and current research. I'll see if I can find the article I read which attributed every point of LDL above 100 with a 6% increase in heart disease. At any rate - several cardiologists told me that LDL <70 is needed for people with heart disease because that's the level plaque will not form or can be reversed.


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[Stewie]

I was just passing on what my cardiologist buddy told me based on all his research. It actually gets more complicated than that - involving specific particle sizes of LDL and HDL and there is another test to determine how "Sticky" the LDL particles are. If you check out Berkley Heart Lab or Boston Heart Lab it will give you an idea about some of the genetic markers and current research. I'll see if I can find the article I read which attributed every point of LDL above 100 with a 6% increase in heart disease. At any rate - several cardiologists told me that LDL <70 is needed for people with heart disease because that's the level plaque will not form or can be reversed.


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This could be a topic in-and-of-itself. Although and importantly, I don't want to hijack or derail this gentleman's thread. For the last several years I've intentionally kept my LDL-C at or slightly >120mg/dL. I've had two CT calcium scans done over the last 5 years, both scan scores showed zero coronary calcium. At 51 years old, I'd say that's reasons enough not to fall prey to the cholesterol hypothesis

I've also had several NMR and VAP tests done looking at several different lipoprotein subfractions. I know many others here can attest to the same with their LDL >100mg/dL.

Nonetheless, addressing raising/lowering strategies on the different lipoprotein subfractions is of value. Though it's not the leading cause of CVD.

With that, some of the suggestions outlined prior is relevant to be discussed that may hinder a beneficial outcome for the individual (OP).

I personally don't favor the use of Statins. Unless, one's predisposed to familial hypercholesterolemia. Nonetheless, by the standards set forth by the American College of Cardiology (ACC)/American Heart Association (AHA), this individual doesn't fit into the criteria for Statin therapy.

Amongst other criterias' for the lowering of LDL-C, one would be as : Adults ≥ 21 years of age with a primary LDL-C ≥ 190 mg/dL should be treated with high-intensity statin therapy unless contraindicated. This is also subject of the treating clinician if the patient falls within other criterias'.

Nonetheless, I'd like to point out a few things that would hinder boosting this individual 25-hydroxyvitamin D levels by suggesting a Statin. Statins induce activation of the pregnane X receptor, in which by doing so, can disrupt his vitamin D metabolism/function. As well, Statins induce mitochondria dysfunction. It's known that Statins interfere with the production of mevalonic acid, in which is a precursor to the synthesis of CoQ10, which this can lead to insufficient CoQ10 levels. Aside from depletion of CoQ10, two vital enzymes are responsible for activation or inactivation of 25-hydroxyvitamin D. These two enzymes are CYP27B1 (1a-hydroxylase) and CYP24A1 (24-hydroxylase). Both enzymes are located within the mitochondria, this could potentially lead to vitamin D insufficiency on the metabolism and function of from Statin therapy. This would be a one-two punch on this individuals attempts to regain his vitamin D status.

Not to mention Statins can pose the detriments of neurological and myopathic syndromes, as well, a compromised immune system from taking ones LDL-C too low from Statin therapy. Also, Sex hormones are synthesized via cholesterol. So why would we want to drive it low? Take away sufficient amounts of the raw material (cholesterol) would equate to insufficient hormones synthesis.

CVD is more-so related to endothelial dysfunction/chronic inflammation/hyperglycemia/hyperinsulinism than that independently of lipoproteins. Given that, oxidation of both LDL and HDL is a contributor to arteriosclerosis. Dysfunctional HDL via elevated copper levels induced by supraphysiological estradiol levels and the use of progestin based hormones can lead to arteriosclerotic plaques. Many here use several aromatizing compounds, without controlling their E2 levels. Bad, bad idea.

As a final note, LDL acts on repairing damaged (inflammation, scaring) of the endothelial that leads to plaques. Not the over-abundance of or greater than 100mg/dL of LDL-C.

Back to the OP. Are you still taking Lexapro? Have you had your prolactin levels checked. SSRI's are not Sex hormones best friend, at all.

On a side note, there's an interrelationship of upping your magnesium intake, should help raise your Vitamin D levels. Try to get some natural sunlight

 

[grizz007]

Stewie, thank you for your response.

Prolactin was 4.8ng (2-18)

I am currently on 5mg lexapro (prescribed 10mg) but I hate taking it. I want to stop taking it, but still feel anxiety/ panic when I stop it completely. What is bizarre to me is I'm my 28 years of life I've never had any anxiety or panic attacks, why all of a sudden is this an issue?

Also, with my LH being 1.5 MIU (1.5-9.3) couldn't this be a cause of low T?

 

[JimGainz]

This could be a topic in-and-of-itself. Although and importantly, I don't want to hijack or derail this gentleman's thread. For the last several years I've intentionally kept my LDL-C at or slightly >120mg/dL. I've had two CT calcium scans done over the last 5 years, both scan scores showed zero coronary calcium. At 51 years old, I'd say that's reasons enough not to fall prey to the cholesterol hypothesis



I've also had several NMR and VAP tests done looking at several different lipoprotein subfractions. I know many others here can attest to the same with their LDL >100mg/dL.



Nonetheless, addressing raising/lowering strategies on the different lipoprotein subfractions is of value. Though it's not the leading cause of CVD.



With that, some of the suggestions outlined prior is relevant to be discussed that may hinder a beneficial outcome for the individual (OP).



I personally don't favor the use of Statins. Unless, one's predisposed to familial hypercholesterolemia. Nonetheless, by the standards set forth by the American College of Cardiology (ACC)/American Heart Association (AHA), this individual doesn't fit into the criteria for Statin therapy.



Amongst other criterias' for the lowering of LDL-C, one would be as : Adults ≥ 21 years of age with a primary LDL-C ≥ 190 mg/dL should be treated with high-intensity statin therapy unless contraindicated. This is also subject of the treating clinician if the patient falls within other criterias'.



Nonetheless, I'd like to point out a few things that would hinder boosting this individual 25-hydroxyvitamin D levels by suggesting a Statin. Statins induce activation of the pregnane X receptor, in which by doing so, can disrupt his vitamin D metabolism/function. As well, Statins induce mitochondria dysfunction. It's known that Statins interfere with the production of mevalonic acid, in which is a precursor to the synthesis of CoQ10, which this can lead to insufficient CoQ10 levels. Aside from depletion of CoQ10, two vital enzymes are responsible for activation or inactivation of 25-hydroxyvitamin D. These two enzymes are CYP27B1 (1a-hydroxylase) and CYP24A1 (24-hydroxylase). Both enzymes are located within the mitochondria, this could potentially lead to vitamin D insufficiency on the metabolism and function of from Statin therapy. This would be a one-two punch on this individuals attempts to regain his vitamin D status.



Not to mention Statins can pose the detriments of neurological and myopathic syndromes, as well, a compromised immune system from taking ones LDL-C too low from Statin therapy. Also, Sex hormones are synthesized via cholesterol. So why would we want to drive it low? Take away sufficient amounts of the raw material (cholesterol) would equate to insufficient hormones synthesis.



CVD is more-so related to endothelial dysfunction/chronic inflammation/hyperglycemia/hyperinsulinism than that independently of lipoproteins. Given that, oxidation of both LDL and HDL is a contributor to arteriosclerosis. Dysfunctional HDL via elevated copper levels induced by supraphysiological estradiol levels and the use of progestin based hormones can lead to arteriosclerotic plaques. Many here use several aromatizing compounds, without controlling their E2 levels. Bad, bad idea.



As a final note, LDL acts on repairing damaged (inflammation, scaring) of the endothelial that leads to plaques. Not the over-abundance of or greater than 100mg/dL of LDL-C.



Back to the OP. Are you still taking Lexapro? Have you had your prolactin levels checked. SSRI's are not Sex hormones best friend, at all.



On a side note, there's an interrelationship of upping your magnesium intake, should help raise your Vitamin D levels. Try to get some natural sunlight

Very good info and +1 on the calcium CT scan. I had one done a few years ago and was literally holding my breath hoping everything turned out OK because of all the gear I ran back in the 80s. Everything came back A-OK – calcium score of zero.

Another topic – and I don't want to hijack the OP's thread – but I might actually come off the Statin since my total cholesterol was under 125 from a recent cycle – and continually taking the Statin may prevent boosting the total cholesterol which as you noted is needed for T levels.

For the OP - get that D level up and you will notice some very positive changes in mood and energy levels. I would go 5,000 IU for a few weeks and then back it off to 2,000 / day for life.

 

[JimGainz]

Stewie, thank you for your response.



Prolactin was 4.8ng (2-18)



I am currently on 5mg lexapro (prescribed 10mg) but I hate taking it. I want to stop taking it, but still feel anxiety/ panic when I stop it completely. What is bizarre to me is I'm my 28 years of life I've never had any anxiety or panic attacks, why all of a sudden is this an issue?



Also, with my LH being 1.5 MIU (1.5-9.3) couldn't this be a cause of low T?

Your total T is ok (although low,for someone your age). I would try Clomid to help raise it - maybe 50/25/25/25.

I know what you mean about anxiety – it's horrible. I struggled with this a couple of years ago – it just sort of came on in a wave and then left by itself – I think it was mostly job induced with not enough working out. I would bag the Lexapro and try to get on some low dose Xanax (just take as needed). I had a bout of depression when I was in college – and they put me on Prozac and some other shit and I swear to god it was like the worst thing ever. These drugs suppress e nervous system make you tired and lethargic and generally feel like crap. When I went through my bout of anxiety a few years ago – just taking .25-.5 mg of Xanax – knocked out the anxiety like a Mac truck within about 15 minutes. This is a much better route to take – because it allows you to control the dose and only take it when you feel panicky.

 

[grizz007]

Been awhile since this thread started, wanted to try and provide some feedback on my current situation.

My labs have been all over the place in regards to test. Ive had results of 390-460-360-588.

My endo addressed the high TSH levels. He put me on 100mcg of levothyroxine. Ive been on this for about 4 months now. The first 2 weeks of being on this medication I felt great, energy was up, mood felt better, elevated body temp, etc. After 2 weeks, I felt the same way I did before taking the thyroid med.

On my last visit I had my TSH tested and it was close to being HYPER-instead of HYPO. So obviously the medication is doing its job, but I still feel like shit....

The last appointment I had the endo was going to prescribe a sleep study to evaluate my sleep patterns, etc....

It seems like TEST will be his last resort of treatment.

Overall, Im just frustrated that I still don't feel well (ill be 30 in 2 weeks). Ive debated about trying TRT on my own, but the wife and I are trying to conceive right now. I am scheduled to get full labs done in about 12 weeks. Ive also contemplated using an oral to suppress my T levels. Anyone have any advice on this? The only thing I have is oral winny, what dosage and duration would be recommended for suppression?

 

[typhoon]

Posting to follow your thread.

Do you think the anxiety is related to low t levels? I just came off of a 14 week cycle about a month ago and my anxiety has been horrendous, on cycle I was perfectly okay. Haven't had this bad anxiety since my early 20's (i'm your age btw).

 

[grizz007]

Posting to follow your thread.

Do you think the anxiety is related to low t levels? I just came off of a 14 week cycle about a month ago and my anxiety has been horrendous, on cycle I was perfectly okay. Haven't had this bad anxiety since my early 20's (i'm your age btw).

I do, the less medication I take the better I feel and less symptoms I have.