Big D Test Quest

[bigdtv3]

After joining 'ology a couple months ago, I've researched, read, studied, etc. and finally have some blood test results to ponder upon.

Lipid Panel
Cholesterol, Total, 222 mg/dL (100-199)
Triglycerides, 87 mg/dL (0-149)
HDL Cholesterol, 79 mg/dL (>39)
VLDL Cholesterol, 17 mg/dL (5-40)
LDL Cholesterol, 126 mg/dL (0-99)

Thyroid Panel With TSH
TSH, 4.440 uIU/mL (0.450-4.500)
Thyroxine (T4), 8.7 ug/dL (4.5-12.0)
T3 Uptake, 33% (24-39)
Free Thyroxine Index, 2.9 (1.2-4.9)

Testosterone, Free/Tot Equilib
Testosterone, Serum, 357 ng/dL (249-836)
Testosterone, Free, 8.21 ng/dL (5.00-21.00)
% Free Testosterone, 2.30% (1.50-4.20)

PSA, 1.0 ng/mL (0.0-4.0)

IGF-1, 214 ng/mL (101-267)

Estradiol, Sensitive, 9 pg/mL (3-70)

LH, 1.3 mIU/mL (1.7-8.6)
FSH, 4.3 mIU/mL (1.5-12.4)

• Since LH is low and test is low, that points to secondary hypogonadism.
• TT and FT are in the crapper, as I suspected.
• Cholesterol is worse than it was three years ago, though I'm happy that the HDL is as high as it is.
• Estradiol is only at 9?? That could explain my lack of libido, joint pain, lower drive and focus at work, and stagnant gains in the gym.

I'm not sure how to interpret the Thryoid tests. Some folks totally discount TSH as an unreliable, meaningless number, while others swear by it. The other thyroid parameters look to be midrange, so I'm thinking thyroid function is OK.

I did not test cortisol, prolactin, free T4, and vitamin D, as I can only afford so many tests at a time (insurance covers NONE of these tests).

The course of action I intend to follow is calling up Chip in a few months when I can afford the Hormone Replacement Therapy (HRT) regimen. It appears to me that I may not need an Aromatase inhibitor (AI) at first since E2 is already low. Any thoughts on this or the rest of my boring post?

 

[JOWS6]

Dude! How the hell are ya! Damn, you're in great shape! I envisioned a suit-and-tie with beer-belly dude! You said you did not test free T4 but you did. It's Free Thyroxine. What's more important is that you test for Free T3 (Triidothyronine). T3 is the more important thyroid hormone. T4 is jus' a precursor hormone.

I'm not sure where you are hearing that TSH is a "unreliable meaningless number". It's unreliable under heavy stress like being in a car accident as the thyroid and your endocrine system is in a state of shock. It's meaningless to test it during periods of sicknesses I've heard. Your TSH value is pretty high. You're only 0.011 away from outside of "normal". The new revised AACE guidelines for the treatment of Hyperthyroidism and Hypothyroidism has reduced it's range to 0.3-3.0 for a optimal euthyroid hormone range. It states that the previous range is no longer valid because it was tainted with TSH values from those with undiagnosed hypothyroidism or hyperthyroidism and it also states that in the future, they are considering reducing the range even narrower to 0.3-2.0.

Here's where it gets interesting. Before when I was trying to find the culprit of my low testosterone scores I was heavily researched thyroid studies. It appears that correcting underactive thyroids indirectly corrects and normalizes testosterone levels. On the flip side, I've read studies where individual's TSH values decreased (healthier thyroid function) from TRT.

Here's one. Do a Google Search for the entire article:

Testicular dysfunction in men with primary hypothyroidism; reversal of hypogonadotrophic hypogonadism with replacement thyroxine

OBJECTIVE Primary hypothyroidism can cause disturbances in normal gonadal function. The aim of this study was to investigate the relationship in men between hypogonadism and primary hypothyroidism and the extent to which free and total testosterone levels rose after introduction of replacement thyroxine.

DISCUSSION We conclude that primary hypothyroidism can induce a state of hypogonadotrophic hypogonadism in men that is reversible with thyroxine replacement therapy. A derangement of gonadotrophin secretion must be present and could be due to either a direct effect of hypothyroidism on the hypothalamus or pituitary, or mediated by perturbations of prolactin levels. Importantly, some of the clinical manifestations of primary hypothyroidism in men may be due in part to a reduction in free testosterone. Further evaluation of this potential clinical interaction would require a controlled trial of androgen replacement in the hypothyroid state. However, the data support the resolution of hypogonadotrophic hypogonadism with thyroxine replacement and restoration of normal thyroid function.