Initial blood work. Suggestions & advice appreciated.

[Cap'n]

I'm 41 and just had my annual blood work done through the VA, I'm a disabled vet. I asked my doc to have my testosterone checked along with everything else and it came in at 524 (241 - 827), total test was 553 a year ago, and they used Quest for the Free T and it clocked in at 76.2 with a reference range of 46 - 224.

Getting my VA doc to test for all of the recommended levels is basically impossible so I'll have to go somewhere out of pocket for those. When I look at test levels by age I'd be in the same neighborhood as that of a 65 year old by several age related charts.

Not sure if it matters but I have had a TBI (Traumatic Brain Injury) after service where I was assaulted with a bat in 2008. MRI showed my brain bleeding and I was really out of whack for about a year. I was using prednisone about 1 month before my blood tests for some cracked ribs from BJJ.

I do have mild/moderate sleep apnea that has been treated for the past 2 years and no history of steroids.

As far as symptoms go, I believe these are the ones that affect me:

Bad mood swings, especially anger
Depression and feeling blah, nothing crazy
Reduced libido
No spontaneous erections or in the morning
Can't concentrate/focus
Memory sucks
Slight gyno
Night sweats
Can't fall asleep/can't stay asleep/wake up early

 

[Cap'n]

41 years old @ 6' 3" and 205 lbs. Try to eat healthy most of the time and train BJJ about 3X a week.

Test Name: ALANINE AMINOTRANSFERASE
Result: 35
Units: IU/L
Reference Range: (15-63)
Interpretation: Effective 09/25/2012: Reference range is 15-63 IU/L (males)
and 14-54 IU/L (females).
Previous reference range was 5-40 IU/L.
----------------------
Test Name: ALBUMIN
Result: 4.0
Units: G/DL
Reference Range: (3.3-4.8)
Interpretation: Effective 09/27/2012: Reference range is 3.3-4.8 g/dL.
Previous reference range was 3.1-4.5 g/dL.
----------------------
Test Name: ALBUMIN/GLOBULIN
Result: 1.4
Units: RATIO
Reference Range: (1.1-2.2)
Interpretation: --
----------------------
Test Name: ALKALINE PHOSPHATASE
Result: 68
Units: IU/L
Reference Range: (32-91)
Interpretation: Effective 09/27/2012: Referrence range is 32-91 IU/L
Previous reference range was 39-117 IU/L.
----------------------
Test Name: ANION GAP
Result: 11
Units: mmol/L
Reference Range: (10-20)
Interpretation: --
----------------------
Test Name: ASPARTATE AMINOTRANSFERASE
Result: 30
Units: IU/L
Reference Range: (15-41)
Interpretation: Effective 09/27/2012: Reference range is 15-41 IU/L.
Previous reference range was 5-37 IU/L.
----------------------
Test Name: BILIRUBIN
Result: 0.8
Units: mg/dL
Reference Range: (0.3-1.2)
Interpretation: Effective 09/27/2012: Reference range is 0.3-1.2 mg/dL.
Previous reference range was 0.1-1.5 mg/dL.
----------------------
Test Name: CALCIUM
Result: 9.7
Units: MG/DL
Reference Range: (8.9-10.3)
Interpretation: Effective 09/27/2012: Reference range is 8.9-10.3 mg/dL.
Previous reference range is 8.4-10.2 mg/dL.
----------------------
Test Name: CARBON DIOXIDE
Result: 31
Units: MMOL/L
Reference Range: (22-32)
Interpretation: --
----------------------
Test Name: CHLORIDE
Result: 105
Units: mmol/L
Reference Range: (101-111)
Interpretation: Effective 09/27/2012: Reference range is 101-111 mmol/L.
Previous reference range was 96-108 mmol/L.
----------------------
Test Name: CREATININE
Result: 1.02
Units: MG/DL
Reference Range: (.64-1.27)
Interpretation: Effective 09/27/2012: Reference range is 0.64-1.27 mg/dL
(males)
and 0.44-1.03 mg/dl (females).
Previous reference range was 0.40-1.20 mg/dL.
----------------------
Test Name: GLOMERULAR FILTRATION RATE.PREDICTED
Result: 85.5
Units: ML/MIN/R
Reference Range: (60SEE INTERP)
Interpretation: All individuals with GFR <60 ML/MIN/R(1.73m2)R for 3 months are
classified as having chronic kidney disease, irrespective of the
presence or absence of kidney damage.
All individuals with kidney damage are classified as having
chronic kidney disese, irrespective of the level of GFR.
EGFR results >60 ML/MIN/R(1.73m2) are imprecise. Many variables
affect the calculated result. Interpretation of eGFR results >60
ML/MIN/R(1.73m2) must be monitored over time.
EGFR is calculated from patient creatinine value, age, gender
and race. If the patients race is "Undeclared" or "Unanswered",
the COMMENT field comment will populate with "MISSING PARAMETER" text.
The EGFR check will calculate the formula without the race variable.
The doctor will need to evaluate this when viewing the reports in CPRS.
----------------------
Test Name: GLUCOSE
Result: 98
Units: MG/DL
Reference Range: (74-118)
Interpretation: Effective 09/27/2012: Reference range is 74-118 mg/dL.
Previous reference range was 70-105 mg/dL.
----------------------
Test Name: POTASSIUM
Result: 4.6
Units: mmol/L
Reference Range: (3.6-5.1)
Interpretation: Effective 09/27/2012: Reference range is 3.6-5.1 mmol/L.
Previous reference range was 3.6-5.2 mmol/L.
----------------------
Test Name: PROTEIN
Result: 6.8
Units: g/dL
Reference Range: (6.1-7.9)
Interpretation: Effective 09/27/2012: Reference range is 6.1-7.9 g/dL.
Previous reference range was 5.9-8.4 g/dL.
----------------------
Test Name: SODIUM
Result: 142
Units: MMOL/L
Reference Range: (136-144)
Interpretation: Effective 09/27/2012: Reference range is 136-144 mmol/L.
Previous reference range was 133-145 mmol/L.
----------------------
Test Name: UREA NITROGEN
Result: 19
Units: MG/DL
Reference Range: (8-20)
Interpretation: Effective 09/27/2012: Reference range is 8-20 mg/dL.
Previous reference range was 6-19 mg/dL.
----------------------
Test Name: UREA NITROGEN/CREATININE
Result: 18.6
Units: RATIO
Reference Range: (12-20)
Interpretation: --
=========================================================================


Lab Test: Lipid Panel
Lab Type: Chemistry/Hematology
Ordering Provider: XXX
Ordering Location: SOUTHERN NEVADA HCS
Specimen: Plasma (substance)
Date/Time Collected: 10 Feb 2015 @ 0810
Collected Location: SOUTHERN NEVADA HCS
-------------------------------------------------------------------------
Test Name: CHOLESTEROL
Result: 148
Units: mg/dL
Reference Range: (5-200)
Interpretation: Desirable: <200
Borderline High: 200-240
High Risk: >240
----------------------
Test Name: CHOLESTEROL.IN HDL
Result: 57
Units: MG/DL
Reference Range: (SEE INTERP)
Interpretation: No Risk Mod Risk High Risk
Men >55 35-55 <35
Women >65 45-65 <45
National Cholersterol Education Program (NCEP) guidelines:
<40 mg/dL: Low HDL-cholesterol (major risk factor for CHD)
>59 mg/dL: High HDL-cholesterol ("negative" risk factor for CHD)
----------------------
Test Name: CHOLESTEROL.IN LDL
Result: 71
Units: mg/dl
Reference Range: (0-129)
Interpretation: Desirable LDL: <130
Borderline LDL: 130-160
High Risk LDL: >160
----------------------
Test Name: CHOLESTEROL.IN VLDL
Result: 20
Units: mg/dL
Reference Range:
Interpretation: --
----------------------
Test Name: TRIGLYCERIDE
Result: 101
Units: MG/DL
Reference Range: (10-200)
Interpretation: --
=========================================================================


Lab Test: Hemogram V
Lab Type: Chemistry/Hematology
Ordering Provider: XXX
Ordering Location: SOUTHERN NEVADA HCS
Specimen: Blood (substance)
Date/Time Collected: 10 Feb 2015 @ 0810
Collected Location: SOUTHERN NEVADA HCS
-------------------------------------------------------------------------
Test Name: BASOPHILS
Result: 0.0
Units: K/mcL
Reference Range: (0.0-0.2)
Interpretation: If CBC indicates need for manual diff, contact lab within 24
hours.
----------------------
Test Name: BASOPHILS/100 LEUKOCYTES
Result: 0.1
Units: %
Reference Range: (0.0-2.3)
Interpretation: --
----------------------
Test Name: EOSINOPHILS
Result: 0.1
Units: K/mcL
Reference Range: (0.0-0.5)
Interpretation: --
----------------------
Test Name: EOSINOPHILS/100 LEUKOCYTES
Result: 1.7
Units: %
Reference Range: (0.0-6.2)
Interpretation: --
----------------------
Test Name: ERYTHROCYTE DISTRIBUTION WIDTH
Result: 13.2
Units: %
Reference Range: (13.0-15.0)
Interpretation: --
----------------------
Test Name: ERYTHROCYTE DISTRIBUTION WIDTH
Result: 43.3
Units: fL
Reference Range: (35.1-43.9)
Interpretation: --
----------------------
Test Name: ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN
Result: 29.0
Units: pg
Reference Range: (27-34)
Interpretation: --
----------------------
Test Name: ERYTHROCYTE MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION
Result: 32.1
Units: g/dL
Reference Range: (32-36)
Interpretation: --
----------------------
Test Name: ERYTHROCYTES
Result: 5.35
Units: M/mcL
Reference Range: (4.7-6.1)
Interpretation: --
----------------------
Test Name: ERYTHROCYTES.NUCLEATED
Result: 0.00
Units: K/mcL
Reference Range: (0-0.012)
Interpretation: --
----------------------
Test Name: ERYTHROCYTES.NUCLEATED/100 LEUKOCYTES
Result: 0.0
Units: %
Reference Range: (0-0.2)
Interpretation: --
----------------------
Test Name: GRANULOCYTES.IMMATURE
Result: 0.02
Units: K/mcL
Reference Range: (0-0.031)
Interpretation: --
----------------------
Test Name: GRANULOCYTES.IMMATURE/100 LEUKOCYTES
Result: 0.3
Units: %
Reference Range: (0-0.429)
Interpretation: --
----------------------
Test Name: HEMATOCRIT
Result: 48.3
Units: %
Reference Range: (42-52)
Interpretation: --
----------------------
Test Name: HEMOGLOBIN
Result: 15.5
Units: g/dL
Reference Range: (14-18)
Interpretation: --
----------------------
Test Name: LEUKOCYTES
Result: 7.6
Units: K/mcL
Reference Range: (4.8-10.8)
Interpretation: --
----------------------
Test Name: LYMPHOCYTES
Result: 1.9
Units: K/mcL
Reference Range: (1.3-2.9)
Interpretation: --
----------------------
Test Name: LYMPHOCYTES/100 LEUKOCYTES
Result: 24.8
Units: %
Reference Range: (20-40)
Interpretation: --
----------------------
Test Name: MEAN CORPUSCULAR VOLUME
Result: 90.3
Units: fL
Reference Range: (80-100)
Interpretation: --
----------------------
Test Name: MONOCYTES
Result: 0.6
Units: K/mcL
Reference Range: (0.3-0.8)
Interpretation: --
----------------------
Test Name: MONOCYTES/100 LEUKOCYTES
Result: 7.3
Units: %
Reference Range: (0-12.5)
Interpretation: --
----------------------
Test Name: NEUTROPHILS
Result: 5.0
Units: K/mcL
Reference Range: (1.1-6.4)
Interpretation: --
----------------------
Test Name: NEUTROPHILS/100 LEUKOCYTES
Result: 65.8
Units: %
Reference Range: (50-75)
Interpretation: --
----------------------
Test Name: PLATELET MEAN VOLUME
Result: 10.8
Units: fL
Reference Range: (9.4-12.4)
Interpretation: --
----------------------
Test Name: PLATELETS
Result: 193
Units: K/mcL
Reference Range: (150-400)
Interpretation: --
=========================================================================


Lab Test: Testosterone~ADVIA CENTAUR
Lab Type: Chemistry/Hematology
Ordering Provider: XXX
Ordering Location: SOUTHERN NEVADA HCS
Specimen: Serum (substance)
Date/Time Collected: 10 Feb 2015 @ 0810
Collected Location: SOUTHERN NEVADA HCS
-------------------------------------------------------------------------
Test Name: TESTOSTERONE
Result: 524
Units: NG/DL
Reference Range: (241-827)
Interpretation: --
=========================================================================

Free T at 76.2 with a reference range of 46 - 224.

 

[TRTnooby]

Your labs look great. your T levels could definitely be higher but you are not hypogonadal. Try this:
How to Increase Testosterone Naturally | The Art of Manliness

Counseling can do wonders for the anger and depression. Its done wounders for me.

Good luck man!

 

[Cap'n]

I know the total T is ok but not great. I thought the free T was pretty low.

Should I get the other stuff checked like e2, FH, etc? If so, which ones should I get?

 

[Megatron28]

Not sure where you got your info from, but 524ng/dl is pretty close to normal for a man your age. And by the way, was the blood drawn first thing in the morning after a good night's sleep? That makes a big difference.

 

[Cap'n]

Not sure where you got your info from, but 524ng/dl is pretty close to normal for a man your age. And by the way, was the blood drawn first thing in the morning after a good night's sleep? That makes a big difference.

Blood was drawn at 8am after a night's sleep. I was looking at charts similar to this. Image wouldn't work so here's the page: elitemensguide.com/testosterone-levels-by-age/

My thought process is what would bumping these up to "optimal" levels be like?

 

[Megatron28]

Blood was drawn at 8am after a night's sleep. I was looking at charts similar to this. Image wouldn't work so here's the page: elitemensguide.com/testosterone-levels-by-age/

Your table is a little misleading. It isn't providing any sense of standard deviation. I would estimate that you are withing one standard deviation of the mean. You aren't optimal, but far from being hypogonadal. I think it is great that you are monitoring it though.

Have you ever checked your thyroid (TSH)? And have you checked your estradiol?

Have you read the Basic TRT Overview sticky thread?

 

[Cap'n]

Your table is a little misleading. It isn't providing any sense of standard deviation. I would estimate that you are withing one standard deviation of the mean. You aren't optimal, but far from being hypogonadal. I think it is great that you are monitoring it though.

Have you ever checked your thyroid (TSH)? And have you checked your estradiol?

Have you read the Basic TRT Overview sticky thread?

My doc checked TSH last year (1/23/14) and it was 1.770 uIU/mL Ref Range .55 - 4.78

I have a normal body temperature of about 97.6 which I've always thought was kind of odd but doctors dismiss it.

I've just dug into that sticky. I've been reading a few different forums and joined this one after so much participation and knowledge so it's taking me a bit to catch up on this stuff, I'm in unfamiliar territory.

Maybe my biggest issue is getting older and feeling like I'm getting older and worn out I just don't feel like I used to but I have started taking a few supplements that have seemed to help a little. Acetyl L Carnitine, Zinc w/copper, Vit D, fish oil.

Gonna try NAC and Ubiquinol as well.

 

[Megatron28]

My doc checked TSH last year (1/23/14) and it was 1.770 uIU/mL Ref Range .55 - 4.78

I have a normal body temperature of about 97.6 which I've always thought was kind of odd but doctors dismiss it.

I've just dug into that sticky. I've been reading a few different forums and joined this one after so much participation and knowledge so it's taking me a bit to catch up on this stuff, I'm in unfamiliar territory.

Maybe my biggest issue is getting older I just don't feel like I used to but I have started taking a few supplements that have seemed to help a little. Acetyl L Carnitine, Zinc w/copper, Vit D, fish oil.

Gonna try NAC and Ubiquinol as well.

It is very possible your TT used to be higher and is dropping as you age. So while you may not be hypogonadal, you may not feel the same. I would be interested in seeing your estradiol, LH and FSH. See my signature below for how to get cheap and fast blood work. You don't need a doc to get it and the results remain private. It only costs $54 with a coupon code. Sign up for their email list and you will get it.

What is your height, weight and body fat%?

 

[Cap'n]

I would be interested in seeing your estradiol, LH and FSH.

What is your height, weight and body fat%?

I'll look into getting those other tests. I'm 6' 3" 200 lbs and guessing at around 15% body fat.

ETA - For the blood test panel do I need to stop taking supplements or just roll with what I'm doing now?

Thanks again!

 

[Megatron28]

I'll look into getting those other tests. I'm 6' 3" 200 lbs and guessing at around 15% body fat.

ETA - For the blood test panel do I need to stop taking supplements or just roll with what I'm doing now?

Thanks again!

You could get the blood work on Monday if you want to.

Sounds like you have covered your bases. Treating sleep apnea. Not obese. Thyroid checked. Maybe more extensive blood work will show something.

Do you know what your vitamin D is at? And how much are you supplementing daily?

 

[Cap'n]

Do you know what your vitamin D is at? And how much are you supplementing daily?

Not sure where it is but I pop a 5000 iu a day just to be on the safe side.

This picture was roughly a year ago. Arms and chest are a little bigger today but everything else is about the same. Still can't post images but link works.

i59.tinypic.com/2a5kf40.jpg

 

[Megatron28]

Not sure where it is but I pop a 5000 iu a day just to be on the safe side.

This picture was roughly a year ago. Arms and chest are a little bigger today but everything else is about the same. Still can't post images but link works.

i59.tinypic.com/2a5kf40.jpg

You should check your vitamin D. Too low or too high is bad. See where 5000iu daily puts you.

 

[Cap'n]

I would be interested in seeing your estradiol, LH and FSH.

I won't be able to get these tests until early next week. Should I pay the additional money for the sensitive e2 or is the regular one sufficient? I've read conflicting things concerning estradiol testing.

 

[Megatron28]

I won't be able to get these tests until early next week. Should I pay the additional money for the sensitive e2 or is the regular one sufficient? I've read conflicting things concerning estradiol testing.

The sensitive assay is more accurate. But a lot of us just use the regular assay and know that it is likely 10-20 points overstated. You are probably fine with the regular one -- just keep in mind that you may not get a definitive answer on what is going on with your estradiol unless it comes in really low or high.

If you are going to get the sensitive assay, consider the Hormone Panel for Males as well.

 

[Havasu]

Were your blood tests done while fasted? Your glucose is 98. If that's a fasted glucose that is very high.

 

[Cap'n]

Were your blood tests done while fasted? Your glucose is 98. If that's a fasted glucose that is very high.

I had a big dinner about 8pm and the tests were done at about 8am the next day. 98 appears to be in the middle of the range they show but my knowledge is very limited in these matters.

My labs were done at the VA and my doc had them pull blood and told me he'd see me in 6 months... Never mentioned anything about discussing results.

 

[Cap'n]

New labs in. Any additional info or suggestions pertaining to these numbers?

TT 523 (348 - 1197)
LH 6.0 (1.7 - 8.6 mIU/mL)
FSH 1.8 (1.5 - 12.4 mIU/mL)
Estradiol 22.7 (7.6 - 42.6 pg/mL)

 

[Megatron28]

New labs in. Any additional info or suggestions pertaining to these numbers?

TT 523 (348 - 1197)
LH 6.0 (1.7 - 8.6 mIU/mL)
FSH 1.8 (1.5 - 12.4 mIU/mL)
Estradiol 22.7 (7.6 - 42.6 pg/mL)

What time of day was the blood drawn?

 

[Cap'n]

What time of day was the blood drawn?

8am on Tuesday. My concern was the low FSH but I'm not really sure if that's something to worry about since it's within the "limits".

I've read a few things that stated low FSH was indicative of secondary hypogonadism. But, I'm also not sure if that's considered "low" or "low-normal" or what...