Feedback on Lab Results

[magic8989]

Background: I am 22 years old. I have hypothyroidism and low testosterone levels due to a bengin tumor on my pituitary gland. I have been on HRT and synthroid for almost 3 months now and i am starting to feel better finally. I use androgel at 10g a day and synthroid at 75mcg a day. I have a question about my recent lab results.

Reference Range
Total T 1284 ng/dl........250-1100 ng/dl
Free T 186.3 pg/ml.......46.0-224.0 pg/ml
Bioavail T 432.7pg/ml....110.0-575.0 pg/ml
SHBG 38nmol/L.............7-50 nmol/L

T3, Total 65ng/dl..........60-181 ng/dl
T4, Free 1.2 ng/dl..........8-1.8 ng/dl
TSH .41 miu/l.................40-5.50 miu/l

Talking with my endo this is what we have agreed so far. Since my total T is higher he wants me to reduce my dose to 7.5g. I told him that i feel really good where i am at and want to stay in the high normal range. I agreed to reduce the dose and go back in 6 weeks for more blood work to see if my levels remain in the high normal range after the reduced dosage.

For my thyroid i told him i want to T4/T3 combo because my labs show i am still lower than i would like. He upped my synthroid to 88mcg and will get blood work done when i go back to check my T levels in 6 weeks to see if that helps out. If not then he said he would do a T4/T3 combo.

My main question is should i reduce the dose of androgel because i know what matters the most is free and not total T? Also am i on the right track for my thyroid issue? I just want to make sure i am on the right track overall to feeling good again. I dont have my earlier lab results because they are back at school but i know my prolactin, cortisol, and ACTH are fine. I am pretty sure my E2 is fine also. Thanks for any feedback. If anyone has any questions i will be glad to answer them.

[SPE]

It looks as though you could benefit more from a T3/T4 combo such as armour. Get your Free T3 levels checked too as the free's are what matter most. I would reduce your androgel to 7.5 like your doc has prescribed. See how you feel with the reduction. If in 6 weeks you feel worse, then ask him to up it and let him know that free t is what matters most here. But you never know, you might feel better on 7.5. You really should know what your e2 level is as well as DHT.

[pmgamer18]

Originally Posted by magic8989

Background: I am 22 years old. I have hypothyroidism and low testosterone levels due to a bengin tumor on my pituitary gland. I have been on HRT and synthroid for almost 3 months now and i am starting to feel better finally. I use androgel at 10g a day and synthroid at 75mcg a day. I have a question about my recent lab results.

Reference Range
Total T 1284 ng/dl........250-1100 ng/dl
Free T 186.3 pg/ml.......46.0-224.0 pg/ml
Bioavail T 432.7pg/ml....110.0-575.0 pg/ml
SHBG 38nmol/L.............7-50 nmol/L

T3, Total 65ng/dl..........60-181 ng/dl
T4, Free 1.2 ng/dl..........8-1.8 ng/dl
TSH .41 miu/l.................40-5.50 miu/l

Talking with my endo this is what we have agreed so far. Since my total T is higher he wants me to reduce my dose to 7.5g. I told him that i feel really good where i am at and want to stay in the high normal range. I agreed to reduce the dose and go back in 6 weeks for more blood work to see if my levels remain in the high normal range after the reduced dosage.

For my thyroid i told him i want to T4/T3 combo because my labs show i am still lower than i would like. He upped my synthroid to 88mcg and will get blood work done when i go back to check my T levels in 6 weeks to see if that helps out. If not then he said he would do a T4/T3 combo.

My main question is should i reduce the dose of androgel because i know what matters the most is free and not total T? Also am i on the right track for my thyroid issue? I just want to make sure i am on the right track overall to feeling good again. I dont have my earlier lab results because they are back at school but i know my prolactin, cortisol, and ACTH are fine. I am pretty sure my E2 is fine also. Thanks for any feedback. If anyone has any questions i will be glad to answer them.

Now don't get me wrong but I never had levels this high on 10 g's of Andorgel of Testim unless I put on the gel in the morning before the test. I would then go in an hr. later and have the test done. My Dr. did the same thing your Dr. is doing and I crashed big time. So if your did this you may want to call your Dr. and redo the test hell I would for get so many times that he would ask me if I put the gel on that morning when I went in for the blood test. I have spiked my levels up from 600 to 1800.

[magic8989]

Originally Posted by ISPE

It looks as though you could benefit more from a T3/T4 combo such as armour. Get your Free T3 levels checked too as the free's are what matter most. I would reduce your androgel to 7.5 like your doc has prescribed. See how you feel with the reduction. If in 6 weeks you feel worse, then ask him to up it and let him know that free t is what matters most here. But you never know, you might feel better on 7.5. You really should know what your e2 level is as well as DHT.

Ok, i will get my free T3, e2, and DHT checked. He said i can get whatever i want and is very willing to work with me. I actually told him as soon as i get my levels all normal about the Hcg shots because i want to keep my testes working and he wondered where i learned about this kind of stuff and i told him here so he has thus far been cooperative. Also will reduce the dose like prescribed. Thanks.

Originally Posted by pmgamer18

Now don't get me wrong but I never had levels this high on 10 g's of Andorgel of Testim unless I put on the gel in the morning before the test. I would then go in an hr. later and have the test done. My Dr. did the same thing your Dr. is doing and I crashed big time. So if your did this you may want to call your Dr. and redo the test hell I would for get so many times that he would ask me if I put the gel on that morning when I went in for the blood test. I have spiked my levels up from 600 to 1800.

Thanks for the heads up. I did not put my androgel on before the lab test though.

[magic8989]

Originally Posted by ISPE

It looks as though you could benefit more from a T3/T4 combo such as armour. Get your Free T3 levels checked too as the free's are what matter most. I would reduce your androgel to 7.5 like your doc has prescribed. See how you feel with the reduction. If in 6 weeks you feel worse, then ask him to up it and let him know that free t is what matters most here. But you never know, you might feel better on 7.5. You really should know what your e2 level is as well as DHT.

Ok, i will get my free T3, e2, and DHT checked. He said i can get whatever i want and is very willing to work with me. I actually told him as soon as i get my levels all normal about the Hcg shots because i want to keep my testes working and he wondered where i learned about this kind of stuff and i told him here so he has thus far been cooperative. Also will reduce the dose like prescribed. Thanks.

Originally Posted by pmgamer18

Now don't get me wrong but I never had levels this high on 10 g's of Andorgel of Testim unless I put on the gel in the morning before the test. I would then go in an hr. later and have the test done. My Dr. did the same thing your Dr. is doing and I crashed big time. So if your did this you may want to call your Dr. and redo the test hell I would for get so many times that he would ask me if I put the gel on that morning when I went in for the blood test. I have spiked my levels up from 600 to 1800.

Thanks for the heads up. I did not put my androgel on before the lab test though.

[magic8989]

Bumping this up with new results. These labs are reflective of the following 88mcg on synthroid and 7.5g of androgen.

New Lab.
Lab Result Reference Range
Total T 621 ng/dl........241-827 ng/dl
Free T 119 pg/ml.......34-194 pg/ml
SHBG 41nmol/L.............7-50 nmol/L

T3, Total 50ng/dl..........60-181 ng/dl
T3, Free 201 pg/dl.........230-420 pg/dl
T4, Free 1.4 ng/dl..........8-1.8 ng/dl
TSH .33 miu/l.................40-5.50 miu/
FSH .7 miu/ml.................1.6-8.0 miu/ml
Bioavail Estradiol 7.44 pg/ml....10.5-28.5 pg/ml
Prolactin 8.3 ng/ml.............2.0-18.0 ng/ml

Semen analysis shows
Volume 2.5.....................>2.0 ml
Motility is not available due to fertility.

Another issue with my CBC
WBC 3.0..............................3.8-10.8 thous/mcl
Absolute neutrophils 1329......1500-7800 cells/mcl

I also had a full lipids, glucose, c-peptide, cortisol, insulin, IGF-I, and liver enzymes which all checked out fine.

It seems things are getting better. When i went for these last labs i started in addition to the above 12.5mcg of cytomel. As of right now my dose is being bumped up to 25mcg daily. However, my fertility and estrogen is screwed up and i talked to the doctor about the Hcg for the third time. Finally, this time he said he would refer me to a fertility doctor because he is not familar with Hcg treatment and told me i am the so to speak "guineau pig" as to what will take place in the future. Tuesday i have a consultation and will set up an appointment. I also have to see my primary doctor about the immune function

Is there anything else i should do or am i on the right path? Anyone who has input if you have questions just ask because i have a lot of results and such but did not want to post everything. Also thanks again for everyone who has been helping and to all who help.

[pmgamer18]

Originally Posted by magic8989

Background: I am 22 years old. I have hypothyroidism and low testosterone levels due to a bengin tumor on my pituitary gland. I have been on HRT and synthroid for almost 3 months now and i am starting to feel better finally. I use androgel at 10g a day and synthroid at 75mcg a day. I have a question about my recent lab results.

Reference Range
Total T 1284 ng/dl........250-1100 ng/dl
Free T 186.3 pg/ml.......46.0-224.0 pg/ml
Bioavail T 432.7pg/ml....110.0-575.0 pg/ml
SHBG 38nmol/L.............7-50 nmol/L

T3, Total 65ng/dl..........60-181 ng/dl
T4, Free 1.2 ng/dl..........8-1.8 ng/dl
TSH .41 miu/l.................40-5.50 miu/l

Talking with my endo this is what we have agreed so far. Since my total T is higher he wants me to reduce my dose to 7.5g. I told him that i feel really good where i am at and want to stay in the high normal range. I agreed to reduce the dose and go back in 6 weeks for more blood work to see if my levels remain in the high normal range after the reduced dosage.

For my thyroid i told him i want to T4/T3 combo because my labs show i am still lower than i would like. He upped my synthroid to 88mcg and will get blood work done when i go back to check my T levels in 6 weeks to see if that helps out. If not then he said he would do a T4/T3 combo.

My main question is should i reduce the dose of androgel because i know what matters the most is free and not total T? Also am i on the right track for my thyroid issue? I just want to make sure i am on the right track overall to feeling good again. I dont have my earlier lab results because they are back at school but i know my prolactin, cortisol, and ACTH are fine. I am pretty sure my E2 is fine also. Thanks for any feedback. If anyone has any questions i will be glad to answer them.

Question did you put on the gel before you did your blood test if your did this can be why the test came back this high. My Dr. would have me do he blood test first thing in the morning then when I got home I put on the gel. I have never seen anyone this high on 10g of androgel. If they took your blood and you had gel on the spot where they took the blood this will spick your test. So if you did this and cut the does you will crash and burn.
As for the Thyroid my wife has been seeing a Endo for over 15 yrs. they put her on synthroid she would tell them she still does not feel good tried all the time and cold. The Dam Endo would tell her her levels are fine lose some weight or your depressed. After all of these yrs. she went to my T Dr. and he put her on Armour now after all of these yrs. she feels fine. I just don't care for Endo's have seen 7 in the last 22 yrs for low T and not one was worth a crap.

[magic8989]

Originally Posted by pmgamer18

Question did you put on the gel before you did your blood test if your did this can be why the test came back this high. My Dr. would have me do he blood test first thing in the morning then when I got home I put on the gel. I have never seen anyone this high on 10g of androgel. If they took your blood and you had gel on the spot where they took the blood this will spick your test. So if you did this and cut the does you will crash and burn.
As for the Thyroid my wife has been seeing a Endo for over 15 yrs. they put her on synthroid she would tell them she still does not feel good tried all the time and cold. The Dam Endo would tell her her levels are fine lose some weight or your depressed. After all of these yrs. she went to my T Dr. and he put her on Armour now after all of these yrs. she feels fine. I just don't care for Endo's have seen 7 in the last 22 yrs for low T and not one was worth a crap.

No i did not put the gel on before. I usually put it on in the morning but knew not to as i read it effects the results. The only possible explanations for the high level are 10g was too much (i am at 7.5 now though), or i did not shower before i went and some of the gel from the previous morning, (about 20-24 hours earlier) could have still not absorbed. Other than that i don't know. I also did not put the gel on for my recent lab either. For the recent lab i did take my synthroid about 2 or 3 hours before the blood draw and i was fasted also. At that time i did not have the cytomel yet.

[Edit] Do you think my T levels are good where they are at now? They seem to be in the upper range.

[pmgamer18]

If the Free T was to high then yes I would say lower your dose but one other thing I and my Dr. never lower T meds with the results of one lab test they are so inaccurate that your next test could be a hole different story.

[magic8989]

Well my recent labs were the result of 4 weeks at 7.5g of androgel. When i get some more labs ill make sure it stays around where it is then. If not then ill ask for the bump up back to 10g.

[magic8989]

Ok. I got my new labs back but i am confused about what to do next. Here they are. Current protocl is synthroid 88mcg and cytomel 25mcg. Androgel 7.5ml (6 pumps). Start all this treatment back in October. Also i have a non functioning pituitary tumor that has decreased in size dramatically since last MRI. I think it was from 7x7 to 4x4.

Lab Result Reference Range
Total T 485 ng/dl........250-1100 ng/dl
Free T 58 pg/ml.......46-224 pg/ml
SHBG 38nmol/L.............7-50 nmol/L
T3, Free 201 pg/dl.........230-420 pg/dl
T4, Free 1.0 ng/dl..........8-1.8 ng/dl
TSH .04 miu/l..................40-5.50 miu/
Bioavail Estradiol 7.44 pg/ml....10.5-28.5 pg/ml(This is from my last lab as they did the wrong estrogen by mistake.)
Bioavail Estrone 24.67pg/ml.........18-44pg/ml(They did this one instead.)
Prolactin 8.0 ng/ml.............2.0-18.0 ng/ml
Cortisol 25.1mcg/dl.............4.0-22.0 for AM draw
DHEA 700ng/dl...................180-1250ng/dl
DHT 102ng/dl............................25-75ng/dl
Progesterone 2.0ng/ml........................<1.4ng/ml

Another issue with my CBC
WBC 3.3..............................3.8-10.8 thous/mcl
Absolute neutrophils 1399......1500-7800 cells/mcl

Not sure what this globulin stuff means but endo said since my liver enzymes were fine it was not a big deal
Globulin 2.1L........................2.2-4.2g/dl
Albumin/Globulin 2.2H..............8-2.0
Total bilirubin 2.1mg/dl.............2-1.5mg/dl

The only change my endo did was increase my synthorid to 100mcg from 88mcg. He is afraid of increasing my cytomel due to the irregluar heart issues it can cause. He did not seem concerned about my DHT or progesterone as i can tell he is not up to date on some material. Still, he does work with me and untill he wont do something i want i will stick with him.

I know having high progesterone can lead to gyno but i have no signs and excess DHT can lead to baldness but i have been going bald for 2.5 years now already. So what should i do? I still do not feel completely right but it is getting a little better each time. Biggest issue is still just no libido but i do function fine and wake up erections.

[pmgamer18]

Ok this proves you had gel on the first blood draw in this test. You say you did not shower and yes if you had gel on the spot that the needle went into for the blood test it will come back high. It was not as high as if you had put it on first before the blood test but it came back high. You lower the does and now your way to low I am betting on 10 grams you only about 600 for TT.

Your Free is in the bottom of the range your young but if you go to long at low levels like this you will suffer.

As for seeing a Endo I have no use for them and looking at your Thy. numbers is why. You need to be on Armour. Your FT4 is at the bottom because it is trying to make enough T3 FT3 should be near the top of the range. Your Cortisol would be better up at 30 the range is made from sick people. But you’re a lot better then most I have seen. You should have your Ferritin, Thyroid Microsomal AB and Thyroglobulin AB checked.

If I were you I would find a DO Dr. and get a second opinion. Find one that treats with Armour. My wife wasted 15 yr. feeling like crap doing synthorid with Endo's.

You need to have your TT and FT up in the upper 1/3 of your labs range for a young man. And you need your Estradiol tested and if high keep it down between 10 to 30 best at 20. I would go back up to 10 grams of gel.

Here is a dam good link for Thyroid this link I feel save my wife now we know what is wrong with her and why her thyroid meds are not working.
http://www.stopthethyroidmadness.com
And because you have pituitary problems join this group and post this there.
http://health.groups.yahoo.com/group...pport/messages

[magic8989]

Thanks so much for your reply and i agree with what you suggest. When i looked at my list for my next blood test i noticed the endo didn't put all the tests i asked for. I called back and talked to him about it and he said it was not necessary since my T is in the normal range, total T3 is better, and progesterone and DHT i should not worry about. Well, i tend to disagree with that. I am going to talk things over with my family and maybe find a new endo. I might try Swale's office cuz i love about an hour away.

As for right now what should i do about my elevated DHT and progesterone. Could i try the TMG, indolex/DIM regime or even saw palmetto?

[pmgamer18]

Originally Posted by magic8989

Thanks so much for your reply and i agree with what you suggest. When i looked at my list for my next blood test i noticed the endo didn't put all the tests i asked for. I called back and talked to him about it and he said it was not necessary since my T is in the normal range, total T3 is better, and progesterone and DHT i should not worry about. Well, i tend to disagree with that. I am going to talk things over with my family and maybe find a new endo. I might try Swale's office cuz i love about an hour away.

As for right now what should i do about my elevated DHT and progesterone. Could i try the TMG, indolex/DIM regime or even saw palmetto?

No don't do anything it is bad when low and your not that high. My DHT was 3 times above the top of the range. My wife is seeing a new Dr. on the 17 he treats with Armour and knows about Adrenal Fatigue. He is at 19 mile and Mound Rd. in Sterling Hgts Mi. I am in Rochester Hills Mi. If you can get to Dr. John this is what I would do. But he is not on our health plain. I am dam close to driving to see him my self. It is dam hard to find a Endo that is up on this. Make sure you read the site I gave you make sure you under stand about what is wrong with you do when you do see a Dr. you will know if he is treating good. Progesterone just keep an eye on it could be becasue you TT and FT came down so low and you not stable. What city do you live in.

[magic8989]

Originally Posted by pmgamer18

No don't do anything it is bad when low and your not that high. My DHT was 3 times above the top of the range. My wife is seeing a new Dr. on the 17 he treats with Armour and knows about Adrenal Fatigue. He is at 19 mile and Mound Rd. in Sterling Hgts Mi. I am in Rochester Hills Mi. If you can get to Dr. John this is what I would do. But he is not on our health plain. I am dam close to driving to see him my self. It is dam hard to find a Endo that is up on this. Make sure you read the site I gave you make sure you under stand about what is wrong with you do when you do see a Dr. you will know if he is treating good. Progesterone just keep an eye on it could be becasue you TT and FT came down so low and you not stable. What city do you live in.

I live in Lapeer. It is about 20 minutes north of Lake Orion and about 45 minutes from rodchester. I used to work in rodchester and have been around sterling heights so i am sort of familar with the area. Thanks for the advice. i will look into that and talk it over with my parents since i am not fully supportive of myself yet (graduate tommorow and have a 1 year internship still) about the insurance stuff. I have been to the stop the thyroid madness site before and looked around a bit but need to dive into it more. Could you give me the name or some more information about the Dr. your wife is going to see? I have been trying to look it up but have not found anything yet.