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Lab result interpretations anyone? My doc seems a litte clueless (Testosterone, LH, FSH, Ferritin, DHEA, prolaction, estrogen)

by (2544)
Updated about 18 hours ago
Created February 12, 2011 at 12:40 AM

So I have been paleo/primal for pretty much 1 year now. In the beginning I was very low in carbs, mostly just meat on alot of days and was never eating enough food because I lost weight (this was not purposeful). Last fall from september through december I went way crqzy with raw milk and was having at least 1/2 gallon a aday, sometimes 1 whole gallon (for skin issues and gut flora issues).

Skin is healed now and this past month I have been trying to get my hormone levels right and finally put on some damn muscle. I am 21, male, 5'7 and 135 and way too skinny. I deadlift 200 so I have a decent strength base just no size and I would say I am skinny fat (scale says 12.5% body fat)

In high school I was underweight for a while due to way too much cross country running (110 to 120lbs).. I know this could have messed up my hypothalamus/pituitary.

Anyway these are my labs. I lift heavy twice a week, my sleep is eh, I'd say I get 7 hours usually every night but I wake uo ALOT and almost always in REM sleep. I have some mild anxiety issues as well. Some low motivation, poor concentration. Sex drive is fine but it comes and goes. Some days its great, others not so much.

For whats its worth too, I began puberty at like 12 and was pretty much done by 16 with full on facial hair by 15 and chest hair by 16.

These are quest labs too.

Ferritin - 140 (20-345ng/ml ref range) b12 - 619 (200-1100pg/mL ref range) DHEA - 321 (110-510mcg/dl) FSH - 2.1 (ref range 1.6-8.0 miu/ml) LH - 3.5 (re frange is 1.5-9.3 miu/ml) Prolactin 8.7 (2.0-18.0 ng/ml ref range) TSH - 1.91 t4 - 1.1 (0.8-1.8ng/dl t3 - 3.3 (2.3-4.2pg/ml)

Estrogen - 69 (reference range is 130 or less)

Total Test 371 Free 103.1 (46.0-224.0 ref range) Bioavailable 234.0 (110.0- 575.0) SHBG 9 (7-49)

I have had thyroid tested 3 times now, everything always appears good and I don't have any hyposymtpoms that aren't synomous with low T. No antibodies either.

ANy thoughts? Can I recover this ish and get optimal levels again?

Quick edit: My D levels are 104 ng/Ml so I am a little over there...

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2544 · March 30, 2011 at 3:21 PM

could you please elaborate...

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2544 · March 30, 2011 at 1:23 AM

I know alot of this is coming from a very low calorie intake of 1700-1800 and sometimes only 1300 for someone my age and activity level... wondering if increased good calories and resistance training could help

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2544 · March 30, 2011 at 1:18 AM

I had estradiol tested in August when my test was 341... estradiol was 28 then. In september I drank like more than a gallon of raw milk a day and gained some fat... could that be the cause of the estrogen increase?

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800 · March 30, 2011 at 12:49 AM

Dr. K, Bill lists estrogen, and not estradiol, above.

Medium avatar
39841 · March 30, 2011 at 12:30 AM

You should first try to increase carbs and increase your intake of organ meats and see if your low test might be the result of a deficiency in some mineral such as selenium, copper or zinc.

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2544 · March 29, 2011 at 11:51 PM

And with all do respect... from what I have read online most doctors would just hand me a prescribtion for testosterone and maybe some anti-estrogen? I dont want that for the rest of my life.

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2544 · March 29, 2011 at 11:48 PM

What would I be exposed to and what could be done about it? I would rather now a little something going in before paying a doctor to tell me something I might learn online for free.

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25467 · March 28, 2011 at 11:06 PM

you need to see a doctor..........fast especially if are already paleo.

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800 · February 16, 2011 at 1:00 AM

Why did you test estrogen and not estradiol? Using the calculator at the link I provided gives you a calculated free T of about 110 pg/mL if I have done the math right, Ideally you should be 160 to 260. What time of day was your blood draw?

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2437 · February 15, 2011 at 10:10 PM

You never mentioned partitioning. I went from 174 to 205 on paleo plus dairy but gained a lot of fat. Dropping dairy and adding IF I dropped back to 175 with slightly better body comp then when I started. Robb Wold had this same problem with his bulking phase he went through a few years back. Now he addressed hormones more carefully and he got ripped and big. Hormones do matter

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2544 · February 15, 2011 at 7:35 PM

I'd say my digestion is pretty good. I should be taking digestive enzytmes though but otherwise my flora is pretty good. I take good probiotics and have raw milk kefir or some other fermented food daily. At the risk of TMI, bowel movements are usually good. There is probably much room for improvement though and I will be dropping the dairy and adding in water kefir instead.

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2544 · February 15, 2011 at 7:32 PM

Noted, will be looking into those programs.

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2544 · February 14, 2011 at 4:57 AM

Yeah SHBG is 9, free test 103.1, total test 371, and bioavailable test is 243. Not sure what Albumin, SERUM is but it is also listed at 5.0 (3.6-5.1 ref range) So am I not totally screwed? Maybe I need more time? When I say I lift heavy... I do deadlifts, press, and bench but havent really done squatting yet.. maybe an important piece to the puzzle? Also, my sleep is not great. I wake up alot and while I have enough energy during the day, I have yet to have 1 full nights sleep, no interruptions in a while.

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2544 · February 13, 2011 at 9:22 PM

Like 6000ui per day and my levels are close to toxicity so I am dropping it for a bit

Medium avatar
39841 · February 13, 2011 at 9:06 PM

How much D3 have you been supplementing?

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2319 · February 13, 2011 at 1:59 PM

dropping dairy could make a difference, but you could need 6 weeks to see it.

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2544 · February 12, 2011 at 6:03 AM

it should be like 700

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2544 · February 12, 2011 at 6:03 AM

Yes total test is low at 371

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2544 · February 12, 2011 at 6:02 AM

Last few months it was like 1/2 gallon of raw milk a day with a meal of maybe a sweet potato, veggies, and beef or fish or eggs. Was total test was 425 then... Last two weeks I have been eating 1lb ground beef or some kind of red meat, 1 lb of an organ meat like beef heart, 1 or 1/2 cup of potato or sweet potatato, some kind of green veggie, carrots, a raw egg yolk or two, fermented cod liver oil and now high vitamin butter oil. cook everything in grass fed beef tallow or coconut oil. Dropping dairy as of a week ago. Perhaps that will make a change?

Medium avatar
39841 · February 12, 2011 at 12:51 AM

So the reference range you list for test is for free test, not total, right? Total test seems low. You should also post what you actually currently eat on a daily basis.

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7 Answers

Ed71ab1c75c6a9bd217a599db0a3e117
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25467 · March 29, 2011 at 11:24 PM

You need a doctor. Looks like you're an aromatizer and you maybe exposed to something causing these labs.

Ef4c5b09fdccf73be575d3a0c267fdd9
2544 · March 30, 2011 at 1:23 AM

I know alot of this is coming from a very low calorie intake of 1700-1800 and sometimes only 1300 for someone my age and activity level... wondering if increased good calories and resistance training could help

Ef4c5b09fdccf73be575d3a0c267fdd9
2544 · March 30, 2011 at 1:18 AM

I had estradiol tested in August when my test was 341... estradiol was 28 then. In september I drank like more than a gallon of raw milk a day and gained some fat... could that be the cause of the estrogen increase?

9dd74d3941535d0aaa2c8d3cf454fb7e
800 · March 30, 2011 at 12:49 AM

Dr. K, Bill lists estrogen, and not estradiol, above.

Medium avatar
39841 · March 30, 2011 at 12:30 AM

You should first try to increase carbs and increase your intake of organ meats and see if your low test might be the result of a deficiency in some mineral such as selenium, copper or zinc.

Ef4c5b09fdccf73be575d3a0c267fdd9
2544 · March 29, 2011 at 11:51 PM

And with all do respect... from what I have read online most doctors would just hand me a prescribtion for testosterone and maybe some anti-estrogen? I dont want that for the rest of my life.

Ef4c5b09fdccf73be575d3a0c267fdd9
2544 · March 29, 2011 at 11:48 PM

What would I be exposed to and what could be done about it? I would rather now a little something going in before paying a doctor to tell me something I might learn online for free.

9dd74d3941535d0aaa2c8d3cf454fb7e
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800 · February 14, 2011 at 1:53 AM

Can you double check the SHBG number? On the surface, total testosterone of 371 with an FSH of only 2 is somewhat indicative of secondary hypogonadism. But, if in fact your SHBG is that low (9) you might be all right.

The best way to determine free testosterone is to calculate it from the SHBG value:

http://www.issam.ch/freetesto.htm

The laboratories use radiographic immunoassay, which is relatively inaccurate for free testosterone.] given how minute the amounts are.

9dd74d3941535d0aaa2c8d3cf454fb7e
800 · February 16, 2011 at 1:00 AM

Why did you test estrogen and not estradiol? Using the calculator at the link I provided gives you a calculated free T of about 110 pg/mL if I have done the math right, Ideally you should be 160 to 260. What time of day was your blood draw?

Ef4c5b09fdccf73be575d3a0c267fdd9
2544 · February 14, 2011 at 4:57 AM

Yeah SHBG is 9, free test 103.1, total test 371, and bioavailable test is 243. Not sure what Albumin, SERUM is but it is also listed at 5.0 (3.6-5.1 ref range) So am I not totally screwed? Maybe I need more time? When I say I lift heavy... I do deadlifts, press, and bench but havent really done squatting yet.. maybe an important piece to the puzzle? Also, my sleep is not great. I wake up alot and while I have enough energy during the day, I have yet to have 1 full nights sleep, no interruptions in a while.

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341 · February 15, 2011 at 7:20 PM

"But going from 135 to 155 at 5'7" does NOT require an endocrinologist." This is true for person without any digestive issues. For anyone else with impacted digestion not only this will not work but extra heavy workouts will only make things worse. From my own experience, you have to fix your digestive problems, and get rid of any stress and anxiety, after that muscle gain will be easy with only moderate amounts of exercise.

Ef4c5b09fdccf73be575d3a0c267fdd9
2544 · February 15, 2011 at 7:35 PM

I'd say my digestion is pretty good. I should be taking digestive enzytmes though but otherwise my flora is pretty good. I take good probiotics and have raw milk kefir or some other fermented food daily. At the risk of TMI, bowel movements are usually good. There is probably much room for improvement though and I will be dropping the dairy and adding in water kefir instead.

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30 · February 15, 2011 at 5:58 PM

So, the heart of your question is, "I have been trying to get my hormone levels right and finally put on some damn muscle." You are having trouble gaining weight (muscle) and you assume that this must be the result of your hormone levels?

Even though it is probably inappropriate for me to comment on your blood work, it looks like its within "normal" (whatever that means). But going from 135 to 155 at 5'7" does NOT require an endocrinologist. It just requires a plan that actually works.

We specialize in fat-loss at my place, but we get guys that want to bulk up and have always been skinny too. (these are guys in their 40's and 50's who work 60-80hrs/wk too, so at 21 this is much easier) We just got them on an intelligent program and had them eat better and they all get bigger. Putting on 20lbs of muscle does not require scrutinizing blood work. Deadlifting, pressing and benching are not a program that's just recreation at the gym.

The answer is really, really simple: go get a decent program written by somebody else that is actually an expert in what you want. Like Alwyn Cosgrove's New Rules of Lifting, or one of Jason Ferrugia's programs. (I don't get any money for that sentence.) Get it, but don't alter it. Just do it they way they told you to.

One caveat, I would not follow their nutrition advice when it comes to what to eat... to many nasty grains and processed crap. But, similar ideas apply - eat more, use recovery drink (if you want a "paleo" one - raw honey + eggs + cream).

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2437 · February 15, 2011 at 10:10 PM

You never mentioned partitioning. I went from 174 to 205 on paleo plus dairy but gained a lot of fat. Dropping dairy and adding IF I dropped back to 175 with slightly better body comp then when I started. Robb Wold had this same problem with his bulking phase he went through a few years back. Now he addressed hormones more carefully and he got ripped and big. Hormones do matter

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2544 · February 15, 2011 at 7:32 PM

Noted, will be looking into those programs.

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2319 · February 15, 2011 at 5:08 PM

If you BG tests are good, but you crash after a meal, then perhaps you tolerate glucose just fine and not something else you are eating. Statistically, casein (the protein in milk) is the most likely.

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2544 · February 13, 2011 at 6:23 PM

Eating liver less than once a week and I can never finsh it. Beef heart is twice a week. Not sure about food intolerances but my acne went away when I cut out nuts and grains so I guess my body doesn't like those. I do think I have some blood sugar issues but perhaps that's because of the raw millk? I test great for blood sugar but i do fin myself crashing sometimes after a meal

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2319 · February 13, 2011 at 2:07 PM

Is that a pound of beef heart a day? How much liver are you eating in a week?

Have you ever had a full thyroid panel including the rT3?

How's your blood sugar and are you taking any supplements at all?

do you have any food intolerances or suspect any foods?

Here's a blog post you might find interesting http://celiaccentral.wordpress.com/2011/02/09/sex-and-the-celiac-meets-real-life/

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