I was wondering if you could give your input regarding some bloodwork a friend of mine did a while ago. He's been struggling with his weight lifting and health, and I mean really struggling. To give you some perspective on what his life has been like, he is 26 years old with a past history of heavy alcohol consumption, irregular eating, obesity followed by near starvation (man was a hefty heifer for a couple of years and then starved himself into a skeleton) etc. All possible factors that could have contributed to his current endocrine problems.
Anyway, after a very rough adolescence and young adulthood, he somehow got inspired to lift weights and start eating healthy (probably because he was hanging out with us and watching us do it
). Well, the first 2 years he made OK progress and seemed to be reclaiming his health, or should I say creating it since he never really had it in the past. Now, it is important to point out that he had the markers of pre-onset diabetes, or at the very least insulin resistence, before he cleaned up his lifestyle, so those changes were of paramount importance, and probably saved his life.
After a couple of years of what seemed like a positive direction for him, he started to hit a brick wall with his progress.In fact, he started to regress in a major way. All his lifts came down inexplicably, for instance, he is still struggling to bench more than 80 pounds! And yes, that is not a typo! It has nothing to do with faulty technique, either. I've seen him bench and he does it right. Same goes for the rest of his lifts.
Also, he's been putting on massive amounts of fat lately, too. For a while it seemed as if he was actually building a little bit of muscle, but lately, even with a caloric intake as low as 2400 kcal/day, his waistline has been expanding like nobody's business. It's like.. all he has to do is walk past McDonald's and get a whiff of the burger grease, and his shirt buttons start flying around like bullets from the speed at which his gut balloons.
That, and his joints seem to be perpetually broken. And his back. And his wrists and ankles. He has to take time off lifting every now and then to recuperate from injuries that should not occur for a healthy person (certainly not with the weights he's using & the proper form and technique).
It's almost comical at times, the poor guy's misfortunte!
Anyway, all of these factors combined lead us to believe he might be suffering from complex neuro-endocrine problems.
Here are his blood test results:
TSH - 2.18 (0.3 - 4.2)
Free T4 - 12.1 pmol/l (11 - 22)
Free T3 - 4.8 pmol/l (4 - 6.8)
E2 - 0.156 nmol/l (0.03 - 0.20)
Cortisol - 610 nmol/l (no reference range??)
Fasting Glucose - 5.3 mmol/l (4 - 6)
LH - 2.7 U/l (1.7 - 8.6)
Progesterone - 1.3 nmol/l (no reference range??)
Prolactin - 297.6 mU/l (86 - 324)
Ferritin - 48 ug/l (30 - 400)
C-Reactive protein - Less than 5 (5 - 10)
Vitamin B-12 - 450 pmol/l (140 - 540)
Fe (iron?) - 24.5 umol/l (9 - 34)
Total Testosterone - 15.67 nmol/l (that's 452 ng/dL)
Any treatment suggestions? His thyroid is obviously out of whack, his testosterone is on the low side (LH very low as well), and his prolactin seems higher than it should be.
Anyway, after a very rough adolescence and young adulthood, he somehow got inspired to lift weights and start eating healthy (probably because he was hanging out with us and watching us do it
). Well, the first 2 years he made OK progress and seemed to be reclaiming his health, or should I say creating it since he never really had it in the past. Now, it is important to point out that he had the markers of pre-onset diabetes, or at the very least insulin resistence, before he cleaned up his lifestyle, so those changes were of paramount importance, and probably saved his life. After a couple of years of what seemed like a positive direction for him, he started to hit a brick wall with his progress.In fact, he started to regress in a major way. All his lifts came down inexplicably, for instance, he is still struggling to bench more than 80 pounds! And yes, that is not a typo! It has nothing to do with faulty technique, either. I've seen him bench and he does it right. Same goes for the rest of his lifts.
Also, he's been putting on massive amounts of fat lately, too. For a while it seemed as if he was actually building a little bit of muscle, but lately, even with a caloric intake as low as 2400 kcal/day, his waistline has been expanding like nobody's business. It's like.. all he has to do is walk past McDonald's and get a whiff of the burger grease, and his shirt buttons start flying around like bullets from the speed at which his gut balloons.
That, and his joints seem to be perpetually broken. And his back. And his wrists and ankles. He has to take time off lifting every now and then to recuperate from injuries that should not occur for a healthy person (certainly not with the weights he's using & the proper form and technique).
It's almost comical at times, the poor guy's misfortunte!
Anyway, all of these factors combined lead us to believe he might be suffering from complex neuro-endocrine problems.
Here are his blood test results:
TSH - 2.18 (0.3 - 4.2)
Free T4 - 12.1 pmol/l (11 - 22)
Free T3 - 4.8 pmol/l (4 - 6.8)
E2 - 0.156 nmol/l (0.03 - 0.20)
Cortisol - 610 nmol/l (no reference range??)
Fasting Glucose - 5.3 mmol/l (4 - 6)
LH - 2.7 U/l (1.7 - 8.6)
Progesterone - 1.3 nmol/l (no reference range??)
Prolactin - 297.6 mU/l (86 - 324)
Ferritin - 48 ug/l (30 - 400)
C-Reactive protein - Less than 5 (5 - 10)
Vitamin B-12 - 450 pmol/l (140 - 540)
Fe (iron?) - 24.5 umol/l (9 - 34)
Total Testosterone - 15.67 nmol/l (that's 452 ng/dL)
Any treatment suggestions? His thyroid is obviously out of whack, his testosterone is on the low side (LH very low as well), and his prolactin seems higher than it should be.
He is much too proud and hung up on social prestige & maintaining an appearance of a level headed, middle of the road doctor. Anything that even slightly hints at progressive, outside of the box thinking will scare him off. After all, he has his reputation to uphold, and that is (in his mind) a reputation of a man who adheres strictly to the code and "ethics" of textbook western medical practices. 
). 
