Please review my labs

[LiveWire]

Hi Everyone,

I am 35 years of age. I'll be seeing Dr. Mariano in the middle of January. I have ADHD and no libido. I was on TRT for about one year. Before starting TRT my testosterone was 463 ng/dL (range 241-827) and was put on TRT for low libido and fatigue. I felt a lot better on the TRT. I stopped because my testicle was losing a lot of it's size. I only have one testicle and didn't want to see it disappear. I wasn't aware of HCG therapy being used to preserve it's size at the time. I went ahead and ordered the labs that he usually orders and would like some feedback. My only symptom is no libido and when I work out for more than 3 days consecutively I get very tired. I am not depressed and my sleep is excellent. I have been off of TRT for about a year and I have only posted the critical labs.

Labs were drawn at 8:30 am and I had fasted for 12-14 hours prior to blood draw, ranges are in parenthesis:

Testosterone: 310 ng/dL (249-836)
Pregnenolone: 26 ng/dL (range < 151)
DHT: 33 ng/dL (30-85)
Estradiol, Sensitive: 11 pg/mL (3-70)
Progesterone: 0.5 ng/mL (0.2-1.4)
Prolactin: 13.8 ng/mL (4.0-15.2)
DHEA-S: 203.7 ug/dL (88.9-427)
LH: 4.0 mIU/mL (1.7-8.6)
FSH: 2.7 mIU/mL (1.5-12.4)
Iron, Serum: 70 ug/dL (40-155)
IGF-1: 132 ng/mL (115-307)
Methylmalonic Acid, Serum: 77 nmol/L (73-376)
Magnesium, Serum: 2.1 mg/dL (1.6-2.6)
Zinc, Serum: 132 ug/dL (70-150)
Vitamin B12: 600 pg/mL (211-946)
Folate, Serum: > 20 ng/mL (range > 3)
Vitamin A, Serum: 59 ug/dL (19-83)
Vitamin D, 25-Hydroxy: 19.9 ng/mL LOW (32-100)
Serotonin, Serum: 120 ng/mL (21-321)
Norepinephrine, Plasma: 350 pg/mL (0-874)
Epinephrine, Plasma: 36 pg/mL (0-62)
Dopamine, Plasma: 23 pg/mL (0-48)
TSH: 1.6 uIU/mL (0.450-4.5)
Total T4: 8.4 ug/dL (4.5-12)
Total T3: 110 ng/dL (71-180)
Free T4: 1.17 ng/dL (0.82-1.77)
Free T3: 3.3 pg/mL (2.0-4.4)
Reverse T3: 297 pg/mL (90-350)
Thyroid Peroxidase (TPO) Ab: 9 IU/mL (0-34)
Antithyroglobulin Ab: < 20 IU/mL (0-40)
SHBG, Serum: 19.3 nmol/L (14.5-48.4)
Insulin: 15.5 uIU/mL (0.0-24.9)
Cortisol: 13 ug/dL (2.3-19.4)
Glucose: 77 mg/dL (65-99)
Ferritin, Serum: 499 ng/mL HIGH (30-400)

Because of the low Vitamin D I have started taking 5000 IU Vitamin D3 per day. Any feedback is much appreciated.

 

[hardasnails1973]

Hi Everyone,

I am 35 years of age. I'll be seeing Dr. Mariano in the middle of January. I have ADHD and no libido. I was on TRT for about one year. Before starting TRT my testosterone was 463 ng/dL (range 241-827) and was put on TRT for low libido and fatigue. I felt a lot better on the TRT. I stopped because my testicle was losing a lot of it's size. I only have one testicle and didn't want to see it disappear. I wasn't aware of HCG therapy being used to preserve it's size at the time. I went ahead and ordered the labs that he usually orders and would like some feedback. My only symptom is no libido and when I work out for more than 3 days consecutively I get very tired. I am not depressed and my sleep is excellent. I have been off of TRT for about a year and I have only posted the critical labs.

Labs were drawn at 8:30 am and I had fasted for 12-14 hours prior to blood draw, ranges are in parenthesis:

Testosterone: 310 ng/dL (249-836)
Pregnenolone: 26 ng/dL (range < 151)
DHT: 33 ng/dL (30-85)
Estradiol, Sensitive: 11 pg/mL (3-70)
Progesterone: 0.5 ng/mL (0.2-1.4)
Prolactin: 13.8 ng/mL (4.0-15.2)
DHEA-S: 203.7 ug/dL (88.9-427)
LH: 4.0 mIU/mL (1.7-8.6)
FSH: 2.7 mIU/mL (1.5-12.4)
Iron, Serum: 70 ug/dL (40-155)
IGF-1: 132 ng/mL (115-307)
Methylmalonic Acid, Serum: 77 nmol/L (73-376)
Magnesium, Serum: 2.1 mg/dL (1.6-2.6)
Zinc, Serum: 132 ug/dL (70-150)
Vitamin B12: 600 pg/mL (211-946)
Folate, Serum: > 20 ng/mL (range > 3)
Vitamin A, Serum: 59 ug/dL (19-83)
Vitamin D, 25-Hydroxy: 19.9 ng/mL LOW (32-100)
Serotonin, Serum: 120 ng/mL (21-321)
Norepinephrine, Plasma: 350 pg/mL (0-874)
Epinephrine, Plasma: 36 pg/mL (0-62)
Dopamine, Plasma: 23 pg/mL (0-48)
TSH: 1.6 uIU/mL (0.450-4.5)
Total T4: 8.4 ug/dL (4.5-12)
Total T3: 110 ng/dL (71-180)
Free T4: 1.17 ng/dL (0.82-1.77)
Free T3: 3.3 pg/mL (2.0-4.4)
Reverse T3: 297 pg/mL (90-350)
Thyroid Peroxidase (TPO) Ab: 9 IU/mL (0-34)
Antithyroglobulin Ab: < 20 IU/mL (0-40)
SHBG, Serum: 19.3 nmol/L (14.5-48.4)
Insulin: 15.5 uIU/mL (0.0-24.9)
Cortisol: 13 ug/dL (2.3-19.4)
Glucose: 77 mg/dL (65-99)
Ferritin, Serum: 499 ng/mL HIGH (30-400)

Because of the low Vitamin D I have started taking 5000 IU Vitamin D3 per day. Any feedback is much appreciated.

5,000 ius will not get you any where.
I would suggest more like 10,000 ius a day then retest in 6 weeks then adjust from there.

insulin is a major factor that needs to be further investigated.
Dr M is going to automatically go after that ferritin level - >300 is a concern for him usually
Hemochromatosis or you may have an acute infection which can falsely raise ferritin temporaily.
cortisol is border line but one needs to look at symptoms for proper evaluation then just one test.
Your NE is good so adrenals at least neurotransmitter side looks good
thyroid does not look all that bad but may be border line
good rt3./ t3 ratio
vitamin B12 might be a little low. - need to see CBC
Then why not go back on it with HCG if it made you feel good
Having little to no nut and feeling good is better then feeling like shit.
If you take zinc then I would check ceruloplasm because it can deplete copper and its binding protein.

I would have to look at your eating patterns for 3 days, supplementation, currrent and past stress biological and emotional, past family medical history,

I would have tested prolactin, LH, fsh, CBC, CMP, ceruloplasm, food allergie panel, celiac panel, urine iodine spot

 

[LiveWire]

Thank you very much for your input.

I uploaded the CBC and CMP so you can see it.

I can increase the Vitamin D3 to 10,000 ius a day then retest in 6 weeks then adjust from there.

Can you please explain "insulin is a major factor that needs to be further investigated?"

What might Dr M do with the high ferritin level?

I have no problem going back on TRT with HCG but I'll need a new Rx for that and that is where Dr. Mariano comes in.

I do not currently take zinc.

My eating pattern for today and pretty much every day was:
Breakfast: a bowl of Total cereal with milk, toast with peanut butter
lunch: tuna fish, mayo and triscuit crackers
snack: fiber one bar, peanut butter and a glass of milk
The only supplements I take is the Vitamin D3 I mentioned earlier.

Past family medical history:
Mother(deceased): Mentally ill and drug addict- she had narcissistic personality disorder with psychopathic tendencies; a less technical term- bat shit crazy
Father(living): hypogonadism and had heart surgery for clogged arteries at the age of 47 (he is now in his early 60's)

Does this help you in your assessment?

 

[Sharpman27]

Hi Everyone,

I am 35 years of age. I'll be seeing Dr. Mariano in the middle of January. I have ADHD and no libido. I was on TRT for about one year. Before starting TRT my testosterone was 463 ng/dL (range 241-827) and was put on TRT for low libido and fatigue. I felt a lot better on the TRT. I stopped because my testicle was losing a lot of it's size. I only have one testicle and didn't want to see it disappear. I wasn't aware of HCG therapy being used to preserve it's size at the time. I went ahead and ordered the labs that he usually orders and would like some feedback. My only symptom is no libido and when I work out for more than 3 days consecutively I get very tired. I am not depressed and my sleep is excellent. I have been off of TRT for about a year and I have only posted the critical labs.

Labs were drawn at 8:30 am and I had fasted for 12-14 hours prior to blood draw, ranges are in parenthesis:

Testosterone: 310 ng/dL (249-836)
Pregnenolone: 26 ng/dL (range < 151)
DHT: 33 ng/dL (30-85)
Estradiol, Sensitive: 11 pg/mL (3-70)
Progesterone: 0.5 ng/mL (0.2-1.4)
Prolactin: 13.8 ng/mL (4.0-15.2)
DHEA-S: 203.7 ug/dL (88.9-427)
LH: 4.0 mIU/mL (1.7-8.6)
FSH: 2.7 mIU/mL (1.5-12.4)
Iron, Serum: 70 ug/dL (40-155)
IGF-1: 132 ng/mL (115-307)
Methylmalonic Acid, Serum: 77 nmol/L (73-376)
Magnesium, Serum: 2.1 mg/dL (1.6-2.6)
Zinc, Serum: 132 ug/dL (70-150)
Vitamin B12: 600 pg/mL (211-946)
Folate, Serum: > 20 ng/mL (range > 3)
Vitamin A, Serum: 59 ug/dL (19-83)
Vitamin D, 25-Hydroxy: 19.9 ng/mL LOW (32-100)
Serotonin, Serum: 120 ng/mL (21-321)
Norepinephrine, Plasma: 350 pg/mL (0-874)
Epinephrine, Plasma: 36 pg/mL (0-62)
Dopamine, Plasma: 23 pg/mL (0-48)
TSH: 1.6 uIU/mL (0.450-4.5)
Total T4: 8.4 ug/dL (4.5-12)
Total T3: 110 ng/dL (71-180)
Free T4: 1.17 ng/dL (0.82-1.77)
Free T3: 3.3 pg/mL (2.0-4.4)
Reverse T3: 297 pg/mL (90-350)
Thyroid Peroxidase (TPO) Ab: 9 IU/mL (0-34)
Antithyroglobulin Ab: < 20 IU/mL (0-40)
SHBG, Serum: 19.3 nmol/L (14.5-48.4)
Insulin: 15.5 uIU/mL (0.0-24.9)
Cortisol: 13 ug/dL (2.3-19.4)
Glucose: 77 mg/dL (65-99)
Ferritin, Serum: 499 ng/mL HIGH (30-400)

Because of the low Vitamin D I have started taking 5000 IU Vitamin D3 per day. Any feedback is much appreciated.

Well your testosterone is just above minimum and your estradiol the same.

Prolactin is almost the maximum. Here from wikipedia:

''Prolactin provides the body with sexual gratification after sexual acts: The hormone counteracts the effect of dopamine, which is responsible for sexual arousal. This is thought to cause the sexual refractory period.[6] The amount of prolactin can be an indicator for the amount of sexual satisfaction and relaxation. Unusually high amounts are suspected to be responsible for impotence and loss of libido (see hyperprolactinemia symptoms).''

Reasons for high prolactin might be stress, hypothryoidism or a benign tumour on
the hypothalamus as far as I know. Most probably other reasons as well.

The advise HAN gives is good.

How is your digestion?

If you feel good on TRT, but are concerned about testicle size, you could add
HCG. I think your doctor will understand this as you only have one testicle left.

Your iron level is indeed to high. Are you taking iron tabs? Or vitamin C a lot?

Just my two cents.

Sharpman

 

[LiveWire]

Thank you Sharpman for your input as well.

I am not under any stress, my digestion is very good and I do not take any iron tabs or vitamin C.

Yes, my ferritin level is too high but I have no idea why.

 

[hardasnails1973]

Looking at your EOS it may be indicating a potential infection you may have been having. Elevated ferritin may have been a result of this.

Your diet really needs a complete overhau and potental nujtritional support may be a huge factor in to helping you recover.

 

[rob_07]

Everywhere I have read the rt3/t3 ratios LiveWire has are not very good at all, in fact they are really bad.

total t3/rt3 = 110/29.7 = 3.70 and this number should be greater than 10

free t3/rt3 = 330/29.7 = 11.11 and this number should be greater than 20

I have also read that whenever rt3 is greater than 200 pg/ml that is bad period.


LiveWire - we should keep in touch, I have the same labs in quite a few areas, such as high rt3, low total t3, low dhea-s, low pregnenolone, low progesterone, etc.

My symptoms are horrible brain fog, no ability to concentrate, no ability to work out without getting worsened brain fog and even anxiety if I push my body very hard, chronic fatigue, legs feel inflamed at all times, slow thought process, low libido, zero morning erections.

 

[LiveWire]

Rob_07 thank you for your input. I didn't know those ratio's were important so it's nice to learn about it. I think it is very interesting and keeping in touch is a good idea. Feel free to send me a private message and we can communicate that way for now.

 

[hardasnails1973]

if you read them from some rt3 forum on yahoo group those people are extremist and if you do not follow their reasoning then you are booted off. rt3/ft3 ratio is grossly over exaggerated in many forums. Rt3 is a symptom of a cause. Find the stressor and deal with it rt3 goeas down as well with proper nutrient interactions zinc, selenium, iron, and iodine. Dr mariano uses rt3 as marker for stress on the system not as a direct indicator

when rt3 is really high then look to prolong adrenal stress.

 

[Michael Scally MD]

Confused!@#$ You should be. IMO, for the most part the advice sucks. KISS - Vitamin D, 25-Hydroxy: 19.9 ng/mL LOW (32-100)

 

[hardasnails1973]

Confused!@#$ You should be. IMO, for the most part the advice sucks. KISS - Vitamin D, 25-Hydroxy: 19.9 ng/mL LOW (32-100)

Yep and that would be the only reommendation that needs to be addressed which why I seperated it from the rest.

 

[rob_07]

Well, whatever. You simply said "reverse t3" is fine. Why even say that ? Because if you are going to specifically talk about reverse t3 then no, its not good.

However, I completely agree that the whole yahoo group and "t3 only" mandatory for bad rt3 ratios may be completely wrong. Addressing things like vitamin d3, b12, iron, ferritin, removing stressors etc etc is first and then see what rt3 does.

 

[Michael Scally MD]

See: https://thinksteroids.com/community/threads/134294407