26 yo. TRT & Hypothyroid. 6 week follow-up labs

[dpaul21]

I started TRTabout 6 weeks ago. I just had my first follow-up labs and am scheduled to see my endo again this week. I just wanted to post this here to get some feedback and hopefully some suggestions on what to go over with my doc. These are my labs from the past couple of years. I just started TRT on May 20, 2014.

Stats:
Age: 26
Height: 5'5"
Weight: 150 lbs
Diagnosis: Hypopituitarism, Hypothyroidism
Current Medications: Test C (100 mg/week), Armour (0.5 g/day)...no hCG or AI (yet)

[TD="bgcolor: #000000, align: center"]Date:[/TD]
[TD="bgcolor: #FF0000, align: center"]SHBG (10-50)[/TD]
[TD="bgcolor: #FF0000, align: center"]Test, Total (241-827 ng/dL)[/TD]
[TD="bgcolor: #FF0000, align: center"]Test, Free (9-30 ng/dL)[/TD]
[TD="bgcolor: #FF0000, align: center"]Estradiol(<39 PG/ML)[/TD]
[TD="bgcolor: #FF0000, align: center"][/TD]
[TD="bgcolor: #9900FF, align: center"]TSH (0.3-3.0 mIU/ML)[/TD]
[TD="bgcolor: #9900FF, align: center"]T4, Free (.7-2.0 ng/dL)[/TD]
[TD="bgcolor: #9900FF, align: center"]T3, Free (2.0-4.4 pg/mL)[/TD]
[TD="bgcolor: #FF0000, align: center"]FSH (1.6-8.0 mIU/ML)[/TD]
[TD="bgcolor: #FF0000, align: center"]LH (1.5-9.3 mIU/ML)[/TD]
[TD="bgcolor: #FF0000, align: center"]Cortisol, AM (4.0-22 mcg/dL)[/TD]
[TD="bgcolor: #FF0000, align: center"]Prolactin (2.0-18 ng/mL)[/TD]
[TD="bgcolor: #9900FF, align: center"]Thyroglobuilin Antibodies (<20 iu/mL)[/TD]
[TD="bgcolor: #9900FF, align: center"]Thyroid Peroxidase AB (<35 iu/mL)[/TD]
[TD="bgcolor: #9900FF, align: center"]Ferritin (20-345 NG/ML)[/TD]
[TD="bgcolor: #9900FF, align: center"]Iron, Total (45-175 mcg/dL)[/TD]

[TD="bgcolor: #000000, align: center"]8/9/2012[/TD]

[TD="align: center"]423[/TD]
[TD="align: center"]14[/TD]

[TD="align: center"]50[/TD]

[TD="bgcolor: #000000, align: center"]7/5/2013[/TD]

[TD="bgcolor: #FFFF00, align: center"]186 (L)[/TD]

[TD="bgcolor: #000000, align: center"]7/9/2013[/TD]

[TD="bgcolor: #FFFF00, align: center"]159 (L)[/TD]
[TD="bgcolor: #FFFF00, align: center"]5.1 (L)[/TD]

[TD="bgcolor: #000000, align: center"]11/26/2013[/TD]
[TD="align: center"]26[/TD]
[TD="align: center"]274[/TD]

[TD="bgcolor: #FFFF00, align: center"]<15 (L)[/TD]

[TD="align: center"]3.88[/TD]

[TD="bgcolor: #FFFF00, align: center"]<0.7 (L)[/TD]
[TD="bgcolor: #FFFF00, align: center"]0.4 (L)[/TD]

[TD="align: center"]6.4[/TD]

[TD="bgcolor: #000000, align: center"]1/7/2014[/TD]
[TD="align: center"]26[/TD]
[TD="align: center"]309 (1st), 264 (2nd)[/TD]

[TD="bgcolor: #FFFF00, align: center"]4.79 (H)[/TD]
[TD="align: center"]1[/TD]

[TD="bgcolor: #FFFF00, align: center"]0.7 (L)[/TD]
[TD="bgcolor: #FFFF00, align: center"]0.8 (L)[/TD]
[TD="bgcolor: #FFFF00, align: center"]25.4 (H)[/TD]

[TD="align: center"]<20[/TD]
[TD="align: center"]17[/TD]

[TD="bgcolor: #000000, align: center"]3/25/2014[/TD]
[TD="align: center"]20.1[/TD]
[TD="bgcolor: #FFFF00, align: center"]163 (L)[/TD]
[TD="bgcolor: #FFFF00, align: center"]3.3 (L)[/TD]

[TD="align: center"]2.08[/TD]
[TD="align: center"]1.13[/TD]
[TD="align: center"]2.6[/TD]
[TD="bgcolor: #FFFF00, align: center"]1.2 (L)[/TD]
[TD="bgcolor: #FFFF00, align: center"]1.2 (L)[/TD]

[TD="bgcolor: #000000, align: center"]4/8/2014[/TD]

[TD="bgcolor: #FFFF00, align: center"]23.5 (H)[/TD]
[TD="align: center"]7.3[/TD]

[TD="align: center"]34[/TD]
[TD="align: center"]91[/TD]

[TD="bgcolor: #000000, align: center"]5/9/2014[/TD]
[TD="align: center"]25[/TD]
[TD="bgcolor: #FFFF00, align: center"]176 (L)[/TD]

[TD="bgcolor: #FFFF00, align: center"]1.2 (L)[/TD]
[TD="align: center"]3.8[/TD]

[TD="bgcolor: #000000, align: center"]6/25/2014[/TD]
[TD="align: center"]19[/TD]
[TD="align: center"]721[/TD]

[TD="align: center"]1.84[/TD]
[TD="align: center"]0.8[/TD]
[TD="align: center"]2.9[/TD]
[TD="bgcolor: #FFFF00, align: center"]<0.7 (L)[/TD]
[TD="bgcolor: #FFFF00, align: center"]<0.2 (L)[/TD]
[TD="align: center"]17.1[/TD]

Like I said, I'm meeting with my endocrinologist this week, and I want to come prepared with questions to ask her.

Thanks,

Daryl

 

[Gene Devine]

You're missing a ton of labs to make any clinical evaluation.

This is what you need:

• Total Testosterone
• Bioavailable Testosterone
• Free Testosterone (if Bioavailable T is still unavailable)
• Estradiol (specify “sensitive” assay for males)
• CBC
• Comprehensive Metabolic Panel
• Lipid Profile
• PSA
• IGF-1, IGFBP-3

 

[HarryCat]

Have you felt any improvement in symptoms?

 

[dpaul21]

Yes, definitely and improvement in mood and well-being. Sexual interest is starting to come around again which is nice.

 

[Gene Devine]

You're missing a ton of labs to make any clinical evaluation.

This is what you need:

• Total Testosterone
• Bioavailable Testosterone
• Free Testosterone (if Bioavailable T is still unavailable)
• Estradiol (specify “sensitive” assay for males)
• CBC
• Comprehensive Metabolic Panel
• Lipid Profile
• PSA
• IGF-1, IGFBP-3

Forgot to add:

Hematocrit
SHBG

 

[HarryCat]

Given your SHBG and Total T levels your FreeT calculates out to be 21ng/dL and your Bioavailable T calculates as 493 ng/dL. These number come from here: http://www.issam.ch/freetesto.htm

That would put you in about the middle of the range for FreeT and above the range for bioavailable T according to here:http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/83686

So this makes me wonder how good the bioavailable calculation is.

But in any event since you are seeing and improvement in you symptoms you endo will probably not want to order additional tests at this point and will probably want to wait and see how you are doing in another 6 weeks. You will need to keep a look out for any signs of rising E2 levels.

Doctors are under pressure to keep costs down and unless you present with additional symptoms they won't order the tests. Of course you are free to order them online yourself and pay for them out of pocket.