Blood Test Interpretation Resources. Don't Know What Your Labs Mean Or Need Extra Insight?

[Ihor]

I'd suggest checking LH, FSH, testosterone, estradiol, DHT, estrone-S, prolactin, cortisol, DHEA and calculated free T for a complete idea of your androgens and what's happening to what. It's quite a lot, but it's comprehensive.
You can also check cholesterol and CRP to see if it's thyroid and/or inflammation related. Getting a complete thyroid panel will tell you more about your actual thyroid hormone levels ofc, but cholesterol is a simple measure to see if T3 is sufficient or not.

Thank you, I will be have almost all these labs, but what about SHBG and how calculate free T right?

 

[Hans]

Thank you, I will be have almost all these labs, but what about SHBG and how calculate free T right?

Most tests just estimate fT, so getting a specific one to measure it will give you a better idea. Also, measuring SHBG can be helpful.

 

[Aries]

Most tests just estimate fT, so getting a specific one to measure it will give you a better idea. Also, measuring SHBG can be helpful.

AFAIK testosterone in blood is found either free or tightly bound to SHBG or weakly bound to less specific proteins like albumin. Out of these the SHBG is the only one thought to bind so tightly to T that it affects its metabolism.

So how could the estimation for free testosterone be inaccurate if all the variables are known (TT, SHBG, maybe albumin)? Whenever SHBG is high, free T is low and vice versa.

Am I missing something?

 

[Hans]

AFAIK testosterone in blood is found either free or tightly bound to SHBG or weakly bound to less specific proteins like albumin. Out of these the SHBG is the only one thought to bind so tightly to T that it affects its metabolism.

So how could the estimation for free testosterone be inaccurate if all the variables are known (TT, SHBG, maybe albumin)? Whenever SHBG is high, free T is low and vice versa.

Am I missing something?

From this study:
"FAI was less preferred because it was a unitless number and did not relate to the physiological reality of free T. Furthermore, it can be altered by changes in either T or SHBG and may be misleading. We agree. If both total T and SHBG need to be measured to derive the FAI, why not calculate free and bioavailable T levels? Also, although the FAI index correlated well with free T by equilibrium dialysis in women, it did not do so in previous studies in men."

In a nutshell, measuring it is just more accurate.

 

[Aries]

From this study:
"FAI was less preferred because it was a unitless number and did not relate to the physiological reality of free T. Furthermore, it can be altered by changes in either T or SHBG and may be misleading. We agree. If both total T and SHBG need to be measured to derive the FAI, why not calculate free and bioavailable T levels? Also, although the FAI index correlated well with free T by equilibrium dialysis in women, it did not do so in previous studies in men."

In a nutshell, measuring it is just more accurate.

I think one important point to take away from the review are the different assays for measuring free T. The commonly available immunological assays for measuring small quantities of steroids like estradiol in men or free T are far too inaccurate.

”Using the free T by equilibrium dialysis as a gold standard, previous studies have evaluated the accuracy of other free and bioavailable T assays in men and to a limited extent in women (10–13). In men, calculated free T levels (derived from total T, SHBG, and albumin measurements or assuming a constant albumin concentration) were found to be nearly identical with values measured by equilibrium dialysis. In pregnancy, calculated free T levels were lower than values measured by equilibrium dialysis. Therefore, calculated free T levels are thought to provide accurate estimates of free T in men.”

”In the study by Miller et al. (3), FAI was less preferred because it was a unitless number and did not relate to the physiological reality of free T. Furthermore, it can be altered by changes in either T or SHBG and may be misleading. We agree. If both total T and SHBG need to be measured to derive the FAI, why not calculate free and bioavailable T levels? Also, although the FAI index correlated well with free T by equilibrium dialysis in women, it did not do so in previous studies in men (3, 10, 12). The study by Miller et al. (3) in women and other studies in men do not support the use of direct free T RIA measurements. We strongly agree”

Unfortunately, I don't think equilibrium dialysis is usually available for commercial use. If it is and you can afford it, it can be useful. However, free T assays like RIA are less accurate than cFT so I would not use them.

 

[Ihor]

@Hans Hi, I got results:

Indication	Result	Units	Norms
Progesterone	0.85	ng/ml	male: 0,23 - 1,50
Estradiol (Е2)	77.03	pg/ml	male: < 87,0
Testosterone	4.83	ng/ml	2,2 - 10,5
Testosterone free	27.16	pg/ml	male: 15,0 - 50,0
DHEA-S	146.8	μg/dL	male: 21-30 y.: 85,0 - 690,0
Prolactin	7.36	ng/ml	male: 2.5 - 16.0
Aldosterone	110.9	pg/ml	70 - 300
Potassium	3.5	mmol/l	3.5 - 5.5
Sodium	145.6	mmol/l	135 - 148
TSH	1,01	μMO/mL	0,3 - 4,5
FT4	1,39	ng/dL	0,89 - 1,72
FT3	3,75	pg/mL	2,0 - 4,2
Cortisol (morning serum)	213.56	ng/mL	57,2 - 194,2 (8:00 - 10:00am)
Ceruloplasmin	22	μg/dL	22 - 61
Cholesterol total	6,55	μmol/L	<5,0
Ferritin	63,4	ng/mL	25,0 - 350,0
Calcium	2.29	mmol/l	2.15 - 2.57
PTH	27.36	pg/ml	15.0 - 65.0
Insulin	7.2	μIU/ml	4.03 - 23.46
Hemoglobin	180	g/dL	male: 138 - 172

Two mounth ago test of cortisol was low, and now after taking hydrocortisone for a month and a half for help my adrenal it increased and even a little high, which I think is good at the moment, contrary to popular belief. Other, but not all readings seem to be normal too, but look at free testosterone and estradiol, the reference values here are the ones that the lab refers to seems not so correct, in other internet sources that I found estradiol and free testosterone for my age (I'm 27 y.o.) are normal:

Estradiol (E2): 10-40 pg/mL.
Testosterone free: 47-293 pg/mL.

It seems my freeT is low and E2 is high? What do you think about all that?

 

[Hans]

@Hans Hi, I got results:

Indication	Result	Units	Norms
Progesterone	0.85	ng/ml	male: 0,23 - 1,50
Estradiol (Е2)	77.03	pg/ml	male: < 87,0
Testosterone	4.83	ng/ml	2,2 - 10,5
Testosterone free	27.16	pg/ml	male: 15,0 - 50,0
DHEA-S	146.8	μg/dL	male: 21-30 y.: 85,0 - 690,0
Prolactin	7.36	ng/ml	male: 2.5 - 16.0
Aldosterone	110.9	pg/ml	70 - 300
Potassium	3.5	mmol/l	3.5 - 5.5
Sodium	145.6	mmol/l	135 - 148
TSH	1,01	μMO/mL	0,3 - 4,5
FT4	1,39	ng/dL	0,89 - 1,72
FT3	3,75	pg/mL	2,0 - 4,2
Cortisol (morning serum)	213.56	ng/mL	57,2 - 194,2 (8:00 - 10:00am)
Ceruloplasmin	22	μg/dL	22 - 61
Cholesterol total	6,55	μmol/L	<5,0
Ferritin	63,4	ng/mL	25,0 - 350,0
Calcium	2.29	mmol/l	2.15 - 2.57
PTH	27.36	pg/ml	15.0 - 65.0
Insulin	7.2	μIU/ml	4.03 - 23.46
Hemoglobin	180	g/dL	male: 138 - 172

Two mounth ago test of cortisol was low, and now after taking hydrocortisone for a month and a half for help my adrenal it increased and even a little high, which I think is good at the moment, contrary to popular belief. Other, but not all readings seem to be normal too, but look at free testosterone and estradiol, the reference values here are the ones that the lab refers to seems not so correct, in other internet sources that I found estradiol and free testosterone for my age (I'm 27 y.o.) are normal:

Estradiol (E2): 10-40 pg/mL.
Testosterone free: 47-293 pg/mL.

It seems my freeT is low and E2 is high? What do you think about all that?

Free T is low (but that could be because your total T is not very high) and E high. Have you ever used an AI?
Prolactin isn't high, so that's interesting.
Ceruloplasmin is on the low end. Ferritin is good, but I wonder what your other iron markers are.
I think adding in some liver is a good idea to get ceruloplasmin up.
Have you been using thyroid? Your cholesterol is high, which could indicate low thyroid activity (insufficient T3 or elevated rT3 and/or low copper).
DHEA is low, which just indicates that ACTH is most likely low due to the use of hydrocortisone. How much are you using btw?

 

[Ihor]

Free T is low (but that could be because your total T is not very high) and E high. Have you ever used an AI?
Prolactin isn't high, so that's interesting.
Ceruloplasmin is on the low end. Ferritin is good, but I wonder what your other iron markers are.
I think adding in some liver is a good idea to get ceruloplasmin up.
Have you been using thyroid? Your cholesterol is high, which could indicate low thyroid activity (insufficient T3 or elevated rT3 and/or low copper).
DHEA is low, which just indicates that ACTH is most likely low due to the use of hydrocortisone. How much are you using btw?

Maybe estradiol suppresses LH a little, and also stimulates SHBG that binds free testosterone? Is it worth it then to do a test for SHBG, albumin? Yes, according to other sources, DHEA is also low, a few weeks before the test, I sometimes took 10 mg of DHEA per day, it is unlikely that this can aromatize against the background of a peat diet, besides, I have always been thin with a low fat content. I have never taken selective inhibitors like Letrozole, only rarely a little aspirin and vitamin E, do you think it's worth it?

I have been struggling with low ceruloplasmin for the third year, when I first recorded it, some time before that I took zinc, it may have lowered copper, but since then I have taken 4 cans of copper supplements, often ate liver and it was like 20-22 mcg / dl remained, possibly low cortisol was the culprit all this time.

I think my cholesterol is high through low copper, I took T3, NDT - didn't help.
I used 10-15 mg hydrocortisone / day, before 2 months ago my morning salivary cortisol was 0.068 mcg (ref: 0.400 - 0.736 mcg) which seems very low, but such a comparison of the values of different cortisol fractions is probably not entirely correct.

I have only old iron markers:

2018-09-05

Iron	22.79	μmol/l	ref: 11.6-31.3
Transferrin	258.06	mg/dl	ref: 170-340
Ferritin	134.49	ng/ml	ref: 25.0-350.0

2019-10-23

Iron	11,7	μmol/l	ref: 11.6-31.3
Transferrin	258,49	mg/dl	ref: 170-340
Ferritin	44.99	ng/ml	ref: 25.0-350.0
Transferrin saturation	15-50	18.0%	ref: 15-50

 

[Hans]

Maybe estradiol suppresses LH a little, and also stimulates SHBG that binds free testosterone? Is it worth it then to do a test for SHBG, albumin? Yes, according to other sources, DHEA is also low, a few weeks before the test, I sometimes took 10 mg of DHEA per day, it is unlikely that this can aromatize against the background of a peat diet, besides, I have always been thin with a low fat content. I have never taken selective inhibitors like Letrozole, only rarely a little aspirin and vitamin E, do you think it's worth it?

I have been struggling with low ceruloplasmin for the third year, when I first recorded it, some time before that I took zinc, it may have lowered copper, but since then I have taken 4 cans of copper supplements, often ate liver and it was like 20-22 mcg / dl remained, possibly low cortisol was the culprit all this time.

I think my cholesterol is high through low copper, I took T3, NDT - didn't help.
I used 10-15 mg hydrocortisone / day, before 2 months ago my morning salivary cortisol was 0.068 mcg (ref: 0.400 - 0.736 mcg) which seems very low, but such a comparison of the values of different cortisol fractions is probably not entirely correct.

I have only old iron markers:

2018-09-05

Iron	22.79	μmol/l	ref: 11.6-31.3
Transferrin	258.06	mg/dl	ref: 170-340
Ferritin	134.49	ng/ml	ref: 25.0-350.0

2019-10-23

Iron	11,7	μmol/l	ref: 11.6-31.3
Transferrin	258,49	mg/dl	ref: 170-340
Ferritin	44.99	ng/ml	ref: 25.0-350.0
Transferrin saturation	15-50	18.0%	ref: 15-50

It's quite possible that estrogen is suppressing LH, but your progesterone seems relatively fine. Have you done an LH test? For where your T levels are at, your estrogen is really high. Usually, if T is on the low side, E would be as well, unless there is inflammation going on. Which could also explain the high cholesterol. Have you done a CRP test? Do you perhaps have digestive issues and struggle to absorb certain nutrients, such as copper? Have you done a specific copper test, just in case copper has actually increased, but ceruloplasmin has not? Salivary cortisol is only the free fraction, which could show that your cortisol binding protein is high, possibly due to the estrogen (R).
Transferrin saturation is low, but that's because ceruloplasmin is low as well.
How do you respond to vitamin E, aspirin or other fat-soluble vitamins and aromatase inhibiting compounds?

 

[Ihor]

No, I didn't have LH and CRP test, I had copper for three years in a row together with ceruloplasmin, but it was always normal and never increased from dietary copper, so it is quite possible that I have intestinal and general inflammation? bad absorption, but cleansing the intestines using methods Peat didn’t help me, I’ll probably take another test for CRP albumin and SHBG. I assume that I also have copper-iron imbalance/overload, which is one of the stimulants of tissue inflammation.
Thank you very much for the research, probably at the moment estrogen really stimulates many harmful processes in me, it is interesting that, based on this study, estradiol actually stimulates cortisol-binding globulin (CBG), which binds cortisol, cortisone, progesterone and makes them inactive, this could explain that firstly, my free salivary cortisol is low, and the total serum cortisol is at a decent level, and the fact that when I take hydrocortisone, it does not work on me, estrogen also stimulates SHBG by lowering free testosterone, possibly making me immune to thyroid supplements, affects the level of copper and iron.
I used to take small doses for a while, vitamin E 400 aspirin 250 mg, maybe a couple of days a week. I don't react well to retinol and I had a history of taking it from supplements that brought me the symptoms of vitamin A toxicity known here, and vitamin D is not giving me any improvement.
I think I need to experiment to lower estradiol, are there any suggestions for the dosage of vitamin E, aspirin and other things?

 

[Hans]

No, I didn't have LH and CRP test, I had copper for three years in a row together with ceruloplasmin, but it was always normal and never increased from dietary copper, so it is quite possible that I have intestinal and general inflammation? bad absorption, but cleansing the intestines using methods Peat didn’t help me, I’ll probably take another test for CRP albumin and SHBG. I assume that I also have copper-iron imbalance/overload, which is one of the stimulants of tissue inflammation.
Thank you very much for the research, probably at the moment estrogen really stimulates many harmful processes in me, it is interesting that, based on this study, estradiol actually stimulates cortisol-binding globulin (CBG), which binds cortisol, cortisone, progesterone and makes them inactive, this could explain that firstly, my free salivary cortisol is low, and the total serum cortisol is at a decent level, and the fact that when I take hydrocortisone, it does not work on me, estrogen also stimulates SHBG by lowering free testosterone, possibly making me immune to thyroid supplements, affects the level of copper and iron.
I used to take small doses for a while, vitamin E 400 aspirin 250 mg, maybe a couple of days a week. I don't react well to retinol and I had a history of taking it from supplements that brought me the symptoms of vitamin A toxicity known here, and vitamin D is not giving me any improvement.
I think I need to experiment to lower estradiol, are there any suggestions for the dosage of vitamin E, aspirin and other things?

Estrogen also promotes iron retention, and then too much tissue iron can cause inflammation, which promotes aromatase. So it does seem that estrogen is playing a big role here.
For aspirin, around 1-2g daily is a good dose, vitamin E at 400IU. Perhaps you can also look into other aromatase inhibitors, such as androsterone, Bulbine natalensis, etc. Here is a list of supplements that can inhibit the aromatase: Inhibit Aromatase: 31 Potent Supplements » MENELITE

 

[valdz]

5000IU isn't even a lot. You can easily use 10000IU daily just to get levels back to normal and then reduce the dose again. The reason I mentioned magnesium is because vitamin D supplementation increases magnesium requirements, so vitamin D supplements can give people negative symptoms due to low magnesium.
Elevated cholesterol is most often caused by low thyroid hormones, but excess iron and low copper can also lead to elevated cholesterol and trigs.

So I got some thyroid labs today and seems like the NDT from Lifegivingstore helped lower my TSH. Started taking it beginning of Feb. It also increased fT3 a little bit.. Today my endocrinologist diagnosed me with Hashimoto's bc of my high Thyroid Peroxidase AB whereas my pcp thinks that my level is normal. Still waiting on my Vit D result to show. Thanks for recommending that NDT. I just don't know how I can lower my thyroid antibody.

Thyroglobulin AB

<1 IU/mL

T4, Free

1.2 ng/dL

T3, Free

3.8 pg/mL

TSH, Highly Sensitive

0.65 mIU/L

Thyroid Peroxidase Antibody

18 IU/mL

 

[Hans]

So I got some thyroid labs today and seems like the NDT from Lifegivingstore helped lower my TSH. Started taking it beginning of Feb. It also increased fT3 a little bit.. Today my endocrinologist diagnosed me with Hashimoto's bc of my high Thyroid Peroxidase AB whereas my pcp thinks that my level is normal. Still waiting on my Vit D result to show. Thanks for recommending that NDT. I just don't know how I can lower my thyroid antibody.

Thyroglobulin AB

<1 IU/mL

T4, Free

1.2 ng/dL

T3, Free

3.8 pg/mL

TSH, Highly Sensitive

0.65 mIU/L

Thyroid Peroxidase Antibody

18 IU/mL

Hashimotos are usually liked to the gut and that can be caused by gut irritating foods, poor digestion, slow transit time, SIBO, nutrient deficiencies, etc. However, a few people told me that they started to feel worse on NDT and their antibodies went up, but when they switched to T4/T3 (such as TyroMix), the antibodies dropped and their thyroid hormones increased.

 

[valdz]

Hashimotos are usually liked to the gut and that can be caused by gut irritating foods, poor digestion, slow transit time, SIBO, nutrient deficiencies, etc. However, a few people told me that they started to feel worse on NDT and their antibodies went up, but when they switched to T4/T3 (such as TyroMix), the antibodies dropped and their thyroid hormones increased.

Thanks for the reply.... I don't have slow transit time. I have good BM (2-3x/day).. My TPO AB has been stable this year. It was 19 in Jan and now 18. In 2019, it was actually high at 31!.. Maybe I'll have to give TyroMix a shot. I also have thyroid nodules and cysts. So I'll have to look into something in reducing one of the cysts. I think I have these nodules and cysts due to having lots of amalgam fillings. One of them was actually pretty bad. But I had all of it taken out end of last year. Glad I did...

 

[Hans]

Thanks for the reply.... I don't have slow transit time. I have good BM (2-3x/day).. My TPO AB has been stable this year. It was 19 in Jan and now 18. In 2019, it was actually high at 31!.. Maybe I'll have to give TyroMix a shot. I also have thyroid nodules and cysts. So I'll have to look into something in reducing one of the cysts. I think I have these nodules and cysts due to having lots of amalgam fillings. One of them was actually pretty bad. But I had all of it taken out end of last year. Glad I did...

Yeah I was thinking of heavy metals too. Iron, copper, mercury, zinc, etc. Perhaps you can check a bunch of them to see if some are in excess and some too low.

 

[FitnessMike]

this is extremely helpful, #Banger

 

[valdz]

Yeah I was thinking of heavy metals too. Iron, copper, mercury, zinc, etc. Perhaps you can check a bunch of them to see if some are in excess and some too low.

I think testing for heavy metals is pretty expensive for me. But once I run out of NDT I'll try Tyromix and this would be best applied topically, correct? I really thought the NDT would not work for me b/c I only use their little scooper and combine it with their B1 powder into a gelatin capsule but I guess I was wrong. Lol. My pcp is going to wonder why my TSH went drastically low in about 2 mos. Oh btw, I just got my result for Vit D level (25OHD) and it's now 45 (from 12 in Jan).. I really appreciate your helpful advice!

 

[Hans]

I think testing for heavy metals is pretty expensive for me. But once I run out of NDT I'll try Tyromix and this would be best applied topically, correct? I really thought the NDT would not work for me b/c I only use their little scooper and combine it with their B1 powder into a gelatin capsule but I guess I was wrong. Lol. My pcp is going to wonder why my TSH went drastically low in about 2 mos. Oh btw, I just got my result for Vit D level (25OHD) and it's now 45 (from 12 in Jan).. I really appreciate your helpful advice!

It's my pleasure man!
You'll have to experiment with how you take the TyroMix, but I like sublingual before bed, but the half-life is probably shorter this way. Oral and topical is also good, but I still like sublingual best.

this is extremely helpful, #Banger

Glad you found it helpful!

 

[Gipzy2u]

Good idea. What do you think @charlie?

Where can I find information about how to rid high calcium in arteries plz

 

[Blossom]

Where can I find information about how to rid high calcium in arteries plz

Have you had a CAC test?
I’d recommend starting a new thread specifically on the topic. Sorry but I’ve not dealt with this personally nor have researched it much. The only person I know who talks about it in depth is a low carb proponent. I’ve read vitamin K may helpful but wouldn’t know the dosage etc. Best wishes!