Rate my bloodwork. What steps to improve?

[rayban]

Biochemical:

Fasting glycemia: 89 mg/100ml. Range: 70 - 115
Vitamin D (25-OH): 20.2 ng/ml. Range: 30-1 - 100
Vitamin D (1,25): 27 pg/ml. Range: 25 - 66 (in range but low)
Quantiative albumin: 4.2 g/100ml. Range: 3.80 - 5.10

Hormones:

IGF-1: 149 ng/ml. Range: 100.00 - 591.00
Estradiol (E2): 39 pgr/ml. Range in men: < 55
FSH: 2.36 mUI/ml. Range in men: 1 - 12
LH: 3.2 mUI/ml. Range in men: 1 - 7
Prolactin: 40.1 ngr/ml. Range: 2.50 - 16
Progesterone: <0.2 ng/ml. Range in men: 0.1 - 0.6
Total Tetosterone: 4.9 ng/ml. Range in men: 1.60 - 8.50
Free Testosterone: 11.2 pg/ml. Range: 6.60 - 42.50
DHT: 0.27. Range: 0.25 - 0.99
Dehidropiandrosterone: 13.9 ng/ml. Range: 1.40 - 13.50
Delta 4-Androstendione: 5.16 ng/ml. Range: 0.4 - 3.7
SHBG: 28.7 nmol/L. Range: 10.00 - 57.00
ACTH: 68.3 pgr/ml. Range: 7.00 - 63
Fasting cortisol (morning): 301.4 ng/ml. Range: 70.00 - 250
G.H: 1.97 mcg/l. Range: 0.00 - 5.00
Fasting insulin: 5.4 mcUI/ml. Range: 6 - 25

Fractionated Catecholamines:

Adrenalin: 49 pgr/ml. Range: 20 - 85
Noradrenalin: 434 pgr/ml. Range 0 - 420
Dopamin: 25 pgr/ml. Range 10 - 94
3α-Androstanediol glucuronide 7.1 ng/ml. Range: 3.50 - 22
IGFBP-3: (Insuling growing factor binding): 3.35 mcg/ml. Range: 0.9 - 4.7

Thyroids section:

PTH-i: 50.2 pgr/ml. Range: 18.5 - 88
Thyroglobulin: <1 ng/ml. Range: 1.9 - 59.9
Total T3: 1.02 ng/ml. Range: 0.65 - 1.6
Free T3: 6.1 pmol/L. Range 4 - 8.30
Reverse T3: 0.15 ng/ml. Range: 0.10 - 0.35
Total T4: 6.6 mcg/100ml. Range: 4.70 - 9.70
Free T4: 10.2 pg/ml. Range: 9 - 19.50
TSH: 4.17. mcUI/ml. Range: 0.25 - 5

Inmunology:

Antibodies anti-receptor of TSH (TSI): 0.82 mUI/ml. Range: 0.00 - 1.75
Antimicrosomal Antibody (TPO): 75.6 UI/ml. 0 - 12 UI/ml
Antibodies anti-thyroglobulin (TGL): 88.5 UI/ml. Range: 0 - 18

This lab is from a year ago since covid happened I haven't gone to get another bloodwork. I have been on Euthyrox 75mcg for years. Should I raise the dose to 100mg and test again? TSH is at 4 ish and should be at 1-1.5 from what i've read. FT3 and FT4 should both be higher too. In theory if I raise the dosage, TSH should go low and both FT3 and FT4 should go up. If im not mistaken I don't see convertion problems so I shouldn't need T3 or NDT?

Not sure about the antibodies. The doctors don't even research the root cause of the autoinmunity. Since I got my first bloodwork back in 2009 I was 9 ish TSH, and I remember I got antibodies checked at random times and it fluctuated.

The vitamin D seems on the low end so I have been taking an EVOO based supplement of 200 UI which is the daily recommended dose. And i've got another bottle of this same supplement but includes K2 mk7 at 75 μg per dose. I take a dose of this like a once a week, since I've heard vitamin K deficiencies are so rare. I haven't seen a way to test vitamin K levels tho.

Cortisol was high, but I've been told this is inconclusive because cortisol fluctuates a lot throught the day, and I may have been nervous, or maybe it's chronically high so I should get I guess a saliva test to see a curve?

Prolacting was high too.

Not sure about the rest.

Im 5'9'' 60kg, I don't have strenght problems, im decently fit considering the only sport I do is walk on my threadmill for an hour. Typical hypothyroid sides like low tolerance to cold, some brainfog, and I feel better at night because during the first hours of the day I feel so sluggish.

For reference, this is another hormonal panel I took back in 2013:

3α-Androstanediol glucuronide: 5.8 ng/ml. Range for men: 3.4 - 22.0 ng/mL
TSH: 5.82 mcgUI/mL. Range for adults: 0.25 - 4.5 mcgUI/mL
Prolactine: 6.30 ng/mL. Range for men: 2.6 - 18.1 ng/mL
LH: 1.70 mUI/mL. Range for men: 1.80 - 8.20 mUI/mL
Estradiol (E2): 24.0 pg/mL. Range for men: 11 - 44 pg/mL
Progesterone: 0.64 ng/mL. Range for men: < 0.2
Total Testosterone: 3.70 ng/mL. Range for men less than 50yo: 1.56 - 8.77 ng/mL
Free Testosterone: 20 pg/mL. Range for men between 8.9 - 42.5 pg/mL
Vitamin D (1,25): 35.3 pg/mL. Range: 18 - 78 pg/mL
Vitamin (25-OH): 8.00 ng/mL. Range: 30-100 ng/mL
Delta-4 Androstendione: 2.60 ng/mL. Range: 0.5 - 3.00 ng/mL
PTH-i: 25.0 pg/mL. Range: 11 - 67 pg/mL
DHT: 1.42 ng/mL. Range: 0.25 - 1.00 ng/mL

It's hard to judge because hormones fluctuate a lot at the end of the day. However I could get one of these detailed bloodworks monthly if needed, but since I don't have gameplan to take action, I haven't bothered to do a follow up. Specially since if I go to a doctor, they don't pay much attention to bloodworks, specially how they don't even treat the autoinmunity. I would like to know if someone has managed to lower thyroid antibodies successfully as well as other ideas to try. Given the lack of input from the doctor im asking here. If someone knows an expert in this field I may try at least an online consultation, but im always skeptical thinking im getting scammed.

 

[youngsinatra]

Increasing vitamin D to 50ng/ml will improve a lot of things, just by doing that. Search for a good calculator to know the initial dosage needed for raising your vitamin D. At normal physiological doses like 4000-5000 IU, it might require 3-6 months to remedy a deficiency and I think a vitamin D deficiency should be remedied as fast as possible. (14-30 days preferably)
When doing that you should watch out for K2 too.

300mg of vitamin E has been shown to powerfully lower prolactin. (-70% If I remember correctly)

Magnesium can lower the stress hormones.(cortisol/adrenaline/ACTH)

Also eat enough calories and eat often enough.