1

votes

Please hack my labs VAP Hypothyroidism and Cortisol. Doctor worried

Answered on October 22, 2014
Created July 26, 2013 at 12:40 AM

So a little background... Im a 26 year old guy, been paleo for 6 months I do eat dairy but outside of kefir its not very often. I go a bootcamp (HIIT, strength training, cardio etc) 3-5 times a week. I have had symptoms of hypothyroidism (cold hands and feet, low body temp) so I went and got a bunch of tests done. Also please look at Testosterone I was tested 11/11 and it was 440 and it is now 377 I have been incredibly stressed due to work these last few months. Should I be worried? Thank you

General Chemistry

Sodium    137      136-145mmol/L
Potassium 4.1      3.5-5.1
Chloride  100      95-111
CO2       28       21-32
Anion Gap 13       6-16
Glucose Plasma 94  70-100
BUN       19       <=18mg/dL
Creatinine 1.0     0.8-1.3
Calcium   9.2      8.5-10.1
Protein Total 7.1  6.0-8.7
Albumin   4.5      2.8-4.7
Globulin  2.6      2.4-4.4
Norm. Calcium 9.0  8.5-10.1
Bilirubin Total 0.6  <=1.0
Alkaline Phosphatase 94  <=138
AST       23       <=38
ALT       40       <=65

Cholesterol 284    <=200
Triglycerides 48   <=150
HDL Cholesterol 81 >=40
LDL 179            <=100
Chol/HDL Ratio 3.5  1.5-4.0
Non-HDL Cholesterol 203  <=130
Free T4 0.93       0.77-1.30
Free T3 3.10       1.80-4.20

Special Chemistry

Cortisol AM Level 15.7  5.0-25.0
Testosterone Total 377  160-726
Vitamin D 30.8          30.0-100.0

VAP TM Cholesterol Test 

Total LDL-Cholesterol 205  <=130
Total HDL-Cholesterol 80   >=40
Total VLDL-Cholesterol 18  <30
Sum Total Cholesterol 302  <200
Triglycerides-Direct 59    <150
TTL Non-HDL 222            <160
Total apoB100 133          <=109
Lp(a) Cholesterol 11.0     <10
IDL Cholesterol 14         <20
LDL-R(Real)-C 180          <100
Sum Total LDL-C 205        <130
Real-LDL Size Pattern  A

|___________________||_________||____*________|
Pattern B            Pattern A/B   Pattern A
Small, Dense LDL       A/B          Large Buoyant LDL

Remnant Lipo 24            <30
Risk                       NO
HDL-2(Large Buoyant) 25    >10
HDL-3(Small Dense) 55      >55
VLDL-3(Remnt Lipo) 10      <10

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on July 27, 2013
at 03:22 PM

Where is your TSH?

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 02:18 PM

No I don't wear sunscreen

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 12:29 PM

Also this test was taken at 7:15 am and I had fasted for 11 hours. I got around 7 hrs of sleep

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 12:12 PM

Thanks for the replies I don't eat soy or sugar. I do drink some wine on most nights but a few small glasses.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 26, 2013
at 12:02 PM

do you wear sunscreen when you work? Supplementation may benefit, but open exposure to sun and proper diet maybe all you need.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 26, 2013
at 12:01 PM

@paint94979, I am not an expert, but in my N=1, eliminating sugars and soy made mine jump. But I don't have hormonal deficiencies that might trigger low. I would talk with your doctor and do some research

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 26, 2013
at 11:59 AM

@Kevin, I was going under the assumption that the AM test was taken around 10 (when it normally is) if his test was at 7, then you are right. Re: Vitamin D, you are right for levels above 80, but there is (in my opinion) sufficient and diverse research that shows benefit of maintaining Vitamin D levels between 50 and 80 for healthy individuals. Re: cultures who spend all day in the sun. -- I am not talking about normal or minimal levels, I am talking optimal. So your argument is a strawman.

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 04:36 AM

thank you ill start supplementing Vitamin D

D396b126240f584bc358e6e4fd84e9e3

(455)

on July 26, 2013
at 04:10 AM

It's not that strange unless you work without a shirt on. Also, unlike with supplementation, the body tightly regulates vitamin D production from sun exposure.

D396b126240f584bc358e6e4fd84e9e3

(455)

on July 26, 2013
at 03:51 AM

CD - AM cortisol is not high for his age, it's actually low. In the AM it should be in the upper 25 percentile. Also, new studies are starting to seriously question the benefits of vitamin D above 40 ng/ml. In fact, at higher levels it can be immunosuppressive. Even in cultures where people spend all day in the sun don't have vitamin D levels much higher than 45 ng/ml.

543a65b3004bf5a51974fbdd60d666bb

(4493)

on July 26, 2013
at 03:29 AM

how's your sleep

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 03:07 AM

How can I increase my testosterone to 500?

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 02:35 AM

Thank you ill start doing that tomorrow

D396b126240f584bc358e6e4fd84e9e3

(455)

on July 26, 2013
at 02:28 AM

Yeah, that's certainly low. Do this for the next 3 days - Don't take your temperature right when you wake up. Instead, take it every 3 hours after you wake up for a total of 3 times. For example - if you wake up at 7 am, take your temperature at 10 am, 1 pm and 4 pm. Average the three temperatures and write down the average for each day. If your average temp doesn't vary much from day to day, you're probably dealing with thyroid issues. If it varies a lot (say 0.3 degress or higher), it's probably adrenal related. More info here: http://www.drrind.com/therapies/metabolic-temperature-graph

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 01:53 AM

My temp taken right when I wake up is 97.0-97.2

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5 Answers

1
D396b126240f584bc358e6e4fd84e9e3

on July 26, 2013
at 01:41 AM

I suspect the stress from work combined with possible over-training is starting to take a toll on your adrenals. This is evident from your AM cortisol level, which is low for a 26 year old male. The drop in testosterone is probably related. Stress, specifically cortisol, is known to lower testosterone levels. I would try to get your vitamin D level a little higher to 40 ng/ml or so. Preferably from daily sunshine if possible.

What is your average body temperature (taken orally)? Does it change from day to day or is it pretty consistent?

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 02:35 AM

Thank you ill start doing that tomorrow

D396b126240f584bc358e6e4fd84e9e3

(455)

on July 26, 2013
at 02:28 AM

Yeah, that's certainly low. Do this for the next 3 days - Don't take your temperature right when you wake up. Instead, take it every 3 hours after you wake up for a total of 3 times. For example - if you wake up at 7 am, take your temperature at 10 am, 1 pm and 4 pm. Average the three temperatures and write down the average for each day. If your average temp doesn't vary much from day to day, you're probably dealing with thyroid issues. If it varies a lot (say 0.3 degress or higher), it's probably adrenal related. More info here: http://www.drrind.com/therapies/metabolic-temperature-graph

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 01:53 AM

My temp taken right when I wake up is 97.0-97.2

0
D044c9916a3497d1272ca3b9e20b339f

on October 22, 2014
at 02:59 AM

Hello! I'd love to help from a naturopathic doctors perspective.

Your total cholesterol does look high, although the pattern type A is very good and your HDL is at a good level. Was this test done at 12 hours fasting?

Your triglycerides are too low. I shoot for >60mg/dL. ApoB is also too high, optimal is <80 mg/dL. If the low triglycerides is a continued trend, then you will want to investigate this as I see that it can be related to autoimmune disease suceptibility.

It's possible that some basic nutrient deficiencies are the culprit here. Genetics may also play a role. If you have any inflammatory disorders, this would also raise levels.

The change in testosterone may need a few more data points to see what is going on here, since blood testing is just a snap shot in time and hormone levels fluctuate throughout the day.

0
Af679502f1e31c0c59c79bd08f324b35

on July 27, 2013
at 07:39 AM

to the top ttt...

0
Af679502f1e31c0c59c79bd08f324b35

on July 26, 2013
at 04:02 AM

Its strange to me that my Vitamin D is low because I work construction and am outside in the sun a lot im assuming more most people.

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 04:36 AM

thank you ill start supplementing Vitamin D

D396b126240f584bc358e6e4fd84e9e3

(455)

on July 26, 2013
at 04:10 AM

It's not that strange unless you work without a shirt on. Also, unlike with supplementation, the body tightly regulates vitamin D production from sun exposure.

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 02:18 PM

No I don't wear sunscreen

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 26, 2013
at 12:02 PM

do you wear sunscreen when you work? Supplementation may benefit, but open exposure to sun and proper diet maybe all you need.

0
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 26, 2013
at 02:52 AM

I'm not a doctor, nor did I sleep in a holiday inn last night. But I like to hear myself speak (err type?) so you get my opinion for free...

Cholesterol is high, especially your LDL, might want to try to reduce some saturated fat and increase your dark green veggies. Although I don't understand why there are two cholesterol numbers... I get that one is VAP and the other is basic. but the total should be the same....

The one that really sticks out is your vitamin D. I think recommended optimal health minimum is 50. D is a really critical "vitamin".

AM Cortisol is higher than your might prefer, but not overly concerning.

Low testosterone is typically when you cross 320, so you are ok there. But getting that up closer to 500 might provide some benefit.

D396b126240f584bc358e6e4fd84e9e3

(455)

on July 26, 2013
at 03:51 AM

CD - AM cortisol is not high for his age, it's actually low. In the AM it should be in the upper 25 percentile. Also, new studies are starting to seriously question the benefits of vitamin D above 40 ng/ml. In fact, at higher levels it can be immunosuppressive. Even in cultures where people spend all day in the sun don't have vitamin D levels much higher than 45 ng/ml.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 26, 2013
at 11:59 AM

@Kevin, I was going under the assumption that the AM test was taken around 10 (when it normally is) if his test was at 7, then you are right. Re: Vitamin D, you are right for levels above 80, but there is (in my opinion) sufficient and diverse research that shows benefit of maintaining Vitamin D levels between 50 and 80 for healthy individuals. Re: cultures who spend all day in the sun. -- I am not talking about normal or minimal levels, I am talking optimal. So your argument is a strawman.

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 12:29 PM

Also this test was taken at 7:15 am and I had fasted for 11 hours. I got around 7 hrs of sleep

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 12:12 PM

Thanks for the replies I don't eat soy or sugar. I do drink some wine on most nights but a few small glasses.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 26, 2013
at 12:01 PM

@paint94979, I am not an expert, but in my N=1, eliminating sugars and soy made mine jump. But I don't have hormonal deficiencies that might trigger low. I would talk with your doctor and do some research

Af679502f1e31c0c59c79bd08f324b35

(559)

on July 26, 2013
at 03:07 AM

How can I increase my testosterone to 500?

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