# 5 months post surgery, labs results.



## miguel (Jul 18, 2011)

Lately I'm feeling much better.

-Calcium (not calcium and calcitriol before the test)

-2 oscal 500 mg per day
8.45 mg/dl (8.3 - 10.6) [06-26-11]
8.54 mg/dl [06-29-11]
8.35 mg/dl [07-26-11]
7.95 mg/dl [08-25-11]
4.4 mg/dl (4.6 - 5.3) [09-08-10]
-Calcitriol 0.25 mcg (2 per day) + 2 oscal 500 mg per day
8.60 mg/dl (8.3 - 10.6)[09-26-11]
-Calcitriol 0.25 mcg (2 per day) + 3 citracal 315 mg per day
9.17 mg/dl (8.5 - 10.5)[11-13-11]

-Phosphorus

3.95 mg/dl (2.4 - 5.1) [06-29-11]
4.13 mg/dl [10-11-13]

-CBC

[10-31-11]Your lab results are normal.
LEUKOCYTES 7.07 (4.8-11.5) 10 3/ul
neutrophils 42.4* (45-75) %
lymphocytes 50.9* (23-45) %
monocytes 4.2 (1-9) %
eosinophils 1.4 (0-4) %
basophils 1.4* (0-1) %
ERYTHROCYTES 6.3* (4.7-6.1) 10 6/ul
HEMOGLOBIN 17.3 (14-18.1) g/dl
HEMATOCRIT 52.1* (42-52) %
MCV 82.7 (80-94) fL
MCH 27.5 (27-31) pg
MCHC 33.2 (32.9-37) g/dl
RDW 14.7 (11.6-14.8) %
platelets 221 (140-450) 10 3/ul

-Hormonal

[10-19-11]
(75 mcg of levothyroxine)
T3 Uptake 32.27 (22.5-37) %
T4 Total 9.40 (4.5-10.9) ug/dl
T4 Free 1.42 (0.89-1.76) ng/dlYour lab results are normal.
TSH 0.13 (0.35-5.5) uUI/ml

[11-09-11] (Quest Diagnostics range)
LH 2.17 (1.24-8.62) mUI/ml
FSH 3.48 (1.27-19.26) mUL/ml
Total T 358 (175-781) ng/dl

My endo says I'm not under T, but I have 21 and I have some symptoms of hypogonadism considering that I have an atrophic testis. You believe that TRT is right for me? Someone had a similar experience?

I am now taking

62.5 mcg Eutirox
Generic Calcitriol 0.25 mcg (2 per day)
Citracal 315 mg (3 per day)

Thanks


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## I DClaire (Jul 31, 2011)

I don't know enough about test results to comment but it's certainly good to hear you are feeling better. You've really been through a lot.


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## miguel (Jul 18, 2011)

This Friday I had a blood test that showed a possible relapse to hyper, I stop taking my medication because I feel a bit hyper. I'm seriously considering having the RAI because I want to avoid a relapse. I think partial thyroidectomy was a waste of time.

[10/19/11] 75mcg levothyroxine
T3 uptake 32.27 (22.5 a 37)%
T4 Total 9.40 (4.5 a 10.9) ug / dl
T4 free 1.42 (0.89 a 1.76) ng / dl
TSH 0.13 (0.35 a 5.5) IUU / ml

[12/02/11] 62.5mcg levothyroxine
T3 uptake 34.63 (22.5 a 37)%
T4 Total 11.20 (4.5 a 10.9) ug / dl
T4 free 1,54 (0.89 a 1.76) ng / dl
TSH 0.18 (0.35 a 5.5) IUU / ml

Now I'm feeling great! but I think I am going to hyperexplode. 
This was my first lab:

T3 uptake 2.30 (0.66 - 1.27) U
T4 Total >30.0 (4.5 a 10.9) ug / dl
T4 free >12.0 (0.89 a 1.76) ng / dl
TSH 0.00 (0.35 a 5.5) IUU / ml

Thanks all


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## Andros (Aug 26, 2009)

miguel said:


> Lately I'm feeling much better.
> 
> -Calcium (not calcium and calcitriol before the test)
> 
> ...


It is so good to hear from you! Has your doc commented on high erythrocytes and this stuff below?
http://labtestsonline.org/understanding/analytes/differential/tab/test


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## peacesells560 (Aug 9, 2011)

As far as your Testosterone levels go, I would say you would benefit from an increase. There's a survey online somewhere that shows that the 5th percentile for someone in your age group {mine as well, I'm 22, and I have Testosterone issues as well, mine was 293 the last time it was checked. I'm going to get new results with FSH on the 14th} is 403 or thereabouts. As far as what's causing it, I would say that it's probably a pituitary issue and not a testicular issue, so you my be able to get natural production restarted with Clomid or HCG.


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## Andros (Aug 26, 2009)

miguel said:


> This Friday I had a blood test that showed a possible relapse to hyper, I stop taking my medication because I feel a bit hyper. I'm seriously considering having the RAI because I want to avoid a relapse. I think partial thyroidectomy was a waste of time.
> 
> [10/19/11] 75mcg levothyroxine
> T3 uptake 32.27 (22.5 a 37)%
> ...


According to your most recent labs you are tilting towards hyper again. I agree about the partial and let us know what you decide about the RAI and when you might do this.


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## miguel (Jul 18, 2011)

Andros said:


> It is so good to hear from you! Has your doc commented on high erythrocytes and this stuff below?
> http://labtestsonline.org/understanding/analytes/differential/tab/test


 My endo says that erythrocytes are normal, when I was hyper had mild anemia.



peacesells560 said:


> As far as your Testosterone levels go, I would say you would benefit from an increase. There's a survey online somewhere that shows that the 5th percentile for someone in your age group {mine as well, I'm 22, and I have Testosterone issues as well, mine was 293 the last time it was checked. I'm going to get new results with FSH on the 14th} is 403 or thereabouts. As far as what's causing it, I would say that it's probably a pituitary issue and not a testicular issue, so you my be able to get natural production restarted with Clomid or HCG.


Are you on TRT at this time? Your doc prescribe you clomid or HCG? I will visit a urologist next week, I do not like self-medication.



Andros said:


> According to your most recent labs you are tilting towards hyper again. I agree about the partial and let us know what you decide about the RAI and when you might do this.


My endo said no RAI, the remaining thyroid gland is too small said that most likely is that the antibodies destroy the gland, I think the surgeon did this to protect the parathyroid. My doc told me to stop taking calcitriol and levothyroxine, only I take 630mg of calcium per day. Thyroid labs in 1 1 / 2 months and calcium labs in 15 days.

Thanks all.


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## bigfoot (May 13, 2011)

Glad to hear you are feeling better! As far as testosterone goes, I'm 32 and my Total T was something in the neighborhood of the low 200s last year. Adding in some Androgel (5gm packets x 1 daily) was a huge positive change. Felt sooo much better overall. Eventually my Total T got up to around 550, before starting to drop again. Then another doc raised it up to 7.5gm of Androgel, which gave me a good boost in energy and libido, but seemed to cause some irritability. At that point my Total T was nearing 800, and could have been higher when I noticed the irritability (no way to know, they didn't re-test Testosterone levels before dropping me back down to 5gm Androgel).

There seems to be a lot of disagreement between docs on what Total T range folks should be in. Some see that you're within the range and figure you're fine. Others strive for optimizing what works best for you. My limited understanding is that the average male has about 700 ng/dL of testosterone, with a range between 300-1200 depending on which lab and doctor you are seeing. Certainly striving for something in the area of 500 would probably be a pretty noticeable improvement for you.

It is VERY hard to find a doc that understands hormones. Another angle is you don't want to be having excess Estrogen/Estradiol shunting away the external Testosterone you are applying (aromatase). Most docs are not looking at this area very closely while treating you with TRT (mine included). Just something to be aware of.

Best thing would be to figure out WHY you aren't producing the necessary T before undergoing any sort of replacement therapy. If you move on to treatment, I understand the injections (such as weekly) can leave you feeling awful as the week wears on and you near the next injection date. The gel products are best applied the same time each day, and directly to your shoulders and upper arms once you get out of the shower. Have to watch contact with others, too -- best to cover up with a T-shirt once it dries. If you're going to be intimate you want to shower up first and wash off any gel, although it is alcohol-based and absorbs pretty quickly into your body (hence the open pores after the shower). They say you can apply it to your stomach, too, but that is where more fat/estrogen/aromatase action is going to be.

Just my $0.02 on what limited info I've learned over the last 1.5 years taking Androgel. Hope you can find a good doc to get everything assessed and treated! It's one of those things that can really make you feel much, much better.


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## miguel (Jul 18, 2011)

bigfoot said:


> Glad to hear you are feeling better! As far as testosterone goes, I'm 32 and my Total T was something in the neighborhood of the low 200s last year. Adding in some Androgel (5gm packets x 1 daily) was a huge positive change. Felt sooo much better overall. Eventually my Total T got up to around 550, before starting to drop again. Then another doc raised it up to 7.5gm of Androgel, which gave me a good boost in energy and libido, but seemed to cause some irritability. At that point my Total T was nearing 800, and could have been higher when I noticed the irritability (no way to know, they didn't re-test Testosterone levels before dropping me back down to 5gm Androgel).
> 
> There seems to be a lot of disagreement between docs on what Total T range folks should be in. Some see that you're within the range and figure you're fine. Others strive for optimizing what works best for you. My limited understanding is that the average male has about 700 ng/dL of testosterone, with a range between 300-1200 depending on which lab and doctor you are seeing. Certainly striving for something in the area of 500 would probably be a pretty noticeable improvement for you.
> 
> ...


I have some symptoms of low libido, this problem started since appeared Graves'. I like that my testosterone is higher, but I hate the idea of TRT, I could not pay Androgel, is too expensive and not always work. My libido worsened after surgery, no one can explain why. Also, I think I should change my laboratory because my endo only guide by ranges and does not take into consideration lowish.

Now I have no hypothyroidism or hyperthyroidism symptoms, I really feel like a normal person and I can forget that I have thyroid problems, the only problem is very low libido.

Thanks for your help.


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## peacesells560 (Aug 9, 2011)

miguel said:


> I have some symptoms of low libido, this problem started since appeared Graves'. I like that my testosterone is higher, but I hate the idea of TRT, I could not pay Androgel, is too expensive and not always work. My libido worsened after surgery, no one can explain why. Also, I think I should change my laboratory because my endo only guide by ranges and does not take into consideration lowish.
> 
> Now I have no hypothyroidism or hyperthyroidism symptoms, I really feel like a normal person and I can forget that I have thyroid problems, the only problem is very low libido.
> 
> Thanks for your help.


Have you considered Clomid? It stimulates endogenous testosterone production instead of replacing it with exogenous testosterone.


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## miguel (Jul 18, 2011)

peacesells560 said:


> Have you considered Clomid? It stimulates endogenous testosterone production instead of replacing it with exogenous testosterone.


I have read that Clomid might work to increase testosterone like Nolvadex and Arimidex. I can't think my endo approve the use of this medicament for this purpose. What are the side effects of long term use? Do you use this medicine?.


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## Andros (Aug 26, 2009)

miguel said:


> I have some symptoms of low libido, this problem started since appeared Graves'. I like that my testosterone is higher, but I hate the idea of TRT, I could not pay Androgel, is too expensive and not always work. My libido worsened after surgery, no one can explain why. Also, I think I should change my laboratory because my endo only guide by ranges and does not take into consideration lowish.
> 
> Now I have no hypothyroidism or hyperthyroidism symptoms, I really feel like a normal person and I can forget that I have thyroid problems, the only problem is very low libido.
> 
> Thanks for your help.


Miguel.........................don't forget; it takes time to heal also. You have been through a lot with your body. Check your testosterone again in about 6 months. You may be surprised. Meanwhile eat and live healthy. Get exercise also.


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## miguel (Jul 18, 2011)

01/18/12 laboratory results (feeling a bit hypo)
Synthoid 37.5 mcg

T4 total (thyroxine) 9.20 (4.5 - 10.9)
T4 free, direct 1.31 (0.89 - 1.76)
T3 free, serum 3.3 (2.0 - 4.2) 
TSH 1.68 (0.35 - 5.5)

The only symptom I feel is a little foggy in the brain, I was feeling very well at 62.5 mcg of levothyroxine, but my TSH was 0.18 and FT4 1.54, but my endo does not like a low TSH. He said that this time the results were excellent, but I do not agree, he increase the dose to 50 mcg because I had hypo symptoms.


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## Octavia (Aug 1, 2011)

The 50 mcg dose might be your "sweet spot" - hopefully you'll be feeling great soon!


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## Andros (Aug 26, 2009)

miguel said:


> 01/18/12 laboratory results (feeling a bit hypo)
> Synthoid 37.5 mcg
> 
> T4 total (thyroxine) 9.20 (4.5 - 10.9)
> ...


It's a shame your endo is doing what he/she likes. It would be more important to do what the patient likes in this case. You have wiggle room; my opinion is that your FT3 is a wee bit too low as is your FT4.


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## miguel (Jul 18, 2011)

Octavia said:


> The 50 mcg dose might be your "sweet spot" - hopefully you'll be feeling great soon!





Andros said:


> It's a shame your endo is doing what he/she likes. It would be more important to do what the patient likes in this case. You have wiggle room; my opinion is that your FT3 is a wee bit too low as is your FT4.


When I was taking levothyroxine 62.5 sometimes I felt some palpitations, was a bit annoying, I hope to do well at 50mcg. I am Taking 50 mcg Synthoid and Citracal 315mg per day. I think I have a very good parathyroid recorvery. These are my latest labs:

glucose 76 (65-110) mg/dl
urea nitrogen 10 (6-25) mg/dl
creatinine 0.7 (0.8-1.5) mg/dl
uric acid 6.5 (2.1-7.4) mg/dl
sodium 140.76 (135-150) mmol/l
potassium 4.19 (3.5-5.3) mmol/l
chloride 105.95 (96-114) mmol/l
calcium 9.28 (8.5-10.5) mg/dl
phosphorus 4.1 (2.4-4.7) mg/dl
cholesterol 140 (130-200) mg/dl
hdl 45.6 (35-85) mg/dl
atherogenic index 3.1 (<5.0) 
triglycerides 46 (0-200) mg/dl
total protein 7.7 (6.0-8.5) g/dl
album 4.5 (3.0-5.5) g/dl
globulins (calc) 3.2 (1.9-4.0) g/dl
total bilirubin 0.9 (0.1-1.4) mg/dl
direct bilirubin 0.1 (0.1-0.4) mg/dl
indirect bilirubin 0.9 (0.4-1.2) mg/dl
ALT / TGP 18 (0-45) iu/l
AST / SGOT 24 (0-41) iu/l
lactic dehydrogenase 132 (91-180) iu/l
alkaline phosphatase 104 (10-140) iu/l
ggt 13 (7-52) iu/l
iron 60 (60-200) mcg/dl ''lowish''
LDL (calc) 85 (0-130) mg/dl
VLDL (calc) 9 (21-39) mg/dl
CK 163 (45-235) iu/l

have a good evening


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## miguel (Jul 18, 2011)

How to increase my iron level? I am taking 65mg of elemental iron sulfate and 500 mg of vitamin C daily.


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## Andros (Aug 26, 2009)

miguel said:


> How to increase my iron level? I am taking 65mg of elemental iron sulfate and 500 mg of vitamin C daily.


It would be good to check your Ferritin before supplementing.

Ferritin http://www.thewayup.com/newsletters/081504.htm
(should be 50 to 100; the closer to 100, the better)


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## miguel (Jul 18, 2011)

I called my endocrinologist and he allowed me increase to 62.5 mcg of levothyroxine and test in 1 month and a half. I have 2 weeks at 62.5 and I'm already feeling the change, the headaches are gone, but I have good days and bad days. This is a picture of my scar 7 months after surgery.


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