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What Do My Lab Test Results Indicate?

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Posted on Thu, 16 Jun 2016
Question: My testesterone has been 180ng/do and a high of 325 after testesterone replacement I presently have depression I was recently put on androgen. Do you have any suggestions this is the 3rd time I've had depression in 7 yrs I have been told it's ptsd from 9/11 I was a fireman down there. There was no blood test to determine this just put on a ssri

Thanks
XXXXXXX

Ihad my seretonin taken 2times recently and both times my number was 9. I have recently gone to a endocronologist recently and my testerone was 240 free testerone 4.04 testesterone bioavailable was 100.93.
doctor
Answered by Dr. Shehzad Topiwala (49 minutes later)
Brief Answer:
Thyroid

Detailed Answer:
Sorry to note how you feel.

Considering you have seen an endocrinologist it is very likely your thyroid has been checked. It involves a random blood sample for a test called TSH. You do not have to fast for this and can be done at any time of the day.

Other than that, it is important to investigate throughly as to the cause of your low Testosterone. Again it is extremely likely your endocrinologist ran tests like FSH and LH in addition to Total testosterone at the beginning before starting treatment to get some idea regarding the cause for low testosterone.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH
Free T4
25 hydroxy Vitamin D
Prolactin
Ferritin

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (1 hour later)
1/22/15 blood test fsh-0.5L
1/22/15 blood test lh less than 0.5
1/22/15 progesterone 0.2
1/22/15 testosterone 182L
1/22/15 free testosterone 31.5L

2/04/15 fsh-0.4L
2/04/15 lh -<0.5
2/04/15 progesterone <0.2
2/04/15 creative 0.9.

4/06/2016 testosterone-242
4/06/2016 free testosterone 4.04
4/04/2016 testosterone bioavailable - 100.93
4/04/2016 tsh 2.10



4/04/2016 bilirubin 1.1H
4/04/2016 free bilirubin .20 H
4/04/2016 estradiol <20
4/04/2016 dhea 43. It's always in this low range

10/15/2015 vit d29.6L
10/15/2015 progesterone 0.3

My progesterone , vit d dhea have mostly at the low end of the range or flagged at being below


In addition to these numbers I've had tremors in my hands , they did a Mri on my brain to find out the cause the Mir showed two Tia they said they were old possible Bly from impacts while on the fire dept. I wonder if this any thing to do with depression. I also had afib and had to have a cardio inversion. I've been told the afib might have been triggered by steroidal medicine and that might have something to do with the Tia. I am also on a lot of meds for respiratory ,reflux,and sinus problems as a result of 9/11.in addition I have sleep apnea and sleep with a Capp machine but I still feel fatiqued.with the depression comes constipation. Sorry to be so long winded just wanted to give you the whole picture,and if you could suggest what type of Doctor I should being seeing.

Thanks
XXXXXXX



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Follow up: Dr. Shehzad Topiwala (1 hour later)
1/22/15 fsh0.5L
1/22/15 lh<0.5
1/22/15 progesterone 0.2
1/22/15 testosterone 182L
1/22/15 free testosterone 31.5L

2/04/15 fsh 0.4L
2/04/15 lh<0.5
2/04/15 progesterone<.2
2/04/15 creative 0.9
10/15/15 vit-d
10/15/151 progesterone 0.3


10/
4/04/16 testosterone 240
4/04/16free testosterone 4.04
4/04/16 Bioavailable testosterone 100.93
My progesterone dhea,and vit d are always in the low range or below


4/04/16 free bilirubin .02H
4/04/16 tsh2.10
4/04/16billrubin1.1H
4/04/16 estradiol<20
4/04/16 dhea 43 it's always low

I'm addition to above numbers I've had hand tremors,they did a Mir on my brain to see if anything was causing this,the mri revealed I had two Tia s,the said they were old they might be due to impacts when I was on the fdny,I wonder if this contributing to the depression. I also had afib and had to have a cardio inversion. I've been told the afib might have been kicked of by the steroidal inhalers I've been using. I am on a lot of medicines for sinus,reflux,and asthma as a result of 9/11. I also have sleep apnea and sleep with a cpap machine but still feel fatigued.also with the depression always comes constipation. With all these conditions is there a specific kind of doctor I should be seeing (interest etc.)

Thank you XXXXXXX

doctor
Answered by Dr. Shehzad Topiwala (3 hours later)
Brief Answer:
Follow up

Detailed Answer:

I have reviewed your lab results.

You will be best served by seeing respective sub-specialists like Neurologist for TIAs and Endocrinologist for testosterone and vitamin d.

But it is also important to have an Internist/ Family doctor to coordinate overall care.

When someone presents to me with vitamin D levels in that range I typically advise them to take a daily 1000 IU cholecalciferol supplement, which is often available over the counter.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What Do My Lab Test Results Indicate?

Brief Answer: Thyroid Detailed Answer: Sorry to note how you feel. Considering you have seen an endocrinologist it is very likely your thyroid has been checked. It involves a random blood sample for a test called TSH. You do not have to fast for this and can be done at any time of the day. Other than that, it is important to investigate throughly as to the cause of your low Testosterone. Again it is extremely likely your endocrinologist ran tests like FSH and LH in addition to Total testosterone at the beginning before starting treatment to get some idea regarding the cause for low testosterone. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination: CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts) Electrolytes (Sodium and Potassium in particular) HbA1c (Glycosylated Hemoglobin = your 3 month glucose average) Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase) Kidney function tests (BUN, Creatinine) TSH Free T4 25 hydroxy Vitamin D Prolactin Ferritin