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What Does My Hormone Panel Blood Test Report Indicate?
Question: Hello, so to make an extremely long story short... 2 years ago i one day had what doctors think was a panic attack... and basically, while i was at work i randomly started to feel all of the blood rushing to my head and i was shaking and my heart was pounding... i went to the ER and i had a very high blood pressure 197/136.. ever since that day it's been a constant battle with low energy levels, higher then usual BP (135/87), trouble sleeping, etc.. I've had countless tests/exams from EKG, ultrasound of kidneys, chest x-ray, CBCW/diff, metabolic comp, lipid panel, vitamins, D-Dimer, Metanephrines, UA auto w/ reflex to micro, ESR, Ferritin, PSA, Catecholamines, etc... Everything was normal.. in fact some of which better then normal.. except i came back with low testosterone levels.. I also took a hormone panel (which i will post at the bottom before i got on injections).. now comes to the present... I now take testosterone injections weekly 250mg.. which seems to help ALOT but only to a certain extent and this make me wonder about the diagnoses from my PCP. When i get my testosterone injection my energy levels go down verses up.. and that night i get a burning feeling in and around my nipples and they become puffy. The following day it gets even worse and lasts for about 2 days straight... along side very poor energy levels, trouble sleeping, and etc.. lately when i get this burning sensation a few hours after my injection i take .1 mg of arimidex and the next morning i have no more burning feeling and my energy levels shoot through the roof and my BP drops down to the mid to low 120s. I'm unsure of the complications that may arise with taking .1 mg of arimidex weekly long term for a male.. and the fact i'm having to do this to combat the side effects makes me wonder if this is normal and if there's something still wrong with me that testosterone isn't resolving. Fyi, i'm 25 years old. Here's my hormone panel:
Test Name Result Units Range
Estradiol (Saliva) 0.8 pg/mL 0.5-2.2
Progesterone (Saliva) 12 pg/mL 12-100
Testosterone (Saliva) 52 pg/mL 44-148 (Age Dependent)
DHEAS (Saliva) 4.0 ng/mL 2-23 (Age Dependent)
Cortisol (Saliva) 1.1 L ng/mL 3.7-9.5 (morning)
Cortisol (Saliva) 1.1 H ng/mL 0.4-1.0 (night)
Test Name Result Units Range
Estradiol (Saliva) 0.8 pg/mL 0.5-2.2
Progesterone (Saliva) 12 pg/mL 12-100
Testosterone (Saliva) 52 pg/mL 44-148 (Age Dependent)
DHEAS (Saliva) 4.0 ng/mL 2-23 (Age Dependent)
Cortisol (Saliva) 1.1 L ng/mL 3.7-9.5 (morning)
Cortisol (Saliva) 1.1 H ng/mL 0.4-1.0 (night)
Brief Answer:
Hormones
Detailed Answer:
I follow your questions.
I would like to confirm that the labs you have shared are dated 2 years back and not the present status , isnt it?
There are a few important aspects thats are relevant to your unique situation:
1 Your testosterone laboratory test is measured on a saliva sample here. This is not standard practice.
The best way to do so is in a blood sample taken in the morning time.
This is the recommended to diagnose testosterone deficiency.
Once treatment has begun, it is not important to draw the blood sample in the morning time.
2 You need to see an endocrinologist in person for a comprehensive evaluation of your testosterone and other hormone-related conditions.
One needs to ascertain if you really have testosterone deficiency or not. If you do, further tests (such as FSH, LH, Prolactin) are required to know what is the likely cause of the low testosterone.
Once the diagnosis is made accurately, appropriate treatment options will be presented to you.
3 Many of the side effects you are reporting are possibly related to your testosterone and arimidex.
4 When I see someone like you in my practice I order the following tests including a thorough physical examination (which would include a genital examination):
CBC
CMP
TSH
Free T4
Then if there are no evident signs of 'low androgen state' I would consider stopping the testosterone and arimidex and re-evaluating the testosterone axis in a couple months with tests like
FSH
LH
Prolactin
Total Testosterone
SHBG
Free Testosterone by Equilibrium Dialysis method
Hormones
Detailed Answer:
I follow your questions.
I would like to confirm that the labs you have shared are dated 2 years back and not the present status , isnt it?
There are a few important aspects thats are relevant to your unique situation:
1 Your testosterone laboratory test is measured on a saliva sample here. This is not standard practice.
The best way to do so is in a blood sample taken in the morning time.
This is the recommended to diagnose testosterone deficiency.
Once treatment has begun, it is not important to draw the blood sample in the morning time.
2 You need to see an endocrinologist in person for a comprehensive evaluation of your testosterone and other hormone-related conditions.
One needs to ascertain if you really have testosterone deficiency or not. If you do, further tests (such as FSH, LH, Prolactin) are required to know what is the likely cause of the low testosterone.
Once the diagnosis is made accurately, appropriate treatment options will be presented to you.
3 Many of the side effects you are reporting are possibly related to your testosterone and arimidex.
4 When I see someone like you in my practice I order the following tests including a thorough physical examination (which would include a genital examination):
CBC
CMP
TSH
Free T4
Then if there are no evident signs of 'low androgen state' I would consider stopping the testosterone and arimidex and re-evaluating the testosterone axis in a couple months with tests like
FSH
LH
Prolactin
Total Testosterone
SHBG
Free Testosterone by Equilibrium Dialysis method
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I should have been more clear on the test results... cbcw/diff, metabolic comp, testosterone (blood), etc... are taken very frequent esp seeing as i'm not taking testosterone... the saliva hormone panel was also done very recent (about a month and half ago) before i started taking testosterone replacement.. the arimidex is not doctor prescribed it's something i take on my own to counter the effects i'm receiving.... that said, the combination of testosterone injections + arimidex i feel no side effects and "feel" normal with a more normalized blood pressure and energy level. if i remove arimidex from the equation then i start to experience the side effects which include low energy levels, burning sensation in nipple area, etc..
My latest testosterone levels... you can find below. This is (before) testosterone injections which means it's also a month and half ago.. I also have tests during my testosterone treatment however, i just want to specify this is before. These tests are also by an ordering physician and via blood.
Component Standard Range Your Value
TESTOSTERONE 292 - 1052 NG/DL 212
Sex Horm Bind Globuli 17 - 66 NMOL/L 15
CALC FREE TESTOSTERONE 4.8 - 25.0 NG/DL 5.9
Component Standard Range Your Value
TSH 0.35 - 4.00 uIU/mL 1.55
Other tests such as lipid panel, cbcw/diff, and metabolic were all also taken recently and within normal ranges
Also, as an fyi i've had 2 physical examinations in the past year and half.
After reviewing my previous exams... one result was a bit off.. although i have been told by doctors it was "normal"..
Component Standard Range Your Value
CHOLESTEROL 140 - 200 mg/dl 128
TRIGLYCERIDES 35 - 150 mg/dl 184
HDL CHOLESTEROL >40 mg/dl 30
CALCULATED LDL CHOL 80 - 130 mg/dl 61
CHD 0.00 - 4.44 ratio 4.27
Looking at past results for the same lipid panel results... my LDL chol has always been low.. between 60-70.. and total chol has always been low as well 126-130... triglycerides for the month of may was much higher then usual with it normally in the 130s
My latest testosterone levels... you can find below. This is (before) testosterone injections which means it's also a month and half ago.. I also have tests during my testosterone treatment however, i just want to specify this is before. These tests are also by an ordering physician and via blood.
Component Standard Range Your Value
TESTOSTERONE 292 - 1052 NG/DL 212
Sex Horm Bind Globuli 17 - 66 NMOL/L 15
CALC FREE TESTOSTERONE 4.8 - 25.0 NG/DL 5.9
Component Standard Range Your Value
TSH 0.35 - 4.00 uIU/mL 1.55
Other tests such as lipid panel, cbcw/diff, and metabolic were all also taken recently and within normal ranges
Also, as an fyi i've had 2 physical examinations in the past year and half.
After reviewing my previous exams... one result was a bit off.. although i have been told by doctors it was "normal"..
Component Standard Range Your Value
CHOLESTEROL 140 - 200 mg/dl 128
TRIGLYCERIDES 35 - 150 mg/dl 184
HDL CHOLESTEROL >40 mg/dl 30
CALCULATED LDL CHOL 80 - 130 mg/dl 61
CHD 0.00 - 4.44 ratio 4.27
Looking at past results for the same lipid panel results... my LDL chol has always been low.. between 60-70.. and total chol has always been low as well 126-130... triglycerides for the month of may was much higher then usual with it normally in the 130s
Brief Answer:
Follow up
Detailed Answer:
I have reviewed the additional information you have provided.
Arimidex should be taken only by prescription and that too only if a doctor finds it appropriate for you to do so.
Regarding testosterone, was your sample taken in the morning?
Triglycerides are high but was this a fasting sample?
Arimidex tends to raise the blood estrogen levels and that can indirectly elevate the triglycerides
Follow up
Detailed Answer:
I have reviewed the additional information you have provided.
Arimidex should be taken only by prescription and that too only if a doctor finds it appropriate for you to do so.
Regarding testosterone, was your sample taken in the morning?
Triglycerides are high but was this a fasting sample?
Arimidex tends to raise the blood estrogen levels and that can indirectly elevate the triglycerides
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
All testosterone tests both the saliva and the blood were taken very early morning (around 7:30am).
I was almost never fasting when taking my blood work... The instant i wake up i almost always have to eat something and i tend to eat 7-8 meals a day... that said, i eat the exact same thing every morning which would be 4 egg whites and 2 eggs with yoke along with an organic juice drink and some sort of carb.. usually bread or greek yogurt.
When these exams were taken (specifically the one with triglycerides) i was not taking arimidex... i only take arimidex during my testosterone theory so recently and only when i experience a strong burning in the nipples.. the next day i feel perfectly fine and my energy levels come back.
I was almost never fasting when taking my blood work... The instant i wake up i almost always have to eat something and i tend to eat 7-8 meals a day... that said, i eat the exact same thing every morning which would be 4 egg whites and 2 eggs with yoke along with an organic juice drink and some sort of carb.. usually bread or greek yogurt.
When these exams were taken (specifically the one with triglycerides) i was not taking arimidex... i only take arimidex during my testosterone theory so recently and only when i experience a strong burning in the nipples.. the next day i feel perfectly fine and my energy levels come back.
Brief Answer:
Second follow up
Detailed Answer:
Well then, not fasting can raise the triglycerides too. I understand you are saying you are very consistent with your diet. But the variable fat and carbohydrate content of your food can explain the differing levels on the two separate occasions you had your triglycerides checked on.
Testosterone is known to cause 'gynecomastia' ie painful swollen breasts. So your complaint seems to resemble that.
Second follow up
Detailed Answer:
Well then, not fasting can raise the triglycerides too. I understand you are saying you are very consistent with your diet. But the variable fat and carbohydrate content of your food can explain the differing levels on the two separate occasions you had your triglycerides checked on.
Testosterone is known to cause 'gynecomastia' ie painful swollen breasts. So your complaint seems to resemble that.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
In that particular situation where it is a common symptom... What is the most common resolution for people needing to take testosterone replacement?
Also, from your analysis would you have went the same route as well meaning do you ultimately think the underlining condition is indeed low testosterone levels or do you suspect the possibility of something else based off the given data i have provided to you regarding strange symptoms, elevated blood pressure, etc when not on testosterone replacement?
Also, from your analysis would you have went the same route as well meaning do you ultimately think the underlining condition is indeed low testosterone levels or do you suspect the possibility of something else based off the given data i have provided to you regarding strange symptoms, elevated blood pressure, etc when not on testosterone replacement?
Brief Answer:
Third follow up
Detailed Answer:
Those who get gynecomastia from testosterone use, are sometimes advised to lower the dose.
Regarding your other question, my advise to you is still the same as during my first response:
See an endocrinologist in person for a comprehensive assessment to see if you really have true 'Hypogonadism' ie androgen deficiency that requires treatment with testosterone in the first place
Third follow up
Detailed Answer:
Those who get gynecomastia from testosterone use, are sometimes advised to lower the dose.
Regarding your other question, my advise to you is still the same as during my first response:
See an endocrinologist in person for a comprehensive assessment to see if you really have true 'Hypogonadism' ie androgen deficiency that requires treatment with testosterone in the first place
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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