Have been trying to just tweak these settings and nothing has worked. what would be my next step, thanks.

Win 7 64bit
att uverse 18meg speed
disabled auto tuning

SpeedGuide.net TCP Analyzer Results
Tested on: 2013.04.18 20:17
IP address: 199.193.xxx.xx
Client OS/browser: Windows 7 (Internet Explorer 10.0)

TCP options string: 01010402
MSS: 0
MTU: 40
TCP Window: 16616 (NOT multiple of MSS)
RWIN Scaling: 0 bits
Unscaled RWIN : 16616
Recommended RWINs: , 0, 0, 0, 0
BDP limit (200ms): 665kbps (83KBytes/s)
BDP limit (500ms): 266kbps (33KBytes/s)
MTU Discovery: ON
TTL: 52
Timestamps: OFF
IP ToS: 00000000 (0)