T Nation

21 Y/O Bloodwork Update


#1

hi

i want to know what is the best treatment to keep the testicles functioning (i heard with trt long term atrophy can cause testicle failure).
i tried using clomid for a month and it got my blood level to 19.32 nmol/l (557ng/dl) and lh to 7.51mlu/ml.
is the lh high enough to cause leydig cell desensitization and what does that mean? is it temporary or permanent ?


#2

How much clomid are you using?
Is this the only medication?

How are you feeling now?

High LH may drive up E2.
High E2 means higher SHBG.
Higher SHBG means lower FT and more SHBG+T
SHBG+T is not bio-available, but can exaggerate TT

If LH receptors are less responsive, the testes produce less T for a given amount of LH.

TRT can be: - teste protective
Clomid or Nolvadex
hCG
T + hCG
T + Clomid or Nolvadex

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


#3

hi ksman,

im on 75mcg levothyroxine and 25mg clomid and i supplement iodine ,selenium and cialis.

that test was in December i felt slightly better on clomid than on testosterone cause its easier to manage and i didnt need to use ai.

this is my third week now back on clomid few days ago i took 1/4mg anastrozole for two days until i lost all my energy i think i feel better with higher estrogen but i lose my morning wood.

with clomid i dont feel the side effect that other people have but i still dont feel like what i used to feel 4 years ago.

i might go with test to blast and cruise for few years and do i have to take hcg all year or can i cycle it once or twice a year
im thinking of using clomid for the rest of my life cause its pills rather than injection


#4

You can try Nolvadex to see what feels best.

B&C: you need to support testes with hCG or a SERM all of the time. But not hCG and SERMs together.

Many guys here do not feel right even with ideal TRT labs values if their thyroid function is low. I offered that you can eval your thyroid function via oral body temperatures. Do it.

Thyroid function is not a side issue.


#5

just wondering if i use clomid or nolvadex with testosterone does my hpta stays on or does it get suppressed.

i will do more blood test next week and i will provide more detail about me and my situation

thanks.


#6

When taking T, SERMs keep up LH/FSH production, that is the whole point.


#7

i just ordered nolvadex to try as monotherapy what is the lowest dose i could try for best result.

does hypothyroid lower or increase shbg.

if stay longer than a month maybe 3 months on clomid or nolvadex would i get the same TT(557ng/dl) or would it increase


#8

https://en.wikipedia.org/wiki/Sex_hormone-binding_globulin

SHBG levels are decreased by androgens, administration of anabolic steroids,[21] polycystic ovary syndrome, hypothyroidism, obesity, Cushing’s syndrome, and acromegaly.

SHBG levels increase with estrogenic states (oral contraceptives), pregnancy, hyperthyroidism, cirrhosis, anorexia nervosa, and certain drugs.

Dose?
“using clomid for a month and it got my blood level to 19.32 nmol/l (557ng/dl) and lh to 7.51mlu/ml.”

LH=7.51 was too high. E2 could have been too high.

Nolvadex is often 20mg, try EOD then later test: TT, FT, LH/FSH, E2


#9

im still waiting on the test results ,what pissed me off is that the doctor didnt order ft4 and reverse t3.
he only did t3 tsh and t3 uptake for the thyroid but he did all other test i ordered.

how do i convince the doctor to switch my medicine to t3 or t4/t3 , he doesnt seem to know about reverse t3 and that not all patient convert to t3. i might switch doctors or self medicate with liquid t3.

the reason i think my body dont convert to t3 is that when i was on 50mcg my ft4 was almost high and now im on 75mcg i kinda feel better but on the same time i increased the dosage i added thyriod support supplement
19.8pmol/l the range is 9-20 and tsh 7.4

i took my temperature yesterday at noon it was 97.7 and on the after noon it was 97.9
and in the evening it was 97.1, and this morning it was 96.9 as soon as i woke up.

the iodine i used to take was only 150mcg i reread your post and now i got iodoral 50mg i will take one a day for a week or two.

just wondering how low can i go with nolvadex can i use like 5mg eod ? i want to lower the lh with serms ,now that i have been 3 weeks on clomid one testicle is feels full but the other is not,
is that normal or would it be possible that i have one testicle failure?


#10

i still didnt receive my lab results almost 2 weeks now, so i went through my old lab results and realised that my alt is high and the doctor ignored it i remember he said once we got you on t4 you will get better.

july 2016
LH 2.26 mUI/ml 1.1-7
testosterone 1.93ng/ml 3-10.6

anti tpo 85.82 IU/ml 0-100

ft4 13.85 pmol/l 9-20 (one month on 50mcg t4)

october 2016
testoerone serum >1500ng/dl 348-1197 (200mg once a week cypionate for a 5 weeks and before that took 250mg every 3 weeks twice there may have been sustanon in my system but i doubt it)
estradiol 91.9pg/ml 7.6-42.6
tsh 2.050 uIU/ml (3 months on 50mcg t4)

november 2016
testosterone serum 205ng/dl 348-1197 (one month off testerone)
estradiol 18.2 pg/ml (took 1mg anostrozle a day for a week then stoped for 4 weeks)
tsh 12.12 uIU/ml (one month off t4)
t4 7.4ug/dl 4.5-12
t3 134ng/dl 71-180

december 2017
prolactin 11.9 4-15.2
LH 2.4 mIU/ml(without pct)

january 2017
ft4 19.8pmol/l 9-20 (one month on 50mcg t4)
LH 7.51mIU/ml (one month on 25mg clomid)
testosterone 19.32nmol/l 1.63-34
tsh 7.4uIU/ml (one month on 50mcg t4)

april 2017
tsh 3rd gen 4.968 0.350-5.50 (3 months on 50mcg everyday except friday 100mcg t4)


#11

june 2017
lipid panel
cholesterol total 184 125-200mg/dl
hdl cholesterol 33L >40mg/dl
triglycerides 203H <150mg/dl
ldl 110 <130mg/dl
chol/hdlc ratio 5.6H <5.0
non hdl 151mg/dl
hepatic function panel
protein total 6.7 6.1-8.1 g/dl
albumin 4.5 3.6-5.1 g/dl
globulin 2.2 1.9-3.7g/dl
albumin/globulin 2.0 1.0-2.5
bilirubin total 0.7 0.2-1.2mg/dl
bilirubin direct 0.2 <0.2mg/dl
bilirubin indirect 0.5 0.2-1.2mg/dl
alkaline phosphatase 94 40-115u/l
ast 25 10-40 u/l
alt 22 9-46u/l

tsh w/reflex to ft4 3.68 0.4-4.5 miu/l
ft3		3.3	2.3-4.2pg/ml
t3 uptake	33	22-35%
iodine serum/plasma57	52-109mcg/l

igf-1 lc/ms	111	83-456ng/ml
z score 	-1.6	-2 - +2

pregnenolone lc/ms/ms 16L 22-237ng/dl

cbc
white blood cell count 6.7 3.8-10.8 thousand/ul
red blood cell count 6.09H 4.2-5.8 million/ul
hemoglobin 17.7H 13.2-17.1 g/dl
hematocrit 51H 38.5-50%
mcv 83.7 80-100 fl
mch 29.1 27-33pg
mchc 34.7 32-36g/dl
rdw 13.9 11-15%
platelet count 163 140-400 thousand/ul
mpv 11.7 7.5-12.5 fl
absolute neutrophils 4080 1500-7800 cells/ul
absolute lymphocytes 2084 850-3900 cells/ul
absolute monocytes 415 200-950 cells/ul
absolute eosinophils 101 15-500 cells/ul
absolute basophils 20 0-200 cells/ul
absolute nucleated rbc 0 0 cells/ul
neutrophils 60.9 %
lymphocytes 31.1 %
monocytes 6.2 %
eosinophils 1.5 %
basophils 0.3 %

ferritin		147	20-345ng/ml
vitamin b12		1056	200-1100pg/ml
cortisol total (8:30am) 12.1	4-22mcg/dl
dhea-s			308	24-537mcg/dl
fsh			4.2	1.6-8miu/ml
lh			4	1.5-9.3miu/ml
progesterone 		0.7	<1.4ng/ml
estradiol		20	<39pg/ml
shbg 13	10-50nmol/l
tt			360	250-1100ng/dl (two weeks on clomid 25mg ed)
ft			83.6	35-155pg/ml
selenium 		153	63-160mcg/l

#12

i stopped taking t4 and started taking pregenenolone 25mg for few days and i feel slightly better my body temperature increased a bit


#13

i have been taking t3 sustained release for the past 10 days started on 25mcg 5 days later i increased it to 30mcg and tomorrow i will take 35mcg.
so far i dont feel any improvement how long does it take for reverse t3 to drop i read online that it takes 3 months is that true.
and i have symptoms of high estrogen with 10mg nolvadex eod is there anything i can do about it


#14