First I’ll try to give some context to my specific situation. Apologies in advance for lengthy explanations and background. I’ve read some of the stickies but not all (there’s a lot to read). So hopefully I’m giving the info needed.
HISTORY/RESULTS:
Grade 3 varicocele diagnosed at 18 yrs old & left untreated
Quest Labs from 2013 or 2014
Will post when I find it but total test was about 495 and SHBG/free % were almost the same and test free was somewhere around 120-130.
Quest Labs from 4/7/2016 (don’t recall the time)
Test. Free 77.5 pg/mL (Normal is 47-244 pg/mL)
Testosterone, % Free 2.4 % (Normal is 1.6-2.9 %)
Testosterone Total 329 ng/dL (Normal is 280-1100 ng/dL)
SHBG 20 nmol/L (Normal is 13-71 nmol/L)
Testosterone, Bioavailable 206.8 ng/dL (Normal is 131-682 ng/dL)
Vitamin D 25 OH 34 ng/mL (Normal is 30-80ng/mL)
WBC 4.8 K/mcL (Normal is 3.6-10.6 K/mcL)
RBC 4.95 x10^6/mcL (Normal is 4.50-5.90 x10^6/mcL)
Hemoglobin 14.4 g/dL (Normal is 13.5-17.5 g/dL)
Hematocrit 43.9 % (Normal is 41.0-53.0 %)
MCV 88.7 fL (Normal is 80.0-100.0 fL)
MCH 29.1 pg (Normal is 26.0-34.0 pg)
MCHC 32.8 g/dL (Normal is 32.0-36.0 g/dL)
RDW SD 43.5 fL (Normal is 35.1-43.9 fL)
RDW 13.4 % (Normal is 11.3-15.6 %)
Platelets 214 K/mcL (Normal is 150-400 K/mcL)
MPV 10.5 fL (Normal is 6.6-12.4 fL)
Nucleated RBC Auto 0.0 /100(WBCs)
Immature Granulocytes 0.2 % (Normal is 0.0-0.4 %)
Differential Type Auto
Neutrophil % Auto 59.3 % (Normal is 36.0-66.0 %)
Lymphocyte % Auto 29.3 % (Normal is 24.0-44.0 %)
Monocyte % Auto 9.8 % (Normal is 0.0-12.0 %)
Eosinophil % Auto 0.8 % (Normal is 0.0-5.0 %)
Basophil % Auto 0.6 % (Normal is 0.0-5.0 %)
Immature
Granulocyte,
Absolute 0.01 K/mcL (Normal is 0.0-0.03 K/mcL)
Neutrophil 2.9 K/mcL (Normal is 1.8-6.8 K/mcL)
Lymphocyte 1.4 K/mcL (Normal is 1.2-3.4 K/mcL)
Monocyte 0.5 K/mcL (Normal is 0.2-0.9 K/mcL)
Eosinophil 0.0 K/mcL (Normal is 0.0-0.5 K/mcL)
Basophil 0.0 K/mcL (Normal is 0.0-0.3 K/mcL)
Sodium Level 137 mmol/L (Normal is 137-146 mmol/L)
Potassium Level 4.0 mmol/L (Normal is 3.5-5.0 mmol/L)
Chloride Level 103 mmol/L (Normal is 98-109 mmol/L)
CO2 25 mmol/L (Normal is 19-30 mmol/L)
Anion Gap (Na Cl
CO2)
9 mmol/L (Normal is 3-16 mmol/L)
Glucose Level 74 mg/dL (Normal is 65-99 mg/dL)
BUN 13 mg/dL (Normal is 6-21 mg/dL)
Creatinine Level 0.90 mg/dL (Normal is 0.79-1.37 mg/dL)
GFR, Estimated
(mL/min/1.73 m2)
114 mL/min/1.73
m2
(Normal is >60 mL/min/1.73 m2)
Average GFR for
age
107 mL/min/1.73
m2
Cmt: GFR See Note:
Calcium Level 9.1 mg/dL (Normal is 8.4-10.4 mg/dL)
Protein Total 6.5 g/dL (Normal is 6.0-8.4 g/dL)
Albumin Level 4.3 g/dL (Normal is 3.3-4.8 g/dL)
Albumin Level 4.3 g/dL (Normal is 3.3-4.8 g/dL)
Bilirubin Total 0.8 mg/dL (Normal is 0.2-1.3 mg/dL)
Alk Phos 98 unit/L (Normal is 40-120 unit/L)
AST 30 unit/L (Normal is 9-40 unit/L)
ALT 44 unit/L (Normal is 12-61 unit/L)
Cholesterol Total 137 mg/dL (Normal is 138-199 mg/dL)
HDL 34 mg/dL (Normal is 40-63 mg/dL)
LDL 90 mg/dL (Normal is <100 mg/dL)
Cmt: LDL See Note:
Chol/HDL 4.0 (Normal is <4.5)
Triglycerides 63 mg/dL (Normal is 50-149 mg/dL)
Patient Fasting? Yes
Non HDL
Cholesterol
103 mg/dL (Normal is <130 mg/dL)
VLDL 13 mg/dL (Normal is 10-29 mg/dL)
TSH 0.65 mcIU/mL (Normal is 0.45-4.67 mcIU/mL)
Quest Labs 9/15/16 @ 8 am
Cortisol, Untimed 10.1 mcg/dL (Normal is 2-23 mcg/dL)
LabCorp results from 3/9/17 taken @ 1030 am
Test free & total 191 ng/dL (348-1197)
Free test (Direct) 8.2 pg/ml (8.7-21.5)
LH 5.5 miu/ml (1.7-8.6)
FSH 3.7 miu/ml (1.5-12.4)
Prolactin 13.7 ng/ml (4.0-15.2)
Estradiol 12.9 pg/ml (7.6-42.6)
12/2014 Knee surgery on meniscus & mcl
6/2016 Knee surgery ACL reconstruction
I mention these because the symptoms of low t became much more prevalent after the 1st and even worse after the 2nd.
Rx/OTC:
Adderall
Sleep Aids (i.e. melatonin, unison, zzzquil, etc.)
I was fairly fit and muscular prior to the first knee surgery. I lifted weights 2-3 times a week and played a lot of bball, softball, and occasionally football. I had dealt with some fatigue for years but attributed it to other things and still enjoyed playing. After 1st surgery I gained about 35 lbs and struggled through rehab. Later on, ended up tearing my ACL and having that replaced. I struggled even more through that rehab and at 9 mo. post-op I’m not where I should be physically which caused some pretty severe depression. I just started TRT two days ago. After meeting w/ the urologist to discuss my lab results he diagnosed me w/ primary hypogonadism and we decided to begin a regimen of 200 mg E2W (at their office, he didn’t seem thrilled with the idea of me doing an EOD/E3D or twice/wk @ home ) and 1 mg Arimidex w/o any clear instruction. I had already read on here that although different for each individual a dose of .25 mg or .5 mg anywhere from ED to once a week should be sufficient. But when I asked the doc about taking .25 or .5 so that I don’t crash my E2 (which seemed a little low, isn’t 22-30 preferred?) he was not very clear. He said he’d see me in 6 months to follow up and do some labs. Once again, I’m glad I combed through this forum prior to seeing him. I requested to atleast test it at 6-8 weeks to see if it’s working and to check my PSA, especially since my PSA hasn’t been checked. He agreed and provided me 2 orders for labs to be done whenever I’d like within the 6 months. Anyway, I took the 1 mg when I got the prescription filled about 30 minutes after the first injection. I may get some of this wrong as I’m trying to learn all that I can from everyone here but if my E2 is on the low end of the range, will the AI help make the most of the T being injected or will it crash my E2 and make things worse?
OTHER Q’s:
Would an Endo be preferred over a Urologist? Assuming they’re both proactive and competent (think I saw a sticky saying that’s near impossible)
Is there any benefit to HGH while on TRT, to protect joints and keep my knee healthy?
Thanks for reading and I look forward to any advice. I’ll keep reading the stickies. After looking at some of the Thyroid sticky. I’ll have to start taking Temps and looking into iodine and selenium sups.