T Nation

41 Year Old, 6 Month Lab Test Results

41 year old male
Balding
Overall healthy
Eat mostly healthy, low gluten diet.

T related complaints:

  1. Overall energy is fine, but lifting anything heavy the last couple years and more so this last year leaves me feeling -defeated-, and I’m sore for 5-6 days.
  2. Sexually functional no problems, but definitely lost that youthful urge and vitality. Morning wood a very rare occurence the last few years, definitely the last couple.
  3. Have a harder time finding the occasional word when talking. Hopefully that’s a low T thing.

So 6 months ago finally get on a .com TRT program ($200/month, doctor takes a look and prescribes T and hcg no problem). I picked it cause it was easy and no big upfront cost and knew the doctor was going to say yes.

Pre-Treatment Labs

CBC With Differential/Platelet
WBC 5.4 x10E3/uL 4.0 â?? 10.5 01
RBC 5.34 x10E6/uL 4.14 â?? 5.80 01
Hemoglobin 15.8 g/dL 12.6 â?? 17.7 01
Hematocrit 47.8 % 37.5 â?? 51.0 01
MCV 90 fL 79 â?? 97 01
MCH 29.6 pg 26.6 â?? 33.0 01
MCHC 33.1 g/dL 31.5 â?? 35.7 01
RDW 13.3 % 12.3 â?? 15.4 01
Platelets 250 x10E3/uL 140 â?? 415 01
Neutrophils 60 % 40 â?? 74 01
Lymphs 32 % 14 â?? 46 01
Monocytes 6 % 4 â?? 13 01
Eos 2 % 0 â?? 7 01
Basos 0 % 0 â?? 3 01
Neutrophils (Absolute) 3.2 x10E3/uL 1.8 â?? 7.8 01
Lymphs (Absolute) 1.7 x10E3/uL 0.7 â?? 4.5 01
Monocytes(Absolute) 0.3 x10E3/uL 0.1 â?? 1.0 01
Eos (Absolute) 0.1 x10E3/uL 0.0 â?? 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 â?? 0.2 01
Immature Granulocytes 0 % 0 â?? 2 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 â?? 0.1 01

Comp. Metabolic Panel (14)
Glucose, Serum 91 mg/dL 65 â?? 99 01
BUN 14 mg/dL 6 â?? 24 01
Creatinine, Serum 0.84 mg/dL 0.76 â?? 1.27 01
eGFR If NonAfricn Am 109 mL/min/1.73 >59
eGFR If Africn Am 126 mL/min/1.73 >59
BUN/Creatinine Ratio 17 9 â?? 20
Sodium, Serum 140 mmol/L 134 â?? 144 01
Potassium, Serum 5.0 mmol/L 3.5 â?? 5.2 01

Chloride, Serum 100 mmol/L 97 â?? 108 01
Carbon Dioxide, Total 28 mmol/L 19 â?? 28 01
Calcium, Serum 10.0 mg/dL 8.7 â?? 10.2 01
Protein, Total, Serum 7.1 g/dL 6.0 â?? 8.5 01
Albumin, Serum 4.6 g/dL 3.5 â?? 5.5 01
Globulin, Total 2.5 g/dL 1.5 â?? 4.5
A/G Ratio 1.8 1.1 â?? 2.5
Bilirubin, Total 1.2 mg/dL 0.0 â?? 1.2 01
Alkaline Phosphatase, S 48 IU/L 44 â?? 102 01
AST (SGOT) 23 IU/L 0 â?? 40 01
ALT (SGPT) 32 IU/L 0 â?? 44 01

Lipid Panel
Cholesterol, Total 224 High mg/dL 100 â?? 199 01
Triglycerides 99 mg/dL 0 â?? 149 01
HDL Cholesterol 45 mg/dL >39 01
VLDL Cholesterol Cal 20 mg/dL 5 â?? 40
LDL Cholesterol Calc 159 High mg/dL 0 â?? 99

Testosterone,Free and Total
Testosterone, Serum 388 ng/dL 348 â?? 1197 01
Free Testosterone(Direct) 10.0 pg/mL 6.8 â?? 21.5 02

Luteinizing Hormone(LH), S
LH 6.4 mIU/mL 1.7 â?? 8.6 01

Prostateâ??Specific Ag, Serum
Prostate Specific Ag, Serum 0.7 ng/mL 0.0 â?? 4.0 01

So I start with .5ml test cyp/week and .25ml hcg 2x/week.

Body does not like something in the T so bad swollen and itchy and red at injection sites. I play with IM and subq, sore when IM and painful/itchy/red subq. I suck it up through that bottle of T.

Immediately upon starting I notice drastic reduction in ejaculate volume, noticeably stronger orgasm (but hey, where’s the volume??). At whatever fast rate I notice that I can enjoy my time in the gym (as opposed to feeling defeated after the first lift) and lift hard and I’m only sore for a day or two.

I get into gym mode, eat high fat/protein low carb, see good results in muscle mass and generaly gym happy. I feel like the muscle is what I -should- be seeing with the gym/food habit, and the test is just helping me recover fast/actually recover, and have some umph to hit the gym again.

No increase in libido, no real increase in energy, no increase in aggression/motivation/focus (I was kind of hoping for some.)

At the end of the 6 weeks, 5 of which steady gym work, I think that I’m lifting more than I ever did in college which has me think I’ve always had low t. I always had good genetics so didn’t take much to look good, but I just wasn’t particularly strong even with gym and sports (mediocre athlete).

Time for 6 weeks lab, and they promise to switch to a different pharmacy in hopes the next batch wouldn’t be so inflammatory.

6 week lab

CBC With Differential/Platelet
WBC 5.6 x10E3/uL 3.4 â?? 10.8 01
RBC 5.25 x10E6/uL 4.14 â?? 5.80 01
Hemoglobin 15.6 g/dL 12.6 â?? 17.7 01
Hematocrit 46.3 % 37.5 â?? 51.0 01
MCV 88 fL 79 â?? 97 01
MCH 29.7 pg 26.6 â?? 33.0 01
MCHC 33.7 g/dL 31.5 â?? 35.7 01
RDW 13.7 % 12.3 â?? 15.4 01
Platelets 241 x10E3/uL 155 â?? 379 01
Neutrophils 59 % 40 â?? 74 01
Lymphs 30 % 14 â?? 46 01
Monocytes 5 % 4 â?? 12 01
Eos 6 High % 0 â?? 5 01
Basos 0 % 0 â?? 3 01
Neutrophils (Absolute) 3.2 x10E3/uL 1.4 â?? 7.0 01
Lymphs (Absolute) 1.7 x10E3/uL 0.7 â?? 3.1 01
Monocytes(Absolute) 0.3 x10E3/uL 0.1 â?? 0.9 01
Eos (Absolute) 0.4 x10E3/uL 0.0 â?? 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 â?? 0.2 01
Immature Granulocytes 0 % 0 â?? 2 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 â?? 0.1 01

Testosterone,Free and Total
Testosterone, Serum 625 ng/dL 348 â?? 1197 01
Free Testosterone(Direct) 13.9 pg/mL 6.8 â?? 21.5 02
Estradiol 25.5 pg/mL 7.6 â?? 42.6 01

EOS was HIGH, I attribute that to the inflammation reaction to the esther or oil. New stuff from pharmacy doesn’t irritate me but a tiny bit.

Doctor prescribes higher dose of Test to get test level higher (.75ml/week) which I do all subq and break it up into 3 injections per week. Dr. doubles hcg to .5ml 2x/week to hopefully counter my complaints of seemingly smaller/less dense testes and 75% decrease in ejaculate volume.

-Ejaculate volume never changes (a bit higher day after injection).
-No noticeable increase in benefit from higher dosage of Testosterone. I think I feel a bit less good for a month or two, though the last few seem fine/normal. Was waiting for 6 month labs, I might play with dropping the T dose to see what there is to see.
-Slight increase in morning wood but not anything to write home about.
-Testes still seem a bit smaller/less dense, but nothing I notice much anymore. (The first two weeks was like WHAT THE FUCK?)
-Still very happy in the gym, have energy to push weight, minimally sore, consistent gains. A solid 4 months in the gym and serious eating and I’m up 30 lbs of mass (some fat but mostly muscle), 245 bench 1repmax, 335 deadlift 1repmax, 245 squat 1repmax (my flexibility seriously sucks but have been working on it).

Point being, I never hit those weights in college or a couple times after that over the next 20 years when I lifted seriously for some amount of time.

That’s my main priority going on Test, so I’m happy with that. The libido and youthful urge would be nice I admit I was looking forward to it, I’d like to target that next. $200/month just to go to the gym seems expensive (probably should find a doc to just maintain me at some point for hopefully a lot less), but I do like being able to go to the gym and have some muscle on. Sure beats the alternative, I just dreaded any kind of work out because, well, it felt -really hard-.

Time for 6 month labs

6 month lab
CBC With Differential/Platelet
WBC 5.9 x10E3/uL 3.4 - 10.8 01
RBC 5.69 x10E6/uL 4.14 - 5.80 01
Hemoglobin 17.0 g/dL 12.6 - 17.7 01
Hematocrit 49.1 % 37.5 - 51.0 01
MCV 86 fL 79 - 97 01
MCH 29.9 pg 26.6 - 33.0 01
MCHC 34.6 g/dL 31.5 - 35.7 01
RDW 13.7 % 12.3 - 15.4 01
Platelets 269 x10E3/uL 155 - 379 01
Neutrophils 62 % 40 - 74 01
Lymphs 29 % 14 - 46 01
Monocytes 5 % 4 - 12 01
Eos 4 % 0 - 5 01
Basos 0 % 0 - 3 01
Neutrophils (Absolute) 3.6 x10E3/uL 1.4 - 7.0 01
Lymphs (Absolute) 1.7 x10E3/uL 0.7 - 3.1 01
Monocytes(Absolute) 0.3 x10E3/uL 0.1 - 0.9 01
Eos (Absolute) 0.3 x10E3/uL 0.0 - 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01
Immature Granulocytes 0 % 0 - 2 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01
Comp. Metabolic Panel (14)
Glucose, Serum 85 mg/dL 65 - 99 01
BUN 20 mg/dL 6 - 24 01
Creatinine, Serum 1.16 mg/dL 0.76 - 1.27 01
eGFR If NonAfricn Am 78 mL/min/1.73 >59
eGFR If Africn Am 90 mL/min/1.73 >59
BUN/Creatinine Ratio 17 9 - 20
Sodium, Serum 137 mmol/L 134 - 144 01
Potassium, Serum 4.7 mmol/L 3.5 - 5.2 01

Chloride, Serum 99 mmol/L 97 - 108 01
Carbon Dioxide, Total 26 mmol/L 19 - 28 01
Calcium, Serum 9.7 mg/dL 8.7 - 10.2 01
Protein, Total, Serum 6.8 g/dL 6.0 - 8.5 01
Albumin, Serum 4.1 g/dL 3.5 - 5.5 01
Globulin, Total 2.7 g/dL 1.5 - 4.5
A/G Ratio 1.5 1.1 - 2.5
Bilirubin, Total 1.2 mg/dL 0.0 - 1.2 01
Alkaline Phosphatase, S 53 IU/L 39 - 117 01
AST (SGOT) 15 IU/L 0 - 40 01
ALT (SGPT) 19 IU/L 0 - 44 01
Lipid Panel
Cholesterol, Total 238 High mg/dL 100 - 199 01
Triglycerides 95 mg/dL 0 - 149 01
HDL Cholesterol 35 Low mg/dL >39 01
Comment 01
According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a
negative risk factor for CHD.
VLDL Cholesterol Cal 19 mg/dL 5 - 40
LDL Cholesterol Calc 184 High mg/dL 0 - 99
FSH and LH
LH <0.2 Low mIU/mL 1.7 - 8.6 01
FSH <0.2 Low mIU/mL 1.5 - 12.4 01
Testosterone,Free and Total
Testosterone, Serum 856 ng/dL 348 - 1197 01
Free Testosterone(Direct) 21.8 High pg/mL 6.8 - 21.5 02
Estradiol 39.4 pg/mL 7.6 - 42.6 01
Roche ECLIA methodology
Prostate-Specific Ag, Serum
Prostate Specific Ag, Serum 0.8 ng/mL 0.0 - 4.0 01
Vitamin D, 25-Hydroxy 88.8 ng/mL 30.0 - 100.0 01

So Test level is up but I don’t feel any different at 856 than when it was 625.

Estradiol is up from 25 at 6 weeks to 39.4. I asked the doctor for some AI, waiting on email response. I’d like to play with some AI and see if I can optimize how I feel.

Questions:

  1. I don’t feel any different with an Estradiol of 25 or 39.4. Should I be concerned about lowering it? I don’t want gyno or other side effects, is it a high enough number that I should worry about it?

  2. If I don’t feel any different, would taking an AI and dropping it back to 25 or 20 (just playing with dosage, I imagine) be likely to have me fell more effect of higher T?

  3. Would a 3rd HCG .5ml per week make much of a difference if the current .5ml 2x/week doesn’t seem to do much (though I don’t want to stop it, I was off for a week in the 2nd month and DID NOT LIKE IT as I had a weird testes feeling smaller/hurting a little bit).

  4. Anything else of interest in the labs? For instance, advisor guys says I’m likely primary hypognadism since my LH was higher than not.

  5. Any other thoughts/comments/suggestions?

Before messing around with an AI, drop your T dose back to what it was.
You were feeling very good, and making gains you haven’t in your whole life.
Your libido/erection strength and mood are great indicators wrt the balance
of your hormones…let those things be your guide.

Lots of guys have the mindset that more T will solve what ever issue they are having.
The opposite is usually true, take your T to very high levels and you will have
a lot of side effects.

Also, your Hematocrit is rising, you gonna want to start donating blood.

Good Luck.

Thanks.

  1. Doctor ignored my request for AI. “You look like you have Primary Hypogonadism and should talk to your doctor about seeing an endocrinologist. Otherwise no change in your Test level is needed.”

That was her entire response. I have never expected anything from this doc other than signing prescriptions, but geez, thanks a lot lady.

  1. Turns out I can get Anastrozole elsewhere. As a general answer/response, if my Estradiol is 39.4, what would the recomended dosage be? I’m looking at 100mcg pills, or 1mg pills of Anastrozole.

  2. I was going to drop my Test dosage down after the 6 months labs. I’m planning on dropping down from .75ml/week to .5 ml/week. If I do this, that would assumably drop Estradiol level down too, yes?

3a. If I drop the Test dosage, should I even bother playing with the Estradiol level via AI? I’m guessing not, but curious what anybody has to say.

3b. If I don’t drop the Test dosage, see #2, recomended dosage to try to adjust for best treatment results.

  1. Would it (potentially, theoretically) be more worthwhile to keep the current Test dosage and try to fine tune Estradiol levels with an AI, or drop the Test dosage and see if notice improvement? (I didn’t notice any increase in benefit from upping from .5m./week to .75ml/week.)