T Nation

Advice on Latest Labs and Protocol


Greetings all, I've posted before, but wanted to get some feedback on my latest labs and protocol.

A brief history. I'm a 45 year old male. 230 pounds. 6ft tall. I exercise regularly (Intense interval cardio for 20 minutes and strength training 4-6 times a week). I've always ate healthy and exercised, but had problems with weight and apnea since my teens. The only way I could lose weight was massive cardio and starvation. I eat a low bad carbs, high protien, veggie, fruit and fiber diet. My blood pressure was always good, even when in a "heavy" period averaging 118/60.

Two years ago my urologist at the time (No longer seeing) placed me on Testim for low T (Total T of 295). I couldn't tolerate Testim, it made my blood pressure skyrocket to 158/105. Tried Androgel, but it gave me insomnia. Tried test cyp injection, but again, my blood pressure skyrocketed, I had sweats, cold chills and couldn't sleep for three days. Thought I was going to die.

Most recent doc had me switch to compounded Test which has worked out fairly well. Was still feeling low on energy and had brain fog, so they added HCG and Arimidex. Did the following protocol for three months.

Compounded T Creme: 50mg in am and 25mg in pm.
HCG: 2,000IU E3D
1mg Arimidex Every Day.

My labs came back as follows.

Complete Blood Count Unit (Ref)

WBC 7.1 10e9/L (4.3-11.0)
RBC 5.47 10e12/L (4.44-5.67)
Hemoglobin 16.2 g/dl (13.4-17.4)
Hematocrit 48.6 % (40.2-50.8)
MCV 88.8 fl (82.5-98.5)
MCH 29.6 pg (27.5-33.5)
MCHC 33.3 g/dl (31.9-35.7)
RDW-CV 13.9 % (12.1-14.5)
RDM-ED 45.3 fl (38.3-49.1)
Platelet Count 238 10e9/L (156-367)
Mean Plt Volume 10.9 fl (9.4-12.9)
Neutrophil 44.5 %
Lymphocyte 36.7 %
Monocyte 8.4 %
Bosinophil 9.8 %
Basophil 0.6 %
Neutrophil ABS 3.18 10e9/L (1.80-7.80)
Lymphocyte ABS 2.62 10e9/L (1.00-4.00)
Monocyte ABS .60 10e9/L (0.20-0.90)
Bosinophil ABS 0.70 10e9/L (0.00-0.45)
Basophil ABS 0.04 10e9/L (0.00-0.20)
Dihydrotestos 482 f pg/ml (106.0-719.0)
Estradiol 33 f pg/ml (0-56)
Free Testost 104.8 pg/ml (46.0-224.0)
Sex Hormone BG 18 mmol/L (9-45)
TOT Testost 497 ng/dl (250-1100)
Albumin Ref 4.6 f g/dl (3.6-5.1)
Testos Bioavail 220.2 ng/dl (110.0-575.0)

I have had bad side effects, no labido, ED, moodiness bordering on rage, memory problems, trouble thinking and speaking. Would the side effects be caused by the high dose of HCG?

I've seen a cardiologist throughout my treatment and had several stress tests. My cardiovascular system is strong.

I finally talked the doc into lowering my HCG so it's more in line with what I read people doing (Like KSman's protocol). Currently doing the following.

Compounded T Creme: 50mg in am and 37.5mg in pm.
1mg Arimidex Every Day.

What do we think of the latest labs and the new protocol? I'm trying to get in to see Dr. Mariano, but have not had any success in reaching him yet.

Thanks for your help and input.


Yes the High dose of HCG can problematic. Keep in mind that a big side of ADEX is lethargy and you are taking a pretty bid dose. My biggest dose of ADEX when on 100mg/wk was .25mg ED and that kept me in the 20's for E2, but everyone is different.


Your right. Now that I have lowered the HCG dose, maybe I'll try .25 mg of adex EOD on the same schedule as my HCG injections.


Holy fuck balls...adex 1 mg/day? That is probably the cause of your symptoms...though I'm very surprised to see your E2 results where they are...what labs did you use your test? It could be the wrong one, but the range looks good...what does the 'f' mean in the results?

I would back off to 0.5 mg/E3D and see how that works for you....


Ya, I'm starting to get the feeling this latest doc doesn't know what he is doing either :frowning:

The "f" means footnote.


HCG is known to increase aromatase in the testicles which is not impacted by Arimidex.


Ok, so how about this...

Compounded T Creme: 50mg in am and 37.5mg in pm.
.25mg Arimidex EOD


what is your TSH? there seems to be a correlation between people with hypothyroidism and people who can't absorb transdermal medications.

there is also the chance that your T levels on the blood test may have been solely due to the HCG.

what were your initial test results before you started on treatment?


It doesn't look this doc has been checking that. I am SURE the first doc that originally put me on this stuff didn't. I wouldn't even be surprised if I was initially misdiagnosed. I've seen 4 doctors now over two years trying to determine if (a I even should have been on this stuff in the first place and (b if I should be on it, dosing me correctly. I did find some labs from earlier in my treatment (Below). Hopefully, I can find a more competent doctor in San Francisco.

These were all I could find from the doctors records I have copies of.

From 10-16-09 after being off of TRT for 5 weeks, because of very high BP on testim.

Complete Blood Count
WBC 8.4
RBC 5.22
Hemoglobin 15.2
Hematocrit 46.7
MCV 89.5
MCH 29.1
MCHC 32.5
RDW-CV 13.4
Platelet Count 215
Mean Platelet Volume 10.9
Neutrophil % 61.8
Lymphocyte % 20.3
Monocyte % 10.3
Eosinophil % 7.1
Basophil % .5
Neutrophil ABS 5.22
Lymphocyte ABS 1.71
Monocyte ABS .87
Bosinophil ABS .60 (High)
Basophil ABS .04
RDW-SD 44.3

FSH 4.0
LH 5.0
Testosterone to FSH 188 (Low)

Then tested on 3-12-10 after 5 months on Androgel.

Complete Blood Count
WBC 5.1
RBC 5.07
Hemoglobin 14.9
Hematocrit 47.0
MCV 92.7
MCH 29.4
MCHC 31.7
RDW-CV 13.9
Platelet Count 217
Mean Platelet Volume 10.8
Neutrophil % 50.5
Lymphocyte % 35.2
Monocyte % 10.2
Eosinophil % 3.5
Basophil % .6
Neutrophil ABS 2.57
Lymphocyte ABS 1.75
Monocyte ABS .52
Bosinophil ABS .19
Basophil ABS .03
RDW-SD 46.8
PSA Equimolar 1.03

Testosterone to FSH 313


Your values are meaningless without ranges


With TT in the 800-1000 range from TRT, 1.0mg of anastrozole works well for normal responders. If your T levels were 400, then 0.5mg anastrozole might be a better starting dose, later lab results are used for dose refinement.


Thanks KSman. Should I go .5 EOD?