T Nation

Anti-Aging Dr. Follow-Up


#1

So I have my follow-up with my anti-aging Dr. re: TRT today @ 11:30. Is there anything specific I should be asking about during my appointment as we discuss my blood tests?

Also, is there anything other than TRT I should be discussing with respect to additional prescriptions?

Thanks!


#2

with no other details about your situation and no time to dig through all of the threads, it is hard to say.

can you bump your original thread with all of your details, or give us a recap of the current situation?


#3

Hey PureChance. I don't have another thread, this is my first post here.

I went to an anti-aging Dr. after having done some reading on TRT in order to see if I'm a candidate. To be honest, I'm 41 and really struggle to put on muscle despite eating clean and keeping my workouts extremely intense. I really wanted to go see the Dr. so I could have my levels checked and see if I might need supplementation given my age.

The appointment today is to review my lab tests and see what the corrective plan (if any) will be.


#4

ok, welcome then.

you should read through the sticky threads at the top about blood tests and finding an HRT doctor.

Don't go into the appointment with high expectations. It takes most people here several doctors before they find one who will work with them and who knows what they are talking about.

also get your tests results in your own hands and regardless of what the doctor says, come back here and post your results for the rest of us to review and provide feedback.

good luck.


#5

Thanks PureChance! I found the appointment went surprisingly well (although I admit I'm new to this). This Dr. seemed willing to work with me and was open to discussing info I printed out from the stickies.

Here are my lab results and the recommended treatment.

	Labs
Date	4/2/11
Optimal Range	

Estrogen <50 112
Hemo/Hematocrit <17.5/54 45.2
Progesterone 0.28- 1.22 ng/ml <.5
Total testo 700-1000 ng/dl 234
Free Testo 18-24 pg/ml 6.19
Bio Testo 350-600 ng/dl 158
S-dhea 400-600 micro/dl 256
Free T3 3.5-4.2 ng/dl 2.9
TSH < 1.9 1.99
IGF 275-400 ng/ml 267
Pregnenolone 13-208 ng/dl 63
Vit D 3 25 to 80 24
Albumin 4.7
SHBG 15
Fibrinogen <300 mg/dl 215
hs-CRP <1.3 0.3
Homocysteine <7.5 umol/L 6.6
Cortisol 6 to 22 21
Glucose 60-80 93
Insulin 2 to 3 <2
PSA <4 0.5

Prescription:

75mg Test Cypionate 2X week
DHEA 50mg 1Xday
BIO-TYHROID 1 grain in the a.m.
1mg Arimidex 2x/week

What do you guys think?


#6

what are your symptoms?

estrogen is meaningless. Estradiol levels is what matters. Quest Sensitive Test #4021 is what you need.

your FT3 is just barely out of balance. FT3 ideal is 3.2 - 3.9

I would confirm your thyroid Antibody levels and if they come back normal then maybe supplement with iodine/selenium/iron and see how you react before jumping onto Thyroid meds. If you do decide to dose with dessicated thyroid, split the dose up to twice daily as it contains T3 which has a short half life.

what are your daily body temps?

was the blood draw at 8am? if so, your cortisol looks good.

no mention of starting on D3 supplements? You need at least 6,000iu D3 daily.

75mg twice weekly is a pretty major starting dose. The standard is 100mg weekly with two 50mg shots spread throughout the week. 150mg will stress your system and lead to high estradiol.

having a baseline estradiol level is critical before you start on T or AI.

don't change too many things too quickly. You may want to hold off on the DHEA. If you can introduce one new element every week or month then you can determine how each is impacting you; otherwise you are left to guess and wonder what is causing what. (This is from personal life experience and going through this for four years now).


#7

I put on weight easily, decreased libido, dry skin, trouble getting up in the a.m., stiff joints in the a.m. etc.

I sent an email to my Dr. asking for this specific test in the follow-up bloodwork in 2 months.

Yeah, I'm not keen on the Thyroid meds to start so I won't be getting them filled. Not sure on the body temps, but I can start monitoring that if it would help.

Not quite 8 a.m., but I did go straight to Qwest at 8:00. I wasn't seen until around 8:45, close enough for .govt work though!

Sorry, missed that one. I was put on 50000iu 1 X week.

Agreed, good thing is I can draw/dose less and I plan on doing just that. Will go with 50mg 1 x week and see how that goes.

Roger that, will hold off on both T3 & DHEA at first and see how the second round of bloodwork goes.

Anything else stick out at you?


#8

50mg once a week will shut down what's left of your own production and may not leave you with enough external T to compensate. 50 x2 weekly is the standard starting dose. too little can do more harm.

a prescription for 50000iu D3 is crazy when you can get good D3 from any good health food store.

btw, my advice is that of a non-medical professional, you should only do what you feel comfortable ideally under the guidance of your doctor.


#9

That was a typo Pure. Dose will be 50mg 2 X week.

Also, you're probably right about the D, but I'm not complaining as everything was put through on my insurance. I'd rather pay a co-pay over having it come 100% out of my pocket. I'll take it any way I can get it.... :slight_smile:

So I started today with TRT and a 50mg dose in the quad. I also took the Arimidex along with the injection so I'm good now until Wednesday of next week. I plan on doing a Saturday/Wednesday cycle but I had to do the first one today so I could learn how to inject.

I'm interested to see how I feel in the coming days....


#10

OMG, I woke up with a hard on today like when I was 18. Felt like I could have cut a brick in half with that fucker!


#11

That is transient. Your estrogens were out of range which is worrying.

You have some thyroid problems. Get those waking body temps and try to find daily peak temperatures.

Any iodine in your diet? Iodized salt, sea food, iodine in vitamins?


#12

What causes the estrogen levels being high? Granted, Estradiol wasn't checked, but I asked for that specific test in my next round of bloodwork.

What makes you say I have thyroid problems? Which test is alluding to that?

As for Iodine, it's in my multi. I use the Opti Men and it has:

Iodine 150mcg 100%*

thx


#13

taking external T typically drives up Estradiol.
excess weight drives up Estradiol.
thyroid problems/insufficient cortisol drives up Estadiol.

please read KsMan's thread about his iodine experiment. 150mcg is the minimum to avoid catastrophic thyroid failure or a goiter. It was NEVER meant to maintain ideal iodine levels.

what makes you say I have thyroid problems?

The same reason I think you have possible thyroid issues and why I asked what your waking body temperature was.

your TSH of 1.99 is above range even per the lab range (which in of itself is simply amazing. The fact that the lab actually has that range. I mean it's correct, which I have never seen in any lab report yet).

your free T3 is just slightly below ideal + all of your symptoms could be related to thyroid problems.

Check out the blood test sticky towards the bottom. There is a post about body temps. Try that out and you can quickly confirm or exclude your thyroid as a potential source of your issues.


#14

This I understand and read in the sticky. I was referring to my pre-TRT #'s. Was wondering why my estrogen was high in my baseline tests as I have < 10% BF. That said, that may explain why I have such a hard time losing the spare tire & back handles...

The 1.99 may be a typo, the #'s were transcribed from the lab report into a .xls. I'll need to ask about that. Haven't started the temp monitoring yet, but have been reading up on it. Any recommendations on thermometer type?


#15

oral thermometer is best. other then that I have no idea.


#16

Basal thermometer. Some are more closely calibrated by the manufacturer and can display as well as measure temps to the tenth of a degree, accurately.