T Nation

Blood Panel Done. Need Some Advice

After taking the advice of several members here, I got a blood panel done. A couple of things off balance here and I’m looking for some advice and what to watch out for.
TIA
Male 39YO
6’1"
184
12.6%BF
23.8 BMI

All natural.

CMP12+LP+6AC+CBC/D/Plt+PSA+
Glucose 104 High mg/dL 65-99
Uric Acid 4.4 mg/dL 3.7-8.6
BUN 11 mg/dL 6-20
Creatinine 1.04 mg/dL 0.76-1.27
eGFR If NonAfricn Am 90 mL/min/1.73 >59
eGFR If Africn Am 104 mL/min/1.73 >59
BUN/Creatinine Ratio 11 9-20
Sodium 140 mmol/L 134-144
Potassium 5.0 mmol/L 3.5-5.2
Chloride 100 mmol/L 96-106
Calcium 9.8 mg/dL 8.7-10.2
Phosphorus 3.6 mg/dL 2.5-4.5
Protein, Total 7.1 g/dL 6.0-8.5
Albumin 5.0 g/dL 3.5-5.5
Globulin, Total 2.1 g/dL 1.5-4.5
A/G Ratio 2.4 High 1.2-2.2
Bilirubin, Total 0.5 mg/dL 0.0-1.2
Alkaline Phosphatase 75 IU/L 39-117
LDH 153 IU/L 121-224

CMP12+LP+6AC+CBC/D/Plt+PSA+
AST (SGOT) 28 IU/L 0-40
ALT (SGPT) 35 IU/L 0-44
GGT 38 IU/L 0-65
Iron 113 ug/dL 38-169
Cholesterol, Total 174 mg/dL 100-199
Triglycerides 77 mg/dL 0-149
HDL Cholesterol 72 mg/dL >39
LDL Cholesterol Calc 87 mg/dL 0-99
T. Chol/HDL Ratio 2.4 ratio 0.0-5.0
Estimated CHD Risk < 0.5

Homocyst(e)ine 7.4 umol/L 0.0-15.0
Prostate Specific Ag, Serum <0.1 ng/mL 0.0-4.0

DHEA-Sulfate 182.1 ug/dL 102.6-416.3
Estradiol 18.6 pg/mL 7.6-42.6
Roche ECLIA methodology
C-Reactive Protein, Cardiac 0.73 mg/L 0.00-3.00

WBC 3.8 x10E3/uL 3.4-10.8
RBC 4.85 x10E6/uL 4.14-5.80
Hemoglobin 14.4 g/dL 13.0-17.7
Hematocrit 42.8 % 37.5-51.0

CMP12+LP+6AC+CBC/D/Plt+PSA+
MCV 88 fL 79-97
MCH 29.7 pg 26.6-33.0
MCHC 33.6 g/dL 31.5-35.7
RDW 13.1 % 12.3-15.4
Platelets 272 x10E3/uL 150-379
Neutrophils 54 % Not Estab.
Lymphs 34 % Not Estab.
Monocytes 6 % Not Estab.
Eos 5 % Not Estab.
Basos 1 % Not Estab.

Immature Cells
Neutrophils (Absolute) 2.1 x10E3/uL 1.4-7.0
Lymphs (Absolute) 1.3 x10E3/uL 0.7-3.1
Monocytes(Absolute) 0.2 x10E3/uL 0.1-0.9
Eos (Absolute) 0.2 x10E3/uL 0.0-0.4
Baso (Absolute) 0.0 x10E3/uL 0.0-0.2
Immature Granulocytes 0 % Not Estab.
Immature Grans (Abs) 0.0 x10E3/uL 0.0-0.1

Hemoglobin A1c 5.7 High % 4.8-5.6
Free Testosterone(Direct) 8.5 Low pg/mL 8.7-25.1 BN
Testosterone, Serum 574 ng/dL 264-916
TSH 2.110 uIU/mL 0.450-4.500
Vitamin D, 25-Hydroxy 62.2 ng/mL 30.0-100.0
Insulin 4.1 uIU/mL 2.6-24.9
Apolipoprotein B 90 High mg/dL <90

I’m guessing your SHBG is high. You’re going to need to get your total testosterone to the top range, at least.

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Albumin is also high. T binds “loosely” to albumin, but it does bind to it. Your blood counts are low (RBC and WBC). Low RBC is not surprising with low free T. So, the problem revolves around your free T, and why it is low. SHBG is most likely high. Are you on TRT now? If yes, up your dose. If no, talk to the doc about lowering SHBG.

Yes SHBG is 45

No I’m not on TRT. How can I lower SHBG?

FYI, sorry if its TMI, but I jerk it about 5x wk sometimes twice/day because the wife only gives it up about once a week. Super hard erections get up real quick and I can go twice if I need to.
Lost some motivation in the gym and I’m a really hard gainer. Minimal body hair (dont mind that).

There are drugs for it. There are some things that naturally raise your test levels, which would probably help your free T by extension. Google “elevate testosterone” or something to that effect and see which things you can do realistically.

What is the best way for me to get there?

TRT, I would start with 150mg a week. Be prepared to go higher.

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Im on 75mg 2x week for the past 3wks. Feeling great so far.
Also on HCG 3x wk @ 250iu/dose.
Should I be on Arimidex as well?

Man your Vitamin D is really good for someone with low T symptoms, congrats on that and try to keep it that way.

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your A1c is high. reduce carbs (do not cut them !) chose wisely your carbs. go low IG carbs.
and intermittent fasting will reduce your glucose and A1c.
you should go a little higher on your T dosage.

I wouldn’t do it, at least not yet. Your E2 was lower end and with your SHBG at 45, you may not have any trouble with higher E2 levels. In fact, you may need it.

Sounds as though you’re off to a good start.

Keep in mind the test was taken while not fasting. I do eat a lot of carbs. I also just dropped 1% in body fat in the last month.
I think I will stay with the current dosage as I can feel the results. We’ll see what the next blood lab reveals.

Thank you for the advice.
Yesterday I had one of the best workouts Ive had in a long time. Feeling great too.
A little more aroused than usual. Dick function is still top notch.
Slightly more agitated than normal. I woke up this morning to having an irritating dream.
Noticeably getting more ripped already. I dont usually notice my gains, but my abs are definitely showing more, and I’ve gotten a few recent comments about looking good/ripped. Like I mentioned above I’ve also dropped a % in BF and I haven’t changed my diet.
So the TRT is definitely working. Although the results are mild so far, based on other threads, I wasnt expecting such rapid results. I’m very happy with the results and I dont feel I need to step it up from here.

Two questions. What side effects should I keep an eye out for? When should I get my next labs done?

I hesitate to say. If you rub your nipples enough trying to figure out if they are sore……….they will get sore. High E2, fluid retention, nipple sensitivity, puffiness, tenderness (which is mastalgia, not gynecomastia), sexual dysfunction, emotional, moodiness, etc. Go with what you are feeling, not the number.

Six to eight weeks for follow-up labs.

if its working, keep it. following

Nips are a little pink.