T Nation

Blood Work - Please Review


#1

I'm 49; been on trt for 2 1/2 years - Test Cyp 200 mg e2w. last November convinced doc to up to 400 MG e2w and injected 200 e7d. Doc wanted me to see endo to get their "blessing" on this amount. No ai or hcg. I saw endo on 4/8/2013 and got blood drawn on 4/9. Things to note are the high PSA. Because of this the endo recommended I immediately cease trt and see urologist (after getting second PSA test to confirm it's high). Also note the high total estrogen and above average estradiol. Upping test cyp to 400 mg e2w was a mistake as it aromatized to estrogen.

So now I'm in the position of ceasing trt, getting the high psa analyzed with possible prostate biopsies, and who knows what then.
Been feeling tired, fatigued last few months, probably from high estrogen.

Strength is down probably because I lowered test cyp to a little less than 100 mg e7d and will half that until I run out end of this month, and then it's no trt and not restart protocol after that, unless of course the high psa was false and urologist confirms healty prostate.
Been taking about 4000 IU Vit D3 daily due to low D numbers.

Below are recent blood work #'s from last April and again last week (more thorough). Shown is the test name, my actual number, followed by the reference range.
Please review my blood work and provide thoughts, comments, especially as regards T, free-bioaval T, Estrogen., and low IGFBP-3, low normal pregnenalone, and low normal DHEA. THANKS!

*** FROM 4/9/2013 ***

TEST MY NUMBER REF RANGE

ACTH 35.7 7.2 - 63.3 pg/mL

Testosterone 316 ng/dL (while on 400 mg e2w! - converting to estr?)
Males:
20-49 yrs 72-853

Estradiol 43 pg/mL
Males: 20-56

Sex Hormone Binding 23.5 16.5 - 55.9 nmol/L

issam-ch web site computes free and bioavailable t as follows:
Free Testosterone 7.33 ng/dL = 2.32 %
Bioavailable Testosterone 179 ng/dL = 56.8 %

PSA 7.7 0.0 - 4.0 ng/mL HIGH

Vit D, 25-Hydroxy 29.7 30.0 - 100 ng/mL LOW

Somatomedin (IGF-I) 179 59 - 201 ng/mL

IGF Binding Protein-3 3.6 3.3 - 6.7 mg/L

LH <0.1 MIU/mL Males: 0.8-7.6 LOW?

FSH 0.1 MIU/mL Males: 0.7-11.1 LOW?

Vitamin B-12 760 239 - 931 pg/mL

Thyroid Peroxidase Ab <6 0 - 34 IU/mL

Thyroglobulin Ab <20 0 - 40 IU/mL
Siemens (DPC) ICMA Methodology

Thyroglobulin Ab <20 0 - 40 IU/mL
Siemens (DPC) ICMA Methodology

Magnesium 2.2 1.5 - 2.5 mg/dL

Prolactin 7.6 2.5 - 17.0 ng/mL

Cortisol 13 5 - 25 ug/dL

Cholesterol, Total 162 0 - 200 mg/dL
Triglycerides 263 10 - 150 mg/dL HIGH
HDL 40 30 - 60 mg/dL

Sodium 137 135 - 146 mmol/L
Potassium 4.2 3.5 - 5.3 mmol/L
Chloride 102 98 - 110 mmol/L
CO2 24 21 - 33 mmol/L
Anion Gap 11 3 - 16 mmol/L
BUN 10 7 - 25 mg/dL
Creatinine 0.99 0.50 - 1.30 mg/dL
Glucose 83 65 - 99 mg/dL
Calcium 9.2 8.6 - 10.2 mg/dL
Total Bilirubin 1.0 0.2 - 1.2 mg/dL
AST 28 17 - 59 U/L
ALT 36 9 - 60 U/L
Alkaline Phosphatase 59 40 - 115 U/L
Total Protein 7.3 6.2 - 8.3 g/dL
Albumin 4.5 3.6 - 5.1 g/dL
GFR MDRD Af Amer 97 See note.

WBC 7.1 3.8 - 10.8 10E3/uL
RBC 5.62 4.20 - 5.80 10E6/uL
Hemoglobin 15.3 13.2 - 17.1 g/dL
Hematocrit 46.6 38.5 - 50.0 %
MCV 82.9 80.0 - 100.0 fL
MCH 27.3 27.0 - 33.0 pg
MCHC 32.9 32.0 - 36.0 g/dL
RDW 14.3 11.0 - 15.0 %
Platelets 164 140 - 400 10E3/uL
MPV 6.8 7.5 - 11.5 fL

*** BLOOD WORK ONE MONTH PRIOR 4-9-2013 ***

Testosterone 683 ng/dL
Adult Male Ranges:
20-49 years 270-1194 ng/dL

Estrogens, Total 121 40 - 115 pg/mL HIGH, but not the sensitive test

Pregnenolone, LC/MS/MS 41 13 - 208 ng/dL

DHEA 75 31 - 701 ng/dL

Iron 82 45 - 170 ug/dL
% Iron Saturation 20.0 15.0 - 55.0 %
TIBC 421 261 - 462 ug/dL

Ferritin 13.7 18.0 - 464.0 ng/mL

Cholesterol, Total 182 0 - 200 mg/dL
Triglycerides 259 10 - 150 mg/dL HIGH
HDL 45 30 - 60 mg/dL

TSH 2.03 0.45 - 4.50 mIU/L

Free T4 1.08 0.61 - 1.76 ng/dL

T3, Free 4.7 2.8 - 5.3 pg/mL


#2

Did you ever find out more about your PSA levels?
Also 400MG e2w seems awful. I'd think 100mg 2x weekly would be better, but that's relatively high dosage. Regardless, the e2w dosing seems like a problem in and of itself. Not sure if that could relate to PSA or not, but it would seem injecting 400mg all at once would make your T spike like crazy, then gradually fall down to baseline / lower until your next injection... probably would heighten your E2 for a while in the first few days as well.

How long after a shot were the labs taken? Obviously it was several days out after you crashed.

Post back up with an update- I'm curious.