Bloodwork & TRT Cheatsheet

as you know some people just can’t absorb transdermal medications.

other doctors say that Transdermal does not impact blood levels of pregnenolone (which I say is BS).

other doctors say that you would have to take massive amounts of Transdermal pregnenolone for it to actually show up on blood tests (seems more reasonable).

some people on other forums have had success with taking lipid matrix micronized pregnenolone (available OTC online). the lipid matrix version is suppose to skip the first-pass through the liver so you end up with higher levels. people take anywhere from 50mg to 300mg.

[quote]KSman wrote:
I have written about how you can increase pregnenolone levels by improving mitochondrial function. Have you trying any of the recommendation? [/quote]

Are you talking about:

To which I responded:

[quote]VTBalla34 wrote:
KSMAN: Thanks for the info on cell health…I take a lot of steps to ensure everything is going well at the cellular level, including fish oils (Flameout from this site) and antioxidants (Biotest Superfood)…diet is also very high in antioxidant rich veggies…I will keep the CoQ10 info in the back pocket for now…I really believe that once all my hormone issues are rectified that the cholesterol will follow…
[/quote]

?


I’ve not tried any of the additional supplement recommendations as this is the first blood test I’ve had with pregnenolone, so I didn’t know of a potential problem before. I was only taking it for the past couple months to aid in backfilling cortisol pathways while coming off the Cortef.

Gonna wait till the rest of my bloodwork is in before making any changes. That unfortunately won’t be for a couple weeks since I’m OOC for work.

One theory that HAN suggested is that the serum levels are low because the preg is being immediately converted into the downstream hormones. I’ve tested DHEA and Progesterone on this test, so that should confirm or deny that theory.

As PC mentioned, its also possible that I wasn’t absorbing, especially since I have been diagnosed secondary hypothyroid anyway.

I just wanted to capture this here for posterity in case I forget somewhere down the line.

I stopped taking the adex after my blood test on 26 January. I had been having sore joints and ED issues that I thought may be from too high of adex (0.7 mg/week in EOD doses). Its been a couple weeks and erections are a bit better and joint pain is gone, so it would seem my suspicions are confirmed.

Whether it degrades from here, continues to get better, or flatlines still remains to be seen.

I ordered some tadalafil (20 mg) online and that seems to help the ED immensely. But would certainly rather not have to rely on that.

On 12 February, I began taking Rez-V from Biotest as part of my supplements. Recommended does at 3 caps per day. Will report back on any changes I notice from that.

VTB, can you edit your glossary to remove the junk created by cut and past from a word processor? [The way to avoid this is to save as .txt, then open that file with notepad.exe and cut/paste from that.]

[quote]KSman wrote:
VTB, can you edit your glossary to remove the junk created by cut and past from a word processor? [The way to avoid this is to save as .txt, then open that file with notepad.exe and cut/paste from that.][/quote]

Done

Testicle Pain & Adex

I wrote this in hipsr4runnin’s thread on testicle pain + adex:

[quote]VTBalla34 wrote:
My story is dissimilar from OP, but does involve testicle pain and adex, so I thought I would share…

When I decided to embark on correcting my issues in June 2010, one of my symptoms was occasional dull aching of one of my testicles…when I started taking Adex in June, the pain pretty much disappeared…I started out at 0.5 mg/week and eventually bumped up to 0.7 mg/week…

Thinking I may my E2 aromatization issues under control, I stopped taking adex entirely at the end of January…

A couple weeks later, my left testicle developed the same dull pain, that seems to spike upon deep breaths…This has been ongoing for the past couple weeks…

It seems more pronounced after I take my Rez-V for the day, but that could just be in my head or a function of med timing…

Take this for what its worth, but I thought it interesting and somewhat relevant…

[/quote]

Basically I was having testicle pain before starting Adex, it went away, now that I’ve stopped Adex, it seems to have come back…

I’ve felt around for lumps, and am a bit concerned, so I am going to schedule an appointment with a doc in the next couple weeks to have the boys checked out…

On good news, they’ve been checked out as part of my first-visit routine by two different doctors over the past 8 months, and nothing was obviously amiss, so I’m optimistic that nothing is wrong…but better safe than sorry…

I also called Quest Friday and they told me all my labs had been completed and results mailed out to me on Wednesday…so they’re probably at home now, but I’m on travel until next Sunday so won’t get a chance to view them until then…

I really wish Virginia would get with the program and allow results released directly to patients–I would be able to view them directly on my blackberry remotely…

Just got all the final bloodwork in

[u]Bloodwork - January 2011[/u]

Note: Changes from October test are noted in brackets, when available

Pregnenolone: 24 ng/dL (13-208)[n/a]
Progesterone: <0.5 ng/mL (<1.4)[?]
DHEA-S: 171 mcg/dL (110-510)[-6]
DHEA, Urine: 537 mcg/24h (21-2710)[+215]
DHEA, Urine: 130 mcg/g creat (24-1640)[+56]

LH: 9.1 mIU/mL (1.5-9.3)[+0.1]
[i]Testosterone, Total: 436 ng/dL (250-1100)[-194][/i] <<–WTF???
Testosterone, Free: 66.4 pg/mL (46-224)[-34.7]
Testosterone, Bioavailable: 133.7 ng/dL (110-575)[-105]
SHBG: 28 nmol/L (7-49)[+4]
DHT: 33 ng/dL (25-75)[+8]
[i]E2: 41 pg/mL (13-54)[+12][/i] <<–WTF???
Testosterone, Urine: n/a
Testosterone, Urine: n/a

ACTH: 11 pg/mL (7-50)[n/a]
Cortisol, Total: 5.1 mcg/dL (4.6-20.6)[-.4]
Cortisol, Free: 0.09 mcg/dL (0.07-0.93)[+.01]
Cortisol, AM: n/a

TSH: 2.09 mIU/L (0.4-4.5)[-0.01]
T3, Total: 130 ng/dL (76-181)[+20]
T3, Free: 400 pg/dL (230-420)[+20]
T4, Total: 6.7 mcg/dL (4.5-12.5)[+0.6]
T4, Free: 1.1 ng/dL (0.8-2.7)[-0.3]
T3, Reverse: 24 ng/dL (11-32)[+4]

Vitamin D, 25OH: 84 ng/mL (30-100)[+13]
Vitamin B12, Serum: 818 pg/mL (200-1100)[+513] <<–After supplementing B12

Creatinine urine: n/a
*Iodine, Urine: 1619 mcg/L (34-523)[+1539]<–After supplementing iodine
Albumin: 4.4 g/dL (3.6-5.1)
Ferritin: 58 ng/mL (20-345)[+7]
Folate: 22.9 ng/mL (>5.4)[n/a]

*Total Cholesterol: 220 (<200)
*LDL: 144 (<100)
*HDL: 31 (>40)
*Total/HDL Ratio: 7.1
*Triglycerides: 226 (<150)
*Glucose: 102 (<100)

The following hematology was marked out of range, as usual…all other hematology were “in range”:
*Hemoglobin: 17.4 g/dL (13.2-17.1)
*Hematocrit: 50.8% (38.5-50.0)


Some things I note from the labs:
-Test (total, free, bioA) are heading in the wrong direction…200 drop in free T???
-Estradiol had large increase, even though taking 0.7 mg/week Rx arimidex
-LH has been constantly high on 4 blood tests now…significant?
-Cortisol markers look terrible
-Iodine supplementation needs to be cut back on considerably
-I was taking liver tabs to try and increase ferritin, and that has no appreciable effect…
-Lipids are in the toilet

To say that I am growing discouraged would be a huge understatement…

I had my consult yesterday with HAN and Dr. O…it went well and we are on the same page and I think we have a good game plan going forward…

We are going to look at Celiacs…more blood testing and I am going to schedule a biopsy for confirmation…

In the meantime, we are increasing my pregnenolone dose from 25 mg/day to 100 mg/day (25 mg 4x). Hopefully this will get my preg up and other downstream hormones brought online…Retest in 2 weeks of DHEA (Sulfate serum and DHEA urine) and Progesterone, as well as E2 and testosterone to see if I am absorbing. If no improvement, we are going to look at replacing the Rx pregnenolone with a different brand (more gel based).

As for managing E2 in the meantime, we are switching to Aromasin. We’re thinking the compounded adex caps I was using was either a poor product or wasn’t being absorbed if I have gut issues…the liquid should be absorbed better by my body

I’ve got a blood test set up Monday for more celiacs markers, as well as E2, Vitamin A, and prolactin…I stopped taking the adex over a month ago, so if there are no changes in E2 then that would point to an issue with my adex product…

I will also be doing the Genova Nutra-Eval once I can find a place to draw the blood…my Quest location has refused, but apparently others will…

Glad to hear you’ve got a solid game plan to move forward with. Keep your chin up, brother; we’re all pulling for you here.

Best of luck with all this.

I found out today that there is a good chance (90%) that I have testicular cancer…

I had been having pain on and off for about 8 months now and did a self-exam last week and noticed firmness and a lump in my left one…scheduled an appointment with a urologist who agreed with both and scheduled me for an ultrasound…

Ultrasound confirmed 3 (!) “lesions” in that testicle (right one was fine)…one of which was 2 cm long…the other two were smaller…

I have a follow up with the uro tomorrow to get a confirmation, but based on the sonogram lady’s reaction and discussion, I’m pretty sure I know the answer…

The good news: This proibably explains all my issues…

Diagnosis confirmed…my Orchiectomy is scheduled for 28th March…

From a quick search online, I’ve seen some sites that say an orchiectomy will slightly lower T levels, but overall they should be able to recover…the problem is that mine weren’t all that high to begin with! Does anyone have any experience with this?

Also curious if the tumor is the likely cause of my current lowish T (and other hormone levels)? I know it is at least a contributing factor, but is it the “smoking gun”? Could I actually see an INCREASE in T (and other hormones) once the defective nut is removed?

I realize that most of my labs at this point in time are pretty useless, but the engineer in me is ever curious…got the latest round back today, which included cancer markers:

Bloodwork - March 2011

Gliadin (deamidated peptide) AB (IGG): 5 (<20 [n/a]
Gliadin (deamidated peptide) AB (IGA): 3 (<20) [n/a]
Gliadin AB (IGA): <3 U/mL (<11 = Negative) [n/a]
Gliadin AB (IGG): 69 U/mL (>17 = Positive) [-7]

Vitamin A: 81 mcg/dL (38-98) [n/a]

Estradiol: 27 pg/mL (13-54) [-14]

[i]*Prolactin: 18.8 ng/mL (2-18) [+11.8][/i]

*Glutamine (Amino Acid Urinalysis): 17 mmol/mol creat (21-182)
*Ethanolamine (Amino Acid Urinalysis): 15 mmol/mol creat (21-65)
Note: All values in my amino acid profile (~38 markers) were at the bottom ends of the range, not one was near the upper end…these were the two out of range low

WBC: 8.5 k/uL (3.8-10.8) [+2.3]
RBC: 5.36 M/uL (4.2-5.8) [-0.14]
Hemoglobin: 17.1 g/dL (13.2-17.1) [-0.3]
*Hematocrit: 50.3 (38.5-50.0) [-0.5]
MPV: 7.8 fL (7.5-11.5) [-0.5]

*AST : 41 U/L (10-40) [+15]
ALT: 50 U/L (9-60) [+15]
Creatinine: 1.29 mg/dL (0.8-1.3) [-0.05]

Alpha Fetoprotein: 2.0 ng/mL (<6.1) [n/a]
HCG, QN: 2 mIU/mL (<5) [n/a]
LDH: 206 U/L (100-220) [n/a]


Of note:

  1. Only one gliadin/celiac marker is high, which was also high on my last test…the deamidated peptides, which I understand are the most useful for diagnosing celiacs, are all well below range
  2. E2 has fallen 14 points since my last blood test in January, even though in January I was taking Arimidex and had stopped and wasn’t taking anything for estrogen control at the time of this test…weird
  3. Prolactin has skyrocketed from my test in late 2009–possibly secretions from the tumor?
  4. Lower amino acids across the board
  5. White blood cell counts show a marked increase–tumor…
  6. AST and ALT had a high increase, but not sure what these markers indicate
  7. All my cancer markers (AFP, HCG, LDH) were in range…possible indication that the tissue damage isn’t very sever yet and we have caught things early?

Not expecting any advice since it seems my thread has grown well beyond the scope of this forum, but if anyone has anything to offer, lets discuss…

[quote]VTBalla34 wrote:
I realize that most of my labs at this point in time are pretty useless, but the engineer in me is ever curious…got the latest round back today, which included cancer markers:

Bloodwork - March 2011

Gliadin (deamidated peptide) AB (IGG): 5 (<20 [n/a]
Gliadin (deamidated peptide) AB (IGA): 3 (<20) [n/a]
Gliadin AB (IGA): <3 U/mL (<11 = Negative) [n/a]
Gliadin AB (IGG): 69 U/mL (>17 = Positive) [-7]

Vitamin A: 81 mcg/dL (38-98) [n/a]

Estradiol: 27 pg/mL (13-54) [-14]

[i]*Prolactin: 18.8 ng/mL (2-18) [+11.8][/i]

*Glutamine (Amino Acid Urinalysis): 17 mmol/mol creat (21-182)
*Ethanolamine (Amino Acid Urinalysis): 15 mmol/mol creat (21-65)
Note: All values in my amino acid profile (~38 markers) were at the bottom ends of the range, not one was near the upper end…these were the two out of range low

WBC: 8.5 k/uL (3.8-10.8) [+2.3]
RBC: 5.36 M/uL (4.2-5.8) [-0.14]
Hemoglobin: 17.1 g/dL (13.2-17.1) [-0.3]
*Hematocrit: 50.3 (38.5-50.0) [-0.5]
MPV: 7.8 fL (7.5-11.5) [-0.5]

*AST : 41 U/L (10-40) [+15]
ALT: 50 U/L (9-60) [+15]
Creatinine: 1.29 mg/dL (0.8-1.3) [-0.05]

Alpha Fetoprotein: 2.0 ng/mL (<6.1) [n/a]
HCG, QN: 2 mIU/mL (<5) [n/a]
LDH: 206 U/L (100-220) [n/a]


Of note:

  1. Only one gliadin/celiac marker is high, which was also high on my last test…the deamidated peptides, which I understand are the most useful for diagnosing celiacs, are all well below range
  2. E2 has fallen 14 points since my last blood test in January, even though in January I was taking Arimidex and had stopped and wasn’t taking anything for estrogen control at the time of this test…weird
  3. Prolactin has skyrocketed from my test in late 2009–possibly secretions from the tumor?
  4. Lower amino acids across the board
  5. White blood cell counts show a marked increase–tumor…
  6. AST and ALT had a high increase, but not sure what these markers indicate
  7. All my cancer markers (AFP, HCG, LDH) were in range…possible indication that the tissue damage isn’t very sever yet and we have caught things early?

Not expecting any advice since it seems my thread has grown well beyond the scope of this forum, but if anyone has anything to offer, lets discuss…

[/quote]
Once I get the testing results then I will be able to get a better indication of what is going on. Low Amino acid just reinforces the fact about malaborption/ hyperpermeability issue that may be occuring. Low glutamine would mean your gut is using it at high rate which could being pulled from muscle if it is not being supplied through diet. Celiac has been known to lead into other imbalances such as cancer. The sad thing is that 1 out of 9 people across the planet may have celiac not even knowning it or showing symptoms before it is too late.
Prolactin increases if you have had intercourse the night before, hypothyroidism, low dopamine levels, or as you mentioned some kind of tumor indication with in the body.

I had the surgery today…including registration, pre-op, op, and recovery, I was in and out of the hospital in 3 hours…it was one of the easiest thing I’ve ever done…

Was able to walk to my car 2 blocks away post surgery with little issue, took a nap, and went out to eat with my folks and g/f this evening…some pain since it was a groin incision, and its getting stiffer, but right now I feel fine…still going to take it easy the rest of the week and let it heal up, but I’m not expecting a long recovery time…

The tumor was sent off for inspection and my follow up appointment is next week’s Wednesday, so I will know then what further treatment is necessary, if any at all…

I’m going to stop all the meds I’m currently on to try and get back to baseline and go from there–very hopeful this was the root of my problems, but need to make sure…

TAPER… don’t stop anything cold turkey… especially if you are on multiple medications and/or supplements…

Just got back from my follow-up appointment, and I don’t think it could have gone much better. Basically:

-The tumor was a pure seminoma, which is the most treatable and curable cancers
-It showed no signs of metastasizing outside of the removed testis

One thing that I was a little disappointed with though was the uro doesn’t think the tumor was causing my high LH and other issues…personally, I just don’t see how it couldn’t be playing somewhat of a role, but who knows…he admittedly is not a hormone specialist, so at least he recognizes that weakness…

So basically, I have a CT scan on Friday and if that shows nothing, I can pretty much assume everything is cleared up…

However, I may still opt for 2 rounds of chemo regardless of the CT outcome…I’ve read several studies that have shown in 3 separate trials with multiple hundreds of people who underwent 2 rounds of chemo after seminoma orchiectomy, the 5 year recurrence rate went from 15% (with just monitoring and maintenance) to ZERO percent…literally not a single participant had a recurrence…

Now I know 15% is small, but I think I would probably sleep much easier at night for the rest of my 20’s and early 30’s if I know that there is nothing to worry about…I think the ease of mind is well worth the misery of chemo for a few days…

wow. great news (except for the mixed blessing regarding chemo).

stay strong.

Got my blood back taken a couple weeks ago. 10 days later–looks like Quest is finally getting off the dime and getting results back to people in an acceptable timeframe. Not a good news story though…

[u]Bloodwork - April 2011[/u]

Note: Changes from January test are noted in brackets, when available

Pregnenolone: n/a
Progesterone: n/a
DHEA-S: 166 mcg/dL (110-510)[-5]
DHEA, Urine: n/a

*LH: 16.4 mIU/mL (1.5-9.3)[+7.3]
*FSH: 26.5 mIU/mL (1.6-8.0)[n/a]
Testosterone, Total: 263 ng/dL (250-1100)[-173]
*Testosterone, Free: 41.2 pg/mL (46-224)[-25.2]
*Testosterone, Bioavailable: 82.9 ng/dL (110-575)[-50.8]
SHBG: 25 nmol/L (7-49)[-3]
*DHT: 16 ng/dL (25-75)[-17]
E2: 41 pg/mL (13-54)[+14]**Note: Since March test
Testosterone, Urine: n/a
Testosterone, Urine: n/a

ACTH: 12 pg/mL (7-50)[+1]
Cortisol, Total: 13.4 mcg/dL (4.6-20.6)[8.3]
Cortisol, Free: 0.32 mcg/dL (0.07-0.93)[+.23]
Cortisol, PM: 14.0 mcg/dL (3.0-17.0)[n/a] **Not sure why they did the PM test vice AM test, but it looks good in the range

TSH: 2.86 mIU/L (0.4-4.5)[+0.77]
T3, Total: n/a
T3, Free: 360 pg/dL (230-420)[-40]
T4, Total: n/a
T4, Free: 1.2 ng/dL (0.8-2.7)[+0.1]
T3, Reverse: 20 ng/dL (11-32)[-4]

Vitamin D, 25OH: n/a
Vitamin B12, Serum: n/a

Creatinine urine: n/a
Iodine, Urine: n/a
Albumin: 4.4 g/dL (3.6-5.1)[0]
Ferritin: 60 ng/mL (20-345)[+2]
Folate: n/a

Total Cholesterol: n/a
LDL: n/a
HDL: n/a (>40)
Total/HDL Ratio: n/a
Triglycerides: n/a (<150)
Glucose: n/a (<100)

The following hematology had previously been out of range but has fallen back into range. All other markers were “in range”:
Hemoglobin: 16.2 g/dL (13.2-17.1) [-1.2]
Hematocrit: 47.1% (38.5-50.0) [-3.7]

The following chemistry was out of range, also included markers that had previously been out of range. All other markers were “in range”:
AST: 38 U/L (10-40)[-3]
*BUN: 26 mg/dL (7-25)[+11]
*Creatinine: 1.4 mg/dL (0.8-1.3)[+0.11]


-One bright spot is that it looks like my cortisol is finally improving…not having cancer and recovering from the suppression of the Cortef probably helps
-BUT obviously my androgen levels have fallen over the cliff since the relatively good numbers I enjoyed in October 2010…test has fallen close to 500 since then and I’m borderline now…it doesn’t appear that my remaining testicle is able to keep up with the demands (have we waited long enough since surgery?)
-LH and FSH are SKY HIGH…body wants to make more test, but testicle is not cooperating
-Estrogen is back on the rise. Have not been taking anything for that recently so this should be baseline.
-Thyroid numbers got slightly worse even though I’ve been supplementing with iodine (12.5 mg/day)
-Anything in the hematology and chemistry to be worried about? I think most of those out of range specs can be attributed to weight training…thoughts?

I am a mess…

VT:

I just caught up on this thread, your dx, and your surgery. I wanted to wish you a quick and easy recovery. There is a strong heriditary component to testicular cancer, so if you have any brothers, please remind them to perform testicular self-exams monthly.

[quote]VTBalla34 wrote:
TSH: 2.86 mIU/L (0.4-4.5)[+0.77]
T3, Total: n/a
T3, Free: 360 pg/dL (230-420)[-40]
T4, Total: n/a
T4, Free: 1.2 ng/dL (0.8-2.7)[+0.1]
T3, Reverse: 20 ng/dL (11-32)[-4]

-Thyroid numbers got slightly worse even though I’ve been supplementing with iodine (12.5 mg/day)
[/quote]

Your iodine supplementation may be contributing to your higher TSH numbers.

In a New England Journal study, researchers, led by Dr. Weiping Teng, of China Medical University in Shenyang, looked at the thyroid effects of giving supplemental to three separate groups: people who were mildly iodine-deficient, those with adequate iodine intake, and those with excessive iodine intake. They found that giving iodine to people who had adequate or excessive iodine intake could lead to hypothyroidism autoimmune thyroiditis.

They also found that the key risk factors for new subclinical hypothyroidism in people who started with normal thyroid function included:

TSH level greater than 2
High antithyroid antibody levels

[i] A shift in iodine intake from mildly deficient to more than adequate, or excessive iodine intake [/i] (emphasis mine)

Teng, Weiping M.D., et. al. “Effect of Iodine Intake on Thyroid Diseases in China” New England Journal of Medicine, Volume 354:2783-2793, June 29, 2006, Number 26