T Nation

Endo Says Levels Normal, No Treatment


#1

I am 35 years old and went to urologist 7 months ago with low T symptoms. They only ran TT which came back 270. They put me on 200 mg test cyp weekly. I felt much better with a few side effects such as hot flashes, nipple itching and pain. I started taking vitamin D3 which eliminated the nipple issues. When I mentioned that to the Urologist he insisted on sending me to the endo. The endo freaked out that I my RBC and hemocratic were a little high. He wanted me to stop taking test for two months to re-evaluate. I decided to follow his advice thinking he was an expert. I did surprisingly good coming off.

After two months I got blood work done. I had to request prolactin & E2. I called to get results and was told that they were normal and did not need treatment. I had to ask specifically to get actual results. I had to argue that 207 was not normal for a 35 year old man, even by my limited knowledge. He said based on my free test % of 3.6 I was normal.

After getting results mailed to me today I see that actual free test is 7.45 ng/dl with reference range of 5 - 21. I know I need to wait several more months to recover from 10 weeks of TRT to make final decision but do I need to find a new endo or is he correct. Thanks for helping as I am confused and my Primary Doctor, Urologist and Endo seem clueless.

I have all my test results from the start if needed.


#2

sounds familiar…I was asking my PCP to refer me to Endo…but am worried that I might have the same results as you…

42 with a free of 3 and total of 80


#3

hemoglobin and hematocrit “a little high” is absolutely nothing to be concerned about from what I have read and experienced. The real question is how do you feel while you were on TRT vs how you feel now. blood thickness can be managed through regular blood donations. Your endo may deserve to be shown the door.


#4

Get copies of your labs and post results with ranges. Post all of the labs, not just T etc. Read the stickies. Most endo’s do not do things right.


#5

WBC 5.4 x10E3/uL 4.0 - 10.5
RBC 5.38 x10E6/uL 4.14 - 5.8
Hemoglobin 16.1 g/dL 12.6 - 17.7
Hemotocrit 48.5 % 37.5 - 51.0
MCV 90 fL 79 - 97
MCH 29.9 pg 26.6 - 33.0
MCHC 33.2 g/dL 31.5 - 35.7
RDW 13.4 % 12.3 - 15.4
Platelets 186 x10E3/uL 140 - 415
Neutrophils 69 % 40 - 74
Lymphs 20 % 14 - 46
Monocytes 9 % 4 - 13
Eos 2 % 0 - 7
Basos 0 % 0 - 3

Neutrophils (Absolute) 3.8 x10E3/uL 1.8 - 7.8
Lymphs (Absolute) 1.1 x10E3/uL 0.7 - 4.5
Monocytes (Absolute) 0.5 x10E3/uL 0.1 - 1.0
Eos (Absolute) 0.1 x10E3/uL 0.0 - 0.4
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2
Immature Granulocytes 0 % 0 - 2
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1

Testosterone, Serum 207 ng/dL 348 - 1197
Testosterone, Free 7.45 ng/dL 5.0 - 21.0
% Free Testosterone 3.6 % 1.5 - 4.2

T4, Free (Direct) 1.2 ng/dL 0.82 - 1.77
TSH 1.55 uIU/mL 0.45 - 4.50
LH 3.1 mIU/mL 1.7 -8.6
FSH 3.8 mIU/mL 1.5 - 12.4
Prolactin 7.2 ng/ml 4.0 - 15.2
Estrodiol 14.4 pg/mL 7.6 - 42.6


#6

Free T%: 3.6% of nothing = nothing

T is released in pulses and varies with time of day. Labs can hit peaks or lows. During a peak, % free increases disproportionately. TT is the only thing that should be considered for diagnostics in your situation. And labs are only part of the picture. Diagnosis needs to be based on symptoms and labs confirm.

Hematocrit 48.5 % is rather high for your T levels. Be very careful and watchful of this when you start TRT. EOD injections will avoid peaks. Injecting once a week may cause problems. Do not aim for TT=1000 at first, approach with caution. You do not want to get into blood donations or blood removal.


#7

Thanks for the replies


#8

[quote]KSman wrote:
Free T%: 3.6% of nothing = nothing

T is released in pulses and varies with time of day. Labs can hit peaks or lows. During a peak, % free increases disproportionately. TT is the only thing that should be considered for diagnostics in your situation. And labs are only part of the picture. Diagnosis needs to be based on symptoms and labs confirm.

Hematocrit 48.5 % is rather high for your T levels. Be very careful and watchful of this when you start TRT. EOD injections will avoid peaks. Injecting once a week may cause problems. Do not aim for TT=1000 at first, approach with caution. You do not want to get into blood donations or blood removal.[/quote]

Hematocrit before I started TRT was 48.4, 51 after 2 months on TRT, 52 after 4 months on TRT and 48.5 2 months after TRT. Any thoughts?


#9

Interesting outcome. You seem to be OK.