T Nation

First Blood Work Since Beginning TRT Injections 7 Weeks Ago


#1

I have attached my blood work. As the title says, this is the first time that I have had BW since beginning TRT injections 7 weeks ago. My protocol is 70mg Test Cyp and 500iu HCG, both E3.5 days. No AI. I also take Magnesium Citrate and a multivitamin daily.

Things that stand out to me:
-LDL has increased by about 25 mg/dL
-DHT is pretty low
-DHEA is pretty low
-My Free T3 has improved from 3.1 to 3.5. Also, RT3 looks good.
-IGF-1 has increased quite a bit
-E2 (sensitive) is remarkably low considering I don’t take an AI
-Is Ferritin of 112 high enough?
-Magnesium is pretty low, and I even supplement for it
-SHBG has dropped quite a bit
-My Prolactin is very high

I am feeling pretty good most days, though it is pretty up and down. I definitely feel like I could be feeling a lot better though.


#2

Need more info about you, see first sticky below.

Please also provide oral body temperatures as per the last paragraph.

Your elevated prolactin might be an issue, but recent orgasms or hugging babies, puppies or kittens can elevate and some medications as well.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.


#3

I will get back to you with the oral body temperatures.

Background: 26 Y.O. male. Married, no kids. Roughly 180 pounds. I first started to feel symptoms of low T in summer of 2012 (age 21). I had multiple blood tests done showing that my total T was in the low 200’s and as low as 209. I went to an Endo who diagnosed me with idiopathic hypogonadism. I had multiple brain scans done (I think MRI), no tumor/mass found. I was prescribed Clomid and began taking that Fall of 2013. I took this from Fall of 2013 until April 2017.

During this time, I asked very little questions and did very little of my own research, which was a mistake. I just listened to my doctor and for the most part I was feel better. Not great but better. My total/free T improved and that was all that was ran essentially. No estradiol or anything else. I had an operation in Feb 2017 called a Nissen Fundoplication to address the acid reflux that had turned my life upside down for the year previous. It disturbed my sleep each and every night and I had very little energy during this time. The reflux could not be explained - No hernia, sphincter worked fine, my diet was rediculousc(I lost about 40 pounds during this time).

I mention all this because I am almost certain the reflux was derived from hormonal imbalance, though I could never find a definite connection. After the surgery 4 months ago, my reflux was much improved but I still felt no energy. I still was not sleeping well, still had my terrible anxiety. No libido to speak of and probably had sex once every couple weeks. I joined with Defy Medical and took my first injection 4/27/17. Libido has been through the roof, erections great, feeling much better over all.

The only thing that I am still experiencing is insomnia. I wake all throughout the night. I had a sleep test and the doc said no sleep apnea. So its pretty much a coin toss nowadays. If I sleep good I will feel like a million bucks, if not, I feel terrible. I feel uncoordinated, my vision is oddly blurry, I feel super sensitive to sugar spikes, and I feel very anxious. I experience a slight to medium stutter on these days. As far as diet, I avoid gluten/dairy and try to eat lean meats. A little bit of a paleo styled diet but I’m not too strict on it. For exercise, I am only able to do light cardio. Still recovering from the surgery.


#4

With GERD I expect that you were taking PPI’s and other heart burn meds. Hopefully not cimetidine/Tagamet. These meds can led to multiple mineral deficiencies as well as low B-12.

Are you now free of heartburn meds? Might explain low mag.

Any leg or foot cramps or able to contract a muscle and make it lock up? That is a magnesium deficiency.
When did you start magnesium?

We have a lot of guys at your age and hormone condition find their way here. It may not be a common problem, but is with the guys who self-select to be here.

What exactly had Defy prescribed and how are you dosing. Please do not report volumes, but mg’s, IU’s etc.

Did Defy discuss preserving your testes and fertility?

Gluten/dairy: Why exactly? Digestive issues?

Ferritin 112 is sufficient for thyroid T4–>T3 conversion.

Get 25mg DHEA, take with higher fat and lower fiber meals.
Take fish oil, natural source Vit-E and 5000iu Vit-D3 the same way.
Find a high potency B-complex multi-vit with trace elements including 150mcg iodine and 200mcg selenium.
Vitamin C, 1000 or 2000mg per day, at night may improve sleep.

Sleep: Find 5-6mg time release melatonin, must be time release. Magnesium can help too.

Inject T twice a week for smoother levels. -doing that.
Do labs always halfway between injections, time of office visits can be wrong.
Inject subq with #29 1/2" 0.5ml insulin syringes.

Ignore serum iron, levels change a lot with recent foods.

Your lab screen shots are very difficult to read. Did not see glucose.

Yes, SHBG is low, some are that way, some have causes.

Did you loose blood with your condition and surgery. Labs suggest that you could use more iron and that is unusual for males. GI blood loss is then a concern and an occult blood test is conclusive.

fT3 is oddly high, midrange or slightly higher is good, more may be some kind of compensation. But a good thing overall VS alternatives.


#5

I am now free of PPI’s. However, I did take Nexium for a long period of time. I neglected to say in my background that I did test for a B12 deficiency about 10 months ago. I now supplement with B12 sublinguals and my levels are always >1000 whenever I test (water-soluble so not worried about taking too much, correct me if I’m wrong). This definitely could explain the low Mg. as well. I have been been taking Mg. Citrate 200mg daily for about the last month. I had been dealing with excessive muscle twitching and someone recommended taking the Magnesium, and well it worked.

Defy prescribed me 70mg Test-Cyp and 500iu HCG, each E3.5D (so 140mg Test-Cyp and 1000iu HCG weekly). They also prescribed .25 Arimidex weekly (.125 E3.5D) though I made a decision to not take it and wait to see how much I converted to E2. Looks like I made a good decision.

I did discuss testes/fertility with the Defy - the doctor seemed to think that the 1000iu HCG would be good, though he did admit that Clomid is more effective for fertility purposes. The wife and I will be trying to have a kid probably next year and I’m hoping that my fertility will be good enough to get the job done with the test-cyp/hcg combination.

Gluten/dairy - I’m prone to digestive issues. Going back and forth from constipation to diarrhea. I also get pretty bad brain fog when I eat these things. I feel like it is getting better though since the operation and getting onto TRT. I tested negative for Celiacs Disease though, so maybe its just in my head.

I actually took 25mg DHEA last night for the first time, after putting up this post. I slept like a baby. Maybe that is what I needed.

I plan on getting fish oil. My lipid situation is pretty bad right now. I think I eat too much meat. Vitamin D I didn’t test because I am usually very good in that actually. Upper 60’s typically. I spend alot of time in the sun.

Why the iodine/selenium? From what I can tell my thyroid looks pretty good. I am working on gathering my temperatures for a few days though.

I inject every Sunday night and Thursday morning. I had these labs drawn on a Thursday morning before my injection so it should be pretty good trough data.

Fasting Glucose was 74 (65-99).

I’m interested, which lab shows that I could use more iron? UIBC? Ferritin? Platelets? Or something else. I’m sure I did lose a bit of blood in surgery but it was laparoscopic so it wasn’t as intense as an open surgery.

Regarding ft3, yes that kind of caught me by shock as well. I have been hovering right at 3.1 in the last couple years that they occasionally test it. 3.5 is definitely a considerable increase. Perhaps thanks to TRT?

Thank you sir!

@KSman


#6

When fT3 is higher, rT3 may be the cause.
Need those oral body temperatures.

With strong T levels, we expect strong RBC, hemoglobin, HTC and ferritin [if tested]. You can be down from surgery and/or low level GI blood loss, an occult blood test can rule that in/out.

Most people are iodine deficient and may are also selenium deficient. Selenium deficiency can lead to thyroid auto-immune disease. Not taking the time to explain the mechanics of that.


#7

I don’t think it was the surgery, for the last couple of years mt RBC, hemoglobin, HCT has been at the bottom of the range or even below. I was happy to see on this test to see they have increased. My doctors have just kind of shrugged it off.


#8

That is a large part of a doctor’s workload.


#9

I have posted screenshots of my labs at http://imgur.com/a/7boGI.

I had bloodwork peformed 6/15 and switched up my protocol from:
-TEST-CYP 70mg E3.5D
-HCG 500iu E3.5D
-MG Citrate

To:
-TEST-CYP 50mg EOD
-HCG 280iu EOD
-MG Malate
-Fish Oil Pills
-25mg DHEA (GNC Oral, taken in evenings)

The blood work was taken on 8/11, approximately 6 weeks after I altered my protocol. I am very concerned! Below I listed important variances from labs on 6/15 compared to the labs performed 8/11:

*TSH increased from 1.260 to 1.330
*T4, Free decreased from from 1.29 to 1.19
*Lipid improvement (LDL decreased from 151 to 135, HDL decreased from 45 to 44)
*Testosterone Increased from 648 to 949
*Free Testosterone increased from 24.7 to 29.9
*DHEA increased from 191.9 to 366.4
*Prolactin decresed from 24.4 to 14
*Estradiol increased from 27.1 (sensitive) to 40.8 (non-sensitive). This was an error by Lab-Corp, the Dr’s orders were sensitive Estradiol. Nonetheless, looks like an increase of E2.
*Reverse T3 increased form 14.9 to 17.2
*Free T3 decreased from 3.5 to 3.2
*Progresterone only .2 (range is 0-.5); not tested on 6/15
*SHBG decreased from 15.4 to 11.7 (was in 40’s before starting TRT in March, but was on CLOMID previously however)

Symptom wise - I have felt like hot shit for the past couple of weeks. I attributed that to poor sleep. I would wake each morning feeling like I had not slept all night. Very sensitive to light. I have had no morning erections for the past couple of weeks. I have had extreme bloating. Anxiety all together not too bad surprisingly. Very little energy.

I stopped taking DHEA two nights ago. I had immediate improvement the next day. I am wondering if taking DHEA had a poor effect on me. If I suffer from low cortisol, perhaps the DHEA made the cortisol even lower. This would explain the decreased FT3 and increased RT3 in my opinion.

My low SHBG keeps decreasing. This is pretty disturbing. I have known I had mild O.S.A for about a year now but could not sleep with a CPAP. I will be receiving a Dental Appliance which might improve my O.S.A. Perhaps that would in turn increase my SHBG.

Any thoughts would be greatly appreciated, and let me know if there is any information that I neglected to include.