T Nation

Got Bloodwork, Help with Questions


#1

Here is my situation brothers. Any help would be amazing. Sorry for the long story.

I have been following this forum for some time now. Saw some amazing dudes here that seem very very bright (KSMan).
So i just came from work and have got all this info FINALLY together for you guys to check out. Cheers

-age 26
-height 184 cm
-waist
-weight 75 kg
-describe body and facial hair
Have a lot of body and facial hair

-describe where you carry fat and how changed
Stomach area

-health conditions, symptoms [history]
High prolactin, low total t and free t, spinal fracture

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
-- real dangers! see this http://propeciahelp.com/overvi...
-lab results with ranges
2011

testosterone 4.00 ng/ml 2.60-9 (first thing am)
ft3 5.51 pmol/l 3.10-6.80
ft4 1.30 ng/dl 0.93-1.71
tsh 2.81 miu/ml 0.27-4.20
pth 37.40 pg/ml 8-76
lh 5.86 miu/ml 0.60-10
fsh 3.73 miu/ml 0.80-15
estradiol 38 pg/ml 5-70
prolactin 15.39 ng/ml 4-15.50
17-oh prg 0.70 ng/ml 0.30-3.30
shgb 26.50 nmol.l 9-80
cortisol 9am 182 ng/ml 43-240
Albumin 5 gr/dl 3.4-5
Blood sugar 84 mg/dl 70-110

2013 (before treatment 1 month)

Total T 3.65 ng/ml 2.60-9
Albumin 5.18 g/dl
SHBG 26 nmol/l 11-80
Free T 0.0752 ng/ml 0.09-0.30
Creatinine 1.24 mg/dl 0.6-1.3
Pottasium K+ 4.16 nmol/l 3.5-5.1
Sodium 141 nmol/l 136-145
Triglycerides 31 60-165
HDL 65 mg/dl 35-80
LDL 127 mg/dl 50-150
B12 1123 pg/ml 170-960
Vitamin D 52 ng/ml 25-80
ft3 5.25 pmol/l 3.10-6.80
ft4 1.34 ng/dl 0.93-1.71
tsh 2.05 miu/ml 0.27-4.20
DHEA 6.45 ng/ml
DHEA-S 344 mg/dl 89-457
D4 androstenedione 80 ng/dl 40-150
AST/SGOT 19.3 u/l 5-38
ALT/SGPT 19.4 u/l 5-41
ALP 54.3 U/L 39-120
yGT 11.8 u/l 6-45
LDH 127 u/l 120-225
Prolactin 15 ng/ml 4-15.50

BIG MISTAKE i made here was that i did not check estradiol levels exactly before treatment. I did not realise how important it was until i got the book the testosterone syndrome which was after the treatment.

2013 results during treatment 6 weeks after treatment and then every two weeks until today

55 mg test enanthate twice a week (first six weeks)

Total T 8 ng/ml 2.60-9
Albumin 4.97 g/dl 3.4-5
SHBG 24.65 nmol/l 11-80
Free T 0.192 ng/ml 0.09-0.30
Estradiol 51.45 pg/ml 10-40
Prolactin 14.65 ng/ml 4-15.50
HGB 16.1 gr/dl 13.5-18
HCT 46.3 % 40-54

55mg test enanthate twice a week plus letro 0.625 x3 week

Total T 11 ng/ml 2.60-9
Estradiol 8.24 pg/ml 10-40
5mg test enanthate twice a week plus letro 0.625 x2 week
Estradiol 14 ng/ml 10-40
STOPED LETRO bloods after 2 weeks of stopping
Estradiol 38.60 pg/ml 10-40
Total T 7 ng/ml 2.60-90
Started Arimidex 0.5 twice a week. 1 week has passed since that will do blood tests in 1-2 weeks.

-describe diet [some create substantial damage with starvation diets]
Pretty clean diet. Do IF don�¢??t eat breakfast and according if its a workout day or not i manipulate carbohydrates. Try to eat veggies, take green vibrance supplement eat meat, fish and healthy fats saturated etc

-describe training [some ruin there hormones by over training]
Weight training 3 times week training 3 bodyparts per day
-testes ache, ever, with a fever?
-how have morning wood and nocturnal erections changed
Last time i had morning wood i was a teenager. Lost them around 18 and returned now with TRT but disappeared again

My story begins when i was around 18 years old. I suffered a fractured spine from an accident before i joined the army. It was an L1 spinal fracture. They sat me in hospital for 15 days lying down. Did several x rays and finally let me go telling me that i will heal fine and no neurological nerves were affected.

After a few months i returned to the military and thats when i first started to notice ED issues. Had no idea what was causing it and thats when my long ass safari began. I visited different doctors in two different countries. I was keen in solving the problem or finding the cause asap.

I didn�¢??t come from a rich family and my dad has psychozephrenia for the past 30+ plus years so i pretty much saved money from working from a young age and also did some bank loans. I visited orthopaedics, urologists, endocrinologists, neurologists, naturopaths, and diebitologist. I did several MRIs. Brain scan twice, full spinal MRI, CT angiogram)

When i first began my journey to DRs i thought i had solved the problem quite at the beginning. I was diagnosed with high prolactin (29ng/ml range 4-15). So the doctor was like yea dude here is some dostinex and soon you will be fine. I was like fuck yea i am lucky and run home to start dostinex and see when i start having normal erections. Throughout my 8 year journey i only had 2 relationships with hot chicks. Wasnt cheating/drinking just trying to have normal sex without using cialis, Viagra and other supplements ALL the time (spent a fortune).

Anw ill try not to bore you guys to death. I took dostinex for a period of a few months and my prolactin went down and stayed down and all MRIs showed clean. My prolactin now basically stays in the upper range of normal and has been stable the past years without any medicine. Is it okay though in the upper normal range?

BUT nothing changed with my ED issues so i continued my journey. Was difficult though because i was a student in another country and could not save any more cash. Was studying with loan money.

About 3 years ago i started reading my blood tests and starting doing some research hoping to find the problem. All dr�¢??s were telling me my T levels are fine and very good but according to my research they weren�¢??t. My t levels were the same as a 50-60 year old.

About 3-4 months ago i had enough. I tried all diets, supplements, sleep, reducing bodyfat (im13-15 max always), limiting xenoestrogens, reading books on how to increase t naturally but still nothing was working. I always had to plan sex time or look far into the day to guess when it will happen and take my supplement in time!

After i finished my studies and came back home and got a stable job and apartment with my partner i started visiting more dr�¢??s since now i had an income coming in. I also told my partner what was going on and we both decided (after i did some research at john crilsers site and reading testostearone a mans guide second edition) that i should start self administering T.

I have excellent, real and constant sources of high quality Test Enanthate. No Dr was willing to help and just told me to visit a psychologist. That just pissed the fuck out of me. I started to have fatigue, mood swings, muscle weakness and ED. I definitely wanted to solve these issues to continue with life prepared and strong mentally and physically.

I did before and during blood tests which you can see above. One huge mistake i did was that i did not test estradiol exactly before treatment. I bought test enanthate, letrozole, arimidex, hcg and bacteriostatic water.
I started injecting 55mg Monday and Thursday about 2.5 months ago. First weeks i started to feel MUCH MUCH better. I felt like a man again, fatigue was going away, libido coming back , no moodiness and most importantly MORNING
WOOD again! My erections were getting much much better.

Then something happened. Erections disappeared and go some anxiety moodiness. I did blood tests and saw estradiol going over range at 53 and total t 700.

So i bought letrozole (because my source said i would have to wait 3 weeks for arimidex). I took letro 0.625 x 3 week and my E2 went to 8. Then i took 0.625 twice weekly and it went 15. I couldt dose it any less and since i started it i noticed my libido dissapearaed and did not feel very well. So i exchanged it with arimidex waited until my e2 went to 40 and stared arimidex 0.5 twice weekly on injection days about 9 days ago.

In a few or two i will do further blood tests to see how im doing with arimidex and adjust dose.

My concerns i have are:

What do you guys see? See any important issue? How do you read my situation.

Should i start HCG now or should i wait until i dial in arimidex first?

Will/should my erections return like the beginning of trt. Im guessing they are up and down because of Estrogen control.

What should my next steps be?

Judging now i have realised that i might have jumped into TRT a bit ignorantly because i should have noticed my high E2 levels about 2-3 years ago and maybe an AI on its own would have worked.

I definitely want to live my life the fullest. My life is just beginning and i have many responsibilities that require my full attention and devotion. I did not feel comfortable and able to continue my life without doing something since this issue has been buzzing in my head day and night for the past 8 years. Only now i feel i am seeing some solid results and have the necessary drive to live life to the max!

Any input would be amazing and deeply appreciated. Thank you for your time brothers.
Jon


#2

From first labs I would have said HPTA repressed by E2 and prolactin. Did you get MRI of pituitary?

Spinal fracture: What blows to the head that would damage pituitary.

Hard to believe both factors at once, so suspecting prolactin secreting adenoma.

Your low T and high E2 is suspicious. Liver labs say no problem. Would have recommended anastrozole + Dostinex/cabergoline.

Letro is too harsh as per stickies, dose-response seem unpredictable.

TSH suggests iodine deficiency. Using sea salt? Read the thyroid basics sticky.


#3

Hey KSman thanks for the reply! Greatly appreciated!

Yes i have done 3 MRI's the past 8 years. All doctors said they look fine! When i saw one of the results one of them said "small pituitary cyst" but all doctors reassured im completely fine and to continue doing mri's every 5 years. Well its been 3 years since my last one.

I read the thyroid basics and will buy a thermometer as soon as i come back from my holiday in 2 weeks and do the necessary checks.

Once again thanks for the help

I ll keep you posted

Jon


#4

Hey guys

Came back from holiday bought 2 digital thermometers and took my morning temperature yesterday and today

96.98. From what i have been reading in the thyroid basics this is pretty low

I guess i should start iodine supplementation

I'm going to read the basics again and go buy a supplement

I will also take my afternoon temperature today

Thanks
Jon


#5

Just bought iodoral 12.5 mg per capsule. Started at 4 of these a day after every lunch. Will be reporting body temperature and general well being changes.


#6

hey guys,

its been 4 days since i start 50mg iodoral.

My morning body temperature has increased from 36.1 to 36.4 celcius. Do i feel better? Im not sure yet, pretty much feel the same.

My afternoon temperature has also increased and is now 36.6 celcius. Will continue 50mg a day for two weeks.

jon


#7

Interesting. Please describe your prior use of iodized salt.


#8

For the past 5 years or so i have been using mostly sea salt from i remember. At my work there is normal table salt and i remember sometimes using it without even tasting my food first.

When i was a teenager and still living with my parents i remember we always had normal table salt at home but after that when i went to the study in another country i mostly used sea salt. For the past 4 years since living with my gf she also only bought and used sea salt. I also tested her morning temperature and she was 36.6 two days ago.

Last night i remember waking up in the middle of the night and actually feeling hot even though i was sleeping using the same amount of quilts like always. Dont know if iodine is responsible for that. Also noticed now when i wake up at 6am to work out im not that cold anymore


#9

I see KSMAN already adressed you.

Adding to what he's telling you, prolactin is elevated.

If MRI with contrast can detect anything, its probably a very small lesion. (Supported by only a slight elevation)

I'd suggest testing all other pituitary hormones to make sure they are working well. Keep monitoring prolactin for increases. Caber can lower that.

Pituitary hormones
Costisol
Acth
GH
IGF1

Honestly, they're probably ok, but its good to be safe. Use Iodized salt when cooking.


#10

Hey Tuna!

Thanks for chipping in. I will definitely take your advice and test those hormones. In 3 months i get my bonus from work and will do all the necessary blood tests i was planning on doing and now i will also add these.

Thanks dude


#11

Labs are very cheap via lef.org if you get a membership there


#12

Thank you KSman for the tip.

I actually have a friend that is a DR and owns a medical lab so he does all the testing for me very very cheap!


#13

continuing to take iodoral at 50mg a day will be reporting more temperatures tomorrow.

I have noticed that every morning when i wake up at 6am to workout i am actually not cold even though the weather has gotten pretty cold.

Also at work everyone is cold and putting on the ac on hot and i sweat and go and close a few of them (they open like 20 ac in a small office)

Will report new morning and afternoon temperatures tomorrow


#14

Hey guys quick update! It's been 7 months i have been on TRT test e 110 a week plus 250iu hcg 3 times week plus 0.5 arimidex twice a week.

Blood tests are looking good with total and Free t in the upper ranges and e2 hovering around 20-30pg/ml.

Also improved my thyroid with iodoral and all my body temperatures look good.

All my symptoms i had before starting TRT are nearly all gone. Energy very good, muscle growth and fat loss very good, no more anxiety, psychologically feeling perfect. Everything is going very very well except 1 important thing.

ED is still there. I am 100% its not psychological and i do not take any medication. I find it very weird that ED is still there. I started TRT because of that and that is the only issue that has not been resolved.

If anyone has any clue of what is causing this or what extra blood tests i should do to find the cause of this please let me know. I am willing to do any tests necessary to resolve this issue. I have done full spinal MRI, brain MRI, lung ct scan, angiogram which showed all blood flow and everything should be fine BUT still the issue is there.

Any help or info would be GREATLY appreciated.

Thank you


#15

Process of elimination. Try to get Rx cabergoline/Dostinex and see if lower prolactin levels are helpful. Note that brain pattern/function response can take time when you change hormones or neural transmitter levels. If it work, that is your solution and your diagnosis in one package. If not helpful, problem is not strictly caused by prolactin. Dose is 0.5 mg/week, suggest divided doses twice per week.

When prolactin is elevated, dopamine levels are lower and that can cause mood problems, lack of joy and less reward. If your brain is not reward seeking, then sexual pursuit to achieve orgasms might suffer.

If everything else is working right, male libido is often a measure of well-being, vitality, energy etc. And vice versa, so there can be many factors. Do not over look stress and not that stress can leave deep foot prints such as adrenal fatigue.

Otherwise, glad to hear that other things are better.


#16

KSman thank you for the reply.

I already have dostinex will do exactly what you said and report back soon. Only issue with dostinex is that last time i tried taking it i had severe vomitting for 2 days and stopped it. Maybe it was food posoining though and not the dostinex. I ll give it a try and report back.

Regarding stress i can re assure you i never get stressed. I hate feeling stressed and make sure i eliminate any factors that might cause me to get stressed.

One doctor told me that my ed might be caused by a damage in nerves after my lower spinal fracture and that that might never get resolved. I went to neurologist thought and did full spinal mri and did not show anything.

Hopefully it is the prolactin causing the problem and that will be resolved. Just hate having to take another medicine together with adex, test and hcg but if the result will be fixed then i ll just take it and shut up.

One thing i have never got tested is gh and igf 1. I thought maybe i have low levels and that can cause ed by lowered nitric oxide production?

Once again thank you for help and time. Greatly appreciated man.


#17

little update

It's been 2.5 months since i have been taking dostinex at 0.5 a week in two divided doses.

I know it is 2 early as it takes time but i have not seen any significant difference up to now. I have ordered grape seed extract + arginine + pycnogenol and will also give that a try!

The thing that i forgot to mentioned is that during the initial 4 weeks i started trt (about 9 months ago) all ED went away nearly completely. I am just trying to get back to then. I started TRT with fairly high E2 (around 37pg/ml). I dont know what happened during those first 4 weeks but the problem was 90% solved then everything went bad in the ED.

I am also guessing now that e2 might be an issue and might start playing around with it to bring down to 10-20 instead 20-27 which it is now.

Any other suggestions/thoughts are welcome.

Thanks