T Nation

Help Needed with Lab Results

Hey everyone, first post in this subforum. Maybe someone has a little insight here that can help me or make me understand something I don’t see.

First off the attending physician of the clinic couldn’t explain shit to me because a) she doesn’t really know anything about the topic which is why I made sure she would collect the doctor’s recommendation who originally put me on TRT and have him decide. Aaaaand b) her German is fucking terrible. She has a super heavy Russian accent and I (and other patients) have to second guess every other word! For fucks sake she is also a therapist there! Thank god not mine though. Disclaimer because I am an angry German complaining about a foreigner: My Ex was born in Russia, my former therapist was Russian. I couldn’t care less but before accepting such a position make sure you speak the fucking language sufficiently!

So here are the things I can’t wrap my head around:

  • the original lab test gave my test level as ng/ml. The latest result was presented in mg/l. That’s a difference of X * 1000! I can only assume that is a typo or otherwise my test is actually as close to zero as it gets.
  • the doctor said and I quote “your test level is now lower than before the trt treatment”, which is just not true! It was 3.15 ng/ml naturally and is now at 5.5 ng/ml (assuming a typo). The recommended range on the lab result is 8.9 - 42.6 which means I am still well under!
  • the doctor decided after consultating the doc who originally prescribed trt (at least she told me she talked to him on the phone, I have no idea if he saw the actual lab results or not) to stop the TRT treatment altogether. I have not received anymore testosterone gel even though they ordered it for me.
  • the only thing I could kind of interpret from her try at explaining the reasoning is that it had something to do with my natural production being limited (I suggested the term natural production, so not sure here but she confirmed that’s what she wanted to say). So what I don’t get is: My natural production was not sufficient in the first place, is not high enough with external hormons and still is supposed to now go handle things on it’s own again?!
  • largely unrelated to the trt: The dosage of my anti depressants was raised over two weeks ago. I am now at or close to the max dosage one should take of that stuff. Yet the lab results show (according to her) that the drug concentration in my blood has actually gone down! Even though the intake was raised from 225 mg to 300 mg. She had no explanation. I will admit I am unsure if I took the medicine the day before or not. I worried about that all day but decided to not risk taking twice the amount. So it might have happened that I didn’t take them the day before they took blood. But for a medicine which work with a certain concentration in the blood instead of an effect after taking it, could that really make the difference?

What can I do on my own about this?
I will definitely try to get through to the doc who prescribed me trt on the phone and hope that he can help me understand the decisions made and erase my doubts or admit wrong doing.
I can ask the head doctor who visits us once a week (usually on Tuesday or Monday) about it.

So thanks for sticking with me and if you have any insights, I’d appreciate it. I’ll attach both lab results for reference.

If any translation is required let me know. Freies Testosteron = free testosterone.

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Second test is in ng/l not mg/l. The first test doesn’t say free so is that a TT measurement? Is that after treatment had already started?

A few other notes/questions:

  • is the second doc on board or are they looking to one-up the prescribing doc?
  • generally speaking no one has luck with gels
  • when did you go onto TRT and why?
  • what is your anti-depressant drug? for how long?
  • how old are you?
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I am not sure what kind of test measurement that was. I don’t really know a lot about the topic.
The first result was without TRT. The second is after one month of testosteron gel.

  • she is the attending physician of a mental health clinic I am currently going in daily (it’s like a mental health clinic but you don’t stay the night or weekend). She admitted when I got there that she has no knowledge of TRT whatsoever. She has also repeadetly stated that if therapy goes right, I maybe won’t need the TRT anymore. Which makes me doubt her credibility even more.
  • when: 15.01.2020. why: Severe clinical depression over a long period of time + new symptoms associated with low testosteron (like extreme sweat bursts, loss of mental faculties and extreme tiredness and fatigue - both over the extend of what I already was experiencing from depression).
  • the drug is called Venlafaxin. I started with this particular medicin in October 2019 at 150 mg. The dose has since doubled. Before that I was taking Citalopram for a very long time.
  • I am 25 years old, 188cm tall and weigh about 125 kg

Ironically if the TRT goes right you may not need the therapy, or drugs. Not always, but depression can be part of low T.

If you’ve only been on T gel for 4 weeks your system probably hasn’t shut down its production yet. I would get those measurements in order so that you have a proper record of what is going on.

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The first doctor ironically stated that in his experience, hormone levels like mine can be the reason for severe depression in men. Granted I have some emotional issues which seem to stem from my past, I can definitely see the hormone thing being a big part of the puzzle

Well let me assure you that once you get that testosterone kicking things change. Outlooks, sense of wellbeing, purpose, regrets, etc…it all seems different. There may be other things that need attention as well. If you want throw full blood work up and let the masses here have a look to see what’s up. We have some intelligent folks here who have been through a lot and seen a lot.

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I am definitely willing to share anything necessary/ that I have. I’ll post the regular blood results and drug monitoring results when I come home. In terms of hormone stuff that is all I have. It’s not standard procedure to test for that stuff and even if you show symptoms it’s unlikely that someone will draw the Connection. I don’t know why it is that unpopular here.

Whatever you have. Thyroid, complete blood panel, etc.


lab results from the 13th of October 2019

lab results from the the 22nd of January and the 14th of February.

Medikamente = drug monitoring. On the 22nd I was on 225 mg Venlafaxin and the result came back as 141. Now I am on 300 mg which is at or close to the max dosage and the result came back as 21. So barely a trace of it in my blood.

Medical history (well only the relevant stuff of course)

  • I had leukemia at the age of ca. 8. Treatment was chemotherapy. No transplantation or radiotherapy.
  • first diagnosis of depression and anxiety disorder at the age of 20 or 21. Treatment: Ambulant psychotherapy and Citalopram 40 mg.
  • drastic deterioration of depression and another outbreak of anxiety disorder in October 2019. Got off the Citalopram and started with Venlafaxin.
  • diagnosed with hypothyroidism/ thyroid insufficiency in November 2019. Therapy: L-Thyrox 50 micro gram
  • currently treated in a non stationary mental health clinic.
  • current medication I am taking: Venlafaxin 300 mg daily, L-Thyrox 50 micro gram daily, until recently 5 testosterone gel (testotop; each dose containing 125 mg (2,5%) testosterone)

Well that’s all I have currently available. If you need any translation, let me know.

were you fasted for this blood draw?

yes.

Doc talk to you about high Triglycerides and glucose? Are you diabetic?

No I am not. I mean I fucking hope so, but no doc ever brought it up. My Triglycerides have been high in about every blood drawing I can remember. Seems to be the same for other family members. Docs never worried about it much.

TRT isn’t going to screw you down the road like these frankenstein drugs will, so if you can completely get off of them, you’ll be better off in the long run. These drugs cause so many problems down the road, which is why I was diagnosed with low-T which led to a worsening of diabetes after 30 years usage of clonazepam (benzo).

T-gel isn’t always effective as men typically absorb poorly through the skin, injections is the best method to increase T (injecting 1 or more times per week of Test E or Test C). Sometimes men will lose glucose control when T declines, normally this is seen in middle aged men.

Docs these days don’t get excited about much, you can’t blame them considering the current state of our medical systems, you basically have to be pretty bad off for them to spring into action.

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Just some things to consider. Don’t freak out and get it rechecked. Fasted means nothing but water for 12 hours.

https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351199