T Nation

Help with Lab Numbers and Med Schedule

Hi, pretty new here on the site although I have been reading off and on for a while. Started HRT a few years back. The attached image shows some numbers over the span of a few years. I just started trying to better track them in a spreadsheet. Basically tried pellets first, then moved on to subq injections. Feel a lot better and had been riding my bike like a maniac until it turned cold. I am 47 years old. Struggled with ED for a long time. Had Peyronies Disease and surgery when I was about 19. Surgery was largely successful although left with some minor loss of feeling. I do take 5 mg tadalifil each night and this seems to help with nighttime erections. Varicose veins worsening over the past 5 years.

I would like some advice on where my numbers are if some of you more experienced with HRT could have a look. For general health and anything important to increasing my benefits from HRT, are there other numbers that I should be tracking? If so, I will add them to my spreadsheet. Also, I would like to ask if my new med schedule is better or worse than the old. I am not very knowledgeable about the half-life of T, HCG, and anastrozole, but of course I am looking for the most stable and consistent regimen possible. Currently going through Defy Medical for HRT which I am pretty impressed with. Hopefully, my numbers will show up when I try to attach the jpeg.

Up front, thank you to anyone able to take the time to advise.

Best, tdsg

Anastrozole half life is 47 hours, your dose once a week is creating changing levels and your lab results may not be representing things properly.

If injecting twice a week, take anastrozole at the same time. For simplicity, inject hCG at this time, so all three at once. Some do all three everyother day [EOD].

How did you lower cholesterol and triglycerides?

Hematocrit seems too low for your T levels, get an occult blood test [in stool] to see if a GI bleed.

Hi KSman,

Appreciate the reply. I have read/followed some of your posts so I know you are a true resource on this forum.

I have been wondering why my hematocrit levels have not risen more since starting HRT. I have certainly been watching it. I do not have an answer, but thankful that it is within range thus far.

About three years ago out of nowhere I started having issues with gluten. Developed some rashes, lost a lot of hair on my head, neuropothy in my legs, and was generally feeling like crap. Have a friend with Hashimotos who was familiar with gluten problems and she suggested I get tested. Turns out I tested positive for 2, maybe 3 of the antibodies. Had a colonoscopy/endoscopy and luckily did not have any small intestine damage so I believe I only developed a sensitivity rather than full blown celiac. Not sure what triggered this although at the time I was with a woman who finds out tomorrow if she has Lyme disease. I am not positive this is true, but have read that there is some research suggesting Lyme can be sexually transmitted. It is certainly interesting that many of my health problems began when I was with her. It was a one time encounter and I am skeptical that I too may have Lyme from her. But I do know that Lyme can trigger other immunity problems.

Anyway, after the gluten issues began, I cut out all offending foods and also had to stop dairy for 4 months. I could not get rid of the neuropothy until I stopped dairy. I have since returned to dairy except for milk and the neuropothy has not returned. I also read Wheat Belly and became convinced that all the carbs are not good for me. Eat way more veggies now than I ever did growing up. Lost about 25 pounds not even trying. Also, began riding a bike about 4-5 days a week. So, my overall health has improved and I’m sure the HRT is helping as well. I feel pretty good, not great, but much better than I had for some time. I believe these lifestyle changes are responsible for my improved cholesterol and triglycerides. Although from what I have read, I believe much of the mainstream information on cholesterol is hype and myth.

I believe I have read on this forum about doing all meds on the same day. I have wondered about doing the anastrozole every 6th day and if there was much fluctuation in between. I take such a tiny amount as is, but I wonder if I should/can even get a smaller amount to take E3D along with the T and HCG. The anastrozole I get through Defy also contains DIM and is compounded so I assume .125 mg is doable. They are in capsule form so not sure how easily I could take 1/2 a capsule at a time in the current .25 dose I have. If I did begin doing all three meds E3D, which day should I have labs run on? The day before? Also, I do meds at 4 pm - does it matter what time of day?

I did find out that LabCorp did the wronge DHEA-S test on the last run. They did serum rather than sulfate so that last one is like comparing apples to oranges with the other ones. Also, the range posted is for the serum. I need to change that to the sulfate range which for Labcorp I believe is 71-375. My 12/5/13 test showed me topped out at 373.9, but I have not been taking my 10 mg micronized DHEA supplement as regular as I was instructed since I started with Defy. Actually, doc recommended 25 mg but I believe it cause me some heart palps. Wonder how important it is to be at the top of the range on this. I know it has something to do with adrenal gland, but I’m not too up on it.

Thank you for the reply. Much appreciated.

Best, tdsg

If labs are done 1/2 way between labs then they probably represent average levels and if you change frequency of injections, you are still comparing averages.

If anastrozole manages your E2 levels, I don’t see any need for compounded with DIM. So do whatever is more cost effective for you.

Anastrozole is a competitive drug and its serum levels should match T levels. So you need steadier T levels and same for anastrozole. If injecting every 3.5, 3 days, take anastrozole at the time of injection and then T and anastrozole will tend to roughly rise and fall together.

Some GI blood loss can happen with your GI issues. Typically I flag this possibility when I see that blood appears thin when on TRT or when even thinner when not on TRT. In your case, you have already identified the cause. Still, hematocrit seems a bit low.

Using iodized salt?

I began using sea salt about a year ago. I do take a kelp pill sporadically. Also garlic and some vitamin E here and there. I do like to take breaks in supplements (Ray Sahelian philosophy) so I rarely take too much of anything everyday. Really I am trying to use up some supplements I have and eventually switch to a high quality multivitamin.

I will definitely consider your advice on taking the anastrozole on the same day as the testosterone, but I also wonder about this being necessary. Seems like those little pockets of oil in my stomach where I subq inject would keep a fairly steady rate in my system as it is absorbed. The oil pockets can take a week, sometimes more to fully absorb and in giving myself shots E3D, there are always multiple pockets of varying size. Is there any merit in this line of thinking? I honestly don’t know.

I wonder too about the need for the DIM. I have been pleased with my labs so kind of don’t want to mess with what is working. I will try to read up on DIM more and decide if I am just throwing money away.

Appreciate, tdsg

Many have reported lumps in belly fat injections and then find that SC on tops of their legs do not do that. And some vice versa - experiment.

You really do not want to be dancing with iodine deficiency, sea salt will lead to major issues. Please see the thyroid basics sticky and check your waking and mid-afternoon body temperatures. Note that lab reference ranges for thyroid are rather useless. Better to have TSH near 1.0 and T3, T4, fT3, fT4 mid range.

That’s interesting about the oil pockets not forming on the legs. My legs are pretty muscular from bike riding and I’m not sure where I have much fat to stick. I will look into this though. If I could easily reach my backside, I would like to try some there. I’m a wimp when it comes to needles, so I like the control I have when I inject into my stomach area. I’m not a needle jabber, but rather use a slow and controlled method.

I was concerned a few months ago about my thyroid numbers and had T3 and maybe RT3 done. I am aware of the limitations of TSH testing alone due to my Hashimotos friend. On my next labs, should probably have all thyroid numbers run.

I have hopefully been safe so far with at least decent iodine intake. I do eat cheese, yogurt, and other dairy products on a daily basis, and also take the kelp pill around 2 times a week on average. Still, I don’t like taking chances with iodine. Although Im not a big salt user, it would probably be wise to go back to iodized salt and at least have that as another source of iodine.

I visit a lady age (massage & energy worker)60 who is on hrt. Her MD was unhappy with her blood test, and that caused her to ask me about the milti’s I take. I told her I was spending $60.00@ month on what I think is the top of the line multi. She tried it for 2 months and had a new blood test. When results came her MD called her in to talk. The question is what did you do to get this much improvement? Just food for thought.