I’ve been lurking here for about 8 Months ( since I started TRT), and I really have found it quite informative. I’m retired, so I have plenty of time to spend reading and I think I’ve learned quite a bit. A little background on me might be helpful. I’ve been an avid cyclist since my late teens (I’m 56 now, so almost 40 years), as well as running, although I’m not physically capable of that anymore and I’ll explain why. When I was 43 I was t-boned twice while cycling. The first accident was caused by a women driving a Ford Expedition who decided that waiting two seconds for me to pass before making her left turn was just a little too much for her to bear, so while I was traveling on a slight downhill with a strong tailwind (hence going almost 30mph), I was suddenly presented with what was essentially a brick wall directly in front of me. I was unable to stop. I hit the bar that is between the front and rear passenger seats, bounced back and landed on my tail bone which cracked and my l5-s1 disk was smashed totally. As a result, I had to have fusion surgery. Since then, the extra stress put on the disks above that level has caused both the l4-l5 and l3-l4 disks to herniate and necessitated two more surgeries. I’m still cycling (I’m at about 3500 miles so far this year), but I’m also on pain management which consists at this point of a Fentanyl patch at 50mcg an hour and 4mg Hydromorphone (Dilauded) for breakthrough pain. All of this has resulted in a condition known as OPIAD (opioid induced androgen deficiency), hence my need for TRT. I started on TRT back in April, but the first Dr. was a total disaster. He started me on 100mg bi-weekly which obviously just made me much worse. If I had known then what I know now, I never would have allowed that. I found a new Endo who is trying, but she is still a little in over her head with this. Treating OPIAD is a little more complicated than treating age related decline because the opioids actually catabolize testosterone which makes achieving normal levels a challenge. I’m now doing 40mg EOD. I started that in July and after a month, I was able to get to 802 ng/dl. My e2 at that point wasn’t too bad (29 pg/ml), but as time went on, I began to feel that it was going high. I went to quest and had it tested on my own using the Ultrasensitive lc/ms/ms test and it came back at 50 pg/ml which is obviously high. My Endo is unfamiliar with both exemestane ( Aromasin my preferred AI) and hcg, so I bought the exemestane as a research chemical and the hcg (Pregnyl) from another source. So I went for bloodwork as follow up last week and my tt and ft were just over the top. Bloodwork is as follows:
Triglyceride 93 mg/dL 30 - 149 mg/dL
Cholesterol 219 mg/dL 100 - 199 mg/dL H
HDL Cholesterol 80 mg/dL >45 mg/dL
VLDL Cholesterol 19 mg/dL 6 - 40 mg/dL
LDL Cholesterol 120 mg/dL 60 - 129 mg/dL
Fasting Time 12 hrs
TC:HDL Ratio 2.74 1.00 - 5.00
LDL:HDL Ratio 1.50 0.50 - 3.55
Non HDL Cholesterol 139 mg/dL 90 - 159 mg/dL Protein, Total 7.1 g/dL 6.0 - 8.4 g/dL
Albumin 4.2 g/dL 3.5 - 5.0 g/dL
Calcium 9.5 mg/dL 8.5 - 10.5 mg/dL
Bilirubin, Total 0.7 mg/dL 0.0 - 1.5 mg/dL
Alkaline Phosphatase 52 U/L 40 - 150 U/L
AST 38 U/L 7 - 40 U/L
Glucose 108 mg/dL 65 - 100 mg/dL H
BUN 7 mg/dL 10 - 25 mg/dL L
Creatinine 0.90 mg/dL 0.70 - 1.40 mg/dL
Sodium 136 mmol/L 135 - 146 mmol/L
Potassium 4.7 mmol/L 3.5 - 5.0 mmol/L
Chloride 93 mmol/L 97 - 105 mmol/L L
CO2 24 mmol/L 23 - 32 mmol/L
Anion Gap 19 mmol/L 9 - 18 mmol/L H
ALT 15 U/L 5 - 50 U/L
Hemoglobin 15.1 g/dL 13.0 - 17.0 g/dL
Hematocrit 43.5 % 39.0 - 51.0 %
Estradiol 17B 45 pg/mL 0 - 60 pg/mL
Testosterone 1703 ng/dL 220 - 1000 ng/dL H
Testosterone Free % 2.7 % 1.4 - 3.2 %
Testosterone Free 458.9 pg/mL 41.7 - 180.2 pg/mL H
I actually reduced the Test dose to 30mg EOD for a month before my bloodwork as insurance that my levels wouldn’t be too high, but apparently something went wrong, I’m not prescribed the hcg at this point, but I wasn’t feeling good two days before the test, so I injected 250iu of hcg. I also skipped my normal 12.5mg EOD dose of exemestane, because, again I’m not prescribed that and I’m trying to get my Endo to prescribe it, so I thought I’de let the E2 go a little high.
My main question is can hcg actually boost testosterone levels that much?
Something that may be confounding all of this is I remember reading that supplemental biotin can skew a number of test results because biotin is actually used in the assay. I take a 2500 mcg biotin capsule every day, but I stopped four days before bloodwork. However, my multivitamin contains 100mcg and the b-complex I take also has 300mcg. I didn’t think that would be enough to throw things off so I continued taking them both until the day before bloodwork. Right now, my Endo is saying my Testosterone level is too high and instead of giving me the Aromasin, she just wants to reduce my Testosterone dose. I brought up the biotin as a possible confounding factor and have asked if I can have the free and total testosterone test redone, but I haven’t heard back from her yet.
So is it really possible for hcg to boost Testosterone levels that much, or is the biotin the culprit, or maybe a combination of the two. I can stop the hcg for a week or ten days, but I’m worried that the test ( if she orders it) will still come back high.
Thanks and sorry for being so long winded. Actually, I’ll be surprised if anyone takes the time to read it all.