T Nation

I Have a Tiny Prescription for T, Risks?


#1

Hi everyone, first post. I honor the expertise and support being offered here.

I have had low-T results a number of times, but my doctors are resistant to providing me with Androgel etc, because of above-range values of hemoglobin and/or hematocrit.

I had been using androgel 50mg, 2 days out of three, and my doctor did not like the results:
Testosterone 444 (desired range 348 - 1197) <<<<< LOW 'NORMAL’
free 7.7 (desired range 6.6 - 18.1)
Hemoglobin 18.1 (desired range 12.6 - 17.7) <<<<< HIGH
Hematocrit 54.4 (desired range 37.5 - 51.0) <<<<< HIGH
RBC 5.84 (desired range 4.14 - 5.80) <<<<< HIGH

I now have tried using it only every third day, for 3 months.
My latest test gave:

Testosterone 197 (desired range 348 - 1197) <<<<< THE PITS…
Free 3.4 (desired range 6.6 - 18.1) <<<<< THE PITS
Hemaoglobin 17.5 (desired range 12.6 - 17.7)
Hematocrit 52.1 (desired range 37.5 - 51.0) <<<< STILL HIGH
RBC 5.48 (desired range 4.14 - 5.80)

I am healthy, except for protracted fatigue after exercise, no heart problems in the family…
I do feel better and think I recover better from exercise when I use the gel…
Thanks for any advice on my results and my risks,
Joe

PS: updated for more details:
-age 64
-height 6’0"
-waist 46"
-weight 253 lbs
-describe body and facial hair. some all over
-describe where you carry fat and how changed belly and chest and sides
-health conditions, symptoms [history] generally healthy but overweight till 18, then after 30ish
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: T get, naproxin, none other
– real dangers! see this http://propeciahelp.com/overview64
-lab results with ranges given
-describe diet [some create substantial damage with starvation diets] trying to stay low glycemic
-describe training [some ruin there hormones by over training] Weight machines, cycle, BJJ
-testes ache, ever, with a fever? No
-how have morning wood and nocturnal erections: Never


#2

You need to start donating blood. The problem is they will not take it with your Hematocrit levels so high. Odd as that lowers the level but such is life. Your doc does not sound like he knows testosterone replacement very well. If he would write you a script for a blood draw that would be nice. Once done all you need to do is donate blood regularly and you will have no problems.

Read the info here. You need to learn enough to take charge of your treatment. You do not sound like you are in good hands right now


#3

Transdermal T creates wave of T, if you self inject twice a week, subq, not IM, T levels will be smooth and that may help.

Self-injected T is least cost and 100% absorbed.
Inject T 50mg twice a week, subq, #29 1/2" 0.5ml insulin syringe
1/2mg anastrozole at time of injections

No other labs? Post, normal or not.

Avoid iron fortified vitamins and foods: cereals, bread, rice, pasta etc. Read labels.
Do not get dehydrated at any times, drink water for fasting lab work.
Donate blood if you can.
Fish oil can help thin your blood, so can 1 mini aspirin per day.

Labs that you need!
TT
FT
E2 !!!
PSA
AST/ALT
IGF-1

Almost all men need anastrozole to get near E2=22pg/ml which seems optimal for almost all men.


#4

Thank you so much!
glucose 89 (65-99)
BUN 18 (8-27)
creatinine serum 1.02 (.76-1.27)
eGFR if non african 77 (>59
eGFR if african 89 (>59
BUN/creatinine ratio 18 (10-24)
sodium serum 144 (134-144)
potasium serum 4.7 (3.5 5.2)
chloride 103 (96-106)
CO2 25 (18-29)
calcium 9.2 (8.6 - 10.2)
protein tot 7.0 (6.0 - 8.5)
albumin 4.2 (3.6 - 4.8)
globulin 2.8 (1.5 4.5)
A/G ratio 1.5 (1.2 2.2)
Bilirubin 0.8 (0 - 1.2)
alkaline Phos. S 88 (39 - 117)
AST(SGOT) 26 (0 - 40)
ALT (SGPT) 16 (0 - 44)
WBC 5.3 (3.4 - 10.8)
MCV 95 (79 - 97)
MCH 31.9 (26.6 - 33)
MCHC 33.6 ( 31.5 - 35.7)
RDW 13.7 (12.3 - 15.4)
platletes 223 (150 - 379)
neutrophils 53
lymphs 34
monocytes 10
Eos 3
Baso 0.0
neutrophils (abs) 2.8 (1.4 - 7.0)
lymphs (abs) 1.8 (0.7 - 3.1)
monocytes (abs) 0.5 (.1 - .9)
Eos (abs) 0.1 (0.0 - 0.4)
Baso (abs) 0.0 (0.0 - 0.2)
Immature Granulocytes 0
Immature gran (abs) 0.0 (0.0 - 0.1)
T tot 197 (348 - 1197)
T free 3.4 (6.6 - 18.1)
LH 2.1 (1.7 - 8.6)
FSH 2.6 (1.5 - 12.4)


#5

BTW way, 67 here, on TRT for 11.5 years.

I am hitting you with a lot of materials.
You will need to make your own lists of things I have things spread across multiple posts and stickies.

What medications are you using?
Cholesterol levels?
Fasting glucose?
A1C?
Are you diabetic?
Pulse rate
Blood pressure
Do your muscles hurt with major effort?

CBC looks good. LH/FSH are low, can be chalked up to age related decline.

Do get oral body temps as requested below to evaluate thyroid function. Thyroid issues are common and account for a lot of weight gain and low energy.

Energy balance: T and thyroid are very critical. Thyroid lab ranges are useless, you will need to follow what I provide. IGF-1 will measure your growth hormone status which also impacts energy balance. Thyroid regulates energy hour by hour, cortisol minute by minute. Get AM cortisol tested and do that at 8AM or 1 hour after waking up.

Supplements:

  • high potency B complex multi-vit with trace elements including 150mcg iodine and 200mcg selenium
  • 1000mg Vit-C
  • natural source Vit-E
  • fish oil, flax seed oil/meal, nuts
  • Vit-D3 5000iu per day, 25,000 for first 5 days
  • 25mg DHEA, in the vitamin aisle, test DHEA-S later on [do not test DHEA]
  • Magnesium if you ever get leg/foot cramps or can induce a cramp by tightening muscles. This site’s Biotest store sells ZMA and Flameout.

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.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#6

I will do all you suggest, quickly. I will see my endocrinologist this week to ask for more.
I take vitamin D3 daily 2000iu, vitamin C 500mg, and naproxin for aches as needed, nothing else except T gel.
I will get those other questions answered too.
As to muscle pain, no, just overall fatigue the day(s) after I do a fun, hard workout. Sometimes a given muscle might be a little ‘barky’ if I’d singled it out for a beating (intentional or not)

I understand abrupt and a target-rich radar screen. I am a swamped expert in my field… :wink:


#7

I wouldn’t use naproxin for exercise induced muscle pain, save it for injuries only
Naproxin can hide pain, causing you to push yourself too hard and it also slows down some of the recovery especially around tendons which could lead to tendon injuries


#8

Interesting! I had no idea… I have a Thursday appt with the endo doc to ask about getting those other stats…


#9

My endo doc referred me to a blood specialist. He went back in the LabCorp
records to years before I was using any T at all, and my hemocrit was high
then too, 49.6, just below the highest normal.
So the hope is the blood specialist can find a way to lower this… The
endo sort-of poopooed the T numbers because the FSH and LH are good. But I
told him that if I worked out w/o T, I’d need 2-3 naps the next day without
exercise, but on days I could use the gel, I could exercise again the next
day. I told him my libido is nil…


#10

Lack of energy is very easily from low thyroid function and iodine deficiency. I can’t see where you have responded to these issues.

You have left other questions unanswered. Audit! Later I will not be doing housekeeping on issues.


#11

I have a lot of extra fat, being on T 2 times a week ( 45 units)with a 1/2 anastrozole has been great in some ways and bad in others, overall is worth being on it. My red blood count went up past high level and I donate every 2 months to keep level good. I have lost 55 pounds in past 7 months which is great. I need to get off my butt and do labs more. I may need to increase my T, one lab was almost max, next was 200, still better than the 70 I had when starting. Sexual function is crazy, gained a lot in overall size width but finishing now is harder, can go on marathon sessions and get wore out before I finish. Before was never a issue. Once I get back from week vacation, getting Labs and going to do them monthly for awhile. I do my labs online and go into local lab to get draw, it is cheaper than my dr and easier. If I could tell anyone doing TRT 2 things, (1) get labs every month or two for first year, don’t overdo T, more isn’t best.