T Nation

I'm Sure I Need TRT, But Have High Blood Count


#1

Hi Guys

Come on here to seek some advice from those in the know.

Basically, 32 years of age, never done anabolic steroids in my life. Trained for around 4 years to gain size and strength. 5ft’6 in height, 13.6 stone in weight. Not sure what that is in kg, but Google seems to think 86.3 kg. Supplemented with whey protein, high protein foods, rice etc - creatine.

My situation unfolds that despite getting into pretty good shape, I’ve battled ‘what now looks likely’ to be the classic symptoms of low testosterone for many years. Not going to list them all here. However, suffice to say I’ve felt pretty crap. Last year, I started looking more into the symptoms of low testosterone - and how they might affect an individual. I tick pretty much every box on that list.

I finally decided to get it checked out. I ordered blood work through an independent laboratory last August, NOT my NHS GP. The reason for this, is I’ve read many stories from guys turning to GP’s for help, only to be not taken seriously (happened to me today more on that later). So, the initial blood work was a complete examination. Not only did it measure hormones, but also took a look at general blood health. For the most part, it was a decent profile. However, abnormalities showed in the red cell count/health. The results of the 3 abnormalities in that panel is: [B]HAEMOGLOBIN (G/L)[/B] *176 g/L (130.000-170.000). [B]HCT[/B] *0525 (0.370-0.500). [B]RED CELL COUNT[/B] *5.88 x10^12/L (4.400-5.800). MCV, MCH, MCHC, RDW were all ok. The one’s that are not appear borderline.

Testosterone levels shown in the initial test were as follows: [B]Testosterone[/B] *8.81 nmol/L (7.600-31.400). [B]17-Beta Oestradiol[/B] *37.34 pmol/L (44.000-156.000). As you can see, my testosterone levels are LOW. Although, not out of range in this test. The doctor reviewing my results suggested TRT may be beneficial, but urged an additional hormone screen. I was supposed to have completed that a month later, but left it for a few months until a week ago (Feb 2017). Plenty of time to see if my testosterone would pick back up on it’s own. Unfortunately, it hasn’t.

The results of my latest test show that Testosterone has dropped further. It now shows the following. [B]Testosterone[/B] *5.74 nmol/L (7.600-31.400). [B]Free Testosterone[/B] *0.157 nmol/L (0.30-1.00). [B]SHBG[/B] *14.43 nmol/L (16.00-55.00) and [B]17-Beta Oestradiol[/B] has risen to
67.64 pmol/L (0.00-191.99). This may explain the worsening of my symptoms the last few months especially, and what seems like more in the way of fat build up.

Problem is guys, I requested TRT privately yesterday, through a reputable service and provided my blood work report. Because I have a raised blood count, they are not willing to proceed and terminated my request for treatment. I understand TRT can cause polycythaemia, and the doctor probably thinks it’s too risky to proceed already having a high blood count - as TRT would rocket an already high result. So what do I do?

As for my NHS GP. Don’t even go there. Took one look at me and my results from these tests. He said, based on your build and size I highly doubt you have testosterone issues. Started asking questions like if I took any supplements, had any problems growing facial hair etc. I mentioned that my request for TRT privately was refused due to a high blood count - and he didn’t even question that. He’s ordered another blood test later this week - but really just didn’t seem at all fussed even after reading the results. In fact I felt the appointment was a disaster.

So I guess I’m just wondering what I can do if TRT is a no go privately or on the NHS?
Gazza


#2

Not an expert, in fact Im a newbie, but maybe go give blood then try for a new private firm. And if not hassle the GP until he caves? Giving blood will drop those blood levels and some guys here religiously give blood every 60 days(minimum timeframe allowable in US)

Hope that helps.


#3

One thing with donating blood to the Red Cross, don’t tell them why you are donating. They will probably black list you from donating ever again. Found out the hard way. I now have to have blood letting done by the hospital. Just keep it quiet.


#4

Hi Guys

Apologies for the late reply & thanks for the help and support. I had to have some more blood work done, including a full blood count. The results of that come back normal and it appears that the high blood count has lowered by itself. Dehydration perhaps? In reply to the previous question, no, I don’t live anywhere of high altitude.

Regarding the latest testosterone test, they won’t give me the results across the phone as the doctor wants to see me to discuss. The fact I’ve been invited for an appointment can only be a good thing? I’ve been feeling at a very low eb and just desperate to feel normal again.

I’ll keep you posted


#5

@richlandfarmboy

No way!? My urologist told me if H and H go above normal… too much T being given… so you cant do that anymore. The guys old school and a dick, I asked for therapeutic phlebotomy and he said for what. So good for you that you got a doc to order it. Im jelling.

@gazza32

Yes dehydration definitely concentrations your blood cells and jacks up values. And an appointment could mean they are ready to talk TRT. Good luck. Is this the GP or private firm?


#6

You should avoid iron fortified foods: breads, cereals, pasta and vitamins should not list iron.

Thyroid can be causing problems. Any labs?
Many in UK are iodine deficient as iodized salt is not readily available.
In UK, one is expected to get iodine from dairy products? You consume those?
Do you eat much sea food?
Do your vitamins list iodine and selenium?
SEE LAST PARAGRAPH IN THIS POST.

Your liver clears E2 and with low FT, FT–>E2 generation is low.
Any liver issues?
AST/ALT tested?
Some medications, Rx and OTC, can increase E2 by competing for the same enzyme pathways that metabolize estrogens. Please list meds.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • 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.


TRT Not Going to Plan
#7

Firstly, apologies for starting a brand new thread. Before replying to the above, just a quick mention about my current situation.

I was indeed put on trt in the end, through the nhs, in the form of Tostran gel 2% (6 pumps daily) applied to stomach and inner thighs as recommended. Pre trt included four lots of blood work. I wish I had the copy to hand, but as an overall level -
testosterone come back low (out of range on all 4 occasions) and is still low 8 weeks after starting treatment at 9.0 nmol/L.

The issue I have, is I still feel like rubbish, and the endo seems happy with the results 9.0 (10-30). Still poor energy, no motivation, low libido, mental fatigue and fog. Just basically really nasty stuff. Was never expecting a miracle. Just to feel better.

3 of those ‘pre’ trt tests were taken early in the morning around 9am, and one was taken in the afternoon at 1pm. The initial time between the first test and the last pre trt approx was 1 year. So as you can see no fluke.

The full blood profile (including thyroid) on all occasions come back fine (apart from a high rbc which resolved after the initial test), thyroid function was also included as part of a complete pre trt hormone profile panel which also included prolactin, hgh, cortisol etc, the only one they didn’t check was oestradiol strangely enough.

Other examinations included complete lifestyle and diet questions, a complete physical which concluded normal testicular function. I’m currently awaiting an mri on pituitary function.

To answer the questions above, I asked about thyroid based on the results and in short - no issues. I do indeed consume dairy products, milk every day, cheeses, yogurt etc. I especially love sea food. In fact my diet is pretty varied. I run multi vitamins and minerals which does not list iodine or selenium. I also run zinc.

No liver issues, labs confirmed this. On no other meds.

However, I have suffered severe anxiety and panic disorder for a number of years, which you would think would drive up stress hormones. It’s funny you should mention atp, as anxiety aside, I have suspected an abnormally elevated level of norepinephrine and epinephrine, and have often wondered if and how these two would impact atp and the hormonal balance in excess. However, I have never had norepinephrine or epinephrine measured. Apparently atp issues can also point to a problem with Coenzyme Q10.

Regardless of the fact it’s gel, you would now generally expect those levels to be higher than 9.0 nmol/L. Even my gp said we need to be aiming for around 20. So I have no idea whether I’m just absorbing it too poorly, or whether my physical and mental fatigue is another issue as well. Just seems a coincidence that testosterone is still low and my symptoms are still there.

That’s why I wondered if something like HCGenerate might help sense of well being and energy at least in the short term?


#8

I think you need to try and find out why your bloods look so abnormal considering your T is no where near being too high, its the total opposite


#9

Hi detonate,

Definitely. As they say no number in the world is a substitute for actually knowing your own body. Facepalm.

I have read gel isn’t for everybody. I’ve also read it can be poorly absorbed. I’ve been applying it as I was instructed to do. Nebido has been mentioned as an alternative, but until I actually get an appointment (months not weeks) that won’t be happening anytime soon.

I suppose I could try upping the dose of the gel and applying to other application areas? However, if 6 pumps isn’t doing much perhaps 8 won’t make a difference. Looks like many people struggle with gel.


#10

Do you think it may be worth while running an overall health complex such as N2Guard? Not for anything other than general wellness…