T Nation

Jakesdog's Labs

T Replacement
#1

I am trying to post up some lab work for you guys to look at, and hopefully I will get some help with my issues. Some of my labs are older, and I will put what date they were taken. I have have been having issues since 2001.

Prior to going on T this last time, my doc checked my Free and total on 4-27-12.
FT: 24.9 Pg/ml Range was 3.8-34.2
TT: 218 ng/dl Range 241-827

My most recent blood work was in May, and it included:
FT: >125pg/ml Range 3.8-34.2
TT: 978ng/dl. Range 175-781
Estrogens: 325pg/ml. Sorry not an E2 sensitive

This is old, but it was done prior to me trying Androgel in 2004. I was 33 years old.
I was not on trt at all at this point.
FSH: <0.3 MIU/ML Range 1.4-18.1
LH: <0.3 MIU/ML Range 1.5-9.3
TT: 332 NG/DL. Range 241-827

These are the first 3 labs in 04 after starting Androgel. These are for Oct, Nov, and Dec. They only included TT.
882
111
323
Same lab(PAL) and ranges as above. I remember feeling like absolute shit that November.

I will be getting new labs soon, and I will make sure they include everything suggested from here. I now know how bad my docs screwed up this last time by not doing all the necessary labs.

-I live in central California!
-age: 42
-height: 6’
-waist: 34-36
-weight: Current is 218, I feel and look better around 230
-describe body and facial hair: Never real hairy. Not much chest hair, hair on legs and arms normal not thick. Facial hair actually pretty decent after a year of TRT. Full head of hair. Never needed or used hair re-growth products.
-describe where you carry fat and how changed: When I do have extra weight on me, I carry it in stomach/oblique area.
-health conditions, symptoms [history]: Felt super great and healthy my entire life until around Jan/Feb 2001. It was at this time that I had a very hard time with depression. My doc tried me on several different antidepressants with out success.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: Tried androgel from Sep.2004 till Dec 2006. Never felt good on it. In Feb 2005 things got real bad, and I felt like I was just going crazy. Might have been high E2 from androgel. Either way, I went to see a psych doc, and I was prescribed 400mg Wellbutrin and 20mg Lexapro per day. I got off of the Wellbutrin and Lexapro in Feb 2013(I actually weened off them over several months). Started Celexa 40mg on Feb 15 2013. Still on it.

-lab results with ranges: Coming soon
-describe diet: I Just try to eat healthy, wife cooks our meals. Take multi-vitamin, plus C,D3,B complex,fish oil,aminos,
-describe training: I have not been in the gym since Oct 2012(I started T-cyp shots at 200mg a week at the end of June 2012. I made good gains, but with no AI I crashed by Oct 2012). Before that I had finally regained training in Jan 2012 after many years of hit and miss workouts. Lost my drive.
-testes ache, ever, with a fever? Never
-how have morning wood and nocturnal erections changed: No morning wood, low libido.

I wish I had found TNation years ago. I was dumb for not looking into this sooner. I started T-cyp shots at the end of June 2012. I was given a script for 200mg a week, with no AI, and no HCG. I didn’t even know what an AI was before coming here. I trusted that my doc was helping me, and I just didn’t question it. I took my shots every week, and by the time October rolled around, I was in full breakdown mode. I came home from work and broke down in front of my wife like a little baby. I was coming off of Lexapro at that time, and that is what I blamed it on. I still can’t prove it without labs, but after 3.5 months of test only, I am sure my E2 was in the 100’s!
I took a week off from work, and somehow went back without changing anything. I continued my 200mg’s a week of test, and I continued to have horrible emotional problems. I saw an Endo in Jan 2013, and he had me go off the test shots for 5 weeks so he could do blood work. He told me if I didn’t really need the test then my body would start making T on it’s own. WRONG!!
I had an MRI done on my pituitary, and it was discovered that I had 2 micro adenomas. I was told they were not producing anything. I did have the proper test done, and I also went for a second opinion at Cedars Sinai in Beverly Hills. They said the Adenomas are very small, maybe 4mm. My prolactin test came back at the lower end of normal.
I think I might be able to feel pretty good on TRT, as long as I have the right combo of T+AI+HCG.

KSman is Here
#2

This is horrible… Not even basic lab work was done!?

Did you do steroids?

#3

No, I never did steroids. I was a 30 year old guy that was happy 24/7, until all of a sudden one day I just started to crash. That was back in 2001. My doc tried me on several antidepressants, but not a one of them made me feel better. It was me in 2004 who suggested that my testosterone be checked. I have been through hell with this stuff. I don’t know how I make it some days. My wife and kids are the ones that give me my will to fight. I really need to feel better soon!! I’m missing out on so much, and my kids are missing out on the real me.

#4

I’m really frustrated right now with my new doc. He only likes saliva test for hormones. If I were a doc I would also want blood work for total test. I can’t afford to pay $175 every time he wants to do a saliva hormone panel. Not to mention buying every supplement under the sun from this guy. My first visit cost me over $500. He mentioned last visit about doing a Neuro transmitter test. But that is also expensive.
Would I be better off in the long run to get away from this guy, and go back to my old doc for actual labs? My old doc would write me a script for just about anything.

I feel like my E2 is a huge part of why I don’t feel good right now, and with the info I have now I would be better of just staying with a doc that would be willing to get me what I need.
I was not given an AI with the troches, and I have read that they can drive up the E2 because of how fast they get into the blood stream. My new doc wants me to control E2 with the stuff I purchased from him. I bought from him, Estro-dim, resveratrol, I3C, andro-plex, and a few others.

I don’t think his way is going to work for me. He may mean well, but I feel like I can only feel as good as my budget will allow with this new doc.
I really think I have been on a E2 roller coaster ride since starting trt last year. I was started with 200mg test cyp a week with no AI. 3 months down the road I was in full breakdown crisis at work. I didn’t even try an AI until the middle of this past May. Even then, it was Letrozole dosed at 2.5 mg a day to start, and the. I was supposed to cut back to 3 days a week. All I did was crash the E2 levels according to the saliva panel.

My new doc told me to stop the letrozole, and to use the products I got from him to control E2. So I stopped the letro, dropped the 200mg a week test cyp, and started 80mg test cyp a week, and added in HCG shots. Well, I didn’t feel great after about 2 weeks, and I thought my E2 was climbing again. So I started dosing 1.25mg of the letro again.
It was at this time that I learned from my new doc that I had almost zero E2 according to the saliva test. So again I stop the letro, and I just start using the compounded troches. The troches have 250U(whatever “U” is) of hcg and 10mg of testosterone per troche.

No wonder I feel like shit all the time.

#5

Guy is a money grab and the saliva testing only is a bunch of shit if you ask me.

4 point cortisol is the gold standard but other then that stick to blood work.

I’d get away from this doc yes.

Have you read the finding a trt doc sticky?

Read the advice for new guys sticky and edit your first post.

A lot of questions in that sticky should be answered in your opening post.

Sorry you are having a hard time… I am also very hurting and frustrated so I feel your pain bro. You will get there

You can order your own labs from lef.org assuming your in the United States

#6

IW84aces, thanks for the encouragement! I will fix up my post soon. I’ve been using my phone to post on here, so as soon as I get my computer I will do some cut and paste and get all my other info on here.
I really think I’m getting a double whammy here. I lowere the amount of test I was taking, and I have no AI to control E2. I took my last dose of letro last Sunday. It was 1.25mg. I wonder if my E2 is rebounding from stopping the letro. I am definately going to see my old doc this week, hopefully tomorrow. I am going to ask him for 100mg tcyp, hcg, and arimidex. I will also get labs done ASAP. I will hold off on the T,hcg, and arimidex until I get labs back from the doc.

I think if I can continue injecting, and have an AI that I can control better than letro, I can start to feel better. I really think my body needs some test, but I need to keep the E2 in check. I may wait to add the hcg in until I get my e levels in check.

#7

Google anastrozole research chemical. Several reputable companies out there. I am currently doing a trial run with letro, but 95% of the guys find that anastrozole (arimidex) is easiest to manage E2. You will also find the most detailed information on how to dose anastrozole properly to achieve optimal E2 levels.

Your doctor mainly deals with older people who are trying to “stay young” and don’t care how much it costs them. Given that he is a hormone specialist, it surprises me that he was pushing the troches. Usually they go for testopel or topical creams.

2.5mg of letro a day is AAS (steroid cycle) dosage. Letro is very strong, and you probably bottomed out your E2 and that can make you feel terrible as well. I’m currently on .75mg liquid letro EOD if that gives you an idea.

The over-the-counter AIs probably won’t cut it. You can run a trial test, but anastrozole DOES WORK, and it works well. I would skip the middle man if I were you.

Getting hCG from GPs can be tiresome. They just don’t understand why you’re trying to lose weight on TRT–“hCG is illegal for weight loss, I think” (actual quote). They aren’t educated on it’s benefits on TRT. You could probably email your specialist and he will throw hCG at you. He should understand it’s benefits.

You are SEVERELY secondary hypogonadic. That means your testes work, but aren’t getting the “signal” for some reason. This can sometimes be corrected, so that’s a good thing. You need a lot more blood work done (don’t worry, TRT isn’t going to mess with most of it) to find out what’s going on. Can you connect it to any event in 2001? Was this a particularly difficult time in your life?

Low testosterone is a symptom of another problem. Need to find out the “why”, or we are just covering up symptoms.

Good luck, brother.

#8

Some labs I found from 4-1-13 from endo doc:

IGF I, LC/MS 252 range 52-328 ng/ml
Z score 1.3 range -2.0 to +2.0
ACTH, plasma 47 range 6-50
Cortisol, total 15.7 range (7-9am) 4-22
Growth hormone <0.1 Range < or =10.0 ng/ml (this was an unstimulated GH test)
Prolactin 8.3 range 2.0-18 ng/ml

#9

Just got labs back.
E2=21 quest range is < or = 39pg ml

TT 757 range is 250-1100 ng dl
FT 193.4 range is 35-155 pg ml

I still feel like shit. No energy, depression, brain fog, low libido, no morning wood etc.

Is that due to my FT being off?
How do I get my free T in range? I think my high E2 levels from Oct-May messed my FT levels up. If I keep my E2 in check will that help get my FT in range?

He did write me an Rx for Anastrozole. I want to keep my E2 in check. I know the level looks good now, but how do I make sure it doesn’t go too high or too low? My new protocol will be:
100mg t cyp a week. 50mg twice a week
HCG 250 2x a week
Anastrozole .25 eod.
With my E2 currently at 21 should I even take the AI? My E2 is recovering from me crashing it. That was confirmed with a saliva test. It was almost 0 according to the saliva panel.
How long does it take the brain to recover from a crashed E2 level?

I had high E2 in May, but I ended up crashing it with too much letro.

#10

Why not start at 1/2 the recomended dose here and retest in a month. E2 is perfect right now but hcg might have a say in that

Free T above range isn’t hurting anything. you don’t want to lower your total T numbers look ok.

You have other issues is all. Everything cannot be bled on testosterone. The body is way more complex then that

You need thyroid and adrenal labs plus a shit load more.

Get a 4 point cortisol test.

If you don’t know what labs you need refer to lab work sticky and get everything you can. We can’t help you with this little data bud

#11

Can you do me a favour and list all your symptoms and try and explain them as well as possible.

We are running blind on guess work.

#12

Current symptoms are:
Depression
Anxiety
Restlessness
Over emotional
Not sleeping good. Very light, wake up feeling nervous.
My appetite is off. Not very hungry.
Low energy
No drive

Current meds:
Celexa 40mg a day since Feb for depression. I did lower this about a month ago to 20mg, but I’m thinking of going back to the 40mg. I may be having withdrawal affect from this.

Supplements:
Vit D3 40,000 iu for 15 days, and then to 3000iu Dr. Prescribed
One a day men’s multi
Ester C
B 12
DHEA 25mg
Amino acids
I was taking 50mg iodoral, but stopped because I thought it might have had something to do with this crappy feeling.

Is it possible that my brain is just going to need time to stabilize? What I mean is, I had very high estrogen from about Oct-May. I then crashed those levels with Letrozole, and I felt even worse. Now my E2 is coming back up to where it should be, but I have not had stable E levels yet. I’m wondering if I keep my E2 in check, and keep my test levels up, if my brain will adjust to stable levels. Just a thought.

Could my FT be high due to low androgen receptors? From what I have learned on here, androgen receptors can get messed up from high E2. Which would screw up your FT, and result in not feeling great because your FT is bound up with no where to go. That’s why I was asking if I keep my E2 in check, and my T levels stay where they are, won’t my body be able to create more androgen receptors? I understand this can take some time happen, and from what I have read it can take a few months for the brain to stabilize.

#13

Bah fucking antidepressants… Who knows what side effects they have… So hard to know what’s going on with someone when already on fucking big pharma drugs.

If I were you I would do a full thyroid panel and check Rt3

Plus I would check the adrenals…

Yes it can take time for e2 to get settled in and steady

#14

AD meds are prescribed often for hormone caused symptoms.

Read the thyroid basics sticky and come back with symptom hits and body temperatures. Your sex hormones seem to be good, so looking for something else and thyroid is often the cause.

Are you using sea salt? If so, you are iodine deficient.

This is standard advice maintained here:

There is a huge amount of knowledge in the stickies. Please study these. Start with the advice for new guys sticky.


There is a lot to read there, so read carefully. There are suggestions for things that are root causes of low testosterone [T]. Low T is a symptom, not a root cause itself. But low T itself is a root cause of many of the symptoms one experiences. Note that other things cause the same spectrum of symptoms, so do not have T tunnel vision. Many docs are guilty of that and they only treat the symptom [low T] and do not attempt to find the real problem. If you go to a clinic that specializes in low T, you will get T tunnel vision for sure.

Post info about yourself as suggested in the above sticky. We need labs, almost all of your labs, not just hormones. We also need the lab ranges.

We see a very high number of thyroid issues in the population of guys that show up here. So there is a strong focus on that. Most people are iodine deficient to some degree. Your history of iodine intake from iodized salt and vitamins that list iodine is important. If you become iodine deficient, the RDA [recommended daily allowance] is inadequate for recovery of iodine stores. Please see the thyroid basics sticky for more information.


You do not want to suffer from subclinical hypothyroidism or get Rx thyroid meds to treat iodine deficiency.

If you are injecting T or contemplating that, read the protocol for injections sticky.

There are stickies for finding a TRT doc, estradiol [E2] and lab work.

Do not place your history or treatment details in the stickies! That belongs in your thread. Keep all of your posts in your thread so we can have a clear picture of your situation and needs.

#15

Why do you say you thought idoral might have had something to do with your feeling shitty?!

Did this start after taking iodine??

Ksman he already tried iodine, give it up…

Your thyroid ideas are insane and you mess with a gland with high doses when some of the best endocrinologists in the world do not fully understand thyroid function… You need to get a life, your advice has fucked up my thyroid do you not get that??? What might have worked for you might not work for everyone… Give it up

You’re on every drug on the planet have you ever thought this is self induced from being on all this shit??

You’re living in a dream world… I dropped my E2 just by cleaning up my diet and taking a little milk thistle yet you tell people with lower T and higher E2 to jump on an AI… Again give it up…

Can’t just run around telling everyone they need drugs to make the body work better… How bout making it work better without drugs!!!

#16

New labs:

DHEA: 411 (61-1636ng/dl)
Serotonin, serum: 18 (56-244ng/ml)
Pregnenelone: 40 (13-208ng/dl)
Growth hormone: 2.6 (< or =10ng/ml)
TT 597 (250-1100ng/dl)
FT 137 (46-224pg/ml)
Bio T 299.5 (110-575ng/dl)
SHBG 16 (10-50 nmol/l)
Albumin,serum 4.8 (3.6-5.1 g/dl)

No E2 on this one, but I have a lab slip in hand for it. I have been feeling very down and depressed lately. I’m also on Celexa, and I have been since Feb 2013. I am going to switch over to Prozac, because I have not felt good on Celexa at all. My Doc says my serotonin levels should be higher since I’m on the celexa, but he seems to think my body is just not responding to the medication. I have had issues with depression since 2001, but I have also had very low TT levels too. This last lab was taken 3 days after a 50mg T cyp shot. I recently upped my T to 120mg a week divided into 2 shots.

Is my SHBG too low? Is my bio t too high?
Any and all advice is welcome. Thanks.

#17

Bio T to high?? No

I would rather low shbg then high that’s for sure…

Have you considered seeing a naturopath or homeopath?

#18

SHBG is a tricky hormone and honestly we know little about it in comparison to other hormones. As it was pointed out your thyroid plays a large role in the production of SHBG. It is made in the liver so it could be suggestive of a liver problem as well, mainly insulin resistance leading to non-alcoholic fatty liver disease.
Having a good free roaming testosterone percentage is good, but when it gets too high, IE : SHBG gets too low, men will feel insulin resistant symptoms.
It is well documented that men with low SHBG have a high probability of diabetes and other metabolic syndromes, so although a high free T reading is good, when its get really high that is not so good.
SHBG is a carrier protein, its responsibility is to carry the testosterone to its target tissues. If that number is really low then there is not enough carrier to move the testosterone where it needs to go. The other responsibility of SHBG is to preserve testosterone in the blood, by binding it.
So you can not think of it as the testosterone gets attached and then stays attached until it gets discarded, it is constantly detaching and attaching.
Lastly recent literature has suggested that not only does SHBG carry the testosterone it also participates in cross talks with the receptor, essentially affecting the testosterone molecule’s ability to activate the androgen receptor.

I don’t think this applies to you…

#19

What time were your cortisol tests done?
Were u fasting??