T Nation

Just Got Bloodwork Back, Advice Appreciated


#1

Just got my labwork back…hematocrit sitting at 56%. I donate blood about every 8 weeks. I quit taking HCG, try and limit Iron fortified foods, etc. Another concern is I routinely fly international for work every 3 months. Roughly a 15 hour flight. My test dose is standart 100mg divided over 2 doses weekly.

Another concern. Estradiol was less than 25. Has been as low as 6. I only take 0.5mg arimidex with injections on Monday. Labs drawn were 1 week post last arimidex. Clearly an over responder. Ugh.

I see my endo tomorrow 4/20. Should I see if therapeutic phlebotomy is an option. Or just say screw it and go off trt altogether and do a PCT/HPTA reboot. I have been on TRT 4 years.

Lastly my total testoerone came back at 485 this last draw (which was done on 4/17 with the HCT and E2). Was hoping for more in 600’s. I am 45 years young. Obviously I need HCG boost but honestly afraid of that HCT number. Being 56% can also be why I am fatigued at times, but again E2 and sub 500 testosterone may also be contributing to that.

Any input from someone with similar experince would help alleviate some concern and give me something to mull as far as solutions.

Thanks!


#2

You now have 4 threads for your case and this one has no record of past labs, advice or responses. Not good.

HTC:
take mini aspirin
take fish oil
try to not get dehydrated and that is a risk on air travel

  • these may improve how you feel with this condition

Your T levels are low, but HTC does not allow for increase at this time.

Any progress on thyroid issues.

You never posted oral body temps.

Do you know how to find your prior threads/topics? Click on your “B” icon in TH top corner of any forum window’s banner.


#3

Thanks KS man. Was not aware of how to find prior threads/topics so appreciate the patience.

Like many guys, just frustrated with how things are progressing. Had my doc run TSH ft3 and ft4 to see where thyroid is sitting. Also looking at am cortisol.

Last TSH was 1.040 in april 2015. Original TSH was 4.1 in Feb 2014. Oral temps (when I have been home to do them) start 97.9/98.0 when waking up to 98.6 mid day. (awake time varies due to shift work. Sometimes I get up at 9 am other times it is 4pm.)

I will get on the fish oil pronto. Would you recommend 1000mg twice daily? It is concentrated so provides 300mg per capsule.

Baby aspirin 81mg or 325mg tab?

Is restart an option and will just live at pre trt levels which were 270’s? If so, not sure what that protocol would look like since my E2 levels seem to fluctuate drastically on AI.

Just stressing over what route to take and what to discuss with endo tomorrow. Top things off I will be out of the country starting 4/29 until 6/1. I have hcg and arimidex at home but would need a serm like nolvadex if I plan to stop TRT. That route brings up a whole slew of questions such as what “protocol” I would adhere to. Not sure I am comprehending the restart sticky. (Can I blame it on brain fog?) Interpreting that I would stop testosterone, take Hcg 250 IU EOD for 4- 6 weeks then start SERM for 4-6 weeks all the while keep taking AI and taper after completing 12 total weeks (6 weeks HCG+6weeks SERM)

Still waiting on my thyroid labs to result BTW., will update if they come back today.

Your time is very much appreciated.


#4

300 mg of Omega 3 FA per tab is what I meant


#5

I do not know what amounts of fish oil are required to get the blood thinning effects. Mini aspirin are all that is required to achieve the effect of making red blood cells more slippery to achieve better micro circulation. You could take 325 for first few days to move this along.

So your thyroid now appears completely normal.
Can you summarize what you did to achieve that?

HPTA restart is as summarized by you.
Outcome depends on ?age?


#6

KSman,

Thanks for the input. I am going to try the restart. Worse case I end up back on trt. I am 45 so I am not sure a restart will even be possible at my age. Hoping the HCG doesn’t increase my hematocrit too much. I am not due to give blood until 5/2 but will be out of country and won’t be able to donate until 6/2.

As far as thyroid goes, only thing I can attribute to that normalizing is TRT, and taking multivitamin which had selenium and iodine in it. The 4.0 was pre trt and the 1.0 was during. Same lab testing company performed both. Is this even possible? That is why I want thyroid panel retested.


#7

So update, labs, advice, questions.

Saw endo 4/20. He ordered therapeutic blood draw of 500 ml for my HCT of 55.8. Re-draw lab in 6 weeks. I also started 325mg aspirin for 2 days then switched to 81mg daily. I requested Thyroid, Dhea-s, ACTH, Cortisol Am, and Free T just to see where I stand.

4/25 labs:
TSH 1.32 (0.4-5.5)
T3 Free 2.8 (2.3-4.1)
T4 Free1.2 (0.9-1.7)
Cortisol 16.3 (3.4-26.9 AM)
ACTH 15 (8-42)
DHEA-S 94.1 (44.3-331.0)
Free T (not resulted yet)

I leave for overseas 4/29. I have not taken my testosterone injections for 14 days as of this posting. The high HCT and upcoming travel had me spooked. Was feeling suprisingly well but today kind of in a funk and imagine T is bottomed out. Waiting for Total and Free T results from the 4/25 draw (10 days post Testosterone) to se where my levels were sitting.

On to advice and questions. I am thinking I will re-start my 100mg Testosterone for the next week and add 250mcg HCG for that week.
Then I am planning on just taking HCG for next 4 weeks until I return stateside on 6/1.
I will redraw Free/Total T at that time and Estradiol.

Question here. Should I be taking my AI during this? The AI won’t touch the Estrogen produced from taking HCG correct? I am an over responder to begin with per past E2 results.

After returning home I plan on 4-6 weeks of Nolvadex per HPTA restart sticky then retest labs, adding in LH and FSH. I will take AI at usual dose for me which is 0.5mg/wk during the SERM phase.

Depending on if HPTA restart works (I am 45) per labs, I will either restart TRT (and hopefully can keep my HCT managed) or live in my pre state TRT levels for as long as I can.

Do you see any kinks with this strategy? Or any advice as I respect your dedication to this topic and knowledge of the subject.

Thanks,

Frank
PS. Is there a way to merge my past “cases” into one?


#8

hCG has no direct effect on HTC that I have ever seen. Increased T levels and high peak T levels can increase HTC. So hCG could have a secondary non-direct effect.

Anastrozole will reduce T–>E2 everywhere but inside your testes. T created via hCG can still T–>E2 in your peripheral tissues and anastrozole will modulate that. With falling T levels, you AI can be too much and E2 may get low enough to make you feel bad.

Any way to use Nolvadex+AI while traveling and reduce the hole?

There is no way to merge your threads other than manual effort.

Please get 25mg DHEA and take that. Note that DHEA is mostly considered a scheduled drug everywhere outside of the USA.


#9

Thanks for the reply. No chance of nolva before departure tomorrow. I will head out and grab the dhea tonight. If I how that low E feeling will hold off the AI for a week and resume. Cheers. Will update in 4-5 weeks when stateside.


#10

Got the DHEA. I actually have a bottle of clomid that i never used. They may be expired but do you think i should substitute the clomid for the nolva the month i am gone?


#11

Clomid and Nolvadex do the same thing. The only difference is that for a few guys [not rare], Clomid creates estrogenic side effects that can be very depressive in nature. You could try 25mg E2D or E3D.


#12

KS as usual, thanks for guidance. I am sitting in the airport re-reading hpta restart stickies and various other related posts. Starting to go cross-eyed and confused somewhat still. Just don’t want to screw things up while overseas. I have a suitcase with just my meds (hcg, arimidex, test cyp, dhea, zma, and clomid.

My last injection of test cyp was 2 weeks ago. I was waiting for my TT and FT lab 10 days post injection to come back but they still have not resulted. I took an IM of 50mg of test cyp today just of how I was feeling yesterday.

In your opinion, should I take Test cyp 50mg twice per week for this next week then taper that to 25mg twice per week for the following week while simultaneously adding 250mcg hcg EOD for the next 6 weeks? Then testing to see if testes have restarted? I will take arimidex of 0.25-0.5 mg/week during this.

I know it seems like i am rehashing the same plan discussed earlier but in your last reply you mentioned using the serm and ai while using the hcg (or that is the way i took it at least) but in the sticky it says to not take serm and hcg together.

My plan was after 6-8weeks stopping test cyp and using hcg to then use serm for phase 2 of restart for 6weeks then test LH/FSH etc to see if i restarted.

This should line up with endo appt and whether trt for life it is for me or if i can live with my baseline production.

Sorry to be a pain or not comprehending everything completely.


#13

Well finally got TotalTestosterone and FT back from blood draw 10 days post testosterone injection.

Total 242 (193-824)
Free 60.6 (41.6-180.2)

Total on 4/17 was 485. Drop as expected given not taking any T for 10 days.

Restarted T for next 2 weeks then taper to hcg for restart attempt. Will update along the way.


#14

SERM+hCG not OK
SERM+AI OK
hCG+AI OK


#15

Thanks KSman. Tapering Test now, added HCG for next 6 weeks then will get appropriate labs upon return to US. Will taper off the hcg and add SERM for 6 weeks then see if restart was success. WiIl update labs and journey. Dosing AI appropriately for symptoms as I have over responded in the past. Starting with 0.5mg weekly and will go from there.

Can I start the serm immediately after my last hcg shot or should I wait a week?


#16

Also I have clomid but can probably can get Nolvadex upon return to states. Should I use nolva over clomid or combo like some guys use?


#17

Do not pause between hCG and SERM.

Nolvadex and Clomid work the same except for the few who are affected. Nolvadex is a good choice that avoid surprises.


#18

So just got back to the states. Have been on just HCG for past 5 weeks. Going to take one more week and then test labs to see if I can try next phase of restart (Clomid or Nolva.)

Overall feeling pretty good. Biggest complaint has been libido issues. Have been taking 0.5mg arimidex weekly so will be interested to see where my Estradiol and T levels are sitting.

Will update when labs come back.


#19

So latest labs. 5.5 weeks from last testosterone shot. Have been taking 0.5mg arimidex weekly and hcg 250units eod.

Still waiting on total and free test results but here is what I have back so far.

LH 0.4 (1.8-10) to be expected though right? At least until i start clomid/nolva

FSH 1.4 (1.5-12.4)

Estradiol 17-B <25 (10-65) even on hcg and only 0.5 mg weekly AI. I still seem low. Should I stop the AI? Will I rebound too high during SERM phase or post?

HCT 48.8 (38-51) giving another round of blood donation today but this has come down nicely from 53%

What do you think KSman?


#20

Welp got testosterone results back:

Total Test 288 (193-824)
Free Test 2.8% (1.4-3.2)
Free test 79.4 (41.7-180.2)

These are 5.5 weeks post testosterone injection. Drawn 8am. 1 day post hcg injection of 250units

Given these borderline levels should i consider the restart a bust or finish up my last week of hcg then start clomid for pituitary restart?