T Nation

Lab Results and ED

Hello Everyone! First post but long time lurker. I am 41. Ive been doing cycles…badly for about 6 years now. I went off cycles and went to TRT about 3 years ago. I did it on my own with blood work at first but basically got sloopy and it was going so well forgot about the blood work. I also got out of shape along the way, drank like a fish then started elevating my estrogen. You could tell just by looking at me. Also developed some ed issues about 5-6 months ago. I got on anastrozole and cleared up my estrogen but my ed issues have improved but are still there.
So I got on board and did some blood work. I am working out now, I am not drinking. I am taking test e 250mg once a week (I know I should break this up twice a week) and Im taking .5mg eod of anastrozole.
Below are my blood results. As you can see, I am thinking I need to up the anstrozole right>? It is not in the high range but still should be lower?
Do you guys see anything that could be causing my issues or do I just need to give the workout and abcense of drinking time to set in?
Maybe there was another panel I should have added to my test?

Really, given the results I see here I have been contemplating dropping trt all together for 6-8 months to let my body recover while I continue to work out and eat/stay healthy

Tests Result Flag Units Reference Interval Lab
CBC With Differential/Platelet
WBC 9.9 x10E3/uL 3.4 - 10.8 01
RBC 5.60 x10E6/uL 4.14 - 5.80 01
Hemoglobin 18.2 High g/dL 13.0 - 17.7 01
Hematocrit 53.4 High % 37.5 - 51.0 01
MCV 95 fL 79 - 97 01
MCH 32.5 pg 26.6 - 33.0 01
MCHC 34.1 g/dL 31.5 - 35.7 01
RDW 13.9 % 12.3 - 15.4 01
Platelets 218 x10E3/uL 150 - 379 01
Neutrophils 63 % Not Estab. 01
Lymphs 22 % Not Estab. 01
Monocytes 12 % Not Estab. 01
Eos 2 % Not Estab. 01
Basos 0 % Not Estab. 01
Neutrophils (Absolute) 6.3 x10E3/uL 1.4 - 7.0 01
Lymphs (Absolute) 2.2 x10E3/uL 0.7 - 3.1 01
Monocytes(Absolute) 1.1 High x10E3/uL 0.1 - 0.9 01
Eos (Absolute) 0.2 x10E3/uL 0.0 - 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01
Immature Granulocytes 1 % Not Estab. 01
Immature Grans (Abs) 0.1 x10E3/uL 0.0 - 0.1 01
Comp. Metabolic Panel (14)
Glucose 84 mg/dL 65 - 99 01
BUN 20 mg/dL 6 - 24 01
Creatinine 1.09 mg/dL 0.76 - 1.27 01
eGFR If NonAfricn Am 84 mL/min/1.73 >59
eGFR If Africn Am 97 mL/min/1.73 >59

BUN/Creatinine Ratio 18 9 - 20
Sodium 139 mmol/L 134 - 144 01
Potassium 4.4 mmol/L 3.5 - 5.2 01
Chloride 98 mmol/L 96 - 106 01
Carbon Dioxide, Total 26 mmol/L 18 - 29 01
Calcium 9.4 mg/dL 8.7 - 10.2 01
Protein, Total 7.0 g/dL 6.0 - 8.5 01
Albumin 4.8 g/dL 3.5 - 5.5 01
Globulin, Total 2.2 g/dL 1.5 - 4.5
A/G Ratio 2.2 1.2 - 2.2
Bilirubin, Total 0.3 mg/dL 0.0 - 1.2 01
Alkaline Phosphatase 39 IU/L 39 - 117 01
AST (SGOT) 31 IU/L 0 - 40 01
ALT (SGPT) 70 High IU/L 0 - 44 01
Lipid Panel w/ Chol/HDL Ratio
Cholesterol, Total 186 mg/dL 100 - 199 01
Triglycerides 177 High mg/dL 0 - 149 01
HDL Cholesterol 40 mg/dL >39 01
VLDL Cholesterol Cal 35 mg/dL 5 - 40
LDL Cholesterol Calc 111 High mg/dL 0 - 99
T. Chol/HDL Ratio 4.7 ratio units 0.0 - 5.0
Please Note: 01
T. Chol/HDL Ratio
Men Women
1/2 Avg.Risk 3.4 3.3
Avg.Risk 5.0 4.4
2X Avg.Risk 9.6 7.1
3X Avg.Risk 23.4 11.0
Testosterone , Free+Total LC/MS
Testosterone, Total, LC/MS 1391.7 High ng/dL 264.0 - 916.0 02
This LabCorp LC/MS-MS method is currently certified by the CDC
Hormone Standardization Program (HoSt). Adult male reference
interval is based on a population of healthy nonobese males
(BMI <30) between 19 and 39 years old. Travison, et.al. JCEM
2017,102;1161-1173. PMID: 28324103.
Disclaimer: 02
This test was developed and its performance characteristics
determined by LabCorp. It has not been cleared or approved
by the Food and Drug Administration.
Free Testosterone(Direct) 39.7 High pg/mL 6.8 - 21.5 02
Prolactin 10.3 ng/mL 4.0 - 15.2 01
Estradiol, Sensitive 25.1 pg/mL 8.0 - 35.0 02
Sex Horm Binding Glob, Serum 11.0 Low nmol/L 16.5 - 55.9 01

Summary:

  • Some of your labs are not very useful because of injecting once a week.
  • SHBG is very low which means that T dose should be reduced.
  • Blood too thick, reduce dose and inject twice a week.
  • Retested hormones after changes.

Your T is making your blood too thick.

  • Donate blood if you can.
  • Do not get dehydrated.
  • Avoid iron fortified:
  • flour and mixes
  • rice
  • pasta
  • vitamins listing iron

SHBG is very low.

Glucose was very good. So we will not associate your low SHBG with insulin resistance or diabetes. Some guys simply have low SHBG. With low SHBG there is less T tied up in SHBG+T and there is then more FT and Bio-T. Your T status is much higher than your TT implies and again you should reduce T dose and low SHBG and these factors can be part of why your blood is getting too thick.

Avoid dehydration. Be aware of pulse and resting BP.

You should reduce T dose.

ALT may be high from lifting and sore DOMs muscles.

HDL needs improvement
Injecting twice per week reducing peaks will help.

With injections once a week your hormone levels change a lot and then lab results are strongly determined by lab timing. Inject twice a week and always do labs halfway between injections.

E2 looks good. But unknown because of above.

Reduce T to 100mg twice a week.
Take 1mg anastrozole at time of injections or calculate to 2mg/week divided EOD
Stay on this for two weeks and test:

  • TT
  • FT
  • E2

You did E2 with a 8.0-35 range. The upper bound it a bit lower than we see for Labcorp. Do not know if that has any significance.

Then we can refine E2 further based on labs.
Example: If you get E2=28 and target is E2=22, new dose = old dose X 28/22. Same method will down calculate dose as well.

With TRT guys we often see that when SHBG is very low they simply do not find a balance very easily. Perhaps others have suggestions from there experiences.

if you stop TRT you will be miserable and then have to do all of this later again.

Thyroid: Most guys who come here have some issues. Please evaluate via oral body temperatures - see below. This is important and not a side issue.

  • Age=41
  • height
  • weight
  • waist size
  • fat
  • fat patterns
  • diet
  • supplements
  • health problems
  • medications Rx and OTC

Do not test prolactin again.

You are not using hCG. At your age fertility probably not a concern.

HDL:

  • fish oil, flax seed oil, nuts - for EFA’s [Biotest Flameout]
  • high potency B-complex multi-vit with 150-170mcg iodine, 150-200mcg selenium with other trace elements and without listed iron - aka men’s formula.
  • DHEA 25mg EOD, test DHEA-S later on
  • Any leg or foot cramps - magnesium deficiency [Biotest ZMA]

Now the fun part: 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.

No wonder you want to quit, your protocols all wrong! Low SHBG guys should be injecting smaller micro doses at least EOD or ED, it’s a simple as that. Who put you on this ridiculous protocol?

Inject 20-25mg EOD and do labs 6 weeks later, but that whopper of a dose is likely lowering your already low SHBG. You might feel even better injecting 10-15mg every day.

High SHBG guys purposely inject very large doses in order to drive down their overly high SHBG, this is what your doing and your SHBG is already low.

This is why you don’t feel well. You’re free hormones must be insanely high, typical of low SHBG men.

Thanks for pointing that out. But not sure if we are in a shortened half-life situation as with hyper metabolizers. But your suggestion will avoid some peaks when SHBG is not soaking up T.

I think that if you read between the lines he is self-medicating.

Thank you guys for these useful replies. Basically, lowering dose significantly and more frequently is the start. I also just started a hell of a diet and lifestyle change as well. Its not secret when Ive been as lazy as Ive been the past two years coupled with excessive alcohol use on the weekends that Ive gotten to where I am at, of course, with this blood work also shows you I haven’t been doing a good job at all with my injections or blood work. time to take advice and turn over a new leaf.

I am continuing a protocol I was under when I was actually under physician administered TRT. Yes, they didn’t know what they were doing and its obvious to be honest I don’t either but yes, I am self medicating. Been doing this for many many years but now it’s caught up with me, thus the post…kinda looking in the mirror, admitting my ignorance and being honest about it for health’s sake.

We make a best effort to have guys survive the bogus things that doctors do and the same advice will work in the context of your case. “You” need to the requested labs and should also be looking at blood pressure and resting pulse rate.

In a case like yours we are trying to keep you from harm via education and you should be able to have a better understanding than most doctors. In these cases, there is a concern about self discipline and avoiding ones hands in the cookie jar - taking large doses of T.

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