T Nation

Lab Test Results Looking for Feedback


#1

Hello,

I'm new to the forum and just began T-replacement therapy about 60 days ago. I am looking for feedback on my labs. My LH has dropped in a big way since beginning the therapy, but I was told that the HCG and clomiphene I am taking as part of my therapy would minimize this. Is this drop normal or is something off about my treatment? Just want to make sure i'm not making my situation worse with this course of treatment. I am interested in having children within the next 12 months and I'm trying to make sure I don't completely eliminate that possibility. I'm aware there are many factors that can impact fertility, I'm mostly concerned about the obvious risk of shutting down my testicles completely. Here are the specifics of my regimen:

Testosterone Enanthate 75mg injected 2x weekly
Clomiphene 25mg 7x week
Anastrozole .25 mg 5x week
HCG 600iu injected sub cu 2x per week

Initial Lab Values:

LH 2.2
T3 3.2
Estradiol 35
Total T 316
Testosterone Free 60.4

Lab Values 45 Days:

LH .9
T3 3.3
Estradiol 10
Total T 861
Testosterone Free 198.4


#2

Read the protocol for injections sticky!!!!!

FT means nothing if you do not supply the lab range.

LH should go to zero with injected T. However, clomid is keeping LH [and FSH] level up. You would be better off with FSH labs from a fertility perspective, as hCG is taking care of the LH receptors. hCG may confound LH labs too. From a fertility point of view, hCG alone is often adequate. Clomid alone would be better than hCG alone, but can have side effects: Are you overly emotional? Nolvadex works well and does not have those estrogen effects. SERMs should not be used long term.

150mg T eth is typically too high for a starting dose.

How long after T injection was the lab work done?

E2 is too low. Does is say "10" or "<10"? If it really is 10, you might have low libido, mental problems and maybe aching joints. If 10, cut your anastrozole dose in half.

If E2<10, you either feel like crap or have a lab error. In any case, your target is E2=22pg/ml. You may be an anastrozole over-responder:
http://www.google.com/search?q=site:tnation.T-Nation.com+anastrozole+over-responder

hCG is better EOD because of half life considerations. 250iu SC EOD is a LH replacement dose, 1200/wk could be a problem. Combined LH+hCG might down regulate LH receptors - a step in the wrong direction.

A SERM plus hCG is sort of nuts. If you reduce this combo, your anastrozole dose will need to be changed again.

Is this from a local doc or an on-line clinic?
You get paper scripts or meds in the mail?
How do you feel?
How is libido? Peaked then dropped?


#3

Ksman,

I appreciate the feedback. Hopefully I can answer all of your questions.

With regard to the way I feel at my current levels. I generally feel good, actually my joints don't ache any more(they did before I started), libido has generally been much better(it was non existent when I began), no emotional issues(if anything i'm less emotional than before I started). I feel better than before I started, but I had hoped to feel MUCH better if that makes sense.

With regard to the labs, here are the ranges(both sets of labs from quest diagnostics):

t3, free 3.3 ..... test range - 2.2-4.2 pg/ml
total, 861 ..... test range - 250/1100 ng/dl
testosterone, free 198.4 ..... test range - 46-224 pg/ml
testosterone, bioavailable 390.8 ..... test range - 110-575 ng/dl
SHBG 20 ..... test range - 9-45 nmol/L
estriadol 10 ..... test range 13-54 pg/ml (the test results indicate this is out of range)
LH 0.9 ..... test range 1.5-9.3 mIU/ml

I was referred to a doctor through and online service. My doctor did not want to address my issues because my initial 316 was within range. I do not receive the prescriptions personally, they go to the "middle man" then i receive the filled orders from a pharmacy in south florida.

Even though the doctor did not recommend lowering the anastrozole dose when he reviewed these labs I was going to lower the amount I am taking. Would you think 3 doses per week rather than the 5 he has me on would help get that estradiol number up? Also I had read the injection protocol, but I don't set my dosages, the doctor did. I made mention of it when I went in, but that obviously didn't affect the dosages he put me on... I can also modify the amount of HCG that I am taking, but that would require another round of blood tests which I pay for out of pocket because I don't have insurance...

I appreciate any further feedback you can give. Thanks again.

As a side note, I know I am paying way more for these drugs than I need to because of the online middle man. If anyone knows of a good doctor in Michigan that I can approach about my situation please feel free to PM me. As it is I had to drive 2 hrs each way to visit the doctor I used.


#4

http://www.allthingsmale.com/index.htm

To get near 22pg/ml, multiply current dose by 10/22. Yes it is that simple. Might need to do that once again when you are not so extreme.

Your E2=10 can be expected to make you have problems.

You can find doses that work for you without asking a doc for permission. At some point you may need to change things if the is too much product in the mail.

If you reduce hCG or SERM, your E2 production may go down, leading to a AI reduction.

There is a possibility that you are an anastrozole over-responder and high E2 production in the testes from too much LH receptor stimulation from hCG+SERM could be masking that problem to some extent. In such a situation, there is the possibility of even lower E2 levels in the brain from too much peripheral T-->E2 reduction. That might show up as some indistinct metal/mood/energy/libido issues.

T levels are great, T dose is fine.

fT3 looks good. If your waking body temps are near 97.8, you are good to go. If near 97F, you would want to test rT3. Review iodine intake from salt and vitamins.

Do you have any muscle aches or joint aches?


#5

No, no muscle or joint aches or pain. I'm going to try and find another doctor that will just give me the prescriptions directly, but it is a real hassle. I wondered about taking the clomiphene long term in addition to some of the other potential issues that might be caused by taking HCG as well.

In the interim, I think i'll keep my t dosage as is, move to 3x weekly on Anastrozole and move to 250iu EOD for the HCG. Beyond that, i'm not sure whether i should or should not stop taking the clomiphene or keep on it then retest and see where things are at...Does that sound like a reasonable approach?

Of course I'd also like to find a local doctor that will provide the prescriptions directly to me, or at least a doctor within 2 hours...haha


#6

I also forgot to mention that those results were roughly 4 days post T injection. I tested on a Monday a.m. before my dose. I dose Monday and Thursdays.

Another question re: HCG injections, should i take those on the days I am not injecting my T doses? Or doesn't it matter?

Thanks again for all your feedback.


#7

hCG keeps your testes working. When you dose does not matter much. You can do all injections at the same time and many find that more convenient. hCG EOD and anastrozole EOD start dictating a need for T EOD for conveniences and simplicity.