T Nation

Labs Interpretation

Hey guys, I posted my initial labs from about a year ago in another thread but didn’t want to bump it. I had to put everything on hold due to work commitments. I am NOT on a TRT regimen. Would appreciate any opinions. Stats and Labs below.

Sounds like Post-Finasteride Syndrome. Your numbers look decent. Is your doc concerned with your high liver enzymes?

Your Free T is decent, but if I were at the same level I would be experiencing low testosterone. I’ve seen other men coming in here with the same Free T levels complaining of low testosterone, once they get Free T at the top of the ranges or high, symptoms vanish.

Ranges exists because there are those naturally high normal and 2% are higher, if you are one of those men who had a naturally high Free T, you would be symptomatic where you are now.

Midrange for you would be higher than everyone else.

I typically have high liver enzymes. In this past, this has been attributed to athletic endeavors.

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@systemlord - very interesting, thanks.

SHBG is your issue. Your free test calculated to 109pg/mL, not too bad thanks to your higher total test. However, double the free T and you’ll be a lot happier. You might be better off with higher E2 as well, SHBG impacting free E2 as well.

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Bumping this.

Spoke with Defy today.

Recommended dosages are:
80mg Test Cyp every 3 days
500 IU HCG every 3 days
AI prescribed if needed (.125mg biweekly)

Anyone with high SHBG experience have opinions on this protocol?

Thanks.

Are you taking any supplements ! Another guy here was on a supplement and could very well be the cause of high shbg. Everything else is perfect. I would of worked on the high shbg and figured out what was causing it. If nothing helped then I’d start trt. Sounds like that hair growth med might of caused it to permanently high?

That’s awesome. If you have sides in the coming weeks and days remove the hcg before taking an ai. Or lower it. You might not need ai if you just take the T. Some guys love hcg and have no issues. It seems the chemical of hcg causes the sides not necessarily high e2. Hope that helps.

Hcg causes me to be fatigued, depressed and angry. I removed it and felt much better 5-7 days later. I treid 100mg and 200mg didn’t notice much.

I’ve been off hcg for a month or so and my boys haven’t even shrunk.

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High SHBG guys generally have no business with an AI. I would hold off on it if I were you.

I think because so little of your estrogen is free, its easier to crash it. At least, it was for me.

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@highpull
I was browsing here early this morning and saw you had some choice words regarding Defy. This definitely gave me some hesitation regarding my prescribed treatment (which I have not yet begun).

I believe that there is some legitimacy to how you are interpreting the telemedicine industry. I began to wonder something that has bothered me since: at what rate do clinics like this write prescriptions? How often does someone walk away with no prescriptions at all? This isn’t an attack on Defy - they have been nothing but professional.

I made it clear that I was personally content with walking away with no treatment whatsoever if the doctor deemed that necessary. But obviously, there is an incentive on their end to provide treatment. I contacted them for a reason and they are providing the service which I contacted them for, but how often does a telemedicine company say “no”?

@zedsdead

I have no issues with Defy specifically, it’s telemedicine in general. Many of these businesses are operating illegally. Most states (almost all) require licensure in the state in which the patient lives for telemedicine practice. Also, many require an initial face to face with the patient prior to going with the telemedicine route and that is even if the doctor and patient are in the same state. This is why most have the patient travel to the doctors office for the first visit. Thereafter, you can use telemedicine even if not licensed in the patient’s state as the initial engagement was in the doctor’s state and follow-ups are an extension of that.

As for prescribing practices, I do not know. I suppose most patients know something is not right with them prior to engaging the practice and with the focus on symptoms, there is a more subjective element to the TRT practice. I do not think there is anything wrong with, as long as it applies, telling the patient you cannot guarantee a positive result, but are willing to try barring any reasons not to.

My bias is that for me, I would not feel comfortable dealing with a stranger, and someone that I have never met face to face is a stranger to me. If I am the doctor, same thing would apply. I’d want the exam provided within the practice in person and I would have to meet with the patient personally.

I recognize that some have no choice but to go the telemedicine route. If I wanted to go with, for example, the guys at Defy, I would fly there and see them personally.

They will not prescribe t to a man who has lab ranges in the upper end. Someone who is on the low end and with symptoms sure. But how can the doc say otherwise. One guy can walk in with 500/14 and feel horrible. The next guy at 500/14 is not feeling bad but wants t.

In the end who cares. You can tell which clinics care and which are really trying to help. Eventually that clinic might be shut down for running a bad practice. The government or state isn’t going to shut down all clinics because of one bad apple. It just won’t happen. There’s too much good happening. This is totally different than a pain clinic where they are getting folks addicted and ruining lives. High rate of death and ruined lives.

Most folks can not afford or are to cheap to pay an actual trt doc out of pocket.

What about FaceTime or video conferencing? What’s the difference meeting a doc in person or via video.

You go to a pcp get a physical and send that to the doc. Get blood work. Do a consultation. The doc has covered all basics and probably asked the right questions.

This is where the industry is headed. It will lower costs and allow docs to make more revenue. I’m all for it.

@enackers

What about it? Obviously, there is a market for it or they would not exist. Just saying I prefer a different relationship with any doctors I see. I’m admitting to a personal bias.

Regarding costs and all that goes along with the business side of health care, we’ll see. Doctors working within the insurance networks are making less than ever.

Yup I agree with you. I was responding to the other gentlemen.

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Sorry, I saw my name on the post.

My bad. I just hit reply haha.