Lots of Bloodwork & Curious on Opinions

So i had a ton of bloodwork done and just looking to get opinions… I also had an MRi of my pituitary and it shows normal.

Creatinine eGFR - 1.0

HGB - 17.3

HCT - 50.1

MCHC - 34.5

TIBC - 425.00

IRON - 128

TRANSFERRIN - 340

PROSTATIC SPECIFIC ANTIGEN - TOTAL - 0.52

LUTEINIZING HORMONE - 3.05

FOLLICLE STIMULATING HORMONE - 4.26

PROLACTIN - 9.12

ESTRADIOL - 19

SEX HORMONE BINDING GLOBULIN - 10

TESTOSTERONE, TOTAL - 152

TESTOSTERONE,FREE (Q) - 44.7 (Reference Range: 46.0-224.0)

TSH 3RD GENERATION - 3.88

I know its a lot but figured better to post more data than less.

Your numbers look a lot like mine did, there is only one type of TRT protocol that has any chance of working and it’s a daily injection protocol because of really low SHBG. T-cream applied to the scrotum 1-2x daily which may also work well, these are offered by compounding pharmacies and have many time better absorption than T-gels.

Low SHBG men really struggle to control excess T and E2 on TRT injecting large infrequent doses once or twice weekly. SHBG hands out all the cards, low values mean lower Total T in relation to Free T, so targeting high normal levels will only cause more symptoms, you need mid-range levels or lower, you will not need much.

You need to use 27-29 gauge insulin syringes which are painless. Your hematocrit and hemoglobin are towards the higher end, this may be a problem on TRT forcing frequent blood donation. If this turns out to be the case you will need to watch your ferritin levels.

Anything other than daily injections will fail, if daily injections or T-cream doesn’t work, nothing will.

TSH is not good and is too high, you more than likely have hypothyroidism, free thyroid hormone need to be checked, Free T3 and Reverse T3, T4 would hurt either. The TSH reference ranges currently in use are not normal, many included were later found to have thyroid problems, 95% of healthy individuals have a TSH <1.5 and those 2.5> are on their way to hypothyroidism.

Those with hypothyroidism will often see SHBG suppressed, thyroid medicine will increase SHBG which is exactly what you need because low SHBG is associated with metabolic syndrome and diabetes.

Reference ranges for TSH and thyroid hormones

Though TSH remains the most commonly used endocrine test in clinical practice, the issue of an appropriate TSH, and to a lesser extent, free T4 and free T3 reference ranges is still under debate. First of all the distribution of TSH reference range is not normal, with median values (also depending on population iodine intake) usually between 1-1.5 mU/L.

On the other hand, upper TSH reference limit is (assay-dependent) usually around 4.2-4.5 mU/L. There is also an argument that significant number of patients (up to 30%) with TSH above 3.0 mU/L have an occult autoimmune thyroid disease.

jepper, those are pretty standard. You should find plenty of help here.

Could you provide the lab ranges? Different labs use varying methods, and report in different units, and have different ranges for what they consider normal.

Do you have any of the following:

Lipids
CMP
IGF-1
DHEA-S
VitD
free T3
free T4

A little medical/health background would also help. Age, etc.

1 Like

35 yr old male, white, no history of diabetes or anything. What else would you like to know?

7-26-2019 Blood results

Creatinine eGFR

Result: 85

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Result: 1.0
Units: mg/dL
Reference Range: 0.5-1.5
Lab Test: Creatinine eGFR

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Test Name: HGB
Result: 17.3
Units: g/dL
Reference Range: 13.7-17.5
Lab Test: Hemoglobin & Hematocrit

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Test Name: HCT
Result: 50.1
Units: %
Reference Range: 40.1-51
Lab Test: Hemoglobin & Hematocrit

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Test Name: MCHC
Result: 34.5
Units: g/dL
Reference Range: 32.3-36.5
Lab Test: Hemoglobin & Hematocrit

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Test Name: TIBC (POST 1/00)
Result: 425.00
Units: ug/dl
Reference Range: 204-475
Lab Test: Iron Total and Combining

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Test Name: IRON (POST 1/00)
Result: 128
Units: ug/dl
Reference Range: 40-160
Lab Test: Iron Total and Combining

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Test Name: TRANSFERRIN (POST 7/15/02)
Result: 340 High
Units: mg/dL
Reference Range: 191-330
Lab Test: Iron Total and Combining

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Test Name: PROSTATIC SPECIFIC ANTIGEN - TOTAL
Result: 0.52
Units: ng/mL
Reference Range: 0.00-4.00
Lab Test: Prostate Specific Ag

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Test Name: LUTEINIZING HORMONE
Result: 3.05
Units: mIUnits/mL
Reference Range: 1-9
Lab Test: Luteinizing Hormone~ARCHITECH C8000

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Test Name: FOLLICLE STIMULATING HORMONE
Result: 4.26
Units: mIUnits/mL
Reference Range: 1-19
Lab Test: Follicle Stimulating Hormone~ARCHITECH C8000

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Test Name: PROLACTIN (POST 4/18/00)
Result: 9.12
Units: ng/mL
Reference Range: 3-20
Lab Test: Prolactin

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Test Name: TESTOSTERONE, TOTAL (WH) (POST 8/11/14)
Result: 201.14 Low
Units: ng/dL
Reference Range: 220-892
Lab Test: Testosterone

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Test Name: ESTRADIOL, SERUM
Result: 19
Units: pg/mL
Reference Range: ><=39

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Test Name: SEX HORMONE BINDING GLOBULIN
Result: 10
Units: nmol/L
Reference Range: 10-50
Lab Test: Sex Hormone Binding Globulin

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Test Name: TSH 3RD GENERATION
Result: 3.88
Units: uIUnits/mL
Reference Range: 0.35-5.00
Lab Test: Thyroid Stimulating Hormone

On 7-9-2019 I had the Testosterone of 154 / free test of 44.7 as i listed above.

Do the ranges help?

Yes, you need TRT. You need more detailed thyroid tests.

You’ll likely get a lot of varying suggestions here. If I am you, I am starting with 150mg a week. I would also start with once a week dosing. I would see how I responded with that and go from there. You may need to go higher. You may find that you need more frequent dosing. I would hold off on an aromatase inhibitor until it is determined that you need one due to high E2 symptoms.

Ok Great, i’ll look at getting a full thyroid panel and posting those results when i get the test done.

Make sure you get Free T3, not T3 included in your thyroid panel.

@highpull

The OP does 150mg once weekly it will hammer his SHBG into oblivion and put his estrogen into the stratosphere. I’ve never seen a protocol like this work for a low SHBG guy except maybe once.

There’s is no escaping the fact that his ability to bind androgens is weak and that he will have to deal with excess Free T and the estrogen that comes along with it.

This protocol will give him a negative impression of TRT and will more than likely make him want to quit TRT altogether.

While I understand your position and your rationale behind it, I know plenty that do fine with what I suggested. Most men are not as sensitive to hormones and hormonal fluctuations as you seem to be. I do not know what level would be necessary for you to call it in β€œthe stratosphere”, but as I have mentioned previously, some guys do very well with E2 over 100.