T Nation

My Lab Values


#1

On TRT (Androgel 1%)for almost five months now. Feeling more motivated and energetic, but still feeling a bit uninterested in life generally, though. Libido still not great (only slightly better), can get half-decent erection while sitting, but can't keep it long. Erection very weak if lying flat on my back, and this does not improve if I change to standing position. In short, can't get hard enough to do anything, and often feel like I can't get excited enough to get it up. Watching porn seems to get me going a bit but I don't watch much of it.

Doctors have been of little help, and one I've seen is a GP who specializes in treating ED. Their standard answers are Cialis and Androgel, and maybe intercavernosal injections if the ED pills don't work.

The ED doc I saw seemed to have heard of the role that estrogen plays, but says aromatase inhibitors are not legal to prescribe in Canada for men experiencing andropause. His argument re being on TRT and having poor libido: "If the testosterone receptors are burnt out or damaged, TRT won't be as effective." Bottom line, sorry about your luck pal, here's a scrip for Androgel and Cialis.

Here are two sets of lab values. In neither case was LH, FSH or E2 tested.

Here are lab values and general stats about me:

Age: 50
Height: 5'7" (170cm)
Weight: 230lbs. (104kg)

Current Health Issues:

Type 2 Diabetes (being treated with diet and exercise)
Obstructive Sleep Apnea (being treated with CPAP)
ED, poor libido

Lab Values (as of August 2012) - all values posted in SI (metric) units:

Hemoglobin: 140 g/L
Hematocrit: 0.43 (flag range is 0.40 ~ 0.50)
White Blood Cell Count: 9.1 (flag range: 4.0 ~ 11.0)
Red Blood Cell Count: 4.80 (flag range: 4.50 ~ 6.00)
MCV: 90.4
MCH: 29.2
MCHC: 323
RDW: 14.2
Platelets: 253 (flag range 150 ~ 400)

Fasting Glucose: 6.7 mmol/l
A1c: 0.063
Creatinine: 97 (range is 67 ~ 115 µmol/l)
eGFR: 71
Sodium: 141 mmol/l (range is 135 ~ 147)
Potassium: 4.1 mmol/l (range is 3.5 ~ 5.5)
Urate: 321 (range is 12 ~ 49)
Alanine Transaminase (ALT): 25 U/L (range is 12 ~ 49)

Cholesterol: 3.94 mmol/l
LDL Cholesterol: 2.39 mmol/l
HDL Cholesterol: 2.39 mmol/l
Cholesterol/HDL Ratio: 4.5
Triglycerides: 1.50

Thyrotropin (Sensitive TSH): 2.09 (flag range is 0.35 ~ 5.00) mIU/L

Testosterone: 5.4 nmol/l (normal range is 8.4 ~ 28.7)
SHBG: 12.5 (normal is 10.0 ~ 70.0)
Bioavailable Testosterone: 3.7 nmol/l (flag range 2.0 ~ 14.0)


TEST RESULTS MAY 2013 (done after being on Androgel 1% for three months):

Hemoglobin: 152 g/L
Hematocrit: 0.48 (flag range is 0.40 ~ 0.50)
White Blood Cell Count: 10.1 (flag range: 4.0 ~ 11.0)
Red Blood Cell Count: 5.18 (flag range: 4.50 ~ 6.00)
MCV: 91.7
MCH: 29.3
MCHC: 320
RDW: 13.8
Platelets: 281 (flag range 150 ~ 400)

Fasting glucose: 7.7
A1c: 0.065 (6.5%)

Creatinine: 103 (range is 67 ~ 115 µmol/l)
eGFR: 66
Sodium: 140 mmol/l (range is 135 ~ 147)
Potassium: 4.3 mmol/l (range is 3.5 ~ 5.5)
Urate: NOT TESTED
Alanine Transaminase (ALT): NOT TESTED

Cholesterol: 3.78 mmol/l
LDL Cholesterol: 2.32 mmol/l
HDL Cholesterol: 0.91 mmol/l
Cholesterol/HDL Ratio: 4.2
Triglycerides: 1.20

Testosterone (total): 16.1 (normal range is 8.4 ~ 28.8 nmol/l)

Thyrotropin (Sensitive TSH): NOT TESTED

SHBG: NOT TESTED
Bioavailable Testosterone: NOT TESTED


#2

This is bad… So many things left untested… Your doctor is really bad … Tsh over. 2 is a problem I would retests this and all thyroid labs plus get a full set of basic bloodwork. Your doc hasn’t even done that or you haven’t listed everything

Lh and fsh Should have been tested… Fail by your doctor

Where in canada maybe I can help


#3

[quote]iw84aces wrote:
This is bad… So many things left untested… Your doctor is really bad … Tsh over. 2 is a problem I would retests this and all thyroid labs plus get a full set of basic bloodwork. Your doc hasn’t even done that or you haven’t listed everything

Lh and fsh Should have been tested… Fail by your doctor

Where in canada maybe I can help[/quote]

I live in London, Ontario. Where are you? I agree, the bloodwork is shitty. Lazy friggin’ docs, I tell ya. What I’ve listed is in fact everything that has been tested. I suspect the doc thinks my TSH is normal because it’s well below the upper limit of 5, but I’ve seen a lot of stuff on the web indicating that US endocrinologists now think that 3.0 is the upper limit, suggesting that anyone over 1.5 or so is probably hypothyroid.


#4

http://www.ratemds.com/doctor-ratings/91794/Dr-Marc+Anthony-Fischer-Hamilton-ON.html.

This is the only doctor around who has a good view on trt besides masters men’s clinic in Hamilton who I have heard mixed things about and places where u pay 1000 up front and 300 every 3 months plus plus.

somehow you should get off everything and start over.

You need more labs. trt is not always the answer.

The link I sent you is for dr.marc Anthony Fischer. He does like deca though and my advice to you is to stay away from it. If you want an Ai plus hcg talk about your concerns for fertility. He is a urologist who majored in andrology and does know about current trt protocols and sub q injections.

My advice is to get off the gel and see if you can get the Hpta back in action and find out if you are primary or secondary or what is causing your problems.