T Nation

New Blood Test Results - Help

Trying to have a child with the wife and found out my test was low and I had a ZERO sperm count.

Doc put me on HCG to get the test up and Dostinex to get my prolactin down. Everything worked like it was supposed to except my estrogen shot up and he added Arimidex to the mix. Complaining of some gyno symptoms, he ran another blood test after being on the Arimidex for 30 days.

Here’s the numbers:

Prolactin 2.75
LH .2 (said this is normally low when on HCG)
FSH .59 (said this is normally low when on HCG)
Total T 5.74
Free T 1.47
Estradiol 39.03 (was 68 before starting Arimidex)

My doc is a Urologist, not an HRT / TRT doctor, so he probably isn’t as knowledgeable as I would like for him to be regarding my levels and what needs done. His main goal was to get my sperm going (which he has) and has now taken the role of “I fixed your sperm problem, so let’s not change anything”. But, I’ve shifted from the main goal of having a child (if it happens great, if not it’s ok) to wanting to get my hormones straightened out / build more muscle / lose fat / increase sex drive. He is always open to suggestions and listens to me when I tell him what I would like to do.

My question is…isn’t that Free T level of 1.47 extremely low? What can I do to change that and increase the Free levels? Also, my Estradiol has almost been cut in 1/2 after 1 month of Arimidex. If this keeps going lower will that help out my Free T level?

Thanks in advance for your help!

Can you post the ranges for the labs?

Yes less E2 will lead to more free T due to a decrease in SHBG. Beyond that the only drug I’m away of that will bind to aromatase and SHBG is Proviron.

If fat loss is your goal HCG at monotherapy levels will certainly help with that!

I’ve leaned by experimentation with HCG doses that I can adjust my body composition through changes in HCG dosing. I wondered what the craze was about the HCG diet and now I know from reading the package insert. It also acts as TSH… Duh…

Sex drive is a whole different story. Sex drive is driven by a mental state and the ability to be stimulated by T or E2 for that matter. This is an easy question to ask yourself to fix sex drive. Are you less interested in sex or are you less interested in everything in life?

If it’s the latter it’s depression which sometimes is helped with T. If you’re on HCG with decent T levels and reasonable E2 and you’re still having issues there is an underlying mental state that needs to be addressed.

Sorry for my lack of knowledge / ignorance…hope this is what you’re asking for:
First value is my new results…

…second value compares that to my last test
about a month ago…and after a month of being on 1mg Arimidex ED
LH .2 (same) RANGE = 1.5 to 9.3
Prolactin 2.77 (up from 1.95) RANGE = 2.64 to 13.13 ng/ml
Test total 5.74 (up from 4.54) RANGE = 1.75 to 7.81 ng/ml
Test Free 1.47 (no prior test reading) RANGE = don’t know?

FSH .59 (down from .64) RANGE = 1.27 to 19.26 mlU/mL (sound right? can’t read writing)
Estradiol 30.03 (down from 68.47) RANGE = 11.60 to 41.20 pg/ml

That being said…you thoughts?

Your labs look good except for your E2. It’s still a bit to high. How much Adex are you on? Also how much HCG are you on now?

Your free T may be a little on the low side but I’d need to see the ranges on that one since the other ranges don’t look familiar. The number you really need is “bioavailable T”.

How do you feel overall? Just low libido or low mood in it’s entirety? Address to E2 for 4 weeks and see how you feel then and go from there.

I was on 1mg per day of Adex, which I started because of an E2 reading of 68 (range of 11-41) and I complained to the doc about my sore & puffy nipples. After 6 weeks on Adex and my nipples getting worse, I had to take matters into my own hands and started Letrozole. 2.5mg per day of that stuff and WHAM, 11 days later the Gyno problems are 95% gone.

From what I understand Adex stops the T to E conversion…it does nothing for the excessive E that was already floating around in my body, thus, it did nothing for the Gyno / Nipple problem. The Letro did…and now I’m about to go back to the Adex only and see if the Gyno stays away this time.

The HCG dose is 1500 iu Every Other Day…yes, you read that right, 1.5 ML / CC’s every other day from a 10,000 unit vial (1000 units per ml / cc) I’ve asked the doc several times if this is too much and gave him all the stories I read about too much HCG and burning out your Leydig (sp?) cells. He assured me that is not the case and this is the normal dose.

Here’s my total T labs…bet you can guess when I started the HCG? (range = 1.75-7.81
3/08 1.62
4-08 0.83
5-08 1.65
7-08 7.61
12-08 4.54
2-09 5.74

Here’s my thoughts…and correct me if I’m wrong. I do think I’m taking too much HCG and it’s forcing my body to make as much T as it can possibly make. The extra that my body can’t use is being converted to E, excessive amounts of E and thus caused the GYNO.

So…the trick (I think?) is going to be finding the right HCG dose that maximizes my T production but doesn’t have too much spill-over to E.

Or…keep pumping almost 2-1/2 vials per month of HCG into my glutes and take massive amounts of Adex & Letro which is obviously not the proper course of action.

To answer your other questions, I thik the Free T number is a percentage of the total.
If total at last test was 5.74 (574) and my FREE was labeled as 1.47, I would assume that means 1.47% of 574. Thus, a bioavailable Testosterone rating of 8.44
Does that make sense, or am I way off base?

…and your final question. Actually, pretty good mood lately, plenty of energy, but the sex drive had taken a nose dive (even before the letro) It’s really odd because before when I had the low libido, (and low test) I was always tired along with not wanting to fool around with the wife…yes, she turns me on and is very attractive and we have an awesome relationship (so that’s not an issue at all) I just don’t feel like I did before my estrogen shot up sky-high. I guess I’ll give it some time as these things don’t happen over night. Now that my T is up and my E is dropping, time will tell if everything falls into place.

Thanks again for your help…thoughts comments given the above info?

First go here and read this. This will give you a start on learning about TRT.
www.allthingsmale.com/word_docs/TRT.doc

It’s difficult to tell you exactly what to do because everyone is different. I’ve found that I respond best to 600IU of HCG every three days and 50mg of T cream daily. That’s really a split between two protocols. It took me a year of tweaking to figure that out. A lot of guys like T cyp but I just don’t respond well to it. The constant high T levels make me feel bla and gives me unpleasant sides.

Also you aren’t shooting the HCG IM are you? If so you can stop that and buy some insulin syringes. HCG is fine to inject SC.

There are a lot of guys that use 1500IUs of HCG but only twice a week. Every other day is way to much and not needed because of the long half life of HCG.