T Nation

New Guy - Lab Work

Starting in Mar 2009 I got interested in feeling better and lost from 270 down to 220 in Aug doing nothing but cardio and eating next to nothing. Started lifting weights then and continued to lose down to 191 lbs in Dec. Started looking “skinny fat” so I raised calories in effort to gain muscle.

Nothing much was working - it came back on more fat than muscle. Talked to a bodybuilder friend and realized I had many of the symptoms of low T (and/or overtraining) without realizing it - fatigue, remaining abdominal fat, borderline high sugar, high cholesterol (when not taking meds), depression, anxiety, hot flashes, night sweats, irritability and apathy. Had T checked in Mar 2010 and found it to be 175. LH was low (but in scale), so had MRI - negative for pituitary problem.

Been on Androgel ever since. Back and forth with injuries, so not entirely sure how capable I am of gaining muscle / losing fat. However, finally fairly healthy again and back lifting weights - hard - but not feeling all that great again. Went and got bloodwork done to make sure nothing was going to sabotage my training results.

Test Results:
Total T - 476 ng/dL (range 250-1100)
Free - 8.45 ng/dL (range 4.6-22.4)
Estradiol - 28 pg/mL (range <39)
LH - <0.2 (range 1.5-9.3)
T4, lipids, platelets, etc all in middle of ranges.

Primary and Endocrine Doc agree that everything is in range but LH and they won’t do anything different given the negative MRI. Are these numbers moderately OK or should I be concerned of T to E ratio?

If of concern, I’m obviously not going to get any more natural T from the LH <0.2. Should I seek a third (out of network) doc? Or has anybody had success with Life Extension Foundation’s Super MiraForte as an aromitization suppressant?

Thanks for any advice!

Whoops shoulda said - 45 yo, 225lb, ~24%BF. Best ever was 191 lbs ~18%BF but everyone said I looked sick.

You may need to increase your androgel dosage or move to shots (some people don’t absorb gels well). Your T is low for someone who is on TRT. IF you’re going to do it, might as well get it higher. Your E2 is fine.

Of course LH is 0 since you are on exogenous test…your doctors should realize this (and has nothing to do with your prior pituitary MRI).

[quote]VTBalla34 wrote:
You may need to increase your androgel dosage or move to shots (some people don’t absorb gels well). Your T is low for someone who is on TRT. IF you’re going to do it, might as well get it higher. Your E2 is fine.

Of course LH is 0 since you are on exogenous test…your doctors should realize this (and has nothing to do with your prior pituitary MRI).[/quote]

Well, I’d like to increase the androgel dosage, but both Docs say it’s in range so won’t prescribe. Doc said the LH was lower than he normally saw even for exogenous, but I figured same as you.

Thanks for advice. Maybe I’ll just try going to greater lengths to make sure it does absorb (wait longer to get dressed, etc.)

[quote]BillLee3 wrote:

Well, I’d like to increase the androgel dosage, but both Docs say it’s in range so won’t prescribe. [/quote]

You need to chase symptom improvement and not “lab ranges”. Clearly if you’re still having symptoms, you need to be more “in range”.

[quote]
Doc said the LH was lower than he normally saw even for exogenous [/quote]

I suspect he doesn’t look too closely, since it happens in 100% of cases where a pituitary andenoma isn’t present.

I suggest finding a new doc.

[quote]VTBalla34 wrote:

You need to chase symptom improvement and not “lab ranges”. Clearly if you’re still having symptoms, you need to be more “in range”.
[/quote]

Appreciate advice. Sugar is down from 99 to 84, HDL is at 42 (from 36) and total is 125 (from 220, but am still taking Simcor). I have occasional morning “yearnings” and I’m at least no longer having hot flashes or night sweats.

Still having fatigue, but maybe that’s just 1900 calorie / low carb diet as I try to go back down to <20%BF to reduce the mentioned abdominal fat. Still have depression, anxiety, irritability and apathy, but maybe that’s just my personality.

Guess I’ll try maximizing absorption while continuing to address the 20 lbs or so of fat I need to lose before targeting muscle growth through increased calories is reasonable. If I don’t start feeling better at that time I’ll look for a new Doc that’ll follow a more aggressive approach.

It’s all a process, right?