New Guy. Test Results.

Pharma / TRT Testosterone Replacement
1

Hey guys. I’m new here. Looking for info and opinions. A little background info. I’ve got high blood pressure that I take amlodipine besylate 5 mg. In aug of 07 I had testicle cancer. They removed my right testicle and had I think 17 rounds of radiation. That is my basic background. My va doctor told me in the fall that my t was low. She info me to get another test done and see my regular doctor.

Fast forward to feb of this year. I finally get around to seeing my doctor. Explain to him the info and he orders a blood test. The t comes back at a 258. He sends me to see a endo. The endo goes over my background and comes up with the same conclusion. The endo orders another blood test. Same results with low t. Just lower t this time.

I’ve since talked to the doctor and he’s worried about starting trt because my wife and I are trying to get pregnant. He’s going to consult with a specailist before any meds are started. Oh yeah. My sperm count is normal for only on ball.

Test results from 2-26-13
LH 3.4, 1.7-8.6 NORMAL
FSH 5.5, 1.5-12.4 NORMAL
PROLACTIN 19.6, 4.0-15.2 NORMAL
TESTOSTERONE SERUM 258 348-1197 NORMAL

TEST FROM 3-15-13
LH 4.8
FSH 5.6
PROLACTIN 21.8
TESTOSTERONE 213
SEX HORM BINDING GLOB SERUM 14.8, 16.5-55.9 NORMAL
ESTROGENS TOTAL 128, 40-115 NORMAL

I’ve read up on some of the sticky. What else should I be looking for or asking my doctor? I’m hoping to hear back from him this week and find out more about trt. The specialist my endo is checking with is from washington I think. This specialist just deals with trt is my take on it.
Thanks
Daniel

2

Looking at some of the other threads I see I’ve left out some info. I’ve been having some chest pains for a while now. Its from my boobs. There not big but starting to grow. My right one is larger than my left and hurts more also. My almost 3 year old finds it often while playing. My endo say they should shrink in size one trt is started. I also seen a plastic surgen last week. She said its not bad yet. She also said trt should help out.

I’ve also had ankle ligument surgery along with wisdom teeth pulled. I’m not as active as I was before ankle surgery. My ankle has been messed up since 05. Before surgey I played basketball and hockey. Now I just play hockey once to twice a week and thats about it for exercise. My ankle wont take the jumping and flexing that basketball puts on it. My cardio has dropped and it seems harder to get back up after a lay off from playing hockey.

As for my size. I’m a little over weight but not much. In 2000 when I got out of the marines I weighed 178. I was thin at that point. I’ve since gone up to 215 with a 25% bmi. Its mostly in my belly. I’m 6-3. I have lost about 15 pounds in the last ten weeks. My endo ask me if I did physical work because my muscle mass was still good. My work has always been physical. For the last ten years I was a pipefitter and that was very physical. In aug on 2011 I took a new job which is alot easier on the body. I still weld alot but the rest of my work load got easier.

3

Why are out of range items marked ‘normal’?

E2 is high. Liver clears estrogens so we are interested in liver function: AST, ALT -got labs? Your high E2 is reducing your T levels. You could take anastrozole 0.5mg/week in divided doses, you need a liquid preparation so you can dispense by the drop.

E2 is causing gyno. Your prolactin is contributing to this; cabergoline 0.5mg/week will be beneficial.

Suggest anastrozole and cabergoline and see if your T levels improve.

You can do TRT with hCG to preserve your teste and can switch to nolvadex periodically and during times when you are seeking pregnancy.

Read these stickies:

  • advice for new guys
    – give us more info please
    – note concerns re iodine and body temperatures
  • protocol for injections
4

I’m sorry. I wasn’t marking my test as normal. Just the normal ranges. I’ll add my two test ordered by two different doctors. I will add everything thats on the test results. Both test where performed by labcorp and drawn by doctors at work. First test was orded by my family doctor after I brought up the t levels with him from a previous va lab test. Second test was ordered by endo after first office visit. I’ve only talked to him by phone since the test. He didn’t seem to worried about anything except the t levels. I’m waiting to hear back after he talks to a specialist.

TESTED ON 2-26@ 7:30 AM ORDERED BY FAMILY DR.
test results units reference
basic metabolic panel
glucose, serum 86 mg/dl 65-99
bun 18 mg/dl 6-20
bun/creatinimne ratio 1.34 HIGH mg/dl .76-1.27
egfr non african am 69 ml/min/1.73 >59
sodium serum 139 mmol/l 134-144
potassium serum 4.1 mmol/l 3.5-5.2
chloride serum 100 mmol/l 97-108
carbon dioxide total 24 mmol/l 20-32
calcium 9.5 mg/dl 8.7-10.2

microalb/creat ratio, random ur
creatinine, urine 23.8 LOW mg/dl 24.0-392.0
microalbuim urine 2.2 ug/ml 0.0-17.0
microalb/creat ratio 9.2 mg/g creat 0.0-30

fsh and lh
lh 3.05 miu/ml 1.7-8.6
fsh 5.5 miu/ml 1.5-12.4

estradiol 26.4 pg/ml 7.6-42.6
roche eclia methodology

hcv ab w/rflx to verification
hcv ab 0.1 s/co ratio 0.0-0.9

prolactin 19.6 HIGH ng/ml 4.0-15.2

testosterone, serum 258 HIGH ng/dl 348-1194

TESTED ON 3-15@ 7:30 ORDERED BY ENDO
cbc with differential platelet
wbc 4.9 x10e3/ul 4.0-10.5
rbc 4.82 x10e3/ul 4.14-5.80
hemoglobin 14.6 g/dl 12.6-17.7
hematocrit 43.4 % 37.5-51.0
mcv 90 fl 79-97
mch 30.3 pg 26.6-33.0
mchc 33.6 g/dl 31.5-35.7
rdw 13.9 % 12.3-15.4
platelets 190 x10e3/ul 140-415
neutrophils 68 % 40-74
lymphs 22 % 14-46
moncytes 7 % 4-13
eos 3 % 0-7
basos 0 % 0-3
neutrophils (absolute) 3.4 x10e3/ul 1.8-7.8
lymphs (absolute) 1.1 x10e3/ul 0.7-4.5
monocytes (absolute) 0.3 x10e3/ul 0.1-1.0
eos (absolute) 0.1 x10e3/ul 0.0-0.4
baso (absolute) 0.0 x10e3/ul 0.0-0.2
immature granulocytes 0 % 0-2
immature grans (abs) 0.0 x10e3/ul 0.0-0.1

fsh and lh
lh 4.8 miu/ml 1.7-8.6
fsh 5.6 miu/ml 1.5-12.4

prolactin 21.8 HIGH ng/ml 4.0-15.2

testosterone serum 213 LOW ng/dl 348-1197

sex horm binding glob serum 14.8 LOW nmol/l 16.5-55.9

estrogens total 128 HIGH pg/ml 40-115

This is all new to me and a brain overload. I’ve never researching any info till this weekend. Thats how I found this site. I’m trying to go through the sticky pages attached above. Honestly its overwhelming me with everything. Any input on what to bring up to my doctor would be great. I’m also going to print out a few of the stickies and give to my doctor.

5

Yes, it is a steep learning curve and we can only help you, but you have a lot of effort to make. You need to do this and you have to take charge of this aspect of your health care because docs are not very good at it.

You have secondary hypogonadism. High estrogens and high prolactin are inhibiting your hypothalamus and pituitary release of LH and FSH.

Why are estrogens up? We often suspect liver function and want to see ALT/AST lab results - which you do not have.

You can try low dose anastrozole and Dostinex/cabergoline and see if your LH/FSH/T improve.

High estrogens and low SHBG is unexpected. SHBG is made in the liver in response to estrogens, again a liver factor.

You need to consider possible prolactin secreting pituitary adinoma. MRI is usually used to detect. Dostinex/cabergoline is the front line treatment, 0.5 - 1.0 mg/week.

Still need more info, do not see your age yet.

6

Age is 34. I didnt post before but fatige is a major problem also. I can sleep for hours at any point during the day then sleep soundly at night.

I read on here how amlodipine can cause gyno. I did a google search and found that and hair loss can be linked to that med. My small case of gyno had gotten worse and hair has thinned out on top since I started amlodipine. I wrote my family doctor questioning this and asking ask that my meds to be changed. His reply was he had not seen those side affects. He prescribed verapamil sr 120 mg. One side effect listed is Endocrine

Endocrine side effects have rarely included interference with the release or synthesis of prolactin inhibitor factor in the hypothalamus; however, the mechanism is not known. A single case of hyperglycemic metabolic acidosis has been associated with sustained-release verapamil. Galactorrhea/hyperprolactinemia has been reported during open trials/postmarketing experience. Due to verapamil-induced hyperprolactinemia, rare cases of galactorrhea have been reported in both sexes.

I haven’t filled the script yet. I dont know if it would be any better for me to take. I’m still waiting to hear back from the endo. Maybe he can help out with a script for bp. I was hoping to hear back this week but still haven’t heard anything.

One other past medical scare I’ve had in the past was high creatinine levels. Last summer they were high after a mri with die used. After several blood test I was sent to see a specialist. She come to the conclusion that the die is what caused the high number. By time I seen her my numbers had dropped. She stated that mine was a little higher than the 1.27 range but no need to worry. She stated size should be the reason for that. My first blood test posted has my level at 1.34