T Nation

New to Forum and TRT....Blood Test Results


#1

Hi,
45 years old
6 foot
185 pounds
12% BF
Experienced symptoms of low T and went to get it checked at men's health clinic 3 months ago.
Results came back at 310 Total T.
Started 125mg Test Cyp per week.
.25mg Arimidex EOD
Current labs are as follows:
T:778 ng/dL 250-1100
Free T% 2.74 1.5-2.2
Free T 213.4 pg/mL 35-155
E2 34 pg/mL
DHT 30 30-85

I've experienced improvements in muscle mass, body fat, libido etc...
I've increased protein intake to 1 gram per lb of body weight
I take Creatine.

My labs are showing some concerning numbers relating to kidney function.
GFR 65 (ref range: above 89 normal, 60-89 normal to mildly reduced)
Urea Nitrogen (BUN) 27 7-23
Perhaps due to protein/creatine intake?

Any thoughts on my labs or suggestions or questions for me?

Thanks guys!


#2

E2 is way too high suggesting that you need to increase Arimidex dose by 0.25 EOD 34/22 = 0.39 EOD or 1.35 mg/week. It is hard to make dose refinements with pieces of tablets. Note that the rule of thumb for stating doses of anastrozole is 1mg/week per 100mg injected T ester per week. So this calculated result is not an unexpected result. You cab try 0.25mg five times per week.

Otherwise, you would need a liquid anastrozole product which is not typically "medically available". [You could also take 0.5 three times per week.]

Expect to feel changes from increase dose in 10-14 days.

You will feel a lot better when E2 is near 22pg/ml.

Lab results depend on timing if the lab. Injecting once a week creates problems. Inject more often. Do labs 1/2 between injections. Lab work done one week after injecting is really bad practice. Then always do labs with the same timing so changes reveal more than the timing effects of the lab.

Read the stickies for details re frequent injection of T with insulin syringes.

Taking any meds that might effect kidney function? Have you had an angiogram or other procedure using a radio-contrast dye? Are you taking anti-oxidants as supplements [need to]? Do you have pre TRT labs that show normal kidney markers? Are you dehydrated from fasting before lab work?


#3

Thank you KSman!!
Your insights are very helpful and much appreciated!

I will make your suggested changes to Arimidex immediately.

With regard to your follow up questions/suggestions about kidney function:

1)I haven't had an angiogram with radio-contrast dye....good suggestion...I will look into it.
2)Other meds which I'm taking: Celexa, Cialis
3)Other supplements which I'm taking: Creatine, Jack3d, BCAA, Glutamine, Fish Oil, Protein Powder, Vit D, Zinc, Alpha Lipoic Acid, Resveratrol, DHEA, Pregnenelone.
4)Don't have recent pre-trt labs showing normal kidney markers. Prior to starting TRT, I hadn't had blood work done for over a year...was normal at that time.
5)I Did fast for 15 hours before lab work...might that have caused dehydration?

Any further thoughts based upon this info?
Thanks again!


#4

1) Radio contrast dyes can harm or destroy kidneys WHEN ones antioxidant status is poor or there are preexisting problems!!!

5) You need to be drinking water when fasting. If dehydrated, that can shift numbers. Obviously an issue for urine analysis.


#5

Thanks KSman....can you explain the relationship between anti-oxidants and kidney function?
How does one know if one's "anti-oxidant status is poor"?


#6

E2 may be a bit high but that depends on SHBG
lower shbg lower e2 has to be.
Kidney function is more indicative of prediabetic state or blood sugar dysregulation
I would check aldosterone and renin levels to rule out issues with electrolyte imbalance and angeiorention system.
I would also like to see ft3 and ft3, tsh, total t4 and t3, reverse t3, tpo, tgab, cortisol, shbg, and ferritin, vitamin d 25 oh.
Bun is elevated due to creatine use and also heavy training.


#7

Thanks!!


#8

Quick follow up question if u don't mind:
If elevated bun is due to creatine usage and training, do u think I have reason to be concerned about it? Or would u need to see results of all the other tests which u mentioned?

Thanks!


#9

One more follow up q please:
Are u in agreement that optimal E2 would be 22 or are u implying that u feel that optimal E2 would be a function of SBHG? In which case how does one go about trying to find a personal optimal E2 target in your opinion?
Thanks!


#10

creatine is not a concern the other marker is a big red flag and dehydration could be possible cause of the reading.

E2 is an indiviudal issue. some have e2 of 40 and perform like animal other have e2 of 30 and feel like crap. You have to find out what works for you. The general best sweet spot is 20-25, but it can vary. Remember symptoms may over lap thyroid and estrodial issues are the identical which makes it a real challenge to find the culprit.


#11

Thanks! When u say "the other marker" what are you referring to?


#12

Radio contrast dyes can lead to kidney failure in the context of someone having an heart attack and an angiogram. In these cases, heard disease has also damaged the circulation in the kidneys and free radical damage occurs. Similar to Tylenol overdoses. NAC can be administered before an angiogram and around 80% of the kidney failures can be eliminated. However this is not done.

The point is that oxidative dresses can play a role in these pathologies and anti-oxidants can be preventative. Using anti-oxidants are part of any decent age management effort.


#13

Thank you!!


#14

Protecting mitochondrion from free radicals is crucial to proper functioning of all cells and also helps reduce the aging process to some extent.

To most powerful antioxident at cellular level are ubiquinol and reservatrol. I use these as cellular shields. One can add in ALCAR as well.


#15

Thank you!!


#16

Still a little confused as to whether you think BUN of 27 and GFR of 65 is reason for concern and if so, what my next steps should be.

Thank you for all this help! Much appreciated!


#17

bun is increases with protein and creatine intake
GFR does need to be watched. Certain medications can lower this level. My father was on diabetic medicine that where killing his kidney his GFP was 59. Once he discontinued this medicine his level went up.