My latest labs:
Havenāt posted here in a couple of weeks, wanted to post new lab from last week and report progress.
Feeling ok. Energy levels still low at times. Libido is much better since beginning TRT. Strength in the gym is up. Have not lost weight, but body comp is changing - carrying more muscle than i was, for sure.
I have had a bit of edema in the lower legs. I did not notice as my feet did not appear swollen, but my doctor pushed his thumb into my shin and noticed some pitting. He assumed that maybe my e2 was high, but labs showed otherwise (19.1 pg/ml on non-sensitive). Now he is saying that it may be low progesterone causing this and that he wants to test it in two months if swelling persists. He also suggested that I give blood again in three weeks (which will be two months since last blood donation).
The labs look really good for the Total T and Estradiol balanceā¦ tough to get too much closer to that.
Not too up to speed to speed on the lower extremity swelling or progesterone balance stuff but iām sure someone else can chime in.
Iād keep up the program as it appears to be working as intended - body weight changes can take a while and happened over in time in the long-term study conducted in germany (4% body weight lost in the first year, 13% in the first 5 years).
About different labs ranges, if I were to go in for labs and send one blood sample to lab with ranges 241-916 and another blood sample to Lab Corp previous 348-1197 would the OP be above range at no name lab but within range at Lab Corp? Iāve always wondered about that because the OP labs are showing above range, is it really though if we go by the older Lab Corp range?
Ok thank you thatās what I thought too. My doc said that my E2 was too low, slightly. Also wanted my T to be slightly higher and increased my T Cyp dose from 45 mL to 48 mL e3.5 (or 192 mg/wk, increase of 12 mg/wk), while keeping Anastrozole dose the same.
@KSman hoping to get your input on my latest lab values. My protocol (weekly: 175 mg Test Cypionate, 875 iu HCG, 1.75 mg Anastrozole) has not changed, however my T and E2 have fallen considerably.
Latest labs:
From my labs two months ago, my T has decreased to almost half of what it was (1009 ng/dL). Over the same period, e2 has decreased from 19.1 to 6.5.
Obviously I am way overdoing it on the AI. On the other hand, since T has been cut in half, then less T is aromatizing to E2. Not sure what to make of this aside from knowing that I should stop the AI for now.
Any input would be appreciated.
@KSman I have an appointment with my hrt doc tomorrow, hoping to get your input beforehand if at all possible. Thanks in advance.
Just had more labs drawn to confirm TT and E2. Ill update this post with values once i receive them.
Stopped taking the AI.
Dr. Also tested cortisol levels (blood, not 24 hr saliva test as he probably should have) and my cortisol level was 7 @ 9 am. Prescribed me 10 mg cortef to take each morning.
Have not taken the cortef yet as I would like to do some more research and hopefully get some feedback from @KSman or anyone else on here that can help. Seems like cortef would be like putting a band aid on a wound of unknown origin- hope to figure out what the root cause or adrenal insuffiency is beforehand.
I cannot see where you have indicated frequency of injections. Twice a week for T and anastrozole suggested then always to labs halfway between to reduce lab timing effects. If injecting once a week, that can be the T drop problem.
Otherwise you seem to be an anastrozole over-responder. Resume at 1/4th the dose after 5-6 days then observe changes to mood, libido and energy. You may need to make up a solution 1mg/ml in vodka and dispense by volume or by the drop to manage arbitrary low dosing.
Without FT, we are a bit in the dark. E2 is from FT or Bio-T ā E2. SHBG+T does not --/ā>E2
@KSman thank you for the reply.
In regards to injection frequency, I take 50 mg T, 250 iu HCG and .5 mg Anastrozole every other day, so there should not be much fluctuation between peak and valley TT. Labs were drawn in a.m. just before injection (so just about 48 hours after previous injection).
For the last two injections, I have skipped the anastrozole. I will pick back up at 1/4 the dose (.125 mg EOD) and monitor symptoms going forward and see where I land for my next labs. Using vodka to dilute will be helpful, Iāll try that.
I will ask HRT doc about adding FT to my next labs.
Any idea how long it will take to recover from e2 crash?
Any thoughts on use of cortef for adrenal insufficiency? At my request, my doctor just drew new labs this a.m. and will be testing for pregnenalone and progesterone to hopefully glean more about cause of low cortisol.
Thanks again.
Please read Wisonās book on adrenal fatigue. Too complex to address here.
E2 recovers very fast, in a week. However, brain and tissue responses have their own clocks.
Thank you for the recommendation re: Dr. Wilsonās book. I ordered it.
I just got my new labs back from last week. They re-tested my total testosterone and e2.
If you recall, my TT fell to 520 ng/dL - which was strange because I hadnāt changed my T-cyp dose. I had them re-test it (like 6 days later, without changing t dose), and it came back as 1055 ng/dL. Iām thinking it must have been a lab error. Doesnāt make sense otherwise. I am considering reducing my T dose to 140 mg/wk (instead of 192 mg/wk), and may lower it further from there depending on how I feel.
e2, which had fallen to 6.5 pg/mL, was also retested 6 days later and came back this time as 14 pg/mL. Since I stopped the anastrozole for those 6 days, this could be right.
They also tested my pregnenalone and progesterone.
Pregnenalone came back as ā<10 ng/dLā (no range given). Doctor said this was normal and no cause for concern.
Progesterone was ā<0.1 ng/mLā (range: 0.0 - 0.5) . Dr. said this was low and that I should begin taking 50 mg of progesterone at night before bed. Did not say anything about what kind to take or where to get it.
Curious as to your thoughts on all of this. Thanks!
You can find OTC 2% progesterone cream and apply to inner arms at night. Some will sleep better but some freely progesteroneā>cortisol which disturbs sleep and you should be able to work out when to apply. Have you tested serun AM cortisol - at 8AM or 1 hour after waking? Low progesterone can be part of low cortisol. DHEA is another adrenal hormone and you should do serum DHEA-S labs to eval.
On Amazon, look for KAL brand progesterone cream. Most women have progesterone levels start to fall in mid-30ās and this progesterone cream can be helpful with painful periods and breast pain caused by estrogen dominance, but later on, something more potent is required.
If T levels actually were lower, E2 would also fall.
RE: AM cortisol, yes I had it tested about a week prior to the progesterone labs and my cortisol (serum, 9 a.m, fasted) was 6.5 ug/dL. Dr. recommended cortef @ 10 mg every morning. I asked him to check progesterone as Iād read that deficiency could cause low cortisol.
For the low progesterone, the Dr. recommended I take a 50 mg troche each night. Iāll start with the KAL brand cream and see how that goes. How long should I wait before retesting progesterone? Any idea how long it should take to notice improvement from raising progesterone levels?
Iāll ask my dr. to test DHEA asap.
Thanks @KSman youāve been a great help.
forgot to ask, what is your interpretation of the pregnenalone (my value: <10 ng/dL, range: <151 ng/dL)? Is it normal for it to be that low? Dr. says itās in range so Iām fine, but I know the ranges are often not ideal.