I do sincerely apologize and thank ahead of time, for my sounding ignorant but I’m trying to figure out this forum as it is my first. I don’t have much experience with this stuff online so please bare with me. I’m trying to learn enough and read and navigate around just to try and figure out where to ask my question about what labs to tell your doctor you want ran to properly monitor trt and necessary hormone levels. Then would like advice and help interpreting results. I want to be safe. And have been trying to figure out this stickies thing. Please help
are you currently on TRT or planning on going on? If your on trt, give us your dosage and plan.
At the top of the page where it says “About the T Replacement Category” click on “read more”.
Those are the “stickies”. Reading those will give you a grasp on what is going on here.
Yes I’m currently through my second month going into the 3rd. I’m 40 years old 5’9" 183lbs and very active. I’m a welder master by trade, I work out every day and eat pretty good as far as I’ve been told. I take rainbow light Mens one multivitamin every morning with 1000mg of L-lysine for proactive cold sore treatment that I’m prone to when I get overly stressed. I have battled anxiety and depression here and there since my early 20’s and had possibly 2 breakdowns years apart that put me down for 2 weeks at a time. I haven’t ever really slept that great as far back as I can remember. Was diagnosed with sleep apnea couple years ago but I couldn’t ever get used to sleeping with a cpap on so I just deal with the restlessness. I recently started hitting the gym a lot more and working out harder than I have in the past due to working a job away from home and nothing else to do. While my physique is looking amazing I was getting sluggish and my sex drive was diminishing as of the last 6 months or so. I started hearing on the radio a lot about low t and centers for it so I made an appt. The first center I started going to it was obvious they just dose you and send you on your way. Only thing they even watch and check for is low T, FT, and make sure your blood doesn’t get thick. The biggest problem was also the drive every week to the center since they wouldn’t do home dosing. I went here 4 visits/1month, and by my 3rd visit/dose I was already getting cystic back and neck acne. He told me to see a dermatologist for that issue and continued giving me 200mg T cyp/week and anastrozole .25mg/week day after dose to keep E2 in check he said. When I started treatment here my labs where as followes.
TT=176 ~ 300-890 NG/DL
FT=4.2 ~ 4.8-25.7 NG/DL
SHBG=21.2 ~ 16.5-55.9 NMOL/L
DHEA=146 ~ 82-455 UG/DL
Estradiol=17
I found a urologist now that seemed knowledgeable and would write a script for my T cyp to be done at home and was covered by insurance. So as my first visit he ordered labs.
WBC=7.9
RBC=4.57
Hemoglobin=14.2
Hematocrit=42.9
MCV=93.9
MCH=31.1
MCHC=33.1
Platelets=216
MPV=11.3
RDW=13.8
RDW-STDEV=47
Neutrophils=64
Lymphocytes=24
Monocytes=9
Eosinophils=2
Basophils=1
Neutrophil Absolute=5.01
Lymphocyte Absolute=1.89
Monocyte Absolute=0.72
Eosinophil Absolute=0.18
Basophils Absolute=0.05
Immature Granulocy=0.02
Sodium=140
Potassium=4.2
Chloride=101
CO2=25
Calcium=9.5
Bun=21 ~ 
Creatinine=1.5 ~
GFR=52 ~ 
GFR,African American= >60
Glucose=106
Total protein=6.4
Albumin=4.4
Bilirubin total=0.4
Alkaline Phosphatase=74
AST=26
ALT=33
Anion Gap=14
Vitamin B12=1032 ~
Vitamin D total=45
Estradiol=15 ~
TT=858
TSH=0.89
This set of labs I was given do not show testing ranges only the values.
He kept me on 200mg T cyp per week which I split into 2 doses, so 100mg every 3 1/2 days and I quit the anastrozole. I’m still fighting cystic back and neck acne which I already had since my 3rd dose at the low t center. It’s been 1 month now since my first visit with the new urologist and last lab work but he doesn’t have me scheduled for labs again for another 2 months.
You will need blood work from before you started and from after.
200mg is a higher than average. (that is what I am taking so it is not unheard of high)
“cystic back and neck acne”
If you are only taking testosterone your estradiol levels are probably too high for one. With that dose your testosterone levels very well may be to high as well. In other words your doc is not doing you right. Get those labs up. The guys here know this subject well. You will get this straitened out
Here are my labs from beginning to last month. So in a months time I jumped a lot in my test levels which concerned me where they would be at currently. Or if they still would be climbing. I’ve been on the same dose he started me out with of 200mg.
what other panels should I request them to run today to get a better idea of what I should be doing. im seeing lots of other posts about different labs that I don’t think my DR is monitoring. I’m new to this and am feeling much better already on my TRT, but I want to make sure that long term is what I’m looking at safely.
From what you are showing your testosterone levels are still not very high. But that is hand written, I may be missing something. And I do not see your latest estradiol. But if your testosterone levels really are only 307 I doubt E2 is very high. If you are taking 200mgs a week. I dont think I am seeing reality here. Im I overlooking something? Is something missing?
Thanks for taking the time to help me. This is my last lab I had done. Not sure if you were able to see it. Test was at 858 and estradiol was at 15. So in a month that’s what I jumped up to.
What I am seeing here. you have low estrogen and perfect testosterone. That is of course assuming you feel perfect. Your E2 is a little bit on the low side and I would worry a little if you are taking anything to lower it.
Are you only taking testosterone?
Others here can read the rest your test better than I. being as it is Labor Day weekend you may not see them for a while. So I will help you with what I know
You had questions regarding the stickies. if you have any let me know. otherwise I’m going to recommend a few of them to you
I’m guessing he’s taking an AI as his estradiol did not increase with a 2.8 fold increase in his testosterone. Could drop the dose a little and feel maybe a little better to get it around that 20-25 range. Not sure if that’s going to help with the cystic acne problem or not.
Reducing the T dosage slightly along with the AI would be the best bet as long as you’d still be good with ~600ish T.
I’m told that when acme shows up drop your dose. But others with experience with that would be better at advising him there. His T level is the same as mine. For me that is prefect. For him maybe he needs to be a bit lower. If it were me I would cut my AI dose get some sun on my back and see what happens. His E2 levels need to be back in the 20s where they belong.
actually yes I was taking anastrozole at first just a 1/4 of the pill .25mg/week day after dose. when I was doing a single dose per week of T cyp. at first. This was at a low T center, I realized I didn’t like the way they did things pretty quick after a month, which is when I searched out and found my current urologist. My first visit and labwork with him was the results showing test-858 e2-15. He kept me at my current dose of 200mg after looking over all my labs I had provided for him from previous center and my current with him. This is when I also quit taking the anastrozole and switched my dose to 100mg 2/week. He agreed this would be better since my E2 was low. He rescheduled me for a follow up in 3 months. I want to get one done now which is a month since my last one just to keep close tabs on everything. Since I’ve changed up. But are there other things they need to test for as well fsh etc. ?
LH/FSH are going to read 0 or very near 0 since you are on Testosterone replacement and not an SERM like Clomid or nolvadex, so I wouldn’t waste your money on those ones.
Honestly, your TSH looks pretty good from the previous tests and if you’re feeling good Total Testosterone and Estradiol should be about all you need. I wouldn’t even both with the free testosterone at this point since your free looks like it is a normal percentage of your total testosterone from the first two labs you posted.
I noticed your serum glucose was flagged as slightly high from your previous test, you may ask to get an A1C average glucose taken that will estimate what its been for the past three months - its a more reliable indicator of prediabetes or diabetes than the samples that measure instantaneous values.
Thank you for the input. I will look into that. I guess what got all this started is that I’ve never had acne issues and I know it’s due to my hormones changing. This is why I want to make sure I monitor and get plenty of input on my levels.
obviously you over respond to an AI. I believe you’re on the right path then. Sun or a tanning bed works really well On acne. Even when your hormones are right it might take the cysts a while to go away. so that’s just a suggestion. About your glucose levels. if you didn’t fast before the blood test it’s inaccurate. From my Personal experience unless they are specifically looking at your glucose levels they never tell you to fast. I’m not even sure why they take that test When they don’t have you prepared beforehand for it.
Are you also using HCG?
You are correct. I didn’t fast before the test. And no I’m not using HCG. That’s another question and subject I guess. Should I be using it. I know about the possible atrophy issue, how bad could that get out of curiosity and I’m not concerned with having any more children.
just a general question. Has your energy or/and wellbeing improved. What about sex drive?
That’s kinda the thing. If it wasn’t for the acne I feel pretty good all around. Just the acne is so bad it’s embarrassing. Energy is decent. Nothing spectacular but hell I’m 40.