T Nation

TRT Journey is Starting, Crazy Lab Results


#1

I had a lower end T results a few years back when me and my wife were dealing with fertility issues. Usual low test symptons for a few years and finally found myself a very good and proactive doctor. I did the inital blood tests and some really interesting numbers came back:

LH 5 (2-6 iu/l)
FSH 2 (2-8 iu/l)
Progesterone 3 (<4.0nmol/l)
Estradiol <70 (<150pmol/l)
Test 15.5 (8.4-28.7)
Free Test 35.8 (19-66pmol/l)
Test Bioavailable 7.4 (2-14nmol/l)
Dihydrotestosterone 2760 (860-3406 pmol/l)
SHBG 33.4 (19-76nmol/l)
DHEA sulphate 14.5 (1.1-7.9)
TSH .20 (.35-5.mlu/L)
Free t3 5.1 (2.6-5.7 pmol/l)
Free t4 17 12-22 pmol/l
anti-tpo 6 (<35 IU/ml)

So the DHEA is sky high, and I definately was not expecting to be hyper thyroid (exhausted all the time).

Going to get retested to make sure these are not anolomies. But high DHEA seems like a good thing, but unfortunately isnt getting my T sky high. Having a hyperactive thyroid seems like it is better than hypo.

If anyone has come across this scenario would be interested in their take...doesnt seem to be that common in this forum.

Nevertheless, bad news is I have another round of tests before me and my doctor can get to work.


#2

So the second round of tests came back normal - DHEA was lower and in range, and the thyroid at 40 was still very active, but within range. Will test monthly to monitor.

So the doc was ready to start…so using a compounder, daily cream at 1%.

My concerns are suppressing my own function/testicle atrophy as well as transfer (I’m 40 with two young kids). Not sure how quickly the testicles begin to shrink, I hope I am one of the dudes this doesnt affect greatly.

As for the transfer, will just be very careful…


#3

[quote]lowpost wrote:
My concerns are suppressing my own function/testicle atrophy as well as transfer (I’m 40 with two young kids). Not sure how quickly the testicles begin to shrink, I hope I am one of the dudes this doesnt affect greatly.[/quote]

Not sure if this is a question.

My experience after about a year of TRT was that atrophy was very minimal but still present. When I reported atrophy to my dr we managed HCG into the protocol, which provided some benefit in that area.

I am sure others will have different experiences to report.


#4

Thanks. I do have some anxiety over the testicle shrinkage factor. I have been on TRT for two weeks, and no atrophy but it does seem the boys are pulling up…a lot of the time feels like I came out of the swimming pool.

Is that normally how the atrophy process starts?


#5

Your T numbers are really not that bad. It seems possible that treating the hyperthyroidism (even if mild) first might have improved T levels and would perhaps have been preferable to jumping on TRT.


#6

Interesting my T tested much lower a few years back (wife/I went to fertility clinic for our first child). But you are correct, the last test relative to what I see in the forums is not horrible.

The hyperthroyidism isnt presenting with any of the typical symptoms. And the treatment is pretty rough (the endo basically said we basically convertto hypoactive, and then drug you to get you back to speed). So he thought best to leave alone.

My clinic doctor was looking at targeting optimal levels (typical 600-900 range), so a low dose 1%cream is what I am on. I see him every three months, so will bring it up…add HCG or perhaps forgo TRT all together.

But having natural OK levels, and shutting that natural process is what is stressing me out a bit.


#7

Another option to explore with your doc could be running HCG only. No additional T.

I understand your anxiety about atrophy. I was in the same boat. Per your question, my experience with atrophy was minimal and based on feel. The boys just felt a little smaller and less ‘robust’, if you will.


#8

The sense I get us that atrophy has wide variations…some it seems no noticeable effect, others moreso. I just didn’t realize how much anxiety the idea of it gave me.

I do think you are right on the hcg only protocol. The doctor mentioned it, but when I said I was done having kids he went to cream, seemed the easiest option for a newbie. I will likely as to switch after I finish this round of cream (3 months)

Doesn’t seem there are many on this forum that do hcg only. Will have to read thru the threads to find pros/consider. If you took that route let me know your thoughts.


#9

I did not go the HCG only route. I had T levels that were <175 and I am 36, so T replacement was the right choice for me.

You seem to have a good dr, so perhaps the next best step is to have a visit and share your concerns while asking to explore treatment options that will minimize atrophy risk.

There are also others on this forum that are far more informed and experienced than myself. KSman being the one that comes to mind. Also be sure to read the Advice For New Guys sticky.


#10

Thanks been trying to read as much as possible, stickies have been great.

The challenge for me is finding similar cases to learn from. Frankly I was expecting worse results. But my total/free t was not horrible (total is around 420 in the more standard measure).

So I am what I think is a borderline case for trt. Which is making options and approach a bit more complicated. The real question is what benefits will I see with t in a more decent range or how my doctor says in an optimal range.


#11

If low dose SERM works, that’s probably the best route. If that doesn’t work, you could try HCG only. I wouldn’t jump into full-on replacement unless you have to.


#12

Thanks, I have been doing as much reading as possible, and I do think I want to relook at current protocal (which is daily application of 1% test cream). My goal is to retain/enhance my current function, with possible continuance of my daily cream application. I am at the beginning stages of my TRT journey, and so evolving slowly to the ideal protocal.

I will see my doc, in a month so was planning to look at the optin of adding HCG (and some A) to the process, but after going through many threads thinking of asking my doctor about a SERM option as well.

So while the HCG +AI protocal seems most common, and there are numerous threads on that topic. I see far fewer threads that talk about a SERM along with test cream/androgel (or even a SERM alone). If anyone has had +/- experience with that I would be really interested in thoughts.


#13

So I have been on TRT (compounded cream) for over 9 months and while my free test has gone up it hasnt been that significant. The Doctor feels I am in a decent range and making good progress. I dialed in my diet so body fat went down from 22.5 to 18%, TSH at .54 and Estradiol in check.

But the test numbers are just in range, so would I be classified as a non absorber?

Here are the specific details:

Test 10.7 nmol/l (range 6.0-27)
Free Test 56.1 pmol/l (range 15.6-146)
TSH .54 (range .30-5.6)
Estradiol <73


#14

So most recent blood work shows a change for the better on the tfront:

Test 40.5 (range 8.4-28.8 nmol/L)
Free T 787 (range 196-636 pmol/L)

What is challenging is that I am one of the few hyperthryoid cases in the fourm:

TSH .27 (range .30-4.00)

So seems I am abosbing well, but difficulty with lean body mass gains. Actually has gone down a couple pounds over the last quarter. Adjusting my workout and moving away from low carb diet to a more cyclical keto diet. Changing the workout as well to see how the body responds.

The hyper thryoid is unique…in the case of test creams doctor feels it is a good thing. The downside is packing on muscle is a bit more challenging.


#15

So I have shifted to injections (as everyone has done) after a year of creams.

I am on 120Mg of test per week injected E3D. Overall, feeling very good, but most recent results came back with T slightly elevated and my doc wants to ratchet me down to 100MG, he was even talking…gasp…80mg per week.

Here are the key data points:

  • Free T 687 pmol/l (range 196-636)
  • Test 33.0 nmol/l (range 8.4-28.8)
  • Estradiol 128 pmol/l (range <150) (this is 35pg/ml)
  • DHT 3540 pmol (range 860-3406)

overall feel good, down to 13% bodyfay, increased lean muschle, personality/confidence are back. All other bloodwork was good.

So the quesiton is are these really a health concern to run this high continously? Seems borderline over ranges, so not sure why he raising all the alarms. He talked about hair loss, aggression etc.

I can easily continue to run 120mg, and then pull down for a few weeks prior to my bloodtest.

Any thoughts?


#16

Yes. When was your injection done prior to the blood being drawn for your lab work?


#17

I took the blood work day before my injection…which I believe is standard protocal.


#18

When was your last injection prior to your labs?


#19

Two days prior.

I am injecting every three days. So I injected Monday, and the blood work was done on Wednesday. My next injection was thursday morning.


#20

Testosterone blood serum levels typically peak on the third day after injections, so you could argue that the last blood test captured a peak and shouldn’t be weighed as representative.