T Nation

Would Appreciate Feedback on Latest Labs - UPDATE


#1

I am new to this forum and damn glad that I found it. A wealth of info for sure. I have been on TRT for roughly 4 months now. I was initially going to a well known TRT clinic, but it was a real inconvenience to make the weekly appointments. My primary internal medicine doc agreed to match the prescriptions and fully supported my decision to self administer (Pfizer 200mg Depo Test, HCG, Arimidex). He's great to work with and totally open to any of my suggestions. Lucky to have this guy.

I am 35 years old, 6'1", 190 lbs. I was close to 200 lbs before TRT.
My base labs at the TRT clinic reflected 429 Total T and subpar Free T. The only other thing they test is CBC and PSA. They gave some pretty high weekly doses and obviously I felt much better immediately. When I made the switch to manage this with my doctor, my labs showed 1250 ng/dl Total T and 290 ng/dl Free T. E2 was at 30 pg/ml and SHBG was at 38 nmo/L. At this time I was taking 160mg Test weekly, 500 IU HCG twice weekly, and .5 Arimidex twice weekly.

My doc prescribes a full 200mg of Test weekly, but I have been taking 70mg E3D. I take 300 IU HCG twice a week. I have been taking .5 Arimidex 3 times weekly. I give myself a monthly 1mg B12 injection. I am on Liptor as well. My latest labs collected 8/16 at 12:45 Afternoon:

Total T - 1041 ng/dl [280-1070 ng/dl]
Free T - 250pg/ml [47-244 pg/ml]
Estradiol - 22 pg/ml [0-39.8 pg/ml]
SHBG - 30 nmo/L [13-71 nmo/L]
Triglycerides - 71 mg/dl [<150 mg/dl]
Cholesterol - 133 mg/dl [<200 mg/dl]
HDL - 39 mg/dl [>/=40 mg/dl]
LDL - 80 mg/dl [<130 mg/dl]
Coronary Risk Ratio 3.41 [Average for Males 4.97]
PSA - .8 ng/ml [0-4 ng/ml]
Cortisol PM - 11 ug/dl [PM 3-17 ug/dl]
PTH - 35 pg/ml [10-65 pg/ml]
TSH - 1.515 uIU/ml [0.350-5.500 uIU/ml]
T3 - 1.20 ng/ml [0.60-1.81 ng/ml]
T4 - 8.4 ug/dl [4.5-12.0 ug/dl]
Free T4 - 1.35 ng/dl [0.71-1.85 ng/dl]
LH - <0.1 miu/ml [2-12 miu/ml]
IGF 1 Random - 24 ng/ml [0-40 ng/ml]
Prolactin - 6.5 ng/ml [3-20 ng/ml]
WBC - 7.3 [5-11 thou/cmm]
RBC - 5.86 [4.3-5.7 mll/cmm]
Hemoglobin - 15.9 [13-17.5 gms/dl]
Hematocrit - 47.3 [39-55%]
MCV - 80.7 [78-102 u(3)]
MCH - 27.1 [25.35 uug]
MCHC - 33.6 [30-38%]
RBC Width - 13.1 [11.5-16%]
Platelets - 296 [150-500 thou/cmm]
SEGS - 68.8 [50-70%]
Lymphocytes - 20.9 [20-40%]
Monocytes - 7.8 [2-11%]
Eosinophils - 1.8 [1-5%]
Basophils - 0.7 [0-3%]
ABS SEGS - 5.0 [2.5-7.0 K/uL]
ABS Lymphocytes - 1.5 [1-4 K/uL]
ABS Monocytes - 0.6 [0.1-1.1 K/uL]
ABS Basophils - 0.1 [0-0.3 K/uL]
ABS Eosinophils - 0.1 [0.05-0.50 K/uL]
Vitamin B1 - 6 [4.5-15.1 nmol/L]
Vitamin A - 36 [38-106 ug/dl]
Vitamin D - 31 [25-66 pg/ml]
Vitamin K1 - 0.12 [0.10-2.20 ng/ml]
Vitamin E Alpha - 7.9 [5.5-18 mg/L]
Vitamin E Gamma - 1.0 [0.0-6.0 mg/L]
Vitamin B12 Serum - 1257 [211-911 pg/ml]
Vitamin D - 42 [32-100 ng/ml]
Iron - 36 [65-175 ug/dl]
Total Iron Binding - 379 [250-400 ug/dl]
% Saturation - 9 [20-50%]

I wish I fully understood all of this. I know my LH is nonexistent and Iron is low. My doctor made those same points and of course said everything else is "normal". I would appreciate any feedback and direction that the veterans of this forum can offer.

Thanks,
BlownLS7


#2

Apologies for the above format. I had everything nice and spaced out so it would be easy to read. Different story when I hit the Submit button.


#3

Your LH at 0 is fine...that is what is supposed to happen when all of your T is exogenous (your doctor should know this).

Your iron is low, and your Vit D needs some work. Are you supplementing D right now? 4-6k iu of a good bioavailable brand is a good point.

You may no longer have a need for the cholesterol meds. In fact, your total CHOL is a bit on the lower side and they could be lowering your HDL as well (this is bad).

Overall, what are your symptoms?

Many here would kill to have your doctor and ensuing bloodwork.


#4

Thanks, Balla. I was expecting the HCG to keep my LH levels up. Am I wrong?

I just started taking a D3 supplement. It's 1000 IU and I take one daily - I'll up the dose. I was shocked that my iron was so low. It's usually high as hell. I've been cutting back on red meats, greens, nut and berries, thinking it will help me keep my hematocrit low so I can give blood regularly. The blood donation center won't let you donate if your hemoglobin is over 18. That would roughly be 54% hematocrit. Mine was so high a while back, it took a full day of pounding down water to get it low enough to beat the test. Trying to avoid that again.

I agree with you, about the cholesterol. I actually just quit taking the Lipitor a few days ago. We'll see what my lipids look like in the next labwork.

My original symptoms were the usual. Feeling tired/fatigued all the time and lack of motivation. My erections would fizzle out sometimes during sex. Aside from the physical improvement from the T, I feel sharper and more focused especially at work. Less anxiety and more energy to do things with my kids. Im throwing it to my wife like the old days too! Good stuff.

I experimented a little with Test and Equipoise when I was a teenager. After about 4 weeks I realized I was too hot-headed and immature to continue. I knew I would eventually get myself in trouble. I remember feeling like a machine. Of course I don't quite feel like that now, but the moderate doses of Test have me feeling "young" again. Even old injuries don't hurt as bad as usual. I think I might actually get back in th gym. It's been almost 2 years!

Yes - the doc is a good one for sure. Everytime I see him, I let him know how much I appreciate him and don't take it for granted.

So, the rest of the above values look okay to you? I've been worried lately that I may have a thyroid issue. I run out of steam sometimes, even on the T. I guess thats normal for a human being.


#5

If your protocol seems to have alleviated your prior symptoms, I would say its a success.

Your thyroid looks fine. TSH of 1.5 is pretty good. Would be better if you had Free T3/Free T4 values instead of total, but they appear to be ok, and your TSH hasn't risen that high to indicate an issue. More T3 probably wouldn't hurt, but I wouldn't bother with it.

HCG does not keep your LH up. It mimics LH to the testes, but is not actually LH.


#6

VTBalla34 and All,

Here are my latest labs, drawn 11-19-2011. Total and Free Test remain relatively high. I am still dosing 70 mg T E3D, 300IU HCG twice a week, and .5mg Anastrozole 3 times a week. My E2 is high again. I do sometimes forget to take my Anastrozole. In turn, SHBG is high as well. Cholesterol is climbing back up since I have stopped taking Lipitor. Might need 10mg/day. My iron and vitamin D are still low. Why the hell would my iron be sow low? I have a pretty well rounded diet. Ferritin is low. DHEA and DHT look pretty high. Not sure what to think. I wish I had a better understanding for these values. I need to start studying, I guess.

For some reason they missed T3. I would appareciate any feedback you can offer. Thanks

Sodium - 140 [135-145 mEq/L]
Potassium - 4.2 [3.85-5.3 mEq/L]
Chloride - 102 [98-107 mEq/L]
Carbon Dioxide - 25 [21-31 mEq/L]
Urea Nitrogen - 14 [7-25 mg/dl]
Creatinine - 0.93 [0.6-1.3 mg/dl]
Glucose - 69 [65-100 mg/dl]
Calcium Total - 9.0 [8.6-10.3 mg/dl]
Protein Total - 7.5 [6.4-8.3 g/dl]
Albumin - 4.8 [3.5-5.2 g/dl]
AST - 29 [13-40 U/L]
ALT - 13 [7-52 U/L]
Alkaline Phospatase - 67 [34-104 U/L]
Bilirubin Total - 0.9 [0.3-1.2 mg/dl]
Triglycerides - 79 mg/dl [<150 mg/dl]
Cholesterol - 225 mg/dl [<200 mg/dl] HIGH
HDL - 48 mg/dl [>/=40 mg/dl]
LDL - 161 mg/dl [<130 mg/dl] HIGH
Coronary Risk Ratio 4.69 [Average for Males 4.97]
WBC - 5.6 [5-11 thou/cmm]
RBC - 5.88 [4.3-5.7 mll/cmm] HIGH
Hemoglobin - 14.4 [13-17.5 gms/dl]
Hematocrit - 44.2 [39-55%]
MCV - 75.2 [78-102 u(3)] LOW
MCH - 24.5 [25.35 uug] LOW
MCHC - 32.6 [30-38%]
RBC Width - 14.4 [11.5-16%]
Platelets - 282 [150-500 thou/cmm]
SEGS - 55.5 [50-70%]
Lymphocytes - 31.9 [20-40%]
Monocytes - 9.0 [2-11%]
Eosinophils - 2.5 [1-5%]
Basophils - 1.1 [0-3%]
ABS SEGS - 3.1 [2.5-7.0 K/uL]
ABS Lymphocytes - 1.8 [1-4 K/uL]
ABS Monocytes - 0.5 [0.1-1.1 K/uL]
ABS Basophils - 0.1 [0-0.3 K/uL]
ABS Eosinophils - 0.1 [0.05-0.50 K/uL]
Vitamin B12 Serum - 851 [211-911 pg/ml]
Vitamin D - 45 [32-100 ng/ml]
Iron - 36 [65-175 ug/dl] LOW
Total Iron Binding - 407 [250-400 ug/dl] HIGH
% Saturation - 9 [20-50%] LOW
T4 - 8.9 ug/dl [4.5-12.0 ug/dl]
T3 Uptake - 32.8 [23-36%]
Free Thyroxine Index - 2.9 [1.1-4.4]
TSH - 1.475 uIU/ml [0.350-5.500 uIU/ml]
Free T3 - 3.7 [2.3-4.2 pg/ml
Free T4 - 1.13 ng/dl [0.71-1.85 ng/dl]
Ferritin - 1.13 [0.71-1.85 ng/dl LOW
Cortisol AM - 19 ug/dl [AM 4-22 ug/dl]
FSH - <0.3 [1-12 MIU/ML]
LH - <0.1 miu/ml [2-12 miu/ml]
Prolactin - 6.7 ng/ml [3-20 ng/ml]
Total Test - 1163 ng/dl [280-1070 ng/dl] HIGH
Free Test - 258pg/ml [47-244 pg/ml] HIGH
Estradiol - 38 pg/ml [0-39.8 pg/ml]
SHBG - 41 nmo/L [13-71 nmo/L]
PSA - .8 ng/ml [0-4 ng/ml]
IGF 1 - 228 ng/ml [109-307 ng/ml]
DHEA - 11.99 [1.30-9.80 ng/ml] HIGH
DHES (DHEA Sulfate) - 245 [80-560 ug/dl]
DHT Dihydrotestosterone - 946 [106-719 pg/ml] HIGH


#7

Symptoms!


#8

Less energy and moody like a bitch half the time. Maybe a little depression. I have been skipping the gym and eating fast food and sweets. Kind of reminds me of my wife when she's on her period LOL. Somethings up with the iron thing. How doe the Thyroid stuff, Prolactin and Cortisol look to you? Labs were drawn at 8:30am after fasting since 7pm the night before.


#9

Forgot to mention that I gave Double Reds exactly 1 month ago.


#10

Aside from your higher than optimal E2 and the iron thing, I think everything looks great...you might want to consider knocking your T dose back just a little bit and see if that takes care of the aromatization and gets you within range for your androgen hormones...Otherwise, you will need to increase your Adex slightly to get E2 in the 20's...

I have no idea about the iron issues...

No idea what Double Reds are


#11

Thanks, man. No chance of hypothyroidism here? I need to figure out the iron and ferritin situation. Just wierd. Double reds is an option when I give blood. They hook you up to a machine and take only your red blood cells. They take twice the amount of rbc's than if you give whole blood. You get your platelets and plasma back. Seems to be a life saver since I've been on TRT. My hematocrit gets up there in 3 or 4 months and then it's time to bleed! Maybe this is why my iron is low?