Just had labs taken what do you all think? Ill list what the doc proscribed.

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Just had labs taken what do you all think? Ill list what the doc prescribed.

Hello everyone,
I'm new to the site and TRT. A little back ground on myself I have been dealing with fatigue for three years now. I was living in CO and just moved to MN. I had an endo in CO that found my thyroid to be low and low T. Im 34 6'1" and 200lbs. He started me on Levothyroxin .05MG and clomid 25.mg i think…needless to say it did raise my numbers to 550 for T from high 200 where i started but I didn't feel much better. My TSH level started at 4.85 and were brought down to 3.85. He stopped climid after one year do to no research past 1 year in men. So after just moving to MN I started to look for TRT doctors. I found a good doctor in Maple Grove MN. Here are my labs before I went to see him. These were completed with in the last 3 weeks.
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I highlighted the things I had questions on.

After spending an hour talking about my labs this is what the doctor recommended:


Levothyroxin I would recommend that we try increasing your levothyroxin from 50 μg daily to 75 μg daily.

Testosterone I would recommend that we begin the use of some injectable testosterone at a dose of 0.5 mL injected once per week subcutaneously. (Cypionate 200mg/ml)

Anastrozole This medication helps to slow the conversion of testosterone to estrogen. You will take one half tablet .5 twice per week for total of 1MG per week.

Cortrex This is a well-rounded adrenal support supplement. You will take one capsule in the morning and one capsule around noon. It is my hope that this will help improve the consistency of energy through your day.

Basic B-complex this specialized B-complex contains the activated forms of several of the B vitamins. This has potential to help with mood, energy, and focus. It may also help positively impact estrogen metabolism.

DHEA This hormone is normally produced in the adrenal glands. Your level was low so we will begin supplementing. You will take a single 25 mg capsule each morning. With the use of DHEA, monitor for side effects similar to those mentioned with testosterone.

Fish oil I would recommend 2 capsules of Orthomega fish oil as it is pharmaceutical grade and each capsule contains 820 mg of EPA/DHA. This will help improve your triglyceride levels.


So I have started the pills but not the injections. I want to make sure I’m doing the right thing before I jump head first. I’m going to start the injections at a lower dose. I’m super sensitive to things so i don’t want a bad reaction and want to quit taking it before it has done anything. Does this cause and issues like rapid heart beat or things I will notice right after injecting? I truly appreciate everyones input and thanks for taking the time to read through this.
 
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Defy Medical TRT clinic doctor

Nelson Vergel

Founder, ExcelMale.com
I agree with starting testosterone if your level was low. I would not take anastrozole until at least 6 weeks after you start TRT and get your estradiol by ultrasensitive test. I will let Chris on here comment on your thyroid and calcium, protein, BUN numbers since they are associated with dosing of your thyroid medication.

You may think about taking 50 mg DHEA per day and get it retested after a few weeks after being on it. That should give some energy.

I am glad to see your kidney function is great despite your high protein and BUN levels. Chris will tell you if these variables can be improved with better tweaking of your thyroid medication.

Your triglycerides are high, so lower your sugar and processed carb intake.

I know fatigue well. I am writing a book about it now. You may want to read some of this information.
Thread: Fatigue- When Testosterone Is Not Enough
 

Bass

New Member
I agree wit Nelson getting on TRT, also about the AI, definitely wait and treat based on BW and how you feel. and if you split your injection to twice a week you may not need AI, also will help avoiding a lump at injection site.
 
Thank you both for the in-put, I will start my injections tomorrow and take your advice above. I will let you know how everything turns out. Thanks again!
 

Vettester Chris

Super Moderator
On your cortisol profile, can you tell us what time in the day you took the first two? I presume the 2nd one would be around 8:00 AM, as the plot is at the highest.

On the thyroid, with what you provided you might hear the term "Subclinical Hypothyroidism". There could be a few variables to why this is taking place. However, IMO, you need a few other labs before getting too far into the conversation. You should get a Reverse T3 and both antibody labs, TPO & TgAb. Both your storage (T4) and active (T3) hormone is sitting moderately low, and I suspect the RT3 /FT3 Ratio is lower than desired. In a lot of the subclinical situations you will find that the body is low on selenium, iodine, magnesium to name a few. Again, get the other labs so we can see the full picture. Would be good to also see iron serum, TIBC, ferritin, magnesium (mentioned above).

On your calcium, my first thought was just making sure the Parathyroid is in order. A PTH lab would tell the tale on that subject. Again, magnesium comes into the picture with this topic just as it did with the thyroid productivity. If you are going too excessive with Vitamin D, it can also play a role in declined PTH activity. Best advise I can give at this point is to do the 3 R's ... Read carefully, Research vigorously, and Review adamantly with a knowledgeable physician.
 
I believe the first AM test was taken at 7AM, AM2 was at 9AM. With what your saying should I not start my TRT until I have these other labs checked? Or is that only for my thyroid? Thanks for the help.
 

Vettester Chris

Super Moderator
You're OK IMO on the TRT, as noted by Nelson and Bass. My comments pretty much center around the thyroid, parathyroid and adrenals. Also, I didn't read close enough myself on the first post, where it looks like you are on some Levothyroxin, which is a T4 only medication. Do you by chance know what your FT4 and FT3 numbers were prior to starting the T4? With that said, I would definitely want to see the RT3 and antibody labs at this point.

I believe the dosage you're taking is at 50mcg, which wouldn't be all that much. In the meantime with getting the other labs, take a look at STTM.com. They have a stockpile of information on everything I'm talking about, and there's a ton of information on Natural Desiccated Thyroid medications, e.g., Armour, which might be an alternative to your current program.
 
I'm not sure what my starting numbers were it's been over 2 years now. My doctor offered to put me on armour but worried it would raise my T3 causing some anxiety. He thought by raising my levexthroin from 50 to 75 it may help. He thinks I will end up on 1mg to get me feeling good. I will see if I can get him to run the labs your suggesting, if he will not can I go request them on my own and pay for them? I've always had labs drawn by doctor referel only. Thanks for the help and I'll start to do some research.
 

Vettester Chris

Super Moderator
Sorry, but your physician's rationale just doesn't make any sense. T4 is the storage hormone and it's purpose (for the most part) is to convert downstream to T3, which is the active form of thyroid hormone in the body. When there are issues like illness, stress, nutrient & electrolyte deficiencies, adrenal & iron concerns, etc., the body will redirect the T3 conversion into more Reverse T3 conversion. In similar fashion to a fever, it's the body's way of defending a preserving until balance is restored.

If everything is functioning correctly then you would hope to see both FT4 and FT3 in the 50% to 80% area of their respective lab ranges, and RT3 at a respectable ratio when calculated to FT3. The whole point of a productive thyroid is to get FT3 to the cells in the body to promote energy, metabolism, and all the benefits that come with it. Armour provides what your thyroid would see naturally with T4, T3, T2 & T1, with some variation on the ratio between humans and pigs. Anxiety would be a factor when you are over doing it with the medications, or if other issues are evident where RT3 is elevated and FT3 is pooling, which can revert back to adrenal issues and having the resources to cope with stress.
 

Vettester Chris

Super Moderator
No worries. If your RT3 is in a healthy range you could always start out with 1 grain of Armour, then titrate up to where your lab ranges look good, and where you feel the best. If RT3 is out of balance, then other factors are probably in play, which should be addressed before jumping on any of the thyroid meds. However, it's all speculation at this point. When you get the additional labs we can revisit where things are at ...
 
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