One year into TRT.....I have yet to feel any change

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Current Protocol: Please review and comment. Thank you

Testosterone: 200mg/mL- 1 mL weekly ( 0.5mg x2 )
Anastrozole: 0.25mg- 1 capsule weekly.
HCG: 500IU x3 weekly

CBC With Differential/Platelet
WBC 10.6 x10E3/uL 3.4 - 10.8 01
RBC 4.69 x10E6/uL 4.14 - 5.80 01
Hemoglobin 16.0 g/dL 13.0 - 17.7 01
Hematocrit 45.3 % 37.5 - 51.0 01
MCV 97 fL 79 - 97 01
MCH 34.1 High pg 26.6 - 33.0 01
MCHC 35.3 g/dL 31.5 - 35.7 01
RDW 13.9 % 12.3 - 15.4 01
Platelets 248 x10E3/uL 150 - 379 01
Neutrophils 69 % Not Estab. 01
Lymphs 22 % Not Estab. 01
Monocytes 6 % Not Estab. 01
Eos 3 % Not Estab. 01
Basos 0 % Not Estab. 01
Neutrophils (Absolute) 7.3 High x10E3/uL 1.4 - 7.0 01
Lymphs (Absolute) 2.4 x10E3/uL 0.7 - 3.1 01
Monocytes(Absolute) 0.6 x10E3/uL 0.1 - 0.9 01
Eos (Absolute) 0.3 x10E3/uL 0.0 - 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01
Immature Granulocytes 0 % Not Estab. 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01
Comp. Metabolic Panel (14)
Glucose, Serum 90 mg/dL 65 - 99 01
BUN 11 mg/dL 6 - 24 01
Creatinine, Serum 0.89 mg/dL 0.76 - 1.27 01
eGFR If NonAfricn Am 103 >59


BUN/Creatinine Ratio 12 9 - 20
Sodium, Serum 140 mmol/L 134 - 144 01
Potassium, Serum 4.6 mmol/L 3.5 - 5.2 01
Chloride, Serum 101 mmol/L 96 - 106 01
Carbon Dioxide, Total 25 mmol/L 18 - 29 01
Calcium, Serum 9.0 mg/dL 8.7 - 10.2 01
Protein, Total, Serum 6.9 g/dL 6.0 - 8.5 01
Albumin, Serum 4.6 g/dL 3.5 - 5.5 01
Globulin, Total 2.3 1.5 - 4.5
A/G Ratio 2.0 1.2 - 2.2
Bilirubin, Total 0.8 mg/dL 0.0 - 1.2 01
Alkaline Phosphatase, S 65 IU/L 39 - 117 01
AST (SGOT) 24 IU/L 0 - 40 01
ALT (SGPT) 31 IU/L 0 - 44 01
Lipid Panel w/ Chol/HDL Ratio
Cholesterol, Total 223 High mg/dL 100 - 199 01
Triglycerides 175 High mg/dL 0 - 149 01
HDL Cholesterol 49 mg/dL >39 01
VLDL Cholesterol Cal 35 5 - 40
LDL Cholesterol Calc 139 High 0 - 99
T. Chol/HDL Ratio 4.6 0.0 - 5.0
Please Note: 01
T. Chol/HDL Ratio
Men Women
1/2 Avg.Risk 3.4 3.3
Avg.Risk 5.0 4.4
2X Avg.Risk 9.6 7.1
3X Avg.Risk 23.4 11.0
Testosterone, Free+Total LC/MS
Testosterone, Total, LC/MS 596.5 ng/dL 264.0 - 916.0 02


Free Testosterone(Direct) 21.4 pg/mL 6.8 - 21.5 02
Dihydrotestosterone 49 ng/dL 03
Reference Range:


Estradiol, Sensitive 7.5 Low pg/mL 8.0 - 35.0 02


Sex Horm Binding Glob, Serum 24.9 nmol/L 16.5 - 55.9 01
 
Defy Medical TRT clinic doctor
With that low of estradiol level why are you on Anastrozole, I'm surprised how low your testosterone is.
 
Current Protocol: Please review and comment. Thank you

Testosterone: 200mg/mL- 1 mL weekly ( 0.5mg x2 )
Anastrozole: 0.25mg- 1 capsule weekly.
HCG: 500IU x3 weekly

CBC With Differential/Platelet
WBC 10.6 x10E3/uL 3.4 - 10.8 01
RBC 4.69 x10E6/uL 4.14 - 5.80 01
Hemoglobin 16.0 g/dL 13.0 - 17.7 01
Hematocrit 45.3 % 37.5 - 51.0 01
MCV 97 fL 79 - 97 01
MCH 34.1 High pg 26.6 - 33.0 01
MCHC 35.3 g/dL 31.5 - 35.7 01
RDW 13.9 % 12.3 - 15.4 01
Platelets 248 x10E3/uL 150 - 379 01
Neutrophils 69 % Not Estab. 01
Lymphs 22 % Not Estab. 01
Monocytes 6 % Not Estab. 01
Eos 3 % Not Estab. 01
Basos 0 % Not Estab. 01
Neutrophils (Absolute) 7.3 High x10E3/uL 1.4 - 7.0 01
Lymphs (Absolute) 2.4 x10E3/uL 0.7 - 3.1 01
Monocytes(Absolute) 0.6 x10E3/uL 0.1 - 0.9 01
Eos (Absolute) 0.3 x10E3/uL 0.0 - 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01
Immature Granulocytes 0 % Not Estab. 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01
Comp. Metabolic Panel (14)
Glucose, Serum 90 mg/dL 65 - 99 01
BUN 11 mg/dL 6 - 24 01
Creatinine, Serum 0.89 mg/dL 0.76 - 1.27 01
eGFR If NonAfricn Am 103 >59


BUN/Creatinine Ratio 12 9 - 20
Sodium, Serum 140 mmol/L 134 - 144 01
Potassium, Serum 4.6 mmol/L 3.5 - 5.2 01
Chloride, Serum 101 mmol/L 96 - 106 01
Carbon Dioxide, Total 25 mmol/L 18 - 29 01
Calcium, Serum 9.0 mg/dL 8.7 - 10.2 01
Protein, Total, Serum 6.9 g/dL 6.0 - 8.5 01
Albumin, Serum 4.6 g/dL 3.5 - 5.5 01
Globulin, Total 2.3 1.5 - 4.5
A/G Ratio 2.0 1.2 - 2.2
Bilirubin, Total 0.8 mg/dL 0.0 - 1.2 01
Alkaline Phosphatase, S 65 IU/L 39 - 117 01
AST (SGOT) 24 IU/L 0 - 40 01
ALT (SGPT) 31 IU/L 0 - 44 01
Lipid Panel w/ Chol/HDL Ratio
Cholesterol, Total 223 High mg/dL 100 - 199 01
Triglycerides 175 High mg/dL 0 - 149 01
HDL Cholesterol 49 mg/dL >39 01
VLDL Cholesterol Cal 35 5 - 40
LDL Cholesterol Calc 139 High 0 - 99
T. Chol/HDL Ratio 4.6 0.0 - 5.0
Please Note: 01
T. Chol/HDL Ratio
Men Women
1/2 Avg.Risk 3.4 3.3
Avg.Risk 5.0 4.4
2X Avg.Risk 9.6 7.1
3X Avg.Risk 23.4 11.0
Testosterone, Free+Total LC/MS
Testosterone, Total, LC/MS 596.5 ng/dL 264.0 - 916.0 02


Free Testosterone(Direct) 21.4 pg/mL 6.8 - 21.5 02
Dihydrotestosterone 49 ng/dL 03
Reference Range:


Estradiol, Sensitive 7.5 Low pg/mL 8.0 - 35.0 02


Sex Horm Binding Glob, Serum 24.9 nmol/L 16.5 - 55.9 01

what sticks out to me is the very low E2. I'm surprised you're not miserable with that number. Were these labs drawn at trough?
 
Here are my results from 2017-05





TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB


CBC With Differential/Platelet


WBC 9.0 x10E3/uL 3.4 - 10.8 01


RBC 5.15 x10E6/uL 4.14 - 5.80 01


Hemoglobin 17.3 g/dL 12.6 - 17.7 01


Hematocrit 51.2 High % 37.5 - 51.0 01


MCV 99 High fL 79 - 97 01


MCH 33.6 High pg 26.6 - 33.0 01


MCHC 33.8 g/dL 31.5 - 35.7 01


RDW 13.6 % 12.3 - 15.4 01


Platelets 256 x10E3/uL 150 - 379 01


Neutrophils 67 % 01


Lymphs 19 % 01


Monocytes 9 % 01


Eos 5 % 01


Basos 0 % 01


Neutrophils (Absolute) 6.0 x10E3/uL 1.4 - 7.0 01


Lymphs (Absolute) 1.7 x10E3/uL 0.7 - 3.1 01


Monocytes(Absolute) 0.8 x10E3/uL 0.1 - 0.9 01


Eos (Absolute) 0.4 x10E3/uL 0.0 - 0.4 01


Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01


Immature Granulocytes 0 % 01


Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01






Comp. Metabolic Panel (14)


Glucose, Serum 83 mg/dL 65 - 99 01


BUN 10 mg/dL 6 - 24 01


Creatinine, Serum 0.92 mg/dL 0.76 - 1.27 01


eGFR If NonAfricn Am 100 mL/min/1.73 >59










eGFR If Africn Am 116 mL/min/1.73 >59


BUN/Creatinine Ratio 11 9 - 20


Sodium, Serum 139 mmol/L 134 - 144 01


Potassium, Serum 4.6 mmol/L 3.5 - 5.2 01


Chloride, Serum 102 mmol/L 96 - 106 01


Carbon Dioxide, Total 23 mmol/L 18 - 29 01


Calcium, Serum 8.9 mg/dL 8.7 - 10.2 01


Protein, Total, Serum 6.3 g/dL 6.0 - 8.5 01


Albumin, Serum 4.1 g/dL 3.5 - 5.5 01


Globulin, Total 2.2 g/dL 1.5 - 4.5


A/G Ratio 1.9 1.2 - 2.2


Bilirubin, Total 0.5 mg/dL 0.0 - 1.2 01


Alkaline Phosphatase, S 60 IU/L 39 - 117 01


AST (SGOT) 18 IU/L 0 - 40 01


ALT (SGPT) 25 IU/L 0 - 44 01






Lipid Panel w/ Chol/HDL Ratio


Cholesterol, Total 183 mg/dL 100 - 199 01


Triglycerides 100 mg/dL 0 - 149 01


HDL Cholesterol 37 Low mg/dL >39 01


VLDL Cholesterol Cal 20 mg/dL 5 - 40


LDL Cholesterol Calc 126 High mg/dL 0 - 99


T. Chol/HDL Ratio 4.9 ratio units 0.0 - 5.0






Please Note: 01


T. Chol/HDL Ratio


Men Women


1/2 Avg.Risk 3.4 3.3


Avg.Risk 5.0 4.4


2X Avg.Risk 9.6 7.1


3X Avg.Risk 23.4 11.0






Testosterone, Free+Total LC/MS


Testosterone, Total, LC/MS 962.0 ng/dL 348.0 - 1197.0 02





Free Testosterone(Direct) 27.5 High pg/mL 6.8 - 21.5 02






Dihydrotestosterone 69 ng/dL 03


Reference Range:


Adult Male: 30 - 85






Estradiol, Sensitive 40.5 High pg/mL 8.0 - 35.0 02






Date Issued: 05/18/17 1017 ET FINAL REPORT Page 2 of 3










Sex Horm Binding Glob, Serum 18.5 nmol/L 16.5 - 55.9 01
 
Prime Body prescribed that with in the last (4) months.

Has Prime seen this blood test? If so, they should have contacted you right away to stop the AI. Well....If I ran PB that is what I would have done.

Your lipids were better back on 5/17 are you watching your diet? A southern diet is a heartattack making machine.

With a E2 sens of 40 which around here is OK but might need something if it get higher. I would have taken my AI @ .25/week. I prefer my E2 between 25-32 YMMV
 
Not really a state-of-the art protocol, more of cookie cutter protocol.

Test for most guys should be injected twice weekly, not once weekly. Anastrozole should only be prescribed if lab work and symptoms of high E2 are present - not just given to everyone that starts TRT as a matter of course.
 
I emailed it to them this morning. I never hear anything from them other than "your shipment" has gone out. Zero follow ups, nothing.......I have to contact them.
 
Lonestar71...........who's your network doc?
PM me and I'll get some more info for you.
Definitely a few things that need to be changed.
Your labs are not GTG at all.
 
Morning Guys-

I've been having some heart palputations the last couple of weeks so I went to my GP and it appears my BP is now elevated. 180/95 ish.....I've never had HBP nor does it run in my family. I've been reading the threads on this topic but couldn't draw any conclusions although I'm leaning towards my super low E2 from my last labs. I have been off my weekly/.250mg of Estradiol for three weeks. I donated blood on Feb 16th. In short, I've decided to get another set of labs drawn. I've always used discounted labs so please shoot me your suggestions on which tests you recommend.

PS: My libido is still dead and has been since Feb 2015.

As always, thank you! -Travis

PS: My GP knows I'm on TRT.....didn't question anything about it...wrote me a script for BP medication. I'm not having it filled unless I can't get it under control myself. So frustrating that he quickly wrote it up and sent me on my way without even attempting to draw a connection or offer advice on TRT.
 
Morning Guys-

I've been having some heart palputations the last couple of weeks so I went to my GP and it appears my BP is now elevated. 180/95 ish.....I've never had HBP nor does it run in my family. I've been reading the threads on this topic but couldn't draw any conclusions although I'm leaning towards my super low E2 from my last labs. I have been off my weekly/.250mg of Estradiol for three weeks. I donated blood on Feb 16th. In short, I've decided to get another set of labs drawn. I've always used discounted labs so please shoot me your suggestions on which tests you recommend.

PS: My libido is still dead and has been since Feb 2015.

As always, thank you! -Travis

PS: My GP knows I'm on TRT.....didn't question anything about it...wrote me a script for BP medication. I'm not having it filled unless I can't get it under control myself. So frustrating that he quickly wrote it up and sent me on my way without even attempting to draw a connection or offer advice on TRT.

I understand your frustration with your primary care doctor's not engaging with you on TRT-related matters, but he may have actually been doing you a favour. It's likely he really doesn't know what to ask, has no idea what to offer, and chose to remain quiet. In a sense, you're fortunate he doesn't break your bones about being on a TRT protocol (as has happened with a lot of guys when their GP decided to challenge their use of testosterone.
 
Beyond Testosterone Book by Nelson Vergel
In addition to total and free testosterone, e2/sensitive, I'd pull prolactin and DHT. That estradiol level almost certainly has to be playing into this in a significant way.
 
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