Ended up in ER last month

lukas_az

Member
I had heart racing in the past, mostly when doing cardio like bicycle.
no idea why. look at your diet/potassium/minerals etc....
any other pills you are on? any other things you did recently medically speaking.
I doubt it is TRT TBH.
 

cheters23

Member
I got my labs back finally Defy. I am going to donate blood as soon as I can. I think I am also going to pull back on dosage of Testosterone for a bit as well. Hopefully this will clear out some of these symptoms.

CBC With Differential/Platelet WBC 6.8 x10E3/uL 3.4-10.8
RBC 6.26 High x10E6/uL 4.14-5.80
Hemoglobin 18.4 High g/dL 13.0-17.7
Hematocrit 56.1 High % 37.5-51.0
Testosterone,Free and Total Testosterone, Serum 1324 High ng/dL 264-916
Free Testosterone(Direct) 21.8 High pg/mL 6.8-21.5
Pregnenolone, MS 150 ng/dL
Thyroxine (T4) Free, Direct, S T4,Free(Direct) 1.11 ng/dL 0.82-1.77
DHEA-Sulfate 343.0 ug/dL 102.6-416.3
TSH 1.500 uIU/mL 0.450-4.500 01 Prolactin 13.0 ng/mL 4.0-15.2
Prostate-Specific Ag, Serum Prostate Specific Ag, Serum 1.8 ng/mL 0.0-4.0
Reverse T3, Serum A 21.2 ng/dL 9.2-24.1
Estradiol, Sensitive 32.3 pg/mL 8.0-35.0
Triiodothyronine (T3), Free 3.9 pg/mL 2.0-4.4
Sex Horm Binding Glob, Serum 31.4 nmol/L 16.5-55.9
 

cheters23

Member
Tried to donate blood today and was turned away because my HR wouldn't go below 105 and the cut off is 100 :(. I have to wait to get a script to donate now. How do you find a place locally to do a therapeutic phlebotomy?
 

cheters23

Member
Red Cross turned you away?
Try your PCP.
Im in sacramento, ca and I usually goto vitalant. I talked to my PCP today and he said he won't do that and my trt clinic should be the ones handling that. My PCP is being a total prick and thinks what I am going through is all in my head because all of the test are coming up normal. Hopefully I can get a script from Defy soon. How do I find a place in Sacramento that does therapeutic phlebotomy?
 

madman

Super Moderator
I got my labs back finally Defy. I am going to donate blood as soon as I can. I think I am also going to pull back on dosage of Testosterone for a bit as well. Hopefully this will clear out some of these symptoms.

CBC With Differential/Platelet WBC 6.8 x10E3/uL 3.4-10.8
RBC 6.26 High x10E6/uL 4.14-5.80
Hemoglobin 18.4 High g/dL 13.0-17.7
Hematocrit 56.1 High % 37.5-51.0
Testosterone,Free and Total Testosterone, Serum 1324 High ng/dL 264-916
Free Testosterone(Direct) 21.8 High pg/mL 6.8-21.5
Pregnenolone, MS 150 ng/dL
Thyroxine (T4) Free, Direct, S T4,Free(Direct) 1.11 ng/dL 0.82-1.77
DHEA-Sulfate 343.0 ug/dL 102.6-416.3
TSH 1.500 uIU/mL 0.450-4.500 01 Prolactin 13.0 ng/mL 4.0-15.2
Prostate-Specific Ag, Serum Prostate Specific Ag, Serum 1.8 ng/mL 0.0-4.0
Reverse T3, Serum A 21.2 ng/dL 9.2-24.1
Estradiol, Sensitive 32.3 pg/mL 8.0-35.0
Triiodothyronine (T3), Free 3.9 pg/mL 2.0-4.4
Sex Horm Binding Glob, Serum 31.4 nmol/L 16.5-55.9

I think I am also going to pull back on dosage of Testosterone for a bit as well.

A bit?

What then to end up back at square one.

Looking over your labs it is clear as day that running a TT 1324 ng/dL with an SHBG of only 31.4 nmol/L would have your FT through the roof and these are most likely your trough levels so peak TT/FT/e2 levels would be much higher.

Top it off that although your FT is flagged as high you had it tested using the piss poor direct immunoassay which is known to be inaccurate.

You have been on the forum long enough to know that FT needs to be tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration to know where it truly sits.

Why you would waste your time let alone use/rely upon the direct immunoassay is beyond me.

If you would have tested your FT using such then you would clearly see how absurdly high your FT would be with a TT 1324 ng/dL (most likely trough) and SHBG of 31.4 nmol/L.

You are battling high RBCs/hemoglobin/hematocrit due to running absurdly high FT levels!

What is your protocol (dose T/injection frequency)?




Take a close look at how high FT can be with a TT 1300s and yes with an SHBG of almost 50 nmol/L.....who knew!

 

Fortunate

Member
Im in sacramento, ca and I usually goto vitalant. I talked to my PCP today and he said he won't do that and my trt clinic should be the ones handling that. My PCP is being a total prick and thinks what I am going through is all in my head because all of the test are coming up normal. Hopefully I can get a script from Defy soon. How do I find a place in Sacramento that does therapeutic phlebotomy?
Sorry about the quick reply above, I was on a phone, in a hurry. You could go about this a few ways. You might start by calling Defy and asking them if they have a referral for you in your area. If they do not have a recommendation, you can use good old Google to find a TRT clinic in your area. You will probably have to become a patient, but it may not be a bad idea to have a local physician (for situations like this, for example).

While I think word of mouth is better than blind internet searches, you can try finding a local doc through this organization.
 

readalot

Active Member
Im in sacramento, ca and I usually goto vitalant. I talked to my PCP today and he said he won't do that and my trt clinic should be the ones handling that. My PCP is being a total prick and thinks what I am going through is all in my head because all of the test are coming up normal. Hopefully I can get a script from Defy soon. How do I find a place in Sacramento that does therapeutic phlebotomy?


1620998422904.png



Probably not the cheapest option but could you get the Rx from Defy and call these folks in your area? Please drop your T dosage and get that Hct down.

Another option for research purposes (perhaps these folks will have more relaxed requirements?) and you don't need a Rx order:
 
Last edited:

cheters23

Member
I think I am also going to pull back on dosage of Testosterone for a bit as well.

A bit?

What then to end up back at square one.

Looking over your labs it is clear as day that running a TT 1324 ng/dL with an SHBG of only 31.4 nmol/L would have your FT through the roof and these are most likely your trough levels so peak TT/FT/e2 levels would be much higher.

Top it off that although your FT is flagged as high you had it tested using the piss poor direct immunoassay which is known to be inaccurate.

You have been on the forum long enough to know that FT needs to be tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration to know where it truly sits.

Why you would waste your time let alone use/rely upon the direct immunoassay is beyond me.

If you would have tested your FT using such then you would clearly see how absurdly high your FT would be with a TT 1324 ng/dL (most likely trough) and SHBG of 31.4 nmol/L.

You are battling high RBCs/hemoglobin/hematocrit due to running absurdly high FT levels!

What is your protocol (dose T/injection frequency)?




Take a close look at how high FT can be with a TT 1300s and yes with an SHBG of almost 50 nmol/L.....who knew!

I am running 26 mg Test Cyp every other day and 210 IU/HCG
I was running 26 mg of Deca every other day to help with shoulder pain, but I stopped taking that a couple weeks ago.
I came tired to come off of TRT for a bit in Janurary using Defys protocol. I did my labs on last day i took clomid and these were my numbers.

March 8, 2021 (Last pill of clomid)
CBC With Differential/Platelet WBC 6.1 x10E3/uL 3.4-10.8
RBC 5.76 x10E6/uL 4.14-5.80
Hemoglobin 17.0 g/dL 13.0-17.7
Hematocrit 50.0 % 37.5-51.0
MCV 87 fL 79-97 01 MCH 29.5 pg 26.6-33.0
MCHC 34.0 g/dL 31.5-35.7
RDW 12.9 % 11.6-15.4
Platelets 248 x10E3/uL 150-450
Neutrophils 55 % Not Estab.
Lymphs 32 % Not Estab.
Monocytes 10 % Not Estab.
Eos 2 % Not Estab.
Basos 1 % Not Estab.
Neutrophils (Absolute) 3.4 x10E3/uL 1.4-7.0
Lymphs (Absolute) 1.9 x10E3/uL 0.7-3.1
Monocytes(Absolute) 0.6 x10E3/uL 0.1-0.9
Eos (Absolute) 0.1 x10E3/uL 0.0-0.4
Baso (Absolute) 0.1 x10E3/uL 0.0-0.2
Immature Granulocytes 0 % Not Estab.
Immature Grans (Abs) 0.0 x10E3/uL 0.0-0.1 01
Glucose 90 mg/dL 65-99
BUN 12 mg/dL 6-24
Creatinine 1.03 mg/dL 0.76-1.27
eGFR If NonAfricn Am 90 mL/min/1.73 >59
eGFR If Africn Am 105 mL/min/1.73 >59
BUN/Creatinine Ratio 12 9-20
Sodium 139 mmol/L 134-144
Potassium 4.3 mmol/L 3.5-5.2
Chloride 103 mmol/L 96-106
Carbon Dioxide, Total 26 mmol/L 20-29
Calcium 9.6 mg/dL 8.7-10.2
Protein, Total 6.9 g/dL 6.0-8.5
Albumin 4.4 g/dL 4.0-5.0
Globulin, Total 2.5 g/dL 1.5-4.5
A/G Ratio 1.8 1.2-2.2
Bilirubin, Total 0.7 mg/dL 0.0-1.2
Alkaline Phosphatase 94 IU/L 39-117
AST (SGOT) 17 IU/L 0-40 01 ALT (SGPT) 23 IU/L 0-44
Testosterone,Free and Total Testosterone, Serum 503 ng/dL 264-916
Free Testosterone(Direct) 13.4 pg/mL 6.8-21.5
LH 6.3 mIU/mL 1.7-8.6
Estradiol, Sensitive 25.5 pg/mL 8.0-35.0
Ferritin, Serum 148 ng/mL 30-400

The numbers on paper looked decent on paper, but I felt like shit and knew those numbers would go down because they were artificially raised because of clomid. I went 2 weeks after and notice no change and was feeling like garbage and super depressed feelings and decided to go back on my Test/Deca/HCG mix, which I would do all the time in the past. I would only run the deca 1-2 month period to help lubercate my shoulder joint and wrist joint then I would come off of it until I felt my joints start to ache again then Deca again for a bit. I am prescribed these meds and done it plenty of times in the past. I didn't donate any blood at this point because everything looked good on paper.

Right now I just need to focus on getting blood out and see if symptoms resolve.

Cardiologist has me on Diltiazem to help with BP and heart rate. Last visit the nurse said my holter monitor report did say I had 3 different SVT episodes that lasted a short period of time. I have a treadmill stress test on June 4th.
 
Last edited:

madman

Super Moderator
I am running 26 mg Test Cyp every other day and 210 IU/HCG
I was running 26 mg of Deca every other day to help with shoulder pain, but I stopped taking that a couple weeks ago.
I came tired to come off of TRT for a bit in Janurary using Defys protocol. I did my labs on last day i took clomid and these were my numbers.

March 8, 2021 (Last pill of clomid)
CBC With Differential/Platelet WBC 6.1 x10E3/uL 3.4-10.8
RBC 5.76 x10E6/uL 4.14-5.80
Hemoglobin 17.0 g/dL 13.0-17.7
Hematocrit 50.0 % 37.5-51.0
MCV 87 fL 79-97 01 MCH 29.5 pg 26.6-33.0
MCHC 34.0 g/dL 31.5-35.7
RDW 12.9 % 11.6-15.4
Platelets 248 x10E3/uL 150-450
Neutrophils 55 % Not Estab.
Lymphs 32 % Not Estab.
Monocytes 10 % Not Estab.
Eos 2 % Not Estab.
Basos 1 % Not Estab.
Neutrophils (Absolute) 3.4 x10E3/uL 1.4-7.0
Lymphs (Absolute) 1.9 x10E3/uL 0.7-3.1
Monocytes(Absolute) 0.6 x10E3/uL 0.1-0.9
Eos (Absolute) 0.1 x10E3/uL 0.0-0.4
Baso (Absolute) 0.1 x10E3/uL 0.0-0.2
Immature Granulocytes 0 % Not Estab.
Immature Grans (Abs) 0.0 x10E3/uL 0.0-0.1 01
Glucose 90 mg/dL 65-99
BUN 12 mg/dL 6-24
Creatinine 1.03 mg/dL 0.76-1.27
eGFR If NonAfricn Am 90 mL/min/1.73 >59
eGFR If Africn Am 105 mL/min/1.73 >59
BUN/Creatinine Ratio 12 9-20
Sodium 139 mmol/L 134-144
Potassium 4.3 mmol/L 3.5-5.2
Chloride 103 mmol/L 96-106
Carbon Dioxide, Total 26 mmol/L 20-29
Calcium 9.6 mg/dL 8.7-10.2
Protein, Total 6.9 g/dL 6.0-8.5
Albumin 4.4 g/dL 4.0-5.0
Globulin, Total 2.5 g/dL 1.5-4.5
A/G Ratio 1.8 1.2-2.2
Bilirubin, Total 0.7 mg/dL 0.0-1.2
Alkaline Phosphatase 94 IU/L 39-117
AST (SGOT) 17 IU/L 0-40 01 ALT (SGPT) 23 IU/L 0-44
Testosterone,Free and Total Testosterone, Serum 503 ng/dL 264-916
Free Testosterone(Direct) 13.4 pg/mL 6.8-21.5
LH 6.3 mIU/mL 1.7-8.6
Estradiol, Sensitive 25.5 pg/mL 8.0-35.0
Ferritin, Serum 148 ng/mL 30-400

The numbers on paper looked decent on paper, but I felt like shit and knew those numbers would go down because they were artificially raised because of clomid. I went 2 weeks after and notice no change and was feeling like garbage and super depressed feelings and decided to go back on my Test/Deca/HCG mix, which I would do all the time in the past. I would only run the deca 1-2 month period to help lubercate my shoulder joint and wrist joint then I would come off of it until I felt my joints start to ache again then Deca again for a bit. I am prescribed these meds and done it plenty of times in the past. I didn't donate any blood at this point because everything looked good on paper.

Right now I just need to focus on getting blood out and see if symptoms resolve.

Cardiologist has me on Diltiazem to help with BP and heart rate. Last visit the nurse said my holter monitor report did say I had 3 different SVT episodes that lasted a short period of time. I have a treadmill stress test on June 4th.

Definitely need to look into bringing down your trough FT let alone using an accurate assay (gold standard Equilibrium Dialysis or Ultrafiltration) when testing.

Again running a trough TT 1300s with an SHBG 30s is going to have your trough FT through the roof.

Looking over some of your previous threads on here seems clear that you are being overmedicated when it comes to T as at one time you were hitting an absurdly high trough TT 1500 ng/dL which would have had your trough FT insanely high.

To top it off that although your FT was flagged as (highish/high) on both sets of labs, unfortunately, it was tested using the piss poor direct immunoassay which is known to be inaccurate and I would put money on it that your FT is much higher than you think!

The only way to truly know such is to have it tested using accurate assays (ED or UF).

Running too high FT is going to have a significant impact on driving up your RBCs/hemoglobin/hematocrit let alone estradiol which you were well aware of as you needed to control with the use of an AI.




40mg Test cyp 3x/week
250 IU HCG 3x/week
.125 Anastrozole 2x/week
15 mcg/ Cytomel everyday
DHEA 25 mg one BY MOUTH EVEY NIGHT
Vitamin D 5000IU EVERY DAY
Selenium 250mcg EVERY DAY
Fish Oil 2grams EVERY DAY

I was not taking the Anastrozole until after my 12/10/18 Labs, so that is really the only thing that has changed. Here are my last 2 sets of labs. Can anyone think of any reason why I am getting these tired spells pretty much everyday for the past couple of months?

3/27/19 Labs(Taking Anastrozole and Cytomel since the last labs)

Testosterone, Serum 859 ng/dL
264-916
Free Testosterone(Direct) 23.4 pg/mL 8.7-25.1
DHEA-Sulfate 521.1 H ug/dL 102.6-416.3
TSH 2.760 uIU/mL 0.450-4.500
Triiodothyronine (T3), Free 3.6 pg/mL 2.0-4.4
Vitamin D, 25-Hydroxy 56.7 ng/mL 30.0-100.0
Estradiol, Sensitive 22.8 pg/mL 8.0-35.0
Sex Horm Binding Glob, Serum 32.9 nmol/L 16.5-55.9

12/10/18 Labs(Was not taking Anastrozole or Cytomel)

Testosterone, Serum 1494 ng/dL
264-916
Free Testosterone(Direct) 29.8 pg/mL 8.7-25.1
DHEA-Sulfate 425.0 ug/dL 102.6-416.3
TSH 3.020 uIU/mL 0.450-4.500
T4,Free(Direct) 1.02 ng/dL 0.82-1.77
Triiodothyronine (T3), Free 2.8 pg/mL 2.0-4.4
Reverse T3, Serum 20.3 ng/dL 9.2 - 24.1
Estradiol, Sensitive 52.3 H pg/mL 8.0-35.0
Sex Horm Binding Glob, Serum 42.4 nmol/L 16.5-55.9
Ferritin, Serum 50 ng/mL 30-400
 

cheters23

Member
Ok, Finally got my therapeutic phlebotomy done today 5/18/2021. He wants me to test my CBC & Diff in 2 weeks to see where my levels are. Hopefully this will help resolve some of my symptoms. How long does it usually to take after the phlebotomy for the symptoms to go away if it was the blood causing it?
 
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cheters23

Member
My endo ordered a 24 hour urine for cortisol and 5-HIAA. The cortisol results are back and still waiting for 5-HIAA to come back. I have a zoom meeting with her on Monday. What should I make of these results?
 

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Fortunate

Member
Need to find out why cortisol is high. Endocrinologist will be helpful for that. Your creatinine is high. This reflects kidney function. If you are taking a lot of NSAID’s or creatine, you can insult the kidneys enough to cause damage. Lots of other things can insult the kidneys, but common things are common. It could also mean you were a little dehydrated when you got your blood drawn.
 

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