High: Lipids, CO2, PH, E, creatine kinase, hct, low:Vit D and more!

[nodoctor]

First of all--thanks for the amazing and science/data driven advice I've received from you guys!

I totally agree with treating symptoms not labs, but I've got some results that I think warrant action.

Latest labs attached. Any help or questions much appreciated!

General background: strict vegetarian, on b12. no caffeine/alcohol in 8 years. moderate stress, bp 122/75 consistently. Daily meditation/relaxation exercises and stretching. 45 years, caucasian. Work out 7+ days/wk--typically 5-6 weights and maybe another 3-5 cardio.
On TRT for 10 years pretty successfully
100mg/wk cypionate
500ius hcg for 8 weeks on, 8 off
experimented with some peptides: ipamorelin, cjc w/o dac (mod grf), bpc157, bt500, mainly.
semaglutide and cardarine but after labs
planning to run a little deca, clen--but maybe not given lipid profile)
No family history of heart issues, but cholesterol often high.
Bodyfat around 12%.
Melanotan 2 at the moment as well (but started post-labs)

Biggest issues:

1. Lipids not ideal:
LDL of 124 (midrange=100-130) I've been as high as 214, but this is high
HDL 55 (mid=40-60) lower than I want
Apo B 111 mid=80-120
Peak LDL size: (mid=218-222) 218.7 low
LDL Particles 2040 - (high=1538)
Medium LDL 556 - high=271

Solution: I'm going to see if I can get an MRI and plaque score to assess arterial plaque and heart health. My new GP who is fairly clueless and overly confident said a stress-test ekg is better. No idea if he's right yet. He was willing to refer to a cardiologist though.

2. Estrogen: 48. high=39 maybe a bit more emotional than when it's lower but no huge symptoms.
Solution: Maybe I'll do like 1/8th arimidex once every week or two. I'm super sensitive to AIs.


A little surprised discountlabs didn't include fsh/lh but maybe I did something wrong with the order?

Free Testosterone: 164.5 and feeling about right
Total T: 763

3. CO2 31: (top of range 30). Never really heard of this...but my urine was like 9 ph so it makes sense. Anyone have experience with this? I know vegan diets can be highly alkalizing and the body puts lots of bicarbonate in the blood to balance that high ph. I've always been 24-30 on the high end (30 is top of range) so maybe not a huge issue. Maybe clen will help as a bronchodilator.
Urine: Cloudy. PH off charts high (9+)
Interestingly, my kidney markers are all fine: creatine, egfr, bun, albumin, etc. I had a parasite called blastocystis hominis that I think I picked up in Asia many years ago. I've read that high urine ph could be a parasite signal (debatable and can't find a very credible source), so I'm thinking of getting a stool sample test to check. Or else maybe I'm over-thinking this one.

Solution: No idea. I had some kidney stones but it wasn't a big deal and I think that's more for acidity. I definitely don't have a UTI.

4. Creatine Kinase: 285 (top of range 196) I supplement creatine at least a few times/wk so maybe this is that? I workout a decent amount and I know post workout this number can go up.
Solution: Maybe nothing for now--pretty elevated though.

5. Hematocrit: 48.3 (high=51) but I'd still like it a little lower--particularly given the lipids, so I'll donate unless someone sees a reason not to. Go to 45 or so.
Solution: I'll be donating blood again right away.

6. 25-Hydroxy Vitamin D: 24 (low=30) struggled with this pretty consistently. I will start supplementing immediately and realize it has effects on T and other important factors. Supplement.
adding vitamin D supplements 5k iu daily

The rest of my values are very in line and generally around middle of normal. I track trends on wellnessfx.com (but planning to check out nelson's graphing/tracking app as well.

will get labs done again in 6 months to check the efficacy of these steps

Please let me know if I left anything important out?

 

[Systemlord]

25-Hydroxy Vitamin D: 24 (low=30) struggled with this pretty consistently. I will start supplementing immediately and realize it has effects on T and other important factors. Supplement.

Vitamin D has a profound effect on muscle tissue! I'm on TRT and over time I noticed my muscles were getting soft and I was getting weak like my knees wanted to buckle without any change in my testosterone panels.

The moment I started vitamin D due to a levels of 15, the muscle started getting harder and stronger within a couple of weeks. Vitamin D is important for just about everything, physique, neuroprotective, regulates immune function and helps with calcium balance.

Vitamin D actually isn't a vitamin, it's a hormone.

Hematocrit: 48.3 (high=51) but I'd still like it a little lower--particularly given the lipids, so I'll donate unless someone sees a reason not to. Go to 45 or so.

Seriously, your HCT is fine, it's one of the benefits on TRT and carries more oxygen to your bodies tissues. Donating because of a 48% HCT is completely unnecessary.

 

[nodoctor]

Thank you! Do you happen to know your before and after of your Vit D? I'll definitely update once I've got some time with the supplementation!

I do agree with you about HCT, but my thought was with super high lipids, and the high hct correlation with Myocardial infarction, it wouldn't hurt to get closer to 45 or so.

 

[Systemlord]

Do you happen to know your before and after of your Vit D?

I'm actually experiencing vitamin D toxicity at the moment, started taking 8000 iu D3 and worked my way up to 14,000 and get stuck in a trap of increasing the dosage to treat what I now know was excessive supplementation.

Vitamin D toxicity = excessive urination, dehydration and kidney/back pain.

I have diabetes and need a little more of everything, except for vitamin C and vitamin D which I'm very sensitive.

I was diagnosed with a vitamin D deficiency of 15, a month later 38, and 2 months later 68. After that is when bad stuff started happening.

Are you adjusting your vitamin D intake to account for the Fall/Winter months of limited sunlight exposure?

I went to urgent care today with all too familiar symptoms, they had been creeping up on me gradually over the last couple of weeks. Revisit 2019 and I had multiple deficiencies, vitamin D being on of them. A vitamin D deficiency is devastating for anyone with diabetes as it makes managing...

www.excelmale.com

 

[Systemlord]

I do agree with you about HCT, but my thought was with super high lipids, and the high hct correlation with Myocardial infarction, it wouldn't hurt to get closer to 45 or so.

I run 50-57 HCT on Jatenzo, I believe it's because twice daily my Total T levels shoot up from 298->980 in 2-hours, then decline over 12-hours, then it begins again at 8 p.m.

I have left ventricular dysfunction and am on a beta-blocker. I notice my heart beats a little more strongly when reaching 57%, BP still in range though, barely.

If anyone's HCT is high, it's mine. BP is normally 110/66, 76 bpm.

The guidelines for HCT for someone on TRT is <55%, some doctors prefer it <52%.

I require frequent phlebotomies which is reducing my ferritin levels even with aggressive iron supplementation.

 

[nodoctor]

Thanks. I'll look at my iron carefully, titrate up vit d slowly (it sort of has that reputation of a vitamin that you can just pop a ton of, so I appreciate the guidance), and I'll maybe still donate for the people that need it instead of my hct.