Latest blood work with a couple of questions

This is the history of my blood test results since I started treating my high E2 and prolactin in May using anastrozole. I've been feeling very much better, with energy, motivation and sex drive. The numbers show a decrease of E2 from 41.5 to 17.0. At this point, I'm going to reduce my dose slightly because 17 is a bit lower than ideal, and I've been feeling a bit of brain fog.

At the same time, my high prolactin has been reduced to the normal range, and my T seems to have increased. I have two questions, and would appreciate any input from those who know better than I do!

1. LabCorp changed their reference range for serum T in July. There are two rows with T values in the table. The first row is the new reference range, the second row is the original range. Question is, can I adjust the new T value of 496 by assuming it would have been higher under the old higher reference range? If this is valid, it looks like it is the equivalent of 650 or so in comparison to the older numbers.
2. My LH and FSH have risen during this treatment. They are now at the high end of the reference range. Why is this happening? Should I be concerned?

Thanks!

K-

keigwin said:

6/14/20177/11/20178/4/2017UnitsRange

	5/17/2017	[TD="width: 68"]	[/TD] [TD="width: 68"]	[/TD] [TD="width: 68"]	[/TD] [TD="width: 64"]	[/TD] [TD="width: 64"]	[/TD]
Testosterone, Serum				[TD="align: right"]496[/TD]	ng/dL	264-916
"	[TD="align: right"]504[/TD]		[TD="align: right"]566[/TD] [TD="align: right"]	[/TD]	ng/dL	348-1197
Free Testosterone (Direct)	[TD="align: right"]12.1[/TD]		[TD="align: right"]13.6[/TD] [TD="align: right"]11.5[/TD]	pg/mL	7.2-24.0
Estradiol	[TD="align: right"]41.5[/TD]		[TD="align: right"]27.0[/TD] [TD="align: right"]17.0[/TD]	pg/mL	7.6-42.6
Prolactin	[TD="align: right"]21.5[/TD] [TD="align: right"]18.9[/TD] [TD="align: right"]16.1[/TD] [TD="align: right"]10.9[/TD]	ng/mL	4.0-15.2
LH	[TD="align: right"]7.0[/TD]			[TD="align: right"]8.2[/TD]	mIU/mL	1.7-8.6
FSH	[TD="align: right"]8.6[/TD]			[TD="align: right"]10.0[/TD]	mIU/mL	1.5-12.4
DHEA-S	[TD="align: right"]181.7[/TD]		[TD="align: right"]143.4[/TD] [TD="align: right"]175.5[/TD]	ug/dL	71.6-375.4
PSA, Serum	[TD="align: right"]0.8[/TD]		[TD="align: right"]0.9[/TD] [TD="align: right"]1.0[/TD]	ng/mL	0.0-4.0

This is the history of my blood test results since I started treating my high E2 and prolactin in May using anastrozole. I've been feeling very much better, with energy, motivation and sex drive. The numbers show a decrease of E2 from 41.5 to 17.0. At this point, I'm going to reduce my dose slightly because 17 is a bit lower than ideal, and I've been feeling a bit of brain fog.

At the same time, my high prolactin has been reduced to the normal range, and my T seems to have increased. I have two questions, and would appreciate any input from those who know better than I do!

1. LabCorp changed their reference range for serum T in July. There are two rows with T values in the table. The first row is the new reference range, the second row is the original range. Question is, can I adjust the new T value of 496 by assuming it would have been higher under the old higher reference range? If this is valid, it looks like it is the equivalent of 650 or so in comparison to the older numbers.
2. My LH and FSH have risen during this treatment. They are now at the high end of the reference range. Why is this happening? Should I be concerned?

Thanks!

K-

Click to expand...

LabCorp arbitrarily lowered their levels - the values that you posted are not impacted by that (foolish) decision. You are measuring estradiol with the incorrect test (ranges are a dead giveaway). The standard test, which you used, is unreliable in men. You should always request the sensitive, LC, MS/MS, test. Your e2 *may* actually be lower than what the standard test reported.

Are you self-directing these efforts, or working with a doctor? A question, not a criticism.

To join my friend CW, testosterone values are what they are, the range doesn't matter, 4967 is 496 and it's not extrapolated to another number.

CoastWatcher said:

LabCorp arbitrarily lowered their levels - the values that you posted are not impacted by that (foolish) decision. You are measuring estradiol with the incorrect test (ranges are a dead giveaway). The standard test, which you used, is unreliable in men. You should always request the sensitive, LC, MS/MS, test. Your e2 *may* actually be lower than what the standard test reported.

Are you self-directing these efforts, or working with a doctor? A question, not a criticism.

Click to expand...

I am self-directing. The background description of my efforts is in the new member section (can't post a link because I'm a new member, sorry). I'd like to think that once I demonstrate this is working for me, my doctor will agree to get on board, but I honestly don't trust his advice above what I already have learned on my own!

On the question of the T values, I'm surprised that my T hasn't gone up. If the anastrozole is blocking conversion of T to E2, that would lead me to expect that there should be more T now. Same for the increase in LH - seems like my T shouldn't be flat.

Good catch on the E2 test, I'd never have known otherwise because this is the test my Dr. used and it's the test that comes as part of the Male Hormone Panel from Life Extension, where I've been buying my tests. Seems like a huge oversight on both of their parts!

LEF hasn't joined the last few years of knowing that that's the wrong testing to be performed for males. And you would think that less aromatase = more testosterone but everyone is different in these regards.

Thanks for the helpful feedback.

Anyone have thoughts on the increase in LH and FSH? Any issues there?

I chalked up the LH/FSH changes are statistically insignificant...those are really small changes.

Vince Carter said:

I chalked up the LH/FSH changes are statistically insignificant...those are really small changes.

Click to expand...

Great to hear. Thanks again!

keigwin said:

I am self-directing. The background description of my efforts is in the new member section (can't post a link because I'm a new member, sorry). I'd like to think that once I demonstrate this is working for me, my doctor will agree to get on board, but I honestly don't trust his advice above what I already have learned on my own!

On the question of the T values, I'm surprised that my T hasn't gone up. If the anastrozole is blocking conversion of T to E2, that would lead me to expect that there should be more T now. Same for the increase in LH - seems like my T shouldn't be flat.

Good catch on the E2 test, I'd never have known otherwise because this is the test my Dr. used and it's the test that comes as part of the Male Hormone Panel from Life Extension, where I've been buying my tests. Seems like a huge oversight on both of their parts!

Click to expand...

You can purchase labs from www.discountedlabs.com. Nelson owns this testing service, many of us use it, and the prices are competitive.

Update with new blood work



You can find my background in my initial post here.

After a (too) long gap I've gotten updated hormone tests. During this six month period, I've continued taking anastrozole 0.225mg E2D and cabergoline 0.125mg E3D. My estradiol seems to have settled in to a reasonable level. My prolactin, however, has continued to drop until it's nearly zero! This might explain why for the past few months I've been feeling unmotivated, low energy, and less sexual arousal.

The surprise for me here is that my test is up significantly. I'm not sure why that would be. At the same time, LH and FSH have gone high. Aren't high levels of these usually tied to low testosterone? I've had people (not doctors) suggest primary hypogonadism in the past, but with rising T what does it mean?

I'd like to lower my cab intake, but I'm already cutting the pills so small I can't get an even dosing. Should I be dissolving it in water like the anastrozole?

Any feedback is appreciated!

ya back off the caber, most guys would otherwise be envious of your numbers. More LH, less E conversion = T is up. Logical.

I'm thinking I'll go to 50% of the current dose. I dose E3D on the caber to match the half-life of the drug, so I'm thinking I'll skip one dose and then start dosing at 50% which should provide a smooth transition. Looks like caber is soluble in alcohol, so I'll try taking it in solution going forward.

Update and question about new lab results

Since March, I've been on half the previous dose of cabergoline, now dosing at 0.0625mg E3D. I lowered my dose because my prolactin had gone nearly to zero. I continue to dose anaztrozole at 0.225mg E2D.

Latest numbers (most recent first):


Prolactin is now back on the scale, not as close to 4ng/mL as I wanted but low enough that my libido is good (sometimes too good). I had orgasm within 12 hours of the blood draw. Could this have given a higher value for prolactin?

Unfortunately, T has dropped - not sure if/how the cab made this happen.

What puzzles me most is the large drop in E2. Anastrozole has been constant, so some other factor must be the cause. I have been eating less and exercising more, and have lost a bit of weight. I'm thinking I now need to keep a closer eye on it. Not sure whether a slight reduction in the AI is in order.

I have also been experiencing occasional mood swings (feel fantastic one day and depressed the next) and some weird obsessive thinking (can't break my mind out of thinking about a particular woman). Plus I've had the sense of too much energy and needing to exercise to burn it off (opposite of normal for me). I guess this is all hormone related, but not sure if I need to change something.

Thanks in advance for any input!

First, I couldn't get anyone to provide feedback on my latest labs. Now my thread with the history of my lab results since last year has gotten trashed by the new forum, which apparently can't handle tables. Very disappointing.