TP and Blood Test Timing

Formula364 · Sep 5, 2017

I understand blood tests are done at trough, not peak.
I take T on Tues and Fri (hCG Mon & Thurs), so blood tests are normally early Friday before shot.

This week, I have a TP (therapeutic phlebotomy) scheduled for Wed morning. Hemo is 16.9 and Hemat is 51.2. Wed seems to fit my schedule well for TP.

Will the TP greatly effect the FT, TT, and E2 tests if I schedule for Friday AM? OR should I wait until next week Tues AM or Fri AM for the blood test? I'm wondering if serum levels are greatly effected by a recent TP.

Thanks

Vince Carter · Sep 5, 2017

I cant say why in a concise manner but I wouldn't do a TP and a blood draw for labs in the same week, seems like not the thing to do. I'd split em up by two weeks, do the TP and then in two weeks your labs with a CBC...2 weeks after the phlebotomy should give a good picture on how your HCT/HGB have been effected.

Formula364 · Sep 5, 2017

Formula364 said:
Will the TP greatly effect the FT, TT, and E2 tests if I schedule for Friday AM? OR should I wait until next week Tues AM or Fri AM for the blood test? I'm wondering if serum levels are greatly effected by a recent TP.

Thanks

CBC is usually 4 weeks post.
My inquiry was pertaining to TT, FT, and E2 as mentioned.

ratbag · Sep 5, 2017

Also be sure you don't have low ferritin because a blood donation will bring it much lower and if your ferritin is already low the resulting symptoms will be low iron and hypothyroidism. Not many speak of this but it's something you really need to know before you plan on a donation.

Formula364 · Sep 5, 2017

Thanks, ratbag,
I am aware.
My RBC is finally coming down after a year. Steady downward progress, but I still need a bit more progress.

My T dosage was adjusted upwards approximately 6 weeks ago without Anastrozole adjustment. I want my E2 back under control, so I need good TT, FT, and E2 numbers to go by. In a perfect world, we don't have multiple concerns like TP near blood test.

Vince · Sep 5, 2017

I think it's easier to inject both T and HCG on the same day and time. Also that way it's easier to do labs

Vince Carter · Sep 5, 2017

Formula364 said:
CBC is usually 4 weeks post.
My inquiry was pertaining to TT, FT, and E2 as mentioned.

And it was answered if you didn't notice. Dr Saya tells me two weeks for CBC post donation so your source for 4 weeks is suspect.

Formula364 · Sep 5, 2017

Sorry Vince Carter:
I didn't see specificity in your response - labs and hct/hgb so I conflated the two and saw no reference to TT, FT, and E2. Internet isn't always easy to communicate.
Nurse Jill schedules my CBC panels after TP's. She might be suspect.
Two weeks would help as it allows more time for other testing and less conflicts such as this.

Vince:
Dr. Crisler wrote my protocol just before leaving Defy. I'll question the reasoning on my next consult. Thanks

Formula364 · Sep 6, 2017

Sent Defy an e-mail, and they called me back.
TP has no bearing on hormone panel, so I ordered the tests. I'm waiting to see how soon I can get scheduled.
CBC can be done after 2 weeks of TP, so I have some room to juggle different tests.

Vince Carter · Sep 6, 2017

Formula364 said:
Sent Defy an e-mail, and they called me back.
TP has no bearing on hormone panel, so I ordered the tests. I'm waiting to see how soon I can get scheduled.
CBC can be done after 2 weeks of TP, so I have some room to juggle different tests.

Good deal...we know all these practitioners seem to say one thing one day or something different when asked at different times about tests. Opinions vary, a lot.

Formula364 · Sep 19, 2017

Got the test back (FT, TT, E2, and Ferritin).
Ferritin was low: 25 (30-400). But this was two days after TP.

Back in June, I had TT 739, FT 19.4, E2 18.4, SHBG 37.9. T dose was increased from 140 mg/week to 180 mg/week w/no AI increase.
Now, TT 749, FT 22.9, E2 26.5.

I don't know what's happening to all the T increase? 40 mg/week increase and a TT increase of only 10?

When I first started (9/16), I was at 160 mg/week, no AI, and had TT 1157, FT 34.6, and E2 87.3. So I have had higher numbers before.

Vince · Sep 19, 2017

My question is, which protocol did you feel the best. I am surprised that your latest protocol did not raise your testosterone more.

Formula364 · Sep 19, 2017

Good question, I don't feel dialed-in after a year!
Before TRT, I was TT 230, FT 5.98, and E2 11.8. Then I rocketed up to those 160 mg/week numbers, but have been chasing numbers ever since. Depression has lifted, libido up some, erection quality is down, and fatigue has been a consistent problem. Body comp is starting to come around finally, as I've lost 15 lbs. since 6/1. HCT is slowly coming under control. VLDL Chol Calc is 16, with T Chol/HDL ratio of 4.
I'm 56 yrs old, and workout 4-5 days/week for 45 minute sessions (one bodypart/week). Twice/week, I'll do low intensity cardio for 30 minutes after workout.
So I was at 1150 @ 160 mg (11/16), then 739 @ 140 mg (6/17), now 749 @ 180 mg (9/17). This Defies explanation (pun). Hoping to get some ideas before I schedule a consult.

Vince · Sep 20, 2017

How did you feel at this level. I think it's best to avoid AI. Even at higher levels of estradiol.

When I first started (9/16), I was at 160 mg/week, no AI, and had TT 1157, FT 34.6, and E2 87.3. So I have had higher numbers before.

Formula364 · Sep 20, 2017

I felt bloated and emotional. Very glad to have the E2 down.
In fact, the June numbers with E2 at 18.4, felt ok. I did feel the drop in T and less aggression and workout intensity. But as for E2 that low, I liked it and was leaning out.

I might consider lowering T to 100 mg/week with no AI. I mean, low 700's for TRT seems like too much inconvenience for those numbers. Money is tight, and experimenting around means more blood tests, more consults, and more blood tests = $$.

June's SHBG (28-32 range) was 37.9 - slightly high, but not enough to count for all the T dosage.
Since fatigue has been a problem, it must be metabolic in nature.

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