First Bloodwork Post

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Parajack

New Member
61 yr old male. 6'3", Lean, 185-190. Plant strong diet. Regular exercise. Plenty of stress. Got quite sickly 6-7 years ago. First blood work showed seriously low T levels. Got on HRT without knowing shit about anything with a doctor that was just as ignorant. Obviously should have got healthy FIRST. Anyway it is was it is. Tried different things. Last 3 years been .2 mil Tcyp E3D injected SQ around the BB with small insulin needle. On and off 1/4-1/3 mg Anastrozole E3D can't tell any difference one way or the other.

Facing some major life decisions need to figure stuff out and decide if feeling like shit half the time is the end game or if there are things within my control. Been really bad about keeping after the TRT with testing and monitoring. Here I am finally. First blood work in 3 years. Also working with a good Thyroid doc who says this is a good resource...

Please let me know which labs I'm missing/need to add here so that you can better help me.

Thanks very much for helping me figure things out.
 

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Systemlord

Member
You have a lot of important labs missing, SHBG would tell us how well you hold onto your testosterone and help in designing a protocol tailored to you, no estrogen testing either. Estrogen levels will largely determine how you feel while on TRT. Most doctors are oblivious when it comes to male hormones and monitoring estrogen,

Your thyroid is a complete mess and is missing a lot of important tests, most doctors will struggle with proper thyroid treatment and testing, I don't see any tests for antibodies. If your immune system is attacking the thyroid antibodies will be high, no Reverse T3 tested either an if high can block fT3 slowing down every cell in your body making you feel weak and terrible even if fT3 levels are good.

You most certainly have a thyroid issue and as long as you do TRT won't really do anything for your as every cell in your body is slowed down, TRT attempts to rate metabolic rates and it cannot because the thyroid is holding everything up. TSH increases when your pituitary detects a problem, this is why TSH is near the top of the ranges, it's screaming at the thyroid to produce thyroid hormones.

If you believe you can learn this and teach you current doctor how to do TRT, forget it. You need a knowledgeable hormone doctor to be able to look at you labs and determine the next steps.
 

DragonBits

Well-Known Member
You have a lot of important labs missing, SHBG would tell us how well you hold onto your testosterone and help in designing a protocol tailored to you, no estrogen testing either. Estrogen levels will largely determine how you feel while on TRT. Most doctors are oblivious when it comes to male hormones and monitoring estrogen,

Your thyroid is a complete mess and is missing a lot of important tests, most doctors will struggle with proper thyroid treatment and testing, I don't see any tests for antibodies. If your immune system is attacking the thyroid antibodies will be high, no Reverse T3 tested either an if high can block fT3 slowing down every cell in your body making you feel weak and terrible even if fT3 levels are good.

You most certainly have a thyroid issue and as long as you do TRT won't really do anything for your as every cell in your body is slowed down, TRT attempts to rate metabolic rates and it cannot because the thyroid is holding everything up. TSH increases when your pituitary detects a problem, this is why TSH is near the top of the ranges, it's screaming at the thyroid to produce thyroid hormones.

If you believe you can learn this and teach you current doctor how to do TRT, forget it. You need a knowledgeable hormone doctor to be able to look at you labs and determine the next steps.

Fyi he did have estradiol sensitive which was 44.9 on a 8-35 scale and was hand written in and reverse T3 was further down in the report. reverse T3 at 14.6 ng/dl was in the middle of the range. I can see his TSH while in range was in the upper part of the range, don't really know what that means. His higher than normal estradiol stands out the most.
 

Parajack

New Member
Thanks for the reply. I believe the guy I'm working with is plenty open and smart enough to help work through this. So let's not discount him out of the gate. He knows how important this is to me and wants to help me work through it.

Could you please take a moment and give me a list of the tests you'd like to see added and I'll get those done early next week. Also, you said no estrogen testing..... Did you not see the E2 result or were you looking for something additional?

thanks

Jack
 

Parajack

New Member
thanks. Other than the SHBG, what other tests should I get so that we have good information to move forward?

Thanks again,

Jack
 

Vettester Chris

Super Moderator
Your Free T3 is at 67% of reference range
Your Free T4 is at 51%. Free T3/RT3 ratio is 24.65
Your FT3/RT3 ratio is 24.6

You said you're working with a good thyroid doctor ... Does this mean you are taking thyroid medications? If these are stand alone labs without medication, they are not bad (we'll get to the TSH), whereas it's good seeing both FT4 and FT3 somewhere in the 50% to 80% zone of the reference range, and the FT3/RT3 ratio sitting above 20, which is usually a good indicator that T3 is not pooling ... (again, all bets are off if you state you're taking Cytomel and/or even some form of NDT??)

Again, if these are stand alone labs without any medicinal treatment, the actual thyroid hormone levels are somewhat decent. Optimally, it would be good to see both FT4 and FT3 relatively close in respective reference range, e.g., FT4 at 59%, FT3 at 61%, etc., and of course TSH much lower, maybe somewhere in the 1.0 -2.25 range.

Dr. Bruce Rind is one of my mentors early on, and he would no doubt probably look at this as some form of potential nutrient deficiency, maybe mitochondria complications and/or infection. Me personally, I lean for more of a simplistic possibility for a subclinical consideration. Yeah, definitely want to to see antibodies (TPO & TgAb), but I think protein or enzyme attacks would paint a different picture with these results, and I would guess that T4 would be converting at higher rates of Reverse T3.

How is your body temperature? It might be helpful to take it throughout the day 3x every 3 hours or so, keep a log, we can get the average. Honestly, I was once dealing with subclinical TSH; having TSH up over 5 at one point. Kid you not, iodine w/kelp and selenium took that down several points by itself, nothing else administered. So many of us (like vitamin D3) are highly deficient. Iodine with Kelp is a game changer in my book!!

Other areas that will help get this part of the picture a bit more optimal ... Look into some good elemental iron to help get that iron serum up in the 130's to 150's, and aiming to get the ferritin 100'sh, 110'sh IMO is adequate. That can and will affect FT3 getting transported to the cells in the the body; promoting metabolism, ATP, energy and wellness. Vitamin D3 (yours could stand to go up 30 points IMO), get some adequate amounts of vitamin C to support iron intake, and browse through our forums to to get more information on supplements and experiences that can help your personal program.
 

Parajack

New Member
Thanks that's very helpful. My doc is a Hashimoto's specialist, herbalist, acupuncturist, and is focused on the functional medicine approach to wellness. I'm in a 6 month treatment program with him working on all fronts. This could/should be an excellent resource for both of us.

Anyway, no, I'm not on any thyroid medication. This last winter viral chest infection really took me down hard, just a small step from being hospitalized. Scary stuff. All the time off work got me reading a bunch, and I've been supplementing with Iodine (only a 2% solution and not much) for some months now, along with selenium and other cofactors.

The lowish D3 number was after supplementing with 20,000 iu daily for months. I'm now paying attention to the Vit C, Magneisum, and NAC as well, so that I can hopefully get that # up. What's the general consensus in this forum for D3 - 70-100?

I'll get a thermometer and get going on a temp log, and I'll talk to my doc about the iron and the best way to address that.

Nobody has mentioned the Testosterone panel. I don't believe I've ever had anywhere near a total number that high, and don't think I've ever had an E2 number that high as well. When I saw the high E2 I immediately started back on the Anastrozole, even though I can't seem to tell the difference one way or the other... Thoughts? Should I lower my E3D dosage?

So next blood work:

SHGB
TPO
TgAb

Thanks so much,

Jack
 

Parajack

New Member
I was hoping to have this be a productive thread and get some real answers moving forward trying to figure stuff out.

I'd like to do follow up blood work to fill in the missing blanks from the first round, and check the E2 again now that I've started back on the anastrozole.

Nobody commented on the high E2 result. Here are the basic numbers again:

LabCorp Total T 895.5. (264-916)
Free (Direct) 13.7 (6.6-18.1)
Estradiol (sensitive) 44.9 (8-35)

What would be the recommended Anastrozole dosage to deal with this? Go with 1/4mg E3D or go with a 1/2mg E3D and then retest?

Also, I don't believe my total and free numbers have ever been this high (I'm 61) since starting TRT several years ago..

Also, is my original attached blood work which I started the thread with still available for people to see? I can't seem to see or access it....
 

CoastWatcher

Moderator
I was hoping to have this be a productive thread and get some real answers moving forward trying to figure stuff out.

I'd like to do follow up blood work to fill in the missing blanks from the first round, and check the E2 again now that I've started back on the anastrozole.

Nobody commented on the high E2 result. Here are the basic numbers again:

LabCorp Total T 895.5. (264-916)
Free (Direct) 13.7 (6.6-18.1)
Estradiol (sensitive) 44.9 (8-35)

What would be the recommended Anastrozole dosage to deal with this? Go with 1/4mg E3D or go with a 1/2mg E3D and then retest?

Also, I don't believe my total and free numbers have ever been this high (I'm 61) since starting TRT several years ago..

Also, is my original attached blood work which I started the thread with still available for people to see? I can't seem to see or access it....

What symptoms are you dealing with that you attribute to the elevated e2 value? In and of itself, that isn't a terribly high result. In the absence of subjective issues, I would watch and wait. Lowering estradiol is always a risky undertaking, even when it's necessary, and I wonder if it is here.
 

Parajack

New Member
Thank You Yes it's the monster challenge of trying to figure stuff out in the face of overwhelming subjective possibilities on multiple fronts. That's clearly what I'm faced with. 5% here, 2% there, etc. I guess I strongly believe that it's pretty naive to think that my endocrine system is anywhere near 100%. Why would it be? Especially with the years of TRT and poor monitoring, and as sick as I've been getting.

Generally, I'm 61 and "healthy" but feel like shit half the time. When I first got in to TRT years ago the E2 was supposedly a huge deal. Eventually I quit the Anastrozole cuz I couldn't tell the difference one way or the other with the 1/4mg E3D.

Can you link me to something I can read which can help me understand the risk of lowering E2 vs just leaving it alone?

Thanks Again,
Jack
 
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