Help with my most recent bloodwork, please review NELSON

Hi Nelson,

I value your opinion because of your vast knowledge in this subject.

I am a 54 year old male 201 lbs 6'3" I have been on TRT for over a year.

T CYP INJECTIONS 180 1XWEEK
HCG 2X week on day 5 and 6
anastrozole 1/4 tab 2 times a week

I am considering changing my therapy to Defy medical and have an appt for a consult with Dr. Saya next week. I am considering changing because I feel as though I am not monitored as closely as I would like and it is frustrating me.

I would appreciate your opinion on my recent blood work:

8/25/14

CBC all normal range except

Neutrophils 76 HIGH
Lymphs 13 LOW

CMP all normal except
Creatinine 1.49 High
eFGR 52 LOW
BUN/CREATININE RATIO 8 LOW

LIPID PANEL ALL NORMAL EXCEPT
CHOLESTEROL 212 HIGH (PREVIOUSLY 169 ON 2/14/14 AND 245 ON 2/13/13)
LDL 131 HIGH

Testosterone 1212 and this was day 7 after an injection of 180 and went for my regular inj. after the blood was taken.

Free Testosterone over 51 HIGH

DHEA 758.3 (i take 50 a day of DHEA supplement probably need to cut in half or...)

LH <0.2 LOW

IGF -1 144

My most recent Estradiol was 19.9 on 8/18/14

My goal is to sleep better at night, I have mild sleep apnea (12 episodes as measured in last sleep study) I wear a mouthpiece and sleep with a o2 canula set at 2 liters. I wake up 1 to 2 times per night but am able to go right back to sleep.

I also would like to lose the remaining belly fat that I can'T seem to work off. Thank you for taking the time to read this!

Have you talked to your doctor about your neutrophils and lymphs ? Are you on any medication that can cause neutropenia? Are you going through any infections?

I am concerned about your creatinine clearance (eGFR) of 52. Are you drinking enough water? Working out hard? Eating lots of protein? Taking supplements that can decrease your kidney function?


What is your hematocrit like?

I think you will love Dr Saya.
How is your diet? Your cholesterol may imply that it is not the best unless you have a strong genetic predisposition to higher lipids.

What is your height/weight/neck and waist circumference?

Your oral DHEA supplement needs to be reduced to 25 mg/day. I do not want to imply that DHEA may be affecting your creatinine, but it would be interesting to see if your eGFR increases if you stopped all oral supplements.

Nelson, Thank you for your response,

Let me see if i can answer all of this...

I have never had my Neutrophils and lymphs out of range before last time they were measured 2/14/14 Neutrophils were 51 and Lymphs were 32

I take minocycline 100 mg daily to keep my skin clear from the testosterone, omepremozole 20mg 1 time daily for heart burn, Nuvigil 125mg 1 time daily because it makes me alive again from the sleep apnea

I drink a lot of water and work out very hard with a trainer 5 hours a week and 2 or 3 on my own. I drink a whey protein shake about 3 or 4 times a week, my Hematocrit is 49.3

Supplements:
multi vitamin Vitamin A 2500 IU Vitimin C 90mg Vitamin D3 500IU VitaminE 50iu Vitamin K 30mcg Thiamin 1,5mg B2 1.7mg Niacin 20mg B6 3mg Folate 500mg B12 25mg Biotin 30mg Pantothenic Acid 10mg Calcium 220mg Phosphorus 110mg Iodine 150mg magnesium 50mg zinc 11 mg Selenium 55mcg copper .9mg Manganese 2.3 mg Chromium 45mcg Molybdenum 45mcg Chloride 72mg potassium 80mg boron 150mg Nickel5mcg silcon 2mg vanadium 10mcg, lutein 250mcg lycopene 300mcg)

Alpha Lipoic Acid 200mg
Reseratol 250mg
Acetyl Garnitine 500 mg
Acetyl Glutathoine 250mg
Coenzyme Q Ubiquinol 100mg
Grape Seed Extract 100mg
Fish Oil 1200mg
Flax seed oil 1000mg
Melatonin 3mg
Garcinia Cambogia 1000mg
Manganese 10mg
L-arginine 100mg
Vit E 400iu
DHEA 50 dropping to 25mg
B6 100mg

My diet is decent mainly: meat, vegetables, fruit, whole grain, water, tea

6'3/201/17.5/35

I do enjoy some wine and beer but nothing excessive

Minocycline is great to treat acne but it can cause neutropenia. Just monitor your neutrophils to make sure they do not go up any more than they have. Google neutropenia.

Your low creatinine clearance may be caused by exercise, high protein intake, and some of your supplements. I would stop the Garcinia and Manganese for now. Drink lots of water. Do not work out during the 3 days before your next blood analysis. I think this will bring your creatinine clearance back up. As it stands, your kidneys may be a bit burdened.

Dr Saya will be able to review and comment a lot more.

thank you, most appreciated and will take your advice!!