Latest labs - Any guidance appreciated!

Current protocol is 160mg/week split 80mg/.4mL E3.5D + 350iu HCG + .20 anastrozole. I lift 5X weekly along with "some" cardio that I honestly need to increase.

Currently feel "good" now that my numbers have rebounded from my last draw showing mid 600s after prednisone caused a low reading. I had my thyroid labs drawn suspecting potential slow metabolism/hypothyroid issues after not seeing any weight loss in many months.

Any thoughts on things I need to look at? Is "high" free test an issue? Should SHBG be checked as well?

Blood was drawn at 8:30a right before my 9:15a shots.

Amazing TRT related labs. Absolutely nothing I can even begin to nitpick, and I'm a notorious nitpicker! You're making this tough for me!

How many times have you donated blood this year?

Your thyroid looks off, the high RT3 is not a good thing. I don't know much about the thyroid so I'll let others comment on it. Looks like you might be correct.

Free testosterone being a bit high is fine.

Your high free T indicates that you may have low or low-ish SHBG, but that is not really something that is fixable. Some low SHBG guys find they feel better on a daily or every other day injection protocol while others (like myself) feel no difference.

Zero blood donations. Should I start to lower that RBC?

johndoesmith said:

Amazing TRT related labs. Absolutely nothing I can even begin to nitpick, and I'm a notorious nitpicker! You're making this tough for me!

How many times have you donated blood this year?

Your thyroid looks off, the high RT3 is not a good thing. I don't know much about the thyroid so I'll let others comment on it. Looks like you might be correct.

Free testosterone being a bit high is fine.

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What's your age and how long have you been on TRT. You may think about getting a more through lipid panel, HDL is low.

FrankUnderwood said:

Zero blood donations. Should I start to lower that RBC?

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Really? no donations at all?

I don't think a donation is in order, RBC isn't the problem, it's HCT and HGB.

I think you may be iron deficient tho. I'm not 100%, but isolated elevated RBCs is odd, and it seems you're on the low end of RBC size, so trending towards microcytic anemia possibly?

I don't know for sure, but since you're with defy, if you get labs covered by insurance, an iron panel wouldn't be a bad idea.

Vince said:

What's your age and how long have you been on TRT. You may think about getting a more through lipid panel, HDL is low.

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41 y/o, on TRT 8 or 9 months.

johndoesmith said:

Really? no donations at all?

I don't think a donation is in order, RBC isn't the problem, it's HCT and HGB.

I think you may be iron deficient tho. I'm not 100%, but isolated elevated RBCs is odd, and it seems you're on the low end of RBC size, so trending towards microcytic anemia possibly?

I don't know for sure, but since you're with defy, if you get labs covered by insurance, an iron panel wouldn't be a bad idea.

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Yep, this is the first time RBC has been out of range. Should be talking to Dr Saya mid Jan. Might grab an iron and SHBG panel in the interim just so we have more data.

With your RBCs I believe the MCV is the size of those cells and being on the low side is good. I don't think it's a worry.

FrankUnderwood said:

Yep, this is the first time RBC has been out of range. Should be talking to Dr Saya mid Jan. Might grab an iron and SHBG panel in the interim just so we have more data.

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I don't want to worry you, as that's a minor elevation in RBC.

I just think it may be a sign of IDA and that an iron panel wouldn't hurt. It's not concerning IMO in the same way that a 55 HCT is.

johndoesmith said:

I don't want to worry you, as that's a minor elevation in RBC.

I just think it may be a sign of IDA and that an iron panel wouldn't hurt. It's not concerning IMO in the same way that a 55 HCT is.

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I've got a draw scheduled for both a ferritin serum and iron+TIBC this week. will post results as soon as i get them.

johndoesmith said:

I don't want to worry you, as that's a minor elevation in RBC.

I just think it may be a sign of IDA and that an iron panel wouldn't hurt. It's not concerning IMO in the same way that a 55 HCT is.

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heres my iron, TIBC and ferritin results :

FrankUnderwood said:

heres my iron, TIBC and ferritin results :

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Seems pretty decent to me, my initial hunch was wrong. Good! I'm glad I was wrong about this.