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<blockquote data-quote="sbstrum_MD" data-source="post: 247655" data-attributes="member: 17682"><p>To Steve from another Steve:</p><p>Your labs were reviewed. You have an ↑ bili (total) which may be due to a genetic disorder called Gilbert's Syndrome or it may be due to actual biliary disease. Gilbert's is common and no cause for alarm. You could benefit by keeping a table of labs showing results over time. </p><p>Your hematocrit (HCT) is high at 56% and puts you at risk for thrombosis--blockage of a blood vessel(s). The ↑ in HCT is likely due to the TRT and dose you are using plays a role here. </p><p>Your estradiol or E2 is high due to aromatization of T ⇢ Estradiol. Yes, you would benefit by an aromatase inhibitor (AI) and your MD should be using anastrozole (Arimidex®) or exemestane (Aromasin®) at a low dose such as arimidex 0.5 mg twice a week to see if the E is < 30 (most labs that is the upper level of normal). </p><p>Your HDL of 48 is low and puts you at risk for cardiovascular disease (CVD). You would get more information from an NMR lipoprofile done by LabCorp. This quantifies the number of HDL and LDL particles and fractionates them into large and small HDL and LDL. </p><p>Your CRP is high at 3.3 with normal being ≤ 0.9 in your lab. This puts you at risk for a serious vascular event like thrombosis. </p><p>Your LDL is normal at 98 but on NMR lipoprofile it may be shown to be abnormal. Therefore get the NMR lipoprofile. </p><p>Your PSA is healthy at < 1.0 ng/ml but keep track of the PSA if you continue on TRT. </p><p>Your free testosterone is high and you should definitely consider lowering your TRT dose. </p><p>Your Triglycerides (TG) at 121 are wnl but In my opinion are high if this was a fasting blood draw. Your TG/HDL ratio is 121/48 = 2.5 which is a significant risk factor for CAD (coronary artery disease) and you need to act on this as your top priority. Don't risk your life with TRT while your metabolic profile is so much of a concern. Yes, weight loss is or can be critical to your life at this point. </p><p></p><p>You need to consider serious caloric restriction with major reduction in high glycemic carbohydrates. Your MD, assuming you have one, should be giving you guidance. </p><p></p><p>You may wish to consider also check blood glucose using a Freestyle Libre System (FLS) by Abbott with special attention to glucose levels at 2 hours post meals and if you do this monitoring then keep a food diary of what you ate for breakfast, lunch and dinner for at least 3 or 4 days in a row. You may be prediabetic or diabetic. </p><p></p><p>Daily weights, blood pressure should be logged. </p><p></p><p>The use of TRT is not kid's stuff. There are many effects of high levels of testosterone in the blood. Educate yourself to the max. </p><p>Take good care, </p><p>Stephen</p></blockquote><p></p>
[QUOTE="sbstrum_MD, post: 247655, member: 17682"] To Steve from another Steve: Your labs were reviewed. You have an ↑ bili (total) which may be due to a genetic disorder called Gilbert's Syndrome or it may be due to actual biliary disease. Gilbert's is common and no cause for alarm. You could benefit by keeping a table of labs showing results over time. Your hematocrit (HCT) is high at 56% and puts you at risk for thrombosis--blockage of a blood vessel(s). The ↑ in HCT is likely due to the TRT and dose you are using plays a role here. Your estradiol or E2 is high due to aromatization of T ⇢ Estradiol. Yes, you would benefit by an aromatase inhibitor (AI) and your MD should be using anastrozole (Arimidex®) or exemestane (Aromasin®) at a low dose such as arimidex 0.5 mg twice a week to see if the E is < 30 (most labs that is the upper level of normal). Your HDL of 48 is low and puts you at risk for cardiovascular disease (CVD). You would get more information from an NMR lipoprofile done by LabCorp. This quantifies the number of HDL and LDL particles and fractionates them into large and small HDL and LDL. Your CRP is high at 3.3 with normal being ≤ 0.9 in your lab. This puts you at risk for a serious vascular event like thrombosis. Your LDL is normal at 98 but on NMR lipoprofile it may be shown to be abnormal. Therefore get the NMR lipoprofile. Your PSA is healthy at < 1.0 ng/ml but keep track of the PSA if you continue on TRT. Your free testosterone is high and you should definitely consider lowering your TRT dose. Your Triglycerides (TG) at 121 are wnl but In my opinion are high if this was a fasting blood draw. Your TG/HDL ratio is 121/48 = 2.5 which is a significant risk factor for CAD (coronary artery disease) and you need to act on this as your top priority. Don't risk your life with TRT while your metabolic profile is so much of a concern. Yes, weight loss is or can be critical to your life at this point. You need to consider serious caloric restriction with major reduction in high glycemic carbohydrates. Your MD, assuming you have one, should be giving you guidance. You may wish to consider also check blood glucose using a Freestyle Libre System (FLS) by Abbott with special attention to glucose levels at 2 hours post meals and if you do this monitoring then keep a food diary of what you ate for breakfast, lunch and dinner for at least 3 or 4 days in a row. You may be prediabetic or diabetic. Daily weights, blood pressure should be logged. The use of TRT is not kid's stuff. There are many effects of high levels of testosterone in the blood. Educate yourself to the max. Take good care, Stephen [/QUOTE]
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