6 week labs after diag, need help

[blshaw]

All,
I am new to this forum but a member on Tnation and All Things Male.. It appears this forum is more active so here it goes. I went to the GP for lethargy and anxiety (on anti-anxiety meds) and asked them to test my thyroid. Labs came back with low T, twice. So I started a protocol of 140mg/week with anti-E meds and HCG 400iu on day 5 and 7 of the week. After 6 weeks my E levels are nil and my DHT has sky rocketd. These tests for week 6 were performed 4 days after my injection. Any input other than decreasing the anti-E? My energy levels have improved and so has my mood probably 10-20% over before. Any opinions on the TSH being over 2?
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Initial Blood Work 4/08
TT: 459 (348 - 1197)
Free T: 4.5 (8.7-25.1)
PSA: .7 (0-4.0)
LH: 4.8 (1.7-8.6)
TSH: 2.290 (1.7-8.6)
FSH: 4.5 (1.5-12.4)
T4: 1.19 (.82-1.77)

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Second Blood Work 4/14
TT: 524 (348 - 1197)
Free T: 8.3 (8.7-25.1)
PSA: .7 (0-4.0)
LH: 2.6 (1.7-8.6)
TSH: 1.96 (1.7-8.6)
FSH: 4.3 (1.5-12.4)
T4: 1.18 (.82-1.77)
BUN/Creatine 20 (8-19)
Cholesterol 215 (100-199)
LDL 137 (0-99)
HDL 58
Dihydrotestosterone 14 (30-85)
DHEA 378 (138-475)
Estradiol 14.9 (7.6-42.6)
IFG-1 126 (88-246)
Reverse T3 14.3 (9.2-24.1)
Vitamin D 42.8 (30-100)
B12 694 (211-946)
Esterone Serum 79 (12-72)
SHBG 54.8 (16.5-55.9)

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Third Blood work after TRT
Cholesterol Total 233 / 100-199
Triglycerides 207 / 0-149
HDL 35 / >39
VLDL 41 / 5-40
LDL 157 / 0-99
Test Serum 1399 / 348-1197
Test Free 24.1 / 8.7-25.1
DHT 154 / 30-85
T4 1.12 / .82-1.77
TSH 2.32 / .450-4.5
Estradiol 5.0 / 7.6-42.6
IGF-1 121 / 88-246
T3 15.1 / 9.2-24.1
Triiodothryronine 3.3 / 2.0-4.4

 

[Vince Carter]

How much AI are you taking? The TSH I'd just keep pulling that, it's been up, its been down, I'd just keep an eye on it as you progress thru HRT.

 

[CoastWatcher]

Welcome to Excelmale. Can you confirm some details on your protocol? Are you injecting 140mg of testosterone in one weekly dose, or spreading it out - 70mg every 3.5 days? Going forward, you should measure your estradiol via the sensitive (LC, MS/MS) test. You should verify that is what is being used. And your SHBG, is at the upper end of your lab's range.

 

[blshaw]

I am injecting once a week on Sunday which I call day 1. I know some people spread it out, but I had high SHBG so I've read that the higher dose once can beneficial and that's what the doc's instructions are anyway. For anti-E I take one capsule a night of a blend from a compounding pharmacy which is Anas/DIM/Prog in .15/300/30mg respectively. I inject 400iu HCG on Thurs and Sat which is days 5 and 7. Hope that helps! My anxiety was better the first 3-4 weeks but its been bad the past couple possibly due to having no E. I'm also getting hot spells.

 

[CoastWatcher]

You are right, high SHBG is typically dealt with via higher doses of testosterone. But that is an awfully significant dose of Anastrozole to be taking, over a milligram a week. You have likely knocked your estradiol levels far too low. Nelson and Dr. Justin Say we're recently discussing a study that showed how depressed E2 can present with symptoms very much like your own - hot spells/flashes included. Estradiol that is too low is as much a problem as when it climbs too high. Why not approach your doctor and see about going to an every other day use of the AI?

 

[blshaw]

Thanks for the input. I have an appointment tomorrow. The patient care coordinator who sent me the results said they will likely do just that, adjust the dose significantly. I've read that low E like mine can also cause fatigue and anxiety. I think mid range is best or so I've heard. Although my estradiol wasn't high to begin with but my estrone was which I think is due to stress. My other concern is that my HDL is down and my LDL is up. But I eat super healthy, I mean religiously. I also work out 4x a week for an hour and walk 8 miles a week so I don't know what else to do. I'm already supping with fish oil

 

[Vince Carter]

Low E and high E have remarkably similar symptoms, more than a couple in common that can make it hard to navigate "by feel", as it were.

 

[CoastWatcher]

Low E and high E have remarkably similar symptoms, more than a couple in common that can make it hard to navigate "by feel", as it were.

So very true. To take it one step further, I have given up trying to puzzle out where my estradiol is sitting on symptoms alone. I have been mistaken as often as I have been right. I still pay attention to how I feel, that is the single 'oat important factor in evaluating my situation, but I always back it up with labs.

 

[blshaw]

Well the doc removed the anastrazole to help with the E, kept the DIM the same and upped the progesterone for DHT purposes. They also lowered my T dose to 120mg a week... ugh... LOL

 

[CoastWatcher]

Well the doc removed the anastrazole to help with the E, kept the DIM the same and upped the progesterone for DHT purposes. They also lowered my T dose to 120mg a week... ugh... LOL

All the best. Keep us posted.

 

[MikeXL]

Any update?