7 Week labs TRT: Total T Low and Thyroid Issues

[finkelet]

Hi all. Here is the background 39 years old, tried a clomid restart didn't work. So I moved to TRT with the following protocol below. I'm feeling better now than on Clomid, however still libdo is decreased and it seems penile sensitivity is decreased as well. I've also had some pedal edema. This is new. I do have a history of controlled hypertension, but I dont think this is cardiac related. I had a full cardiac workup last year including a stress echo, it was all clear. And my lipids suck, might follow up with a lipidologist? I think I need to work on my T/E ratio, maybe increase my test and inject more often, and increase my Thyroid medication. Maybe increase HCG? Up my metformin. Please let me know what you think.

Protocol: Every 3.5 days: Test cyp 80 mg, HCG400IU, Arimidex 0.25mg. Daily: Selenimum 400mcg, Desicated Thyroid 1grain, DHEA 25mg, fish oil 4g.

WBC 6.9 x10E3/uL 3.4 - 10.8
RBC 5.54 x10E6/uL 4.14 - 5.80
Hemoglobin 16.9 g/dL 12.6 - 17.7
Hematocrit 48.3 % 37.5 - 51.0
MCV 87 fL 79 - 97
MCH 30.5 pg 26.6 - 33.0
MCHC 35.0 g/dL 31.5 - 35.7
RDW 13.6 % 12.3 - 15.4
Platelets 230 x10E3/uL 150 - 379
Neutrophils 52 %
Lymphs 35 %
Monocytes 7 %
Eos 5 %
Basos 0 %
Neutrophils (Absolute) 3.6 x10E3/uL 1.4 - 7.0
Lymphs (Absolute) 2.4 x10E3/uL 0.7 - 3.1
Monocytes(Absolute) 0.5 x10E3/uL 0.1 - 0.9
Eos (Absolute) 0.3 x10E3/uL 0.0 - 0.4
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2
Immature Granulocytes 1 %
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1
Comp. Metabolic Panel
Glucose, Serum 94 mg/dL 65 - 99
BUN 9 mg/dL 6 - 20
Creatinine, Serum 0.94 mg/dL 0.76 - 1.27
eGFR If NonAfricn Am 102 mL/min/1.73 >59
BUN/Creatinine Ratio 10 9 - 20
Sodium, Serum 143 mmol/L 134 - 144
Potassium, Serum 4.5 mmol/L 3.5 - 5.2
Chloride, Serum 100 mmol/L 96 - 106
Carbon Dioxide, Total 22 mmol/L 18 - 29
Calcium, Serum 9.9 mg/dL 8.7 - 10.2
Protein, Total, Serum 7.0 g/dL 6.0 - 8.5
Albumin, Serum 4.6 g/dL 3.5 - 5.5
Globulin, Total 2.4 g/dL 1.5 - 4.5
A/G Ratio 1.9 1.2 - 2.2
Bilirubin, Total 0.3 mg/dL 0.0 - 1.2
Alkaline Phosphatase, S 45 IU/L 39 - 117
AST (SGOT) 26 IU/L 0 - 40
ALT (SGPT) 42 IU/L 0 - 44
Lipid Panel
Cholesterol, Total 187 mg/dL 100 - 199
Triglycerides 337 High mg/dL 0 - 149
HDL Cholesterol 22 Low mg/dL >39
VLDL Cholesterol Cal 67 High mg/dL 5 - 40
LDL Cholesterol Calc 98 mg/dL 0 - 99
Testosterone,Free and Total
Testosterone, Serum 648 ng/dL 348 - 1197
Free Testosterone(Direct) 20.6 pg/mL 8.7 - 25.1
T4,Free(Direct) 1.12 ng/dL 0.82 - 1.77
DHEA-Sulfate 362.1 ug/dL 102.6 - 416.3
TSH 4.010 uIU/mL 0.450 - 4.500
Prostate Specific Ag, Serum 1.3 ng/mL 0.0 - 4.0
Estradiol, Sensitive 34.5 pg/mL 8.0 - 35.0
Thyroglobulin Antibody 4.1 High IU/mL 0.0 - 0.9
Thyroid Peroxidase (TPO) Ab 443 High IU/mL 0 - 34
Triiodothyronine,Free,Serum 3.3 pg/mL 2.0 - 4.4
Sex Horm Binding Glob, Serum 16.1 Low nmol/L 16.5 - 55.9

Thanks guys

 

[Vince Carter]

I go right to your SHBG @ 16 I think you need to consider EOD, should help with your rather mediocre TT trough, and Free T. Consider perhaps 40-45mg EOD Cyp.

My opinion on HCG is that you're using plenty, I wouldn't change anything there.

 

[CoastWatcher]

Your thyroid values - the antibodies and your TSH - certainly call for further investigation. Are these new developments?

 

[finkelet]

Thanks Vince.

CoastWatcher- these were noted when i started with my Clomid restart. We are thinking it's Lilley Hashimoto. We started on the selenium and NDT. The NDT was started at 1/2 grain and increased to 1 grain. I think I need to go up again.

I'm trying to get a Thyroid US lined up for a more solid Dx.