Blood Test Results

Don Schultz · Mar 19, 2015

Attached are my most recent results. It looks like I need to make some adjustments. Let me know what you think. Currently taking HCG, Anastrosole and T Cyp .19 ML at 200mg/ml, all E3D.

Nelson Vergel · Mar 19, 2015

Not bad.

Cut down dose of anastrozole. Your E2 is under 20 pg/mL.

Your TSH is up there almost to the suspect zone.

Your creatinine is probably high due to exercise or high protein diet. Your eGFR is still good, though.

Your HDL is lower than normal due to your TRT.

T and free T are good.

T4 Life · Mar 19, 2015

Your free t is up there, How are you feeling overall?

Don Schultz · Mar 19, 2015

I feel pretty good most of the time. I'm on Liptior. Yes to the high protein and exercise. Is the very low Lutenizing Hormone a concern?

Vettester Chris · Mar 19, 2015

Don, you're administering exogenous testosterone, which will cause the HPTA to suppress GnRH - LH & FSH. If your diagnosis was secondary, your LH was already at a low level. Once you start TRT, it goes in the tank for good!

Nelson noted the TSH. You "need" a complete thyroid panel, including Free T4, Free T3, Reverse T3 & Antibodies (TPO & TgAb if you have not had them done). Seems the majority of docs and patients are really overlooking the thyroid side of it, which in many cases can be directly linked to hypogonadism. Check it out and let us know ...

Don Schultz · Mar 19, 2015

Okay, good, so its not a concern as low LH is more or less a side effect of TRT. The attached test is the Hormone and Wellness Panel for men from discountedlabs.com. I will add the other tests as you suggest. Of course, its a great relief to get a "not bad" rating from "the man", Nelson. As you look at my test, do you have any concerns other than the ones Nelson mentioned?

Don Schultz · Mar 19, 2015

TSH: I am trying to understand this a little better. I am currently on 112mcg of Levrothyroxin daily. Your suggestion is that my TSH could be a little lower, what would I do to make that happen?

Vettester Chris · Mar 19, 2015

Don Schultz said:
TSH: I am trying to understand this a little better. I am currently on 112mcg of Levrothyroxin daily. Your suggestion is that my TSH could be a little lower, what would I do to make that happen?

Like LH in relation to testosterone, TSH is functioning on a negative feedback loop with thyroid hormone levels of T4 & T3. In "most" cases, increased TSH demand is in place when thyroid hormone levels are low (hypo), whereas TSH would signal the thyroid to produce more hormone. However, other factors can be in play, one being an increase in Reverse T3 conversion. Without getting too deep in the speculations, get the other labs so we can discuss your situation properly. I would hope a physician administering a T4 only medication would be monitoring this properly. I'm not a big fan of the synthetic T4's, but that's just my .02.

Don Schultz · Mar 20, 2015

I have not been donating blood. Should I be?

Don Schultz · Jul 24, 2015

Nelson Vergel said:
Not bad.

Cut down dose of anastrozole. Your E2 is under 20 pg/mL.

Your TSH is up there almost to the suspect zone.

Your creatinine is probably high due to exercise or high protein diet. Your eGFR is still good, though.

Your HDL is lower than normal due to your TRT.

T and free T are good.

I am E3d on test and .25 mg Anastrozole. Will stay at e3d on test cyp and try .25 mg every 6 days on the Anastrozole since I already have quite a few .25 tabs. Sound reasonable?

Vettester Chris · Jul 24, 2015

Don, being that the last labs were taken in March, IMO, you should run a new set of E2 labs ("Sensitive or Ultra-Sen Only). Your E2 might be at a level where you don't need any AI's, or it could even be low enough where you need some time to let Test convert to Estro, to get to a desired level. On the LabCorp E2 Sensitive, I've always seemed to be about right in the 25pg to 35pg area, but everyone is a little different.

Don Schultz · Jul 25, 2015

Very true but I have no evidence that any thing has changed since march. Whats a good blood test interval for regular monitoring?

CoastWatcher · Jul 25, 2015

I would never consider an adjustment in a protocol without current labwork in hand. Gradual change in levels can take place over weeks/months and in a fashion that one isn't conscious of. Estradiol can slip too low, creep too high, hematocrit can slide into a dangerous range, your psa may climb. You simply don't know. Avoid driving in the dark without headlights and get some tests.

Vettester Chris · Jul 25, 2015

Don Schultz said:
Very true but I have no evidence that any thing has changed since march. Whats a good blood test interval for regular monitoring?

From what I can see, your E2 test in March "wasn't" a sensitive based test, and even with that the result was 19. You have been administering a small amount of Arimidex since then. Your "evidence" would be a new set of labs, at least the E2 sensitive should be taken until you have it dialed in at a sustainable range that compliments your TRT protocol. How can anyone suggest what amount to adjust your AI when nobody knows what your current E2 is? Just saying ...