Concerned, Confused and Trying Not to Freak Out Over Blood Test Results & Diagnosis

[JNole]

Hi Everyone:

Below is my LONG snapshot of protocol and blood test results I posted in January 2015 since I began TRT in April 2014 (nelson gave me a prize for the longest and most detailed first post!). Based on my research that included excellent input from Gene and others, I stopped the Clomid part of the protocol and have decided I no longer want to see the physician who set up the protocol described below. 3 weeks ago I had an annual checkup with my GP who I really like who ordered routine blood work and referred me to a Urologist (I know) who has experience in TRT. A week after seeing my GP, I met with the uro who reviewed my blood test results I collected since I began TRT. The doc could not believe some of my numbers that included Test levels in the 1100-1200 range (I know this is not necessarily bad) and higher range hematocrit levels (one result was 52 (37.5-51)). I am donating blood every 2 to 3 months. On a side note, I told the uro that I was having some frequent urination with waking up once or twice every night. The uro did a DRE and discovered my prostate was enlarged with a tiny nodule felt (All previous PSA tests in the 1.0-1.3 range). The uro recommended based on this finding that I reduce my Test Cyp dosage to 100mg temporarily e2wks (I was injecting 150 mg ew and had lowered the dosage to 130 mg ew along with the clomid). 2 weeks after the 100mg dose, get blood work for Total Test, Free Test, PSA & hematocrit.

In addition to not trying to freak out after the uro diagnosis (I know an enlarged prostate can be a few different things), I just received the following HIGH blood test results I obtained from my GP one week after my LOWER 100mg dose:

Total Test 1235 (348-1197)
Free Test 28.65 (5.0-21)
Hematocrit 52.1 (37.5-51)
AST (SGOT) 49 (0-40)
MCV 100 (79-97)
Estradiol (sensitive) 47 (8.0-35)
TSH 5.970 (.450-4.5) *I have been hypothyroid for 20 years, previous TRT doc switched me to NatureThroid from Levothyroxine

Any input, suggestions and hopeful reassuring words would be appreciated - thank you.

First Post - Testosterone, E2 and Anastrozole Hi Guys - first of all, I really appreciate this great forum & site. It has certainly educated me on TRT while opening my eyes regarding different protocols and treatment. Also entertaining sometimes!

I am 54 years old and began TRT in April 2014. I have been a consistent non-competitive body builder and fitness guy for 39 years now. I am 5'11" 194 lbs and have less than 10% body fat.

I am seeing a physician who has specialized in HRT for 20+ years. I finally took the step to TRT after experiencing brain fog, decreased muscle mass, increasing aches, hot flashes and joint pain for probably 4 years prior to my treatment.

Pre-TRT blood results from Doc:

Total Testosterone 273 (300-890 ng/dl)
Testosterone, Free 49.6 (47-244 pg/ml)
SHBG 37 (13-71 nmol/ml)
Estradiol (NON-sensitive) 19.6 (0-39 pg/ml)

Prescribed Protocol After Above Results, April 2014 from Doc:

150 mg Test Cyp e7 days (inject subQ Thursday AM)
CLOMID, 51 MG M-W-F

6 Week Blood Results After Beginning Protocol from Doc:

Total Testosterone. 1231 (300-890 ng/dl) *Blood drawn 1 day after injection
Testosterone, Free 269 (47-244 pg/ml)
Estradiol (NON-sensitive). 42 H (0-39 pg/ml)

Doc does not want to just yet to prescribe AI

3 Month Blood Results from Doc:

Total Testosterone. 1073 (300-890 ng/dl) *Blood drawn mid-week after Thurs injection
Testosterone, Free 209 (47-244 pg/ml)
SHBG 48 (13-71 nmol/ml)
Estradiol (NON-sensitive) 43 (0-39 pg/ml)

Doc prescribes Anastrozole, .25 MG twice per week

About this time, I learn how powerful Anastrozole can be depending on the individual but follow protocol for this. After 4-6 weeks following this, I begin to feel some pre-TRT symptoms and I OBTAIN OWN BLOOD TEST from LabCorp with the following results:

Total Testosterone. 736 (348-1197 ng/dl) **Blood drawn day of Test injection, prior to, and also
Prior to next Anastrozole dose
Testosterone, Free 9.5 (7.2-24 pg/ml)
Estradiol (SENSITIVE) 21 (3-70 pg/ml)

After this result, I change my Anastrozole protocol to once every 4 to 5 days for the next 4-6 weeks because of the weird symptoms I was getting on the twice per week regimen since my 21 E2 result was the day before I was supposed to take my next Anastrozole dose.

Test results FROM DOC after the above 4-6 weeks of my personal change with Anastrozole dose:

Total Testosterone 1106 (300-890 ng/dl) *Blood drawn mid-week
Testosterone, Free 257 (47-244 pg/ml)
Estradiol (NON-SENSITIVE) 36 (0-39 pg/ml)

After learning about how the non-sensitive E2 test could be 10-20 pg/ml's over actual E2 levels, I decided to take my Anastrozole on the day after my Thursday injection, once per week.

FINALLY, after 4-6 weeks of my latest day after injection taking one .25 MG capsule of Anastrozole, I just obtained the following blood test results FROM DISCOUNTED LABS/DEFY/LabCorp (thanks Nelson!):

Total Testosterone 1271 (348-1197 ng/dl) *Blood drawn day of and prior to Thursday injection
and day before Anastrozole dose
Testosterone, Free. 20 (7.2-24 pg/ml)
Estradiol (SENSITIVE) 41 (8-35 pg/ml)

*I am now not sure how to dose my Anastrozole. In addition, I am wondering if I should lower my Test Cyp dose since I seem to be a little high and to also lower E2 but I am not sure how much to lower by.

Suggestions, comments, etc. are appreciated!

Thank you.

 

[Nelson Vergel]

Hi Jnole

Did you change the way you inject? Was the blood sample taken right before the next injection?

Your TSH is high for someone on thyroid treatment. Do you have your free T3, free T4 and reverse T3?

Gladly your PSA is fine. Have you tried daily Cialis for the BPH symptoms? It's your chance to get it paid by insurance.

Have you gotten an ultrasound test of your prostate and urethra?

 

[JNole]

Thanks so much for your quick response, Nelson.

I requested free T3, free T4 and reverse T3, but the dang doc office did not marl the lab requisition form correctly. I did get:

T4 5.7 (4.5-12.0)
T3 Uptake 29 (24-39)
Free Thyroxine Index 1.7 (1.2-4.9) *is this Free T4?
T3 124 (71-180)

Now previous TRT doc switched me from 125 mcg levothyroxine to 1.5 grain of NatureThroid. After a somewhat similar over 5 reading about 6 months ago he increased dosage to 2 grain

The crazy thing about the latest blood test was that I got it 5 days after the lower 100mg injection (I know this was not trough but I knew I was going to get this tested again by uro - actually had blood drawn today for that and is 2 weeks after 100mg injection has uro wanted).

I am doing Cialis for prostate (generic through same company I believe others here use). Urination symptoms especially at night have subsided.

I have not yet got ultrasound for prostate and urethra (uro did do a bladder ultrasound which did show some wall thickening but no retained urine). Uro is waiting for blood test results from today's draw which included PSA and Total Test to decide what is next I believe.

Also, I am supposed to inject 100mg tomorrow AFTER 2 WEEKS but now I am not sure if I should given the results I obtained from last week draw (again these results from GP lab requisition).