Hello Guys: Checking in

[Henry]

Hello,
I just wanted to drop in and say hello. I bought Nelson's book and read it back and forth and now I'm here to learn more about hypogonadism. I'm 38 years old and had a reading of 290 (241-827) and 277 (241-827) for testosterone levels last year. After trying to raise it for a year, I tested again and it came back at 210 (270-1194) and 292 (348-1197).

I started Androgel 1.62 and my numbers on 2 pumps and 750 iu's of HCG split up to 250iu's on M-W-F are 489 (241-827) and E2 was 43 (<=39). I increased it to 3 pumps and 1050iu's of HCG split into 350 iu's on M-W-F and those numbers are 585 (348-1197), free T is 11.9 (8.7-25.1), E2 was 63.4 (7.6-42.6) and DHT was 78 (30-85).

Now I'm on 4 pumps and dropped back down to 750iu's of HCG. I'm 5'11.5 and 205lbs.

 

[Nelson Vergel]

Henry

I am glad you joined us and that you read my book. You can now really get into optimizing your health.

Is the estradiol number obtained via ultrasensitive analysis?

Labcorp Test Number: 500108 CPT Code: 82670 or

Quest Diagnostics Test Code 30289 CPT Code 82670

 

[Henry]

Hello Nelson,
Thank you for the reply. No, none of my E2 tests were done with Ultrasensitive. I just read that I'll need an Ultrasensitive done. In a way, I'm glad. I was freaking out because I saw my E2 was high but I didn't have any symptoms. Now I know why, I was taking the wrong test.

 

[Vettester Chris]

Henry, welcome to the forum. Yeah, don't get too excited on that E2 score. Just get the sensitive assay, then you can see where you need to go from there. Even if it's a bit elevated with a sensitive assay you can get it under control relatively quickly. The first year can be somewhat of a learning curve and balancing act.

Keep in mind that other variables (both upstream and downstream) can come into play when getting your program sorted out. Keep an eye on the adrenals, thyroid, and supporting supplements like D3, Vitamin B's, iron, etc. (as needed).

 

[Bass]

welcome here Henry.

 

[Henry]

Thanks for the warm welcome Gentlemen,
I did have labwork done before I started. Let me post it here. My doc looked them over and said everything was ok.

LH = 4.1 Ref 1.5-9.3
FSH = 3.9 Ref 1.6-8.0
Prolactin = 8.6 Ref 3-19
Glucose, fasting 83 Ref 65-99
Sodium 141 Ref 135-146
Potassium 4.9 Ref 3.5-5.3
Chloride 104 Ref 98-110
Carbon dioxide 27 ref 21-33
urea nitrogen 13 ref 6-22
Uric Acid 5.2 Ref 4.0-8.0
Phosphorus 3.5 ref 2.5-4.5
Cholesterol, total 138 Ref 100-199
HDL Cholesterol 50 ref >=39
Cholesterol/HDL Ratio 2.8
VLDL Chol 8 ref 5-40
LDL Cholesterol, 80 ref 0-99
Triglycerides 40 ref <150
Protein, total 7.0 ref 6.2-8.3
albumin 4.6 ref 3.8-5.1
Globulin, Calculated 2.4 ref 2.1-3.7
A/G ratio 1.9 ref 1.0-2.1
Bilirubin, total 0.4 ref 0.2-1.2
Bilrubin, direct 0.1 ref <=0.2
GGT 19 ref 3-90
AST 22 ref 10-40
ALT 13 ref 9-60
LD 157 ref 100-220
TIBC 330 ref 250-425
Transferrin saturation 26 ref 20-50%
EGFR NON AFR American 88 ref >60 mL/min/1.73
EGFR AFR American 102 ref >60 mL/min/1.73
OSMOLALITY, serum 293 ref 275-295 mOsm/kg H2O
MICROALBUMIN 0.4
MICROALBUMIN, RANDOM URINE 2 ref < 30
Creatinine Random Urine 185 ref 20-370
TSH 0.68 ref 0.40 - 4.50
T4, Total 6.0 ref 4.5-12.0
T3 Uptake 31 ref 22-35 percent
T4, free, calculated 1.9 ref 1.4-3.8
Amylase, Serum 70 ref 21-101
WBC 6.5 ref 3.8-10.8
RBC 4.92 ref 4.20-5.80
Hemoglobin 14.5 ref 14-18
Hematocrit 44.5 ref 40-52
MCV 84.3 ref 80-95
MCH 28.0 ref 27.0-33.0
MCHC 32.8 ref 32.0-36.0
RDW 13.3 ref 11.0-15.0%
Platelet count 250 ref 140-400
MPV 8.8 ref 7.5-11.5
BUN, 15 REF 9-23
Creatinine, 1.0 REF 0.7-1.3
BUN/Creatinine Ratio, 15 REF 8-28
Calcium, 9.7 REF 8.7-10.4
Protein, total 6.9 ref 5.7-8.2
albumin 4.4 ref 3.2-4.8
Globulin, 2.5 ref 1.8-4.0
A/G ratio 1.8 ref 0.8-2.7
ALK.Phosphate, 77 REF 40-156
C-Reactive Protein (CRP), <0.4 REF <1.0
HbA1c 5.3 REF 4.8-5.6
PSA (Prostatic Antigen), 1.0 REF 0.00-4.00
Vitamin B12, 802 REF 211-911
Ferritin, 69 REF 22-322
Iron, 89 REF 65-175
SHBG 27 REF 13-71
Vitamin D, 25-Hydroxy, 89.9 Ref 30-100

 

[Henry]

I have mild, bilateral varicoceles and a small cyst in my epididymis. I also have chronic prostatitis and chronic low back pain. I was on pain meds 10 years ago (only for a year). I didn't like how they made me feel so I stopped and now I'm med free (except for the testosterone, hcg and multivitamins).

The doctor said that my varicoceles are the cause for my hypogonadism. He said that because my LH, FSH and prolactin are within normal range, the problem is in my testicles and he pin pointed the varicoceles. But, from what I read, since my LH and FSH are within normal range, I don't think my varicoceles are the cause of my low testosterone. He's saying that I'm primary, but I think I'm secondary.

 

[Nelson Vergel]

Your blood work is pristine. Super healthy man besides your low T.

Why do you think your doctor is wrong?

Read this:

"Varicocele in infertile males is associated with Leydig cell dysfunction and hypogonadism. The effect of varicocelectomy on serum testosterone level is not yet established. We analysed 200 heterosexual infertile men diagnosed to have clinical varicocele they were divided into two groups: group 1 (100 men) had microsurgical varicocelectomy, and group 2 (100 patients) underwent assisted reproduction procedures. All participants had semen analysis, serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and total testosterone (TT), measured both at recruitment time and 6 months later. In group 1, the mean TT level increased significantly after varicocelectomy and testicular size correlated with the mean change in TT. No similar change was found in group 2. Out of the 100 patients in group 1, 78 had postoperative normalization of TT unlike only 16 men in group 2."

Reference:
Clinical Study
Does Varicocelectomy Improve Gonadal Function in Men with Hypogonadism and Infertility? Analysis of a Prospective Study

 

[Henry]

Thanks Nelson,
I have to clean up my diet. I'm cutting back on salt, sugar, candies to help clean things up.

The reason why I don't think it's the varicoceles is because my LH and FSH are low. My urologist says it's the varicoceles. I also see Dr. Olivieri in NYC and he said it's secondary since my brain isn't reading the low testosterone and increasing my LH and FSH. Also, I had a sperm analysis done last year and these were the results:

Sperm count 102M/ml ref 20-250M/ml
Motility 69% ref >30
Fructose Assay: Progression 3 ref 2-3
Semen volume 2.3 ref 1.5-5ml
viscosity 1 ref 1-1.5
pH 7.9 ref 7.0-8.3
Total sperm in ejaculate 234.6 million
Total motile sperm in ejacualte: 161.9 million

Now that I started TRT, I went down to 45 million sperm but the doctor said I'm still good since I'm above 20M. I banked sperm anyway, just in case.

 

[Nelson Vergel]

Your LH and FSH are not too bad, actually.

Was the last sperm sample done after using TRT+350 IU HCG twice per week?

 

[Henry]

Hi,
Yes, the 45M was after 350iu's, 3 times a week.

 

[Henry]

I'm going to go back to 350iu's again. I dropped down to 250 because the high E2 scared me, I didn't realize that I was using the wrong test.