Hello to All - My Intro & Labs 54.8

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cadcard

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Hello to everyone that maintains this forum and to all that frequent the site. I'm glad I found such a good resource and I hope I will be able to share intelligent conversation that benefits those seeking information.

I am a 55yo guy that had testicular cancer in 2002. I felt ok until sometime in 2005. Then, I started having low T type problems. I perservered until 2009 at which time I sought help. At first, I was placed on compounded T. I did not absorb that well. I was then put on T cyp injections of 60mg every third day. This is the dosage I've been shooting up until recently.

My starting to become worried about elevated Hematocrit, Hemoglobin and RBC. I have other concerns as well, but they are temporarily on the back burner.

My latest labs are as follows

RBC 6.08 4.14-5.80
Hemoglobin 19.2 12.6-17.7
Hematocrit 54.8 37.5-51.0
Platelets 139 150-379

I have had several labs done in the last year with a pattern of high red type numbers and low platelets. I don't want to give blood but I feel I have to in order to get my RED numbers more in line. I have a bloodtype of A+ so the redcross doesn't really want my double reds.

My kidney functions are somewhat showing redflags, as are my cholesterol numbers.

I like to lift weights. Could ilfting have a bearing on RED numbers?

Any comments on my concerns would be greatly appreciated.

Thanks very much.

Jim
 
Defy Medical TRT clinic doctor
Hello to everyone that maintains this forum and to all that frequent the site. I'm glad I found such a good resource and I hope I will be able to share intelligent conversation that benefits those seeking information.

I am a 55yo guy that had testicular cancer in 2002. I felt ok until sometime in 2005. Then, I started having low T type problems. I perservered until 2009 at which time I sought help. At first, I was placed on compounded T. I did not absorb that well. I was then put on T cyp injections of 60mg every third day. This is the dosage I've been shooting up until recently.

My starting to become worried about elevated Hematocrit, Hemoglobin and RBC. I have other concerns as well, but they are temporarily on the back burner.

My latest labs are as follows

RBC 6.08 4.14-5.80
Hemoglobin 19.2 12.6-17.7
Hematocrit 54.8 37.5-51.0
Platelets 139 150-379

I have had several blabs done in the last year with a pattern of high red type numbers and low platelets. I don't want to give blood but I feel I have to to try to get my RED numbers more in line. I have a bloodtype of A+ so the redcross doesn't really want my double reds.

My kidney functions are somewhat showing redflags, as are my cholesterol numbers.

I like to lift weights. Could ilfting have a bearing on RED numbers?

Any comments on my concerns would be greatly appreciated.

Thanks very much.

Jim

Welcome to the Forum, cadcard. You'll find a lot of excellent material in the "sticky" posts in each subforum. I've provided a link to one such post on therapeutic phlebotomy, the only way to lower elevated hemoglobin and hematocrit. How long ago were those labs obtained? Do you know how long you've had elevated levels? Is this a sudden development?



https://www.excelmale.com/forum/sho...rone-Replacement-Therapy&highlight=phlebotomy
 
My red counts have been elevated since 2/14.

Since I seem to have a history of low platelets dating back to 2011, I'm reluctant to give blood.

I'm considering asking my NEW doctor to switch me to topical T. I really don't want to smeer this stuff all over me, but he may want to stop me on TRT, which is not an option.
 
If you are reluctant to give blood your only other option is either significantly reducing your dosage or stopping TRT.

It's very dangerous to your health to have elevated Hematocrit serum levels.
 
[ "My kidney functions are somewhat showing red flags, as are my cholesterol numbers." ]

Hi Jim, This would be my absolute top concern. A CT scan would be my next move ( tomorrow ) hands down even if creatinine BUN and eGFR are all within normal range. Why?

A: (1) Kidney disease is a silent killer. There are absolutely no symptoms in early stage tumors yet this is when they are most curable.
(2) Incidence of tumors, benign or not, are as high as 50% of all men over 50
(3) Kidney disease is a national epidemic. BUT, cure rate runs as high as 95% IF they are small enough (found early).

Mark this as your top priority and do not delay. An advanced urinalysis ruling out microhematuria is in order. Even if negative proceed with the CT or at the very least a sonagram.

My advice is to shop around for the facility with the newest high resolution, fast and low radiation CT machines rather than going to a hospital. All respectable facilities will be happy to discuss radiation levels to be used and the age/type of machine. The probability that something will be found is high. The next step is for the radiologist to rate the findings on the Bosniak scale. This can only be done with high quality, high contrast images. You do not want to have to repeat the scan because that means unnecessary radiation. Only with an accurate classification of tumor Bosniak stage will you be able to decide to monitor or move forward with immediate excision. As a patient YOU have the last say on the scanner's intensity setting. Discuss this thoroughly in advance.

I'll repeat that kidney function is NOT the same as kidney health implied by eGFR, BUN, creatinine. These values can all be in excellent range until late stage tumor. No one over 50 should not rely on blood, urine work or lack of symptoms. Imaging is a essential! Someone close to me has way above average function and no symptoms whatsoever yet imaging revealed a gargantuan inoperable tumor. What could have been dealt with easily is now going to require complete excision of the kidney with the hope that nothing else is involved.
 
Thanks Re-Ride for your feedback. I plan on stopping to give a pint of blood tonight, after work.

I wish I were a candidate to give a double red donation, but since my blood type is just 'garden variety', the Redcross doesn't want it.

My eGFR is ok, but my creatinine seems to be always high. I will be checking into my kidneys functions deeper, in the near future.

The red blood numbers is what I need to get under control right now. I'm going to try the grapefruit thing (I don't take anyother meds) and green tea as well. I've cut back on my Tcyp dose from 60mg, to 50mg. I may try cutting back to 45mg if I feel ok.

Thanks again
 
Thanks Re-Ride for your feedback. I plan on stopping to give a pint of blood tonight, after work.

I wish I were a candidate to give a double red donation, but since my blood type is just 'garden variety', the Redcross doesn't want it.

My eGFR is ok, but my creatinine seems to be always high. I will be checking into my kidneys functions deeper, in the near future.

The red blood numbers is what I need to get under control right now. I'm going to try the grapefruit thing (I don't take anyother meds) and green tea as well. I've cut back on my Tcyp dose from 60mg, to 50mg. I may try cutting back to 45mg if I feel ok.

Thanks again

All the best.
 
[ "My kidney functions are somewhat showing red flags, as are my cholesterol numbers." ]

Hi Jim, This would be my absolute top concern. A CT scan would be my next move ( tomorrow ) hands down even if creatinine BUN and eGFR are all within normal range. Why?

A: (1) Kidney disease is a silent killer. There are absolutely no symptoms in early stage tumors yet this is when they are most curable.
(2) Incidence of tumors, benign or not, are as high as 50% of all men over 50
(3) Kidney disease is a national epidemic. BUT, cure rate runs as high as 95% IF they are small enough (found early).

Mark this as your top priority and do not delay. An advanced urinalysis ruling out microhematuria is in order. Even if negative proceed with the CT or at the very least a sonagram.

My advice is to shop around for the facility with the newest high resolution, fast and low radiation CT machines rather than going to a hospital. All respectable facilities will be happy to discuss radiation levels to be used and the age/type of machine. The probability that something will be found is high. The next step is for the radiologist to rate the findings on the Bosniak scale. This can only be done with high quality, high contrast images. You do not want to have to repeat the scan because that means unnecessary radiation. Only with an accurate classification of tumor Bosniak stage will you be able to decide to monitor or move forward with immediate excision. As a patient YOU have the last say on the scanner's intensity setting. Discuss this thoroughly in advance.

I'll repeat that kidney function is NOT the same as kidney health implied by eGFR, BUN, creatinine. These values can all be in excellent range until late stage tumor. No one over 50 should not rely on blood, urine work or lack of symptoms. Imaging is a essential! Someone close to me has way above average function and no symptoms whatsoever yet imaging revealed a gargantuan inoperable tumor. What could have been dealt with easily is now going to require complete excision of the kidney with the hope that nothing else is involved.

Agree 100% with this! My mother passed away 5 years ago from kidney cancer that was not found until the tumor was too large to be removed. She was 87 at the time, but had always been in excellent health. As you say, there were no symptoms until it was too late.
 
Cadcard, Glad to hear that you'll be getting that pint drawn today.

["I will be checking in to my kidney *function* in the near future... eGFR good, just the creatinine"]

Kidney health and Kidney function are two different animals.

Function as implied by labs will be fine as the operable tumor grows. Labs mean nothing when it comes to kidney health which is only verified through imaging.

In TRT labs form the core of diagnostics and therapy. With all the emphasis correctly placed on lab work here it is easy to loose sight of other things we must also pursue.

Sadly the vast majority of kidney tumors are discovered accidentally or only in end stand disease. Neither a history of cancer **nor flagged kidney function labs** are required to suggest a need for imaging. Being over 50 is enough. In your case you have all three indicators.

Everyone: Please talk to your doc about the three imaging options. Sonigrams are low cost, low resolution but do not involve radiation. MRI has the advantage of no radiation but is expensive. CT scans are the gold standard but the latest equipment only should be used and the intensity setting discussed in advance of the procedure. Takes about 20 minutes.
 
Re-Ride
Thanks for the wisdom.
Unfortunately, my health insurance has become very expensive, and my deductible is very high. I couldn't afford out of pocket expenses for most of the types of tests you have mentioned.
 
Wait a minute.

Cadcard has not even told us what his creatinine and eGFR are and people are telling him to get a CT scan?? Did I miss something?

Re-ride, I like your posts a lot since you seem to be a well educated guy.

Cadcard, can you post a copy of all your blood work?

Platelets can be decreased in certain androgen sensitive patients using anabolic steroids. I just want to make sure you are not taking an oral anabolic, right?

Also, certain medications can reduce the number of platelets in your blood. Sometimes a drug confuses the immune system and causes it to destroy platelets. Examples include heparin, quinine, sulfa-containing antibiotics and anticonvulsants. Just checking you are not taking any of these.
 
Shop around prices have come down. Medicaid covers 100%. Most states have multiple avenues to qualify. Ignore those who say you won't qualify, especially county workers. There are other programs and grants. Think about this situation before pulling any red levers in November.

Mods: Just as so many docs fail to order essential tests or adopt the latest knowledge so it is with kidney health. Please consider a sticky explaining the difference between kidney health and kidney function particularly because you recommend labs for Creatinine, eGFR and BUN. It's all too easy to become complacent if these tests return in the normal range.
 
Wait a minute.

Cadcard has not even told us what his creatinine and eGFR are and people are telling him to get a CT scan?? Did I miss something?

Re-ride, I like your posts a lot since you seem to be a well educated guy.

Cadcard, can you post a copy of all your blood work?

Platelets can be decreased in certain androgen sensitive patients using anabolic steroids. I just want to make sure you are not taking an oral anabolic, right?

Also, certain medications can reduce the number of platelets in your blood. Sometimes a drug confuses the immune system and causes it to destroy platelets. Examples include heparin, quinine, sulfa-containing antibiotics and anticonvulsants. Just checking you are not taking any of these.

Nelson,
No I have never taken any sort of AAS.

My eGFR always tests in the 59-61 (>59) range.
My creatinine levels always seem a bit high ranging from 1.31 to as high as 1.42. The last labs were 1.32.
I take a low does trazodone as a sleep aid, but other than T cyp, I take no other meds.
 
Thanks for the link Nelson. I'll be sure to read it.

I'm thinking that I don't hydrate enough, the mornings that I have the blood drawn. I usually have a couple of beers every evening. I probably shouldn't drink the night before the draw.
 
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