Initial blood work (pre-TRT)

[Rodney Stewart]

These are tests I had performed by Dr. Larry Lipshulz in Houston, prior to starting TRT. I currently take Axiron (60mg per day I believe? Once for each armpit.) and will go back for follow-up blood work on 3/31. These values were tested at approximately 5:00 pm and the testing was performed by Clinical Pathology Laboratories, 9200 Wall St., Austin, TX 78754.

The doctor hasn't spoken to me about these results or what they mean, but some immediate questions that pop to mind:


Hemoglobin is at the high-end of the normal range, does this mean anything?
Somatomedin-C is near the low-end of the normal range, does that mean anything?
FSH looks way over the normal range, which I assume would be normal in primary hypogonadism(?)
SHBG is so high that they had to re-test it to confirm, any worries there?

Would love to hear any other thoughts.

Thanks!

Test	Range	Tested Value
T3 UPTAKE	20.0 - 38.5 %	30.4
T4 TOTAL	4.4 - 12.4 UG/DL	9.2
FTI	1.05 - 4.50	2.80
HEMOGLOBIN A1C	4.0 - 5.6 %	5.5
DIHYDROTESTOSTERONE	112 - 955 pg/mL	362
PROLACTIN	3.0 - 30.0 NG/ML	4.2
SOMATOMEDIN-C	77 - 250 NG/ML	78
HEMATOCRIT	37.0 - 49.0 %	41.4
HEMOGLOBIN	13.0 - 17.0 G/DL	13.6
LUTEINIZING HORMONE	6.0 - 19.0 mIU/ml	10
FOLLICLE STIMULATING HORMONE	4.0 - 10.0 mIU/ml	17
DHEA-S	1419 - 3867 ng/ml	1422
SHBG (Retested for confirmation)	10 - 55 nmol/L	153
ESTRADIOL	0.5 - 5 ng/dl	3
TESTOSTERONE LEVEL	200 - 1000 ng/dl	279
FREE TESTOSTERONE-CALCULATED		1.66

 

[Rodney Stewart]

*crickets*

Update for anyone interested. The left is prior to starting TRT, the right is after two months of 60mg (two applications) Axiron every day. SHBG is still very high and DHEA has dropped quite a bit. Total T and Free T are looking much better, but I feel Free T could be much higher.

Would love any input / advice from people more seasoned than me.

 

[Vince]

Rodney HI, how are you feeling, did you have any symptoms before you started TRT?

 

[Nelson Vergel]

Rodney

Looking good. You may want to consider DHEA at 50 mg with breakfast and 5000 IU of Vitamin D daily. Those two will also help you with lowering SHBG.

 

[Rodney Stewart]

Heya Vince, thanks for asking. Things are definitely going better and I'm very happy with the decision to start replacement therapy. Main symptoms prior were fatigue, brain fog, and lack of libido. Everything downstairs still worked, I just didn't care about it. Also, despite a proper diet and exercise, I seemed to be building strength and lean body mass extremely slowly.

Rodney HI, how are you feeling, did you have any symptoms before you started TRT?

 

[Rodney Stewart]

Thanks Nelson, I'll definitely start with the Vitamin D right away (as I have some at home already). Dr. Lipshultz prescribed me an aromatase inhibitor (I'll have to check my prescription to see which one) but told me to only worry about filling it if I experienced any symptoms (I was having slight nipple tenderness).

Assuming I don't start the inhibitor, do I have to worry (excessively) about such a small amount of DHEA aromatising?

Rodney

Looking good. You may want to consider DHEA at 50 mg with breakfast and 5000 IU of Vitamin D daily. Those two will also help you with lowering SHBG.

 

[Rodney Stewart]

Dr. Lipshultz prescribed me an aromatase inhibitor (I'll have to check my prescription to see which one)

Checked the prescription, it's Nolvadex / Tamoxifen.

 

[Nelson Vergel]

Unfortunately, Dr Lipshultz (a good friend of mine) still uses immuno-assays to measure estradiol (not LC/MS). So your E levels are likely to be low. We need estradiol for sex drive!

Tamoxifen decreases IGF-1. I would not take it unless you are one of the rare cases of gyno on TRT.

https://thinksteroids.com/articles/avoid-nolvadex/
http://www.ncbi.nlm.nih.gov/pubmed/11299809

 

[Vettester Chris]

The thyroid labs are virtually useless! Needing Free T4, Free T3, Reverse T3 & antibodies (TPO & TgAb).

 

[Rodney Stewart]

Hey Chris, these aren't thyroid labs, just my doctor's hypogonadism panel. Here is my thyroid panel from 2/6/2015, if a thyroid panel was run on my latest blood work (03/30), I don't have it yet.

The thyroid labs are virtually useless! Needing Free T4, Free T3, Reverse T3 & antibodies (TPO & TgAb).

 

[Nelson Vergel]

Chris will tell you that those tests tell him little about your thyroid. Free T3, free T4, reverse T3 and antibodies is what he needs.

http://www.discountedlabs.com/complete-thyroid-profile/

http://www.discountedlabs.com/reverse-t3/

Of course, I would not bother with those tests unless you are tired a lot even with 7+ hours of sleep.