Initial blood work (pre-TRT)

Rodney Stewart

New Member
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!

[TABLE="class: grid, width: 500, align: center"]
[TR]
[TD]Test[/TD]
[TD]Range[/TD]
[TD]Tested Value[/TD]
[/TR]
[TR]
[TD]T3 UPTAKE[/TD]
[TD]20.0 - 38.5 %[/TD]
[TD]30.4[/TD]
[/TR]
[TR]
[TD]T4 TOTAL[/TD]
[TD]4.4 - 12.4 UG/DL[/TD]
[TD]9.2[/TD]
[/TR]
[TR]
[TD]FTI[/TD]
[TD]1.05 - 4.50[/TD]
[TD]2.80[/TD]
[/TR]
[TR]
[TD]HEMOGLOBIN A1C[/TD]
[TD]4.0 - 5.6 %[/TD]
[TD]5.5[/TD]
[/TR]
[TR]
[TD]DIHYDROTESTOSTERONE[/TD]
[TD]112 - 955 pg/mL[/TD]
[TD]362[/TD]
[/TR]
[TR]
[TD]PROLACTIN[/TD]
[TD]3.0 - 30.0 NG/ML[/TD]
[TD]4.2[/TD]
[/TR]
[TR]
[TD]SOMATOMEDIN-C[/TD]
[TD]77 - 250 NG/ML[/TD]
[TD]78[/TD]
[/TR]
[TR]
[TD]HEMATOCRIT[/TD]
[TD]37.0 - 49.0 %[/TD]
[TD]41.4[/TD]
[/TR]
[TR]
[TD]HEMOGLOBIN[/TD]
[TD]13.0 - 17.0 G/DL[/TD]
[TD]13.6[/TD]
[/TR]
[TR]
[TD]LUTEINIZING HORMONE[/TD]
[TD]6.0 - 19.0 mIU/ml[/TD]
[TD]10[/TD]
[/TR]
[TR]
[TD]FOLLICLE STIMULATING HORMONE[/TD]
[TD]4.0 - 10.0 mIU/ml[/TD]
[TD]17[/TD]
[/TR]
[TR]
[TD]DHEA-S[/TD]
[TD]1419 - 3867 ng/ml[/TD]
[TD]1422[/TD]
[/TR]
[TR]
[TD]SHBG (Retested for confirmation)[/TD]
[TD]10 - 55 nmol/L[/TD]
[TD]153[/TD]
[/TR]
[TR]
[TD]ESTRADIOL[/TD]
[TD]0.5 - 5 ng/dl[/TD]
[TD]3[/TD]
[/TR]
[TR]
[TD]TESTOSTERONE LEVEL[/TD]
[TD]200 - 1000 ng/dl[/TD]
[TD]279[/TD]
[/TR]
[TR]
[TD][TABLE="width: 500"]
[TR="class: grid"]
[TD]FREE TESTOSTERONE-CALCULATED
[/TD]
[/TR]
[/TABLE]
[/TD]
[TD][/TD]
[TD]1.66[/TD]
[/TR]
[/TABLE]
 
*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.

TRTProgress.webp
 
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.
 
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?
 
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.
 

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Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

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The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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