Lab results. Diagnosing ED/Libido

[Nixter]

So trying to figure out why I'm having on/off ED issues. Currently on scripted 200mg test E and 1mg adex, split into twice weekly doses. I pin sub Q Mon nights and Fri mornings. Blood was taken Thursday afternoon. Anything here that might be linked to ED/libido? I see Progesterone is at the bottom of range. E2 is right in the middle but was higher in the range, naturally, before I did TRT and had no ED issues.

 

[Systemlord]

Anything here that might be linked to ED/libido?

Your Total T is over 1000, your Free T is almost 3x the reference ranges and your SHBG is low. Some guys just don't do well on even moderate doses, especially men with low SHBG. The AI's caused me nothing but problems sexually regardless of estrogen levels.

No man has hormone levels this high naturally, maybe these hormones levels are just to high for you.

 

[Nixter]

Thanks, something to consider. I have a follow up appt with the doc tomorrow so we'll see what he has to say about the results.

 

[madman]

So trying to figure out why I'm having on/off ED issues. Currently on scripted 200mg test E and 1mg adex, split into twice weekly doses. I pin sub Q Mon nights and Fri mornings. Blood was taken Thursday afternoon. Anything here that might be linked to ED/libido? I see Progesterone is at the bottom of range. E2 is right in the middle but was higher in the range, naturally, before I did TRT and had no ED issues.

You are Canadian as I can tell you had your blood work done at Lifelabs.

How long have you been on said protocol?.....200mg test E and 1mg adex, split into twice weekly doses. I pin sub Q Mon nights and Fri mornings.

What was the main reason for jumping on the aromatase inhibitor.....fear of a high e2 number or were you truly experiencing symptoms?

Keep in mind that you did not have blood work done at true trough as you injected Monday night and did labs Thursday afternoon when you should have waited until Friday morning just before your next injection.

As you can see your TT level (12-18 hrs short of your true trough) is high 41.3 nmol/L (1190.2 ng/dL) and your FT is very high (mind you it is the calculated Vermeulen method which is not only outdated but inaccurate).

If you had your FT tested using the gold standard Equilibrium Dialysis or Ultrafiltration or just take your TT, SHBG and Albumin and use the newer TruT calculator than you would truly be able to see where your FT level sits.....with a TT 1190.2 ng/dl, Albumin 4.3 g/dL (mean), SHBG 18.4 nmol/L than your FT (trough) is 45.04 ng/dL (well above the top end of the range).

Understand that your peak TT/FT and e2 levels (if your were not taking an a.i.) would be much higher and although I see no major issue running a TT/FT trough level as yours if you felt great overall and your blood markers were in a healthy range.....but the kicker here is your SHBG is somewhat on the lower end so running such a high TT/FT level would have your e2/free e2 very high which could lead to issues for some but seeing as you are using an aromatase inhibitor it brought down your estradiol levels and you stated....."So trying to figure out why I'm having on/off ED issues."

Were you experiencing these issues when you were not using an a.i.?

Also keep in mind that your e2 levels may very well be much lower than what your labs show as you had the regular estradiol test done.....not the estradiol sensitive (LC-MS/MS).

If you truly were experiencing negative symptoms due to high e2 before the aromatase inhibitor was added to your protocol.....than I would say that since your SHBG is on the lowish end you definitely have room to lower your dose slightly and bring down your TT/FT levels and you could very well drop the a.i. as you may end up not needing it when using a lower overall weekly dose of T and you may very well feel better overall.

Have you been donating blood often because your ferritin is lowish?

You need to get your ferritin levels higher and definitely start supplementing with iron let alone Vitamin D as your levels can be improved upon.

 

[Nixter]

You are correct! BC Canada!

I've been on this protocol for 8 weeks. Prior to that I was on 100mg/wk and no AI. Felt fine but had similar ED issues. I had a panel done across the border on that protocol but it was very limited. Drawn at about the same as the recent bloodwork, Thursday afternoon. At least it had e2 sensitive.

Testosterone, Total, LC/MS 484.4 Normal range- 264.0-916.0 ng/dL

Estradiol, Sensitive 30.6, Normal range- 8.0-35.0 pg/mL

When I went back up to 200, yes I used AI to prevent potential issues, and it was the amount originally prescribed via the ND at the men's health clinic. Perhaps I don't need much or any? Or I should lower my test amount and drop the AI. Sigh, what to do!

I haven't donated in about a year and I take 5000iu vit D/day. Weird. I haven't been seeing much daylight lately though that's for sure.

Ok maybe I'll increase iron first as I don't like to make multiple changes at once. Thoughts? I see the ND on Thursday to review the test results so we'll see what he recommends too.

I seriously appreciate your insight, madman!

 

[Nixter]

So I just came back from the Doc. He wants to try INCREASING my test lol. I mean, sure why not. Im getting a script which is fully paid for so might as well! I can always try lowering it myself later and I'll have a stockpile of legit pharma test. So current plan is to increase to 225/wk and keep AI the same at 1mg. Doc said I'm not anemic, just low ferritin but to add an iron supp anyways. Also gave me a script for viagra in the meantime.

 

[wondering]

Your T is way over range and you're going to increase your dose? Seriously?