Lab results on follow up

[LiveX2]

I've finally gotten my results back and here they are (3 mth f/u):

TT - 990 (MS)
FT - 178 (Dialysis)
Estradiol - 44 (LC/MS)
Free T3 - 3.2
SHBG - 37
Hematocrit - 54
Hemoglobin - 17.2
LH - <0.2 Reference Range: 1.5-9.3 mIU/mL

I'm feeling great and I would not change anything in my protocol. Still, as I wait my consultation, I'm curious if anything looks odd with my results. I already got a comment from my provider that I should consider donating blood with my H&H elevated to the high end. Also consider my estradiol a little high, not sure if the number is a problem, but I don't have any symptoms of a level too high. My libido and everything related in that regard is great, and not feeling irritable, not overly (emotionally) sensitive, etc. As a matter of fact, my nipples were sensitive and a concern I had a mild case of gyno prior to starting TRT. I got a mammo and US...all checks out ok and physician said I have a portion of dense tissue under my breast - benign and not noticeable. The sensitivity went away about 2 months in to my TRT treatment.

My protocol is 80mg Q3.5 T cypionate (160mg/wk), 50mg Q7 nandrolone (50mg/wk), hCG .25ml Q3.5

Original protocol had hCG .25ml once per week, I increase to 2x's because I wanted my boys more full...seems to be effective, even though my wife and I make them work a lot. I just wasn't expecting LH to be low bc of the hCG.

Appreciate your thoughts.

 

[Systemlord]

I'm curious if anything looks odd with my results.

Hematocrit - 17.2
Hemoglobin - 54

These ratios are off, indicating dehydration.

How is your sleep quality?

I just wasn't expecting LH to be low bc of the hCG.

This is to be expected, because hCG isn't LH, it mimics LH and therefore doesn't increase LH. LH and FSH will be shut down while on injectable exogenous testosterone.

 

[LiveX2]

You're either dehydrated or possibly you have sleep apnea.

These ratios are off, indicating dehydration.

How is your sleep quality?


This is to be expected, because hCG isn't LH, it mimics LH and therefore doesn't increase LH. LH will be shut down while on exogenous testosterone, except if on Natesto.

I could drink more water - probably dehydrated. I sleep well. Had sleep apnea years ago and corrected with septoplasty.

do you mean the ration H/H is off? Prior to TRT my H&H was hema 48.8; hemo 16.5
I was fasting for both tests...next time I will continue drinking water all night (as well as all along) and see if anything changes.

 

[Systemlord]

Had sleep apnea years ago and corrected with septoplasty.

TRT can cause or worsen sleep apnea. There's a strong possibility you have sleep apnea again.

do you mean the ration H/H is off?

The hemoglobin to hematocrit ratios is off, the hematocrit is high relative to the hemoglobin.

This is typically seen in sleep apnea cases.

 

[LiveX2]

TRT can cause or worsen sleep apnea.

Thanks. I was expecting H&H to increase while on TRT naturally. Haven't gotten any complaints from my wife about excessive snoring or not breathing...But also good to know.

 

[LiveX2]

TRT can cause or worsen sleep apnea. There's a strong possibility you have sleep apnea again.


The hemoglobin to hematocrit ratios is off, the hematocrit is high relative to the hemoglobin.

This is typically seen in sleep apnea cases.

interesting. Thanks @Systemlord this is something to watch for.

EDIT - I'm going to need to look into having a sleep study. Did some searching on DiscountLabs and found a list of possible reasons.

Search results for: 'blog high hematocrit caused by trt how to lower it'

www.discountedlabs.com

 

[LiveX2]

LOL I flipped the H&H numbers :|

Hematocrit 54
Hemoglobin 17.2

 

[Systemlord]

LOL I flipped the H&H numbers :|

Hematocrit 54
Hemoglobin 17.2

I unflipped them when I read the results. They ratios are still off. When my hemoglobin is 17.2, my hematocrit is <50%

 

[WestB87]

So @Systemlord , my hematocrit and hemoglobin levels are extremely similar to @LiveX2 and just three weeks ago we’re:
Hemoglobin: 17.5 g/dL
Hematocrit: 53.8%.

This is indicative of dehydration or sleep apnea? Any studies or data explaining these? You’ve piqued my interest sir. Looking at my sleep data on my Apple Watch, I have “awake” moments 7-9 times per night. Never had a sleep study done, but with the right research/data push, I’d be willing to take a shot at it.

 

[LiveX2]

So @Systemlord , my hematocrit and hemoglobin levels are extremely similar to @LiveX2 and just three weeks ago we’re:
Hemoglobin: 17.5 g/dL
Hematocrit: 53.8%.

This is indicative of dehydration or sleep apnea? Any studies or data explaining these? You’ve piqued my interest sir. Looking at my sleep data on my Apple Watch, I have “awake” moments 7-9 times per night. Never had a sleep study done, but with the right research/data push, I’d be willing to take a shot at it.

@WestB87 there are several reasons you may have high H&H... H&H increase while on TRT, aside from dehydration and sleep apnea. TRT causes an increase in RBC, or erythrocytosis. From an article on DiscountLabs (post #6), they provide a list of causes and ways to manage (excerpt RE erythrocytosis below):

"Erythrocytosis is a medical condition that appears when the body is making too many red blood cells. RBCs are responsible for transporting oxygen to organs and tissues. When they are too many, the blood can become too thick and cause cardiovascular complications.

There are two types of erythrocytosis – primary and secondary. Primary erythrocytosis is usually caused by bone marrow problems. RBCs are made in the bone marrow, and something might trigger an increase in their production. Secondary erythrocytosis is caused by certain diseases or drugs, including testosterone replacement therapy.

Some studies concluded that testosterone reduces hepcidin (a hepatic hormone) which is related to iron absorption paths. When hepcidin is reduced, erythrocytosis is increased [1]

This medical condition is represented by an increase in hemoglobin (Hb) and hematocrit (Hct). When the Hb is higher than 18.5 g/dL, and the Hct is higher than 52% in men, the patient suffers from erythrocytosis."

 

[WestB87]

@WestB87 there are several reasons you may have high H&H... H&H increase while on TRT, aside from dehydration and sleep apnea. TRT causes an increase in RBC, or erythrocytosis. From an article on DiscountLabs (post #6), they provide a list of causes and ways to manage (excerpt RE erythrocytosis below):

"Erythrocytosis is a medical condition that appears when the body is making too many red blood cells. RBCs are responsible for transporting oxygen to organs and tissues. When they are too many, the blood can become too thick and cause cardiovascular complications.

There are two types of erythrocytosis – primary and secondary. Primary erythrocytosis is usually caused by bone marrow problems. RBCs are made in the bone marrow, and something might trigger an increase in their production. Secondary erythrocytosis is caused by certain diseases or drugs, including testosterone replacement therapy.

Some studies concluded that testosterone reduces hepcidin (a hepatic hormone) which is related to iron absorption paths. When hepcidin is reduced, erythrocytosis is increased [1]

This medical condition is represented by an increase in hemoglobin (Hb) and hematocrit (Hct). When the Hb is higher than 18.5 g/dL, and the Hct is higher than 52% in men, the patient suffers from erythrocytosis."

Thanks, I read the paper when you posted it earlier. My curiosity lies with the ratio between the hemoglobin and hematocrit *ratio* as an indicator of sleep apnea or dehydration. My provider discussed with me that I wasn’t necessarily dehydrated, but was getting close per some of my other markers. My sleep has never been remarkable and it makes me curious if I do perhaps have sleep apnea. I don’t snore and my wife remarks about how silent a sleeper I am aside from clicking my teeth together/bruxism. I’m in a bit of a pickle regarding my hematocrit and ferritin levels. Ferritin was a 23 so donating would crash my levels further (I was a frequent donor but that may have bitten me). The sleep apnea angle may be worth perusing.

Are you considering a sleep study? Or are you interested in other options for the time being?

 

[LiveX2]

You and Systemlord are right. The ratio between the two is a good indicator of sleep apnea...can't seem to find that study right now.

I had a sleep study done years ago...mild case. I then had septoplasty done (and other related procedures) and I no longer have it. Still, as Sytemlord mentioned, TRT can cause SA to return. IDK...but I'm not doing a new sleep study. I will donate blood, take turmeric and curcumin, ensure I remain hydrated and evaluate next steps after I get measured again.

 

[WestB87]

You and Systemlord are right. The ratio between the two is a good indicator of sleep apnea...can't seem to find that study right now.

I had a sleep study done years ago...mild case. I then had septoplasty done (and other related procedures) and I no longer have it. Still, as Sytemlord mentioned, TRT can cause SA to return. IDK...but I'm not doing a new sleep study. I will donate blood, take turmeric and curcumin, ensure I remain hydrated and evaluate next steps after I get measured again.

Sounds like a solid plan dude. I hope it all works out for you!

 

[Systemlord]

Hemoglobin: 17.5 g/dL
Hematocrit: 53.8%.

I would typically have a hematocrit of 51% and a hemoglobin of 17.9 on my current protocol.

 

[LiveX2]

I would typically have a hematocrit of 51% and a hemoglobin of 17.9 on my current protocol.

the 3 of us have similar ratio...my hemoglobin being proportionately less than both of you at 31.9%, @WestB87 at 32.5%, and @Systemlord at 35.1%.

 

[LiveX2]

Had my f/u today and my doc indicated that I shouldn't change anything in terms of protocol...was happy about that. Asked about the ratio...we're gonna keep an eye on it, see how it changes on next f/u, and donate blood.

@WestB87 if this the first time seeing your HH elevated, perhaps some diet/lifestyle changes would help before getting a sleep study done. Hydrate more, donate blood, and eat less red meat. I know I have not followed that same advice...I've been eating red meat 4 times a week. SMH - I will also try to eat less red meat + turmeric and curcumin. Potential other option is to lower your T
:0