Latest Test Results vs. Old Results...Your thoughts

[stlstudent]

Like many of you, I have spent countless time researching and reading about HRT on this site and others. I have also had an opportunity to speak with Mr. Vergel and discuss these topics. If you get a chance i highly recommend speaking with him as his knowledge and positive attitude and help were such a blessing (and no I'm not a paid spokesman).

I am currently under the care of a local "pay by the month" clinic but have just recently had my blood drawn and paid for my initial consultation with Defy as I hope to switch my care over to them. I have been tracking ALL my blood work over the past 3 years and have been on a steady protocol for the last year and a half so that is where I will keep my focus.

The current protocol is 1cc of 200mg test cyp once a week and 500 units of HCG twice a week. I also take .25 mg of Anastrozol every 5 days.

Here are my results from 3 of my previous blood tests (in order from oldest to newest) on some of the main factors:

Testosterone Total: 850/857/987
Testosterone Free: 47/46/294* (*was done by Quest and other by Labcorp but both say pg/ml??)
Estradoil: 28*/40/72 (*was .25 anastrozole every 4 days, others were every 5 days)
TSH: 3.78/2.66/4.29
T3: 3.1/3.3/3.4
T4: 1/.85/.8
Hematocrit: 49.6/54.2/51.3 (donated blood between 2nd/3rd draws)
RBC: 5.85/6.16/5.9
SHBG: 9.2/9.6/not done


If there are any others to help you paint a more complete picture, let me know and I'll post them.
The first two (of the three listed) were done by Labcorp and the third was done by Quest. Would that explain the difference in numbers that much? I haven't changed the protocol so I'm wondering why there is such variation.

I have come a LONG ways since starting HRT and am grateful I found it, but I still find my self very sluggish, a bit foggy on periodic days and still having trouble losing weight.

Just figured I'd throw it out there and see what your input you may have and we can start a dialogue that may not only help me but others in the same boat as I have learned so much from reading other peoples post as well.

Thanks,
Nick

 

[Vince Carter]

I think you've got a real Thyroid issus, your TSH is way to high in the three tests. You need a better panel of Thyroid tests....T3, T4, Reverse T3, and antibodies, along with TSH, but something is off, a much better TSH would be in the 1-1.5 range. Its essentially the body thinking it's (or is) low on Thyroid hormones and it's being told to make MORE, like being in overdrive.

Also, stick with one lab and be religious about your testing. I do all mine @ 0800-0830 on a Friday at the same Quest service center. There can be differences between labs.

Re your SHBG is very very low and most of us in that situation do best with injecting CYP EOD, 200mg once per week is too much at one-time, spikes your Estrogen because of the excess. Could be why your SHBG is the low. The Estrogen spike and being elevated in general can directly contribute to you feeling foggy and sluggish, with weight loss issues.

 

[stlstudent]

Thanks for the reply. When I talked with Nelson, he said the very same things about my Thyroid so I spoke with my PCP about it and how the the reference ranges are not that great an indicator. I printed out the research that Nelson posted on here but he was not swayed and said I would need to talk to an endocrinologist. That is one of the reasons I am checking in with Defy to see what they think and if they can help.

You mention that it is in 'overdrive' so wouldn't that be HYPERthyroidism although I seem to show more signs of HYPOthyroidism?

I try to be religious on the labs I use and times when i test, etc... but it is not always possible. When I use discountedlabs.com they use Labcorp but if I do any others through my doctor, clinic and defy I have to use Quest because my insurance covers them at 100 percent.

Agree on the SHBG, I always feel great the first couple days but by the end of the week i seem to feel at the lowest mentally/physically. The clinic I use does not want to have me doing it more than once a week (another reason I'm looking at Defy).

But on a side note, wouldn't low SHBG be ideal? More of the T gets in and gets to work where others with higher SHBG get their T all bound up and its basically 'wasted' because it cannot get free?

Thanks again for starting the conversation!

Nick

 

[Sean Mosher]

I'm a little curious as to the last labs................those estradiol and free T numbers don't make sense with your protocol not having changed..........the consistency of the 1st 2 labs looks good though.

 

[Vince Carter]

Im not to hip on the intricasies of Hypo or Hyper Thyroid so I'll leave that alone, noentheless the Pituitary is telling your Thyroid to make more so something is wrong there.
Low SHBG just requires a different approach to injections, EOD seems to be the thing, some use daily injections, smaller but more frequent dosing. Also limits the excess that could aromatize. Typical SHBG translates to really high, off the scale high, Free T, like over 3%, which is not a bad thing. Low SHBG in my opinion having it, get's unfairly targeted as a problem. It can't be "raised", so you just have to work around it.

 

[stlstudent]

I'm a little curious as to the last labs................those estradiol and free T numbers don't make sense with your protocol not having changed..........the consistency of the 1st 2 labs looks good though.

Agreed, especially the free T. I triple checked and all reports said they used the same measurements (pg/ML) as I thought that might be it. I'm really not sure. And that last lab was drawn the day before my next injection

 

[Helboi]

Agree on the EOD for low SHBG guys. That's what I'm doing now and it's been the best dosing I've tried yet (out of weekly, then every 3.5d, now EOD).

 

[CoastWatcher]

All the points made above are on the money. I urge you not to focus on the low SHBG value - as Vince Carter and Helboi note it is an issue that can be dealt with by adjusting your injection and doseage. I inject on a daily basis and have achieved solid levels across the board. The TSH value indicates your pituitary is being stimulated to produce more thyroid hormone - the higher that value the more likely it is you are dealing with hypothyroidism.

 

[ERO]

Thanks for the reply. When I talked with Nelson, he said the very same things about my Thyroid so I spoke with my PCP about it and how the the reference ranges are not that great an indicator. I printed out the research that Nelson posted on here but he was not swayed and said I would need to talk to an endocrinologist. That is one of the reasons I am checking in with Defy to see what they think and if they can help.

You mention that it is in 'overdrive' so wouldn't that be HYPERthyroidism although I seem to show more signs of HYPOthyroidism?


I try to be religious on the labs I use and times when i test, etc... but it is not always possible. When I use discountedlabs.com they use Labcorp but if I do any others through my doctor, clinic and defy I have to use Quest because my insurance covers them at 100 percent.

Agree on the SHBG, I always feel great the first couple days but by the end of the week i seem to feel at the lowest mentally/physically. The clinic I use does not want to have me doing it more than once a week (another reason I'm looking at Defy).

But on a side note, wouldn't low SHBG be ideal? More of the T gets in and gets to work where others with higher SHBG get their T all bound up and its basically 'wasted' because it cannot get free?

Thanks again for starting the conversation!

Nick

Low SHBG is the opposite of ideal - more like one of the worst things you can have. I know from having SHBG that hovers around 10 and the 5 years I have been on TRT with no relief whatsoever. Said another way, I feel basically the exact same now as I felt with diagnosed Low T.

 

[Vince Carter]

Low SHBG is the opposite of ideal - more like one of the worst things you can have. I know from having SHBG that hovers around 10 and the 5 years I have been on TRT with no relief whatsoever. Said another way, I feel basically the exact same now as I felt with diagnosed Low T.

No...nothing works for you, but, In that context you can blame every component of TRT for why you get no relief, not just low SHBG. Might as well blame this that and the other while you're at it, but this nothing works for me song has gotten tiresome.

 

[ERO]

My point of my post was that having low SHBG is not a desirable state to be in.

 

[stlstudent]

TRT has worked wonders for me, I have went from the bottom and up to a 7 or 8 (if we were using a 1-10 scale). I'm just having a hard time getting to that 9 and 10 range or at minimum staying consistent. Even if I am low SHBG that at least would be consistent wouldn't it? So i'm curious as to why my other numbers do not stay consistent.

Definitely hope Defy will look at the thyroid side of things because I have a gut feeling something is off there (sluggish, weight gain, etc...) but no doctor so far will even take a second glimpse at it for me.

 

[stlstudent]

Had my initial consult with Defy and spoke with Dr Chrisler. He thought I had a good start but wanted to do some fine tuning so here is the new protocol:

200mg Testosterone .5 ml twice a week (Sub Q)
100 i/u HCG every morning (Sub Q)
.25 mg Anastrozole on the mornings of my T injections

Fish oil 3mg every day
Natural Desiccated Thyroid 60 mg every morning


Was good talking with him and I trust his experience and knowledge. I'll be honest, I'm not necessarily looking forward to an injection every morning but if it works I'm sure it worth it. I'm also going to have to do some reading on doing Testosterone sub-q because i'm not familiar with that method

 

[CoastWatcher]

I'll be honest, I'm not necessarily looking forward to an injection every morning but if it works I'm sure it worth it. I'm also going to have to do some reading on doing Testosterone sub-q because i'm not familiar with that method

I inject on a daily basis. It will soon be as routine as showering and shaving. All the best.