My extensive initial blood tests. Lots of stuff to fix, don't you think?

[Ricardo Salta]

Hi all, I'm Ricardo. I just arrived, via the FB group. Thanks for the chance of posting here!
After much crippling procrastination, here they are finally, my lab results (below, after the fold).
If you don't care about context right now, please scroll down for the results already.

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So, some context:

Since I can remember I've had trouble concentrating, unless it's something I'm really excited about, and then I hyperconcentrate, to the point I won't eat, drink.... I've eventually been officially diagnosed with ADHD when I was around 20. I'm 33 now. Also been diagnosed Borderline Personality Disorder. Medications never really helped much. I'm taking none since a long time.

But I'm struggling to get anything worth done with my life. I have ambitions that I am not delivering on, simply because I'm lacking the drive, the resilience, etc.... I guess you know what I'm talking about. And I want to change things now and forever. I want to be at my best, period.

I don't have health insurance, but back in my home country my mom is a doctor (gyn/ob) and she can send me the meds as necessary. I was asking her to send me injectable T, hCG and Arimidex. Though for her tranquility she decided to first put me in contact with a urologist colleague.

The phone conversation with the urologist lasted 25 minutes and was extremely friendly, but he definitely likes to play it safe, and he said two things:

- He believes from my symptom descriptions, I have a "masked depression"; googling this, makes me wonder, because "masked depression" seems to even have been dropped as a serious diagnosis. He says he could refer me to a psychiatrist that almost never used drugs and that usually sorts people out in two sessions. But I've been to a few mental health practitioners. Results were almost close to none....

- He also insists that if I really want to give testosterone a try, that I try the gel first. Then he also mentioned that if I really would want the injectable form, that then I should simply go with Nebido.

I much look forward to all the wisdom you can share with me, about how I should proceed.


Thanks in advance for all your comments.


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Ricardo Salta’s blood tests
February/March 2016
With suspicions of hormonal problems (testosterone, thyroid, cortisol...) being able to explain my variety of health struggles (from the head down to my feet....)
These tests were made privately at the BioScientia laboratory in Berlin, Germany
I compiled the desired tests from various websites I had been studying for a long time about Testosterone dysfunction and therapy, and did as many tests as I could believing that in this case, more is more (sometimes, less is more.....)
I believe I could still do a few more (e.g. SHBG) and expect to get some feedback and feedforward from the online community when I share this
Since the results were delivered to me in German, I did my best with Google Translate, to produce, on the side of the German words/phrases, the equivalent in English. Please consider that the English version is not supposed to be professional.

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BLOOD TEST RESULTS RIGHT BELOW
[You can also download the PDF, which I attach to this post! I recommend the PDF I made based on the results the lab gave me (I did my best to translate it to English, in smaller text next to the German words). ALL that's below is also in the PDF but the PDF also contains more information (comments from the laboratory) which I also translated]
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Personal stats:
- Born March 7 1983 (33 years in 2016)
- 90 kg, 1m77cm (198 pounds / 5.8 feet)


Primary Materials
- Complete Blood
- EDTA-Blood
- NaF-Blood
- Heparin Blood


Clinical Chemistry
- Uric Acid: 6.2 mg/dl
- Cholesterol, total: 203+ mg/dl
- Tryglycerides: 108 mg/dl
- LDL-Cholesterol: 132 mg/dl
- HDL-Cholesterol: 57 mg/dl
- Atherosclerosis Index (LDL/HDL): 2.3
- Hb (for HbA1c) (EB): DELETE
- HbA1c (NGSP) (Immunoturbidimetric) (EB): 5.5%
- HbA1c (IFCC) (EB): 36 nmol/mol
- Glucose (Sodium Fluoride): 92 mg/dl


Hematology
Hematopoietic, small
- Leokocytes: 11.3+ /nl
- Erythrocytes: 5.4 /pl
- Hemoglobin: 16.1 g/dl
- Hematocrit/PCV: 0.46 l/l
- MCV: 85 fl
- MCH: 30 pg
- MCHC: 35 g/dl
- Thrombocytes: 249 /nl


Differential hematopoietic / blood picture
- Basophils: 1%
- Basophils absolute: 57 /µl
- Eosinophiles: 6%
- Eosinophiles absolute: 668+ /µl
- Neutrophiles: 69%
- Neutrophiles absolute: 7822+ /µl
- Lymphocytes: 13- %
- Lymphocytes absolute: 1472 /µl
- Monocytes: 12%
- Monocytes absolute: 1302+ /µl


Endocrinology
- TSH basal: 3.22 µU/ml
- FT4 (Thyroxine, free): 1.20 ng/dl
- FT3 (Trijodthyronin, free): 3.8 pg/ml
- Cortisol: 14.2 µg/dl
- Insulin (fasting): 15.9 µU/ml --- NOTE: I had already drank a Chai Latte this day and don't remember if I had eaten something, 50/50 chance I had eaten something small.
- HOMA-Index: 3.6+ (insulin resistance likely)
- Dehydropiandro testosterone sulfate (DHEA-S): 230 µg/dl
- Dihydrotestosteron (S): 13.3 µg/dl
- Testosterone, total: 3.14- ng/ml (314ng/dl)
- Testosterone, free: 9.0 pg/ml
- Prolactin (ECLIA, Fa. Roche): 10.4 µg/l
- FSH: 1.4- mIU/ml
- Estradiol (E2): 19 pg/ml


Tumor marker
- PSA, total: 0.367 ng/ml
Method: ECLIA, (Fa. Roche)
Heparin blood specialised for metal analysis

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Again, thanks!

 

[Nelson Vergel]

I apologize since no one seemed to have replied to your post yet.

Your testosterone is on the low end. Your LDL cholesterol is high but HDL is good. Insulin resistance is also a potential issue. Some psych meds can cause insulin resistance. Are you taking any?

Your lymphocytes are slightly high. Possible infection?

I have several coaching clients in Germany. Yes, Axiron and Nebido seem to be the preferred TRT methods along with Testogel. So far, it seems that testosterone cypionate and enanthate are not as commonly used like they are in the US, specially in small twice per week protocols. HCG is also hardly discussed in Germany. However, the German system seems to be friendlier than the rest of Europe when it comes to freedom of blood testing to include more parameters that what insurance companies cover in the US.

Nebido at 1000 mg every 8-10 weeks may work well for some men.

My book is available in Germany if you need more info: http://www.amazon.de/Testosterone-G...&qid=1460940750&sr=8-1&keywords=nelson+vergel

 

[Ricardo Salta]

Thanks for your time and attention Nelson.

Answering your question about the psychiatric meds:

I've been on quite a few throughout the years (Zoloft, Paxil, Wellbutrin, Risperidone, Topamax, Concerta...), but it's been quite a few years that I haven't been on any.

Other drugs:

I have also had, for the last 10 years, a pretty unproblematic relationship with a variety (bigger variety than for most people who try them even, yes I'm very curious and experimentalist) of recreational drugs. Basically, it's weeks that I can go without anything. But sometimes, here and there, it happens. I suspect I will have less interest on these various substances once my T levels are up where they should. Time will tell. Incidentally, looking back to my complaints in this life, which can be related to T, I was having them to a significant point already, way before I started experimenting with the so-called recreational drugs.


Sedentary Lifestyle

I have a hunch my ultra-sedentary, "internet addiction" lifestyle of many years (which is much different in the last 5, at least I walk at least 30km a week) has more to do with it all than whatever drugs I might have been taking, even the psychiatrics. Thoughts?

Cannabis

Incidentally I'm interested in the effect of cannabis on T. Something tells me that for vulnerable people, it brings it even further down. It also seems like for someone with healthy levels kept in check, it might even be good. I like to smoke sometimes, with space in between. But if I smoke all the time (it happened in periods in the past) then I don't like how it leaves me, too apathetic, too contented....

Lymphocytes

I was on the tail end of a cold, with sore throat and cough, when I finally couldn't keep myself from it any longer, and went to take the tests. Might this be the reason?

Sugar Abuse and Insulin

Since I remember, I've been a sugar junkie. I would be 13 years old and devour, with a soup spoon, a whole jar of strawberry jam. I would drink to-dillute-in-water sugary drinks, straight from the bottle, without dilluting. Heck, I'd even eat white sugar with a spoon. It's gotten better -- this barely happens to me today. But under stress, it does come back in full force. Back in December, when for a short few days I was unsure if I could pay my rent, and started seeing everything through dark lenses, I devoured unhealthy, high-sugar stuffs, until I would get sick.

Optimised Powder Nutrition

Last year I ate for more than six months, a DIY Soylent alternative, Nerdshake (German recipe). I had to interrupt because life got a bit chaotic. Now that it's stabilised, I've already ordered (must be arriving anytime) some Huel. I'm looking much forward.

A few questions:

If I find my way to get cypionate or enanthate already to do 2x a week subQ, is this what you'd advise me personally?

If I can also get myself hCG, should I start it immediately? Will I also inject it at the same time as the testosterone?

What about Arimidex, if I can also get it? Should I start already? Or wait for issues to manifest, if they do at all?

About testing parameters: I'm doing all this out-of-pocket anyway. Should I get tested for more things? If so, what?

Also: I can't understand my thyroid results. Somehow it makes me wonder if I have some sort of hypothyroidism. But my combination of results (FT3, FT4, TSH) I find is uncommon. But, I have tinnitus, and hypothyroidism seems to be one of its causes. Also, the list of symptoms of hypothyroidism is huge anyway.

Should I simply start T already, and then test everything again soon enough, and see if there's still anything to mess with further? Or should I also try to check better with thyroid specialists?

I already struggle to do one thing. Maybe I should stick just with T! Or with the T-hCG-Arimidex trifecta...?

Thanks so much for all feedback and feedforward.

 

[Nelson Vergel]

Reply from Nelson

Answers after each question:

Thanks for your time and attention Nelson.

A few questions:

If I find my way to get cypionate or enanthate already to do 2x a week subQ, is this what you'd advise me personally?

I suggest you follow my protocol (with or without HCG) https://www.excelmale.com/?s=149-Ho...o-Preserve-Fertility-Libido-and-Testicle-Size

If I can also get myself hCG, should I start it immediately? Will I also inject it at the same time as the testosterone?
see above

What about Arimidex, if I can also get it? Should I start already? Or wait for issues to manifest, if they do at all?
No one should start Arimidex at baseline. Wait until week 6 to test your estradiol via sensitive test to make a decision.

About testing parameters: I'm doing all this out-of-pocket anyway. Should I get tested for more things? If so, what?

Your tests were pretty complete. I would not spend more money until week 6 after you start TRT.

Also: I can't understand my thyroid results. Somehow it makes me wonder if I have some sort of hypothyroidism. But my combination of results (FT3, FT4, TSH) I find is uncommon. But, I have tinnitus, and hypothyroidism seems to be one of its causes. Also, the list of symptoms of hypothyroidism is huge anyway.

Your TSH is elevated but free T3 is not bad. I would just retest both at week 6 again.

Should I simply start T already, and then test everything again soon enough, and see if there's still anything to mess with further? Or should I also try to check better with thyroid specialists?

I would not go to a thyroid specialist now. Do you have cold intolerance, fatigue, unexplained weight gain?

I already struggle to do one thing. Maybe I should stick just with T! Or with the T-hCG-Arimidex trifecta...?

Yes. One step at a time. No need to complicate yourself. The only issue will be trying to see if Germany's health system can provide testosterone cypionate or enanthate and HCG.

Thanks so much for all feedback and feedforward.

Yes. One step at a time. No need to complicate yourself. The only issue will be trying to see if Germany's health system can provide testosterone cypionate or enanthate and HCG.