My wife is thinking about HRT

[HamburgerChef]

After seeing the huge impact that TRT has had on me, my wife would like to see if HRT is right for her. She is 38yr, obese, and has a copper intrauterine device implanted for birth control (implanted 3-4 months ago in the hopes of improving symptoms of low energy, low sex drive, and weight gain). Prior to the copper IUD she was on a hormonal intrauterine implant for 12 years. Her main goals are to loose weight, increase motivation/energy, and increase sex drive.

I am posting her labs hoping someone sees something that could be treated. What stands out to me is the TSH being on the low side, MCH being low, and sex hormones being on the low side. I currently use DefyMedical for my TRT with excellent results, so she is planning on scheduling an appointment with Dr. Saya soon. Do you think we should pull a Thyroid panel prior to talking to the Doctor? Anything else we should test, or expect? Is there a good forum like ExcelMale for women? I know this forum is for men, so I totally understand if no one has any experience interpreting female lab values. We just got her blood labs back. Blood was drawn 2 days prior to the onset of menstruation.

CBC With Differential/Platelet WBC 11.1 High	x10E3/uL	3.4 - 10.8	01
RBC 4.98	x10E6/uL	3.77 - 5.28	01
Hemoglobin 13.1	g/dL	11.1 - 15.9	01
Hematocrit 41.5	%	34.0 - 46.6	01
MCV 83	fL	79 - 97	01
MCH 26.3 Low	pg	26.6 - 33.0	01
MCHC 31.6	g/dL	31.5 - 35.7	01
RDW 14.5	%	12.3 - 15.4	01
Platelets 792 High	x10E3/uL	150 - 379	01
Neutrophils 68	%	Not Estab.	01
Lymphs 24	%	Not Estab.	01
Monocytes 4	%	Not Estab.	01
Eos 3	%	Not Estab.	01
Basos 1	%	Not Estab.	01
Neutrophils (Absolute) 7.5 High	x10E3/uL	1.4 - 7.0	01
Lymphs (Absolute) 2.6	x10E3/uL	0.7 - 3.1	01
Monocytes(Absolute) 0.5	x10E3/uL	0.1 - 0.9	01
Eos (Absolute) 0.3	x10E3/uL	0.0 - 0.4	01
Baso (Absolute) 0.1	x10E3/uL	0.0 - 0.2	01

Immature Granulocytes 0	%	Not Estab.	01
Immature Grans (Abs) 0.0	x10E3/uL	0.0 - 0.1	01
Comp. Metabolic Panel (14) Glucose, Serum 86	mg/dL	65 - 99	01
BUN 11	mg/dL	6 - 20	01
Creatinine, Serum 0.61	mg/dL	0.57 - 1.00	01
eGFR If NonAfricn Am 115	[TD="colspan: 2"]mL/min/1.73 >59[/TD]
[TD="colspan: 4"] eGFR If Africn Am 133 mL/min/1.73 >59[/TD]

BUN/Creatinine Ratio 18 9 - 23
Sodium, Serum 141 mmol/L 134 - 144 01
Potassium, Serum 5.3 High mmol/L 3.5 - 5.2 01
Chloride, Serum 102 mmol/L 96 - 106 01
Carbon Dioxide, Total 25 mmol/L 18 - 29 01
Calcium, Serum 8.6 Low mg/dL 8.7 - 10.2 01
Protein, Total, Serum 7.0 g/dL 6.0 - 8.5 01
Albumin, Serum 4.1 g/dL 3.5 - 5.5 01
Globulin, Total 2.9 g/dL 1.5 - 4.5
A/G Ratio 1.4 1.2 - 2.2
Bilirubin, Total 0.3 mg/dL 0.0 - 1.2 01
Alkaline Phosphatase, S 78 IU/L 39 - 117 01
AST (SGOT) 22 IU/L 0 - 40 01
ALT (SGPT) 19 IU/L 0 - 32 01
Lipid Panel w/ Chol/HDL Ratio
Cholesterol, Total 188 mg/dL 100 - 199 01
Triglycerides 190 High mg/dL 0 - 149 01
HDL Cholesterol 36 Low mg/dL >39 01
VLDL Cholesterol Cal 38 mg/dL 5 - 40
LDL Cholesterol Calc 114 High mg/dL 0 - 99
T. Chol/HDL Ratio 5.2 High ratio units 0.0 - 4.4
Please Note: 01
T. Chol/HDL Ratio
Men Women
1/2 Avg.Risk 3.4 3.3
Avg.Risk 5.0 4.4
2X Avg.Risk 9.6 7.1
3X Avg.Risk 23.4 11.0
Testosterone,Free and Total
Testosterone, Serum 19 ng/dL 8 - 48 01
Free Testosterone(Direct) 1.6 pg/mL 0.0 - 4.2 02
DHEA-Sulfate 205.7 ug/dL 57.3 - 279.2 01
TSH 1.490 uIU/mL 0.450 - 4.500 01
FSH, Serum
FSH 4.6 mIU/mL 01
Adult Female:
Follicular phase 3.5 - 12.5
Ovulation phase 4.7 - 21.5
Luteal phase 1.7 - 7.7

Estradiol 23.9 pg/mL Adult Female: Follicular phase 12.5 - 166.0 Ovulation phase 85.8 - 498.0 Luteal phase 43.8 - 211.0 Postmenopausal <6.0 - 54.7 Pregnancy 1st trimester 215.0 - >4300.0 Girls (1-10 years) 6.0 - 27.0 Roche ECLIA methodology

01

Progesterone 0.3 ng/mL Follicular phase 0.1 - 0.9 Luteal phase 1.8 - 23.9 Ovulation phase 0.1 - 12.0 Pregnant First trimester 11.0 - 44.3 Second trimester 25.4 - 83.3 Third trimester 58.7 - 214.0 Postmenopausal 0.0 - 0.1

01

 

[FeelingLost]

Hi HamburgerChef,
Me and my wife are Defy patient. I am 64 and she is 56 and has been thru menopause. She is not at full doses yet but already I have noticed improvements in her mood and desires in bed. We are both pretty excited to get our love life back.

For her birthday last year I got her a DiscountedLabs blood test. We googled every value since I could not find a womans forum like this one. Some of her number were very bad and for Christmas one of her presents was to become a Defy patient. Best money I have ever spent.

My PM box is open if you have any questions you don't want to post for the boys and I am sure if your wife has any more personal questions my wife would be happy to talk with her thru PMs.

 

[CoastWatcher]

In answer to one of your questions, there is no forum similar to EM with a focus on female health. It's been remarked, on a number of occasions, that this is certainly regrettable.

All the best.

 

[Dr Justin Saya MD]

After seeing the huge impact that TRT has had on me, my wife would like to see if HRT is right for her. She is 38yr, obese, and has a copper intrauterine device implanted for birth control (implanted 3-4 months ago in the hopes of improving symptoms of low energy, low sex drive, and weight gain). Prior to the copper IUD she was on a hormonal intrauterine implant for 12 years. Her main goals are to loose weight, increase motivation/energy, and increase sex drive.

I am posting her labs hoping someone sees something that could be treated. What stands out to me is the TSH being on the low side, MCH being low, and sex hormones being on the low side. I currently use DefyMedical for my TRT with excellent results, so she is planning on scheduling an appointment with Dr. Saya soon. Do you think we should pull a Thyroid panel prior to talking to the Doctor? Anything else we should test, or expect? Is there a good forum like ExcelMale for women? I know this forum is for men, so I totally understand if no one has any experience interpreting female lab values. We just got her blood labs back. Blood was drawn 2 days prior to the onset of menstruation.

CBC With Differential/Platelet WBC 11.1 High	x10E3/uL	3.4 - 10.8	01
RBC 4.98	x10E6/uL	3.77 - 5.28	01
Hemoglobin 13.1	g/dL	11.1 - 15.9	01
Hematocrit 41.5	%	34.0 - 46.6	01
MCV 83	fL	79 - 97	01
MCH 26.3 Low	pg	26.6 - 33.0	01
MCHC 31.6	g/dL	31.5 - 35.7	01
RDW 14.5	%	12.3 - 15.4	01
Platelets 792 High	x10E3/uL	150 - 379	01
Neutrophils 68	%	Not Estab.	01
Lymphs 24	%	Not Estab.	01
Monocytes 4	%	Not Estab.	01
Eos 3	%	Not Estab.	01
Basos 1	%	Not Estab.	01
Neutrophils (Absolute) 7.5 High	x10E3/uL	1.4 - 7.0	01
Lymphs (Absolute) 2.6	x10E3/uL	0.7 - 3.1	01
Monocytes(Absolute) 0.5	x10E3/uL	0.1 - 0.9	01
Eos (Absolute) 0.3	x10E3/uL	0.0 - 0.4	01
Baso (Absolute) 0.1	x10E3/uL	0.0 - 0.2	01

Immature Granulocytes 0	%	Not Estab.	01
Immature Grans (Abs) 0.0	x10E3/uL	0.0 - 0.1	01
Comp. Metabolic Panel (14) Glucose, Serum 86	mg/dL	65 - 99	01
BUN 11	mg/dL	6 - 20	01
Creatinine, Serum 0.61	mg/dL	0.57 - 1.00	01
eGFR If NonAfricn Am 115	[TD="colspan: 2"]mL/min/1.73 >59[/TD]
[TD="colspan: 4"] eGFR If Africn Am 133 mL/min/1.73 >59[/TD]

BUN/Creatinine Ratio 18 9 - 23
Sodium, Serum 141 mmol/L 134 - 144 01
Potassium, Serum 5.3 High mmol/L 3.5 - 5.2 01
Chloride, Serum 102 mmol/L 96 - 106 01
Carbon Dioxide, Total 25 mmol/L 18 - 29 01
Calcium, Serum 8.6 Low mg/dL 8.7 - 10.2 01
Protein, Total, Serum 7.0 g/dL 6.0 - 8.5 01
Albumin, Serum 4.1 g/dL 3.5 - 5.5 01
Globulin, Total 2.9 g/dL 1.5 - 4.5
A/G Ratio 1.4 1.2 - 2.2
Bilirubin, Total 0.3 mg/dL 0.0 - 1.2 01
Alkaline Phosphatase, S 78 IU/L 39 - 117 01
AST (SGOT) 22 IU/L 0 - 40 01
ALT (SGPT) 19 IU/L 0 - 32 01
Lipid Panel w/ Chol/HDL Ratio
Cholesterol, Total 188 mg/dL 100 - 199 01
Triglycerides 190 High mg/dL 0 - 149 01
HDL Cholesterol 36 Low mg/dL >39 01
VLDL Cholesterol Cal 38 mg/dL 5 - 40
LDL Cholesterol Calc 114 High mg/dL 0 - 99
T. Chol/HDL Ratio 5.2 High ratio units 0.0 - 4.4
Please Note: 01
T. Chol/HDL Ratio
Men Women
1/2 Avg.Risk 3.4 3.3
Avg.Risk 5.0 4.4
2X Avg.Risk 9.6 7.1
3X Avg.Risk 23.4 11.0
Testosterone,Free and Total
Testosterone, Serum 19 ng/dL 8 - 48 01
Free Testosterone(Direct) 1.6 pg/mL 0.0 - 4.2 02
DHEA-Sulfate 205.7 ug/dL 57.3 - 279.2 01
TSH 1.490 uIU/mL 0.450 - 4.500 01
FSH, Serum
FSH 4.6 mIU/mL 01
Adult Female:
Follicular phase 3.5 - 12.5
Ovulation phase 4.7 - 21.5
Luteal phase 1.7 - 7.7

Estradiol 23.9 pg/mL Adult Female: Follicular phase 12.5 - 166.0 Ovulation phase 85.8 - 498.0 Luteal phase 43.8 - 211.0 Postmenopausal <6.0 - 54.7 Pregnancy 1st trimester 215.0 - >4300.0 Girls (1-10 years) 6.0 - 27.0 Roche ECLIA methodology

01

Progesterone 0.3 ng/mL Follicular phase 0.1 - 0.9 Luteal phase 1.8 - 23.9 Ovulation phase 0.1 - 12.0 Pregnant First trimester 11.0 - 44.3 Second trimester 25.4 - 83.3 Third trimester 58.7 - 214.0 Postmenopausal 0.0 - 0.1

01

Hi Hamburgerchef!

Checking a full thyroid is never a bad idea, at minimum a FT3 and FT4 for a little deeper look.

Was she sick at time of labs? Could explain the high WBC and even inflammation can contribute to high platelets, but in the meantime she should take a baby apirin (81mg) a day to reduce risk of clotting with such a high platelet level. I would recheck that CBC panel before a consultation as well. My office can arrange any additional testing you need, just call.

 

[blackebob]

How did you upload your labs? I have not done it because I am to typing challenged to enter every one by hand and keep it looking neat. Now if I can just enter the test level.....?

 

[Matt Leiser]

What is your wife’s diet like? Her triglycerides are high and HDL is low which may point to possible insulin resistance.

 

[Saxon]

Wife is on HRT. It's a simple protocol for her. She takes 12mg of testosterone cypionate every six days. It has all of her markers as dialed in as we could hope for. It's been exceptional.

 

[captain]

Low calcium check Vitamin D level and parathyroid hormone. Is she taking a blood pressure med causing the High potassium? I wouldn't think you could start HRT with the high platelets.

 

[Davet]

Here in the UK my lady is on Bio hormones... E2, Prog and DHEA all compounded creams...they have totally transformed her into a new woman...she is post menopausal and has her 60th bday this year and we are having a ball.
She is now hitting the gym and I cant believe my luck ...lol.......bring it on !

 

[HamburgerChef]

Thanks for all the suggestions! We just ordered all those labs you guys suggested, and are rechecking CBC. Will post up more when we get the results. Her dad has always had very high platelets, like in the millions, so it could be genetic. He has been on aspirin for years to prevent a stroke. She wasn't actively ill at the time of these labs but had recently recovered from a cough/sore throat.

Her diet is bad. She is hoping to change that soon. She does not take any blood pressure meds, it is always on the low side.

 

[HamburgerChef]

How did you upload your labs? I have not done it because I am to typing challenged to enter every one by hand and keep it looking neat. Now if I can just enter the test level.....?

I downloaded my labs as a PDF file. Then on a Windows computer, I hovered over the file, used a right mouse click and selected open with Word. It converted the file to text upon opening in Word. Then I highlighted everything but her patient info stuff on each page, and copy/paste into this forum. Hope that helps.