New Blood Work and looking for comments prior to my follow-up

[crazycanuck]

Hey guys, I just got my latest blood work back in advance of my next follow-up which I moved up a month early due to major crashing and fatigue coming back in. I am bi weekly 50 mgs, 500 iu HCG 2X/ wk the day before my Test E shots. Here's the results and please remember, this is from Canada so no sensitive E2 test only the traditional.


HEMATOLOGY

[TD="class: Tbl_Result_Item_Column, colspan: 2"]WBC[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]8.1[/TD] [TD="class: Tbl_Result_Item_Column"]4.0 - 11.0[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]RBC[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]4.83[/TD] [TD="class: Tbl_Result_Item_Column"]4.50 - 6.00[/TD] [TD="class: Tbl_Result_Item_Column"]x E12/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Hemoglobin[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]149[/TD] [TD="class: Tbl_Result_Item_Column"]135 - 175[/TD] [TD="class: Tbl_Result_Item_Column"]g/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Hematocrit[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]0.445[/TD] [TD="class: Tbl_Result_Item_Column"]0.400 - 0.500[/TD] [TD="class: Tbl_Result_Item_Column"]L/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]MCV[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]92[/TD] [TD="class: Tbl_Result_Item_Column"]80 - 100[/TD] [TD="class: Tbl_Result_Item_Column"]fL[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]MCH[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]30.8[/TD] [TD="class: Tbl_Result_Item_Column"]27.5 - 33.0[/TD] [TD="class: Tbl_Result_Item_Column"]pg[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]MCHC[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]335[/TD] [TD="class: Tbl_Result_Item_Column"]305 - 360[/TD] [TD="class: Tbl_Result_Item_Column"]g/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Platelets[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]242[/TD] [TD="class: Tbl_Result_Item_Column"]150 - 400[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]RDW[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]13.1[/TD] [TD="class: Tbl_Result_Item_Column"]11.5 - 14.5[/TD] [TD="class: Tbl_Result_Item_Column"]%[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 6"]Differential[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Neutrophils[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]4.0[/TD] [TD="class: Tbl_Result_Item_Column"]2.0 - 7.5[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Lymphocytes[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]3.2[/TD] [TD="class: Tbl_Result_Item_Column"]1.0 - 3.5[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Monocytes[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]0.5[/TD] [TD="class: Tbl_Result_Item_Column"]0.2 - 1.0[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Eosinophils[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]0.3[/TD] [TD="class: Tbl_Result_Item_Column"]0.0 - 0.5[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Basophils[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]0.1[/TD] [TD="class: Tbl_Result_Item_Column"]0.0 - 0.2[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

PITUITARY FUNCTION

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Follicle Stimulating Hormone [FSH][/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"]LO[/TD] [TD="class: Tbl_Result_Item_Column"]0.3[/TD] [TD="class: Tbl_Result_Item_Column"]1.3-19.3[/TD] [TD="class: Tbl_Result_Item_Column"]IU/L[/TD]
[TD="class: Tbl_Result_Item_Column, colspan: 2"]Luteinizing Hormone [LH]	[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"]LO[/TD] [TD="class: Tbl_Result_Item_Column"]<0.2[/TD] [TD="class: Tbl_Result_Item_Column"]1.2-8.6[/TD] [TD="class: Tbl_Result_Item_Column"]IU/L [/TD]

The conversion for the Test is 678ng/dl.

Other blood work I've had recently showed Cholesterol within check as well as all other markers. I know the good Dr likes to have the T in the higher 20s for TRT so I foresee a slight increase of dosage as this will be the 5 month with sub 700 numbers. Just wondering if the high end non sensitive E2 (some literature saws 70-80 being optimal) at play? Also, was surprised to see the complete shutdown of LH and FSH

 

[CoastWatcher]

Hey guys, I just got my latest blood work back in advance of my next follow-up which I moved up a month early due to major crashing and fatigue coming back in. I am bi weekly 50 mgs, 500 iu HCG 2X/ wk the day before my Test E shots. Here's the results and please remember, this is from Canada so no sensitive E2 test only the traditional.


HEMATOLOGY

[TD="class: Tbl_Result_Item_Column, colspan: 2"]WBC[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]8.1[/TD] [TD="class: Tbl_Result_Item_Column"]4.0 - 11.0[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]RBC[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]4.83[/TD] [TD="class: Tbl_Result_Item_Column"]4.50 - 6.00[/TD] [TD="class: Tbl_Result_Item_Column"]x E12/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Hemoglobin[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]149[/TD] [TD="class: Tbl_Result_Item_Column"]135 - 175[/TD] [TD="class: Tbl_Result_Item_Column"]g/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Hematocrit[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]0.445[/TD] [TD="class: Tbl_Result_Item_Column"]0.400 - 0.500[/TD] [TD="class: Tbl_Result_Item_Column"]L/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]MCV[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]92[/TD] [TD="class: Tbl_Result_Item_Column"]80 - 100[/TD] [TD="class: Tbl_Result_Item_Column"]fL[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]MCH[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]30.8[/TD] [TD="class: Tbl_Result_Item_Column"]27.5 - 33.0[/TD] [TD="class: Tbl_Result_Item_Column"]pg[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]MCHC[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]335[/TD] [TD="class: Tbl_Result_Item_Column"]305 - 360[/TD] [TD="class: Tbl_Result_Item_Column"]g/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Platelets[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]242[/TD] [TD="class: Tbl_Result_Item_Column"]150 - 400[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]RDW[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]13.1[/TD] [TD="class: Tbl_Result_Item_Column"]11.5 - 14.5[/TD] [TD="class: Tbl_Result_Item_Column"]%[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 6"]Differential[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Neutrophils[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]4.0[/TD] [TD="class: Tbl_Result_Item_Column"]2.0 - 7.5[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Lymphocytes[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]3.2[/TD] [TD="class: Tbl_Result_Item_Column"]1.0 - 3.5[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Monocytes[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]0.5[/TD] [TD="class: Tbl_Result_Item_Column"]0.2 - 1.0[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Eosinophils[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]0.3[/TD] [TD="class: Tbl_Result_Item_Column"]0.0 - 0.5[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Basophils[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"][/TD] [TD="class: Tbl_Result_Item_Column"]0.1[/TD] [TD="class: Tbl_Result_Item_Column"]0.0 - 0.2[/TD] [TD="class: Tbl_Result_Item_Column"]x E9/L[/TD]

PITUITARY FUNCTION

[TD="class: Tbl_Result_Item_Column, colspan: 2"]Follicle Stimulating Hormone [FSH][/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"]LO[/TD] [TD="class: Tbl_Result_Item_Column"]0.3[/TD] [TD="class: Tbl_Result_Item_Column"]1.3-19.3[/TD] [TD="class: Tbl_Result_Item_Column"]IU/L[/TD]
[TD="class: Tbl_Result_Item_Column, colspan: 2"]Luteinizing Hormone [LH]	[/TD] [TD="class: Tbl_Result_Item_Column_Right, align: right"]LO[/TD] [TD="class: Tbl_Result_Item_Column"]<0.2[/TD] [TD="class: Tbl_Result_Item_Column"]1.2-8.6[/TD] [TD="class: Tbl_Result_Item_Column"]IU/L [/TD]

The conversion for the Test is 678ng/dl.

Other blood work I've had recently showed Cholesterol within check as well as all other markers. I know the good Dr likes to have the T in the higher 20s for TRT so I foresee a slight increase of dosage as this will be the 5 month with sub 700 numbers. Just wondering if the high end non sensitive E2 (some literature saws 45-80 being optimal) at play? Also, was surprised to see the complete shutdown of LH and FSH

Yiu should be shut down, in regard to LH and FSH - that is an expected effect of exogenous testosterone. Had you presented numbers indicating reasonable levels of either, it would have been a clear indication that your protocol was insufficiently dosing testosterone. No free testosterone, and no SHBG?

As a Canadian I sympathize with you in respect to the lack of a sensitive estradiol test (I travel to the States regularly and have it drawn there via discountedlabs.com). It is likely that you MIGHT be elevated. The ambiguous statement reflects the uncertain (to put it politely) nature of the standard test. You could go to an eod injection schedule, possibly bumping your testosterone dose up slightly. That may well give you a higher level of total test while lowering your e2. If we had your SHBG values we'd know if you are prone to clearing testosterone quickly, free testosterone would shed some light on it as well.

 

[johndoesmith]

Couple of questions.

1. You're on 2x weekly 50mg and 500IU shots, correct?
2. These tests were done the day BEFORE your shot of test? Or day of injection but before injection?
3. How long have you been on TRT?
4. I imagine you're not feeling great, but has anything else improved, or changed?

HPTA shutdown when administering exogenous testosterone is completely normal. It's to be expected! If it didn't happen I'd be concerned.

These are rather basic tests for a TRT follow up unfortunately. CBC looks fine, but no SHBG, thyroid, or anything else.

 

[crazycanuck]

johndoesmith, yes, 50 mgs 2 X per week (3.5 days) the 500 iu HCG is the day before the Test. The blood was done the day of my next injection, before my shot. As I said, its been 5 months on TRT. I wasn't expecting the shut down to be that fast, considering he HCG to mimic LH. The testing is reflective of the Canadian Basic medical system when it comes to TRT.

Unfortunately, no SHBG, or thyroid this time around. All levels were normal on my last blood work and SHBG was mid range when last checked.

Coastwatcher, I am tempted to make the 2.5 hours drive to Michigan to get a full panel done one of these days. I wish New York state was an option as its closer.

So, heres a question. I'm doing Subq shots. Would I see an increase with Shallow IM or would it make no difference?

 

[CoastWatcher]

johndoesmith, yes, 50 mgs 2 X per week (3.5 days) the 500 iu HCG is the day before the Test. The blood was done the day of my next injection, before my shot. As I said, its been 5 months on TRT. I wasn't expecting the shut down to be that fast, considering he HCG to mimic LH. The testing is reflective of the Canadian Basic medical system when it comes to TRT.

Unfortunately, no SHBG, or thyroid this time around. All levels were normal on my last blood work and SHBG was mid range when last checked.

Coastwatcher, I am tempted to make the 2.5 hours drive to Michigan to get a full panel done one of these days. I wish New York state was an option as its closer.

So, heres a question. I'm doing Subq shots. Would I see an increase with Shallow IM or would it make no difference?

"Normal" really doesn't tell you anything in regard to hormone levels. SHBG values are critical in the design and refinement of a protocol - particularly when you are missing a key piece of the puzzle, the actual estradiol value.

As as for IM/SubQ injections, you can try, but there's no certainty one will be more beneficial than the other in your situation. Members have labs that back up both positions. I have labs that showed no difference whatsoever. Moving to yet a more frequent schedule might make a difference, however.

 

[johndoesmith]

johndoesmith, yes, 50 mgs 2 X per week (3.5 days) the 500 iu HCG is the day before the Test. The blood was done the day of my next injection, before my shot. As I said, its been 5 months on TRT. I wasn't expecting the shut down to be that fast, considering he HCG to mimic LH. The testing is reflective of the Canadian Basic medical system when it comes to TRT.

Those aren't bad trough levels IMO. Not everyone needs to be at 900 or 1200 trough. People IMO have too much of an obsession with total testosterone levels, when in reality, they have less bearing on subjective feelings than E2, free test, SHBG, or DHT even. I think it's a guy thing, wanting to have the biggest number

Regarding shutdown, 5 months is a long time, it usually happens within the first week, remember the negative feedback loop by nature must be quick. If it wasn't, it wouldn't be able to do it's job.

It's like if thirst started days after dehydration, you wouldn't have a chance to prevent dehydration. Same with the HPTA.

hCG stimulates the testicles, NOT the pituitary/hypothalamus, so it will do nothing to prevent shut down but will keep the testes alive.

Unfortunately, no SHBG, or thyroid this time around. All levels were normal on my last blood work and SHBG was mid range when last checked.

Coastwatcher, I am tempted to make the 2.5 hours drive to Michigan to get a full panel done one of these days. I wish New York state was an option as its closer.

So, heres a question. I'm doing Subq shots. Would I see an increase with Shallow IM or would it make no difference?

[/QUOTE]

Like coast said "normal" means absolutely nothing, and "mid range" is about the same thing. Numbers are best along with ranges here


I'd recommend getting proper testing done. I have no idea why you're feeling bad. It may be worth the 5 hour drive unfortunately.

What exactly are your symptoms?

 

[madman]

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CC these labs I had done give a good overall picture minus the sensitive estradiol mind you I had to pay for some of these tests................I also have full blood work which I did not post here............my SHBG is 34.9 nmol/L basically middle of range. A 700 trough is a good range but you have to pin point why you feel shitty.............you could try IM and see if you feel a difference but as Coast stated maybe more frequent injections but I would not increase dose right away until you find out where your estradiol sits by getting the sensitive test done. How long have you been on HCG the whole 5 months with trt or just recently and did you notice any difference when adding the HCG to your protocol. Will be interesting to see how things turn out for you!

 

[CoastWatcher]

It is possible to have blood drawn and shipped to a commercial lab in the States so that the sensitive estradiol test can be run. My doctor has done this in the past for patients who can't/won't travel in order to obtain the proper test. It is expensive and your doctor has to be willing to set it in motion.

I'm not endorsing this method, only letting you know it can be done. Frankly, it's more costly than a drive down and back (including the charges you'd incur with discountedlabs.com).

 

[crazycanuck]

Okay, found the labs that have the SHBG. It was 37.8. As for the thyroid panel, I can't seem to find it but when I said mid normal, it was mid normal i.e. if the range was 2.4 to 8, i was 4-5 ish. Those labs will be redone in the New Year at my next yearly.

I am considering the drive to Michigan in the new year for a weekend away anyway so I might just take the plunge and visit the lab.

 

[crazycanuck]

As for the 700 trough values. Still crashing hard to the point of almost falling asleep at my desk. Plus, I was under the impression that with injections twice a week, you numbers are fairly stable across the board without a lot of ups and downs. Because regardless of pre or post injection, the crash is happening so I'm guessing the 700 is pretty close to the value I have give or take.

 

[Vince Carter]

Okay, found the labs that have the SHBG. It was 37.8. As for the thyroid panel, I can't seem to find it but when I said mid normal, it was mid normal i.e. if the range was 2.4 to 8, i was 4-5 ish. Those labs will be redone in the New Year at my next yearly.

I am considering the drive to Michigan in the new year for a weekend away anyway so I might just take the plunge and visit the lab.

if you're pushing a TSH in the 4 or 5 range that's pretty terrible. Most US based testing is going to have a 5 as the upper limit. I would suggest further testing, and fast for ~12hrs prior:
TSH
T3
T4
Free T3
Reverse T3
Antibodies

 

[crazycanuck]

no, those aren't actual numbers. It was just for reference as to me saying mid normal. my GP was actually checking for a thyroid issue when she ran the thyroid panel and everything was normal in the higher mid range.

 

[johndoesmith]

no, those aren't actual numbers. It was just for reference as to me saying mid normal. my GP was actually checking for a thyroid issue when she ran the thyroid panel and everything was normal in the higher mid range.

Unfortunately there's not much input to be given based on "normal in the higher mid range".

 

[CoastWatcher]

Some observations.

You rightly hoped that an every 3.5 day injection schedule would provide you with stable serum levels; now you find that isn't going to be your situation. Many members here inject on an eod basis in order to achieve stability. A few of us, and I'm one of them, inject testosterone on a daily basis. There are still steps you can take to dial things in. It takes time, but it is worth it.

Johndoesmith is correct, absent lab values in respect to your thyroid panel, we can't offer much. I will add this in regard to TSH results. My doctor's told me twice that anytime a TSH value reaches the midrange point (no matter what the scale is, just the midrange) it is a yellow light blinking that demands attention.

 

[Vince Carter]

no, those aren't actual numbers. It was just for reference as to me saying mid normal. my GP was actually checking for a thyroid issue when she ran the thyroid panel and everything was normal in the higher mid range.

[FONT=&quot]You said your 4-5 on an 8 scale in reference to your TSH. Higher mid-range IS NOT good with TSH. [/FONT]