On TRT + HCG, concerned about NMR lab results & IR markers

GeauxBears

Active Member
I am a happy Defy patient on a stable daily TRT + HCG + AI protocol. I'm sure Dr. Saya will translate these results during our consult, but it's not for another few weeks, so I wanted to educate myself as much as possible as I am concerned.

My cholesterol numbers have always been marginal. HDL is always in the 30s or below, and LDL typically right around 130s. So, we ran an NMR to get details. I'll summarize the results here:

LDL-P: 1774 HIGH (<1000)
LDL-C: 136 HIGH (0-99)
HDL-C: 33 LOW (>39)
Triglycerides: 169 HIGH (0-149)
HDL-P: 25.7 LOW (>=30.5)
Small LDL-P: 962 HIGH (<=527)

Perhaps more concerning to me are the IR markers:

Large VLDL-P: 4.2 HIGH (<=2.7)
Small VLDL-P: 962 HIGH (<=527)
Large HDL-P: <1.3 LOW (>=4.8)
VLDL Size: 47.9 HIGH (<=46.6)
HDL Size: 8.3 LOW (>=9.2)

LP-IR Score: 76 HIGH (<=45)

Total T: 882 (348-1197)
Free T: 25.6 HIGH (8.7-25.1)
Sens-E2: 41.5 HIGH (8.0-35) **Need to bring this down a bit as it has crept up on me**

The LP-IR score tells me I have a high level of insulin resistance.

So WTF? I am 6'2", 205 lbs. I could probably lose about 10 lbs as I am carrying a bit more than I'd like around the waist, but am still a 34-35" waist size and relatively in shape. I have a desk job but I have a Cubii desk elliptical and burn 500 calories a day in addition to my 30 minute per day HIIT cardio at the gym.

What do these results tell me? Could I exercise and eat better? Probably and I'm open to any feedback, but I do pretty well and stay consistent for the most part. I don't know how I can practically do any better on my lifestyle. Also, I just can't seem to lose the final 10 lbs I'm needing to.

I am also hypothyroid and am on 75mcg Synthroid. I am going to look into seeing if we need to push the FT3/FT4 a bit higher in the range to see if it will help boost my metabolism a bit.

Curious as to anyone's thoughts. Let me know if I left out any crucial details.
 

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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