Please critique this blood work

[dbossa]

Brief history:

Total test measured 227 ng/dl prior to starting TRT. Started off with 7.5g Androgel which was useless. Bumped it up to 10g and that was still useless. Switched to compounding cream and did 200mg daily, but still didn't feel any differently. Started applying to the scrotum and really started feeling it kick in, yet my lab work was a mess. Moved onto injectables.

Latest lab work with me doing 100mg Test E twice weekly, .25mg Arimidex 3 times a week, and 25mg DHEA in the evenings. Blood taken the morning of injection day prior to taking the injection, which would be an accurate trough reading:

Total Testosterone: 1182 ng/dl
Free Testosterone: waiting for results
Estradiol: 29 pg/ml
SHBG: 21 nmol/l
DHT: waiting for results
Prolactin: waiting for results
Progesterone: 0.3 ng/ml
DHEA-S: 561 ug/dl
CBC/hematocrit/hemoglobin: all normal

My DHEA is high and my PSA values are also elevated. Figured I should just drop the DHEA altogether and see what happens.

Thinking about trying .25mg arimidex EOD instead of 3 times a week to bring it down a little more... thoughts?

25-OH VIT D came up as 64 nmol/L out of a range of 76-250. Figure I should add 3000iu daily and see what happens.

Prolactin has always been at the high end of normal so I'm anxious to get that result. DHT was extremely high the last time which was probably due to applying the compounded cream to the scrotum. This should hopefully go down now that I'm on injectables.

Am I on the right track or is there anything differently I should be doing?

 

[Vince Carter]

Major thing is DO NOT add to your Anastrozole as 29 is just fine. Real question though is what E test were you given, please post the lab range/value as shown on your results, you could have been given the female test which would overstate your E level. Hint: we like labs and lab results around here, even scanned pages as attachments...we like good hard facts for a thorough conversation

 

[dbossa]

Major thing is DO NOT add to your Anastrozole as 29 is just fine. Real question though is what E test were you given, please post the lab range/value as shown on your results, you could have been given the female test which would overstate your E level. Hint: we like labs and lab results around here, even scanned pages as attachments...we like good hard facts for a thorough conversation

Thanks Vince,

I'm from Montreal and the labs are in French with different units of measure that you guys use (I used an online calculator to get everything converted)

Estradiol came up as 107 pmol/L with a range of <159 pmol/L

I'll get edit out any personal info in the PDF and add some screen shots.

 

[dbossa]

Here are the actual labs

 

[Vince Carter]

ah yes you'll have trouble getting the right test, one of our Canadian members actually comes over the border to the US for testing. Maybe CoastWatcher will come by and offer advice but I think you're otherwise doing well, by the numbers.

 

[dbossa]

I was wondering if I should consider reducing the T dose. 1182 ng/dl measured 3 days after an injection isn't THAT high... is it?

 

[CoastWatcher]

As a fellow Canadian, I understand the challenges of monitoring your estradiol with the proper test. I cross the border and book the appropriate test via www.discountedlabs.com. If that's not a possibility for you, I'd pay close, close attention to how you feel and judge from there.

As as far as your testosterone level, it's a trough reading? Just prior to injection?

 

[dbossa]

Correct. I used to do Friday morning and then Monday night to make 3.5 days however I always had a hard time sleeping on Monday nights so I just started doing Friday and Monday mornings. The test was taken Friday morning prior to injecting.

The interesting thing is that I don't feel all that different compared to the way I did prior to starting TRT. Same level of energy, fat mass hasn't changed, libido up and down, ED symptoms, etc. My blood work looks a million times better so I'm curious why I'm not feeling that big difference that everyone talks about.

 

[Vince Carter]

I was wondering if I should consider reducing the T dose. 1182 ng/dl measured 3 days after an injection isn't THAT high... is it?

you're testing wrong, testing is only to be done right before your injection, not three days later.

 

[dbossa]

I am testing right before my injection. I did my blood test Friday morning, then went home and gave myself my regular injection. Am I missing something here?

 

[dbossa]

I'm injecting Fridays and Mondays. So I gave myself an injection on Friday, then again on Monday, did my blood test Friday morning and then went home for my Friday morning injection.

 

[Vince Carter]

...3days after injection is what threw me off, if you're shooting as you say then you're doing it right. 1182 isn't too high.

 

[CoastWatcher]

I'd agree with Vince Carter's assessment. That said, is there any pattern to when you feel the benefits of TRT? Without overthinking it, what suggests itself?

 

[dbossa]

Sorry, I can see how that could have thrown you off. Worst case I can do 4ml on Friday and 6ml on Monday considering I'm not doing exactly 3.5 days. If it's not too high then I guess I'll keep it like that.

Maybe it will take some time for the benefits to appear. It took me a year to get this figured out. Maybe now that everything is more or less ok, I just need to give it some time.

 

[dbossa]

All I can definitely say for sure is that I feel like I'm in a better mood these days. Happier.. less stressed out... more relaxed. I trained at a gym for years, off and on, and always quit because I was never getting anywhere (with 227 test, now I know why). I got back to the gym two weeks ago so I'm curious to see if the higher test levels make any difference. I'm just not feeling that "night and day difference" that so many users here are experiencing. I still have issues with ED, though not as bad as before. Used to take me forever to orgasm and that's been improved somewhat. Had mild gyno prior to starting TRT... even now the little bump gets painful every now and again which made me wonder if I should increase Arimidex. Haven't been sleeping well this past week... like I constantly have the equivalent of 3 cups of coffee in my system. Maybe it will take some time for everything to balance out now that more of the numbers are starting to make sense. You should have seen some of my last test results.. sheesh!

 

[CoastWatcher]

Sorry, I can see how that could have thrown you off. Worst case I can do 4ml on Friday and 6ml on Monday considering I'm not doing exactly 3.5 days. If it's not too high then I guess I'll keep it like that.

Maybe it will take some time for the benefits to appear. It took me a year to get this figured out. Maybe now that everything is more or less ok, I just need to give it some time.

Patience is the key virtue when looking for success on this thing. Easy to say, I realize, but it's true. Once things are in place, give it a good-faith trial. All of us, with very few exceptions, faced challenges in getting it right. Uninformed doctors, poor protocols, odd, subjective responses to e2...all kinds of things.

 

[CoastWatcher]

All I can definitely say for sure is that I feel like I'm in a better mood these days. Happier.. less stressed out... more relaxed. I trained at a gym for years, off and on, and always quit because I was never getting anywhere (with 227 test, now I know why). I got back to the gym two weeks ago so I'm curious to see if the higher test levels make any difference. I'm just not feeling that "night and day difference" that so many users here are experiencing. I still have issues with ED, though not as bad as before. Used to take me forever to orgasm and that's been improved somewhat. Had mild gyno prior to starting TRT... even now the little bump gets painful every now and again which made me wonder if I should increase Arimidex. Haven't been sleeping well this past week... like I constantly have the equivalent of 3 cups of coffee in my system. Maybe it will take some time for everything to balance out now that more of the numbers are starting to make sense. You should have seen some of my last test results.. sheesh!

Whatndid doctors attribute the gynecomastia to?

 

[dbossa]

I haven't found a single doctor in Montreal who is knowledgeable in this stuff. First doctor suggested 100mg injections once a month.. an endocrinologist if you can believe that. I literally told him that he has no right to be practicing medicine based on that statement and walked out the door. Second doctor would test for LH, FSH AFTER starting TRT and did estradiol based on women... no test for DHT, progesterone, prolactin, etc.

I've read up so much on these boards for the past years that I'm now basically teaching my doctors what to do... and I don't know a damn thing in comparison to most. It's sad.

 

[dbossa]

Whatndid doctors attribute the gynecomastia to?

They didn't. All they said was that they could refer me to a plastic surgeon to have it removed. My prolactin levels at the time tested at 14 ng/dl and they brushed it off. Estradiol was at 13 pg/ml (I was using Calcium D-Glucarate at the time to keep the gyno down).

My body is fairly lean but I have a lot of fat on my chest and around my stomach/sides. Yet my arms are super vascular. It's weird.

 

[CoastWatcher]

Keep in mind that Defy Medical and their medical director, Dr. Justin Saya, offer out-of-country consultations. No patient relationship is established and no drugs are prescribed, but you wind up with a road map from one of the leading doctors in this field, something to assist you and your local physician. It's all done remotely after a thorough review of your medical records.

It it may not be as expensive as you fear.