Pre-TRT bloods: Anything stand out?

[person]

Current meds: Armour Thyroid 30mg, diagnosed/prescribed by a GP.

Working with Defy. I meet with "PA Michael" next week for initial consult.

Any thoughts, broadly speaking? Any specific questions/concerns you would have with these results?

Thanks!

IGF1, Serum 262 (ref range 82-242)

Cholesterol 242 (75-200)

Triglycerides 142 (<150)

HDL 29 (>39)

LDL 168 (<130)

Testosterone 327 (205-781 ng/dl)

SHBG 16.4 (13.3-89.5)

Luteinizing Hormone 2.72 (1.24-8.62)

Estradiol 42 (<20-47)

PSA 0.26 (0.00-4.0)

TSH 0.68 (0.34-5.0)

DHEA Sulfate 266 (35-430)

Free test, percent 2.66 (1.6-2.9)

Free test, calc. 87 (33-227)

Test, bio available 218 (131-682)

 

[MarkM]

Welcome to the forum!

Person, when you open up the attachment with your lab work it has your name. You might want to re-save the file and repost.

I am sure you realize you need to get that LDL cholesterol down and that HDL up. Need to also get those triglycerides down even though they are in range. I would try to get it down naturally with a better diet and exercise verse taking a statin. Those things are not good for you.

You could definitely benefit from TRT. Both your TT and Ft are in range but the low end and you need them in the upper quartile to be optimal. Your SHBG is low, 16.4, and typically low SHBG individuals do best with small multiple injections per week such as every day or every other day. More than every other day (EOD) probably won't be successful. It takes a commitment to inject that often but if you can commit to it you can get to feeling better.

It looks like the estradiol was the wrong test and that surprises me if Defy ordered the labs. When you speak with Defy make sure the estradiol test is the Estradiol Sensitive test, LC/MS/MS assay. It is the only estradiol test for men that is accurate. If by chance this is the Estradiol Sensitive test then your estradiol is on the high side. If it is the non-sensitive (Roche ECLIA methodology) test then your Sensitive test will be considerably lower, typically speaking.

LH is low at 2.72 which indicates that your hypogonadism is secondary verse primary.

IGF is just over range but that isn't an issue.

Once again, welcome and if we can help you let us know.

 

[person]

Thank you very much. Copy-pasted.

 

[person]

I wonder if they'll recommend I drop the amour thyroid? That's obviously something I'll bring up.

 

[MarkM]

I wonder if they'll recommend I drop the amour thyroid? That's obviously something I'll bring up.

Don't know. All you posted was your TSH which looks good but I don't see the Free T3, Free T4, Reverse T3, or antibodies. If all is in line it may be cause you are taking the Armour. If your thyroid is not performing well it will give you Low T symptoms. We highly recommend a healthy well performing thyroid when starting TRT. It will make things a little easier.

 

[person]

Thank you.

 

[MarkM]

You're welcome. Keep us posted on how you are doing and how the consult goes.

 

[person]

Update: I have been instructed to start out with

Anastrozole 0.125, daily (as needed)
Clomid 12.5, daily
DHEA 25 mg, daily

No test to begin. Get bloods in 8 weeks, re-assess based on labs and how I feel.

Definitely not what I expected to be taking but I believe I understand the logic, based on my labs.

 

[MarkM]

Anastrozole of 0.125 mg daily? Did they advise you to take the anastrozole daily of just want you to have it on hand in case you feel like you need it?

 

[person]

Anastrozole of 0.125 mg daily? Did they advise you to take the anastrozole daily of just want you to have it on hand in case you feel like you need it?

Sorry I should clarify. "every day as needed." He said I could probably get away w/ a few times per week.

 

[MarkM]

That stuff is very strong and you might need it and might not. I'd be careful and only take it if you have high E2 symptoms.

 

[person]

That stuff is very strong and you might need it and might not. I'd be careful and only take it if you have high E2 symptoms.

Thank you for the advice Mark. I'm trying to stay positive here, but I can't help but feel some disappointment. I was all ready and geared up to take test every other day and now...clomid.

I'm trying to keep an open mind.

 

[MarkM]

Stay positive. TRT is a life long commitment. You will have many years ahead of you to be on TRT if that is what is needed down the road. No sense in rushing it. At least you are dealing with a T Mill that just arbitrarily puts you on a TRT protocol. Defy is tryng to make sure they do the right thing for you.

 

[person]

Update. After 9 weeks on the aforementioned drugs, my blood work was excellent. Total test in the upper 800's, etc. But I didn't feel any differently. Apparently this is common with clomid. So, I'm starting TRT.

Cyp 200 mg/ml – 0.25 ml IM/SQ three times weekly
HCG 300 iu SQ three times weekly
Anastrozole 0.125 mg three times weekly
DHEA 25mg every night