Recent blood tests don't match up

[FlMedic89]

Hey guys,

So I went to a doc two weeks ago that specializes in TRT. A little background on myself. I am 25 years old, 5'11" and 190 lb. When I was around 20 years old I started messing around with pro hormones and steroids without looking at the later consequences. As of the past 2 years my energy has dropped to nothing, I have the sex drive of an 80 year old and erections are few and far between. On top of all this I have gyno that has been around for about 3 years now that causes me pain and hot flashes in the middle of the night. It doesn't help that I am a first responder and work 24 hour shifts either. After talking to the physician he ordered blood work and the values were as follows:

[h=4]Lab Test Results[/b]Reverse T3, Serum

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Igf-1

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Vitamin B12

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Hemoglobin A1c

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Dihydrotestosterone

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Bioavailable Testost. W/O Shbg

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Lipid Panel

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Comp. Metabolic Panel (14)

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Homocyst(E)Ine, Plasma

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Estradiol

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Prolactin

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Fsh, Serum

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Luteinizing Hormone(Lh), S

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Cortisol

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Dhea-Sulfate

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Testosterone, Serum

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Triiodothyronine,Free,Serum

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Thyroid Peroxidase (Tpo) Ab

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Tsh

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Thyroxine (T4) Free, Direct, S

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As you can see, my test ranges look normal and the only thing that sticks out is my high LH which typically is a sign of primary hypogonadism. ... Heres the catch - Two weeks prior to getting my labs drawn I stopped taking letrozole that I had at home. I was on it for 3 weeks at a dosage of 2mg daily. My gyno pain subsided during this time and according to my girlfriend who did not know I was taking the letro my mood drastically changed for the better. Is it possible that the letro skewed my results on the blood work? I am new to this TRT stuff so if anything sticks out to you guys feel free to share.

thanks!

 

[Nelson Vergel]

Letrozole, like any other aromatase inhibitor, increases testosterone. The increase is usually not "felt" by the men who use it as monotherapy.


You were taking a high dose, by the way!


Eur J Endocrinol. 2008 May;158(5):741-7. doi: 10.1530/EJE-07-0663.
Letrozole once a week normalizes serum testosterone in obesity-related male hypogonadism.Loves S1, Ruinemans-Koerts J, de Boer H.
[h=3]Author information[/b]

[h=3]Abstract[/b][h=4]OBJECTIVE:[/b]Isolated hypogonadotropic hypogonadism (IHH) is frequently observed in severely obese men, probably as a result of increased estradiol (E(2)) production and E(2)-mediated negative feedback on pituitary LH secretion. Aromatase inhibitors can reverse this process. This study evaluates whether letrozole once a week can normalize serum testosterone in severely obese men and maintain its long term effect.
[h=4]DESIGN:[/b]Open, uncontrolled 6-month pilot study in 12 severely obese men (body mass index>35.0 kg/m(2)) with obesity-related IHH and free testosterone levels <225 pmol/l, treated with 2.5 mg letrozole once a week for 6 months.
[h=4]RESULTS:[/b]Six weeks of treatment reduced total E(2) from 123+/-11 to 58+/-7 pmol/l (P<0.001, mean+/-s.e.m.), and increased serum LH from 4.4+/-0.6 to 11.1+/-1.5 U/l (P<0.001). Total testosterone rose from 5.9+/-0.5 to 19.6+/-1.4 nmol/l (P<0.001), and free testosterone from 163+/-13 to 604+/-50 pmol/l (P<0.001). Total testosterone rose to within the normal range in all subjects, whereas free testosterone rose to supraphysiological levels in 7 out of 12 men. The testosterone and E(2) levels were stable throughout the week and during the 6-month treatment period.
[h=4]CONCLUSION:[/b]Letrozole 2.5 mg once a week produced a sustained normalization of serum total testosterone in obese men with IHH. However, free testosterone frequently rose to supraphysiological levels. Therefore, a starting dose <2.5 mg once a week is recommended.

 

[Nelson Vergel]

One letrozole pill a week quadruples testosterone level

 

[FlMedic89]

None of my lab results match my symptoms.

 

[FlMedic89]

Thank you for your fast reply! If letro quadruples test then why don't all men take letro? Also I still feel like crap despite having these great lab values. I just updated the lab values and was wondering if anything sticks out to you? THANKS AGAIN!

 

[FlMedic89]

Im sorry I misread your post. So you are saying though my serum test looks good, my free test is probably damn near nothing. Im hoping my physician will help me out with this one. I haven't taken letro for over a month now. How long do you think it will take for my serum levels to come back down and reveal the crappy lab work I was expecting?

 

[Vettester Chris]

Letro would be the absolute worse thing to defer to for raising testosterone. Well, it's effective with promoting LH, but it's a suicide AI inhibitor, which can be next to dangerous (been there, done that).

Are you taking any T3 or other thyroid meds? Your RT3/T3 ratio looks great, and FT3 serum levels are damn near optimal! You have that going for you if it helps!!

 

[FlMedic89]

nope never messed around with my thyroid. how long until the letro is no longer affecting my lab results and my true testosterone level will be shown?

 

[abram134]

why don't you post labs when you don't take the letro pill

 

[FlMedic89]

I just had my labs redrawn yesterday as my doc knew I was taking letro(he wasn't happy with me). been off the letro now for a little over 8 weeks and my gyno is already starting to get irritated again(estro rebound). Ill post the new labs when I get them. Part of my problem is my PSA as well. My initial PSA was 4.4 which is very high. I had a prostate ultrasound which showed nothing so wish me luck.

 

[Vince Carter]

your 2d set will be interesting if they're indeed "clean", the first set, I didn't see anything alarming there at all.

 

[FlMedic89]

My initial set had an e2 of 20 and an LH of 10...both highly indicative of an aromatase inhibitor ... I have terrible gunk, no libido and chronic lethargy

 

[FlMedic89]

*gyno ....

 

[CoastWatcher]

Your "gyno": lumps at the breast or simply itchy, sensitive nipples?

 

[FlMedic89]

Both...the lump is very large..my doc said its really big as well.

 

[FlMedic89]

8 weeks off letrozole and here are the latest labs...and no I'm not obese lol

 

[CoastWatcher]

And how are you feeling?

 

[FlMedic89]

Not good...gyno lump is extremely painful, tired all the time and no sex drive

 

[CoastWatcher]

Your doctor's take on these results?

 

[FlMedic89]

I haven't had my appointment yet.just got my labs today