shoulda coulda woulda.... Looking for opinions on what my dr. should have done

[FLmale]

I'm a new guy here that came looking for answers, I've done a lot of reading and I know have more questions then before... The following are the results from my blood work from a couple years back, I'm really trying to determine if I am primary or secondary and what the initial course of action should have been.

Thank you for your time!

FL Male


Initial test by general physician:


Test Result Range UOM
Free T4 .94 .93-1.7 ng/dL
TSH 1.73 0.500-6.000 N/A
Free Test 42.2 46.0-224.0 pg/mL


Additional tests by urologist:


Test Result Range UOM
PSA .3 0.0-2.5 ng/mL Age Spec.
Free Test .55 .56-2.7 ng/dL
Total Test 299 280-800 ng/dL
Percent Free 18% 0.1-0.27 %
FSH 3.8 1.5-12.4 mIU/mL
LH 6.7 1.7-8.6 mIU/mL
Prolactin 5.4 4.0-15.2 ng/mL
Serum Albumin 4.7 3.2-5.2 g/dL



Edit, sorry the formatting didn't work as well as I had hoped.

 

[ERO]

Welcome to the forum!

I am not quite following, though. Are you on TRT now or are you asking if you should be? How are you feeling overall?

 

[CoastWatcher]

We're glad you joined Excelmale, but need some clarification. Are you asking if the test results you posted would lead to a specific diagnosis? Make you a candidate for TRT? Just add a bit more and the discussion will result.

 

[johndoesmith]

He's trying to see if his test results indicate Primary or Secondary. He said that pretty clearly.

I think you are primary. LH of 6.7, and total test of 300 along with low free test certainly makes this pretty clear.

I'd also look at your thyroid more. Free T4 of .01 above range certainly isn't a great sign, you'd need Free T3 and maybe some more thyroid panels, I am not a thyroid expert here so will defer to other members.

 

[FLmale]

Thanks for the welcome and replies.


The test results above were prior to being prescribed TRT (no hCG) no T3 prior to starting TRT.


Having a lot of ups and downs, and wondering if I should be on TRT or if it may be more of a thyroid issue.


The following are post TRT BUT ARE NOT RECENT:


Test Result Range UOM
TSH 1.46 .040-4.5 mIU/L
T4 Total 6.9 4.5-12.0 mcg/dL
T4 Free Index (T7) 2.0 1.4-3.8 N/A
T3 Total 95 76-181 ng/dL
T3 Uptake 29 22-35 %
Thyroglobulin Antibodies <20 <20 IU/mL
Thyroid Peroxidase Antibodies <10 <35 IU/mL
Testosterone Free 76 46-224 pg/mL
SHBG 43 10-50 nmol/L
Estradiol US 16 < or =29 pg/mL
FSH 3.3 1.6-8.0 mIU/mL
LH 3.0 1.5-9.3 mIU/mL
Prolactin 4.0 2.0-18.0 ng/mL

 

[johndoesmith]

Thanks for the welcome and replies.


The test results above were prior to being prescribed TRT (no hCG) no T3 prior to starting TRT.


Having a lot of ups and downs, and wondering if I should be on TRT or if it may be more of a thyroid issue.


The following are post TRT BUT ARE NOT RECENT:


Test Result Range UOM
TSH 1.46 .040-4.5 mIU/L
T4 Total 6.9 4.5-12.0 mcg/dL
T4 Free Index (T7) 2.0 1.4-3.8 N/A
T3 Total 95 76-181 ng/dL
T3 Uptake 29 22-35 %
Thyroglobulin Antibodies <20 <20 IU/mL
Thyroid Peroxidase Antibodies <10 <35 IU/mL
Testosterone Free 76 46-224 pg/mL
SHBG 43 10-50 nmol/L
Estradiol US 16 < or =29 pg/mL
FSH 3.3 1.6-8.0 mIU/mL
LH 3.0 1.5-9.3 mIU/mL
Prolactin 4.0 2.0-18.0 ng/mL

This thread is like a puzzle.

The test results here, are on TRT? Can you provide more information, like protocol? How long ago, and how long were you on TRT at the time of this taken? When was it drawn relative to injection?

You're leaving out a lot of info.

Also, this test was on TRT? Are you sure? You aren't shut down.

With the thyroid tests, it's impossible to tell based on those, some of those are really really useless.

 

[CoastWatcher]

Thanks for the welcome and replies.


The test results above were prior to being prescribed TRT (no hCG) no T3 prior to starting TRT.


Having a lot of ups and downs, and wondering if I should be on TRT or if it may be more of a thyroid issue.


The following are post TRT BUT ARE NOT RECENT:


Test Result Range UOM
TSH 1.46 .040-4.5 mIU/L
T4 Total 6.9 4.5-12.0 mcg/dL
T4 Free Index (T7) 2.0 1.4-3.8 N/A
T3 Total 95 76-181 ng/dL
T3 Uptake 29 22-35 %
Thyroglobulin Antibodies <20 <20 IU/mL
Thyroid Peroxidase Antibodies <10 <35 IU/mL
Testosterone Free 76 46-224 pg/mL
SHBG 43 10-50 nmol/L
Estradiol US 16 < or =29 pg/mL
FSH 3.3 1.6-8.0 mIU/mL
LH 3.0 1.5-9.3 mIU/mL
Prolactin 4.0 2.0-18.0 ng/mL

As I noted initially, we need more information. It is more than a simple question of primary or secondary hypogonadism, that can be easily inferred from the lab work. But what is you current situations? There's too much ambiguity in your posts. Are you on TRT? Protocol? Symptoms?

 

[FLmale]

Sorry for being vague, just trying reconstruct the situation with the limited information and knowledge I have.

The initial PRE TRT test above was from 6-2012

Yes, I was on compounded TRT for about 6-months prior to this test. From the label: testosterone 60MG/ML Gel (30GMS) apply 2 pumps every AM. This was compounded from the script for Androgel 1.62% 2pumps every AM. I don't recall if I applied the gel the day of the test, I'd assume not.

Thank you for your time!!

 

[FLmale]

My current situation is:


Test Enan 0.25 ML every 5-days


The following are about 30 days old and taken the day before testosterone injection.


Test Result Range UOM
TSH 1.60 .040-4.5 mIU/L
T4 Free 2.0 0.8-1,8 mIU/L
T3 Free 3.0 2.3-4.2 pg/mL
Pregenolone <5 13-208 ng/dL
DHEA-S 45 70-495 mcg/dL
Testo Total 773 250-1100 ng/dL
Testo Free 78.7 46.0-224.0 pg/mL
Test Bio Avail 154.9 110.0-575.0 ng/dL
Albumin, Serum 4.3 3.6-5.1 g/dL
SHBG 50 10-50 nmol/L
Estradiol 39 < or =39 pg/mL
PSA Total 0.4 < or= 4.0 ng/mL
PSA Free 0.2
Hematocrit 50.4 10-50 nmol/L

 

[johndoesmith]

Sorry for being vague, just trying reconstruct the situation with the limited information and knowledge I have.

The initial PRE TRT test above was from 6-2012

Yes, I was on compounded TRT for about 6-months prior to this test. From the label: testosterone 60MG/ML Gel (30GMS) apply 2 pumps every AM. This was compounded from the script for Androgel 1.62% 2pumps every AM. I don't recall if I applied the gel the day of the test, I'd assume not.

Thank you for your time!!

You are adding to the confusion here. Make a single post, containing the lab tests, with dates, and what you were taking at the time. I have no idea what test you're referring to here, and you said 6 months prior to this test you were on TRT. So does that mean 1/2012 you started TRT for 6 months, THEN took this test?
Test Result Range UOM
TSH 1.46 .040-4.5 mIU/L
T4 Total 6.9 4.5-12.0 mcg/dL
T4 Free Index (T7) 2.0 1.4-3.8 N/A
T3 Total 95 76-181 ng/dL
T3 Uptake 29 22-35 %
Thyroglobulin Antibodies <20 <20 IU/mL
Thyroid Peroxidase Antibodies <10 <35 IU/mL
Testosterone Free 76 46-224 pg/mL
SHBG 43 10-50 nmol/L
Estradiol US 16 < or =29 pg/mL
FSH 3.3 1.6-8.0 mIU/mL
LH 3.0 1.5-9.3 mIU/mL
Prolactin 4.0 2.0-18.0 ng/mL

My current situation is:


Test Enan 0.25 ML every 5-days


The following are about 30 days old and taken the day before testosterone injection.


Test Result Range UOM
TSH 1.60 .040-4.5 mIU/L
T4 Free 2.0 0.8-1,8 mIU/L
T3 Free 3.0 2.3-4.2 pg/mL
Pregenolone <5 13-208 ng/dL
DHEA-S 45 70-495 mcg/dL
Testo Total 773 250-1100 ng/dL
Testo Free 78.7 46.0-224.0 pg/mL
Test Bio Avail 154.9 110.0-575.0 ng/dL
Albumin, Serum 4.3 3.6-5.1 g/dL
SHBG 50 10-50 nmol/L
Estradiol 39 < or =39 pg/mL
PSA Total 0.4 < or= 4.0 ng/mL
PSA Free 0.2
Hematocrit 50.4 10-50 nmol/L

.25ml is not a dose that is a volume. What is the mg dose? or the concentration of test e?

How long have you been on this protocol? Why was it taken day before injection?

How do you feel?

 

[TMI]

Your upstream hormones (DHEA, pregnenolone) are low. Take a look at these threads:

https://www.excelmale.com/forum/showthread.php?6619-low-dhea-due-to-trt

https://www.excelmale.com/forum/sho...HBG-DHEA-pregnenolone-and-progesterone-in-men

 

[FLmale]

Thanks for the replies, I will dig deeper into the files and post everything I have into a single post tomorrow.

FLMale

 

[CoastWatcher]

Thanks for the replies, I will dig deeper into the files and post everything I have into a single post tomorrow.

FLMale

When you do, spell out what sort of advice you're looking for. We really do want to start a productive conversation; we just need your help.

 

[johndoesmith]

When you do, spell out what sort of advice you're looking for. We really do want to start a productive conversation; we just need your help.

He did ask a question. only one, so you still have a point.

I'm really trying to determine if I am primary or secondary and what the initial course of action should have been.

 

[CoastWatcher]

He did ask a question. only one, so you still have a point.
[/COLOR]

I understand he asked a question. The ambiguity surrounding his other posts can be dispelled if he organizes his thoughts and focuses his inquiry. That would include a cogent restatement of his needs. Let's hope we can generate some reasoned responses once he returns.

 

[johndoesmith]

I understand he asked a question. The ambiguity surrounding his other posts can be dispelled if he organizes his thoughts and focuses his inquiry. That would include a cogent restatement of his needs. Let's hope we can generate some reasoned responses once he returns.

Yep. I can't make sense of his organization of labs or anything else so I agree with you entirely.

 

[FLmale]

EDIT, Deleted test results; don't want anyone to waste any more time on this.

I want to thank everyone for their time, I'm working with someone who is going to help me.

FLMale