Thoughts on my recent blood work....

[canada]

Over the last three months, I have been on the following protocol:

EOD injections - test cyp 40mg + HCG 250 IU, and no AI. Both injections, sub q in my stomach.


As a result, here is my resulting blood work (and ranges)... please note that my tests are coming from Canada, where the test, units, and ranges differ from some of the other labs posted on this forum.


Any thoughts/advice is greatly appreciated:



HGB - 169 (135-175) g/L
RBC - 5.56 (4.30-6.00)
HCT - 0.51 (0.41-0.52)

Estradiol - 174 (<200) pmol/L
Testosterone (am) - 32.2 (10.3-29.5) nmol/L
Testosterone (pm) - 31.1 (8.0-26.7) nmol/L
Free Testosterone - 776.1 (175-700) pmol/L
SHBG - 24 (6-65) nmol/L
DHEAS - 9.1 (<14.0) umol/L
Free T3 - 5.9 (3.5-6.5) pmol/L
Free T4 - 13.1 (9.0-23.0) pmol/L
TSH - 2.42 (0.20-4.00) mU/L
Ferritin - 73 (12-300) ug/L
Cholesterol - 4.23 (<6.20)
Triglyceride - 0.63 (<1.70)
HDL - 1.19 (>0.90)
LDL - 2.75 (no range given)
Chol/HDL ratio - 3.6

 

[MikeXL]

Hormones and lipids look very good. H&H seems to be getting close to time to donate? Do you know if these are on the rise? or is this normal for you?

 

[canada]

Hormones and lipids look very good. H&H seems to be getting close to time to donate? Do you know if these are on the rise? or is this normal for you?

I noticed the same - but with no frame of reference in regards to my last rounds of testing. Regardless, I think I should make a trip to the blood clinic soon.

So question... how often should TRT patients donate? Is there a common timeframe that is used? Every 3 months? 6 months?

 

[CoastWatcher]

I noticed the same - but with no frame of reference in regards to my last rounds of testing. Regardless, I think I should make a trip to the blood clinic soon.

So question... how often should TRT patients donate? Is there a common timeframe that is used? Every 3 months? 6 months?

Not all TRT patients need to donate blood as they don't experience the hemoglobin/hematocrit issues that are cause for concern. Nelson outlines his thoughts on the subject here. There are other excellent sticky posts on the Forum related to this topic.

https://www.excelmale.com/forum/sho...ia-Caused-by-Testosterone-Replacement-Therapy

 

[canada]

Not all TRT patients need to donate blood as they don't experience the hemoglobin/hematocrit issues that are cause for concern. Nelson outlines his thoughts on the subject here. There are other excellent sticky posts on the Forum related to this topic.

https://www.excelmale.com/forum/sho...ia-Caused-by-Testosterone-Replacement-Therapy

Thanks CoastWatcher - i think i may wait until my next BW in three months and reevaluate. Then i can see where i am at.

 

[canada]

In regards to estrogen levels... can anyone chime in on my Estradiol level? 174 (<200) pmol/L

I know this is below range, but it is also not the sensitive test (which I can not get). Can someone explain this test/range and advise if I am at a good #?

 

[CoastWatcher]

In regards to estrogen levels... can anyone chime in on my Estradiol level? 174 (<200) pmol/L

I know this is below range, but it is also not the sensitive test (which I can not get). Can someone explain this test/range and advise if I am at a good #?

Simple answer, nope. I, too, live in Canada had a reading of 156 and my doctor, correct,y, told me it was meaningless. So, I travel to the States regularly and obtain a sensitive estradiol reading through Discountedlabs.com. The sensitive test is almost unheard of outside the US.

 

[Jackie Treehorn]

Thanks for posting your lab results, but even more important...how do you feel? Energy, libido, mood, etc. Give us a breakdown.

 

[CoastWatcher]

Thanks for posting your lab results, but even more important...how do you feel? Energy, libido, mood, etc. Give us a breakdown.

Absolutely. Please let us know.

 

[John O'Connor]

Free T3 - 5.9 (3.5-6.5) pmol/L
Free T4 - 13.1 (9.0-23.0) pmol/L
TSH - 2.42 (0.20-4.00) mU/L

Your TSH is creeping up a little, but other thyroid numbers are good. Keep an eye on it. Being from up north I'd also recommend checking Vitamin D. There is a big link between Vit D and thyroid as well as other auto-immune diseases. If you want me to post links to those studies - just ask. I've posted them a few times this week in other posts too.

 

[canada]

Thanks for posting your lab results, but even more important...how do you feel? Energy, libido, mood, etc. Give us a breakdown.

Energy - slightly better. But still feeling run down.

Libido - sex drive is higher for sure. Performance is back to normal. ED issues seem to be resolved. Performance anxiety has been reduced. Morning erections came back, nighttime erections too! I don't feel 18 again, but I feel 10 x better than I did a year ago.

Mood - better as well. Much more optimistic outlook on life. I seem to care less than usual (in a good way). Seem to be more at ease.

Health/Fitness - my lifts are going up. Seems like I set a new PR frequently at the gym. Muscle mass going up slowly. Weight loss is still an issue. But ironically, I have put on 15 pounds since I started Trt, and my waistline is going down. Go figure.

Anxiety - I still have incredible anxiety. I always have. Xanax helps. But TRT does the opposite. I have great anxiety on TRT. It scares me. I am scared to be on for life. Scared of the risks as well. but i am commited to this for the next year before I reevaluate.

 

[canada]

Free T3 - 5.9 (3.5-6.5) pmol/L
Free T4 - 13.1 (9.0-23.0) pmol/L
TSH - 2.42 (0.20-4.00) mU/L

Your TSH is creeping up a little, but other thyroid numbers are good. Keep an eye on it. Being from up north I'd also recommend checking Vitamin D. There is a big link between Vit D and thyroid as well as other auto-immune diseases. If you want me to post links to those studies - just ask. I've posted them a few times this week in other posts too.

Can you explain TSH? I am not too familiar with this at all.

Agreed on the vitamin D. My Dr has me on 2000 IU of vitamin D daily.

 

[John O'Connor]

TSH = thyroid stimulating hormone. https://en.wikipedia.org/wiki/Thyroid-stimulating_hormone

The anterior pituitary releases TSH to signal your thyroid to produce T4 (and some T3). The T represents the amino acid Tyrosine. The numbers 4 and 3 represent the number of iodine atoms attached to a single Tyrosine atom. So imagine T4 as a single molecule composed of 1 Tyrosine atom, and 4 iodine atoms. To make T3 one of those iodine atoms is removed (this action is primarily done by your liver) - thus producing the active T3 molecule.

T4 = https://en.wikipedia.org/wiki/Thyroid_hormone

T3 = https://en.wikipedia.org/wiki/Thyroid_hormone#Effects_of_triiodothyronine

Off topic, but as a related example: Just as your hypothalamus produces GnRH (gonadotropin releasing hormone) to signal the anterior pituitary to release LH & FSH, which then signal the gonads to produce sperm & testosterone...

A similar feedback mechanism is involved in maintaining T4 & T3 levels circulating in our bodies. This is called, https://en.wikipedia.org/wiki/Hypothalamic–pituitary–thyroid_axis

Essentially the hypothalamus is constantly measuring circulating T3 & T4, and responding to low levels by signalling the anterior pituitary to release TSH, which again signals the thyroid to make T4 and some T3. Most of the active T3 results from the liver breaking T4 down to T3.

Hashimoto's thyroiditis is an auto-immune disease that attacks your thyroid, thus reducing its ability to produce adequate amounts of T4 & T3. This lead to low levels, thus leading the hypothalamus to release TRH, which leads the pituitary to release more TSH.

Anti-TPO is the antibody which is commonly tested when TSH is high to confirm the diagnoses of Hashimoto's thyroiditis. Treatment is pretty simple. Synthroid (generic = levothyroxine) = synthetic T4. Since your thyroid can't produce enough, you simply take this medication to make up the difference.

Recent studies are showing a link between low Vit D and the development of auto-immune disease, including Hashimoto's thyroiditis. Note normal range for Vitamin D = 30-100 ng/mL. But optimal vitamin D levels are 50+. Cancer patients are recommended to get levels above 65, and some doctors are recommending 80 as optimal. Vit D has a big role in proper immune functions, including protecting against cancer.

 

[John O'Connor]

Recent studies showing link between Low Vitamin D and auto-immune diseases:

2011 study http://www.ncbi.nlm.nih.gov/pubmed/21751884
CONCLUSION: Vitamin D insufficiency is associated with HT. Further studies are needed to determine whether vitamin D insufficiency is a casual factor in the pathogenesis of HT or rather a consequence of the disease.

2013 study http://www.ncbi.nlm.nih.gov/pubmed/23337162
The association between severity of vitamin D deficiency and Hashimoto's thyroiditis.

2015 study http://www.ncbi.nlm.nih.gov/pubmed/26637501
These findings suggest that vitamin D deficiency may be related to pathogenesis of HT and that its supplementation could contribute to the treatment of patients with HT.

And other auto-immune diseases (Multiple Sclerosis, Rheumatoid Arthritis...)
http://www.ncbi.nlm.nih.gov/pubmed/26751969
Serum Vitamin D Level and Rheumatoid Arthritis Disease

2013 http://www.ncbi.nlm.nih.gov/pubmed/23052893
Because of its suggested immunomodulatory capacity vitamin D deficiency or disturbance in the vitamin D metabolism might be a risk factor for the development of autoimmune diseases, such as multiple sclerosis; but supplementation with vitamin D might also be a therapeutic option. Substantial epidemiologic evidence indicates an association between vitamin D levels and risk of multiple sclerosis, suggesting vitamin D to be one of the long searched environmental factors for the development of this most common chronic inflammatory disease of the central nervous system.

http://www.ncbi.nlm.nih.gov/pubmed/24358684
2013 Impact of vitamin D in neurological diseases and neurorehabilitation: from dementia to multiple sclerosis

 

[John O'Connor]

Note TSH of 2.42 is not terrible. But since 1.0 is optimal - keep an eye on it. If you notice it increasing, you should probably have anti-TPO antibody checked. Like many diseases, they are progressive and become worse over time. Catching it early and using low dose synthroid/levothyroxine is likely all you would need. But maybe just getting Vitamin D levels up to optimal levels could bring your TSH levels back towards 1.0. Many people do not catch high TSH until it is in the 10.0+ range. Similar to not getting treated for hypogonadism until levels are critically low. Better to be proactive and have TSH measured annually.

Also, just as many doctors will not treat hypogonadism unless testosterone is below 350, or 300 or 250 - many will also not treat thyroid issues unless TSH is over 5.0.