What labs should I order?

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Amaps

New Member
Hey guys, thanks for an awesome source of information!

I’m a 42 year old male with most of classic signs of low T. But my case is somewhat unique, or at least, I haven’t been able to find anyone with similar case.

Fifteen years ago I had a gastric bypass and lost a lot of weight. I got to my goal weight pretty fast and kept it off for many years. I’m 5,6 and at the time of gastric bypass i was 240lbs, I got down to 145 with 11% body fat and I felt great. Until three years ago when I got really sick. Constant nausea with vomiting, dizziness, weakness, body aches. I waited for about a week for it to pass but it didn’t, so I went to a doctor and had a full work up. Doctor told me he tested everything including thyroid and testosterone. When labs came back he told me I was very anemic, low b12, low d3, low folic acid, everything else within normal limits. So I had twelve iron infusions and I was put on 1mg b12 monthly, 1mg folic acid daily and 50000 iu twice a week. I felt great after a short period. That went on for about two years, then I started gaining weight no matter how much I work out or diet. I normally just do push ups, pull ups and air squats everyday to stay fit. Now I added weights and cardio, reduces carbs and calories but still getting fat. Currently I’m 180lbs 20.8% body fat. So all this plus other signs of low T like low libido, bad mood and less and less energy every day got me researching low testosterone.

I went to local testosterone clinic and got tested.

Total T: 360. 50 Range : 198 - 679

Free T: 5. 72 Don’t know range but I was told it’s really low.

SHGB: 46.70 Range: 13.3 - 89.5

Estradiol: 26.00. Range: 0 - 47

Second blood test confirmed these results. I was prescribed 140mg Test cypionate once a week and 0.5mg anastrozole on the day of Test injection. After second injection I started feeling really good first two days but the rest of the week I was pretty much back to how I was before. After third week I started having dull pain in one of my testicles.

I called the clinic and asked if I should try splitting the dose in two per week and was told absolutely not. They said that they want me to come in a week early for my six week blood test and that I will most likely get my dose increased. When I asked about the pain in my balls, they said that only 20% of men get it and if I doesn’t go away we will discus treatment.

Sorry for the long post! I just felt like I needed to give some context to get an advice .

I’m planning on discussing why they said absolutely not to splitting dose and also want to get a full blood work up again. I haven’t checked b12, folic acid or d3 since the time I got sick, so I want to get that checked And the TRT related labs.

What else do you guys think I should get tested when I go in next week?

Here’s my full labs from last time (before TRT)

Thanks in advance
 
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Defy Medical TRT clinic doctor

Systemlord

Member
There is TRT honeymoon phase as we like to call it, It happens when you inject testosterone which shuts down the HPTA which ceases your natural testosterone production, it will pass in time and you should start feeling good in the weeks to come. The full testicles ache is related to the HPTA shutdown and will subside in time.

There are some TRT clinics out there who just aren't up to date on modern TRT protocols, they tend to only offer once weekly injections and do not care to optimize treatment. It's not unusual for someone to want more frequent injections and most often is better and should have recommended at least twice weekly injections to start out.

I inject testosterone every 2 days because it works best for me, once or twice weekly never really did much for me. We are all biochemically unique and our protocols need to be tailored to our biology, if this clinic isn't interested in making your treatment more effective, it may be time to look elsewhere for treatment.

Stick to your current protocol and retest at the 6 weeks mark and see where you stand and go from there.
 
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Amaps

New Member
I realize I wrote a long post and you probably didn’t read all the way to the end, But thanks for taking the time replying anyway!
 

CoastWatcher

Moderator
I would note that, based on the reference range, you tested your estradiol with the incorrect (standard) test that is of no value for men. All men should test e2 with the sensitive, LC, MS/MS, lab test.

Please be sure your doctor selects the correct test in the days ahead. This is important.
 
I would note that, based on the reference range, you tested your estradiol with the incorrect (standard) test that is of no value for men. All men should test e2 with the sensitive, LC, MS/MS, lab test.

Please be sure your doctor selects the correct test in the days ahead. This is important.
excellent...great catch on that test.
 

Amaps

New Member
You got a very good reply from a really smart guy. I wouldn't add to his response in any way.

I know there are many smart guys here, that’s why I posted my question. I appreciate him and everyone else taking the time to reply but he didn’t answer my question.
 
Last edited:

Amaps

New Member
I would note that, based on the reference range, you tested your estradiol with the incorrect (standard) test that is of no value for men. All men should test e2 with the sensitive, LC, MS/MS, lab test.

Please be sure your doctor selects the correct test in the days ahead. This is important.

Thank you! I will definitely make sure to get the right one tested next time.
 
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