Bloodwork advice

[Crest]

H, just received results of bloodwork I had taken last week. The clinic doctor made some generic notes. Could I kindly ask for opinion of you all please?

Total test: 247 Range 240.24-870.68 ng/dL (21-49 Yr old)
Free Testosterone 6.15 nd/dL = 2.49%
Bioavailable Testosterone 145 ng/dL = 58.7%
LH: 3.23 Range 0.57 - 12.07
Albumin: 4.33 Range 3.5 - 5.2 g/dl
Estradiol <10 Range 11-44 pg/ml
SHBG: 20.23 Range 17.10 - 77.60

[Cylon357]

H, just received results of bloodwork I had taken last week. The clinic doctor made some generic notes. Could I kindly ask for opinion of you all please?

Total test: 247

Free Testosterone 6.15 nd/dL = 2.49%

Bioavailable Testosterone 145 ng/dL = 58.7%

LH: 3.23

Albumin: 4.33

Estradiol <10

SHBG: 20.23

You should post ranges to get the best responses.

But, assuming standard ranges, your total T looks a bit low. Free doesn't look awful as a %, likely due to what is probably SHBG on the lower end of normal.

Two things...

Post the ranges

What are you looking for? All we can say is well, estradiol looks low, total t looks low, etc. Without more info, like how you are feeling, what your goals are, we are just guessing.

I would say it looks like you can benefit from TRT.

More info gets you better responses...

[teedoff]

You have another thread about doing a test only cycle coming up. All those numbers will change in a few weeks of a blast.

Pull labs again mid cycle and see where they're at.

Plans for post cycle in place? You're not already on trt, correct?

[Crest]

Hi guys thanks for replies. Sorry, have added a little more info. I hope it's not too long winded!

I'm 39 year old.
Did not cycle for last 10 years
Tests were taken at 12.30/1pm
I'm not sure if it's relevant but I've been under a little stress recently due to unresolved ongoing issue with neighbour plus some work stuff. Not chronic stress but a little. I don't know to what degree this impacts levels.
I'm not currently on TRT
Yes planned to cycle in next few months (have gear + pct) but looking at these numbers maybe would like to see if TRT is a route I might need to go down later.
My goal. I'm recreational guy just wanting to look and feel great. I'm not competing or anything. These bloods were just for a check before cycling to know if back at baseline after cycle. But after seeing the results it kinda got me thinking if TRT longer term is a good/bad idea. If i had to guess, throughout my lofe I've never had high test, but wasnt expecting to be right at the very bottom of the scale. Some of the symptoms of low T might actually be happening. I don't feel uber depressed but at the same time I don't feel amazing for the last few years and I wonder whether I've drifted into just feeling 'ok' rather than 'good' (you don't know what you don't know). Confusingly, when doing some research yesterday I'm getting all kinds of different numbers of what's considered low test from 230 or 280 ng/dl (UK) to 300 (US). The Dr at clinic is saying my test is low stating the 300 US measurement while the range from his lab begins 240...


Total test: 247 Range 240.24-870.68 ng/dL (21-49 Yr old)
Free Testosterone 6.15 nd/dL = 2.49%
Bioavailable Testosterone 145 ng/dL = 58.7%
LH: 3.23 Range 0.57 - 12.07
Albumin: 4.33 Range 3.5 - 5.2 g/dl
Estradiol <10 Range 11-44 pg/ml
SHBG: 20.23 Range 17.10 - 77.60

[Cylon357]

Hi guys thanks for replies. Sorry, have added a little more info. I hope it's not too long winded!

I'm 39 year old.
Did not cycle for last 10 years
Tests were taken at 12.30/1pm
I'm not sure if it's relevant but I've been under a little stress recently due to unresolved ongoing issue with neighbour plus some work stuff. Not chronic stress but a little. I don't know to what degree this impacts levels.
I'm not currently on TRT
Yes planned to cycle in next few months (have gear + pct) but looking at these numbers maybe would like to see if TRT is a route I might need to go down later.
My goal. I'm recreational guy just wanting to look and feel great. I'm not competing or anything. These bloods were just for a check before cycling to know if back at baseline after cycle. But after seeing the results it kinda got me thinking if TRT longer term is a good/bad idea. If i had to guess, throughout my lofe I've never had high test, but wasnt expecting to be right at the very bottom of the scale. Some of the symptoms of low T might actually be happening. I don't feel uber depressed but at the same time I don't feel amazing for the last few years and I wonder whether I've drifted into just feeling 'ok' rather than 'good' (you don't know what you don't know). Confusingly, when doing some research yesterday I'm getting all kinds of different numbers of what's considered low test from 230 or 280 ng/dl (UK) to 300 (US). The Dr at clinic is saying my test is low stating the 300 US measurement while the range from his lab begins 240...


Total test: 247 Range 240.24-870.68 ng/dL (21-49 Yr old)
Free Testosterone 6.15 nd/dL = 2.49%
Bioavailable Testosterone 145 ng/dL = 58.7%
LH: 3.23 Range 0.57 - 12.07
Albumin: 4.33 Range 3.5 - 5.2 g/dl
Estradiol <10 Range 11-44 pg/ml
SHBG: 20.23 Range 17.10 - 77.60

Some simple fixes. Kill your neighbor.

I'M KIDDING!!!

(or am I?)

Yes, I am.

You should pull your numbers at a consistent time, usually first thing in the morning. The numbers probably aren't far off, so the real questions to me are a) are you ready to commit to trt for life and b) are you done having kids? The first one isn't that big a deal, the second one could be. We have a couple of members who are currently coming off to conceive, and it is... well, I will let you dig for the threads.

That said, I do not regret for one minute getting on TRT. It keeps the levels stable and allows all sorts of fun with mini-blasts. At 55, I am done with even thinking about having more kids. I did the cream (20% compounded) and sub-q injections. Cream is a viable option if two conditions. First, you get the 15 to 20% compounded cream, not the 1 to 2% gel. Second, you can tolerate the elevated DHT that comes with topical application. I had good consistent numbers with the cream but my DHT was over 200 with range being 15-60 or something like that.

The injections are essentially painless, and like I said, I can add a little something something from time to time if I want. I have used HCG throughout my TRT, a lot of men don't. I like for my potatoes to complement my meat, so to speak, makes for the total package thing. Well, OK, I use HCG more to keep parts of the HPTA functioning "just in case", but the added benefit is that nothing looks out of place.

[Crest]

Joking/not joking/definitely a neighbour burried under your patio

I'm not far off but still on the diplomatic route.

Do you mind if I ask what T level you were when you decided to take TRT. Maybe you just didn't want to cycle off...

Will book another set of bloods in a couple of weeks and earlier in the AM. Then maybe again two weeks later. I think if tHe next two are lower than a baseline it's something I might seriously consider. I'm a routine kinda guy, but still it's probably a 30+ year commitment.

I read the sticky threads in the TRT forum. All the tests are necessary or can I make it with the same as provided above?

[Cylon357]

Joking/not joking/definitely a neighbour burried under your patio

I'm not far off but still on the diplomatic route.

Do you mind if I ask what T level you were when you decided to take TRT. Maybe you just didn't want to cycle off...

Will book another set of bloods in a couple of weeks and earlier in the AM. Then maybe again two weeks later. I think if tHe next two are lower than a baseline it's something I might seriously consider. I'm a routine kinda guy, but still it's probably a 30+ year commitment.

I read the sticky threads in the TRT forum. All the tests are necessary or can I make it with the same as provided above?

My total T was around 400 when I decided to pursue hrt. TBH, overall the numbers weren't BAD, they just weren't real good. I'm in a field flooded with younger people, so I need to keep the mind sharp. No brain fog allowed!

The bloods I like to pull are:
Total and free T
Estradiol sensitive
DHT
PSA
Thyroid panel
CBC
Lipids
CMP
PSA

You might consider a few others like SHBG, but those will provide a good base.

[Crest]

My total T was around 400 when I decided to pursue hrt. TBH, overall the numbers weren't BAD, they just weren't real good. I'm in a field flooded with younger people, so I need to keep the mind sharp. No brain fog allowed!

The bloods I like to pull are:
Total and free T
Estradiol sensitive
DHT
PSA
Thyroid panel
CBC
Lipids
CMP
PSA

You might consider a few others like SHBG, but those will provide a good base.

Appreciate your feedbacks Cylon. Will update here in a couple of weeks.

Peace. ✌️

[Honkey_Kong]

Joking/not joking/definitely a neighbour burried under your patio

I'm not far off but still on the diplomatic route.

Do you mind if I ask what T level you were when you decided to take TRT. Maybe you just didn't want to cycle off...

Will book another set of bloods in a couple of weeks and earlier in the AM. Then maybe again two weeks later. I think if tHe next two are lower than a baseline it's something I might seriously consider. I'm a routine kinda guy, but still it's probably a 30+ year commitment.

I read the sticky threads in the TRT forum. All the tests are necessary or can I make it with the same as provided above?

Rather than worrying about what number your test levels are, what low-t symptoms are you suffering from? Everybody's bodies are different and some people don't need as much free test as other people need. The doc at the TRT clinic has financial motivation to tell you that you need TRT. I'll tell you this much though, if you're looking to cycle while on TRT, you're going to have to wait until they do bloodwork less frequently. If your total test is sky high and you're just supposed to be on 125mg per week, they might even refuse to treat you.

[Crest]

Hey HK

That's exactly it. I don't know if the way I feel at the moment is normal or whether I have symptons that I've learned to live with for last few years. AlI I can say is I'm not sleeping as well as I used to, maybe my sex drive is not amazing. I mean I wake up with wood everyday, but the drive to go out and get 'it' might be lacking, I'm a bit foggy maybe... Now again, I did not really start thinking about this until I had taken the blood test. So are these really symptoms, or am I being a hypercondriact. I'm not jumping at the idea of lifelong injections, but if I do not start, am I missing out on feeling better than I do. Tough one!

I wasn't planning to cycle until April or May, so two options. Jump on now, do a PCT then look further at the blood test/TRT route, or go down that route now, which means I can't run a cycle.

What are your thoughts?

Completely understand what you're saying about TRT clinic. I've contacted some regular hospitals to either look at the results I have or run more comprehensive panel.

[Honkey_Kong]

Hey HK

That's exactly it. I don't know if the way I feel at the moment is normal or whether I have symptons that I've learned to live with for last few years. AlI I can say is I'm not sleeping as well as I used to, maybe my sex drive is not amazing. I mean I wake up with wood everyday, but the drive to go out and get 'it' might be lacking, I'm a bit foggy maybe... Now again, I did not really start thinking about this until I had taken the blood test. So are these really symptoms, or am I being a hypercondriact. I'm not jumping at the idea of lifelong injections, but if I do not start, am I missing out on feeling better than I do. Tough one!

I wasn't planning to cycle until April or May, so two options. Jump on now, do a PCT then look further at the blood test/TRT route, or go down that route now, which means I can't run a cycle.

What are your thoughts?

Completely understand what you're saying about TRT clinic. I've contacted some regular hospitals to either look at the results I have or run more comprehensive panel.

A bit foggy? Are you getting enough sleep at night? Is your diet good? Do you have sleep apnea? There's a lot of reasons why you have a decreased sex drive. In fact one of them can be a prolactin issue. In fact, I'm really surprised that clinic didn't order that bloodtest.

What I would do if I were you is look around at several clinics. If they're going to treat it as if they're some drug dealer just giving you gear and not as medical care professionals that are concerned with treating your symptoms/condition, then you probably shouldn't want to be treated by them.

But as for doing a cycle and PCT. If you're going to go on TRT, there's no point in doing a PCT. What I would suggest is that you consult with some good clinics and doctors who understand low-testosterone and how to treat it and if they think you will benefit from TRT, get that treated. Then wait 6 months to a year or however long it takes for them to be satisfied with your dose and bloodwork that they aren't constantly checking it. And only then think about doing a cycle (and I'm not telling you to do a cycle).

[Crest]

Yes I'm tired many days. Normally I'd sleep 8 hours around 11pm to 7am and but recently I'm waking up early at 5am most days. I don't have sleep apnea. My diet is reasonably good and consistent in meal times.

As I mentioned earlier in thread, I'm also a little stressed but im quite sure these are external factors. So my thoughts are am I feeling tired, stressed etc because my T is at 247 or is my T at 247 because I'm having some stress which effecting sleep etc etc I plan to take a couple more bloodworks over the next month or so. Hopefull that helps to mitigate short term variables a little... Maybe I'm just wishful thinking and i'm naturally in the grey/low T area nowadays. Might be more simple if the number was 100 lol

I'm not sure to what degree the above factors really effect the overall production of hormones. Are we talking 5%, 50% or?

[Crest]

Have some updated bloodwork.

What do you think? LH and FSH are really low?

Test is little better (this reult 8am vs 1pm last time), but bioavailable is quite high?



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[Cylon357]

Have some updated bloodwork.

What do you think? LH and FSH are really low?

Test is little better (this reult 8am vs 1pm last time), but bioavailable is quite high?

Lh and fsh will trend towards zero in the presence of exogenous test. These numbers are likely your normal and explain the mediocre feelings you are having.

If you want to continue to cycle, pct ad nauseum, you can, but I still think TRT would be a good choice for you.

[kelkel]

That's exactly it. I don't know if the way I feel at the moment is normal or whether I have symptons that I've learned to live with for last few years.

You definitely adapt to low T and think you're normal. I was down to a 59 T level before I was diagnosed (pituitary tumor) which started my journey on TRT. I honestly don't know how long I was that low but when I look back there were definitely symptoms that I wrote off as getting older, etc. Big mistake.

Glancing over your BW def work on your cholesterol. You total is high but that's never a big deal in my mind but your triglycerides should be half of what they are. You need a good fish oil supplement containing EPA and DHA. At least about 2k per day. Consider supplements such as Endur-Acin or Slo-Niacin to help with your HDL. Regarding cycling, you'll live without it for a while. Get your BW in order first. Just optimizing your T levels with TRT can do wonders for you when coupled with good training and nutrition. Add in some Vit D as well as you're near the bottom.

Be well.

[Crest]

Thanks Kelkel, Cylon

Interested to know your view on T level? Should I be looking at this as 400 at 8am means most of the day, 10am onwards possibly down to 300 and then less as day goes on, or is it normally better to take the view that 400 isnt high but not so low at this time?


Normally my colestorol and triglycerides are within range. I think this just takes a tweak to me 10am meal to bring this back down. Eating a convenient high protein/carb meal at our cafeteria which is prob high in cheap oils.

Have ordered some fish oils, D3 and zinc sups. Thanks for advice

You definitely adapt to low T and think you're normal. I was down to a 59 T level before I was diagnosed (pituitary tumor) which started my journey on TRT. I honestly don't know how long I was that low but when I look back there were definitely symptoms that I wrote off as getting older, etc. Big mistake.

Glancing over your BW def work on your cholesterol. You total is high but that's never a big deal in my mind but your triglycerides should be half of what they are. You need a good fish oil supplement containing EPA and DHA. At least about 2k per day. Consider supplements such as Endur-Acin or Slo-Niacin to help with your HDL. Regarding cycling, you'll live without it for a while. Get your BW in order first. Just optimizing your T levels with TRT can do wonders for you when coupled with good training and nutrition. Add in some Vit D as well as you're near the bottom.

Be well.

[Cylon357]

Thanks Kelkel, Cylon

Interested to know your view on T level? Should I be looking at this as 400 at 8am means most of the day, 10am onwards possibly down to 300 and then less as day goes on, or is it normally better to take the view that 400 isnt high but not so low at this time?


Normally my colestorol and triglycerides are within range. I think this just takes a tweak to me 10am meal to bring this back down. Eating a convenient high protein/carb meal at our cafeteria which is prob high in cheap oils.

Have ordered some fish oils, D3 and zinc sups. Thanks for advice

400 total test is just ok. Two quick thoughts

1 - we really want to balance our hormones, not just test. This means free test, dht, estradiol, tsh.
2 - natural production ebbs and flows over the course of the day, highest in the morning, lowest later in the day. Not sure how much it varies.

TRT, maybe for me the biggest advantage of TRT, is that it essentially eliminates the ebb and flow and puts you in a more steady state. Yes, levels will vary some from injection to injection, but a good twice weekly protocol with a C or E eventually will make that negligible.

Just rando thoughts this morning...

[Honkey_Kong]

400 total test is just ok. Two quick thoughts

1 - we really want to balance our hormones, not just test. This means free test, dht, estradiol, tsh.
2 - natural production ebbs and flows over the course of the day, highest in the morning, lowest later in the day. Not sure how much it varies.

TRT, maybe for me the biggest advantage of TRT, is that it essentially eliminates the ebb and flow and puts you in a more steady state. Yes, levels will vary some from injection to injection, but a good twice weekly protocol with a C or E eventually will make that negligible.

Just rando thoughts this morning...

Total test really isn't that terribly important. Most of that test is bound and can't bind to the androgen receptor. It's really his free test (and SHBG) that are more important since that's what is active in the blood. And from the looks of that, it's "middle of the road" in the lab's scale.

If he's suffering low-t symptoms (and he says he is), then he probably should get more bloods drawn. One blood test doesn't tell you what his levels normally are. They only capture it for that individual day at that individual time. What I would do is supplement the vitamin D, the fish oil, pay real good attention to diet, drink extra amounts of water and how much bed rest he gets at night and then do another blood test to see if it causes improvement. And then from there possibly consider TRT

[Cylon357]

Total test really isn't that terribly important. Most of that test is bound and can't bind to the androgen receptor. It's really his free test (and SHBG) that are more important since that's what is active in the blood. And from the looks of that, it's "middle of the road" in the lab's scale.

If he's suffering low-t symptoms (and he says he is), then he probably should get more bloods drawn. One blood test doesn't tell you what his levels normally are. They only capture it for that individual day at that individual time. What I would do is supplement the vitamin D, the fish oil, pay real good attention to diet, drink extra amounts of water and how much bed rest he gets at night and then do another blood test to see if it causes improvement. And then from there possibly consider TRT

That was my first point - total t isn't the end all, be all we sometimes think it is. Thyroid issues can masquerade as low T - lethargy, inability to gain weight, etc. So can low DHT... the worst brain fog of my life was when I tanked my DHT.

It sounds like you are saying he shouldn't consider TRT yet, not without some diet and life style scrutiny. Totally makes sense. The only difference I would say is that if he is basically 40 and going to cycle and PCT anyhow, a blast and cruise approach might make be smart. Assuming of course, he can commit to the life long commitment that TRT is.

[Crest]

Okay, so an update for those that are interested. Took a 3rd test at a private hospital and discussed with endocrinologist.

The key takeaway for me this time is that total T was 370, bioavailable test (measured not calculated) was 93 on a scale of 90-300. LH, FSH etc all similar to previous tests.

Dr has suggested we trial for a couple of months at 200mg per 2 weeks (1 injection every two weeks). From my own research I know this isn't the best protocol. I plan to pin 50ml/mg every 3.5 days and prior to our next appointment I'll take final dose as he prescribed so bloods look how he is expecting.

I've been prescribed Test C at 200mg per 2ml so I plan to transfer from amps to vials because if I'm running 50mg every 3.5 days, there would be a lot of wastage or I'll need to store three filled syringes (which I'd rather not do)

My Q.... If I am transfering pharma grade from amp to vial, am I required to use .22 filters, or can I just draw from amp and inject oil directly into the vials, which I have bought and will sterilise myself.

Thanks again for your help gents.

[Cylon357]

Okay, so an update for those that are interested. Took a 3rd test at a private hospital and discussed with endocrinologist.

The key takeaway for me this time is that total T was 370, bioavailable test (measured not calculated) was 93 on a scale of 90-300. LH, FSH etc all similar to previous tests.

Dr has suggested we trial for a couple of months at 200mg per 2 weeks (1 injection every two weeks). From my own research I know this isn't the best protocol. I plan to pin 50ml/mg every 3.5 days and prior to our next appointment I'll take final dose as he prescribed so bloods look how he is expecting.

I've been prescribed Test C at 200mg per 2ml so I plan to transfer from amps to vials because if I'm running 50mg every 3.5 days, there would be a lot of wastage or I'll need to store three filled syringes (which I'd rather not do)

My Q.... If I am transfering pharma grade from amp to vial, am I required to use .22 filters, or can I just draw from amp and inject oil directly into the vials, which I have bought and will sterilise myself.

Thanks again for your help gents.

If you everything you work with is sterile, you shouldn't need to filter anything.

[teedoff]

I dont get why Dr's prescribe that kind of injection protocol. Every two week injections seems like you have huge swings in test levels!

If I recall, the Dr that initially put me on the gel mentioned injections would be once every 2 weeks if I opted for them.

[Crest]

They're loco.

I was offered gel also, which I rejected. It was also 5x the price of the 4 amps, and even worse, 4 amps from the hospital were the price of 40 amps (yes 40) of the same brand in a local pharmacy!

Am still deciding whether to run cycle first, before dropping to this TRT dose though.

[Crest]

If you everything you work with is sterile, you shouldn't need to filter anything.

Ok thanks. Yes my assumption is that if its already clean and sterile, introducing more potential points of contact would mean more likelyhood of contaminating.

Assume glass shards from amp.breaking are unlikely to be transfered from the amp.to the vial.

[teedoff]

They're loco.

I was offered gel also, which I rejected. It was also 5x the price of the 4 amps, and even worse, 4 amps from the hospital were the price of 40 amps (yes 40) of the same brand in a local pharmacy!

Am still deciding whether to run cycle first, before dropping to this TRT dose though.

I have really good insurance. The gel I was on initially was costing me 10 bucks a bottle. Dr started me on one pump a day and the bottles were for a 30 day supply at 2 pumps. So 5 bucks a month.

When I switched to injections, through a hormone clinic, I started getting my test at Harris teeter. I get 10 vials dosed at 200mg/ml. Each vial is 1 ml. I'm only taking 100mg/week and my script is for 150mg week. So I have a buffer so to speak, that I can play around with dosage if needed. I have yet to file these on my insurance as it's so cheap. I think 10 vials are around 60 to 80 bucks depending on coupons available.