Blood Work - Androgel @ 4-Pumps Per day

[lvs]

Hey Guys,

Here are blood work numbers after being on Androgel 4-pumps for 4-weeks. The previous 4-weeks which yielded low numbers were on 2-pumps. As you can see I am not absorbing the gel, just enough to keep me in shutdown. My endo, based on these results has started me on 200mg/ml test cyp. injections per week. I am 2-weeks in, they gave me my first shot and I pinned myself yesterday. She will be retesting after 5 injections (5-weeks).

Let me know what you think.

Test Name In Range Out Of Range Reference Range Lab
ESTROGENS, FRACTIONATED, LC/MS/MS
ESTRONE, LC/MS/MS 22 < OR = 68 pg/mL EZ
ESTRADIOL, ULTRASENSITIVE EZ LC/MS/MS 4 < OR = 29 pg/mL
ESTRIOL, LC/MS/MS, SERUM <0.10 ng/mL EZ Reference Range:ADULTS: < OR = 0.18

TESTOSTERONE, FREE AND EZ
TOTAL, LC/MS/MS
TESTOSTERONE, TOTAL,LC/MS/MS 196 L 250-1100 ng/dL
Total Testosterone was measured by LCMSMS. The LCMSMS method
correlates well with our extraction/RIA method.
TESTOSTERONE, FREE 37.2 35.0-155.0 pg/mL

COMPREHENSIVE METABOLIC IG
PANEL
GLUCOSE 66 65-99 mg/dL
Fasting reference interval
UREA NITROGEN (BUN) 18 7-25 mg/dL
CREATININE 1.29 0.78-1.34 mg/dL
eGFR NON-AFR. AMERICAN 66 > OR = 60 mL/min/1.73m2
eGFR AFRICAN AMERICAN 76 > OR = 60 mL/min/1.73m2
BUN/CREATININE RATIO NOT APPLICABLE 6-22 (calc)
SODIUM 140 135-146 mmol/L
POTASSIUM 4.5 3.5-5.3 mmol/L
CHLORIDE 102 98-110 mmol/L
CARBON DIOXIDE 28 21-33 mmol/L
CALCIUM 9.6 8.6-10.2 mg/dL
PROTEIN, TOTAL 7.0 6.2-8.3 g/dL
ALBUMIN 4.3 3.6-5.1 g/dL
GLOBULIN 2.7 2.1-3.7 g/dL (calc)
ALBUMIN/GLOBULIN RATIO 1.6 1.0-2.1 (calc)
BILIRUBIN, TOTAL 0.7 0.2-1.2 mg/dL
ALKALINE PHOSPHATASE 63 40-115 U/L
AST 26 10-40 U/L
ALT 28 9-60 U/L
ESTROGEN, TOTAL, SERUM 98 130 OR LESS pg/mL EZ
The total estrogen assay is not recommended for use in
pre-pubertal children.
CBC (H/H, RBC, INDICES, IG
WBC, PLT)
WHITE BLOOD CELL COUNT 4.4 3.8-10.8 Thousand/uL
RED BLOOD CELL COUNT 4.69 4.20-5.80 Million/uL
HEMOGLOBIN 15.0 13.2-17.1 g/dL
HEMATOCRIT 44.8 38.5-50.0 %
MCV 95.7 80.0-100.0 fL
MCH 32.0 27.0-33.0 pg
MCHC 33.5 32.0-36.0 g/dL

Test Name In Range Out Of Range Reference Range Lab
RDW 13.5 11.0-15.0 %
PLATELET COUNT 207 140-400 Thousand/uL
DHEA SULFATE 116 45-345 mcg/dL IG

[kelkel]

Hello Ivs.
Curious, was it 1% or 1.62% gel?
Did your doc pull you off the gel for a couple days or right to the 200mg shot?
Speaking of shots, why did she start you at that level? Is it her way of front-loading you and then adjust from there?
Any HCG or AI involved?

[steroid.com 1]

Without getting into all the details about your panel here; you are correct that the gel did nothing for you. Test is very low, E2 very low (no aromatization taking place).

Next panel will be worth a good review.

There are other things I'd want to see if I were you; please see Kel's sticky at the top of the forum for correct labs.

200 mg of Test Cyp right out of the gate is a bit much UNLESS the Doc is smart enough and just front loaded the initial injection.

To Kel's point, any discussion re hCG and the use of aromatase inhibitor if necessary? You need these...trust me.

Post you next panel Ivs.

[lvs]

1.62%

I have tried Axiron, and was absorbing this but it caused sinutitis, so we switched to testim and I couldn't stand the smell and the sticky application and then tried androgel. No delay after stopping the gel.

I have had pretty low levels now for quite some time, so that is why I am assuming she started me on that dose, she didn't give a reason and I didn't make any suggestions. She likes the gels and perhaps may not have much experience with injections I don't know. She said let's start there re-test in 5-weeks and adjust the dose.

She won't prescribe HCG and I also asked my GP about it but he said there is no scientific evidence for using this in men so he wouldn't prescribe it either. I have acquired HCG elsewhere, but have stopped it since switching to injections. Waiting to see what shots alone do for now, then add HCG in later. She will prescribe an AI depending on my next E2 levels.

Hello Ivs.
Curious, was it 1% or 1.62% gel?
Did your doc pull you off the gel for a couple days or right to the 200mg shot?
Speaking of shots, why did she start you at that level? Is it her way of front-loading you and then adjust from there?
Any HCG or AI involved?

[steroid.com 1]

Yea, she doesn't get testicles that will be shut down and atrophy BECAUSE she doesn't have a set of balls!

Your GP doesn't understand the mechanics of HPTA suppression. If you're a young guy and ever want kids or ever want to re-start again you'll need hCG.

Glade you sourced hCG on your own just be careful about what you're buying...some of the hCG out there is so weak it's worthless.

Ok, on the AI...at least she's good on that.

Teach her about why you need hCG...Crisler's paper on it is very will done even if it's a bit date Ivs.

[lvs]

Thanks gd, I am trying but also trying not to be overbearing... she is working with me albeit very slow... she is more open to my suggestions than the other endo I tried who has a set of balls at least I think he had them... because he asked me why I was worried about testicular atrophy? I really wanted to say something witty but decided to bite my tongue...

Believe it or not she was worried about the injections because of testicular atrophy, so she understands... but... no HCG.

Because my levels have been in the pit for sometime now, it hasn't taken long to start noticing a change from the shots. Mostly libido at this point, but already starting to feel a bit more energy, nothing profound but definitely notice a difference. Think we are on the right track, and expect my levels on 200mg/ml once per week to probably be high after 5-weeks and fully expect to be cut in half after that, but we will see because I haven't been on injections at once per week ever, started every 14-days with GP and that didn't work at all.

where is kels thread sticky thread on blood tests? I know she is ordering thyroid and corisol levels on this next test. Also where is a thread listing symptoms of low E2? I have been feeling a great deal of anxiety which is unusual for me and some dizzyness/lightheadness and wondering if that could be related to my hormone levels?

Yea, she doesn't get testicles that will be shut down and atrophy BECAUSE she doesn't have a set of balls!

Your GP doesn't understand the mechanics of HPTA suppression. If you're a young guy and ever want kids or ever want to re-start again you'll need hCG.

Glade you sourced hCG on your own just be careful about what you're buying...some of the hCG out there is so weak it's worthless.

Ok, on the AI...at least she's good on that.

Teach her about why you need hCG...Crisler's paper on it is very will done even if it's a bit date Ivs.

[kelkel]

http://forums.steroid.com/showthread...-TRT-Physician

Conditions of Low Estrogen Levels

Physical Conditions

• Artherosclerosis
• Headaches / Migraines
• Vaginal Infection **skip this one!
• Fatigue
• Hot flashes
• Night sweats
• Joint Pain
• Vaginal Dryness **this one too! Aargh...
• Dry Skin
• Loss of Libido
• Thinning tissues
• Rapid heartbeat
• Bloating
• Low back pain
Mental Conditions

• Depression
• Panic Attacks
• Low Self Esteem
• Mood swings
• Memory Lapses

[lvs]

Thanks kel!

http://forums.steroid.com/showthread...-TRT-Physician

Conditions of Low Estrogen Levels

Physical Conditions

• Artherosclerosis
• Headaches / Migraines Better since starting shots
• Vaginal Infection **skip this one! WHEW!
• Fatigue
• Hot flashes
• Night sweats
• Joint Pain Better since starting shots
• Vaginal Dryness **this one too! Aargh...
• Dry Skin
• Loss of Libido Better since starting shots
• Thinning tissues
• Rapid heartbeat
• Bloating
• Low back pain Better since starting shots
Mental Conditions

• Depression
• Panic Attacks
• Low Self Esteem
• Mood swings
• Memory Lapses

[HRTstudent]

Hey I'm just curious how did you like the physical properties of the androgel compared to testim? I am about to switch off of testim because it is so sticky and not producing good results at 1 tube/dose per day.

[lvs]

Physical properties are awesome compared to Testim. I could not stand that about the Testim, took forever to dry, then remained sticky for several hours and I could also smell it. Androgel is more alcohol based and applies quickly and dries with just a minute or two and does not smell. My test results were higher on Testim than Androgel, so I was absorbing that better. I hope Androgel absorbs for you because you will like it much better than testim. I tried Axiron, a bit harder to apply but it also dries quickly and slight odor but it is a very pleasant viral odor. I absorbed this the best and results were good but it caused some sinus issues for me. On shots FINALLY and liking this better than having to apply gels everyday.

Hey I'm just curious how did you like the physical properties of the androgel compared to testim? I am about to switch off of testim because it is so sticky and not producing good results at 1 tube/dose per day.

[HRTstudent]

Thanks lvs. Happy New year!

[lvs]

Thanks. Happy New Year!

Thanks lvs. Happy New year!

[lvs]

After switching to injections 200mg test cyp ew for 5 weeks blood draw on day of injection. There was suppose to be a sensitive estrogen assay on here so need to call doc and find out what happened. I even verified it with the Phlebotomist prior to the draw.

TSH 2.13 0.40-4.50 mIU/L IG
T4, FREE 1.4 0.8-1.8 ng/dL IG
T3, FREE 3.3 2.3-4.2 pg/mL IG

TESTOSTERONE, TOTAL,
LC/MS/MS 595 250-1100 ng/dL
TESTOSTERONE, FREE 160.7 H 35.0-155.0 pg/mL
CORTISOL, A.M. 13.5 mcg/dL IG

[HRTstudent]

Your free T is above the normal range, and this is your moment right before injecting if I read your stuff correct. If you're going for a physiologic dose you should lower the dose.

Did you get your hematocrit or hemoglobin checked? You need to keep an eye on these especially if you stay at this dose.

[lvs]

I am waiting to discuss the results with the doctor, as it took Quest 10 business days to get these results back for whatever reason. No hematocrit or hemoglobin this time, they were taken 5 weeks prior. Will do another full panel in about 3-months. However, I am still aggravated that E2 was not tested again this time.

[zaggahamma]

Your free T is above the normal range, and this is your moment right before injecting if I read your stuff correct. If you're going for a physiologic dose you should lower the dose.

Did you get your hematocrit or hemoglobin checked? You need to keep an eye on these especially if you stay at this dose.

is the statement in bold based on reference numbers alone? the term physiologic, does it not look at patient symptoms or the absence of them?

[lvs]

I agree as I feel so much better now than before. Terrible tendonitis in my elbow is 90% better, plus my energy level, well-being and libido are improving all the time. Doc still may lower my dose and I will update the thread after I have consulted with her. I have no signs of acne, sensitive nips etc, at the current dosing level.

is the statement in bold based on reference numbers alone? the term physiologic, does it not look at patient symptoms or the absence of them?

[HRTstudent]

is the statement in bold based on reference numbers alone? the term physiologic, does it not look at patient symptoms or the absence of them?

medically, our aim is to get into a physiologic dose. of course symptoms and the patient's subjective feelings are very important as well. however, going into supraphysiologic ranges (as is definitely happening, and apparently to a significant degree here) introduces potential complications and side effects down the road.

if someone was high-normal but they still had some symptom or problem then it would be wise to consider that there could be a problem in another area.

and another point would be, if the person felt no change at high normal, but did feel subjectively better at a slightly higher dose then maybe you could make the case. but if someone pretty much starts out at supraphysiologic, coming from hypogonadal, then it is completely reasonable that they would feel far far better. but they could probably feel better at a physiologic level as well in addition to avoiding extra risks.

[zaggahamma]

medically, our aim is to get into a physiologic dose. of course symptoms and the patient's subjective feelings are very important as well. however, going into supraphysiologic ranges (as is definitely happening, and apparently to a significant degree here) introduces potential complications and side effects down the road.

if someone was high-normal but they still had some symptom or problem then it would be wise to consider that there could be a problem in another area.

and another point would be, if the person felt no change at high normal, but did feel subjectively better at a slightly higher dose then maybe you could make the case. but if someone pretty much starts out at supraphysiologic, coming from hypogonadal, then it is completely reasonable that they would feel far far better. but they could probably feel better at a physiologic level as well in addition to avoiding extra risks.

that makes 100% sense
except where you say that in THIS case it is SIGNIFICANTLY out of range high...seems as it is just above the high range? or am i reading wrong?
i do see many patients even of the great crisler where free test is a bit above the high range and dose stays

just my .o2

i dont always think more is better and also why i believe it a person is serious about dialing in on there "sweet spot" then start low and work higher if necessary (dose wise) and adding in other compounds one at a time as well

[HRTstudent]

He took that bloodwork just before the next shot that was happening the same day. In other words, his trough was above normal.

[zaggahamma]

He took that bloodwork just before the next shot that was happening the same day. In other words, his trough was above normal.

point taken