Odd Test Level...

[Rusty11]

Hi. Great website here with a lot of great info and great people. I'll try to keep my question short.
-51 years old
-Three months ago put on one tube testim/day. Test at 240
-One month bw showed free test at 307
-Another month on one tube per day. Ask doc to go up to two tubes per day because my sleep was finally getting better and my libido/well-being really improved. Endo said 'ok'.
-Same day, I fax a letter asking for all of the levels in the sticky to be tested. After a week, he agrees.
-BW done last week after being on two tubes/day for about three weeks.
-BW showed Test at around 4000. He said my estrodiol was about one point higher than the normal range. They mailed me the complete BW, but haven't received it yet.
-Been sumplementing with 4000iu/day of Vit D3, nothing else.
-Sooo, my question is....is there any way, besided a contaminated sample, that this could be valid?
-Going in Monday for another draw for test.
-He said to continue as is until he sees the next BW. He also said that most guys only do one tube per day (wrong) and is pretty convinced that this result is valid.
-My BP is normal and libido is not great.
Anyway, I'm confused and a bit nervous.
Thanks for any info

[Rusty11]

btw, I apply testim at 6a.m. to shoulders and upper arms. Blood was drawn at 4p.m. Don't know how the test could have gotten on the draw site.

[bass]

It's possible the sample was contaminated. When you get your BW post everything with ranges.

[HRTstudent]

Easily a contaminated sample. It could have only been a tiny, tiny amount that got onto the draw site and that would effect your results.

Next time, I would not apply cream to the draw site area for a couple days at least to be safe.

I'm suprised the lab can test up to 4000. It seems like most cut off around 1500'ish.

Regardless, two tubes of testim aint gonna do it!

Finally, whats your rationale to testing your blood at 4pm when you apply at 6am? Not that its a terrible idea or anything, but most people start by getting a baseline number, then might get a peak number, but 10 hours post application is really neither. But if the number shows something mid-range I can't say it will really matter. The most important thing is how you are improving.

[Rusty11]

Thanks to both of you. Yes, I'll post all my levels. I wont put the gel on that arm this weekend. Also, I get drawn after work. Tough to get there before. Even though I printed out the things to be checked, I think he tested regular estradiol
One last thing...I shouldn't stop applying due to that bizarre high number, right?? I'm just a bit nervous about it. Endo talked like it's likely legit (rolling my eyes). Thanks again!

[Rusty11]

Sorry. One more dumb question... if test level was anywhere near 4000, wouldn't I be feeling something strange with numerous side effects?

[HRTstudent]

Thanks to both of you. Yes, I'll post all my levels. I wont put the gel on that arm this weekend. Also, I get drawn after work. Tough to get there before. Even though I printed out the things to be checked, I think he tested regular estradiol
One last thing...I shouldn't stop applying due to that bizarre high number, right?? I'm just a bit nervous about it. Endo talked like it's likely legit (rolling my eyes). Thanks again!

No I would not stop applying because I am almost certain you do not have a T of 4000. I only say almost because there is always that .000001% of people who win the lottery or are some kind of medical mystery. But I would put money on contamination in this case!

[J DIESEL3]

Rusty I agree with HRT and bass on this.

I have a very good friend on gel and the same thing happened to him with a crazy high level.Turns out that he had gotten some of the t gel on the area they extracted the blood from.

Don't stress out rusty!Even if the level is correct I don't believe it is but let's say it is you will only have it like that a short time.

[Rusty11]

Rusty I agree with HRT and bass on this.

I have a very good friend on gel and the same thing happened to him with a crazy high level.Turns out that he had gotten some of the t gel on the area they extracted the blood from.

Don't stress out rusty!Even if the level is correct I don't believe it is but let's say it is you will only have it like that a short time.

Thanks, man. Yea, sometimes I worry too much. Here I am at 4 am on the computer...lol. Guess I'll go workout now. Nothing better to do at this time. Wife and dog are snoring away...

thanks again.

[bass]

If gels can elevate test to that level I guarantee you we will all be using it. I'm pretty sure that number is inaccurate.

[steroid.com 1]

What HRT said...most likely some amount made it into the drawing syringe and skewed results.

Post your next round of BW here in this thread complete with ranges and we'll jump in.

[Rusty11]

been on testim for 1 year just got my b/w back after being on 2 tubes for the year went to lab corp this was a peak reading 4 hours after applying numbers were 1499 total and 53.0 free t i was on tilt my anxiety was on a scale 1 to 10 about a 9 my estradiol was at 89.6

Yea, that's interesting. Doc said nothing about my free t (wondering if he even checked it). And, from what I've read, my anxiety/anger/aggresiveness should be through the roof. Well, it's the opposite right now. I'm sleeping the best I have in months without ambien and/or restoril. I'm calm, cool, and relaxed at night.

Here's hoping we both get things straightened out. My wife is understanding, but I think she's tired of hearing me talk about Testosterone. But, man, are hormones a complex issue. Who knew... good luck, testyim. Hope your doc figures things out.

[HRTstudent]

Yea, that's interesting. Doc said nothing about my free t (wondering if he even checked it). And, from what I've read, my anxiety/anger/aggresiveness should be through the roof. Well, it's the opposite right now. I'm sleeping the best I have in months without ambien and/or restoril. I'm calm, cool, and relaxed at night.

Here's hoping we both get things straightened out. My wife is understanding, but I think she's tired of hearing me talk about Testosterone. But, man, are hormones a complex issue. Who knew... good luck, testyim. Hope your doc figures things out.

its tricky... this whole TRT thing can be as complex as we want to make it. Look at it this way, even the medical experts in the field don't have everything close to figured out. Nonetheless, we know some things that work and it will be responsible for probably 90% or more of our results. So focus on that, and try not to get too bogged down. After all, TRT is a quality-of-life treatment -- we need not make it a focus-of-life treatment .

[Rusty11]

Thanks HRT. I didn't apply to my left side yesterday and decided to go to my local outpatient center and just get the BW redone. Didn't feel like waiting 'til Monday. I told the phlebotimist (sp?) what happened and she was extra careful. Another thing I liked about going to the hospital is that all I had to do was ask to have my results mailed and they said, "sure, just fill out this form". With my endo, it's been like pulling teeth. I've called and called. Tomorrow, I'll have to be more obnoxious and tell them to fax it to me. It's ridiculous. Why is it such a big deal?? Just dumb
As I stated in an earlier post, I copied/printed all the BW from the sticky, attached a nice,friendly cover letter, and faxed it to the endos office. We'll see if he actually did what I requested, especially the E2 sensitive assay. He said on the phone that my estradiol was a little bit high (1 pt.), but from what you guys have said, regular estradiol test is not what I/we need. If he didn't test all of those things, off to my GP I go. When I get the results, I'll post them and I'm sure I'll have a few questions. Hope you don't mind. I won't ramble like I have here... Well, time to go lather up. Thanks again, HRT and all.

[Rusty11]

Hello. I received my bw results from the other day. I'm still amazed the Endo was so confident that the T level of 4000 was legit. It boggles my mind. I'll just post the things that ppl seem to comment on.
First, I went to get another T test on Sat. They couldn't send me that one yet because the Dr. had not signed-off on it. But, I asked and my total T was 441. A far cry from 4000. This didn't surprise me because I knew it was getting better (was at mid 200s a couple of months ago).

As I stated earlier, I faxed a nice letter requesting all of the bw suggested in the sticky. However, he didn't test all of them. Not surprised at that either.

Total test: 4400. Range 212-1734 ng/dL
Free Androgen Index: 340.80. Range 30-150
Bogus results!!!

25-Hydroxy Vitamin D: 46.6. Range 30-100 ng/mL
Hemoglobin: 14.9. Range 13.2-17.1 g/dL
Hematocrit: 45.4. Range 38.5-50
SHBG: 44.8 I looked and there is no range listed. weird.
PSA: 0.7 Range <4.0 ng/mL
Estradiol (E2) 47. Range <39 Of course, I requested sensitive assay, but it wasn't checked.

Also not checked, but requested
Cortisol, Prolactin, DHT (Don't know how important that one is.

so, anyway, I made an appt with my GP. He's the one who started me on Testim and is always open to anything. So, he'll test these things that the Endo would not.

Thanks for all who responded.

edit: numerous other things were checked and all came back nice and normal.
Also, Estradiol is high. I know it's not the sensitive assay, but is there something I can do to bring this down. Or just wait 'til I get new BW done from GP in a week?

Crap...one more edit. No thyroid panels were done because I had radioactive iodine 10 years ago and my levels are checked every six months. Levels are always smack dab in the middle. So, all is good there.

[HRTstudent]

Id add in some vitamin D at 5k IU per day to get that up to the 70-80 range.

E2 maybe being high does not need to be treated unless you have obvious symptoms like gyno. Otherwise, get the right tests, keep an eye on the level, and add an AI as needed. If you wanted, you could safely take some natural AI herbs such as chrysin (there are other threads talking about herbal E2 control). That isn't going to be as strong as something like anastrozole/arimidex, But if you just need soemthing mild it very well might do the trick. probably safer long term IMO as well. (Oh yes, DIM seems to be another one of the better "natural" anti aromatases. It seems to be quite potent indeed.)

SHBG might be high, might be low, but really you're not goign to do anything to it. If it's very low, I tend to think the person should especially use more frequent, smaller injections. You seem to not be in the very low crowd though.

When you test cortisol be sure to use saliva and not blood cortisol, because blood cortisol level testing is not very accurate.

DHT may or may not be important again. You'll probably see it go up on transdermals (I did for sure) but DHT can be good and bad. Its good for all things manly, but it can be bad for male pattern baldness and POSSIBLY prostate issues. But really, the prostate thing is debatable, and as many medical people say... all men are going to get prostate cancer, its just a matter of living long enough. Monitoring your PSA, as you're doing, is obviously good.

Prolactin is worth getting a baseline reading as well, just to rule it out.

[steroid.com 1]

Nice post above, I always like reading posts that are easy to read yet have all the information necessary...good stuff.

Ok, let's see:

Total test: 4400. Range 212-1734 ng/dL
Free Androgen Index: 340.80. Range 30-150
Bogus results!!!
Yes it is and we all knew that was coming. Your current total of 441 pg/ml is still low in my opinion. You may want to consider switching to injections...most do any way. At the very least try two tubes per day and retest in a few weeks to see if you get a better response.

25-Hydroxy Vitamin D: 46.6. Range 30-100 ng/mL
Start supplementing 10000 units of D3 daily the 4000 iu are not cutting it. This is one where you want it at the top of the reference range.

Hemoglobin: 14.9. Range 13.2-17.1 g/dL
Hematocrit: 45.4. Range 38.5-50
Both of these are fine.

SHBG: 44.8 I looked and there is no range listed. weird.
Let's go with Lab Corps reference: their SHBG range for >49 years is 19.3-76.4 nmol/L. The 44.8 would put you in a nice range. This is one where mid to lower is optimal.

PSA: 0.7 Range <4.0 ng/mL
Nice for a 51 year old

Estradiol (E2) 47. Range <39 Of course, I requested sensitive assay, but it wasn't checked.
Okay, so it's not sensitive; but it still points to elevated E2. Any symptoms?

Also not checked, but requested
Cortisol, Prolactin, DHT
These would have been nice to see as well as albumin.

Lowering E2 with supplements is not very successful unfortunately. Obviously you should be taking 50mg of Zinc everyday, this will help suppress the aromitaze process. Also, try supplementing with 50mg of Calcium-D Glucarate twice daily as this will help suppress the aromitaze process as well. Google it and you will see; it's a very powerful anti cancer and anti oxident supplement that is widely missed by many for estrogen management (especially in women)...it's a wonderful nutrient in my opinion.

[Rusty11]

You guys are awesome with your clear and concise information/responses.
-Will raise D3 intake for sure
-Will take zinc and look for Calcium-D Glucarate, as well.
-No obvious signs of high E2. maybe a small gut that won't leave, but i don't know... I'm 6', 180, 14%bf. No man-boobs yet. But, a bit tired during the day. And libido could be better. Not sure how good libido should be at my T level, though.
-Been on two tubes/day for about a month. I'll give it a couple more months and then look at my levels. Yes, 441 is low, but it was stuck in the mid 200s 'til I went on two tubes. Really hoping it keeps going up to a respectable level. My sleep has been greatly improved. It was a nightmare for months and months.
-Didn't know if DHT was important for a guy who's been shaving his head for 15 years...ha!
-Will talk to Doc about the saliva test.
-Albumin is 4.5. Range 3.5-5.3 gm/dL

Again, thanks for the quick responses. I appreciate it.

[HRTstudent]

I wouldn't expect miracles from the zinc, but things like the calcium d glurate and DIM can definitely have a noticeable impact on E2 levels. The thing with zinc is, we know it has some anti E properties, but I've just never seen anyone say they added zinc and their e2 issues got much if any better. On the other hand, some of the herbs, you do have people saying that.

I, unfortunately, seem to need a lot of aromatase inhibition so I use anastrozole, but even when I ran that too low of a dose, I added in a few doses of 200mg DIM and saw noticeable improvement in my early gyno symptoms.

As far as the DHT being important, that's really as important as you want it to be. Its just a number after all. It will probably rise up a little, but if you're shaving your head then you pretty much are already avoiding the major major cause of concern when it comes to men and DHT. You'll probably get a little more body hair, but I got that whether on transdermals with high DHT or just on injects with about half the DHT... its just part of the territory for men on TRT. Bottom line for me is, we aren't going to be able to do much if anything with your DHT anyways, short of coming off TRT or switching between injectables and transdermals.

[Rusty11]

Hi. A couple of questions...
-only local place I could find Calcium D-Glucarate is Vitamin Shoppe. On the front of the bottle in big letters, it says, "Especially for Women". This is the stuff I want?
-I found a few places online for DIM (I had no idea what it was). Would I take both-DIM AND Calcium D G?
-If so, how much of each. I'm gathering that taking these 'natural' things will be good for me since I have no signs, but want E2 to go down...OR should I just buy anastrozole/arimidex and take a VERY small dose? Or, should I just talk to the Dr and see what he says. I know for a fact that my GP prescribes the testim, but doesn't know too much about the factors involved. I just don't want to sit back anymore and do nothing while I rely on someone else-someone who may, or may not, know what they're doing...ie, my DR(s).

Hope this all makes sense...

Thanks mucho!

[HRTstudent]

I would absolutely not take, nor advise, anastrozole use unless you had 100% positive signs of elevated E2 (namely, gyno seems the most evident) OR you had a sensitive E2 test show you were too high and you expect it to remain a problem (I.e. you are not going to lwer the T dose nor split injections etc).

Furthermore, if it were me, I would much rather be on DIM or some herbal remedy for years on end than anastrozole. This is a powerful drug. I don't, rather the medical community does not, know what the long term implications are of men taking this drug. I'm pretty much hedging my bets, seeing as how I take it, because I have no alternative sans perhaps another Rx AI.

Personally, 200mg of DIM gives me noticeable E2 relief, but I cannot say what it will do for you. I have no idea what your E2 is, how sensitive your body is to T and E2, nor how DIM effects you. Just too many variables. Just the way I am though, I would probably start out on a small daily dose of like 50mg.

I'm not too up on the CDG from vitamin shoppe, but that's the stuff. These drugs are typically marketed towards women because they are more interested in estrogen control as a population.

And finally, as far as taking both, that's up to you. You don't seem to be in dire need of an AI, and my personal opinion is to make changes 1 at a time. So I would probably use 1 of the 2 drugs and follow up with bloodwork to see how they are effecting you. For an average healthy person, I imagine it is safe to take both though. Id definitely talk it over with your doc though as always.

[Rusty11]

Thanks HRT. As always, great detailed response. Ill pick up some DIM and take a small dose each day and see if/how much it decreases.

[Rusty11]

Hello again. I just received BW from this past saturday. The only thing that stands out (although its within the 'normal' range) is my SHBG.
SHBG: 39. Range 10-50 nmol/L.
Is this really a good level? Yes, I looked online, but wanted your opinions. Is it a tad high because my E2 is a bit high? Are they tied together. Or is it a good level and I need to stop looking for things that aren't there.

Also, and I've never seen anyone list this...

Osmo Calc is 276. Range 280-305
I googled it and it is tied to the amount of sodium in your blood. I do drink a 1/2-3/4 gal/day. So, maybe that's why.

Anyway, any info is appreciated.
Thanks