First follow up Blood work after starting TRT

[calicp]

Hey guys,

I just wanted to post up some numbers for my 1st BW. My doc has me on the current protocol:

Test Cyp: 50mg 2x per week(100 mg total for the week) Tuesday Eve & Saturday Morning
HCG : 250 IU 3x per week (750 IU total for the week) Monday, Wednesday, Friday
Vit D3: 5000IU everyday.

Teat Name	In Range	Out of Range Reference Range	Lab

COMPREHENSIVE METABOLIC PANEL
SODIUM, SERUM 141 135-146 mmol/L SC 

POTASSIUM, SERUM 4.2 3.5-5.3 mmol/L SC 

CHLORIDE. SERUM 104 98-110 mmol/L SC 

CARBON DIOXIDE (CO2) 29 19-30 mmol/L SC 

UREA NITROGEN, BLOOD (BUN) 12 7-25 mg/dL SC 

CREATININE, SERUM	1.00	0.60-1.35 mg/dL	SC


eGFR 98 >=60 mL/min/ 1.73m2 SC

 eGFR AFRICAN AMERICAN 114 >=60 mL/min/1.73m2 SC GLUCOSE	95	65-99 mg/dL	sc
GLUCOSE 82	65-99 mg/dL


FASTING REFERENCE INTERVAL
CALCIUM, SERUM	9.3	8.6-10.3 mg/dL	SC

PROTEIN, TOTAL	7.0	6.1-8.1 g/dL	SC

ALBUMIN	4.5	3.6-5.1 g/dL	SC

GLOBULIN, TOTAL	2.5	1.9-3.7 g/dL	SC

A/G RATIO	1.8	1.0-2.5 ratio	SC

AST (SGOT)	20	10-40 U/L	SC

BILIRUBIN, TOTAL	0.6	0.2-1.2 mg/dL	SC

ALT (SGPT)	23	9-60 U/L	SC

ALKALINE PHOSPHATASE	125	40-115 U/L	SC

LIPID PROFILE
CHOLESTEROL, TOTAL 198	125-200 MG/DL
TRIGLYCERIDES 119	<150 MG/DL
LDL CHOLESTEROL 137	<130 MG/DL
CHOLESTEROL, HDL 37	> OR = 40 MG/DL
NON-HDL CHOLESTEROL 161	MG/DL
CHOLESTEROL/HDL RATIO 5.4	
LDL/HDL RATIO 3.7

CBC 
WHITE BLOOD CELL COUNT 7.4	3.8-10.8 Thousand /uL
RED BLOOD CELL COUNT 5.69	4.20-5.80 Million/uL
HEMOGLOBIN 16.5	13.2-17.1 g/dL
HEMATOCRIT 50.3	38.5-50.0%
MCV 88	80.0-100.0fL
MCH 29.0	27.0-33.0 pg
MCHC 32.8	32.0-36.0 g/dL
RDW 13.7	11.0-15.0%
PLATELET COUNT 249	140-400 Thousand/uL
ABSOLUTE NEUTROPHILS 4810	1500-7800 Cells/uL
ABSOLUTE LYMPHOCYTES 1924	850-3900 Cells/uL
ABSOLUTE MONOCYTES 592	200-950 Cells/uL
ABSOLUTE EOSINOPHILS 74	15-500 Cells/uL
ABSOLUTE BASOPHILS 74	0-200 Cells/uL
NEUTROPHILS 65	
LYMPHOCYTES 26
MONOCYTES 8
EOSINOPHILS 1
BASOPHILS 1

PSA 1.4	< OR = 4.0 ng/mL

ESTRADIOL (E2)	74	<OR = 39 pg/mL	SC 



TESTOSTERONE. TOTAL. MALES
TESTOSTERONE, TOTAL	717	241-827 ng/dL	SC 
TESTOSTERONE, FREE 20.57 ng/dL 5.00-21.00 ng/dL   SC

HIGH SENSITIVITY CRP 2.2
HOMOCYSTEINE, TOTAL 8.1	<11.4 umol/L
SEX HORMONE BINDING GLOBULIN 18	10-50 nmol/L	Q9

VITAMIN D, 25-OH, 33	30-100ng/mL

I feel a ton better on TRT and talked to him about the high e2 levels. I told him I have noticed my chest felt itchy sometimes and he said that if i didn't notice any gyno lumps it really isn't much of a problem. I asked him shouldn't I use some ADEX and he said he just wants me to supplement with zinc picollinate or citrate, flaxseed to help reduce the e2. He sounded hesitant to prescribe Adex until after the next line of bloodwork. Does this sound right? I don't have another appointment with him till November when I get bloodwork work again beginning of that month, so should I try and get some adex?

[calicp]

anyone?

[LowT Mike]

generally E2 should be between 20-30pg/ml. If/When E2 gets 60+ men start to have sensitive nipples. Anastrozole generic for Arimdex is fine. Im shocked docs are still hesitant using this med. They are only scared because we use it "off label" in men for E2 control when "on label" for women as a breast cancer drug to block E2. This stops them dead in there tracks and most dont even bother educating themselves. Very sad. Nothing wrong with anastrozole. Other OTC anti E that actually work. DIM and 50mg Zinc and 2-3mg copper work great along side of anastrozole.

[calicp]

generally E2 should be between 20-30pg/ml. If/When E2 gets 60+ men start to have sensitive nipples. Anastrozole generic for Arimdex is fine. Im shocked docs are still hesitant using this med. They are only scared because we use it "off label" in men for E2 control when "on label" for women as a breast cancer drug to block E2. This stops them dead in there tracks and most dont even bother educating themselves. Very sad. Nothing wrong with anastrozole. Other OTC anti E that actually work. DIM and 50mg Zinc and 2-3mg copper work great along side of anastrozole.

Well when I first got on board with him he said he would have no problem prescribing it, but now that the number came back high after being on trt for the last 2 months he just wants me to supplement with zinc or flaxseed until next bloodwork(Nov 1) he said that should help with the e2. How bad would it be to go without adex with my above number till November? I almost want to try to switch to SQ shots of the test cyp to see if that will help with the E2, or should i get the Liquidex from the sponser for the time being to keep the number in check?

[calicp]

bump

[BallSak]

I would say double your vit D supplementation. When was your blood drawn in relation to your injection?

[powerlifterty16]

Well when I first got on board with him he said he would have no problem prescribing it, but now that the number came back high after being on trt for the last 2 months he just wants me to supplement with zinc or flaxseed until next bloodwork(Nov 1) he said that should help with the e2. How bad would it be to go without adex with my above number till November? I almost want to try to switch to SQ shots of the test cyp to see if that will help with the E2, or should i get the Liquidex from the sponser for the time being to keep the number in check?

you said you feel good so prob not too bad...if i were you id give the picolinate a try...it might lower it to 50 and if you want to try the sub q, try that too, maybe you could get it around 40....if you could be at 40 with out having to use adex, you are prob best off...40 is still high, but the elss drugs the better. adex from what ive read is not great for the lipids.

btw how has your cholesterol changed on trt?

[calicp]

I would say double your vit D supplementation. When was your blood drawn in relation to your injection?

He told me to up my D3 to 7000 IU per day. My blood was drawn right before my injection

[kelkel]

I'd do what LTM said. I wouldn't go around your doctor unless your E is high on your next BW and he refuses to help.

[bass]

Hey guys,

I just wanted to post up some numbers for my 1st BW. My doc has me on the current protocol:

Test Cyp: 50mg 2x per week(100 mg total for the week) Tuesday Eve & Saturday Morning
HCG : 250 IU 3x per week (750 IU total for the week) Monday, Wednesday, Friday
Vit D3: 5000IU everyday.

Teat Name    In Range    Out of Range Reference Range    Lab

COMPREHENSIVE METABOLIC PANEL
SODIUM, SERUM 141 135-146 mmol/L SC 

POTASSIUM, SERUM 4.2 3.5-5.3 mmol/L SC 

CHLORIDE. SERUM 104 98-110 mmol/L SC 

CARBON DIOXIDE (CO2) 29 19-30 mmol/L SC 

UREA NITROGEN, BLOOD (BUN) 12 7-25 mg/dL SC 

CREATININE, SERUM    1.00    0.60-1.35 mg/dL    SC


eGFR 98 >=60 mL/min/ 1.73m2 SC

 eGFR AFRICAN AMERICAN 114 >=60 mL/min/1.73m2 SC GLUCOSE    95    65-99 mg/dL    sc
GLUCOSE 82    65-99 mg/dL


FASTING REFERENCE INTERVAL
CALCIUM, SERUM    9.3    8.6-10.3 mg/dL    SC

PROTEIN, TOTAL    7.0    6.1-8.1 g/dL    SC

ALBUMIN    4.5    3.6-5.1 g/dL    SC

GLOBULIN, TOTAL    2.5    1.9-3.7 g/dL    SC

A/G RATIO    1.8    1.0-2.5 ratio    SC

AST (SGOT)    20    10-40 U/L    SC

BILIRUBIN, TOTAL    0.6    0.2-1.2 mg/dL    SC

ALT (SGPT)    23    9-60 U/L    SC

ALKALINE PHOSPHATASE    125    40-115 U/L    SC

LIPID PROFILE
CHOLESTEROL, TOTAL 198    125-200 MG/DL
TRIGLYCERIDES 119    <150 MG/DL
LDL CHOLESTEROL 137    <130 MG/DL
CHOLESTEROL, HDL 37    > OR = 40 MG/DL
NON-HDL CHOLESTEROL 161    MG/DL
CHOLESTEROL/HDL RATIO 5.4    
LDL/HDL RATIO 3.7

CBC 
WHITE BLOOD CELL COUNT 7.4    3.8-10.8 Thousand /uL
RED BLOOD CELL COUNT 5.69    4.20-5.80 Million/uL
HEMOGLOBIN 16.5    13.2-17.1 g/dL
HEMATOCRIT 50.3    38.5-50.0%
MCV 88    80.0-100.0fL
MCH 29.0    27.0-33.0 pg
MCHC 32.8    32.0-36.0 g/dL
RDW 13.7    11.0-15.0%
PLATELET COUNT 249    140-400 Thousand/uL
ABSOLUTE NEUTROPHILS 4810    1500-7800 Cells/uL
ABSOLUTE LYMPHOCYTES 1924    850-3900 Cells/uL
ABSOLUTE MONOCYTES 592    200-950 Cells/uL
ABSOLUTE EOSINOPHILS 74    15-500 Cells/uL
ABSOLUTE BASOPHILS 74    0-200 Cells/uL
NEUTROPHILS 65    
LYMPHOCYTES 26
MONOCYTES 8
EOSINOPHILS 1
BASOPHILS 1

PSA 1.4    < OR = 4.0 ng/mL

ESTRADIOL (E2)    74    <OR = 39 pg/mL    SC 



TESTOSTERONE. TOTAL. MALES
TESTOSTERONE, TOTAL    717    241-827 ng/dL    SC 
TESTOSTERONE, FREE 20.57 ng/dL 5.00-21.00 ng/dL   SC

HIGH SENSITIVITY CRP 2.2
HOMOCYSTEINE, TOTAL 8.1    <11.4 umol/L
SEX HORMONE BINDING GLOBULIN 18    10-50 nmol/L    Q9

VITAMIN D, 25-OH, 33    30-100ng/mL

I feel a ton better on TRT and talked to him about the high e2 levels. I told him I have noticed my chest felt itchy sometimes and he said that if i didn't notice any gyno lumps it really isn't much of a problem. I asked him shouldn't I use some ADEX and he said he just wants me to supplement with zinc picollinate or citrate, flaxseed to help reduce the e2. He sounded hesitant to prescribe Adex until after the next line of bloodwork. Does this sound right? I don't have another appointment with him till November when I get bloodwork work again beginning of that month, so should I try and get some adex?

flax seed will raise your e2, don't take it. everything else has been answered already. but just wanted to point out that e2 test doesn't look like sensitive assay.

[calicp]

you said you feel good so prob not too bad...if i were you id give the picolinate a try...it might lower it to 50 and if you want to try the sub q, try that too, maybe you could get it around 40....if you could be at 40 with out having to use adex, you are prob best off...40 is still high, but the elss drugs the better. adex from what ive read is not great for the lipids.

btw how has your cholesterol changed on trt?

Ya i do feel a ton better. I am just concerned about the e2 being high and i do notice some itchiness in my chest. I am just worried if it would be bad not to keep e2 in check for the next 3 months until next blood work.

As far as lipids profile it did improve a little bit:

first number would be my number right before TRT which was done about 3 months ago and the 2nd number is from current bloodwork. Also i include range with last numbers
Cholesterol, Total 206, 198 (125-200 mg/dL)
Triglycerides 146, 119 (<150 mg/dL)
LDL Cholesterol 140, 137 (<130mg/dL)
Cholesterol, HDL 37, 37 (> or = 40 mg/dL)
non-HDL Cholesterol 169, 161

[bass]

another thing I meant to mention, up your vitamin D to 20,000 per day for 4 weeks then down to 10,000 per day thereafter. upping your dose by what your doc suggested won't do anything. get your vitamin d from walmat, cheap and very effective.

[calicp]

flax seed will raise your e2, don't take it. everything else has been answered already. but just wanted to point out that e2 test doesn't look like sensitive assay.

I used Quest Diagnostics for the test i believe the test was 4021x. Does anyone else use quest and if so is that the right e2 test?

[calicp]

I'd do what LTM said. I wouldn't go around your doctor unless your E is high on your next BW and he refuses to help.

he suggested DIM and 50mg Zinc and 2-3mg copper, so I am assuming that would be taken per day? Do you think switching to SQ would do any good?

[powerlifterty16]

I used Quest Diagnostics for the test i believe the test was 4021x. Does anyone else use quest and if so is that the right e2 test?

that's awesome you had a slight improvement in your cholesterol numbers, is your diet better?
with high e2 like yourself the non sensitive assay is actually preferred. the sensitive is really only good for low numbers...although i dont think getting the sens will hurt you..just no reason to spend for it, or argue with your dr(if your doc isnt informed)

[LowT Mike]

he suggested DIM and 50mg Zinc and 2-3mg copper, so I am assuming that would be taken per day? Do you think switching to SQ would do any good?

Yes every day. SQ has show less aromatase, however its just as easy to keep your same protocol and start Anastrozole. E2 must be kept between 20-30pg/ml. Period. The main goal of TRT is to optimize T serum and control E2. If E2 goes crazy than most of the T you are injecting is aromatizing and not doing anything. Its all about balance and getting your homones signaling like a symphony.