Got New Labs In - Thoughts?

[USMCSS]

I got my mo recent labs in from the VA and just wanted opinions as to how they look. Mind you, these are through the VA and for Free, Bio, SHBG, and Albumin they send your blood off to Quest Diagnostics to perform the analysis along with the fact that the doc didn't submit for e2 like I asked her to.

I just turned 40, body fat roughly around 17%. The problems I have been having lately are very low sex drive, lethargy, and constant achiness which I originally thought was due to a short winny cycle I was on. So, here are the results:

Total test: 668

Free test: 193.5 pg/ml (Quest reference range 46-224) No I looked up how to convert to ng/ml and that converts to 19.35 ng/ml IF I did my homework right.

Bio test: 389.6 ng/dl (Quest reference range 110-575)

SHBG: 12 nmol/L (Quest reference range 10-50) This is one I'm concerned about because that seems to be pretty low.

Albumin: 4.4 g/dl (Quest reference range 3.6-5.1)

I had prolactin done recently and it was gtg.

[USMCSS]

Anyone?

[lovbyts]

I'm not an expert but I dont think thats bad.

Sex Hormone Binding - Under 30 nanomoles/L - (optimal range) Reference range is 13-71 nanomole/L. Excessive binding inactivates testosterone (297).

There are five possible reasons why free testosterone levels may be low-normal (below the upper third of the highest number of the reference range):

* Too much testosterone is being converted to estradiol by excess aromatase enzyme and/or the liver is failing to adequately detoxify surplus estrogen. Excess aromatase enzyme and/or liver dysfunction is likely the cause if estradiol levels are over 30.

* Remember, aromatase converts testosterone into estradiol, which can cause estrogen overload and testosterone deficiency.

* Too much free testosterone is being bound by SHBG (sex hormone binding globulin). This would be especially apparent if total testosterone levels were in the high normal range, while free testosterone was below the upper one-third range.

* The pituitary gland fails to secrete adequate amounts of luteinizing hormone (LH) to stimulate testicular production of testosterone. Total testosterone in this case would be in the bottom one-third to one-half range. (On LabCorp's scale, this would be a number below 241-500 ng/dL.)

* The testes have lost their ability to produce testosterone, despite adequate amounts of the testicular-stimulating luteinizing hormone. In this case, LH would be above normal, and total testosterone would in very low normal or below normal ranges.

* Inadequate amounts of DHEA are being produced in the body. (DHEA is a precursor hormone to tes-tosterone and estrogen) (250).

[Chauffeur]

Are you on any type of hormone replacement therapy right now?

[USMCSS]

Ya I'm sorry, forgot to mention that. I've been on 100 mg's of test cyp every week for just over a year. My total test level seems to fluctuate alot. Last month it was down to 455 and that was while on a cycle of 50 mg's ED of winny.

[numbere]

Hey USM I got your PM but thought I should reply in this thread. You might want to speak with your Dr about having you IGF binding protein tested. Low SHBG and IGFBP can be a sign of glucose intolerance or cardio vascular disease.

[USMCSS]

I am working with my doc to get sent to a specialist because my labs at the beginning of the month showed my Alanine Aminotransferase is high at 58 U/L on a reference range of 10-35 and that shows some sort of liver issues.

[Chauffeur]

Ya I'm sorry, forgot to mention that. I've been on 100 mg's of test cyp every week for just over a year. My total test level seems to fluctuate alot. Last month it was down to 455 and that was while on a cycle of 50 mg's ED of winny.

How many days after your injection were these labs drawn? Have you ever had your estradiol measured? If so, how'd it look?

[USMCSS]

I pin on Sundays and the test was on a Wednesday. I go through VA they were supposed to do an e2 test but doc didn't submit for it. Will be talking to her again soon and requesting it

[USMCSS]

Update:

My doctor ordered labs for my LH (Leutinizing Hormone) and FSH (Follicle Stimulating Hormone) to be checked to follow up on this. Anybody familiar with those or had it done themselves?

[Chauffeur]

Update:

My doctor ordered labs for my LH (Leutinizing Hormone) and FSH (Follicle Stimulating Hormone) to be checked to follow up on this. Anybody familiar with those or had it done themselves?

There is no need to test LH or FSH while on TRT, as both values will be pretty close to zero. That is a normal finding while on exogenous testosterone.

Why did your doctor want to test these? Doesn't make sense.

[USMCSS]

F*** if I know. It's a VA doctor and is my primary care physician. She doesn't seem to know shit and I've requested a new one. My SHBG was low and Alanine Aminotransferase was high and I complained about the the above complaints soooo....

[ppwc1985]

Dude, you may have to go out on your own to get proper treatment for trt. I tried the VA and I said **** it. I took the insurance they offered at work, I just don't trust VA anymore. The only thing I get from them is a few scripts just because it is cheaper, but I don't let them treat crap. Not that all the Drs are bad and I know they raised their pay to attract better Drs. But till I get out of the NE I'll keep my civilian dr.

[USMCSS]

Well my problem is I'm on Individual Unemployability which pays 100% which is what I have to live off of for now until I go back to work so paying for regular civilian insurance is out of the question. I actually get pretty decent care for most things but this is a new PCP for me and she's a dumbass old Indian who is stubborn as hell and new to the VA. She is obviously far from familiar with TRT so I'm playing along with her games until I get assigned a new PCP or I annoy her enough to where she pawns me off to a specialist which I'm pretty sure is about to happen.

[USMCSS]

There is no need to test LH or FSH while on TRT, as both values will be pretty close to zero. That is a normal finding while on exogenous testosterone.

Why did your doctor want to test these? Doesn't make sense.

Well I got the results back and just as you said, the results were near zero. Going to hit the doc up today and see what her dumbass wants to do next.

I emailed her to see if she would send me for a consult with the endocrinologist or at least the urologist

[Metalject]

The VA is notorious for providing some of the worst TRT care in the country if not the very worst of all.
Secondly, if you are already using testosterone, any physician that orders an LH or FSH panel, this should be a giant red flag. She might as well looked at you and asked to check your ovaries...it's that illogical.

Personally I pay cash for my TRT and I always will. I can't imagine I'll ever use insurance or allow insurance to dictate what I can't and can't do.

[USMCSS]

The VA is notorious for providing some of the worst TRT care in the country if not the very worst of all.
Secondly, if you are already using testosterone, any physician that orders an LH or FSH panel, this should be a giant red flag. She might as well looked at you and asked to check your ovaries...it's that illogical.

Personally I pay cash for my TRT and I always will. I can't imagine I'll ever use insurance or allow insurance to dictate what I can't and can't do.

Well they just called and scheduled a phone appointment with her and I Wednesday to discuss the labs. I had already emailed her saying it was pointless for to have those checked. Any recommendations on what to say to her outside calling her an idiot during the appointment as in what I should tell her I want her to do next? My email did state I wanted her to schedule me with the endo or at least urologist.

[xcraider37]

F*** if I know. It's a VA doctor and is my primary care physician. She doesn't seem to know shit and I've requested a new one. My SHBG was low and Alanine Aminotransferase was high and I complained about the the above complaints soooo....

Sure the winny didn't cause the high aminotransferse? That would be my guess. I think your stressing for nothing. Go get a decent doctor and stop fooling around with other compounds.

[USMCSS]

Sure the winny didn't cause the high aminotransferse? That would be my guess. I think your stressing for nothing. Go get a decent doctor and stop fooling around with other compounds.

Yes I'm sure. Winny was long out of the system before the labs and I wasn't on a high enough dose to have such an affect on the liver

[kelkel]

Your total and free T are not bad at all. It's your FT that's important and much of that is due to your shbg being on the lower end as noted by Numbere. Do some research on this. Know that alt and ast levels can/will rise from AAS. They will also be elevated simply due to working out. Exercise induced elevations can last 7-10 days or so. Start taking some NAC along with your protocol.

When it comes to libido are you talking about sex drive or functionality? Too many guys think (even as they age) that they should be popping boners multiple times per day and it's really just not the case. As long as it works on demand you've got no issues. Consider maybe low dose cialis at 5-10 mgs per day as it's a very healthy thing for a man to take, irrespective of its intended purpose.

And yes, you need a new doc.

[USMCSS]

Your total and free T are not bad at all. It's your FT that's important and much of that is due to your shbg being on the lower end as noted by Numbere. Do some research on this. Know that alt and ast levels can/will rise from AAS. They will also be elevated simply due to working out. Exercise induced elevations can last 7-10 days or so. Start taking some NAC along with your protocol.

When it comes to libido are you talking about sex drive or functionality? Too many guys think (even as they age) that they should be popping boners multiple times per day and it's really just not the case. As long as it works on demand you've got no issues. Consider maybe low dose cialis at 5-10 mgs per day as it's a very healthy thing for a man to take, irrespective of its intended purpose.

And yes, you need a new doc.

Thanks for replying bro. The doc actually called and has submitted a consult to the endo for me so we'll see how that goes.

As for the sexual issues it's all the above. I have ZERO desire and when I do try to bang the girl out, I frequently go limp and for the most part, lose interest. Has nothing to do with her either. Hot little blonde 14 years younger than me. It's just that I have no desire for sex altogether and it's driving me insane. I have plenty of viagra on hand but what good is it when you don't care to use it for it's intended purpose?