Same TRT + New Gym-Me = Feedback needed

[mage]

Hey all, I am new to the forum, but would appreciate some feedback. Everyone here seems to be crazy-knowledgeable about the performance side of TRT.

More specifics about my scenario are below, buy basically I am on TRT, have transitioned from casual to serious in the gym since I started, and have three questions I could use some feedback on:

• When I get my blood work back, it has reference ranges. I am about to get blood work done again, and I am wondering if there are more appropriate numbers/references to which I should be compare my results? (Coincidentally, the day after a high-intensity workout my energy levels are completely shot, and I am wondering if this might somehow be end related.)
• I have a history of gyno, got surgery, but since have noticed some puffiness. Are there particular measures in the blood work that I should be keeping an extra eye on? I want to make super sure this doesn't come back.
• I attract stretch marks like crazy. A dermo (TRT = acne = grr!) told me this was something that could be a result of hormonal balance, but haven't had a chance to talk to a doc about this. Has anyone experienced this?

Finally, I am learn more about this part of my life, and not just accept the doc's word, so I would love feedback on anything that stands out. Is there something else I should be sharing?

Okay, and now the sordid details:

I am 5'10", 29, hypogonadic, and have been on TRT for 5 years. This started after a doctor was smart enough to see gynecomastia where I just saw fat. (Actually, compared to others here, it seems I have had wonderful docs.) If I recall correctly, my test levels were at ~45 before treatment. For the first year I was injecting test cypionate weekly (10ml, I believe), after which new doc/new city switched me to daily 5mg androgen - to mimic the daily test cycle - where I have remained.

When I started TRT I was 200lbs. Within a couple months (with some fierce dieting) I had dropped a lot of fat and was at 160lbs. The gyno, however, remained, and last year I had surgery to get that fixed. Since I started TRT I have put on some muscle (up to 175) but during the last year I have been much more serious and have bulked up to 185.

So, new doc and new city (again), and I am going to have my blood work done next month. This time I want to be a bit more informed about the numbers I will be seeing and would certainly appreciate any thoughts.

[stevey_6t9]

nice first post.

wait until you get your blood work results done, put them on here and im sure everyone can help you out.

[mage]

Thanks for the fast reply. Is there anything in particular that I should get checked that might not normally be included? I think they have always done cbc, psa, test free/total. Sometimes thyroid is done as well. Honestly it has been about a year since I last thought about this.

If there is something specific, I would love to get it added to the list. Thanks again.

[stevey_6t9]

i suggest a full blood panel, that way you get a clearer picture on your bodys current state.

Lipid Panel
Full Hemo Profile
Full hormone profile
Minerals
Liver enzymes etc

but regarding your hormone profile it should have Test total, free, SHBG, Estrogen, Progesterone, LH, FSH etc.

[killswitch]

It gets to be a bit of a mess but I'll try to explain what I can.

The "reference range" for things such as total and free test are different lab to lab...

They are both saying the same thing, just saying it differently..

For example I might say that building is 1 mile away, while another person might say that building is 1.6 km. away. We are both right and technically we are both saying the same thing, just differently. So you must know what language your lab is speaking.

Elevated estrogen (converted from testosterone ) causes gyno. Your estrodiol levels are very important and may require a anti aromatase medication to prevent the conversion.

Hope that helps

[Epic Ed]

Make sure the blood work explicitly indicates E2 is to be tested. It's not uncommon for a regular doc to think it's not important and therefore not check mark the box on the paperwork.

Good job getting back in the gym. It really helps give you the best bang for your TRT buck.

[Epic Ed]

I don't know if you've read this thread yet about testosterone levels in blood work, but it's a good reference:

Interpretation of Free Testosterone, Estrogen, and Total Testosterone Blood Tests

[jeepers]

What's the deal with all the young guys on TRT anyhow.....

[Vettester]

What's the deal with all the young guys on TRT anyhow.....

That's a good question. A good % probably from AAS. Maybe the OP can shed a little more light on what led him to getting on TRT 5 years ago.

[jeepers]

That's a good question. A good % probably from AAS. Maybe the OP can shed a little more light on what led him to getting on TRT 5 years ago.

Vette...

good probability.... I'm certain it lead to my condition... the endocrine system is not really something to fawk with ...

[mage]

I don't know if you've read this thread yet about testosterone levels in blood work, but it's a good reference:

Interpretation of Free Testosterone, Estrogen, and Total Testosterone Blood Tests

Thanks Epic - this is helpful. A lot of information, and I will have to read it all 3 more times, but very helpful.

[mage]

That's a good question. A good % probably from AAS. Maybe the OP can shed a little more light on what led him to getting on TRT 5 years ago.

I wrote a tiny bit about this in the OP, but didn't want to harass people with an essay.

The short version is that a primary physician noticed some gyno when I was 23, and had some blood work done that showed very low test levels (somewhere near what a 65-70 yr old might have). I got transfered over to an endo, and after many scans to make sure I didn't have a brain tumor (they checked other things, this was just the most memorable), an endo started me on TRT.

Happy to provide more details if people are curious. It was a very strange period, and one that seems a little distant now.

As for other people my age on TRT? Can't say that I know.

[mage]

So I picked up my lab results today. My doctor is really great. I explained that I would like to know more about these numbers (particularly in relationship to each other), and have a copy of labs results to start googling with, and a doctor who wants me to just swing by in a couple weeks so we can talk about these number over a cup of coffee. Strange, yes, but also kinda nice.

So, numbers! I think I am missing some results -- apparently one of my blood samples was frozen instead of refrigerated, so some tests might still be pending (please let me know - I can request them easily, but I also don't know what most of these acronyms yet).

LCBC - CBC
WBC 5.6 4-10.5
NEU % 43.6
LYM % 44.1
MON % 9.2
EOS % 2.8
BAS % 0.3
Atyp Lym % 0.7
NEU # 2.44 2-8.1
LYM # 2.47 .9-3.3
MON # 0.51 0-.8
EOS # 0.16 0-.5
BAS # 0 0-.2
Atyp Lym # 0.04

RBC 4.63 4.38-5.62
HGB 14.7 13.5-16.9
HCT 42.5 39.5-50
MCV 92 81.5-97
MCH 31.8 27-33.5
MCHC 34.6 32-35.5
RDW 12.3 11.6-14.4
PLT 185 150-400
MPV 9.2 H 6.2-8.9
PCT 0.171 .1-.2
PDW 19 H 8.0-17


LCMP - Metabolic Panel
NA 138 135-145
K+ 4.2 3.5-5
CO2 32 25-34
GLU (Fasting) 104 70-110
BUN 15 8.0-26
CREAT 1.2 .5-1.3
eGFR >60
CA 10.1 8.5-10.5
TPRO 7.7 6.1-8.3
ALB 4.8 3.2-5.5
A/G 1.7 1.3-1.7
Globulin 3 2.0-4
TBIL 0.8 0-1.4
SGOT(AST) 22 8.0-40
ALP(ALK) 57 20-125
SGPT(ALT) 19 0-45


LHepFuncLi
SGOT(AST) 22 8.0-40
SGPT(ALT) 19 0-45
TBIL 0.8 0-1.4


LLipidPr
TRIG 82 0-150
CHOL 130 99-200
HDL 50 >40
LDL 64 <130
VLDL 16


TFT, Thyroid Cascase
TSH 2.53 .5-5

Test, Tot+Fr
Total Test 1246 286-1511
Free Test 4.9 .69-2.14
% Free 0.4 .3-.4
PSA, Total 1

Cortisol, Urine Free (this report is really confusing)
Cortisol ug/g crt 44.4 Less than 32 ug/g crt (I think)
Cortisol, UR ug/L 119 <=60 (may be per day?)
Creatinine mg/dL 268 1000-2500 (may be per day?)

[PPC]

Your fasting glucose is somewhat high. Optimum between 70-90. I'm doubting you have a high sugar/starchy diet, dropping that weight. Was this test taken first thing in the morning?

TSH - many docs consider anything over 2 warrants further testing. Have you had any free's done like free t3?

I do not fully understand urine cortisol results. If your's are high like they indicate, a trial of phosphatidal sirene (sp?) could help bring them down and revv up congnitive function to boot. Saliva is usually a good indication of what's going on with cortisol. It will be interesting to see what your doc says about your cortisol results.

I did not see an E2...that would be important especially considering your gyno history.

[mage]

PPC - Thanks for the advice, I will get after these things and let you know what the doc/labs say.