Lab Work Back, Time to Re-evaluate and Had a Few Quetions

[forrest_and_trees]

So I received the results today for my latest blood work and there have been some interesting changes. I'd like to hears some opinions.

Total T:
8/3/10 = 923
9/8/10 = 740

Testosterone, Free:
25.53 *High* [Range= 5.00 -21.00]

% Free T:
3.45 [Range= 1.50-4.20]

Estradiol:
8/3/10 = 37.2
9/8/10 = 21.9

IGF-1:
8/3/10 = 128
9/8/10 = 117

Testosterone
I'd been backing down on my T dosage since the doc said 923 was high. I went from 180mg a week [broken up to .4ml twice a week.] to 170mg a week [.35 twice a week]. I have to admit, I'm a little surprised at how much that little change made. Is it possible that after a year on TRT what little production my boys had is now shut down and it's time for HCG ?

Thyroid
I'd also switched from 200mg of Synthroid for my Hypothyroidism to 3 grains of Armour.

E2
I'd back my Arimidex down to .25mg EOD from .5OED but my puffy nipples started to return as did my moodiness, so i went back up to .5EOD and everything seemed fine. Would it be OK to maintain my .5 OED or should I dial that back, if so, to what?

I felt great back when I had my previous tests taken and this past month I've been run down, tired, my muscles are always sore, I wake up with aches and pains were I didn't before and my over all mood is down, emotionally I've been on a bit of a roller coaster too. While my E2 looks to be OK, could it be that I just do better with slightly higher Total T. Also, I don't have a previous Free T to compare to, but what do my current numbers have to say?

I'm thinking of adding 50mg of DHEA back into the mix to get my Total T up and bump my E2 a *little* since I'm on the bottom of the normal range right now. Any thoughts or objections on that? Should I continue my .5 Adex or change that too?

Thanks all!

[frawnz]

Were all the variables for the lab the same as previously? (time of blood draw, amount of time since last injection, diet, etc?)

[forrest_and_trees]

Were all the variables for the lab the same as previously? (time of blood draw, amount of time since last injection, diet, etc?)

Pretty much... although now that I think about it, I pin on Sat and Wed; last time I drew on Tues morn this most recent I did it Wed morn. Would 24 hours explain the significant diff in Total T numbers? [Obviously both tests were before taking my daily meds.]

[flatscat]

So I received the results today for my latest blood work and there have been some interesting changes. I'd like to hears some opinions.

Total T:
8/3/10 = 923
9/8/10 = 740

Testosterone, Free:
25.53 *High* [Range= 5.00 -21.00]

% Free T:
3.45 [Range= 1.50-4.20]

Estradiol:
8/3/10 = 37.2
9/8/10 = 21.9

IGF-1:
8/3/10 = 128
9/8/10 = 117

Testosterone
I'd been backing down on my T dosage since the doc said 923 was high. I went from 180mg a week [broken up to .4ml twice a week.] to 170mg a week [.35 twice a week]. I have to admit, I'm a little surprised at how much that little change made. Is it possible that after a year on TRT what little production my boys had is now shut down and it's time for HCG ?

I doubt you have had any natty production at all since about week 3 or 4, Yes on the HCG - low dose once or twice a week. (which may just bump your E2 up a little as you ask below)and since you are on 2X/week inj's it shouldn't matter when you had your bw done - not that much anyway.

Thyroid
I'd also switched from 200mg of Synthroid for my Hypothyroidism to 3 grains of Armour.

E2
I'd back my Arimidex down to .25mg EOD from .5OED but my puffy nipples started to return as did my moodiness, so i went back up to .5EOD and everything seemed fine. Would it be OK to maintain my .5 OED or should I dial that back, if so, to what?

I felt great back when I had my previous tests taken and this past month I've been run down, tired, my muscles are always sore, I wake up with aches and pains were I didn't before and my over all mood is down, emotionally I've been on a bit of a roller coaster too. While my E2 looks to be OK, could it be that I just do better with slightly higher Total T. Also, I don't have a previous Free T to compare to, but what do my current numbers have to say?
Your E2 could be too low for you

I'm thinking of adding 50mg of DHEA back into the mix to get my Total T up and bump my E2 a *little* since I'm on the bottom of the normal range right now. Any thoughts or objections on that? Should I continue my .5 Adex or change that too?

I can't see running that high of a dose of adex if your number is 21 - you may need to but you would be an exception. I would add the HCG first for about three weeks and see how you feel, Then add in the DHEA and see what happens. What other supp's do you take?

Thanks all!

It all looks good - sorry you are not feeling as good as it looks though. Low E2 is my first guess for you as the culprit.

Flats

[PPC]

So you felt better with your E at around 37? HCG will most likely raise your E and T some. E levels seem to be so individual as they are with women. Some women need E at levels in the 2-400's. Other women would be having terribly sore breasts at that level, they never need more than a level of 100. So it is so individual.

I know there is the common goal of getting male E between 20-30 but you may be just one of those guys who feel better with it higher. I sometimes wish we could jump ten years into the future where I'm sure they'll have some sort of at home, hormone testing contraptions. We'll be ale to test on a much more frequent basis and some sort of digital read out will tell us what hormone to increase or decrease to get everything in balance. Yes, I am longing for that day. They'll probaly look back at us and think 'dark ages.'...wow I got off track...sorry.

[forrest_and_trees]

LOL PPC... Thanks, I appreciate the sentiment. I too long for those days. I'd be testing all the friggin time. =)

Interestingly though, I hadn't thought of the E2 number as the culprit. I was thinking more my Total T; however I could be wrong. As I mentioned, after my last test which took my E from 167 to 43 after just 6 weeks on Adex, [.25 EOD fisrt week then 5 week of .5 EOD.] I dialed it back to .25 OED but that's when I started noticing my puffy nipples returning as well as moodiness and water retention so I went back to .5 EOD. Now for the past two weeks I've noticed my skin begin to clear up! Not just the breakouts from T but little tiny follicle bumps I've had all over my body since I was a kid. We're talking since the early stages of puberty. I was always told by my doc they'd go away and the never did. Until now... Nearly 43 years and just now they're beginning to clear up. So I'm thinking my body likes these new lower E levels. I just think I'm one of those people who are happier with slightly elevated T. I say this because my muscles felt better at higher levels, no soreness, my joints were better too. I even *wanted* to workout and excersize rather than force myself. Now I'm fatigued all the time and it's all I can do to lift weights.

I didn't have the random aches and pains that travel throughout my body either, and I even felt better when I woke up. Prior to TRT, the pain was so severe every morning that it woke me up. That all went away when I began TRT, but now it's come back. Not to the same levels as before but for the past month or so I've been waking up stiff and sore. So I'm thinking I'm just better off around 900. I've been taking DHEA again for the past few days to bump both my T and E and so far it's too soon to tell.

I plan on getting the OK from my doc to increase my T injections to get me back to were I feel good again. I just wanted to get some input from everyone here before I do; because I'm also thinking of adding HCG to my regimen, which should naturally raise my T as well? Correct? But how much?

Sorry for the long ramble but I was feeling *SO* good and now I've been feeling like crap for a while and want to get back to the good! =)

[flatscat]

bro, if you would like for me not to reply to your threads just say so.

[frawnz]

Pretty much... although now that I think about it, I pin on Sat and Wed; last time I drew on Tues morn this most recent I did it Wed morn. Would 24 hours explain the significant diff in Total T numbers? [Obviously both tests were before taking my daily meds.]

It very well could. Test C has a pretty sharp drop off after it's peak.

[BillyBob210]

Looks good to me Forrest! What does your exercise level look like? Don't recall from your previous posts but some heavy lifting really makes me feel better, whatever my levels. Sounds like you are getting a good grip on it though....congrats.

[forrest_and_trees]

bro, if you would like for me not to reply to your threads just say so.

Whoa... hey... not sure what I did or said but please do keep posting. I appreciate all input. I may have my own differing opinion on occasion; but I always welcome a good convincing argument. I'm anything but infallible which is why I ask for the input. I may *think* I know something but the rest of you may see things otherwise. If it turns out I'm wrong, then I'll change my tune. That's how I learn.

Thanks and as always, please keep the comments coming.

[forrest_and_trees]

Looks good to me Forrest! What does your exercise level look like? Don't recall from your previous posts but some heavy lifting really makes me feel better, whatever my levels. Sounds like you are getting a good grip on it though....congrats.

That's the frustrating part, my numbers are looking good but how I feel tells a different story. I've been too tired for much in the way of cardio but I have been lifting. It's the one area I am making some progress. I've changed up my workout a bit and gone with heavier weights and less reps but even so, I feel weak. When my Total T was higher, I had more energy, I *felt* like doing more cardio and regardless of weight, my lifting didn't really hurt my muscles or cause my joints to ache like they do now. Sure, I'd get the "no pain no gain" feeling, but it would quickly pass. In years past, if I did a hard workout, the muscle pain would sometimes keep me awake at night. That's one good thing about being on TRT. But as I said, before, I felt like working out. Now I have to push myself to do it and I feel weaker, not stronger and I get so tired during the day, it feels like someone drugged me.

[Vettester]

Did you run other labs, such as CBC's and lipids? I personally don't think that score in the 700's is the culprit to your fatigue issues. Especially considering your free test score, which in comparison would be equal to a lot of guys who are 800 or 900 on their total, but in the 2% to 3% range on their free test.

On the DHEA ... Did you run a test to see what your DHEA level is? Take it one step further and consider going with transdermal pregnenolone. If you've read my 'HRT Program' thread then you know my passion for this hormone and the benefits it has on the hormonal pathway. Additionally you should look at B-12. Both of these are excellent choices for improving memory, concentration, cognitive function, and energy.

For some reason, I thought you were getting on HCG a few months ago. Maybe you were just considering it then or something. Your LH/FSH levels are probably nothing, thus no natural production occurring with your nads. HCG is the ticket! You will probably need to cut your Cyp down even more when going on it. I would schedule another round of labs no later than 2 months after starting HCG.

I personally think E2 levels are optimal between 25 to 35. You don't want to go any lower on your score! Let some conversion take place to get you up a little.

[zaggahamma]

reading between the lines just makes me agree with you that you felt better when you were at 923...agree with ppc that maybe 37 is fine for e2 FOR YOU....that was a good number for me too....GO WITH THE FEEL not the numbers, imo....i couldnt have even phatomed changing/lowering anything if i felt as good as you said you were..just my .02

[forrest_and_trees]

Vetteman, Thanks for chiming in.

CBC all looks good, Lipids are as follows:

Blood test dates ----- 8/3/10 --- 9/8/10 ---- Range
Cholesterol, Total ---- 182.0 ---- 178.0 ----- 100 to 199
Triglycerides --------- 150.0 ----- 135.0 ----- 0 to 149
HDL -------------------- 35.0 ------ 36.0 ----- >39
LDL ------------------- 117.0 ----- 115.0 ----- 0 to 99

Doc says he's not too worried about the LDL levels as they should come down as my exercise increases. ...which they are.

Liver Function also looks good:

Blood test dates ----- 8/3/10 --- 9/8/10 ---- Range
AST (SGOT) ----------- 18.0 ------ 23.0 ---- 0 to 40
ALT (SGPT) ------------- 20.0 ------ 22.0 ---- 0 to 55

As for the HCG , yes we did discuss it however at the time, I also wanted to switch my thyroid med from Synthroid to natural Armour and we both agreed it was better not to add too many factors to the mix and that I should be OK to hold off another month or two until I got my blood results back indicating how I'm responding to the Armour. Since fatigue, cloudy thinking and difficulty concentrating is something I've been dealing with for a long time now; it's a bit of a priority.

As far as B12, I'm currently taking 1000mcg of sublingual B12 but I've been considering switching to injections, however the more I read, the more confused I got. There seem to be a lot of differing opinions on whether or not its a good idea and or what type to use. I was about to post a thread here on it the other day but decided to hold off because I didn't want to add another factor that might mask another problem. But I'm almost at the point where I'm ready to say "screw it" because none of my other meds seems to be doing the trick.

What are your recommendations on what type of B12 is best for injecting? What's your program? Is this something you do at the same time you inject your T? Can they be mixed like a "cocktail"? or must it be injected in a different location with a different needle? I'm assuming if it's not oil based, it wont mix.

jpkman,

I mainly cut back to find my "sweet spot". Now that I know better where that is, I can adjust accordingly. However, as Vetteman mentioned, if I add HCG, that too will impact my levels so; I'll have to dial it in even further.

And to think when this all started, I just thought, "hey doc, give me a shot and all will be better." Riiiiihgt... LOL.... Oh well... At least I'm far more informed now.

[Vettester]

Forrest, I use the Methylcobalamin B12, which works really good for me. I've posted this link in the past, but will post it again: http://www.dadamo.com/B2blogs/blogs/...alamin?blog=27 . It is a great compliment to my program!

I always draw 1ml (1000mcg) before drawing my weekly test. It's water based and bright red. It stays separated from the cyp (for the most part) and helps flush it out of the syringe. So it can be easily added to your regiment without the need of extra shots or pinning locations.

[forrest_and_trees]

Cool.. Vette, I'll give that a try. That will actually come in handy too as I've recently switched to 1cc/1ml syringes to better moderate my bi-weekly doses and they have a .5ml tip that goes to waste. At least with the B12, I wont have to waste the extra T which comes out to be an extra shot or two per vial.

P.S. I may be closing in on my fatigue, ache joints and weak muscles, etc. issue... but I'll save that for another post once I've confirmed.

[Vettester]

IMO, I think your aches and fatigue, etc. are probably E2 resulted, having it being as high as it was then coming down like a lead balloon. I think this will dissipate as your score goes up a little and other variables balance out. I'll look for your other post and see if we're on the same page.

[forrest_and_trees]

OK... so I've done some more digging around on the 'internets' and have come across some very interesting stuff. I now see where everyone is going with the Low E. Ironically my other hypothesis also holds water [no pun intended] however I'm beginning to lean toward low E.

For those of you doing a face-palm right about now, as I inferred in an earlier post on this thread, I'm always open to a good argument, and while you all may be right, simply telling me it's low E leaves me with many unanswered questions. Which is why I continue to dig and ask. Eventually though, I usually figure it out. So I suppose what I'm saying or asking, is that you bare with me.

On a side note, I found a fascinating site that touches on the subject of over using AI's. We all sing the praises of AI here, [myself included] but I'm beginning to see where it's extremely easy to over do it. I realize I may be overstating the obvious, but I guess as with so many HRT issues, it's a matter of balance. The question is how do we find it and once found, how do we maintain it.

You might already know all this but I like to voice it here for those who follow. I figure if I did not know something there are likely others who are in the same boat. Perhaps this will help them find their answers that much more easily. ...OK I'm steppin off the soap box now.

Assuming it is Low E, and understanding everyone is different, has anyone found a proven and effective ongoing program with AI's that works without having to go the roller coaster route or spending lots of money on regular testing every 8 weeks?

[flatscat]

F/T, sorry was having a moment earlier - of course you should have your own opinion and you should always question everything.

I absolutely hate adex. (except when I need it lol). I have almost gotten to the point where I don't need much at all. I did need it at first, but never went over .5 twice a week.

After not taking it for about 4 weeks I decided to start again just to see what would happen. I did not feel as though I needed it, but wanted to test it out anyway - this is all w/o bw. So I started .25 twice a week. By week 2 I felt just like you described - tired, extremely moody, loss of morning wood by week three. After stopping, by week 5 I started feeling better and only take it when I need it now.

Not suggesting anyone do this at all - I just think my body has adjusted enough to where it does not convert very much. Will confirm on my next BW sometime in the next two months.

I did ask you what you are taking for supplements earlier if you want to list.

The zinc I take prolly keeps my E2 level low enough on its own at this point.

[forrest_and_trees]

The only supplement I'm taking is 1000mcg of sub-lingual B12 and a daily multivitamin.

[flatscat]

do some research on zinc and E2

[forrest_and_trees]

Hey Vetteman,

Is methylcobalamin best acquired through a doc via a script or OTC / the web?

[Vettester]

Hey Vetteman,

Is methylcobalamin best acquired through a doc via a script or OTC / the web?

I get mine on a script through my clinic. Not sure how readily available it is online. It's a little harder to find than the cyanocobalamin. Ask your doctor if he can get you a script, it should be easy enough I would think.

[forrest_and_trees]

I get mine on a script through my clinic. Not sure how readily available it is online. It's a little harder to find than the cyanocobalamin. Ask your doctor if he can get you a script, it should be easy enough I would think.

Vetteman,

Good deal, will do. Thanks again.

...And thanks to everyone else for all your input. Looks like it's a combo of low E2 and overdoing it a bit on the thyroid meds. I should have things dialed back in soon. Next step is figuring out a livable long term program.

PPC, they got those home testers ready yet? I could sure use one. =)

[JuiceBox12]

Great thread. Lots of good info. Thanks everybody!

[forrest_and_trees]

OK, so since it's looking like Low E is definitely part of the prob my next question is how long do I lay off the Anastrozle before my levels should get back to a decent range? I started taking 50mg of DHEA again to get the ball rolling. Any reason to go higher than that or leave it a 50mg?

[Vettester]

OK, so since it's looking like Low E is definitely part of the prob my next question is how long do I lay off the Anastrozle before my levels should get back to a decent range? I started taking 50mg of DHEA again to get the ball rolling. Any reason to go higher than that or leave it a 50mg?

50mg is fine. Give it a few weeks and see how you feel.