Got Bloodwork done...trying to do HRT right

[GetItHot]

So I got my blood work done last week. After searching through some threads, I found a lab that was close enough here. I have been feeling really bitchy, up and down, and I knew something just wasnt right...

Here's some background. Started HRT August 2011 after labs came back with low testosterone. Doc put me on 200mg Cyp once a month. Retested again 3 months later and came back lower. Doc upped it to 300mg 1x/month. Three months later, get bloodwork done, still lower than before. Doc said to stick with it another three months. Got tested again in March 2012. Doc finally gave me a referral to the endo. I dont get to see an Endo until mid June. This has all been done through the VA by the way. I had no idea that this method was wrong until I started reading this forum. In march I started doing 100mg/wk to avoid crashing. I would have liked to have a little more time on this plan before the labs, but I was getting tired of the bitchiness, so I pulled the trigger on the labwork.

So after being referred to this forum, im much better educated than I could have hoped for. Im not currently on an AI, HCG or anything like that. After this last couple of weeks though, I knew something wasnt going right. Instead of feeling like the big bad wolf, I felt like crawling under a rock. Going from high to low all in one workout. I was starting to think I was bipolar...

Here's my stats:
34, 6'0, 225lbs. BF is somewhere between 15-18%. I have a 30' inseam, so I have alot of torso.

I got my labs back, and just as I had suspected, my E2 is high. I have some LDex coming in the mail this week.

1. Should I up my 100mg/wk test dose?
2. What amount of LDex should I run?
3. Is there anything else out of the ordinary? T3, T4, etc...

I appreciate any feedback you can give me in regards to my bloodwork.

[socalfun64]

I'm sure the pros will tell you, your original Dr. was a crackpot, at least as it concerns HRT. These kinds of Dr.s have no right prescribing Test at those doseages/intervals. How can they possibly prescibe Test, without researching the correct doseage?? How do the live with themselves? Close to malpractice in my opinion (which means nothing of course)!!

[socalfun64]

WOW! You need to donate blood IMMEDIATELY Bro!! Your Hemoglobin is pretty dang High. To many Red Blood Cells!!! I'd do that asap if it was me. Most here are on 100-150mg (total) of Test a week. dosed at 2x a week (50-75mg at a time). With that doseage, .25mg of Arimidex 2x a week is about right, but needs to be confirmed with followup blood work. Try to get on HCG on way or another, it really helps!!
Good luck, others will chime in soon I'm sure.

[kelkel]

How you doing GetItHot. Overall your levels are not that bad.

Was your blood drawn 1 week after and before your next injection so your at your trough level?

Assuming that's a sensitive estrogen assay and it appears to be, getting your E level down a bit would help both how you feel and your T levels. Everything works in concert here. http://www.lef.org/magazine/mag2008/...ng-Male_01.htm

Some people may be fine with that E level, others won't. You need to find whats best for you. I don't think increasing your T right now is the answer. Work on lowering your E and see where things are at that point. If you choose the ldex route start low, get bloodwork maybe a month later and see where your at. Titrate your dosage at that time if needed. Make one change at a time so you can actually see what is or is not working for you.

Socal is correct on your hemoglobin levels. You need to give blood asap. I'd suggest donating double red cells at this point as it will remove about 2.5 times the amount of a normal blood draw. It helps you and helps society.

Your TSH level is getting a little high. New standards are .3 - 3.0, not what's on your report. Keep an eye on it. Take some time and read this site: http://www.stopthethyroidmadness.com/

Read gdevines thread on HCG at the top of the forum as well as visit Dr. Crislers site and click on publications.

Others will chime in. Hope this helps.

[GetItHot]

Blood was drawn Friday April 27th. I fasted for 12 hrs prior. I pin on friday mornings. That day I pinned after I got home. So seven days between pins. Sorry I forgot to mention that.

[Brohim]

I would look into adding some HCG in there. It would bump up your test level's a little. And you need to find an AI your E2 is high.

[socalfun64]

I think the High Estradiol and the Low level of Test as a ratio to one another, are probably a lot of the reason you don't feel as good as you should. Get that more inline (higher T/Lower E) and you'll for sure feel the effects in a positive way. As suggested, the best way to do that is to use your Ldex at a low dose to start (.25mg 2x/wk) about 48 hours after pinning your Test, and also raise your Test to around 130-150mg a week (split into two doses, maybe Sunday AM and Wednesday PM). Lastly, get yourself on HCG at 250iu 3x a week (Mon, Wed, Fri).

good Luck with all that, you should be feeling better before to long. Whatever you do, Don't give up!!

[bass]

copy KelKel! if i were you I'd split my dose to 50mgs twice a week, and take 0.25 mg Ldex 12-24 hours after each shot, then do blood work as Kel suggested to see where your E2 is. bitchy mood most likely means elevated e2 doesn't agree with you.

[bass]

I think the High Estradiol and the Low level of Test as a ratio to one another, are probably a lot of the reason you don't feel as good as you should. Get that more inline (higher T/Lower E) and you'll for sure feel the effects in a positive way. As suggested, the best way to do that is to use your Ldex at a low dose to start (.25mg 2x/wk) about 48 hours after pinning your Test, and also raise your Test to around 130-150mg a week (split into two doses, maybe Sunday AM and Wednesday PM). Lastly, get yourself on HCG at 250iu 3x a week (Mon, Wed, Fri).

good Luck with all that, you should be feeling better before to long. Whatever you do, Don't give up!!

beat me to it Socal!

[GetItHot]

I'll be getting BW done again on the 25th hopefully. I'd like to still pin fridays, so friday am pin, saturday afternoon .25mg LDex, Monday P.M. pin again, Tuesday afternoon LDex again. Sound ok?

[kelkel]

Yes it does.

[GetItHot]

What a good target number for E2? Less than 25? For all I know, I've had high E2 all my life.

[Bill_boy2005]

Good chance you will see your T raise when your E2 is in check as well. I convert quite a bit myself and was surprised how my required testosterone is decreasing as I bring my E2 under control. And remember, I started with a 37 on labcorps scale.

[GetItHot]

Alot less bloating after taking the AI. My face looked like I was on Deca.

[zaggahamma]

who referred you to the forum, the endo?

good luck getting dialed in

[ecdysone]

You got alot of good advice, I would just add my own 2 cents.

Your hemocrit is a little high, however not too serious - you'll need some blood-letting soon, but no panic (values >mid 50's are more serious).

HCG could be troublesome for you in that you are producing alot of E2 and HCG will magnify this.

Me, I would keep it simple: go a little heavy on the AI but get some BW asap. You are using the wrong assay for E2: you need the LabCorp "sensitive" one.

Your biggest problem is your test:E2 ratio, if you can't get your test any higher, then you will need to keep your E2 around the mid-20s.

[GetItHot]

You got alot of good advice, I would just add my own 2 cents.

Your hemocrit is a little high, however not too serious - you'll need some blood-letting soon, but no panic (values >mid 50's are more serious).

HCG could be troublesome for you in that you are producing alot of E2 and HCG will magnify this.

Me, I would keep it simple: go a little heavy on the AI but get some BW asap. You are using the wrong assay for E2: you need the LabCorp "sensitive" one.

Your biggest problem is your test:E2 ratio, if you can't get your test any higher, then you will need to keep your E2 around the mid-20s.

I do my labs through directlabs.com Im not sure that I can get the 'sensitive assay'. Im getting BW done on the 25th, and im going to a blood drive on the 30th.
I'll hopefully start my first cycle at the end of the month too.

[GetItHot]

who referred you to the forum, the endo?

good luck getting dialed in

Referred by a friend.

[ecdysone]

Use privatemdlabs.com.

Like I said, unless you can get your test>700, your test:E2 ratio will be more important than it is for most guys.

You will need to keep your E2 in a very narrow range, for example 15-25, and that can only be done with a "sensitive" E2 assay.

It's important you drop your E2 as much as can be done safely, but values in the teens will be pushing the envelope and will definitely need the best E2 assay there is.

[GetItHot]

Use privatemdlabs.com.

Like I said, unless you can get your test>700, your test:E2 ratio will be more important than it is for most guys.

You will need to keep your E2 in a very narrow range, for example 15-25, and that can only be done with a "sensitive" E2 assay.

It's important you drop your E2 as much as can be done safely, but values in the teens will be pushing the envelope and will definitely need the best E2 assay there is.

So now im confused. Your lab does sensisitve assay, but the one i used doesnt. Yet they still use labcorp and I would go to the exact same place for the blood draw.

[ecdysone]

LabCorp has an E2 assay intended for women, but will work OK if your E2 is high. They also offer their "sensitive" assay which is the one meant for men and the one you want.

[GetItHot]

LabCorp has an E2 assay intended for women, but will work OK if your E2 is high. They also offer their "sensitive" assay which is the one meant for men and the one you want.

Thanks for the info! Which of the testosterone labs do you think I should get? Do you see anything else that I missed out on durning my first BW?

[GetItHot]

Im ordering up my labs on monday from privatemdlabs. Which testosterone test do I need to get?

#1 Testosterone, Free (Direct) With Total Testosterone, LC/MS-MS
#2 Testosterone, Free (Direct), Serum
#3 Testosterone, Free (Direct), Serum With Total Testosterone
#4 Testosterone, Free and Weakly Bound
#5 Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS
#6 Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis
#7 Testosterone, Total - Women, Children, and Hypogonadal Males, LC/MS-MS
#8 Testosterone, Total, Serum

Im going to get the E2 sensitive, and prolactin also.

[GetItHot]

*********Update 6/5/12********

Labs where drawn on 5/25/12. That was a friday morning, and I was at my trough for levels. Im on a fri/mon pin and sat/tue AI plan.

Well, I got my labs back after doing the 2x week split of 100mgs and I also added in the Ldex. Here's the results:
Testosterone, Total, LC/MS 503.8 ng/dL Range 348.0-1197.0
Fee Testosterone (direct) 21.4 pg/mL Range 8.7-25.1
Prolactin 3.9 ng/mL Range 4.0-15.2 LOW
Estradiol, Sensitive 7 pg/mL Range 3-70

I feel fine with my E2 being that low. Alot better than when it was 50+. I got my prolactin checked becuase of all the reading I have done here and how the levels pertain to sexual function/disfunction. I seem to not last very long on the first nut. The second and third are fine though. Is there anything I can do to bring it up?

I also plan to start an 8 week cycle on June 15. I am going to run prop 100mg EOD. I have tren, but im going to leave it out since I want my dick to work when I get to college in August. I'll also continue using the Ldex at .25mg EOD while on cycle.

I appreciate any input guys.....

[ecdysone]

E2 at 7 is way too low.

Might be that now you are using the E2 sensitive assay, the previous one you had was completely wrong.

In any event you have to ratchet back your Ldex quite a bit.

While there's no short-term damage, E2 values <20 or so are associated with bone loss and other nasty things.

Personally, I would want to get my E2 dialed-in better before embarking on any other "therapy."

Hopefully, you haven't forgotten about your hemoglobin issue.

[kelkel]

Listen to ecd ^^^. Good advice. Also stay away from Tren unless your experienced with it. You can make substantial gains with just more T.

[Bill_boy2005]

Guys keep in mind that Labcorps sensitive assay has not been real accurate as of late. Mine was 3 on one test and 21 the next with no change in anything on my protocol. For the E2 I would pay more attention to how I felt first and the number second.

OP, just my opinion, but if you are going to be on HRT for life, it is probably worth while to talk to your Dr about getting on Arimidex as a prescription. While I am sure some have had good luck with Lion's products like l-dex, they were not the best at keeping my levels stable when I was using them. Plus there is some comfort in pharma grade products instead of research chems.

[ecdysone]

Guys keep in mind that Labcorps sensitive assay has not been real accurate as of late. Mine was 3 on one test and 21 the next with no change in anything on my protocol. For the E2 I would pay more attention to how I felt first and the number second.

I mentioned this last month: I had spoken with one of their Medical Directors about this issue and their internal investigation revealed that a large batch of specimens were off by one number which caused them all to be wrong. Although in your case that's probably not relevant since you/your Dr. should have been contacted with the updated results.

It's hard to reconcile a 3 vs. 21, although I wouldn't be surprised at a ±35% or even more variance between two results (lab imprecision + normal biological variance), so a 21 or a 10 could well represent the same protocol.

[Bill_boy2005]

I mentioned this last month: I had spoken with one of their Medical Directors about this issue and their internal investigation revealed that a large batch of specimens were off by one number which caused them all to be wrong. Although in your case that's probably not relevant since you/your Dr. should have been contacted with the updated results.

It's hard to reconcile a 3 vs. 21, although I wouldn't be surprised at a ±35% or even more variance between two results (lab imprecision + normal biological variance), so a 21 or a 10 could well represent the same protocol.

I believe they're still having issues beyond a small batch of specimens. I'm a patient of Crisler's and from what he shared with us there still appears to be an accuracy issue as some people are still getting odd numbers. The good news is if its off its generally quite a bit.

[GetItHot]

E2 at 7 is way too low.

Might be that now you are using the E2 sensitive assay, the previous one you had was completely wrong.

In any event you have to ratchet back your Ldex quite a bit.

While there's no short-term damage, E2 values <20 or so are associated with bone loss and other nasty things.

Personally, I would want to get my E2 dialed-in better before embarking on any other "therapy."

Hopefully, you haven't forgotten about your hemoglobin issue.

Yep, I gave blood prior to this blood work. I wasnt able to give double red blood cells, hopefully next time though.

When I see the Endo next week, Im going to try to get on HCG and try for an AI. We'll see how that goes.