Looking for answers

[Ratt]

Hey Gents,

The title should have been "looking for Possible answers"

Recent blod work in pre for my endo appt in july are:
Test Bio Aval: 13.8 H Range 2.1-8.5 nmol/L
Test : 27.6 Range 8.4-28.7 nmol/L
Ferritin: 41 Range 22-322 ug/L
Throxine Free 10.1 Range 9.7-19.9 pmol/L
TSH 1.44 Range 0.50-6.00 mU/L
BUN 6.5 Range 2.5-7.1 mmol/L
Creatinine 90 Range 58-110 umol/l
Prolactin 14.8 Range male: 2.1-17.7 ug/L
Iron: 21.40 range 8.10-32.60 umol/L
% saturation 36 range 20-55
Fe binding Cap: 59.39 range 44.80.55 umol/L

No test was done for E2 and the requisition didn't seem overly comprehensive. I had to actually check off the T3 and T4 boxes as the endo didn't request them which I found odd. My hope is that after the initial consult she will request further testing.

My stats: 48yr, 5' 8" 160lbs est 12-15%bf
75mg test cyp e3.5d

Looking at my test levels I think I will drop back to 60mg e3.5d and see how I feel.
Been on TRT for 2 years now and have been dealing with the military doctors and a urologist who started me on my initial protocol 100ew.
About 5 months in I went to injections every 3.5 which really illimnated my ups and downs. All was good until 10 months ago when I started feeling off and thought it could be an adrenal or thyroid issue. In a normal week I would feel very good for 2 days, 3 days alright and 2 days of feeling like shiat. Went in to see my doc and mentioned that I wasn't doing great even though my test levels were high normal. She sent me back to the urologist again and when I mentioned to him my symptoms he said it was beyond his scope of expertise and refered me to the endo which I will see in July.
Being in the military makes it very difficult to reason with the medical officers and they only see that my t levels are good and I should be fine which has frustrated me to no end.

Any comments/thoughts would be greatly appreciated.

Cheers

[bass]

Ratt i bet your e2 is high, your Prolactin is high so it is an indication that your e2 could be high as well. you need to do e2 test on your own if you have to so you can threat it accordingly. TSH looks fine T3 and T4 could have revealed more about your thyroid. will you be doing more test for thyroid?

[Ratt]

Bass, thanks for your input. I will ask the endo for more thyroid testing. As far as E2 goes, I had it checked a while back and will try to dig up the results and post them. I will ask the endo about a sensitive E2 testing. I live in Canada and have yet to hear anyone from Canada that has been able to get a sensitive test done.
Our health care system is completely different than the US and we don't have the luxury of finding another physician if the one we have seems clueless. I've been talking to my doctor about possible E2 other issues and they don't seem to have a schmick what they are doing.
Also, I had responded to to another post about extreme muscle soreness after a workout that would last for 5 days and you had mentioned you were dealing with a similar issue and thought it was your E2 levels. I know you started using an AI again and was wondering if you have noticed a difference in your recovery time.
Once again, thanks!

[bass]

not really, still stay sore for few days, especially on my chest and triceps workouts. legs, bies and shoulders seems to go away within a day or two. can you get a lab order online in Canada? if so try doing it your self.

[oscarjones]

Your Ferritin is very low, healthy levels are between 70-90. Try supplementing with a plant-based iron supplement and ramp your dose up to 150-200mg a day, and I say ramp because iron supplementation can cause constipation unless you slowly allow your body to adjust. You may need to be on it for a couple months before you see a solid increase. Also, take it with a few grams of Vitamin C to help absorption.

Chances are if you have adrenal issues, you will also have thyroid issues, and with low iron thrown into the mix any type of thyroid treatment will be nullified.

Read this thread for your thyroid concerns please.

http://forums.steroid.com/showthread...t-Why-it-fails

[Ratt]

not really, still stay sore for few days, especially on my chest and triceps workouts. legs, bies and shoulders seems to go away within a day or two. can you get a lab order online in Canada? if so try doing it your self.

Bass, as far as online labs, I haven't been able to find anything but will research some more.
I tracked down the only time they checked my E2 was Apr 2011
Estradiol: 127 Range 0-205 pmol/L Obviously not a sensitive panel, but like I mentioned I haven't heard of any canucks being able to get a sensitive panel. (Hopefully someone can correct me on this)
Also looking at the date of the test, it wasn't much long after that I started to notice a drop in my energy levels and sense of well being.

Your Ferritin is very low, healthy levels are between 70-90. Try supplementing with a plant-based iron supplement and ramp your dose up to 150-200mg a day, and I say ramp because iron supplementation can cause constipation unless you slowly allow your body to adjust. You may need to be on it for a couple months before you see a solid increase. Also, take it with a few grams of Vitamin C to help absorption.

Chances are if you have adrenal issues, you will also have thyroid issues, and with low iron thrown into the mix any type of thyroid treatment will be nullified.

Read this thread for your thyroid concerns please.

http://forums.steroid.com/showthread...t-Why-it-fails

Oscarj:Thanks for your comments. I didn't mention my iron levels as they were in mid range
Iron: 21.40 range 8.10-32.60 umol/L
% saturation 36 range 20-55
Fe binding Cap: 59.39 range 44.80.55 umol/L

Looking at my iron levels in respect to my ferritin levels do you think iron supplementation would still be something to look into?

Thanks again for your comments. It's great to know there is such a wealth of knowledge in this forum when problems arise.

[steroid.com 1]

You stated you checked off T4 and T3 can you post those with ranges?

I'd like to see a complete Thyroid panel including:

TSH
FT4
FT3
RT3
Anti Bodies

Also, did you have Cortisol checked?

Are you back filling your pathways with Pregnenolone and DHEA?

You are HPTA suppressed so are you taking hCG?

If not, read the sticky on hCG and Pregnenolone.

BTW, your Iron levels look fine...men don't need to much of this for a lot of reasons.

[Ratt]

gd,
Thanks for your reply. Please see below for my responses. I appreciate all your input/comments. It's extremely frustrating having to deal with these issues and the only thing the medical officers are concerned about is my t levels. When I went into request an appt with the eurologist the doctor looked at me and said that I didn't look very well. WTF, that's why I keep going in looking for help and answers! I think they have to deal with too many malingerers trying to get time off work or looking for a pension.

You stated you checked off T4 and T3 can you post those with ranges?

I'd like to see a complete Thyroid panel including:

TSH
FT4
FT3
RT3
Anti Bodies

The only results that came back were
Throxine Free 10.1 Range 9.7-19.9 pmol/L
TSH 1.44 Range 0.50-6.00 mU/L

Also, did you have Cortisol checked?
NO, as I mentioned I was surprised the endo didn't request more in-depth blood work

Are you back filling your pathways with Pregnenolone and DHEA?
I do have both suppliments but haven't taken them yet.

You are HPTA suppressed so are you taking hCG?
HCG, I wish, the doctors don't seem to be able to look beyond the test issue and how that can effect many other hormones.

If not, read the sticky on hCG and Pregnenolone.

BTW, your Iron levels look fine...men don't need to much of this for a lot of reasons.
I have been taking a multi vitamin and noticed a very slight improvement with energy.

This is why I'm seeking advise, I want to be able to go into the endo's office in July and present her with a list of things I would like to have checked. I'm not really too optomistic that she will know much about male hrt so I need to get loaded up with information to present an argument when she says that my levels are good and I don't need anything else checked.
THANKS AGAIN!

[oscarjones]

Bass, as far as online labs, I haven't been able to find anything but will research some more.
I tracked down the only time they checked my E2 was Apr 2011
Estradiol: 127 Range 0-205 pmol/L Obviously not a sensitive panel, but like I mentioned I haven't heard of any canucks being able to get a sensitive panel. (Hopefully someone can correct me on this)
Also looking at the date of the test, it wasn't much long after that I started to notice a drop in my energy levels and sense of well being.



Oscarj:Thanks for your comments. I didn't mention my iron levels as they were in mid range
Iron: 21.40 range 8.10-32.60 umol/L
% saturation 36 range 20-55
Fe binding Cap: 59.39 range 44.80.55 umol/L

Looking at my iron levels in respect to my ferritin levels do you think iron supplementation would still be something to look into?

Thanks again for your comments. It's great to know there is such a wealth of knowledge in this forum when problems arise.

Your % saturation actually looks solid, except your serum ferritin levels are what I am concerned about. Serum ferritin measures the amount of iron in body cells and serum iron measures iron levels in the blood, so in respect to your iron test (which should be taken early in the morning due to iron being at it's highest level) it doesn't give a complete picture to why possible T3 could become pooled or "resistant" in your therapy. I would say supplement chelated iron for 1 month and ramp up your dose then re-check your serum ferritin. Again, your % saturation and serum iron look good, and serum ferritin can be measured anytime throughout the day. I'd aim for at least 60, and optimally between 70-90. It shouldn't be too hard to accomplish this as you aren't that low in serum ferritin, which is 41 according to your first post.

[oscarjones]

Also, if you test cortisol, I'd recommend testing via saliva due to it's accuracy.

[Ratt]

Well,
I went to the endo yesterday and she is concerned that my bio available levels were well above the high range.
She wants me to start dosing at 100/w for 6 weeks and then go back to see her. She also mentioned that my blood work before starting TRT showed that my LH was below normal which would indicate a pituitary issue, so she is sending me to get an MRI done. She also wants me to get checked for possible sleep apnea problem.
Another thing she mentioned was changing to patches or gels, which I tried to shoot down. She feels the injections may not be effective but I mentioned that the T seems to be working, it's just that I don't feel well and I know there is some other underlying issue.
Anyway, overall I'm pretty happy with the initial visit. She seems to know what she is talking about and has order me a number of blood tests which will be done 4 weeks from now when my levels stabilize. It was nice to finally have someone actually listen to what I was saying.
Thanks to those who have provided input, it is always appreciated.
Cheers and have a great weekend

[bass]

very good! keep us posted when you get the tests results back. don't let her talk you into patches or gels, stick with injection.

[Brazensol]

Well,
I went to the endo yesterday and she is concerned that my bio available levels were well above the high range.
She wants me to start dosing at 100/w for 6 weeks and then go back to see her. She also mentioned that my blood work before starting TRT showed that my LH was below normal which would indicate a pituitary issue, so she is sending me to get an MRI done. She also wants me to get checked for possible sleep apnea problem.
Another thing she mentioned was changing to patches or gels, which I tried to shoot down. She feels the injections may not be effective but I mentioned that the T seems to be working, it's just that I don't feel well and I know there is some other underlying issue.
Anyway, overall I'm pretty happy with the initial visit. She seems to know what she is talking about and has order me a number of blood tests which will be done 4 weeks from now when my levels stabilize. It was nice to finally have someone actually listen to what I was saying.
Thanks to those who have provided input, it is always appreciated.
Cheers and have a great weekend

Did you bring up the E2 sensitive test? Like mentioned above your E2 is most likely high.