My Quest for Complete TRT and Lab Results

[go2failure]

Some of you may have seen my posts in other threads about my TRT situation (T only for past 2 years due to derp specialists, no AI, HCG , or even tests run on any other the other hormones besides thyroid). I finally was able to get some initial salivary tests run by a Dr. out of pocket who isnt afraid to prescribe AI's. He is however cautious about HCG. Apparently, he told me in in Louisiana there was a huge spike in HCG scripts for weight loss and the state board came down hard on the Drs writing scripts for it. So, I told him state "Spermatogenesis, Testicular Function, and Pregnenolone Support" on the script, to which he concured. I do not have a script yet, he wants to see the bloodwork first.

The salivary tests are for Cortisol 4X/day, progesterone, testosterone , androstenedione, estradiol, estriol, DHEA, 17-OH progesterone, estrone, DHT, melatonin, LH, FSH. I realize there are some who feel anything other than cortisol is worthless, but I will be doing blood draws for some of these as well later. He wants salivary tests for cortisol and just threw in the rest no cost to me for a initial look. I will be posting the results of this panel later this week as well as what scripts I am given to complement my T dosing (currently 200mg/week divided into 80mg every 3 days).


Mine--------Range

E1-------1.9----------<5pg/ml

E2-------0.5----------<2.5pg/ml

E3-------<0.1---------<5pg/ml

Prog-------2.2-------<50pg/ml

DHEA-------.07 L-------.09-1.60ng/ml

Test-------204.3 H-------40-170pg/ml

Melatonin-------5.6-------.1-25pg/ml

17-OH Prog-------7.2 L-------19.5-25.9pg/ml

Androstendione-------109.3 H-------7-89pg/ml

Prog/E2 ratio = 4

DHT-------<10-------<10-50pg/ml

Cortisol AM-------3.22-------1.8 - 3.8ng/ml
Noon-------.35-------.3-1.4ng/ml
Evening-------.08 L-------.1-1.1ng/ml
Night-------.09 L-------.1-.8ng/ml


I'm not sure if ACESS labs derped it or what but they also put the ranges for a pre and post menopausal woman for E2 on the printout and apparently I fall on the bottom range of NORMAL for both as a WOMAN... pretty sure that would warrant at least .25mg every 3 days of arimidex , but I may be wrong. Anyone know how these ng/ml or whatever may convert to a normal blood lab?

[go2failure]

... Labs added

[steroid.com 1]

A couple of questions/observations:

1. Was the Estradiol panels run "sensitive"...very important.

2. Progesterone is very low...was this stated on the actual lab report?

3. DHEA (and probably Pregnenolone as well) is low as would be expected when using exogenous Testosterone and why back-filling the pathways a good idea. Supplementing with 50mg of both each morning will go a long way to increasing these important values.

4. Melatonin is low as well and expected in mid to older guys. Supplement with 3mg of sublingual Melatonin and work up to 9mg if you can. Melatonin is needed for so much in men and way beyond normalized sleep cycles.

5. Test is a bit high and so is Androstenedione as one would expect; did you get Free T or Bio Available? These are more important now...

6. DHT is low and is best mid range.

7. Cortisol is a snap shot like all labs. You are high in the am which is normal and if you were in the Doc's office getting stuck with needles may explain why...hell, just plan nervousness can cause a spike. Evening and night you drop low...how do you feel in the evening?

[HRTstudent]

If its not the estradiol sensitive/ultrasensitive test then I wouldnt give it much thought unless I was also experiencing noticeable bloating or gyno. Getting the right test done matters. And then if/when you go on anastrozole you will need to follow up (with the correct test) to make sure youre not going too low.

Your test was above range though, so that tells me you should lower the dose of that. That alone will help E2 conversion dramatically.

[go2failure]

A couple of questions/observations:

1. Was the Estradiol panels run "sensitive"...very important.

2. Progesterone is very low...was this stated on the actual lab report?

3. DHEA (and probably Pregnenolone as well) is low as would be expected when using exogenous Testosterone and why back-filling the pathways a good idea. Supplementing with 50mg of both each morning will go a long way to increasing these important values.

4. Melatonin is low as well and expected in mid to older guys. Supplement with 3mg of sublingual Melatonin and work up to 9mg if you can. Melatonin is needed for so much in men and way beyond normalized sleep cycles.

5. Test is a bit high and so is Androstenedione as one would expect; did you get Free T or Bio Available? These are more important now...

6. DHT is low and is best mid range.

7. Cortisol is a snap shot like all labs. You are high in the am which is normal and if you were in the Doc's office getting stuck with needles may explain why...hell, just plan nervousness can cause a spike. Evening and night you drop low...how do you feel in the evening?

Thanks for the reply gd, this ws a salivary test--im not sure if it was a sensitive or not. There are sensitive E2 salivary, but i dont know for sure if this one was. I'm leaning towards doubt thought as they put the preMENOpause and postmenopause on there rather than andropause . I think the lab ran it as female.

[go2failure]

A couple of questions/observations:

1. Was the Estradiol panels run "sensitive"...very important.

The Dr said it was, but it was low instead of high. I thought it was weird that I didnt have any conversion to estrogen, but he said I have moderate adrenal stress and supraphysiological T and that backwards conversion to androstene was what was happening based on the blood results.

2. Progesterone is very low...was this stated on the actual lab report?

He prescribed me 10mg a day of pregnenolone

3. DHEA (and probably Pregnenolone as well) is low as would be expected when using exogenous Testosterone and why back-filling the pathways a good idea. Supplementing with 50mg of both each morning will go a long way to increasing these important values.

He has me taking 25mg/day of DHEA with sustained release

4. Melatonin is low as well and expected in mid to older guys. Supplement with 3mg of sublingual Melatonin and work up to 9mg if you can. Melatonin is needed for so much in men and way beyond normalized sleep cycles.

I did ask him about this and he said it was normal for it to be low in the morning and didnt recommend taking it for now.

5. Test is a bit high and so is Androstenedione as one would expect; did you get Free T or Bio Available? These are more important now...

He told me that the androstene being high was because my T was being backwards converted.

6. DHT is low and is best mid range.

He doesnt want to put me on any DHT creams or anything at this point.

7. Cortisol is a snap shot like all labs. You are high in the am which is normal and if you were in the Doc's office getting stuck with needles may explain why...hell, just plan nervousness can cause a spike. Evening and night you drop low...how do you feel in the evening?

I feel tired, but I cant sleep until later. I drink coffee but it's more just to keep headaches away at this point, it doesnt do much for me. He told me I have moderate adrenal fatigue and got me started on some supps to support them. He doesnt want to prescribe cortef at this point, but we will keep checking my levels to see if things are getting better by stopping my huge caffeine intake, getting back on my CPAP, taking the adrenal support supps, and sleeping for more than 5-6 hrs a night.

He did start me on HCG today to help support my adrenals, restart my gnads, and help me feel better! He did not prescribe an AI because I told him not to for now, my E was low on the E sensitive test, but we will check my labs in 8 weeks to see if it has risen--I'm sure it will be. The HCG is outrageously expensive and the pregnyl 10k IU at Sams and Walmart for $67 is not orderable at the moment because of manufacturing delays, so I'm paying about $190 per month for 10,000 IUs right now... Even the damn compounding pharmacies are worthless around here at $200. I cant find 5k IU anywhere here.

He lowered my T dose from 80mg e3d (200mg/week) to 150mg/once weekly with the 250IU HCG taken on the 5th and 6th day. We will see how I respond to the HCG, if I respond well we will know I likely secondary, if not we will know I was primary. We are anticipating having to lower my T to 100mg/week, but we will see.

[steroid.com 1]

hCG is going to make you feel a lot better and may correct a lot of things to be honest. You will get a much better sense of well being and you will feel good when you first start.

What is your hCG weekly protocol?

You may do better adding in some hydrocortisone for your adrenal fatigue...

Keep us posted on how things progress in this thread...it seems you have a Doc who has some sense of what he's doing.

[go2failure]

He wants me to take it every 3 days at 250 ius, but I was thinking I could follow Dr Crisler's protocol and take it the 5th and 6th day before the shot on the 7th day. What do you think?

[go2failure]

Just got my thyroid lab and Vitamin D back:

RT3: 27 ## 11-32
TSH: 1.510 ## .4-4.5
T4 Free: 1.5 ## .7-1.8
T3 Free: 3.5 ## 2-4.4

Vitamin D: 91.4 High


The Dr. swapped me from 100mcgs Synthroid to 60mg Armour. I started that today.

[go2failure]

Keep us posted on how things progress in this thread...it seems you have a Doc who has some sense of what he's doing.

On HCG I feel relaxed and unstressed. I do notice a slight libido boost.

I sent a nutreval (nutrition/heavy metals) off today, I will get the results of that back in two weeks. I will have ferritin, prolactin, IGF-1, FSH/LH, ACTH (possibly 2 weeks), CBC/CMP, ANA, Lyme, Allergy all back by sometime next week.

[go2failure]

B12: 214 -- 211-911 (put on 1 shot of 1000mcg/ML B-12 every 2 weeks)

IGF-1: 182 -- 89-350

Iron: 62.9 -- 26-388

ANA: Negative (for any cutoffs)

Lyme (2 tests): Negative

Prolactin: 6.9 -- 3-14.7

FSH: <0.8 -- 1.42-15.4

LH: <0.6 -- 1.24-7.8

Allergies: Dust Mite (Moderate Stage 2), Ragweed (Mild Stage 1) -- NO food allergies detected

IGE: 8 -- 0-100

----------------------

It appears my pituitary is working fine for now. I will be doing the ACTH and getting the Genova nutritional/heavy metals panel back soon

[xtitan1]

I dunno. I'm in a similar situation and to me it doesn't seem like your pituitary is working fine at all. You've got thyroid problems, adrenal problems, and testosterone problems and your igf 1 is in range but not that great. What's the common denominator? Pituitary. This is just a question not a statement. I'd like to know the experts' thoughts on this.

[go2failure]

I dunno. I'm in a similar situation and to me it doesn't seem like your pituitary is working fine at all. You've got thyroid problems, adrenal problems, and testosterone problems and your igf 1 is in range but not that great. What's the common denominator? Pituitary. This is just a question not a statement. I'd like to know the experts' thoughts on this.

bump