Interpreting Lab Results

[Rev84]

Hello, new member here. I've been reading here about a month and have been using this site amongst others to help educate myself.

Background:

I'm 28, got tested free and total T and came back low on both. I tested because I've had no libido, ED, don't gain muscle even with meticulous dieting and intense training and I'm 170lbs 10% body fat at 5'10", I've no where near filled my genetic potential. I began test cyp 200mg broken up into two 100mg per week. My physician initially prescribed 200-400mg once every two weeks but from educating myself on this site I took initiative to begin with the former I mentioned above.

Unfortunately I did not begin to get many tests done prior to my beginning TRT. My physician did not order any and prescribed me test within probably 2-3 minutes of conversation after I showed him my Testosterone results (labs I ordered myself). So far I am two weeks into therapy.

DONE PRIOR TRT:
Testosterone, Serum 345 LOW ng/dL 348-1197
Free Testosterone(Direct) 7.3 LOW pg/mL 9.3-26.5

DONE 2 WEEKS INTO TRT: (AFTER FOUR 100MG INJECTIONS OF TEST CYP OVER THE PAST TWO WEEKS)
Estradiol 13.2 pg/mL 7.6-42.6
TSH 0.854 uIU/mL 0.450-4.500
Thyroxine (T4) 7.4 ug/dL 4.5-12.0
T3 Uptake 35 % 24-39
Free Thyroxine Index 2.6 1.2-4.9
LH 0.3 LOW mIU/mL 1.7-8.6
FSH <0.2 LOW mIU/mL 1.5-12.4
Cortisol 19.9 HIGH ug/dL 2.3-19.4

My main questions are:

1) Was it pretty pointless to get FSH and LH done after four treatments of test cyp over the past two weeks? I've read here that after you start test your FSH and LH drop out naturally in your body's response to the extra injected test. I wasn't sure if two weeks was long enough to make a difference but I am guessing it likely has been.

2) My E2 was normal but low...people here recommend to get it into the 20's but I assume a great way to raise my E2 will be to...well, take testosterone. Obviously I am glad I didn't start an AI right off the bat without ever checking this. I certainly do not appear to require that now and possibly never will.

3) My cortisol is a little high. I've been training each muscle group twice a week a total of 5-6 training days a week...I'm concerned this may be over training. My test hasn't even had a chance to kick in yet so I know I'll recover better then but is this something I should consider changing? Training maybe 3-4 days a week instead?

Thanks for your time.

[bass]

welcome here Rev. please post entire BW both prior and post TRT with ranges, all of it.

[Rev84]

No problem, I edited the first post and added every test I have done to date with the ranges listed at the end. Thanks.

[bass]

thanks for that Rev. not enough BW and its too soon to make any assessment. yes LH and FSH will shutdown while on TRT, but the bigger picture we need to know is why at your age you have such a low testosterone levels ? its hard to determine whether your primary or secondary without doing a full male hormone panels as outlined in the sticky kelkel posted "Finding a Physician"

any AAS use in the past?
any injuries to your testis?
what is your complete TRT protocol, any AI's hCG included?

PS. your e2 test is not a sensitive assay, its hard to tell what it is, but at this stage its not going to be significant anyway.

[Rev84]

thanks for that Rev. not enough BW and its too soon to make any assessment. yes LH and FSH will shutdown while on TRT, but the bigger picture we need to know is why at your age you have such a low testosterone levels ? its hard to determine whether your primary or secondary without doing a full male hormone panels as outlined in the sticky kelkel posted "Finding a Physician"

any AAS use in the past?
any injuries to your testis?
what is your complete TRT protocol, any AI's hCG included?

PS. your e2 test is not a sensitive assay, its hard to tell what it is, but at this stage its not going to be significant anyway.

Yeah I was concerned after having done a bit more reading that I missed the boat on doing a full pre-TRT test to determine the cause. I have had a recent MRI which came back completely normal however, perhaps that is some help? I've never used AAS, never injured my testis either. I have had ED my entire adult life also, not sure if that helps but it's the truth.

My complete TRT protocol:
100mg testosterone cypionate injected twice per week = 200mg test cyp per week

That's it, I've been treated now for two weeks total. Looks like I needed more blood work to identify the cause of the low T, my doctor didn't seem concerned. Either way I am optimistic that treatment will increase my quality of life.

[bass]

would have liked to see your LH and FSH levels before TRT, you can still stop by doing a simple PCT to help kick start your natural production, wait about 2 months then do a complete male hormone panel as outlined in kel's post. as you know TRT is for life, there is a small window for you to get off but 6 months into it might be too late, and you have to stay on it for the rest of your life. 28 years old is way too young to get on TRT, there are no studies of long term TRT so we don't really know what it will do for/to you 40 years down the road. its up to you, if you decide to continue i suggest you find a good doctor that knows how to treat you, i can say 100% that this doc will do more damage to you than good just from what you said about him and the protocol he prescribed.

[TennTarheel]

After 6 months and you're on for life? I wouldn't agree with that at all.

[Doug350SD]

The low levels LH , FSH only after 2 weeks of injections? I agree with Bass, try a good pct and retest..

[bass]

After 6 months and you're on for life? I wouldn't agree with that at all.

give it a try and let me know how it works for you...

[kelkel]

At 28 years of age and low T levels you need a doc to search for a causative factor. Not just put you on TRT. In my opinion that was a mistake by an incompetent doctor, unless I'm missing something in your post.

"DONE 2 WEEKS INTO TRT: (AFTER FOUR 100MG INJECTIONS OF TEST CYP OVER THE PAST TWO WEEKS)
Estradiol 13.2 pg/mL 7.6-42.6 Low as your T is low as you know
TSH 0.854 uIU/mL 0.450-4.500 Good level but a weak indicator of thyroid function
Thyroxine (T4) 7.4 ug/dL 4.5-12.0 Best mid range
T3 Uptake 35 % 24-39 Good.
Free Thyroxine Index 2.6 1.2-4.9
LH 0.3 LOW mIU/mL 1.7-8.6 as expected
FSH <0.2 LOW mIU/mL 1.5-12.4 same ^
Cortisol 19.9 HIGH ug/dL 2.3-19.4 High cortisol can effect test levels

My main questions are:

1) Was it pretty pointless to get FSH and LH done after four treatments of test cyp over the past two weeks? I've read here that after you start test your FSH and LH drop out naturally in your body's response to the extra injected test. I wasn't sure if two weeks was long enough to make a difference but I am guessing it likely has been. First test after initiating trt is fine to obtain those levels. Indicates things are working basically

2) My E2 was normal but low...people here recommend to get it into the 20's but I assume a great way to raise my E2 will be to...well, take testosterone . Obviously I am glad I didn't start an AI right off the bat without ever checking this. I certainly do not appear to require that now and possibly never will. Hopefully you won't. Most do. Way to soon for you to judge that. Your T dose is probably high and subsequent testing will clue us in

3) My cortisol is a little high. I've been training each muscle group twice a week a total of 5-6 training days a week...I'm concerned this may be over training. My test hasn't even had a chance to kick in yet so I know I'll recover better then but is this something I should consider changing? Training maybe 3-4 days a week instead?" May help. Read this: http://www.lef.org/magazine/mag2011/...ortisol_01.htm

It would be well worth it IMO to find a competent doctor asap and get to the root cause. More in depth thyroid testing may be needed as well. At your age I would do everything possible to NOT be on TRT. If you can find a recent test including LH/FSH it would be great. They are key indicators of pituitary function and can help determine if there is a pathology inhibiting lh/fsh production.

kel

[Rev84]

Thanks guys and especially for that last post Kelkel.

I've been freaking a bit over the whole getting an MRI and pituitary issue secondary hypogonad stuff. I got an MRI a year back and it was one of the worst experiences of my life (claustrophobia). I had to sit down for 20 minutes after from almost passing out once I got to my feet, yeah, I was pretty tense. Thankfully the results came out normal. I'm a bit of a hypochondriac, I was getting tested for any possible brain tumors.

It's a HUGE relief to read Kelkel's statement about the FSH and LH being normal from me injecting 200mg of test per week the past couple of weeks. My test level wasn't abysmal but it was still too low. I'd like to think since I already went through the hell of getting the last MRI and that the cyp will lower FSH and LH anyway clears me of the pituitary tumor issue.

All that said, it still doesn't point me to the causative factor. I've read many with secondary hypogonadism never find a definitive cause to their low FSH and LH regardless. I do not fear TRT, I know it gives many their lives back and hopefully I am one of them. I know men much younger than I have had to go on TRT and have had great success. Hell I know guys way younger than me that have straight up abused steroids hardcore and came down from them and lead normal lives. I am not however opposed to alternate routes of increasing my T levels.

Also thank you for the article on cortisol management Kelkel. I will be looking into possible adaptogen supplementation. I'm a high stress, tightly wound individual in general. I could definitely use it.

[kelkel]

60 years of injecting may get pretty old. Seriously consider making every effort to find a root cause. Hell, even vitamin D3 supplementation will increase your Free T in and of itself as an example of one simple change. Think about things. If you can clear up the issue and be normal for another 20 years wouldn't it be great!

Good luck Rev.

kel

[bass]

Rev, I mentioned LH and FSH will shut down while on TRT, I was trying to tell you it's normal, and not to worry about it.