Need opinions on blood work results

[bethdoth]

I have been trying to find the right doctor to treat me but, it's not going well. I am retired military in North East Wisconsin so the Aurora health system is about it. My family doctor was willing to treat me and started me on androgel about 14 months ago. I used the gel for about 9 months with no change in total testosterone. Then I tried the patch for a month and I hated the patch and wanted to go to Endocrinology. The Endro doctor was a temp and was about 75 years old. He would treat me and wanted to try IM injections for 3 months. After 3 months hunting season was here and I went hunting for 2 weeks. When I returned it took about 3 weeks to get an appointment...so I had my last IM injection on October 24th and did not have this blood test till December 7th. The new temp doc at Endro is a young women that seems to be more knowledgeable but, now doesn't feel I need HRT. That is the quick overview.

I started at 326 total close to 2 years ago and after all this here is where I am
Total Testosterone 332 (300-890)
Sex Hormone BNG GLOB 29 (11-80)
Testosterone, free and Weakly B 181 (131-682)
Testosterone, free 64 (47-244)
% Free Testosterone 1.9 (1.6-2.9)
PSA .33 (.01-4.0)
PROLACTIN 6.2 (2.1 - 17.7)
LH 5.6 (1.5-9.3)
FSH 4.6 (1.4-18.1)
TSH 2.305 (.350 - 5.000)

Other stuff
Sodium 137 (135-145)
Potassium 4.6 (3.4-5.1)
Chloride 102 (98-107)
Carbon Dioxide 24 (21-32)
Anion Gap 16 (10-20)
Glucose 124 (65-99) High
BUN 24 (10-20) High
Creatinine .98 (.5-1.3)
Calcium 8.8 (8.4-10.2)
Total Bilirubin .4 (.2-1.0)
Protein 7.2 (6.4-8.2)
Globulin 3.0 (2.0-4.0)
A/G Ration, Serum 1.4 (1.0-2.4)

Ok so I have an appointment with her Monday at 4PM to try and convince her to treat me with Sub Q injection twice a week starting at 50Mg each total 100Mg a week. Her arguement seems to be that my Testicles are still producing testosterone and she doesn't want to shut them down and also the shrinking of the testicles.
I forgot to add I am 52 years young workout 3-5 times a week (depends on life that week) weigh 204 and have a muscular build because I have been working out since 1988.

I guess would like input on if I should pursue HRT with these numbers and if so what could I use to convince her other than I don't like night sweats, tired in the afternoon, no interest in sex etc etc...
Thanks in advance.

[SD3000]

Im having a hard time finding a knowedgable DR too so I feel your pain. Maybe you can explain to her that using an HCG would prevent your HPTA from shutting down?

[bethdoth]

I was really surprised when she said no to HRT. She is young, just completed her internship. I would have thought she would have been knowledgeable and up to date on HRT. I plan to print a few things from this site and try to convince her. I really don't want to do this without doctor supervision and frequent labs. My goal would be to get into the 600's and see how I feel.

[steroid.com 1]

Welcome to the forum rhoag.

First, did you read the stickies at the top of the forum?

These are very important so you can not only talk to your Doctor about proper treatment but to manage your own health.

You understand Testosterone injection protocol and twice weekly SQ injections would be ideal.

You will be shut down that's why we add in HCG to keep the testicles functioning properly (read the sticky on HCG).

Also, need to test in about 6 weeks for E2 and Testosterone serum levels.

Like you said, you may want to print out some of the stickies and highlight key facts so you can discuss with the Doc at your appointment.

As per your blood work, you are low like in the range of a guy nearing 80.

You are a candidate for TRT no doubt.

You are missing some key labs, see the sticky on Finding a TRT Doc written by kel and you will see the blood work you need.

Go in there armed with knowledge and you may get just what you need. If not, tell her you will fly to see the specialist who will put you on the right protocol...that may have to be one of your options given where you live.

My Doc would only need to see you once a year and that's it; everything else is done virtual.

[kelkel]

Your in charge of your health rhoag. Be proactive. Listen to GD.

Welcome to the forum!

kel

[bethdoth]

Thanks for the reply Gdevine I have been lurking and learning on here for awhile now and i have read all the sticky's. I do plan to try and be political yet educate the young lady (aka Doctor) and try to get what I want. I will also print the recommended labs to show her as well. I hope that she will see that I take really good care of myself and am not looking to a body builder. Maybe she will see that I just want to feel good, look good and enjoy my life. It really sucks when I crash everyday about 1-1:30 and then have to really force myself to go to the gym and workout. There are times that I am yawning when my heart rate is in the 150's on the elliptical!
When all of this started about 5 years ago I did the sleep study and they said nope no problem, then I went and had my deviated septum fixed to try and reduce my snoring and maybe sleep better. Nothing worked. When I first started the adrogel I felt good for a while even though my numbers didn't go up? Maybe it was in my mind? Anyway thanks and great site very educational.

[bethdoth]

After reading the sticky about blood work again, it looks like I need to slow down on the protein a bit. I'm 5' 10" and was at 208 now 201. I would like to get leaner and drop down to 192-193 so I have been cutting simple carbs and eating a lot of protein.

[bethdoth]

Another question before my appointment today. When I was in the Navy overseas I was exposed to Hepatitis B so they gave me a shot since I was exposed. This shot was basically Hepatitis B and I can no longer donate blood. I have read here that I should donate blood to keep my RBC, Hemoglobin and Hematocrit in check, since these level go up while on TRT, you risk getting stroke or heart attach.

Should I be concerned about this if my goal is just to get up into the 600's?

[steroid.com 1]

No.

There are places who will pull your blood and destroy it...and why the 600's and not the 800's?

[bethdoth]

I thought 600's would be a good safe starting point to see how I feel. My appointment went good and bad. The doctor is fresh out of school and I think still reading books all along the way. She said there is no set treatment for me because technically I am in the normal range...just on the very low end. She agreed to write a scrip for 100mg test cp weekly (which I will split) but said she had no idea about HCG so wouldn't prescribe it. I have to try and find a different doctor. She will be gone mid January and another temp Urologist will be there. I have labs ordered for 5 weeks. Can I go 5 weeks without HCG and then get the labs and talk to the new doctor that may be better, or should I just look for a new doctor?

[steroid.com 1]

Send her the sticky at the top re HCG and Pregnenolone see if that will do it...it just might.

Also, is she monitoring E2 and willing to prescribe an AI in case it's elevated?

You can go 5 weeks without HCG or simply buy it from one of the better research sites and self administer...it's a very safe peptide and a lot of members here do just that...but try the email first and see if that gets you anywhere.

[bethdoth]

I used microsoft word and copied/pasted the sticky's into it then added what I felt was important to my case at the top. I made 2 copies so that I would have one and her when we discussed it. She didn't even look at it. When I asked her about checking my E2 she said you wouldn't look like that if you had elevated Estradiol. I just feel she is to inexperienced to vary from the book. It was like she was trying to pass me off because she said a few times that I could seek a second opinion. I'm going to see if Theda Clark (different local hospital) has a doctor that knows anything about HRT.

[bethdoth]

So this doctor never ceases to amaze me. I go to pick up my prescription last night and it is 100MG/ML vise 200MG/ML. The temporary doctor that was there before prescribed the 200MG/ML so to inject 50MG was .25 or 1/4 of a 1ml syringe twice a week vise .5 or 1/2. I called and asked her to change it because it would be less oil, easier to draw up and inject. She said no she prefers the 100MG/ML and again I could seek a second opinion.

Is there any benefit to using the lower concentrated Test? Or is she just a dumbass?

[bethdoth]

Ok so after years of trying to get my testostrone up it's finally there. Interesting how one change finally did it. I did 6 weeks of subQ 50mg e3.5days in my belly fat and it went from 304 to 394. Then I did subQ 75mg e3.5days in what little fat I have on my thighs for 6 weeks and it went from 394 to 826. I guess there is no reason for me to go IM which would have been my next step.

Below is my lab results the doc says lipids are bad and maybe reducing T would improve this? I workout a lot cardio most morning lift most afternoons, eat nothing but protein pancakes, fish, tuna, chicken, brown rice, green veggies, a few hardboiled eggs and liquid egg whites. BF% is down in the teens or lower.

Anything glaring that you guys might see and recommend I change?Attachment 134783Attachment 134784Attachment 134785Attachment 134786Attachment 134787

[bethdoth]

Hummm Estradiol 52 this is high?

[steroid.com 1]

I wouldn't take a statin with your HDL and LDL labs, they are not that bad.

Read up on Statin side effects and you will see.

Try Red Yeast Rice and get the best fish oil you can find and start those as soon as you can. Red Yeast Rice works like a natural statin and worked for me.

You need an AI to get your E2 down...it's a bit elevated.

Total looks excellent.

You're getting close.

[bethdoth]

Man am I glad you jumped in here to help...I feel a bit lost right now. I have the HCG figured out but what about an AI? I was thinking of using Liquid Exemestane 30ml @ 25mg/ml. Is this injectable? Or is it a liquid you just add to something????

I will see if I can find red yeast rice and start researching what fish oil is best. Currently use megared. I don't know why HDL/LDL's are bad. I workout atleast once most days twice a day cardio AM and lift PM. I eat well!

Do you feel that T will go higher if I continue 75mg e3.5 days and add HCG? If so would you reduce to say 60mg e3.5 days and then do labs in 6 weeks?

[steroid.com 1]

24 hours after each injection start with .50mg of the AI. Retest E2 in 6 weeks.

[Trific]

Bet life is better in the 826 area, HCG could bump that a bit higher, your 150mg/week could be a little strong...guess only time will tell.

[bethdoth]

I am learning slowly here ...which sucks, since there are no good doctors in the area. I was just reading this article about HCG http://bodybuilding.************.com...s-bodybuilding So I thought I would go look at my LH that was only tested twice. If I would have looked at it sooner I would have started on HCG sooner, since it dropped like a rock once I started injections (subQ). I have not had any pain in my testicles and it appears that I am still producing the same amount of sperm as before, the sperm count doesn't matter because I had a vasectomy many years ago.

[AnabolicDoc]

I wouldn't take a statin with your HDL and LDL labs, they are not that bad.

Read up on Statin side effects and you will see.

Try Red Yeast Rice and get the best fish oil you can find and start those as soon as you can. Red Yeast Rice works like a natural statin and worked for me.

You need an AI to get your E2 down...it's a bit elevated.

Total looks excellent.

You're getting close.

Interestingly, red yeast rice works bc it has monacolin K which is identical to lovastatin. Lovastatin, now generic, was originally marketed as Mevacor. Bc of this the FDA made a decision to place limitations on red yeast rice basically prohibiting them from containing monacolin K (lovastatin) which is what allows it to improve lipid profile. As such the monacolin content of red yeast rice is highly variable and minimal in most preparations. The brands that do have significant amounts of monacolins are the target of FDA action. Bc of this I would suggest taking a prescription statin over red yeast rice. I also think niacin is a better alternative if you can tolerate.

If you decide to go the niacin route, start at 250-500mg every night of a time released preparation and increase by 250-500mg every month as tolerated. The most common side effects are flushing (sometimes accompanied by itching and palpitations), GI upset, and muscle cramping. Most ppl can tolerate the flushing or significantly minimize it by taking a baby aspirin 30 minutes prior. The muscle cramping causes many to discontinue use.

[cornfedboy2000]

I hear you as far as "no good doctors in the area" I'm in Oshkosh and I'm finding the same thing. Going to my urologist today to ask for more labs and talk to him about hcg etc. Would you mind me PMing you and swapping notes some time? I'm at the beginning of this whole thing and wouldn't mind a local touch stone.

[bethdoth]

Welcome cornfed, I am in Appleton (darboy) I don't think you can receive PM until you get 50 posts but you can e-mail me at rhoag at northeast wis roadrunner I think you know what the address is. I am seeing Dr Kennedy at Baycare in Green Bay. I thought he might be good because he actually does the pellets and manages a few guys but, after he read my last lab and his only suggestion was to get on Statin....well that just didn't give me a warm fuzzy.

I am struggling a bit, finally got my T up and I felt great while it was coming up but for the last 2 days have felt a little tired. I'm blaming the high E2 but, it could be this depressing weather! I ordered HCG and an AI last week and am still waiting. Is a good AI something I can buy locally? Finally got my bodyfat re-checked yesterday and I have went from 208 26.4% BF down to 193 and 17% in 9 weeks.

[cornfedboy2000]

well, I'm sure I'm not breaking any rules by saying that locally there aren't any places to get an AI unless prescribed. I know a few places with some knowlegable people. Nutrition Supply Company here in Oshkosh is pretty good. They also have a ton of supplements (protein, vitamins, natural cooking items, etc) at really great prices. I'm seeing Dr Anderson down here at Urology Associates of Wisconsin. They are affiliated with Theda, so they are in my plan. He might be coming around, I talked to him today and he seemed to be relatively open to new info, although he seemed a little sketchy when I brought up hcg. I'll know more when I go back for my next check up. I'll get my lab results and see where I'm at and go from there. That's why this forum is so good, lots of info, my head is still swimming. Good job on the weight loss. I am about to get back to a semi-regular workout finally. I've been doing physical therapy for a few months, and I'm not really getting anything out of it anymore, and I hate the 20th st YMCA. I'm gonna continue my own strengthening routine and stretching at the downtown Y, which is much more my style of gym. I'll still be very limited because of my leg, but at least I'll actually WANT to go and that should help me get back, or at least start... I've got a long battle ahead. Fighting my severely injured leg, drastically low testosterone, extreme weight... but we can't stop fighting right? Again, congrats on your gains... I hope to be joining you soon.

[bethdoth]

What are symptoms of high E2? I have been having bad night sweats and feeling tired all week with no energy when weight training. Tuesday was my scheduled no workout day so I always reduce carb intake a bit by not eating brown rice with my lunch at about 1PM. I thought maybe I just haven't taken in enough carbs. So yesterday I ate double the carbs I normally eat and then today I feel like I need a nap at 7AM? I did my normal fasted cardio Fri, Sat, Sun, Mon and Wed with weight training in the afternoon on Fri, Monday and Wed. There are 2 other things that are different. I started mixing up my cardio with 25 minutes elliptical and 25 minutes running on the treadmill vise just doing 50 on the elliptical and I joined a challenge at the gym to do 200 squats, 100 sit ups and 65 push ups every day, so those have been added ( did double on Wed ).
My HCG and AI should arrive today so that I can start them. I hope that gets me back to the high energy levels I had when I was going from the 394 up to 842?

added after research: After reading tons of different threads I have another question. Since the AI I ordered Liquid Exemestane says this "Exemestane (Aromasin) is an aromatase inhibitor, which means that it lowers estrogen production in the body by blocking the aromatase enzyme, the enzyme responsible for estrogen synthesization." will it lower my current E2 of 52 or just block more creation of estrogen? Do I need something else to lower the E2 and then block more production?

[Brohim]

rhoag most guys on TRT use Armidex because it last longer than Aromasin. Aromasin has short half life but it will work - I think you need to take it ED or EOD. You can start taking 5mg per day or EOD and see how you fair. Ask your doctor to get you some Armidex.