Blood test results - where to from here - advice please..

[johnhenry]

Hello all, I am wanting to ask the advice of the experienced people here. I hope this post is not too long, but there is a fair bit of info which I hope is understandable. I posted earlier, but maybe the data was not easy to read. I am from Australia, so not all blood markers available c/f US.
Date (blood tests) 28 Nov Units = = Ideal
Lutenizing Hormone 2.7 U/L (Ref range 1.0 - 9.0)
Progesterone 0.7 nmol/L = 0.2ng/ml 0.27-0.9ng/ml
Oestradiol 139 pmol/L = 58.7pg/ml 15-30pg/ml
Testosterone 14 nmol/L = 410ng/dl 600-800ng/dl
SHBG 44 nmol/L 10-30nmol/L
Free Testosterone 231 pmol/L = 63.5pg/ml 140-200pg/ml
DHEA-S 4.6 umol/L = 95.2ug/ml 500-600ug/ml
Cortisol 208 nmol/L 200-700nmol/L
Platelets 127 x 10^9/L Ref range 140-400
Lymphocytes 5.52 x 10^9/L Ref range1.00-4.00
Free T4 10 pmol/L Ref range 7.0 - 17
Free T3 4.8 pmol/L Ref range 3.5 – 6.0
TSH 1.8 mU/L Ref range 0.3 – 4.5

Background:
Age: 58 Height: 179cm – 5’10.5” Weight 79kg = 174lb BMI = 24.5 Carrying a slight bit of fat (maybe 1 kg – ie. 2 lbs) on belt line which is hardly noticeable, but would like to have none – that bit is very hard to shift, and maybe produces some aromatase enzyme….it would go with a two day fast but it seems to return all too easily.
Diet – along paleo lines ie. minimal carbs, sugar, dairy, grains and trans fats. Eat salads, good oils (olive, krill), a little fruit, beef, lamb, etc and periodic fasting to maintain below 80kg
Exercise three times/wk including strength trg (push ups, pull ups, chin ups) and have reasonable muscle definition. Would be in better shape than most men my age I think.
Symptoms – low libido and pe*is sensitivity is not what it used to be – takes a fair while to climax - EQ lacking - married three months ago to a lovely, supportive wife (need 30g of well known V for reliable performance), some brain fog at times, sore joints on some days, bit slow to recover from exercise, skin thinning, sometimes don't sleep well.
My GP (doctor) is a good doctor, but is unfamiliar with successful TRT protocols – so very reticent to prescribe. However, he has agreed to work on this together. I have tried every natural approach – see www.boostyourlowtestosterone.com – Mark Wilson promotes good diet, high intensity exercise, not carrying extra weight etc – which I totally agree with – but when come to the end of that approach & still have unreliable erec*ions & low libido, what then?? So here we are..

Interpretation: (my relatively uneducated)
LH levels look low – not instructing testes to make more T (why?)
Total T low. SHBG high. & Free T low (one half to one third of ideal range). E2 higher than ideal also.
DHEA-S very low. Thyroid looks okay. My doctor is happy enough with these numbers.
Cortisol low, and has been low for a long time.
Platelets lower than ideal and lymphocytes higher than ideal – indicating liver not cleaning out blood debris as well as it should be – not sure why..would like to get to the bottom of this too. Consuming raw beetroot twice a week to aid liver function. Question - will T esters put extra load on the liver to eliminate it?
I have not been in a hurry to start TRT, as once you start it seems you are in for the long haul. But I do want to have good health, vitality and libido without taking unnecessary risks. Comments very much appreciated.

[steroid.com 1]

Ok, let's take a shot at this and see what we have;

Date (blood tests) 28 Nov Units = = Ideal
Lutenizing Hormone 2.7 U/L (Ref range 1.0 - 9.0)
Low but not surprising given your age; fairly common.

Progesterone 0.7 nmol/L = 0.2ng/ml 0.27-0.9ng/ml
Fine


Oestradiol 139 pmol/L = 58.7pg/ml 15-30pg/ml
Oestradiol is Estradiol and you are through the roof! No wonder you have ED problems and Viagra. Elevated E2 at this level can cause of number of significant health issues like cancer and cardiovascular disease. Additionally, being produced by your testosterone being converted into E2. I urge you to read the sticky at the top of the forum on Estradiol and Management; it will telly much. Nevertheless, this needs to come down as soon as possible. You will need to be prescribed an aromatase inhibitor...don't wait, this is one of your biggest problems and it will correct a lot of other things hormonally once in the optimal range.


Testosterone 14 nmol/L = 410ng/dl 600-800ng/dl
Tanked and probably due to two things: 1) just age related androgen deficiency and 2) increased levels of aromatase enzymes converting this into E2...read the sticky.


SHBG 44 nmol/L 10-30nmol/
High and it's making matters worse; what ever Testosterone you have is being bound up by SHBG making the little testosterone you have useless. This needs to come down as well.


Free Testosterone 231 pmol/L = 63.5pg/ml 140-200pg/ml
What's the 231 pmol/L??? Looks like your Free is 63.5 pg/ml which would be consistent with your other labs and elevated SHBG. Really very low and concerning to be honest.


DHEA-S 4.6 umol/L = 95.2ug/ml 500-600ug/ml
Start supplementing with 100 mg of micronized DHEA pills for 4 weeks than go to 50 mg each morning. This is tanked as well and probably age related.


Cortisol 208 nmol/L 200-700nmol/L
Fine.

Platelets 127 x 10^9/L Ref range 140-400
Lymphocytes 5.52 x 10^9/L Ref range1.00-4.00


Free T4 10 pmol/L Ref range 7.0 - 17
Free T3 4.8 pmol/L Ref range 3.5 – 6.0
TSH 1.8 mU/L Ref range 0.3 – 4.5
Thyroid looks fine with what you have here. Would like to see Free T4 higher but nothing too alarming like your other labs.

You need to be on a complete and thorough TRT program including weekly injectable Testosterone, HCG injected 3 to 4 times a week and an AI to get you E2 levels down. Also, need to supplement with DHEA and Pregnenolone as well to back fill the pathways.

All of your symptoms are classic for what you are presenting with here and you need to find a Doctor who understands Testosterone Replacement medicine for men...sooner rather than later.

The quality of your life will change dramatically once you get on a good protocol and you'll wish you started 10 years earlier...trust me on that one

[bass]

nicely put GD. i would also recommend vitamin D3 at 10,000 iu ed, this may not get you where you want to be but i'll bet you'll feel much better than without. hCG mono therapy may do you good here, its worth a try first.

[Vettester]

With a total test serum at 410ng/dl, you're just mildly low, no doubt just a result of your LH being mildly low, which is the hormone generated by the pituitary on a negative feedback loop setup. As GD indicated, this is more than likely an age related situation. Being 58yo, it could be MUCH worse! At 40yo, my LH was 1.9 units if memory serves correctly, and my total test was in the low 200's.

Agree with GD about the estrogen issue you have. This needs to get under control! Follow what GD mentioned on the sticky and the need to seek out an AI script!

In the interim, get yourself on some Vitamin D; probably at least 5,000iu/day if not more. I'll bet you a shrimp on the bar-b that your Vit D is tanked, and it's contributing to your increased SHBG. Possibly also look into a little Nettle Root in combination with the Vitamin D, and wah-lah, you will see your SHBG come down, and your free/bio testosterone go up.

[johnhenry]

Thank you guys, really appreciate your excellent feedback. GD, the 231pmol/L was the free T test result from the lab here in Australia, which is the same as 63.5pg/ml if my conversions are correct. Ideal range is 140 - 200pg/ml Re the Vitamin D3 - I am in the sun quite a bit, so would that cover it? I have read the sticky on hCG & will print it out for my doc - seeing him tomorrow.

[kelkel]

There is really nothing left to be said. You got great answers from some of the best board members here johnhenry!

Get yourself straightened out and let us know how you do!

[johnhenry]

GD, I have a few more questions, but the spam filter will not allow the post - must be ultra sensitive. Is there another way I can run these things past you?

[steroid.com 1]

GD, I have a few more questions, but the spam filter will not allow the post - must be ultra sensitive. Is there another way I can run these things past you?

Yea, get 44 more posts and than you can IM me

Not sure why you can't get your questions posted...try again or let me know what the spam filter says and I will talk to admin...he's a big fan of our forum and only wants what best for our members.

gd

[johnhenry]

Sorry, but your POST was denied for the following reasons:
**SPAM SOFTWARE** New posts by Registered Members with LESS THAN 25 Posts are not allowed to submit URLs or use forbidden words which are commonly used in spam posts.
We apologize for the inconvenience of our "Spam Software" and hope you understand.
Hit the BACK BUTTON and Try Again

[johnhenry]

Thanks Bass - I am in the sun a lot with my profession. Would this cover the Vit D aspect, or supplementation still advisable??

[johnhenry]

Thank you Sir - I mentioned to Bass that I get a fair bit of sun - so Vitamin D was not something I was thinking about. Supplementation still advisable? It's not expensive anyway. I'll check out the nettle root. Thanks again. You guys are a big help in getting to the right place quickly. JH.

[bass]

Thanks Bass - I am in the sun a lot with my profession. Would this cover the Vit D aspect, or supplementation still advisable??

are you butt naked all the time under the sun?! LOL, I am sure you don't get enough sun to make enough vit. D. I live in Southern California and get lots of sun, but still had to take 10,000 ius to get my levels up to where they should be. of course BW will tell you where you sit with vit. D.

[steroid.com 1]

Sorry, but your POST was denied for the following reasons:
**SPAM SOFTWARE** New posts by Registered Members with LESS THAN 25 Posts are not allowed to submit URLs or use forbidden words which are commonly used in spam posts.
We apologize for the inconvenience of our "Spam Software" and hope you understand.
Hit the BACK BUTTON and Try Again

Ok, it's the spam filter; get more posts and you'll be able to post links.