An Open Book

[sandrat62]

Gentleman, I have been a long time lurker on this forum, stealthly gathering information to use for my benefit. I have run into some road blocks along the way, but blindly kept marching on. But with the encourgement of my best friend (a member on this forum and the one to actually introduce me to this site) I have decided to come out of the woodwork to seek help from the experts on this wonderful forum.

Quick background on me. I'm 50 yrs old, 5'11" and around 234lbs. I work in law enforcement (so my hours are crazy) and I have a full household (four daughters AND a wife!).

Injuries I have include shoulder surgery , surgery on both elbows and lost my spleen in a motorcycle accident back in 2001.

Back in sept 2012 I had my standard blood work (feeling kinda crappy) so I asked for a testostrone test also.

Results:

Hemoglobin 14.8 12.6-17.7
Creatine, serum 0.86 0.76-1.27
Potassium, serum 4.9 3.5-5.2
Lipid Panel/ Total Cholesterol 254!! 100-199
Triglycerides 425!! 0-149 ( My Dr. advise a diet first then medication if that doesnt help)
HDL Cholesterol 55 mg/dl >39
Thyroxine (T4), free direct 1.19 0.82-1.77
Testosterone, Serum 345 348-1197
TSH 1.360 0.450-4.500

My doctor prescribed Androgel 1.62% (1 pump a day)
So I did that for about a month an got tested again

Testosterone, serum 592 ng/dl 348-1197

So I did a bone head move, more is better! So I upped it to 2 pumps a day..then weeks later 3 pumps....then 4 pumps a day
and thats when my nipples started to freak out on me and consequently at the same time was introduced to your forum by my friend. After reading and reading..AND more reading I realized I was messing up bigtime and that my Dr. really had no clue about TRT. So I took matters into my own hands and backed waaay down on the Androgel and introduced HCG into my regime. Things were looking better an my nips hurt less.

I went an got another labcorp blood test on my own to see how things look. It would mean the world to me if the experts could chime in an tell me what they think and how I can improve even better. Here are the ones I thought were the important ones ( plus those that are not in range)

Hemoglobin 15.5 12.6-17.7
MCV 102 79-07 high
MCH 32.0 26.6-33.0
MCHC 31.4 31.5-35.7 low
Neutrophils 35 40-74 low
Creatine, serum 0.88 0.76-1.27
Potassium, serum 4.5 3.5-5-2
Alkaline Phosphatase 28 24-150
Lipid Panel
Cholesterol, total 361 0-149 high (but lower that my last blood test)
Triglycerides 361 high ( but also lower that last test)
HDL Cholesterol 42 mg/dl >39
Thyroid Panel with TSH
TSH 2.900 0.450-4.500
Thyroxine (T4) 6.9 4.5-12.0
T3 Uptake 34 1.2-4-9
Testostrone, serum 693 348-1197
Free Testostrone (direct) 21.1 7.2-24.0
Thyroxine (T4) free(direct) 1.18 0.82-1.77
Dhea-Sulfate 133.4 44.3-331.0
PSA 1.9 0.0-4.0
IGF-1 92 59-201
Estradiol, sensitive 15 3-70
Triiodothyronine , Free, Serum 3.6 2-0-4.4

The protocol I have been on for this Blood test is as followed

Androlgel 1.62% 1 1/2 pump in the am and the pm
HCG approx 250 every other day.( ex; mon, wed, fri, sun, tue, thur, sat and so on)
Dhea 50 mg am (started 2 week prior to blood test)
Pregnenolone 50 mg am
Multi vit x1
Saw Palmetto x3
CLA 1000 1.5 g x3
Pro-Biotics x2 in the am
Glutamine 5gms x3
Glucosamine 1500 mg x2 am and pm
Triple Omega (fish,flaxseed safflower oil)
Medication: Lexapro 10mg x1 (antidepressent) but for me to help with my IBS

Well there it is, I hope it wasn't information overload, I just did not want to leave any stone unturned. Once again thank-you again for you time.

[kelkel]

Welcome Sand!

Copy and past this exact post in the HRT Forum so we can all talk about it there. Here is more just for introductions.

Glad to have you!

kel

[sandrat62]

Thanks!, But if I'm not in the right forum, I dont know where to go...

[MickeyKnox]

Thanks!, But if I'm not in the right forum, I dont know where to go...

Over here brother....and welcome.

HRT & Longevity, Wellness, Anti-aging Forums

http://forums.steroid.com/forumdispl...g#.UIEBm67X_fs

[steroid.com 1]

Welcome to the forum may seem odd I guess since you've been lurking so long.

Well, you've learned the first cardinal rule: More is not better!!!

Let's see what you have...I am only going to focus on the assays that matter to us most.


Lipid Panel
Cholesterol, total 361 0-149 high (but lower that my last blood test)
Triglycerides 361 high ( but also lower that last test)
HDL Cholesterol 42 mg/dl >39
Yes, these are on the higher side. Is it diet related? Don't take a Statin if offered to you. Generally diet and exercise will bring these down. Try adding Red Yeast Rice to your supplements as it acts like a natural statin.

Thyroid Panel with TSH
TSH 2.900 0.450-4.500
Thyroxine (T4) 6.9 4.5-12.0
T3 Uptake 34 1.2-4-9
Thyroxine (T4) free(direct) 1.18 0.82-1.77
Triiodothyronine , Free, Serum 3.6 2-0-4.4
TSH is a bit elevated, but you have a healthy Thyroid. Triiodothyronine Free is your Free T3 assay and is important. You are mid range which is nice, this is your bioavailable Thyroxine and we like to see it mid to upper range.

Testostrone, serum 693 348-1197
Free Testostrone (direct) 21.1 7.2-24.0
These look very nice to be honest. I like your Free value, you're living in a very nice place!

Dhea-Sulfate 133.4 44.3-331.0
Start supplementing with 50 mg of micronized DHEA and Pregnenolone if what you're taking now is not. and take in the morning every day. They are easy to find with a Google search.

PSA 1.9 0.0-4.0
Ok, but keep an eye on this. Anything over 2 becomes a bit of a concern.

IGF-1 92 59-201
A bit low but normal for you age. My Doctor would offer you HGH getting you much closer to 150 to 175. You may want to discuss with your Doctor...that is if you're Doc gets it which I believe he doesn't.

Estradiol, sensitive 15 3-70
A bit low, this is best in the upper 20's. I see you're not taking an AI so you must have a great liver! You can add some Flax Seed to your supps to get this up if you'd like.


Overall, you look great man...Congrats and good to see you participating...now don't stop

Peace.

gd

[sandrat62]

Thanks Gdevine for the quick and informative response. In regards to my psa results, I will keep an eye on that. Both my father and his brother got prostrate cancer in their early 60's. Another thing I'd like to ask is that I take a health supplement called DIM~Avail. It supposed to control or surpress some of the cortiol that is produced in the body. Could that supplement effect my Estradiol level? Thanks again

[jseek]

DIM is to control or lower estradiol. Not what you want I believe...per what gdevine just said.

[steroid.com 1]

Thanks Gdevine for the quick and informative response. In regards to my psa results, I will keep an eye on that. Both my father and his brother got prostrate cancer in their early 60's. Another thing I'd like to ask is that I take a health supplement called DIM~Avail. It supposed to control or surpress some of the cortiol that is produced in the body. Could that supplement effect my Estradiol level? Thanks again

I am not a huge believer in OTC AI's; that said, some men over respond to them and yes, it may very well be why your E2 levels are low.

Most men on a transdermal TRT don't need an AI due to the daily low dose use; serum levels almost never spike so aromitization activity is very low.

[kelkel]

Op, curious about your psa. Did you have sex or otherwise ejaculate within a day or two of your blood work? It will spike up your psa temporarily if so...

[sandrat62]

Gdevine, I will stop taking DIM~Avail and see what my Estradiol level is in 8 weeks when I have my next blood test. I want it in the 20's correct?
Kelkel, I honestly do not remember. I do know that I did not ejaculate with 20 hrs (which I thought was good enough). But within 2 days, I might of.
Could you recommend any supplement or foods that might help with prostrate health? Thanks again!

[steroid.com 1]

E2 in the 20's seems to be the best for most men...not all. It's a good place to be and see how you feel.

Many good supplements for prostrate health...look for Urinozinc.

[kelkel]

Cialis, Saw Palmetto, Stinging Nettle...

http://www.fda.gov/NewsEvents/Newsro.../ucm274642.htm

[dreadnok89]

i like higher E better than lower. keeps my sex drive and erections better. keeps my joints feeling real good as well. i know im getting higher E when the tops off my feet start killing me from water retention. i could be totally wrong just how i feel.

[sandrat62]

Funny you mention that...my "kickstand" has been kinda weak....

[sandrat62]

I have another question I would like to ask the expert. Not sure I can be given the exact answer because everyones different some absorbs Androgel better than others, but here's my question. The last time I applied it was 930pm Sunday and I had my blood drawn at 740 am monday (approx 10hrs) an my test serum was 693, could that mean that within the first couple of hrs that I applied the gel that night, my test serum "could" of been well in the 800+? Or am I getting this all wrong?

[steroid.com 1]

I have another question I would like to ask the expert. Not sure I can be given the exact answer because everyones different some absorbs Androgel better than others, but here's my question. The last time I applied it was 930pm Sunday and I had my blood drawn at 740 am monday (approx 10hrs) an my test serum was 693, could that mean that within the first couple of hrs that I applied the gel that night, my test serum "could" of been well in the 800+? Or am I getting this all wrong?

It depends upon how you absorb as you note; in theory your serum levels should be consistent throughout not just after you applied.

[DanMan250]

Most men on a transdermal TRT don't need an AI due to the daily low dose use; serum levels almost never spike so aromitization activity is very low.

Actually, I know of a number of men who were having real problems with high estradiol on the original formulation of Androgel, also known as Testogel in some countries outside the US. Some of these men made the switch to twice weekly shots with no AI rather than continuing on with the gel plus an AI. Androgel/Testogel has a lower concentration of testosterone in relation to the gel compared with the new 1.62% formulation, so it needs to be applied over a larger surface area of skin. These gels and compounded creams with a similar ratio of testosterone often elevate E2 too much because to be absorbed, they must pass firstly through the epidermis and then through the subcutaneous layer, which contains adipose(fat) tissue. Adipose tissue contains a lot of aromatase enzyme, which converts testosterone to estradiol. Often this leaves men with sub par T levels and elevated E2 levels.

[ctenosaura]

Interesting

[dreadnok89]

Hey danman, when i first tried androgel my test went from 190 to 883. My estrogen jumped up as well. Dont have an exact number. But i could def feel the bloat and my feet hurt from water retention and my nips were sore. My endo
said cause my test was too high. Even tho the range was 350 to 1250. I said the same exact thing you did and boy did she get pissed.

[steroid.com 1]

Actually, I know of a number of men who were having real problems with high estradiol on the original formulation of Androgel, also known as Testogel in some countries outside the US. Some of these men made the switch to twice weekly shots with no AI rather than continuing on with the gel plus an AI. Androgel/Testogel has a lower concentration of testosterone in relation to the gel compared with the new 1.62% formulation, so it needs to be applied over a larger surface area of skin. These gels and compounded creams with a similar ratio of testosterone often elevate E2 too much because to be absorbed, they must pass firstly through the epidermis and then through the subcutaneous layer, which contains adipose(fat) tissue. Adipose tissue contains a lot of aromatase enzyme, which converts testosterone to estradiol. Often this leaves men with sub par T levels and elevated E2 levels.

The bold is not true; the synthesis of Testosterone conversion to Estradiol via aromatization happens in the blood stream NOT within the subcuteneous tissue; while it may seem intuitive it is not.

While I will say some men may need an AI using transdermals, most do not as the daily dosage amounts are very low and providing for a much more consistent and stable serum level...more like a zig zaw pattern which mimics more youthful levels.

I will add that increases in serum DHT can happen in the subcuteneous tissues when using transdermals do to the presence of the enzyme 5-ar and why some men, like kel for instance, have to go the IM route.

[sandrat62]

Hello Gentleman. I am Back with the results of my most recent 6 week bloodwork. I am on the same protocol as last time, except for these
changes;
Vit D2- 6000mg
MICRONIZED dhea and preg
Tadalista(Tadalafil) 5mg x 2
REMOVED Dim-Avail (cortsol blocker) from my protocol

Some of the numbers look good, some not so good and are confusing ( this is where the experts come in..lol)

Also this will be my last blood test while on Androgel 1.6%. I will be starting IM Cyp in April. Im excited, but also very nervious. I mean I Have no problems with this current protocol and I feel really dialed in almost. It just had to do with convience and its just not that easy FOR ME to always shower an put the gel on twice a day.

Current BW 03-13-13


Hemoglobin 15.5 12.6-17.7
MCV 101 79-07 high
MCH 33.0 26.6-33.0
MCHC 32.7 31.5-35.7
Neutrophils 32 40-74 low
Creatine, serum 0.93 0.76-1.27
Potassium, serum 4.9 3.5-5-2
Alkaline Phosphatase 27 24-150
Lipid Panel
Cholesterol, total 202 0-149 high (but lower that my last blood test)
Triglycerides 341 high ( but also lower that last test)
HDL Cholesterol 42 mg/dl >39
Thyroid Panel with TSH
TSH 3.750 0.450-4.500
Thyroxine (T4) 6.4 4.5-12.0 (down alittle from last bw)
T3 Uptake 34 1.2-4-9
Testostrone, serum 794 348-1197 (up from last)
Free Testostrone (direct) 17.9 7.2-24.0 (down from last, whats going on?)
Thyroxine (T4) free(direct) 2-2 0.82-1.77 (up from last)
Dhea-Sulfate 129.5 44.3-331.0 (down from last..hell?. taking micro dhea from msm)
PSA 1.6 0.0-4.0 (down from last..yea!)
IGF-1 70 59-201 (down from last..whats up with that?)
Estradiol, sensitive 20 3-70 (up since I dropped that blocker..yea!)
Triiodothyronine , Free, Serum 3.5 2-0-4.4 (just slightly down)

Thank-you all, Matt

[Trific]

Maybe since dropping the Dim which let the E2 come up that affected other things like free T.

What kind of T dose are you planning starting April? Maybe 50mg twice a week?

Your TSH bugs me...wonder if you aren't going to need something like armour someday?

[sandrat62]

First and foremost, I feel pretty good! That being said doesn't mean something horrible isn't going on in my body. I know that my TSH is high..and higher than my last bw too. Could the latest bit of arsenal that I add contribute to this?..also if I had to pick the lesser of two evils isn't a higher TSH better than a really low one?
As far as how much cyp I take would 50mg x2 a week be "almost" the same as 1 an a half pumps of androgel x 2 a day 7 days a wk?
An can anyone tell me why they think my IGF-1 drop so much in 6wks?
Once again thanks all for your help

[ctenosaura]

100mg a week may be wee much, but may be a good starting point and then back down from there if needed.

[sandrat62]

Yes 100mg does seem high to start. Besides my other unanswered questions if someone could suggest a good dosage to start with for an individual who is going from an androgel routine to IM would be greatly appreciated. I know it will be a new learning curve for my body, but to avoided any unecessary hiccups would be nice!

[ctenosaura]

I would go .40mg or .50mg 2x a week. Then get bloodwork in 6 to 8 weeks. Although blood work shows some changes, nothing looks bad. If I'm wrong, may be one of the experts can chime in.

[sandrat62]

Ctenosaura- Do you think I should keep my HCG ritual (which is 250 ever other day) while I was on Androgel the same when I go IM?

[ctenosaura]

Monday wednesday friday would be fine