blood work help for nebie- finally can self inject!

[darkmatter22]

So ive been doing this since JUly 2012- Left my endo In January after we argued about hemoglobin and no HCG an found an anti aging clinic- I was going every week getting 200 mg of test cyp an then recently arimidex to lower estrogen- Now I know weekly isnt good I want to move inject every 3.5 days and I finally got HCG today an I finally got permission after 4 weeks of fighting to do self injects- Im looking for blood word advice and also advice on high hematocrit which again has my 2nd Dr concerned- BTW I donated blood 3.5 weeks ago. Just tell me what to do I have the testosterone I have the hgc whats the best protocol after seeing my blood an how can I fix my hematoccrit.

Im 38 212lbs active at the gym with weights and cardio eating better only the last 2 months an have come down 15lbs- After boot camp in the USMC the lowest weight I could be was 176 but 185-190 is a good weight for my size I always carry a lot of muscle.



139 FSH- 0.1( range 0.7- 11.1)
140 LH -0.10 (RANGE 0.8-7.6)
TOTAL TESTOSTERONE 915 (252-1052)
SHBG- 14 (16-94)
CALC FREE TESTOSTERONE 30.2 (RANGE 4.8-25)
146 TSH 3RD GENERATION-2.020 (RANGE 0.400-4.000)
ESTRADIOL <20 (RANGE <20-56)
3150 DHEA-266 (RANGE 120-520)
IGF-1 -238 (RANGE 132-333)
triglycerides 158 (range 11-150)
HOMOCYSTEINE SERUM 7.5 (RANGE 5-12)
196PSA -1.0 (RANGE 0-4)
WBC -6.1 (4.0-10.5)
HEMOGLOBIN 17.1 (RANGE 13.5-18)
HEMATOCRIT 53 (RANGE 42-52)
GLUCOSE -107 (RANGE 70-105)
GROWTH HORMONE <0.05 (RANGE 0-1)
PROGESTERONE -.38 (RANGE .27-.90)

[Trific]

I think your estradiol lab is not the ultrasensitve like they suggest to have here.

Maybe lowering your test dose is the best way to keep your hematocrit in range?

[darkmatter22]

Yes I have E2 checked 2 weeks ago it was an 86 I was prescribed amridex this blood work that I just got today wasnt the same estrogen test I got 2 weeks ago its just that < > then crap- I was thinking of doing 75mgs 2 x a week Im really hoping G can come on here an help me an give me advice like im 5 cuz Its hard to always understand what it all means- I also just ordered DHEA an Preg 2 days ago on G's advice - I think G and Kel are amazing an help so many ppl Ive always been a lurker but I have result I can finally self inject I finally got HCG which they showed me how to mix now I just need a protocol-

[Trific]

im really hoping g can come on here an help me an give me advice like im 5

lol

[steroid.com 1]

Let's see what we got here and welcome to the TRT forum.

139 FSH- 0.1( range 0.7- 11.1)
140 LH -0.10 (RANGE 0.8-7.6)
HPTA suppressed so these will be tanked, normal.

TOTAL TESTOSTERONE 915 (252-1052)
Nice. When did you do your injection relative to the draw?

SHBG- 14 (16-94)
Way too low! This is best in the mid-range and you are totally tanked. Your Doctor didn't say anything to you about this??? Having SHBG levels that are too low is usually associated with other medical disorders. Nowhere is the impact of low SHBG so profound as in the cluster of conditions known as the metabolic syndrome, which encompasses obesity, insulin resistance, lipid abnormalities, and chronic high blood pressure among other things. Low SHBG is also associated with elevated triglycerides and low-density lipoprotein (LDL)...do you have those labs? What's odd here is that SHBG chases exogenous testosterone and unless the 14 is a typo or lab error something is not right. You need to talk to your Doctor about this right away. You need to know if your low SHBG is a symptom of metabolic syndrome. Read: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004546/

CALC FREE TESTOSTERONE 30.2 (RANGE 4.8-25)
This is over the reference range do to the low SHBG, the low serum level of SHBG is freeing up more testosterone.

146 TSH 3RD GENERATION-2.020 (RANGE 0.400-4.000)
Fine.

ESTRADIOL <20 (RANGE <20-56)
Sensitive assay? If not, the default E2 lab will over estimate your E2 levels so if this says its <20 you could be even lower that what is healthy for you.

3150 DHEA-266 (RANGE 120-520)
Might want to add in 50 mg of micronized (SR) DHEA each morning, this assay is best at the top of the reference range.

IGF-1 -238 (RANGE 132-333)
Fine.

HOMOCYSTEINE SERUM 7.5 (RANGE 5-12)
196PSA -1.0 (RANGE 0-4)
WBC -6.1 (4.0-10.5)
HEMOGLOBIN 17.1 (RANGE 13.5-18)
Fine.

HEMATOCRIT 53 (RANGE 42-52)
There's only two ways to really get this down: 1) Give blood as frequently as you can, or worse 2) Halt your TRT protocol. Give more blood and take a baby asprin each day to thin out our blood as well.

GLUCOSE -107 (RANGE 70-105)
GROWTH HORMONE <0.05 (RANGE 0-1)
PROGESTERONE -.38 (RANGE .27-.90)
Fine.

You need to get on your SHBG issue as soon as you can. Something is amiss.

gd

edit: You don't have sleep apnea do you?

[darkmatter22]

Gdevine- I had the bloodwork last wednesday so my last injection was 1 week before at 200 mg of test cyp- SInce I am able to now self inject I will be doing it twice a week like I have been reading on here as a good thing for some time.

My SHBG is not an error- Its 14 I didnt see my DR today it was a nurse practicioner an she mostly spoke about my hematocrit I didnt notice the shbg till I asked for the BW an took it home to read myself-

also I have extra info my Lipid panel was as follows on this blood work:

Cholesterol 207 range 0-200
Triglycerides 158 range 11-150
HDL 46 range 23-92
LDL/HDL ratio 2.80 range 0-4.97
LDL cholesterole calc 129 range 0-129

And from your advice 3 days ago I order the dhea and preg from the website you listed in another topic-

And yes I have sleep apnea but im using a cpap machine for the last 4 months an have been feeling better then before I used to always feel tired but now I wake good an I used to fall asleep at traffic lights on my way to work and now I feel awake in the morning.

I know being overweight doesnt help for sleep apnea an what you stated earlier but ive been losing weight Im nnot at my goal an still have 25 lbs to go but im a 36 waist an been working out an doing cardio to get to my goals - My highest weight was 236.

[darkmatter22]

Gdevine- My shbg is not a typo its 14 an no the Dr didnt see me today the nurse practitioner did an went over a few things but we didnt touch on the shbg although I made them give me copies of my BW an thats when i noticed it was so low.

My last shot of test was 1 week before blood work-

I do have sleep apnea an I did a sleep study an got a cpap machine 4 months ago , my sleep has improved because I used always be tired and wanted to sleep all the time but now I wake up feeling rested.

I do have more labs as you asked:

Cholesterol - 207 range 0-200
Triglycerides - 158 range 11-150
HDL Cholesterol - 46 range 23-92
LDL/HDL ratio - 2.80 range 0-4.97
LDL Cholesterol calc - 129 range 0-129
VLDL Cholesterol calc - 32 range 5-40
Cholesterol/HDL ratio - 4.50 range 2.00-5.00

I saw the signs of metobolic syndrone- Im not obese i am however overweight im still 25 lbs over at 215 but I have a 36 waiste Im one of those very stocky types that has always had big shoulders thighs glutes etc.. In the marine Corps I was usually at 185-193- I have also been working out doing weights and cardio for 6 weeks now an have lost quite a few pounds being when I started I was 236.

I aslo order dhea and preg 3 days ago when I read what you wrote on the forum I ordered it from the same place you did- should get that soon- what do you think?

[kelkel]

Agree with my friend G and I'll add:

Reduce your T dosage slightly. It "should" allow a rise in shbg. Remember, the quickest way to suppress shbg is to elevate your test, so..... It'll help with hemo/hema as well.

Get the proper E2 sensitive assay asap. No need to fast.

Look into Slo-Niacin to help with cholesterol as well as Red Yeast Rice.

http://www.lef.org/magazine/mag2007/mar2007_atd_01.htm

Drink more water.

[darkmatter22]

Kel I had my E2 tested 2 weeks ago when I demanded it due to symptoms of either high or low estrogen- it was an 86 and the range was 12-52 i believe- since then I have take arimeix 2 x weekly to help control that and morning erections have returned but I believe going on a 2x a week schedule of test will help with e2 as well. I will decrease my test level injection by 50 mg an see how I feel an react with future blood work- Curious what GD thinks about what I wrote b4 about the sleep apnea an HDL numbers etc..

[steroid.com 1]

Dr. Gordon likes to add in 50 mg of Pregnenolone and DHEA as he believes it will increase SHBG as well.

Something tell's me that something is not right, you're SHBG is way way to low and it's one of the most critical hormones to keep you in homeostasis.

Do your research on sleep apnea and low SHBG and you will learn; I think it's your problem to be honest.

J Intern Med. 2003 Nov;254(5):447-54. Related Articles, Links

Endocrine effects of nasal continuous positive airway pressure in
male patients with obstructive sleep apnoea.

Meston N, Davies RJ, Mullins R, Jenkinson C, Wass JA, Stradling JR.

Department of Clinical Laboratory Sciences, University of Oxford,
John Radcliffe Hospital, Oxford, UK.

OBJECTIVE: Obstructive sleep apnoea (OSA) is a relatively common condition producing disabling somnolence and profound physiological responses to hypoxaemic episodes during sleep, including significant oscillations in blood pressure. This study aimed to provide controlled data on the interaction between OSA and endocrine axes to establish whether over representation of pathology such as hypertension and hypogonadism in OSA subjects might have an endocrine basis.


DESIGN, SETTING AND SUBJECTS: Parallel randomized sham placebo controlled 1-month trial of nasal continuous positive airway pressure (nCPAP) in 101 male subjects with OSA presenting to a respiratory sleep clinic.

METHODS: Analysis of gonadotrophins, testosterone , sex hormone binding protein (SHBG), prolactin, cortisol, thyroid stimulating hormone (TSH), free thyroxine (free T4), insulin -like growth factor-1 (IGF-1), renin and aldosterone were performed at baseline and after 1 month's active or placebo nCPAP intervention. Quality of life questionnaire scoring was also recorded over the same time period.

RESULTS: Testosterone and SHBG showed significant negative correlations with baseline OSA severity. Active treatment of OSA produced SHBG elevation and TSH reduction (P< or =0.03). Both groups showed an increase in aldosterone (P<0.001) and IGF-1 (P< or =0.03), associated with a large improvement in subjective quality of life scoring.

CONCLUSIONS: These findings demonstrate significant changes in endocrine axes not previously reported in a placebo-controlled trial. OSA is a recognized reversible cause of testosterone reduction; SHBG suppression correlating to baseline OSA severity supports a diagnosis of secondary hypogonadism. Significant rises in aldosterone and IGF-1 on treatment coincide with increased physical activity and an improved quality of life score.

Publication Types:

* Clinical Trial
* Randomized Controlled Trial


PMID: 14535966 [PubMed - indexed for MEDLINE]

[steroid.com 1]

^^^^Your Doctor doesn't know what he/she is doing.

[kelkel]

^^^

[darkmatter22]

I get the whole sleep apnea theory but ive been using a cpap machine for over 4 months so it has to rule that out doesnt it?

Would lowering my does to 75 mg of testosterone every 3.5 days help ? It would stop my high estrogen spikes an possibly raise my shbg-

Also I did some searching an some were saying dhea and preg actually lower Shbg is that true or misleading information-

If my dr doesnt know what he is doing then I want to know what to do- I think my new protocol of using 200 mgs of test every week which I started in January 29th lowered my shbg cuz I know my estrogen shot up to 86 -

Am i on the wrong path or does my thinking make sense?

[darkmatter22]

Im obviously concerned, and Id really like to understand and learn more, I feel like ive been reading on here for so long but now that this my actual blood work is out there and this is my actual problem Im unsure of the answers- I really respect your opinions esp some of you guys who have been doing this for so long and have thousands of posts on here so anything you think of in response to what i wrote would really be helping me out.

I havent been able to think or concentrate on anything else since last night when I first read GD;s response- I feel like I have more questions and answers.

[steroid.com 1]

Most standard blood work will have a diabetes eval. Do you have these labs: Hemoglobin A1C and Fasting Insulin .

[steroid.com 1]

What's odd about the SHBG assay is that if it is truly that low your Estradiol assay should be elevated...and it's not.

The fact that you have sleep apnea and low SHBG, even if you are being treated, is probably the most telling for the reason here.

Or...

As kel noted, your exogenous testosterone replacement is just tanking your SHBG serum level in which case, as kel recommended, you would need to lower your dose to help get that serum level elevated.

To put it into perspective, Dr. Crisler likes SHBG mid to upper range.

Make sure you are taking micronized Pregnenolone and DHEA every day...this will help as well.

[kelkel]

DM this will help educate you a bit more on shbg:

http://www.lef.org/magazine/mag2011/...-Status_01.htm

Problems arise on occasion. I'm dealing with one now myself. You'll get through it with a good doc and the guys here will help as well! Self-education is a great asset!

[Trific]

I get the whole sleep apnea theory but ive been using a cpap machine for over 4 months so it has to rule that out doesnt it?

Would lowering my does to 75 mg of testosterone every 3.5 days help ? It would stop my high estrogen spikes an possibly raise my shbg-

Also I did some searching an some were saying dhea and preg actually lower Shbg is that true or misleading information-

If my dr doesnt know what he is doing then I want to know what to do- I think my new protocol of using 200 mgs of test every week which I started in January 29th lowered my shbg cuz I know my estrogen shot up to 86 -

Am i on the wrong path or does my thinking make sense?

So if I have it correct, you took blood for BW a week after your last pin and right before your next pin. So that TT of 915 is a week long trough level....so it seems to me you could lower your dose considerably. So I think I would try going down to 150mg/week if not lower and I thought I read where someone with low SHBG should pin often, even as frequent as every day. You'll have to see what works best for you.

Lowering the T dose will help keep the E2 down and hopefully you don't crash the E2 too low. You will probably want to back way down on the armidex.

[darkmatter22]

Yes thats right I hadnt taken any test in week drew blood then got the injection - I took my first shot of hcg last night an im going to bring my shot down to 75mg of test every 3.5 days an im doing 200iu of hcg every 3 days although im thinking of doing everyday like I read on GDs HCG stickey-

Im waiting for the dhea and preg I ordered 4-5 days ago and Im also sending in the chip on my sleep apnea machine to make sure im not still waking up or having interuptions in my sleep- I did look at my olkd blood work from when i was with my endo an my cholesterol an tryglcerides were really high even before TRT so it may have been from the sleep apnea like the others said an now the high T is huring my shbg.

5/15/12 before TRT :

testosterone 129 range 250-1100
free testosterone 28 range 35-155
LDL cholesterol 176 range <130
cholesterol total 252 range 145-200
trigycerides 226 range <156


8/21/12 200mg test every 2 weeks:

testosterone 1084 range 250-1100
free test 285.5 range 35-155
ldl cholesterol 161 <130
cholesterol total 229 range 125-200
tryglcerides 469 range <150

I dont know what to make of all of this except my numbers are better on the lipids and my doctors are dummys an I have to take control of this myself cuz my endo never went over my tryglycerides or my shbg- never even tested me- After this test she just lowered me to 100mg of test every 2 weeks.

[darkmatter22]

GD on my blood work in May before TRT I had bloodwork to check my testosterone an others stuff here is what you asked for -

This wasnt a fast but my Hemoglodbin A1C was 5.9 ranges are as follows:

<5.7 decreased risk
5.7-6.0 increased risk
6.1-6.4 higher risk
> or= 6.5% consistent with diabetes -