Latest Blood Work

[ZenFitness]

Finally found a doc who would let me write my own blood work order (although he thinks most of this is not needed, only the total test and the non-sensitive E2). This is the same doc that put my on 0.5mg of Arimidex daily without blood work, so I don't think I'll be back. I only took that much every day for five days a few weeks before this blood work... I take 0.5mg once a week now. However, I have a much more comprehensive look at various levels than I have previously.

This blood draw was done the day prior to my testosterone shot. This doctor is not going to care about the sensitive E2, but I have both results below.

Comments are appreciated.

CBC:
WBC: 6.1 (4.0 - 10.5)
RBC: 5.09 (4.14 - 5.80)
Hemoglobin: 14.9 (12.6 - 17.7)
Hemocrit: 44.7 (37.5 - 51.0)
(all other CBCs were dead center in range)

Lipids:
Total Cholesterol: 200 (100 - 199) (High, runs in my family even though my diet is clean and I work out at least four days a week)
Triglycerides: 94 (0 - 149)
HDL: 70 (> 39)
VLDL: 19 (5 - 40)
LDL: 111 (0 - 99)

Salivary Cortisol: 0.019 (0.010 - 0.090)
Progesterone: < 10 (< 10 - 11)
Free Progesterone: < 0.24 (< 0.42)
Testosterone: 682 (348 - 1197)
Free Testosterone: 12.62 (5.0 - 21.00)
DHT: 54 (30 - 85)
DHEA: 242.4 (88.9 - 427)
Prolactin: 9.2 (4.0 - 15.2)

This one is interesting
Estradiol: 21.4 (7.6 - 42.6)
Estradiol (sensitive): < 3 (3 - 70) (Obviously low)

IGF-1: 177 (69 - 226)

Vitamin D: 41.9 (30.0 - 100.0) (I do supplement Vitamin D about 4000 IUs a day)

SHBG: 49.1 (16.5 - 55.9)

[100%]

Great example of why a sensitive essay is important. Are your knees hurting?

[ZenFitness]

Not a bit. I've been a bit back and forth on erectile function (erections taking longer to get going), but I started hCG last week and that has improved significantly.

Prior to taking on the Arimidex, I did have soreness in my nipples with some tiny hard lumps. Both the soreness and lumps disappeared quickly after starting the Arimidex. I take 0.5 mg once a week now, and I just started switching my test injections to 2X a week of 50 mg instead of 1X a week at 100 mg to add assistance in keeping E2 levels in check.

My suspicion is that I did have high estradiol prior to the Arimidex but that I dropped it to the floor with the high dose. I'm a little confused on whether or not to stick with 0.5 mg after starting hCG last week. I'm thinking of trying to skip it perhaps.

Input/advice appreciated.

[100%]

You could skip it and get some Nolvadex (Tamoxifen Citrate). It will block the receptor gyno. But not lower your estradiol retest in 4 weeks see were you numbers are at. From what I have read it can take some time to recover.

[ZenFitness]

Does anyone have any studies, etc., to show that the sensitive E2 test is more accurate than the standard E2? I know it is a given around here - and the folks here are smart guys/gals, so I believe it - but seeing something (or better yet several studies) I could show to a doctor would help.

[100%]

In Dr. John Crisler's own words, and he's probably the leading expert in the field of HRT/TRT...


"A word about Estradiol ?Sensitive? Testing

Unless your Doctor specifically requests a ?Sensitive? assay the lab will default to the standard Estradiol assay designed specifically for women, which is useless for men. The reason for the difference between the two assays is the bell curve from which the test was designed sits within the ?normal? range for women and not men.

Therefore, the hormone concentration range appropriate for adult men falls on the flat slope of that bell curve making it completely inaccurate for testing men?s E2 serum levels. Always, ask for the ?Sensitive? assay when your Doctor is conducting a blood test and testing for Estradiol."

He goes on to say that a reading from the "standard" Estradiol test could show much higher levels of Estradiol/Estrogen than the patient actually has..."

Which could lead to the unnecessary prescribing of a very powerful aromatase inhibitor such as Arimidex/Anastrozole when it actually isn't even necessary.

Hope this helps.

[ZenFitness]

Can anyone comment on my DHEA, DHT, Vitamin D, and SHBG levels?

[kelkel]

You could skip it and get some Nolvadex (Tamoxifen Citrate). It will block the receptor gyno. But not lower your estradiol retest in 4 weeks see were you numbers are at. From what I have read it can take some time to recover.

Good advice 100%. Nolva will help with a possible spike and resultant issue when your E2 begins to climb. Retest in a month.

Can anyone comment on my DHEA, DHT, Vitamin D, and SHBG levels?

Like to see your DHEA higher IMO. Are you supplementing? DHEA decreases as we age. Use a micronized product.
DHT is fine. How do you feel? Range isn't that relevant with DHT. It's how you feel. DHT gets bad press it does not deserve.
Vit D. Add more daily as it will help to suppress your shbg. Stinging Nettle may help as well. Or avenacosides.
SHBG. Mid range is best. As test rises it suppresses shbg.

[ZenFitness]

Hey kelkel, thanks for the feedback. I don't supplement DHEA, but I will look into it.

Actually, truth be told, I'm a little nervous about DHEA as it's easy to find articles stating not to use it for long term use. Have you found anything to the contrary, or do you have any concerns with it?

[kelkel]

All meds should be used judiciously and monitored with BW. Even DHEA. Read the attached article as I feel it's a good one:

DHEA Restoration Therapy - Hormone Replacement, Cholesterol, Metabolized - Life Extension Health Concern

If you start, maybe go with 25mg daily in the morning. Micronized is best and micronized slow release even better. Keep an eye on your E2 as it can elevate it slightly. It's also good for lipids!

You can find articles that are negative to most all supplements. Remember, it declines with age.

[ZenFitness]

Thanks again kelkel... you always have some good input.

[ZenFitness]

kelkel, one more question. When you worked through some low E2 issues a year or so ago (I saw your posts from way back then), did you use the sensitive E2 test or the standard E2 test?

[Vettester]

You could always look at cycling in pregnenolone, which will have its own array of benefits, and will compliment the protocol with additional conversion downstream to DHEA. Truthfully, your DHEA is pretty good all things considered. 25mg as stated by Kel, in addition to a similar dosage of pregenolone would probably optimize that area.

You probably need to bump up your D3 dosage to 6K-10K/day. Or, talk with your doctor about getting on a script of Drisdol, which is a weekly dosage of 50,000iu. Getting your D3 levels up in the 70's or 80's will also positively impact your SHBG; possibly getting your level in the 30's. Your free & bio test would increase as well. Your free test is at 1.85%. Again, not all bad, but optimal would be in the 2% to 3% range, or right smack in the middle.

[ZenFitness]

Fantastic info, thanks Vettester. I'm actually seeing my PCP on Monday... I'll ask about the Drisdol.

How would you cycle the pregnenolone (or do you mean just add it into my protocol)? And would you cycle DHEA at all?

[ZenFitness]

Question on the Nolvadex - how would I know this is needed? What if I just quit the Arimidex... would I just wait for nipple sensitivity, etc.? Or should I ask my doctor for a prescription for Nolvadex?

[kelkel]

No need to cycle dhea/preg. Just add them to your protocol if you choose. A.M. dosing is best with these.

Always the sensitive assay. I can provide the proper labcorp codes if you don't have them. I take them with me every time I do BW as they can easily screw it up. The lab workers just aren't used to this one.

Nolva is a safety net here. If your E2 spikes up it can sometimes cause a bit of gyno if prone to it. Some need it, some don't. If you are less than 3 on a sensitive scale definitely stop the adex. If it were me I would ask your doc for a script for nolva and run it. It won't hurt you. Re-test your E2 in a month and make adjustments based on results. I tested mine about 3 months in a row to make sure I was on target.

[ZenFitness]

Thanks again kelkel. Would the gyno show up as sore nipples/breast tissue?

[kelkel]

It can start that way then palpable lumps can develop. Remember a little tenderness is not "always" a sign of gyno. Some people (me included) are just more nip sensitive than others.

[ZenFitness]

My doctor doesn't prescribe Nolvadex (in fact I'm not sure she knows what it is). She did say that I can go to the adex once a month instead of once a week if I want. I'm wondering if I do some kind of titration off instead of cold turkey if that would help? Right now I take 0.5mg a week, maybe back down to 0.25mg next week, then 0.25mg every other week, etc.?

She did let me bump my appointment for bloodwork up... I will get it at the one month mark after starting hCG (which is in about 2.5 weeks or so).