8 Week & 12 Week Lab Work Update

I ended up taking things into my own hands after getting the runaround from my PCP and since I'm going to be 46 soon I just accepted I will be on TRT for life and that doesn't really bother me except for the fact that its possible I might have trouble getting Test C in the future unless I want to keep paying the high anti-aging clinic rates but I will cross that bridge when I get there.

Here are my 8th week and 12th week updates.

My first 8 weeks protocol per week:
Test C 120mg once a week Friday (initially 60mg twice a week)
500 IU of HCG twice a week Monday & Wednesday
0.5mg Arimidex Tuesday

Lab Results at 8 weeks:
Hematocrit 43.7 (37.5 - 51.0)
Eos (Absolute) 0.5 High (0.0 - 0.4)
BUN/Creatinine Ratio 27 High (9 - 20)
AST (SGOT) 95 High (0 - 40)
ALT (SGPT) 50 High (0 - 44)
Total Testosterone 775 ng/dL (348 - 1197)
Estradiol 56.5pg/mL High (7.6 - 42.6) Standard Assay
Doc didn't order Free Test

With what I have learned here on the forum I figured the EOS wasn't much of a concern just a type of white blood cell that was slightly elevated. With the BUN/Creatine I'm not sure but what got my attention were the liver enzymes. Two days before my blood work I was doing some construction work and I literally couldn't move my arms the next day so I figured that skewed the AST result because of muscle trauma. The ALT was a little high but not outrageous so after searching the forum I added NAC 1200mg twice a day to my regimen and have dropped it down to 1200mg once a day after 4 weeks on it. My doc thinks B12 Methylcobalamin 5000 MCG a day could have contributed to high AST & ALT not to mention I was loaded up on Ibuprofen 800mg twice a day.

As far as the Estradiol I decided to try 0.5mg Arimidex three times a week for the next four weeks. I know that sounds like a lot but it appears that I might be a hyper excreter so I decided to risk crashing my Estradiol. I initially was pinning Test C 60mg twice a week and actually enjoying the experience but out of nowhere I developed this bizarre physiological anxiety where my hands really started shaking although I didn't think I was nervous at all so I went back to 120mg once a week. I think I have perfected the art of pinning my quads with a 25g 1 inch pin after getting a blood spurt and hitting a nerve early on so I might try going back to pinning twice a week.

My 8-12 weeks protocol per week:
Test C 120mg once a week Friday
500 IU of HCG twice a week Monday & Wednesday
0.5mg Arimidex Sunday, Tuesday, Thursday

Lab Results at 12 weeks:
Hematocrit 49.7 (37.5 - 51.0) Getting High
Eos (Absolute) 0.4 (0.0 - 0.4) Back to Normal
Total Testosterone 1058 ng/dL (348 - 1197)
Estradiol 8.0pg/mL High (7.6 - 42.6) Standard Assay
Doc didn't order Free Test or Liver Enzymes WTH?

The biggest problem here is my doc didn't order my liver panels so I don't know what they are. I should probably get my own labs so I can get Liver Panels, Free Test, and Estradiol Sensitive. It looks like discountedlabs com is the best deal, is there a better option for labs and what labs do you think I should order? As far as the Estradiol being so low I could tell my joints have definitely been aching and I feel a little less energy so I am dropping Arimidex down to 0.5mg twice a week. Would the Hematocrit at 49.7 cause the drop in energy and should I donate blood since I'm getting close to the upper limit?

Thanks for looking at all of this, it really has been a lot of fun working through it and taking control of my health. My most recent addition as of this week has been adding in Liquid Cia at 9mg a day until I can get tablets but that is for another post.

What are you taking methylB12 for? I cannot see how it can elevate liver enzymes...

Hematocrit will quickly get problematic so you should consider phlebotomy or donating soon. If it stays there it might be unnecessary, but since you're approaching 50's I'd be extra cautious, talk with your doctor.

Your E2 looks just crushed and trust me you can account that for low energy. In the first reading it was probably just right due to standard assay overestimating levels. With bi-weekly pins, smoother peaks usually results in lower aromatization, the arimidex likely completely crushed oestradiol there; you probably needed just none of it.

A standard liver panels usually comprises AST/ALT only as these are the most useful markers, but there are many additional tests available - GGT, (in)direct bilirubin, ALP, albumin...

Started taking B12 mostly for neural support, I have had mild symptoms of MS in the past but not enough for doc to order and MRI.

I definitely want to get labs in about 6-8 weeks with Liver Panel, Free Test, and Estradiol Sensitive. I felt fine at 0.5mg Arimidex once a week so I might go back to that because it seems that I am a hyper excreter, 0.5mg Arimidex three times a weeks is way to much. My Total Test level did go from 775 ng/dL to 1058 ng/dL with 0.5mg Arimidex three times a week so it help raise my Test level. That doesn't really matter though if I don't know my Free Test so I really do need to get the Sensitive Assay done. I would rather have my Test at 775 and only taking 0.5mg Arimidex once a week.

I didn't post all my other liver panels as they were in normal range but this time around the doc didn't order them so I will get the labs on my own next time.

Ultimately I am working towards being able to be self prescribed and managing my own treatment with the help of the guys here on the forum so the next step is getting my own labs.

Good advice from Bizzarro:

Donate soon.

Don't see how B12 can cause liver issues.

Go back to more frequent dosing of smaller amounts. Drop down in needle size to a 25-28G 1/2 or 5/8 inch length. It will feel much better and less muscle damage.

Don't base any decisions on the standard E2 assay. Miss-information is worse then no information. Only use the sensitive (LC/MS/MS) test. Also, you dose of anastrozole is really high. Drop it down and base dosing on lab results with the sensitive test. I find that if you go with more frequent, lower dosing of T, you can get by on much lower amounts of anastrozole.

You can order just about any major hormone test from Discountlabs.com and pricing is about as good as it's going to get anywhere without insurance. They use LabCorp and you can get a standard CMP lab (liver & kidney function) for $32. You get a bunch of results, but I usually just look at the AST, ALT and Alk Phos results to get a good picture of liver function.

If you are resourceful and want to go it without a doc's script, T-cyp (or whatever form of T you want) is very easy to obtain through the internet. It's shipped from overseas pharmacies and the cost is highly competitive to even insurance covered rates in the USA.

You are not a hyper-excreter based on your labs.

Quote:

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Originally Posted by Justice4all

I felt fine at 0.5mg Arimidex once a week

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If ain't broken... don't fix it, as simple as that.

I'm not sure how you developed the idea you're a "hyper-excreter". You bloods tell otherwise. The liver is mainly responsible for sex hormones metabolism and yours doesn't appear to work optimally.

Quote:

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Originally Posted by bizzarro

If ain't broken... don't fix it, as simple as that.

I'm not sure how you developed the idea you're a "hyper-excreter". You bloods tell otherwise. The liver is mainly responsible for sex hormones metabolism and yours doesn't appear to work optimally.

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I totally hear you! After everything I have read on here and in Testosterone for Life & Testosterone: A Man's Guide I knew my doc was wrong but he insisted that the Sensitive Assay is overrated (Translation:they didn't want to pay for Sensitive Assay) and that I was a hyper-excreter so I gave him the benefit of the doubt. I thought who knows maybe I am a hyper-excreter and the way I felt at the time was fine but maybe I will feel even better if I get my Estradiol in range. Lesson learned and now that is one more thing I can move past.

I prefer to learn from others mistakes but I guess I just had to be sure on this. Next time I will get the Sensitive Assay myself and show him next time he wants me to bring my Estradiol down again.

As a side note, after experimenting with pinning my quads I finally found the sweet spot and I'm pretty sure most people that experience pain pinning the quads aren't pinning the right area. If my hands stop shaking so much I will go back to pinning twice a week and I'm sure I won't need Arimidex at all.

Thanks for your feedback!

Quote:

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Originally Posted by Youthful55guy

If you are resourceful and want to go it without a doc's script, T-cyp (or whatever form of T you want) is very easy to obtain through the internet. It's shipped from overseas pharmacies and the cost is highly competitive to even insurance covered rates in the USA.

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I'm still doing my homework on this and testing the waters but I don't want to rush it for the time being.

Quote:

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Originally Posted by Justice4all

I totally hear you! After everything I have read on here and in Testosterone for Life & Testosterone: A Man's Guide I knew my doc was wrong but he insisted that the Sensitive Assay is overrated (Translation:they didn't want to pay for Sensitive Assay) and that I was a hyper-excreter so I gave him the benefit of the doubt. I thought who knows maybe I am a hyper-excreter and the way I felt at the time was fine but maybe I will feel even better if I get my Estradiol in range. Lesson learned and now that is one more thing I can move past.

I prefer to learn from others mistakes but I guess I just had to be sure on this. Next time I will get the Sensitive Assay myself and show him next time he wants me to bring my Estradiol down again.

As a side note, after experimenting with pinning my quads I finally found the sweet spot and I'm pretty sure most people that experience pain pinning the quads aren't pinning the right area. If my hands stop shaking so much I will go back to pinning twice a week and I'm sure I won't need Arimidex at all.

Thanks for your feedback!

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That hand shaking crap happens to me every time I overdose AI, especially anastrozole, but also if I use none... it's annoying as f**k.

Your sweet spot in the quad is named vastus lateralis, or simply the outer quad. It's easy to locate. My %bf is low enough it is visible, no problem for me. It shouldn't hurt at all, remember to inject slowly. Also 1 inch needle is oversized, I use 25g 5/8, but will switch to 27g 1/2 soon.

Quick tip, im using 30g 1/2 pin to my glutes and works well, dont even feel the trace of it just slight pip some days later, if youre lean bodyfat these mosquito needles are very neat to use, PS - heat your oil well before drawing and dont delay injecting, to me its almost efortless while the oil is still warm, and its 30g pin :D

why dont you you try this one first, beforer donation:-)

gestion of grapefruit lowers elevated hematocrits in human subjects.
Robbins RC1, Martin FG, Roe JM.
Author information
Abstract

This study was based on in vitro observations that naringin isolated from grapefruit induced red cell aggregation and evidence that clumped red cells are removed from the circulation by phagocytosis. The effect on hematocrits of adding grapefruit to the daily diet was determined using 36 human subjects (12 F, 24 M) over a 42-day study. The hematocrits ranged from 36.5 to 55.8% at the start and 38.8% to 49.2% at the end of the study. There was a differential effect on the hematocrit. The largest decreases occurred at the highest hematocrits and the effect decreased on the intermediate hematocrits; however, the low hematocrits increased. There was no significant difference between ingesting 1/2 or 1 grapefruit per day but a decrease in hematocrit due to ingestion of grapefruit was statistically significant at the p less than 0.01 level.

PMID:
3243695
[PubMed - indexed for MEDLINE]

Quote:

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Originally Posted by bizzarro

That hand shaking crap happens to me every time I overdose AI, especially anastrozole, but also if I use none... it's annoying as f**k.

Your sweet spot in the quad is named vastus lateralis, or simply the outer quad. It's easy to locate. My %bf is low enough it is visible, no problem for me. It shouldn't hurt at all, remember to inject slowly. Also 1 inch needle is oversized, I use 25g 5/8, but will switch to 27g 1/2 soon.

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I'm going to switch to 27g 1/2 too. I think Kel had said it doesn't matter too much if it makes it into the muscle or subq for TRT.
I want to start pinning my delts too so the 27g will definitely be easier.

Quote:

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Originally Posted by InsaneMuscle

Quick tip, im using 30g 1/2 pin to my glutes and works well, dont even feel the trace of it just slight pip some days later, if youre lean bodyfat these mosquito needles are very neat to use, PS - heat your oil well before drawing and dont delay injecting, to me its almost efortless while the oil is still warm, and its 30g pin :D

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Thanks for the advice, I might try this eventually.
I'm going to go with 27g 1/2 for now.

Quote:

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Originally Posted by Silabolin

why dont you you try this one first, beforer donation:-)

gestion of grapefruit lowers elevated hematocrits in human subjects.

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That's pretty interesting, do you know if grapefruit has any affects on exogenous testosterone positive or negative?

Quote:

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Originally Posted by Justice4all

That's pretty interesting, do you know if grapefruit has any affects on exogenous testosterone positive or negative?

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No, but i doubt it, either way

Your HCT looks fine IMHO. Bun could have went up like that if you worked out a lot before your draw.

Things don't look too bad but your E2 looks a little high.

Hope this helps.

Please consult with your physician before making any changes to your program.

PS going from 0.5mg to 1.5mg a week might be a big jump, thats a non-sensitive essay so anything under 50 is good. Specifically low 40's for a non sensitive.

Quote:

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Originally Posted by Justice4all

Lab Results at 12 weeks:

Estradiol 8.0pg/mL High (7.6 - 42.6) Standard Assay

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Actually now that I look again your 12 week test shows your E2 is bottomed out. Not a good idea to do that. That number could actually be closer to 0 since its a non-sensitive.

Non sensitive essays were designed to test higher concentrations of estradiol in females, so when testing males you can usually assume its 10-15 points lower on a sensitive than it is on a non sensitive.

Quote:

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Originally Posted by IncreaseMyT

Actually now that I look again your 12 week test shows your E2 is bottomed out. Not a good idea to do that. That number could actually be closer to 0 since its a non-sensitive.

Non sensitive essays were designed to test higher concentrations of estradiol in females, so when testing males you can usually assume its 10-15 points lower on a sensitive than it is on a non sensitive.

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Thanks for the confirmation buddy and glad you're on board!

Quote:

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Originally Posted by Justice4all

I'm going to switch to 27g 1/2 too. I think Kel had said it doesn't matter too much if it makes it into the muscle or subq for TRT.
I want to start pinning my delts too so the 27g will definitely be easier.

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Correct. This is assuming TRT amounts only, not cycle amounts.