gyno and bloodwork, looking for informed opinions

[MJRuff01]

Non-steroid or any other drug prescribed or otherwise related. 36 years old.

quick background. Approx 7 weeks ago I noticed a signicant case of gyno focused mainly on my right side. I don't have any health insurance, but I do have a strong background in physiology. I scheduled myself some blood tests. I have not worked ou fro the past 20 months up until 6 weeks ago when I started a stringent workout and nutrition program. I gained a significant amount of weight, especially bellyfat in my time off, though I have always been thick in the belly,, through football, juco football, Army, etc...

Anyway here is my blood test results:

LH is on the very low end of normal 2.7 mIU/ML
FSH is below the normal range 0.8 mIU/ML
Total test is below the normal range 234 ng/dl
Free Test is in the very low end of the normal range 8.9 pg/ml
TSH is in the middle of the normal range 2.580 uIU/ML
estradiol is in the extreme upper range of normal 41.8 pg/ML
DHEA sulfate is in the upper normal range of 331.6 ug/dl


My thinking at this point is to get a script for Anastrozole (Armidex).

is there anything else I should get? I figure the Anastrozole should decrease the estradiol, increase the test, and increase the FSH.


Too add, my progress in losing weight is coming extremely slowly, but I am regaining my strength pretty quickly, even though I am focusing on cardio activity.

[zaggahamma]

usually extreme gyno is only reversable with surgery....if using chemicals i've heard letro can bring some cases back...

youre in the hrt section which we dont discuss a lot of gyno issues other than preventing possible high estrogen on some higher trt doses...you might get better info on another forum within the site...

as far as your hormones yes your test is low and your e2 is a little high...imo, i dont think an AI alone will give you otpimal hormone levels/ratios..

i was your age when i started trt with similar test levels however my e2 was quite normal to start..

best of luck bro

[SlimmerMe]

What was the range for your TSH?
I am a stickler when it comes to TSH results. Many docs/people have no idea how important it is to get that level low.
When reading TSH, it is read inversely. High levels mean low ( hypo) thyroid and low levels means high ( hyper) thyroid. So wondering if your range was 0.450-4.500....and if so, ideally you would want to get your level to under 2.....and we all know that hypo can add unwanted weight

I am speaking in IDEAL terms....and isn't that what we are all after? the fountain of youth?

[MJRuff01]

What was the range for your TSH?
I am a stickler when it comes to TSH results. Many docs/people have no idea how important it is to get that level low.
When reading TSH, it is read inversely. High levels mean low ( hypo) thyroid and low levels means high ( hyper) thyroid. So wondering if your range was 0.450-4.500....and if so, ideally you would want to get your level to under 2.....and we all know that hypo can add unwanted weight

I am speaking in IDEAL terms....and isn't that what we are all after? the fountain of youth?

thanks for the heads up regarding reading the TSH inversely. Yes the .450-4.500 was the range listed, but I just read that a better range where one should .300-3.000

[MJRuff01]

usually extreme gyno is only reversable with surgery....if using chemicals i've heard letro can bring some cases back...

youre in the hrt section which we dont discuss a lot of gyno issues other than preventing possible high estrogen on some higher trt doses...you might get better info on another forum within the site...

as far as your hormones yes your test is low and your e2 is a little high...imo, i dont think an AI alone will give you otpimal hormone levels/ratios..

i was your age when i started trt with similar test levels however my e2 was quite normal to start..

best of luck bro

I understand that to ultimately get rid of gyno it will require surgery, but was
a. Most concerned about the root cause

b. hoping to at least decrease the severity until I get surgery.

[pittbulldad]

letro is supposed to work if its newly aquired... i have a very mild case (i've had it since puberty) and when I take letro it seems much less noticeable...

[SlimmerMe]

thanks for the heads up regarding reading the TSH inversely. Yes the .450-4.500 was the range listed, but I just read that a better range where one should .300-3.000

You are correct. Most labs top the range at 4.5 which is why many docs have only been prescribing thyroid meds for anything over 4.5 for hypothyroid. But they now realize it should have a lower range. So the lower range you mentioned is slowly making it onto the scene....hope this makes sense!..and why I mentioned that getting under 2.0 is preferred and even a bit lower for a more ideal level..which is more in line with the newer ranges....

[flatscat]

Adex should mostly effect your free t.

[bass]

with test that low why not consider TRT at low doses and perhaps AI to aid with your estrogen levels?!

[BeastintheSheets]

As long as your test is that of an 8 year old boy you are wasting your time.

[MJRuff01]

with test that low why not consider TRT at low doses and perhaps AI to aid with your estrogen levels?!

Will most likely do that as well.

Surprisingly my strength has come back quickly. Took a 2 year break for lifting, and became very sedentary. I benched 300 the other day though, just 6 weeks after starting lifting again, and am focusing much more on cardio and circuit training, but am doing some strength training twice a week. I gained a significant amount of fat while sedentary, so my guess now is that my condition is very likely some kind of obesity induced hypogonadism.

[BeastintheSheets]

Obesity induced hypogonadism? lol

[MJRuff01]

Obesity induced hypogonadism? lol

not sure why you think it is funny? I just found the following;

What is the relationship between low testosterone levels and elevated estradiol levels in obese men? What is the impact of elevated estradiol?
Response by Adrian S. Dobs, MD

Obesity in men is associated with depressed levels of free and total testosterone and elevated levels of estradiol.1,2 In a vicious cycle, increasing abdominal obesity worsens hypogonadism, and without a compensatory gonadotropin response, hypogonadism worsens obesity. Worsening obesity is accompanied by increased aromatase activity in adipose tissue, rapidly converting testosterone to estradiol.

Low testosterone adversely affects overall health in many ways. Libido and sexual function are diminished,3,4 resulting in less sexual activity. Psychological effects of hypogonadism include depressed mood, decreased energy, and impaired cognition.3,4 Physical consequences are decreased bone density and higher risk of metabolic syndrome.2-8

The potential impact of high estradiol on men’s health includes an increased risk of cardiovascular disease, including stroke9 and lower-extremity peripheral arterial disease (PAD).10 Abbott et al found that men in the highest quintile of estradiol concentrations face a significantly greater risk of stroke even after adjustment for age and other cardiovascular risk factors (relative risk, 2.2; 95% confidence interval, 1.5-3.4; P<.001).9 The Swedish arm of the international Osteoporotic Fractures in Men (MrOS) study found that free testosterone independently positively correlates and free estradiol independently negatively correlates with lower-extremity PAD, as defined by ankle-brachial index.10 Compared with the general population, lower-extremity PAD is 3.72 times more common for men with both lowest-quartile levels of testosterone and highest-quartile levels of estradiol. Elevated estradiol levels have also been associated with risk for impaired cognition and dementia (ie, Alzheimer disease).11 Cognitive function declines over time with age but deterioriates significantly more rapidly in men when levels of estradiol are in the highest quartiles.

The Endocrine Society Clinical Practice Guideline recommends testosterone therapy for symptomatic men who have low testosterone levels with the goal of inducing and maintaining secondary sex characteristics and improving sexual function, sense of well-being, muscle mass and strength, and bone mineral density.3,4 Treatment should aim to restore testosterone levels to the mid-normal range. The Food and Drug Administration has approved both short-acting and long-acting testosterone formulations: implant pellets, transdermal patches, buccal tablets, topical gels, and short-acting injectables—testosterone propionate , testosterone enanthate , and testosterone cypionate —that are administered every 7 to 14 days.3,4,12

Testosterone undecanoate (TU) 750 mg, delivered by intramuscular injection every 10 weeks, is in clinical development as a long-acting therapy for the treatment of primary or secondary hypogonadism. In 130 men with an average body mass index of 32.0, testosterone was restored to normal physiologic levels (average concentration 300-1000 ng/dL) and maintained in 94% of patients for the entire 10-week dosing period.13,14 Estradiol was maintained at mid-normal range and dihydrotestosterone levels remained in the low-normal range during the dosing interval.

Efficacy of TU appears comparable to other formulations, with significant improvements in all International Index of Erectile Function domains of sexual desire and function (eg, erectile function), psychosexual function,15 mood states (eg, tension, depression, anger), energy, and cognition, even for patients who were clinically depressed.16 Although not clinically established, it may be concluded that maintaining normal levels of testosterone and other sex hormones, such as estradiol, may contribute to the observed benefits of testosterone therapy.

[bass]

Will most likely do that as well.

Surprisingly my strength has come back quickly. Took a 2 year break for lifting, and became very sedentary. I benched 300 the other day though, just 6 weeks after starting lifting again, and am focusing much more on cardio and circuit training, but am doing some strength training twice a week. I gained a significant amount of fat while sedentary, so my guess now is that my condition is very likely some kind of obesity induced hypogonadism.

WOW! 300 pounds! be careful not to screw up your tendons, being away from lifting 2 years then lift that heavy you're asking for an injury, your shoulders especially! good for you but take my advise, with test that low you will not make good gains, or at least you won't keep what you gain. best of luck to you and please keep us posted as we are all learning from each other...

[MJRuff01]

WOW! 300 pounds! be careful not to screw up your tendons, being away from lifting 2 years then lift that heavy you're asking for an injury, your shoulders especially! good for you but take my advise, with test that low you will not make good gains, or at least you won't keep what you gain. best of luck to you and please keep us posted as we are all learning from each other...

I was stronger than that prior to stopping of course. It just seemed that each week my bench would get stronger. Week 1 I was strugling with 135 for 3x10, week 2 2x10 with 155, week 3 2x6 with 185, week 4 1x10 225, week 5 1x7 with 245, and week 6 (this week) is when I put up 300 for 1.

The problem is the weight is simply not coming off like it should. I have an education in exercise physiology, I know exactly what I am doing, and I really should have lost close to 30 lbs by now as opposed to the 8 or 9 that I have lost. Hormones being all out of whack is cause for this. As the article I posted above shows it kind of becomes a big downward spiral once a level of abdominal fat is achieved.

Ideally I would only like to be on some kind of HRT for 3-6 months, allow me to lose 10 inches or so around my belly, and normalize my own endocrine system.

[MJRuff01]

Does anyone know the general cost of these things. I have no insurance so would like to steer my doctor to prescribing me generics only and the lowest costing one's necessary. Anyone have suggestions of what I should suggest to my doc?

I tried looking at CVS and Walmart, but they do not publish their prices, and it is difficult to price shop without a script in hand.

[flatscat]

I have said before that i wish I would have tried an AI alone to start with. You are prolly going to have to take it anyway to get your E2 numbers down. So why not try that first? I know I am offering a different opinion, but I don't see the harm. It might get you over the hump and help free t increase, while lowering your E2, and I believe help switch your metabolism from an overweight high E low T to a more normal ratio. Obviously your diet, cardio and strength training needs to be a priority as well. I don't think you will find a doc that will take you down this road, so if you choose to do it, you are prolly on your own.

Flats

[BOB89]

I'm going to agree with flatcar. Adex doesn't require a script either. Its available as a research chemical. This is against what I'd normally say but sadly seeking treatment is expensive without insurance.

Ideally seek out a Dr though.

[MJRuff01]

I have said before that i wish I would have tried an AI alone to start with. You are prolly going to have to take it anyway to get your E2 numbers down. So why not try that first? I know I am offering a different opinion, but I don't see the harm. It might get you over the hump and help free t increase, while lowering your E2, and I believe help switch your metabolism from an overweight high E low T to a more normal ratio. Obviously your diet, cardio and strength training needs to be a priority as well. I don't think you will find a doc that will take you down this road, so if you choose to do it, you are prolly on your own.

Flats

Right now, when I see the doc on the 7th I am going to suggest an AI and Clomid. AI to get the esradiol down and clomid to get the LH and FSH up, which should take care of the test issue on it's own. I would prefer to increase my own endogenous production of test, prior to seeking an outside source of test.

[zaggahamma]

subscribed

please keep THIS thread updated with how your story goes

thanks

[MJRuff01]

Has anyone dealt with an online pharmacy called Health Warehouse? It seems that many of their prescription drugs are really cheap. Of course you need a legit script and everything. I just could not seem to find prices at Walgreens, CVS, or Walmart.

[MJRuff01]

subscribed

please keep THIS thread updated with how your story goes

thanks

ok, no problem.

[zaggahamma]

Has anyone dealt with an online pharmacy called Health Warehouse? It seems that many of their prescription drugs are really cheap. Of course you need a legit script and everything. I just could not seem to find prices at Walgreens, CVS, or Walmart.

just call up their pharmacy and tell them you want a cash price on whatever med youre looking for ...make sure you have the name of the med and dose with spelling if necessary...there will be no problem giving you the price

[MJRuff01]

I got my results back on my Prolactin levels, and they are high. I guess this will change my treatment protocol.

15.3 ng/ml

[MJRuff01]

does anyone have any experience with a dopamine agonist like cabergoline?

[dosXX]

caber is a very strong/effective compound. At 0.25mg (not 25mg) a week dropped my levels significantly.

[MJRuff01]

caber is a very strong/effective compound. At 0.25mg (not 25mg) a week dropped my levels significantly.

is once a week all that is needed?

[flatscat]

I have used it, but as a precautionary, and to see if there was any other benefits , I will look up my dose, seems like it was more like three times a week, but I will let you know when I find it.

[MJRuff01]

I have used it, but as a precautionary, and to see if there was any other benefits , I will look up my dose, seems like it was more like three times a week, but I will let you know when I find it.

I just checked a drug guide for nurses and it seems the dosage is .25 mg twice a week. Expensive though for 8 0.5 mg pills it is $215 at a discount online pharmacy.

[zaggahamma]

I just checked a drug guide for nurses and it seems the dosage is .25 mg twice a week. Expensive though for 8 0.5 mg pills it is $215 at a discount online pharmacy.

I saw it for less than that...hit me with a pm when u get enough posts

[MJRuff01]

I saw it for less than that...hit me with a pm when u get enough posts

ok.

I have decided to postpone my appt with the endocrinologist and instead have scheduled a consult at a life-extension clinic in San Diego. Main reason was that at least I was able to get some feedback prior to showing up.

how many posts do I need to have to pm someone?

[zaggahamma]

ok.

I have decided to postpone my appt with the endocrinologist and instead have scheduled a consult at a life-extension clinic in San Diego. Main reason was that at least I was able to get some feedback prior to showing up.

how many posts do I need to have to pm someone?

youre gonna save yourself time

not sure about post count for pm anymore...try emailing me

either way good luck

[SlimmerMe]

Need 50 posts before you can PM someone....

[dosXX]

in my case yes but I think end-results varies from person to person.

[MJRuff01]

Just got bakc from my appt. Went over all the blood tests, they wanted to put me on Test Cyponate, arimidex , and a bioidentical (I think that is simply a marketing ploy, but whatever) T4/T3 blend. I told them that I would prefer to start with the hCG and see where that takes my test levels, before I take the test. So they were coool with that, and I am going to retake all my blood tests in about 2 months and see if I want to start the Cyponate at that time.

So I picked up 10,000 IU's of hCG, 2 months supply of arimidex, and 3 months supply of that Thyroid med. The thyroid is being mailed to me, but got the other 2. Very reasonable pricing, and a place I would recommed to anyone in the San Diego area. Just pm me for their details.