Blood Work

[HEVEW8]

Advice please..... 41yo, been on TRT for 8 weeks, started Sept.13...,50mg test cyp Sun/Wed , no AI's , clean diet, weight lifting regiment 4X a week...

[MD2B]

I'll give this a shot, if I've gained any knowledge from scouring the board here for the past month:

As I've learned from bass: your hematocrit level is too high = you need to begin donating blood as frequently as possible. I believe some knowledgeable members here like seeing that below 45. This is very important, you want to make sure you begin doing this as the ramifications of letting this get out of hand can be of the utmost seriousness. Bass even recommends that donating blood should be part of every TRT protocol so that's something to keep in mind.

Your lipids are off, obviously. Logic would point in the diet direction as far as managing this (you stated you already exercise regularly which is helpful). You can raise HDL and lower LDL via upping healthy fats like poly and monounsaturated fats (fish oil, natty pb, etc) and lowering saturated fats along with trans fats. AI's can upset your lipid profile long term but as you stated you do not use any (which is a big plus, way to go on that).

Your estradiol looks descent actually for using 200mg test per week (usual max dosage for TRT) with no AI so that's a big plus. Some members here prefer to get into the low to mid 20's, some like it around 30 where you are currently at, depends how you're feeling.

I'll let more knowledgeable members chime in here but that is my two cents from what I have learned thus far.

[HEVEW8]

Thank you for the input, I corrected my test dose to say 50mg twice a week... Yes, I need to give blood, I started feeling the symptoms of itchy skin after showers and brain fog... My diet is really good, I even take fish oil omega 3 3000mg every morning and eat raw out meal with my protien shakes every day... Chicken and brown rice, egg whites...fresh fruit, whole wheat breads,... I don't know how I can eat better... I drink water all day long... It may be hereditary to have high cholesterol. My blood pressure has been high lately too, been taking a baby aspirin before bed.. I wonder what the deal is with the IGF-1,.. It is very high?

[MD2B]

Yes, I would definitely begin a regular blood donation regimen and recheck hematrocrit levels.

As far as cholesterol goes (microbiology flashback), I actually got hands on experience working with cholesterol disorders and their specific gene expression which cause them. Hypercholesterolemia and hyperlipidemia certainly are known to occur, whether this is your case or not is to be seen. Do high cholesterol issues run in your family? This would be worth seeing a medical physician as your diet and exercise are covered.

Blood pressure: Due to the high hematocrit levels your blood viscosity is going to be increased. This has a direct impact on blood pressure via increased hematocrit -> increased viscosity of blood -> increased blood pressure. This will also lower delivery of oxygen to your tissues, been feeling sluggish lately? Your hematocrit is not extremely high but it's high and should be addressed.

The IGF-1 being elevated is suspect. This basically means your pituitary gland is secreting too much growth hormone . I know very little about this particularly but from what I understand an MRI may be in order to investigate the possibility of acromegaly.

Hope some of this helps, remember I am not a medical doctor (yet), no where close. I would suggest following up with your physician.

[HEVEW8]

My mothers side of the family has a history of diabetes and obesity, so more than likely they had high blood pressure too... Don't know much about my Dads side...except they are all in shape... I wonder if the HCG I'm taking is giving a high IFG-1 reading...? I have a Endo appt on the 9th, I will take my blood work with me and see what they recommend.
Thanks Again
Ruben

[MD2B]

Good luck. I also site searched your IGF-1 concern and came up with this: (still unable to put direct links in my posts)

Looks as though it can be a common occurrence to find elevation of IGF-1 with TRT.

I also found this in my portfolio I've been putting together, a quote from one of the leading HRT physicians in the country:

"IGF-1 will rise from testosterone supplementation, and vice versa." - Dr. John Crisler

[HEVEW8]

Thanks for the search on IGF-1. To answer the question of me being fatigued due to the high hemacrite, yes I am,.. I thought it would be a result of high E2, but now I see the #'s and know it's the "thick blood"... I also get out of breathe when talking on the phone for extended conversations.

[Brohim]

How do you feel since you started TRT?


Yes I would donate blood
Your E2 looks fine
Don't worry about IGF-1 being high is good! I am over the range as well as many other guys. Lifting will elevate IFG-1 levels.
Your test #s look good.

[HEVEW8]

Aside from high blood pressure symptoms that come and go,( ringing in the ears, flush face, some fatigue) I feel good. I have put on 5lbs of muscle, got a little leaner, and have nice erections. I do tend to over think things and make myself worry. I will start donating blood and watch my salt intake, stay on the baby aspirin before bed. Worse case I start taking medication for high blood pressure. Glad to hear your IGF-1 is high too and many others, makes me worry less,.....too bad we can't bottle it up and sell it...LOL

Thank you for the input!

[xcraider37]

Aside from high blood pressure symptoms that come and go,( ringing in the ears, flush face, some fatigue) I feel good. I have put on 5lbs of muscle, got a little leaner, and have nice erections. I do tend to over think things and make myself worry. I will start donating blood and watch my salt intake, stay on the baby aspirin before bed. Worse case I start taking medication for high blood pressure. Glad to hear your IGF-1 is high too and many others, makes me worry less,.....too bad we can't bottle it up and sell it...LOL

Thank you for the input!

Just my 2 cents, with the hematocrit it will rise in some of us and then stabilize after a few months, but always a good idea to donate, also lowering your test dose can/will reduce hematocrit, flushing and keep that e2 below 30. So all around good to reduce.

[HEVEW8]

Just received a email from my TRT doc,..

Mr. Parga.

considering your latest labs you forwarded (a copy has been inserted into your file)- I would decrease the dosing of your current TT protocol by half. Please also have your primary care doctor- (Dr Plunk), who ordered your labs to review ALL of your labs with you ASAP, and we can discuss them further the next time you return to the clinic.
Please email or call with any other concerns.

Sincerely,

Dr. Pare'

WTF!!!!!
He could have at least voiced his concerns! I mean they dont even offer full male blood labs i had to buy it for my own personal use, he probably has no clue what some of the test are for! I have a Endo appt. this Friday with Kaiser, I'm going to see if they will treat me for low testostrone with my currant medication's... Test and HCG ,.. I know it's a long shot, but I'm getting to the point where I feel I should just self medicate!

[TennTarheel]

Yeah bro, that's a ridiculous email to just send to a patient with no explanation.

[MD2B]

I am sure most of us can directly relate with your frustration. I am thankful for the internet, pubmed, and great sites like this to empower with knowledge to ultimately take responsibility for my own treatment. It would be nice to blindly place faith in one's physician as many do but it would seem quality and intelligent HRT treatment is hard to come by currently. Just have patience, where there is a will there is a way. It takes many quite some time to get completely lined out and stabilized on a protocol that works best for them. Stay persistent and you'll get there.

[HEVEW8]

Here is a interesting read I found searching for Hematocrit cure's,...


I would like to add to this as it has worked for me and others I have suggested this approach to.

I have found that one needs to be hydrated upon waking as you are mildly dehydrated upon waking. As most of us reach for that cup of coffee first thing as we know caffeine dehydrates. I prefer ½ of cup of Pedialyte and big glass of water prior to my coffee. I have also found that eating grapefruit helps on lowering elevated hematocric levels, it

seems to work better if ate separate from high protein/iron fortified meals as vitamin C helps with the absorption of iron in return rise in RBC's.

Caution should be of concern for those on statins and certain other meds as grapefruit will increase the effect of these drugs. This approach has baffled 3 of my doctors 1 including a hematologist that thought a TT level of 169ng (250-1100)was healthy. Most doctors if any will not help guide you on ways to control high RBC / they prescribe and thats it.

[MD2B]

Adequate hydration will help decrease thick blood viscosity, especially if you're dehydrated to begin with.

Grapefruit contain low amounts of salicylates. Salicylates block the vitamin K absorption which is necessary to initiate the chemical mechanism of blood coagulation. Aspirin is also a salicylate (specifically an aceylated salicylate; (there are two types: aceylated and nonaceylated)). This is why many regularly ingest aspirin when managing. If you're putting together a supplement blood coagulation management regimen you may consider extra vitamin E and omega 3 fatty acids as well.

[HEVEW8]

MD2B, you are on the ball my friend! Yes I am putting together a hydration regiment as I type this message. I try to drink as much water through the day as I can but I don't think it is enough,.. So I'm going to pick up some pedylite, grapefruits today,.. I also up'd my omega 3 fish oil pills to 6000mg a day, 3k in the morning and 3k before bed, since my bad Cholestoral is high and my Good cholesterol is low... I will pick up some vitamin E since you mentioned it. Along with donating blood this week, and taking a baby asprin before bed,.. it's the best I can do from the alternative, stopping TRT, or having a stroke/heart attack/ blood clot.... I did not sleep well last night with worry... Just when I thought I was on the right path to a more full filing life I get hit with a thick blood curve ball...! But hey, it could be worse.. I hope things start to get better soon.

Thank you for your help!
Ruben

[MD2B]

Your protocol you just mentioned is more than adequate. Remember your hematocrit levels came back high but just barely above normal range (serious excessive hematocrit issues can possibly present with up to 70% hematocrit levels (very serious), for your reference). It was enough to mention your doing some management but not enough to cause excessive sleepless worry on your part. Rest easy and be confident that what you've described you are doing should be more than adequate to resolve any hematocrit issue you may have displayed via blood work.

You are on the right path because you're exercising your ability to acquire knowledge and educate yourself on cautious and responsible treatment. It commonly takes time to get everything dialed in. You add pharmaceutical, allow body to titrate, test levels, assess, address, re-assess, address, etc until your biochemistry is dialed in appropriately.

Just don't get your cortisol tested any time soon ok? Get some sleep!

[HEVEW8]

Wouldn't it be nice if this was how blood was donated,.... I would be drained every day!

[MD2B]

Wouldn't it be nice if this was how blood was donated,.... I would be drained every day!

I like where your head is at...but if this were the case I fear a mass anemia epidemic would break out amongst the male populace...

[kelkel]

Your protocol you just mentioned is more than adequate. Remember your hematocrit levels came back high but just barely above normal range (serious excessive hematocrit issues can possibly present with up to 70% hematocrit levels (very serious), for your reference). It was enough to mention your doing some management but not enough to cause excessive sleepless worry on your part. Rest easy and be confident that what you've described you are doing should be more than adequate to resolve any hematocrit issue you may have displayed via blood work.

You are on the right path because you're exercising your ability to acquire knowledge and educate yourself on cautious and responsible treatment. It commonly takes time to get everything dialed in. You add pharmaceutical, allow body to titrate, test levels, assess, address, re-assess, address, etc until your biochemistry is dialed in appropriately.

Just don't get your cortisol tested any time soon ok? Get some sleep!

^^^Funny!

Op, on your next BW get your DHEA-s tested as well. It's a precurser to T and declines with age. Supplementing with it has many great benefits. It can actually improve your LDL levels and help to balance out cortisol levels as well as many other benefits. Use a micronized product to survive the first pass. I'd suggest (but do your research) no more than 25mg as it can elevate E levels slightly as well. For me, (at 50mg) it dropped my LDL levels 24 pts and brought my DHEA levels up from a paltry 104 to 254 within a couple months. And this was the only change to my protocol. And I monitor and track everything!

[HEVEW8]

Thanks Kelkel, It blew me away when I saw my bad cholesterol is high,.. I don't eat crapy fatty fast foods, or processed foods, I prepare all my food from scratch. Thanks for the tip, I will look into it and start suplimenting with it.

[kelkel]

Cholesterol issues can be hereditary for some of us and even with statins or non-statins you can still run borderline. Take advantage of what you can naturally to assist.