Is this lab order sufficient?

[bethdoth]

Here is the lab my new (5th) doctor is ordering. I have been doing subQ injections for 4 months now and have had labs every 6 weeks. My last lab 4 weeks ago my Test had finally came up to 852 but E2 was at 52. So my main concern right now is my test, E2 and Red Blood Cells. Is there anything else I should be concerned about and will this lab get what I need?

Yes I read the sticky on labs but, it doen't break down what is in each panel. Also how do i know if the E2 is a sensitive test?

[crashfirepm53]

Are you doing Subq Testosterone injections? That needs to be injected IM via a 1'' to 1.5'' needle not subq.

[bethdoth]

crash,
I don't know what percentage of guys on here do SubQ testosterone but I would venture to say about half. My test was at 852 up from low 300's last test so subQ works. It wasn't working to effectively in my belly fat but once I switch to thighs it worked fine.
Anyone want to become a millionaire? I wish I could invent a machine like diabetics have for blood sugar levels. But, instead with a prick of a finger it could tell me my test, E2 and RBC count. I'm sure we could sell a lot of them. I am looking forward to my next lab results...I have a feeling i need some major adjustment. I felt like shit yesterday and not the greatest today. Very tired and some muscle cramping. Bad timing since I leave on vacation tonight.

[steroid.com 1]

The labs your Doc is ordering for you is insufficient.

This is what you need:
• Total Testosterone
• Bioavailable Testosterone
• Free Testosterone (if Bioavailable T is unavailable)
• Estradiol (specify “sensitive” assay for males)
• LH
• FSH
• CBC
• Comprehensive Metabolic Panel
• Lipid Profile
• PSA
• IGF-1

[bethdoth]

Thanks GD,
I did do some research this morning to see what each one of these were. I called the Dr office and had them add the Estradiol (sensitive) and then called them back after reading your post. I now have the PSA and IFG-1 ordered as well. I am really looking forward to the results. I know I will feel great once I get this dialed in but, it has been a long rough road for me.

[bethdoth]

Well the doctors office called me back and said the doctor doesn't feel the Estradiol and IFG-1 are not needed and he doubts insurance would pay for them. "Insert swear word here" it's looking like it will be impossible to get good care from the Aurora medical system here in Green Bay.

[austinite]

Well the doctors office called me back and said the doctor doesn't feel the Estradiol and IFG-1 are not needed and he doubts insurance would pay for them. "Insert swear word here" it's looking like it will be impossible to get good care from the Aurora medical system here in Green Bay.

Fire this doc today. Time for a change.

[bethdoth]

Fire him Hahahaha this is the first visit to this endro. He again is temp till Sept. I faxed over the info from the sticky about estradiol and management. His nurse called today and said he decided he would order the Estradiol and a PSA. So I managed to get blood drawn today and hope to have results before my appointment on Wed.

[junk2222yard]

What about you tell him you feel they are needed and will cover the cost yourself? That seems the "path of least resistance" to me.

[crashfirepm53]

The labs your Doc is ordering for you is insufficient.

This is what you need:
• Total Testosterone
• Bioavailable Testosterone
• Free Testosterone (if Bioavailable T is unavailable)
• Estradiol (specify “sensitive” assay for males)
• LH
• FSH
• CBC
• Comprehensive Metabolic Panel
• Lipid Profile
• PSA
• IGF-1

I go to my new Internal Medicine doc tomorrow and this is the labwork that I will request. I can relate to how you feel as I have been through several Docs(General Med, Endo) and they all don't have a clue. Hopefully this will all change tomorrow.

[steroid.com 1]

Well the doctors office called me back and said the doctor doesn't feel the Estradiol and IFG-1 are not needed and he doubts insurance would pay for them. "Insert swear word here" it's looking like it will be impossible to get good care from the Aurora medical system here in Green Bay.

If your Doctor doesn't understand the vital need to test for Estradiol that my friend is a huge red flag!

Tell him you will pay for it if the insurance company won't BUT if you were diagnosed as being Hypogonadal there is no reason the insurance company wouldn't pay for it.

You need E2 no matter what!

And what about this; let's say you have elevated E2, does this Doctor understand how to administer an AI???

My guess...NO!

[bethdoth]

"And what about this; let's say you have elevated E2, does this Doctor understand how to administer an AI???"

Exactly this is my problem I have liquid stane but, I don't know how to administer. I was doing 5mg a day and felt like crap then stopped taking it while on vacation in Jamaica. Then went to 5mg 24 hours after T and then about 4 days ago I noticed my nipples were itchy and felt symptoms could be getting worse, so I just went to 2.5mg every night before bed???????????? I hope this didn't mess up my lab since I took it the night before about 18 hours before the lab?

[bethdoth]

Lab results. I wonder what is causing the night sweats?
ESTRADIOL 37 pg/mL
FEMALE NORMALS:
FOLLICULAR PHASE: 20-144 pg/mL
MIDCYCLE PHASE: 64-356 pg/mL
LUTEAL PHASE: 56-214 pg/mL
POST MENOPAUSAL:
(UNTREATED): <33 pg/mL
MALE NORMALS: <41 pg/mL

[bethdoth]

The new doc that is here till Sept is from Georgia. He was ok but still no need for an AI or HCG ... the only reason I say ok is because he agrees that my T should be in the 800's. He also ordered an estradiol lab, free test and total test for 4 weeks. he said that by increasing from 60mg to 70mg every 3.5 days it should be stabilized at the 4 week mark. He said the sooner I get this dialed in to be stable in the 800's the better I will feel. His explanation of receptors and estradiol was way different from what I have read. He basically said as long as you have your T in the 800's and your estradiol below 50 the receptors will use the T, but if your T decreases to say 300 and etradiol is at 70 then they could use the estradiol.

[ZenFitness]

I would call your insurance to find out what they cover. I use UHC and they cover 100% of my lab work for low testosterone treatment. This apparently means I can get literally *any* blood work I want and it is covered provided I go to LabCorp.

From your results and posts, it looks like you run high E2 especially if you are already self-administering an AI. Maybe you can stress the high E2 symptoms you are experiencing? Have you told him that you are self-administering the AI?

If he's like my old doc then he may not budge until he sees a number that is literally outside of the "range" (I could be 0.000001 within range and my old doc would say "nope, you're fine, you are in range" not even considering how the range was developed and, moreover, any symptoms or ill feelings I went through from being too high/low).

[bethdoth]

Yes I told him about the night sweats and the itchy nipples. I didn't tell him I was already administering an AI. But he felt as long as it was under 50 it was ok and that you will have symptoms no matter what. He said that the FSH is what normally causes night sweats and he said mine was fine. The good thing is he is willing to order the lab with etradiol in 4 weeks. That gives me time to be consistent with my current protocol and see where I end up in 4 weeks.

So I am currently doing 70mg test subq E3.5days, 250IU HCG M-W-F, and 2.5mg liquid stane every evening. A good lab in 4 weeks should help me dial in and get this straight once and for all.... I hope.

[bethdoth]

Attachment 137755After reviewing all my labs since starting Injection last Dec. the one thing that has changed drastically is the LH. i know this is normal for it to drop once a person starts injecting T. If I am doing HCG should it be this low? Could this be what is causing the night sweats?

[junk2222yard]

I am not an expert, but even with hCG I think your LH is going to be extremely low.

Regarding night sweats, I too suffer them. My research has indicated that they are possibly caused by:
1. E2 too low
2. E2 too high
3. E2 changing rapidly / in flux

For me I believe it is #3, I just have trouble getting my E2 to stay put. I feel the hCG just made it even harder for me. I am not sure if I will ever be dialed in.

[bethdoth]

Junk2222 I feel your pain. I am going to be very consistent for the next 4 weeks then Labs again. I hope to get my E2 down in the 20's and T in the 800's. Then stay there.