Recieved PARTIAL Lab Results Today. Is this Enough Info for Any Advice?

[titleesq]

Good Evening Everyone:

I received the bulk of my lab results today, but I'm not sure if I have enough information for anyone to try to make an informed opinion as to my problem(s). I'm a 38 year old male, 5 foot 6, and weighing 190lbs. There was plenty of overkill as far as tests performed (at least I think so), so I will just try to list what I think may be relevant:

Keep in mind that as of June 20, 2011 my Total T was 252ng. The test that was just performed included my Total T as well as Free T, but those results have not arrived yet. Another important piece of the puzzle that did not come back today either, is SHBG.

I have had two injections of Test Cyp at 200mgs. The first one was Thursday June 23, and the last injection that I had was last Monday June 27.


TSH, 0.79 mIU/L (.40-4.50)
Ferritin, 35 ng/mL (20-345)
WBC, 6.7 Thousand/uL (3.8-10.8)
RBC, 4.32 Million/uL (4.20-5.80)
Hemoglobin, 13.7 g/dL (13.2-17.1)
Hematocrit, 40 % (38.5-50.0)
Reticulocyte Count, Absolute, 108000 cells/mcl (25000-90000)
Cholesterol, 215 MG/DL (125-200)
Triglyceride, 331 MG/DL (<150)
HDL Cholesterol, 35 MG/DL (> or = 40)
LDL Cholesterol, Calculated 114 MG/DL (<130)
Cortisol, Total, Serum, 11.8 mcg/dL (AM) 4.0-22.0 mcg/dL (PM) 3.0-17.0 mcg/dL
Progesterone <0.5 ng/mL (<1.4)
Prolactin, Serum 11.4 ng/mL (2,0-18.0)
LH, Serum, <0.2 mIU/mL (1.5-9.3)
FSH, Serum, <0.7 mIU/mL (1.6-8.0)
T4, Total, 5.9 ug/dL (4.5-12.0)
T3, Total 136 ng/dL (76.181)
T3, Free, 3.7 pg/mL (2.3-4.2)
T3, Uptake, 30.7 % (27.8-40.7)
T4 Free, Calculated, 1.8 UG/DL (1.6-3.7)
T4 Free, Non-Dialysis, 0.8 ng/dL (0.8-1.8)
Estradiol, 72 pg/mL (13-54)
PSA, Total 0.4 ng/mL (0.0-4.0)
IGE, Serum 14 kU/L (0-114)

Without the results of Testosterone, both Total and Free, as well as SHBG, IGF-1, and IGF-BP3, is it possible to guess what the hell is going on with me and what my next course of action should most likely be?

Thanks to all of you in advance,

Ari

 

[zkt]

The results are about what would be expected for a large dose of T. It shut down your pituitary output of LH/FSH and raised E and probably DHT as well. T lab will probably come back >1000.
How ya feeling?

 

[CubbieBlue]

What ZKT said. Like I said, you either need to stop the T for about two months, get new labs, or just keep trucking on the TRT.

Looks like your thyroid is fine. I'd like to see a vitamin D. Other than that, all good.

 

[titleesq]

ZKT,

I feel ABSOLUTELY TERRIBLE. Would you have suspected otherwise?

Cubbie,

If I continue on this course of treatment won't I just continually get worse? I have NO LH, NO FSH, and what looks to be pretty high estradiol levels as well. The only medication in my current protocol is Test Cyp. Wouldn't I need to add something to this mix?

Thanks for all the help guys, I'm kinda freaking right now.

Ari

 

[CubbieBlue]

ZKT,

I feel ABSOLUTELY TERRIBLE. Would you have suspected otherwise?

Cubbie,

If I continue on this course of treatment won't I just continually get worse? I have NO LH, NO FSH, and what looks to be pretty high estradiol levels as well. The only medication in my current protocol is Test Cyp. Wouldn't I need to add something to this mix?

Thanks for all the help guys, I'm kinda freaking right now.

Ari

You have no LH and no FSH because you are on testosterone.

Test cyp. is all you most iikely need for TRT.

Dude, what other types of diagnosis did you pursue before the low T diagnosis? Maybe you have something else entirely going on.

 

[titleesq]

You have no LH and no FSH because you are on testosterone.

Test cyp. is all you most iikely need for TRT.

Dude, what other types of diagnosis did you pursue before the low T diagnosis? Maybe you have something else entirely going on.

Cubbie,

I did not realize that my LH and FSH levels were where they are b/c of the T supplementation. I knew the numbers decreased, but I was not aware that they could go THAT low. Lack of education on my part I guess.

What about the high estradiol level? Do I need to get that in check?

I didn't really pursue any other diagnosis. The Dr. said I have low T and that was causing my problems and I took that at face value. I have all the symptoms, what else could it possibly be? Any insight appreciated.

Thanks.....

 

[CubbieBlue]

Cubbie,

I did not realize that my LH and FSH levels were where they are b/c of the T supplementation. I knew the numbers decreased, but I was not aware that they could go THAT low. Lack of education on my part I guess.

What about the high estradiol level? Do I need to get that in check?

I didn't really pursue any other diagnosis. The Dr. said I have low T and that was causing my problems and I took that at face value. I have all the symptoms, what else could it possibly be? Any insight appreciated.

Thanks.....

Yeah, the E2 is high, but that's because of the 200 mg shots. if you decide to keep at it injecting smaller amount more common will lower the E2 issue.

If fatigue is your primary concern it is a tough symptom to chase. Many possibilities.

 

[titleesq]

Do I need to worry about adding an AI or possibly some hcg? Just as a gauge, how long does it take on trt to feel the great effects that everyone is always talking about?

Thanks....

 

[getz]

That is a impressively high dose, I generally start patients at 100-150 per week.

 

[titleesq]

Getz, thanks for the info. That comment really added a lot to this discussion. Are you trying to get your post count up or something?

It sounds like you are in the medical field in some fashion. Can you please take a look at my case and try to actually help me? Perhaps trying to answer some of my questions and providing me with educated guidance as to where to go from here?

Thanks for any suggestions that can actually benefit me at this point.

 

[CubbieBlue]

Getz, thanks for the info. That comment really added a lot to this discussion. Are you trying to get your post count up or something?

It sounds like you are in the medical field in some fashion. Can you please take a look at my case and try to actually help me? Perhaps trying to answer some of my questions and providing me with educated guidance as to where to go from here?

Thanks for any suggestions that can actually benefit me at this point.

Titleesq - he's a MD.

You ever heard that anecdote about flies and vinegar...?

 

[seeking]

getz has a point


whose idea was it to inject 400mg of testosterone into you in a four day period??!


and as for the "great effects that 'everyone' is talking about", do some more reading on the forum and you will see that many people never like the results from trt, it is not a guaranteed improvement of anything, except maybe exercise tolerance

as for the LH and FSH, mine went right to zero when on testosterone

 

[titleesq]

Cubbie, my grandma taught me that years ago. Guess I'm a little hard headed and it didn't sink in. But in all honesty, I must admit that I had no cause for that remark. I take it back and will try to be more open minded and sensitive in the future. It's just that I am so impatient, scared that I will have to live the rest of my life like this, and am searching for a magic bullet that I guess doesn't exist.

Once again, my apologies to getz for my reaction to his comment. I was in the wrong.

 

[zkt]

"I'm a 38 year old male, 5 foot 6 and 190lbs., married with two beautiful girls. After years of suffering from an entire laundry list of symptoms, including depression, lack of motivation, extreme fatigue, loss of libido, ED, etc., I had NO luck with any of the popular psych meds and combinations thereof."

This does sound like classic hypogonadism.
Why no improvement?
1. Sometimes it takes a while: there is the whole thing of the effect of binding globulins and cyp450 enzymes.
2.Estrogen too high. The classic immediate Sx is lack of libido. Depression, lack of motivation, extreme fatigue usuallly arent. But IF this the case there are ways to treat it, includig lowering the dose of T.
3.Your problems are low T and something else. ACTH and cortisol levels would be good to know.
What psych meds did you try and what were the effects? Maybe elaborate on this a bit.

Read more from the MESO-Rx Steroid Forum at: https://thinksteroids.com/community/threads/134308759

 

[CubbieBlue]

"I'm a 38 year old male, 5 foot 6 and 190lbs., married with two beautiful girls. After years of suffering from an entire laundry list of symptoms, including depression, lack of motivation, extreme fatigue, loss of libido, ED, etc., I had NO luck with any of the popular psych meds and combinations thereof."

This does sound like classic hypogonadism.
Why no improvement?
1. Sometimes it takes a while: there is the whole thing of the effect of binding globulins and cyp450 enzymes.
2.Estrogen too high. The classic immediate Sx is lack of libido. Depression, lack of motivation, extreme fatigue usuallly arent. But IF this the case there are ways to treat it, includig lowering the dose of T.
3.Your problems are low T and something else. ACTH and cortisol levels would be good to know.
What psych meds did you try and what were the effects? Maybe elaborate on this a bit.

Read more from the MESO-Rx Steroid Forum at: https://thinksteroids.com/community/threads/134308759

His cort levels came back fine in this round of labs I believe

 

[titleesq]

"I'm a 38 year old male, 5 foot 6 and 190lbs., married with two beautiful girls. After years of suffering from an entire laundry list of symptoms, including depression, lack of motivation, extreme fatigue, loss of libido, ED, etc., I had NO luck with any of the popular psych meds and combinations thereof."

This does sound like classic hypogonadism.
Why no improvement?
1. Sometimes it takes a while: there is the whole thing of the effect of binding globulins and cyp450 enzymes.
2.Estrogen too high. The classic immediate Sx is lack of libido. Depression, lack of motivation, extreme fatigue usuallly arent. But IF this the case there are ways to treat it, includig lowering the dose of T.
3.Your problems are low T and something else. ACTH and cortisol levels would be good to know.
What psych meds did you try and what were the effects? Maybe elaborate on this a bit.

Read more from the MESO-Rx Steroid Forum at: https://thinksteroids.com/community/threads/134308759

Thanks zkt.

In regards to the elevated estrogen, what do you think is the best way to treat it? From my VERY limited knowledge, it seems my options are to lower the dose of T Cyp in each inject, change the dosing schedule, or add an AI.

I have never heard of ACTH, and do not believe that I was tested for that. My cortisol level came in at 11.8 mcg/dL, which appears to be mid-range if I'm not mistaken, and shouldn't be a factor.

I was basically just on the standard SSRI's, with a little bit of Abilify added. At one point, I guess after nothing else appeared to be working, some Lithium was thrown into the mix. As far as the effects, none of them were positive. Prior to starting any of the meds, I had NO libido, and MAJOR ED anyway, so that really wasn't an issue (although the meds certainly did not help with that). The lack of any of the meds working is what lead me down the path to trt in the first place. I have been off all psych meds for approx 2 months at this point.

Thanks so for all the help, you guys are all great.........

 

[TheOldFart]

Lower your Tcyp until your E2 is in the range of 25-30. Your high E2 is your body deciding that you have too much T and is therefore converting it to E2. It took me almost 3 years to get my T dose correct and I have found that when I keep my E2 in the range of 25-30 (range 20-56) that I feel the best. I feel a lot better with my total T at 600-700 with E2 in the above range than I did with my total T at 1200 and my E2 at 70 to 80. Libido, ED and the general way I feel is so much better now that I have my E2 in check.

Probably not related to how you feel, but your HDL is low and your trigs are way too high. From my experience, carbs are what drive your trig level. I don't know what your diet looks like, but cut the carbs and beer if you are ingesting a lot of either.

 

[titleesq]

Lower your Tcyp until your E2 is in the range of 25-30. Your high E2 is your body deciding that you have too much T and is therefore converting it to E2. It took me almost 3 years to get my T dose correct and I have found that when I keep my E2 in the range of 25-30 (range 20-56) that I feel the best. I feel a lot better with my total T at 600-700 with E2 in the above range than I did with my total T at 1200 and my E2 at 70 to 80. Libido, ED and the general way I feel is so much better now that I have my E2 in check.

Probably not related to how you feel, but your HDL is low and your trigs are way too high. From my experience, carbs are what drive your trig level. I don't know what your diet looks like, but cut the carbs and beer if you are ingesting a lot of either.

Thanks so much for the insight. If you don't mind sharing, why did it take you 3 years to get your protocol down? I sure would love to learn from your experience. Did you not feel ANY better during those 3 years?

The diet is a work in progress, but it is progressing.

 

[zkt]

Thanks zkt.

In regards to the elevated estrogen, what do you think is the best way to treat it? From my VERY limited knowledge, it seems my options are to lower the dose of T Cyp in each inject, change the dosing schedule, or add an AI.

I have never heard of ACTH, and do not believe that I was tested for that. My cortisol level came in at 11.8 mcg/dL, which appears to be mid-range if I'm not mistaken, and shouldn't be a factor.

I was basically just on the standard SSRI's, with a little bit of Abilify added. At one point, I guess after nothing else appeared to be working, some Lithium was thrown into the mix. As far as the effects, none of them were positive. Prior to starting any of the meds, I had NO libido, and MAJOR ED anyway, so that really wasn't an issue (although the meds certainly did not help with that). The lack of any of the meds working is what lead me down the path to trt in the first place. I have been off all psych meds for approx 2 months at this point.

Thanks so for all the help, you guys are all great.........

Lower your Tcyp until your E2 is in the range of 25-30. Your high E2 is your body deciding that you have too much T and is therefore converting it to E2. It took me almost 3 years to get my T dose correct and I have found that when I keep my E2 in the range of 25-30 (range 20-56) that I feel the best. I feel a lot better with my total T at 600-700 with E2 in the above range than I did with my total T at 1200 and my E2 at 70 to 80. Libido, ED and the general way I feel is so much better now that I have my E2 in check.

Probably not related to how you feel, but your HDL is low and your trigs are way too high. From my experience, carbs are what drive your trig level. I don't know what your diet looks like, but cut the carbs and beer if you are ingesting a lot of either.

Very much true

The other way to safely lower E without effecting lipids is a SERM like clomid. It will not only lower E but raise LH and consequently T as well. If you want to optimize results you have to play with the drugs, observe the effects and adjust them accordingy.
BUT since you have documented problems with neurotransmitters this complicates the situation considerably. I`ll read up on Ambilify and get back to you. Now dopamine, epi and serotonin are posssibly at the root. SSRIs are WELL KNOWN libido killers btw.

 

[titleesq]

Very much true

The other way to safely lower E without effecting lipids is a SERM like clomid. It will not only lower E but raise LH and consequently T as well. If you want to optimize results you have to play with the drugs, observe the effects and adjust them accordingy.
BUT since you have documented problems with neurotransmitters this complicates the situation considerably. I`ll read up on Ambilify and get back to you. Now dopamine, epi and serotonin are posssibly at the root. SSRIs are WELL KNOWN libido killers btw.

zkt:

You are GREAT. Is a SERM the same thing as an AI? On Monday, I am due for my next inject of 200mgs Test Cyp. which will put me back on my EOW schedule. I'm pretty much having an anxiety attack agonizing over whether or not to give myself the shot. I sent my doctor the following email (in bold), but unfortunately I have received no reply:

My concern is this:

I am due for my next 200mg Test Cyp injection this coming Monday, July 11 (which will put me back on the EOW schedule). Do you think that I should continue with this protocol, or should I change it? Some of the options that I would like to discuss with you are as follows:

Should I maybe start injecting 100-150 mgs EW as opposed to 200mgs EOW?
Should I start taking an anti-estrogen medication to reduce what appears to be extremely high levels of Estradiol?
Should I consider adding something to stimulate LH production? The only thing I'm aware of is hCG.
Is there a possibility, based on the values presented, that I could have a pituitary tumor? If so, is this serious and/or does it need to be treated ASAP?

FYI, I lost my libido and had ED problems WAY before I ever took any psych meds.