lab results

[saldivar]

WBC COUNT 10.4 3.5 12.5 K/uL

RED BLOOD CELLS COUNT 5.09 4.10 5.70 M/uL

HGB 15.2 13.0 17.0 g/dL

HEMATOCRIT 45.4 39.0 51.0 %

MCV 89 80 100 fL

RDW, RBC 12.1 11.9 14.3 %

PLATELETS COUNT 253 140 400 K/uL

CHOLESTEROL 211 <239 mg/dL

TSH 3.0 0.2 5.5 uIU/mL

TESTOSTERONE FREE 37.9 35.0 155.0 pg/mL

TESTOSTERONE FREE 2.85 H 1.1 2.8 %

TESTOSTERONE, TOTAL 133 L 250 1100 ng/dL

ESTRADIOL 30 pg/mL Normal "using light method, by kaiser permanente regional labs"

LIPASE 19 16 63 U/L

AMYLASE 12 <97 U/L

AST 47 H 10 40 U/L

ALT 129 H <36 U/L
high, tested for hep, did not find anything. Could be because of obesity.

SPECIMEN DRAWN AM
CORTISOL <1.0 ug/dL
normal after taking dexamethazone

glucose fasting 97mg 60 - 99

My testosterone level is very low. I weigh 290lbs. I am a competive powerlifter and am at the age of 21. I've never used steroids or prohormones ever before. I'm now seeing a endocrinologist and she tested for some more stuff like (fsh, psa, lh) and some other stuff which came back normal. I just did an mri on the pituitary gland and am waiting for the results of that. I did go from 230lbs to 290 within 8 months beginning powerlifting. Could the low test be caused because of obesity? I am fat, but have a very muscular build, not just some fat obese average joe we see everyday at McDonalds. I feel like I'm still pretty strong, just always getting tired, feeling grumpy, not wanting to wake up, fatigue, low sex drive. Still have strength to make it to the gym though and still hitting pr's. I've really always had a low sex drive, but I always told myself I was too young to be having this shit happening to me, this was even when I was 185lbs and wrestling.

 

[pmgamer18]

WBC COUNT 10.4 3.5 12.5 K/uL

RED BLOOD CELLS COUNT 5.09 4.10 5.70 M/uL

HGB 15.2 13.0 17.0 g/dL

HEMATOCRIT 45.4 39.0 51.0 %

MCV 89 80 100 fL

RDW, RBC 12.1 11.9 14.3 %

PLATELETS COUNT 253 140 400 K/uL

CHOLESTEROL 211 <239 mg/dL

TSH 3.0 0.2 5.5 uIU/mL

TESTOSTERONE FREE 37.9 35.0 155.0 pg/mL

TESTOSTERONE FREE 2.85 H 1.1 2.8 %

TESTOSTERONE, TOTAL 133 L 250 1100 ng/dL

LIPASE 19 16 63 U/L

AMYLASE 12 <97 U/L

AST 47 H 10 40 U/L

ALT 129 H <36 U/L
high, tested for hep, did not find anything. Could be because of obesity.

SPECIMEN DRAWN AM
CORTISOL <1.0 ug/dL
normal after taking dexamethazone

glucose fasting 97mg 60 - 99

My testosterone level is very low. I weigh 290lbs. I am a competive powerlifter and am at the age of 21. I've never used steroids or prohormones ever before. I'm now seeing a endocrinologist and she tested for some more stuff like (fsh, psa, lh) and some other stuff which came back normal. I just did an mri on the pituitar and am waiting for the results of that. I also went from 230lbs to 290 within 8 months. Could the low test be caused because of obesity? I feel like I'm still pretty strong, just always getting tired, feeling grumpy, not wanting to wake up, fatigue, low sex drive. Still have strength to make it to the gym though and still hitting pr's.

Yes the low T can and will do this I hope the good Dr. checked our E2 Estrodiol also. Do you over do it in your work out program. Have you tried taking some time off to see if your levels come back. Most Pros have lower T levels but not like this. What ever you do don't go on TRT until they find out why your so low.
Phil

 

[saldivar]

I'll send her an e-mail today and ask her if she did check E2. I workout with very heavy weights, using the conjugate method but don't really overdue it. I would never take a break though unless it's the week off before a powerlifting meet or the week after the meet. When I due take those breaks I notice no changes. What I don't understand though is how can I maintain my strength or even still be getting stronger with low t levels?

 

[pmgamer18]

I'll send her an e-mail today and ask her if she did check E2. I workout with very heavy weights, using the conjugate method but don't really overdue it. I would never take a break though unless it's the week off before a powerlifting meet or the week after the meet. When I due take those breaks I notice no changes. What I don't understand though is how can I maintain my strength or even still be getting stronger with low t levels?

What time of the day did you do the test best early in the morning when levels are the highest.

 

[saldivar]

around 8 am. I asked the doctor if she did test the E2 level, she said she didn't, but that i'd have breasts. She said she will let me test. She has ordered a lab test. I don't have breast enlargement though. Is it still worth testing?

 

[pmgamer18]

around 8 am. I asked the doctor if she did test the E2 level, she said she didn't, but that i'd have breasts. She said she will let me test. She has ordered a lab test. I don't have breast enlargement though. Is it still worth testing?

That is some thing that happens with long term high E2. If for some resion your high getting it down can bring up T levels.
http://www.medibolics.com/ArimidexBoostsTestosterone.htm

 

[earthdog]

around 8 am. I asked the doctor if she did test the E2 level, she said she didn't, but that i'd have breasts. She said she will let me test. She has ordered a lab test. I don't have breast enlargement though. Is it still worth testing?

Yes. And your doctor needs to specify the "by extraction" or "ultra sensitive" test to the lab, or you will get the test for women, which is useless.

 

[saldivar]

I hope the doc did. I got my mri results back and it turned out normal.

 

[Axl]

Your E2 will give you an idea of what is going on.

You have an extremely low SHBG. That's the only explanation of why your free T in% is in the normal range while your total T is extremely low. What does your doc think what causes the low SHBG? This is a thing she should look into, I think.

If your LH and FSH were normal, your testes are not responding enough to make sufficient testosterone. There are a lot of reasons why this happens. Most of them are not 'for life'. Try to take a look at the basics and work up from there. Start with having a look at your diet. (You gained a lot of weight in a short time: how much of it was muscle and how much was fat??). Try to avoid stress. Take a look at your training program. See if anything improves. If not: chek your thyroid (it didn't get tested apparantly) and retest the other hormones to see how they have changed.

The reason why you are getting stronger might be due to a high T-to-DHT conversion, even with low T levels.

If everything is still normal at this point, most docs would want to try to bring the HPTA-axis to a higher equilibrium-point with a HCG-only protocol. This means injecting small dosages of HCG for a brief period of time. The dosage may vary for each specific case.

I'm not a doc. But this is how my docs (the good one, not all the others) handled my low T...

 

[Chrisgj2]

Your TSH at 3 has me concerned. I like see around 2 in men. I recommend you get more thyroid testing (TSH is a pituitary hormone, not thyroid). These are the tests you need. Free T3, Free T4 and antibody tests including TPO. Also search for

Thyroid symptoms

or email me and I'll send you my list.

Chris

 

[saldivar]

My regular physician might have tested the t3 and t4 and antibody tests already. I think they were ok but I'll ask for the results. I actually did eat a lot of junk food to gain the weight, a lot of muscle did come in with it though. Anything I could think of to help me get big. I've always had low sex drive though, ever since puberty. I wouldn't even want to have sex because it would destroy all of my energy for the gym, this is even after a couple of days of ejaculation. I am now trying to watch my diet. My doctor prescribed me today 300mg test cyp every 3 weeks. On the prescription slip though it shows a shot every week at 300mg, should I say something or leave it that way? I was reading that weekly is better for cypionate anyways, but it this too high or is it about right considering my t levels were at 133 ng/dL. After giving me the shot the nurse told me come back in 7 days, and if my doctor sees that I have been doing it every week, maybe I can prove to her that it's a better choice in the first place. what do you think?

 

[Axl]

If you can get a shot of 100mg every week: that's the best thing you can do.
It will keep your levels more stable.

Don't do a 300mg shot every week: that's AAS. It will get elevate your E2 considerably. You will risk gynecomastia (birch tits) and ED. It's just not healthy. It will supress the natural LH, FSH and T production considerably. And if you go off this injection scheme (and eventually you will because the doc will notice it in your bloodwork), you will need PCT or a long 'cold turkey" period for your body to adjust to normal levels again.

Try not to do a 300 mg shot every three weeks: it will give you a E2-surge that may cause gynecomastia (aka bitch-tits). The weeks afterwards, your levels will drop below the reference ranges.

Go for the 100 mg shot every week. Then draw follow up labs to see how your dosage must be adjusted. (See sticky: TRT from SWALE)

I did 250 mg of T every two weeks and it gave me the 'rollercoaster ride'. This is not what you want. Weekly injections are best.

Still I think that you are too young for TRT. She should have tried the HCG start up protocol first....

 

[saldivar]

Doesn't HCG only mimic LH. My LH levels came back normal, or would we want to raise my lh above normal to try and get more test production.Would it burn out the testicles if lh was above normal?

 

[Axl]

Good question. It all depends on the dosage you would be using.
Your LH was indeed normal, but you only did 1 test. It is possible that you just had a burst of LH at the moment the sample was taken. So it still *could* be that your average LH levels are below normal.

HCG mimics LH: it stimulates the testes tp produce testosterone. After some weeks of moderate HCG-stimulation, it is *in some cases* possible for the testes to keep producing more testosterone naturally. And this is the ideal situation. But if you don't try it, you will not know that this might work for you.

 

[saldivar]

here are the messages I have been sending and recieving from the doc.

To Dr. ?

If 300 mg of test cyp would really only be beneficial for
the first week because of the short half life of
testosterone cypionate. Why not try 100 mg every week
starting off so levels
could be stable instead of having a patient have the
"rollercoaster ride." Then draw follow up labs to see how my
dosage must be adjusted. We know that after 10 days my
testosterone levels will be extremely low especially at day
21, so why bother. Isn't keeping my t levels at a normal
stable level what we're after. That's what John Crisler, DO
recommends and a lot of others who have had the best results
from their trt injections intramuscularly doing it like
this.

Reply from dr. ?

If you want to get a shot weekly, that would be fine. I will send the new prescription down to the injection clinic. Your free testosterone has actually been normal, although on the low side, so it is the bound testosterone that is low. You may have mild hypogonadotropic hypogonadism or you could just have elevated SHBG levels due to your weight. Because of your borderline levels (and the normal free testosterone which is a better indicator of hormone function), I am not sure if the testosterone is going to help but I see no harm in trying. HCG can help but is usually only needed for fertility.

 

[Axl]

here are the messages I have been sending and recieving from the doc.

Reply from dr. ?

If you want to get a shot weekly, that would be fine. I will send the new prescription down to the injection clinic. Your free testosterone has actually been normal, although on the low side, so it is the bound testosterone that is low. You may have mild hypogonadotropic hypogonadism or you could just have elevated SHBG levels due to your weight. Because of your borderline levels (and the normal free testosterone which is a better indicator of hormone function), I am not sure if the testosterone is going to help but I see no harm in trying. HCG can help but is usually only needed for fertility.

OK: it's a doc you can work with: that's good. She adjusted the frequency: that's GREAT!

There are some strange things in her mail.

Your free T is normal BECAUSE, as I have mentioned before, you will most probably have a very low SHBG along with that low total T. There is no other explanation for that. She should have known that. Strange that she thinks your SHBG can be high.....she should know better than this...

Your total T IS FAR FROM "BORDERLINE", as she stated. It is VERLY LOW - TOO LOW for a 21 yr old guy. (See reference range per age group: a sticky by DavidZ above). I call this statement typical ignorant doc-BS. You can send here the table as extra info.

Anyway: you have indeed mild hypogonadism, but we don't know yet what caused it. (I'm still convinced it was a bad livestyle; but it's just a guess). So concluding it is hypogonadotropic is a bit too early.... We don't even know if it is temporary or longlasting. More follow up and testing needs to be done.

About her comment on the HCG. Again typical doc-BS. HCG *may* help for fertility: it is given as the first-try-medicine. If this doesn't help for fertility, then they prescribe a mixture of HCG (Pregnyl) and FSH (Menopur, Metrodin HP, Puregon,Gonal-F). It is the FSH that stimulates the testis to produce sperm, not the HCG. Again: she made a strange comment, don't you think?

With T injections it is very common that your testis will shrink to the size of raisins... Adding small dosages of HCG will prevent this from happening and will keep on stimulating what is left from your active Leydig cells. These are two good reasons for HCG. Some patient also mention that they feel 'better' after they have added the HCG. So there are three good reasons to take a good look at HCG.

Also, TRT is not always the best thing to do if you want to have children later. On this board there are a lot of guys that are on TRT and that have fathered children, but be aware that this is not an absolute guarantee in all cases. Maybe it would be nice to 'bank some sperm': you're at the best age for that now.

Anyway: if I were you I would keep working with her because she is open to your comments and suggestions. I bet she will learn a lot from you. If you're not sure: just post your questions here and we will all help you as good as we can.

PS: I'm not a doc. I'm only sharing my experience with TRT. (I have IHH). So my comments do not replace professional advice.

 

[saldivar]

Thanks Axi. I will show her the table. She doesn't want to allow me to inject myself, so I have to do it at the hospital. Would it be ok to get the HCG shot + the test shot at the same time. Going once a week to the hospital would be enough for me I don't want to go anymore.

 

[Axl]

That's a decision you have to make.

But no: it would not make sense to have the two shots on the same day. HCG is injected Sub-Q (which is easy for DIY) the day prior and two days before your next shot.

It you would do it together with yout T injection, your levels would 'spike' to much...

Maybe it is best to talk about at your next visit? If you experience atrophy, you will have a good case for adding HCG.

 

[saldivar]

Thanks man. I've learned a lot from this site. Good info. I had a shot 300mg of cypionate yesterday. Am I supposed to feel different or it takes a while after starting trt?

 

[Axl]

I usually feel worse the day of my shot and the day after. Maybe it has to do with the "explosion of hormones" in my blood, I don't know. I think it is different for a lot of guys. Anyway: don't expect too much of it: you will not feel like superman... If you felt really bad, dead-tired and depressed before it will make you feel "normal" again, nothing more. Maybe other can comment on this as well?