Help! Lab Results Are In - Need Assistance

[james2012]

My FT3 is normal, so is FT4 and I have high test and free test just like you except I'm not on trt.

I really think the RT3 in my case is temporary. Doc thinks my weight loss of 10lbs over 3 weeks with no loss in muscle mass is causing the body to react like it is in a caloric restriction zone - which it is (2500 calories is not a lot for my exercise regimen). The fast weight loss is the cause and should reverse itself when I reach my ideal weight and begin to slowly increase caloric intake.

It's a theory.

 

[CubbieBlue]

I don't think it is age related. Numbers as low as 195 ng/dL do not seem to fit that profile. I had a collapse from an ACE inhibitor in early 2000 that knocked all my endocrine systems out of whack. Six months later I had a spontaneous recovery and everything was normal. However, the one thing they could pick on at the time was T and so the supplementation started. MRIs of adrenals and pituitary came back normal and I was labeled as idiopathic. I did respond to Dr. Scally's PCT the first time but my condition (advanced heart disease with tight cholesterol control) aided by my own stupidity concerning diet and exercise compliance dropped the top number of a TT of 600 to less than 390 and then down to 195. I believe I need to backfill due to the low cholesterol and the absence of any CHOL for preg production, thereby destroying the entire chain.

I sure could use some advice from Dr. Scally here. My E2 is 17 and if I drop 1/2 tube of testim and keep my AI regimen I won't be surprised if that number drops - which would not be good. I think I need to back of the 1/2 tube to only a single tube, space out my AI dose to every four days, and drop HCG to 150mg every three days, but that is just a guess. I really need to talk to the Doc.

Paging Dr. Scally! Your advice would be greatly appreciated at this point. .

Again - just drop half a tube of testim and the arimidex. You likely do not need any E2 management. Retest in a few weeks. If you need some adex, add it back in.

Your story does not convince me that some level of age related hormonal decline is in place. Regardless, it doesn't matter right now.

 

[mrmorris]

Cubbie that makes sense to me!

Thanks, mrmorris

Again - just drop half a tube of testim and the arimidex. You likely do not need any E2 management. Retest in a few weeks. If you need some adex, add it back in.

Your story does not convince me that some level of age related hormonal decline is in place. Regardless, it doesn't matter right now.

 

[james2012]

So here is my regimen: 1.5tubes/day of Testim, .25mg Arimidex every third day along with 250IU HCG every third day. I am insulin resistant and have seen low SHBG even when TT was low and %freeT was high and free T was low normal. I have 25 stents. Latest lab work still indicates low cholesterol with:

LDL: 23 (0-99 range) LOW
Total: 92 (range 100-199) LOW but per cardiologist it would be high (he wants < 70)
HDL: 45 (>39 range)

Now here are my eye popping results:

TT: 1481ng/dL (range 280-800) HIGH
Free T (Direct) 52.1 ng/dL (range: 6.8-21.5) HIGH
SHBG: 15.9 nmol/L range (14.5-48.4): LOW NORMAL
Estradiol, Sensitive: 17pg/mL range (3-70) NORMAL

T4 Free, Direct: 1.63 nl/dL (range .82-1.77) HIGH NORMAL

NO MEASUREMENT for T3 which bothers me because!!!!!!: Reverse T3: 481 pl/mL (range 90-350): HIGH (Doc is checking my iron levels and does not seem to be too worried)

TSH: 1.35 uIU/ML (range .450-4.5) NORMAL

Prolactin: 5.4 ng/mL (range: 4.0-15.2) LOW NORMAL

Triiodothyronine: 3.3 pg/mL (range: 2.0-4.4) NORMAL (not sure what the heck this is)

Cortisol: 16.3 ug/dL (range: 2.3-19.4) NORMAL (blood gathered at 9:00am for all tests)

A1C: 6.0

So a couple of questions from a very nervous man that still has ED and Libido issues:

Does SHBG typically lower with TRT? If so, then if my TT lowers my SHBG should raise?

What is the significance of the Prolactin being low normal to libido and ED? What can be done to increase this level?

I am losing weight but not body mass like crazy. Doc thinks my weight loss should equate to lower A1C (it has not moved). His thinking is that A1C is being negatively impacted by high free-T. If free-T were normal then I should see a benefit to insulin resistance and SHBG should increase.

Now for this reverse T3. This is scaring the hell out of me because I have never had thyroid issues. Could this be caused by the very high TT and FT? High RT3 has been tied to MI, but I have no symptoms and am exercising at levels unseen in my entire life.

Moving forward: going down to one tube testim and no more armidex. Dropping HCG to either 150mg every three days or 50mg/day (does it matter which approach I take?)

Continuing diet and exercise with goal of 200lbs. For me this would be very thin with little adipose fat if my muscle mass remains the same. I am 22 lbs away from this. Before TRT I was 245 lbs.

My goal is to get to the upper end of the TT range and mid to upper FT range. Right now I have NO exercise induced angina and I am worried that lowering my FT and TT too much may cause angina to return. However, these high levels may actually be vasoconstrictive rather than vasodilating and being in the 700s may still be okay. I'll know as time goes on. I would love to remain on the current protocol until my weight is where I want it, but I fear that with levels this high (and that troublesome rT3 number) I am setting myself up for heart issues.

Hematocrit levels are normal and RBC is normal.

Any advice would be greatly appreciated.

Bumped in the hope of hearing from Doctor Scally.

 

[zkt]

A few things come to mind:
PRL tends to vary inversely with T. Not surprising that your PLR is a bit low.
Triiodothyronine IS T3: tri-three, its normal so stop worrying aboout that.
Totally agree that you need total, particularily LDL is low as feasable.
You need to get yourr HDL up. I think you said that you were taking Crestor, niacin and a fibrate.
Dont know how else to do except diet and exercise for lipids. A good proportion of ethanol and sugars end up as LDL. but it is supposed to raise HDL too so I donno.
Studies are finding that cocao has all kinds of benefitial effects including antifnlammatory effects. Sure wouldnt hurt since inflammation is a big part of arterial stenosis.
Yes, high levels of T are vasoconstrictive as well as raising LDL, lowering HDL and raising E2.
I really think you would be better off by cutting back on the T, restricting caloric intakeand exercising to reduce the adipose tissue, it IS an endocrine organ, and eventually stopping the Arimidex.
Oh yea one last thing, listen to Thom Hartmann on the radio and reexamine your political views. LOL

So here is my regimen: 1.5tubes/day of Testim, .25mg Arimidex every third day along with 250IU HCG every third day. I am insulin resistant and have seen low SHBG even when TT was low and %freeT was high and free T was low normal. I have 25 stents. Latest lab work still indicates low cholesterol with:

LDL: 23 (0-99 range) LOW
Total: 92 (range 100-199) LOW but per cardiologist it would be high (he wants < 70)
HDL: 45 (>39 range)

Now here are my eye popping results:

TT: 1481ng/dL (range 280-800) HIGH
Free T (Direct) 52.1 ng/dL (range: 6.8-21.5) HIGH
SHBG: 15.9 nmol/L range (14.5-48.4): LOW NORMAL
Estradiol, Sensitive: 17pg/mL range (3-70) NORMAL

T4 Free, Direct: 1.63 nl/dL (range .82-1.77) HIGH NORMAL

NO MEASUREMENT for T3 which bothers me because!!!!!!: Reverse T3: 481 pl/mL (range 90-350): HIGH (Doc is checking my iron levels and does not seem to be too worried)

TSH: 1.35 uIU/ML (range .450-4.5) NORMAL

Prolactin: 5.4 ng/mL (range: 4.0-15.2) LOW NORMAL

Triiodothyronine: 3.3 pg/mL (range: 2.0-4.4) NORMAL (not sure what the heck this is)

Cortisol: 16.3 ug/dL (range: 2.3-19.4) NORMAL (blood gathered at 9:00am for all tests)

A1C: 6.0

So a couple of questions from a very nervous man that still has ED and Libido issues:

Does SHBG typically lower with TRT? If so, then if my TT lowers my SHBG should raise?

What is the significance of the Prolactin being low normal to libido and ED? What can be done to increase this level?

I am losing weight but not body mass like crazy. Doc thinks my weight loss should equate to lower A1C (it has not moved). His thinking is that A1C is being negatively impacted by high free-T. If free-T were normal then I should see a benefit to insulin resistance and SHBG should increase.

Now for this reverse T3. This is scaring the hell out of me because I have never had thyroid issues. Could this be caused by the very high TT and FT? High RT3 has been tied to MI, but I have no symptoms and am exercising at levels unseen in my entire life.

Moving forward: going down to one tube testim and no more armidex. Dropping HCG to either 150mg every three days or 50mg/day (does it matter which approach I take?)

Continuing diet and exercise with goal of 200lbs. For me this would be very thin with little adipose fat if my muscle mass remains the same. I am 22 lbs away from this. Before TRT I was 245 lbs.

My goal is to get to the upper end of the TT range and mid to upper FT range. Right now I have NO exercise induced angina and I am worried that lowering my FT and TT too much may cause angina to return. However, these high levels may actually be vasoconstrictive rather than vasodilating and being in the 700s may still be okay. I'll know as time goes on. I would love to remain on the current protocol until my weight is where I want it, but I fear that with levels this high (and that troublesome rT3 number) I am setting myself up for heart issues.

Hematocrit levels are normal and RBC is normal.

Any advice would be greatly appreciated.

 

[mrmorris]

Great reply zkt, you the man! I do agree with you on what I know that is, not nearly as wise as you, one day maybe!
That was a very informative reply. You're a great guy to have on this site, and hope your here for many years to come!

Thanks, mrmorris!

A few things come to mind:
PRL tends to vary inversely with T. Not surprising that your PLR is a bit low.
Triiodothyronine IS T3: tri-three, its normal so stop worrying aboout that.
Totally agree that you need total, particularily LDL is low as feasable.
You need to get yourr HDL up. I think you said that you were taking Crestor, niacin and a fibrate.
Dont know how else to do except diet and exercise for lipids. A good proportion of ethanol and sugars end up as LDL. but it is supposed to raise HDL too so I donno.
Studies are finding that cocao has all kinds of benefitial effects including antifnlammatory effects. Sure wouldnt hurt since inflammation is a big part of arterial stenosis.
Yes, high levels of T are vasoconstrictive as well as raising LDL, lowering HDL and raising E2.
I really think you would be better off by cutting back on the T, restricting caloric intakeand exercising to reduce the adipose tissue, it IS an endocrine organ, and eventually stopping the Arimidex.
Oh yea one last thing, listen to Thom Hartmann on the radio and reexamine your political views. LOL

 

[james2012]

A few things come to mind:
PRL tends to vary inversely with T. Not surprising that your PLR is a bit low.
Triiodothyronine IS T3: tri-three, its normal so stop worrying aboout that.
Totally agree that you need total, particularily LDL is low as feasable.
You need to get yourr HDL up. I think you said that you were taking Crestor, niacin and a fibrate.
Dont know how else to do except diet and exercise for lipids. A good proportion of ethanol and sugars end up as LDL. but it is supposed to raise HDL too so I donno.
Studies are finding that cocao has all kinds of benefitial effects including antifnlammatory effects. Sure wouldnt hurt since inflammation is a big part of arterial stenosis.
Yes, high levels of T are vasoconstrictive as well as raising LDL, lowering HDL and raising E2.
I really think you would be better off by cutting back on the T, restricting caloric intakeand exercising to reduce the adipose tissue, it IS an endocrine organ, and eventually stopping the Arimidex.
Oh yea one last thing, listen to Thom Hartmann on the radio and reexamine your political views. LOL

Thanks zkt, great reply. Being from Canada and starting out as a flaming liberal, my transformation is complete to fiscal conservative. To you I guess I would be beyond hope.

The wife if from GB and the same thing. We know socialism and it sucks - big time. That aside, discussing TRT rocks and I love this forum. I can't help it if I am always right about politics. [)]

 

[mrmorris]

Glad to see you no longer a flaming liberal. I don't care for them much

It's good to have you here on this forum, hope your here to stay!!!!!!

Thanks, mrmorris!

Thanks zkt, great reply. Being from Canada and starting out as a flaming liberal, my transformation is complete to fiscal conservative. To you I guess I would be beyond hope.

The wife if from GB and the same thing. We know socialism and it sucks - big time. That aside, discussing TRT rocks and I love this forum. I can't help it if I am always right about politics. [)]

 

[CubbieBlue]

Glad to see you no longer a flaming liberal. I don't care for them much

It's good to have you here on this forum, hope your here to stay!!!!!!

Thanks, mrmorris!

Morris - can you cut out the pointless posts? If you have something to contribute, please do. But enough of the "GREAT POST BRO THNX FOR BEING HERE!!!!"

 

[james2012]

Glad to see you no longer a flaming liberal. I don't care for them much

It's good to have you here on this forum, hope your here to stay!!!!!!

Thanks, mrmorris!

Thanks Morris! I just figured out how to join the groups you recommended. And I work in the computer field! Could it be brain fog?!

 

[james2012]

Paging Dr. Scally! Any inputs here Doc? I am going to go down to 1 tube testim, 150IU HCG every third day and only use Arimidex if I start to note symptoms of high E2. Measurements again in 1 month. Do you have any opinion?

 

[mrmorris]

WOW bud your not a very nice person are you! I always give you positive ratings on your postd, because there good!
If your going to slam me and call some of my posts pointless, then keep your thoughts to yourself.
I think completely different of you now, not that I even know you but just from reading your posts and replys.

Have you got a problem with me? I have done absoultly nothing to you, so back off pal!

Morris - can you cut out the pointless posts? If you have something to contribute, please do. But enough of the "GREAT POST BRO THNX FOR BEING HERE!!!!"

 

[mrmorris]

That's great bro! Don't worry I do things like that all the time, nobodys is perfect!

Thanks Again, mrmorris!

Thanks Morris! I just figured out how to join the groups you recommended. And I work in the computer field! Could it be brain fog?!

 

[CubbieBlue]

WOW bud your not a very nice person are you! I always give you positive ratings on your postd, because there good!
If your going to slam me and call some of my posts pointless, then keep your thoughts to yourself.
I think completely different of you now, not that I even know you but just from reading your posts and replys.

Have you got a problem with me? I have done absoultly nothing to you, so back off pal!

I don't give a shit how you rate my posts, I just prefer not to wade through a bunch of BS to get to something meaningful. Again, if you have something to contribute, great. But there is no reason to put "GOOD POST BRO" after every single post.

 

[mrmorris]

Wow you need to grow up! How old are you? I see nothing wrong with giving someone a thumbs up. DO NOT tell me what to do please! You have some issues pal work on them!

I don't give a shit how you rate my posts, I just prefer not to wade through a bunch of BS to get to something meaningful. Again, if you have something to contribute, great. But there is no reason to put "GOOD POST BRO" after every single post.

 

[mrmorris]

Also Cubbie, I don't say good post bro after reply. There may more than a few times I have done that and don't see anything wrong with it. Besides why in heck do you care?
Is it effecting you in some way? I don't think so. So go and nit pick somewhere else, or better yet don't do it all!

 

[CubbieBlue]

Also Cubbie, I don't say good post bro after reply. There may more than a few times I have done that and don't see anything wrong with it. Besides why in heck do you care?
Is it effecting you in some way? I don't think so. So go and nit pick somewhere else, or better yet don't do it all!

That's great bro! Don't worry about it anymore! Like you say, nobodys is perfect!

Thanks Again, Cubbieblue!

 

[mrmorris]

Are you serious Cubbie? It was that easy? Cool then, thanks for being understanding! There is some other guys here you try to work little things out with and they just attack over and over again.

Thanks again, mrmorris!

That's great bro! Don't worry about it anymore! Like you say, nobodys is perfect!

Thanks Again, Cubbieblue!

 

[Get Some]

I don't give a shit how you rate my posts, I just prefer not to wade through a bunch of BS to get to something meaningful. Again, if you have something to contribute, great. But there is no reason to put "GOOD POST BRO" after every single post.

Wow...you're instantly my new favorite Meso Member, haha

 

[MindlessWork]

Wow...you're instantly my new favorite Meso Member, haha

Agreed...if Cubbie can handle Mr M the way he did then strong kudos to him!