UPDATE: New Bloods!
I plugged my September bloods and November bloods into ChatGPT to be better able to review. Below are the results of both tests. NOTE: Obviously take ChatGPT's analysis with a pinch of salt, but the numbers are what's important here. Specifically the trends.
My lipids have improved a little, Triglycerides a LOT! Will focus on lowering LDL a bit more and raising HDL. NOTE: My LDL was 5.6 in Dec 2024, 5.1 in Feb this year, and while still above the range, is now 3.8. Clearly trending the right way.
E2 is a wild swing, from 167 to 76 is huge. I moved from .25mg Anastrazole e7d to e6d, but the main factor in such a swing is I took my dose the night before these morning bloods. Last time it wouldnt have been so close. I dont like the wild swing in E2 from dose day to the day before following dose day - so I am going to discuss with my TRT doc whether Exemestane would be better, since I can control that more stable. Anastrazole tabs are too small to break into more than quarters.
I am delighted with my HbA1C! Phenomenal improvement! The keto diet has been huge for me here! Of course the fat loss too, but dropping carbs like a hot snot has been significant in bringing HbA1C down.
I am delighted with my improvement in Haematocrit too! I started on 100mg of Test/week and would like to push it in the direction of 140/week to get to the typical male range in the 1970's, when men were healthier - arguably when men were men. Doesn't mean exactly 140/week but I want to optimise as much as I can, without the side effects. So now that my H-crit is even lower, I am going to increase my weekly T.
Anyway, gotta get back to work. But just wanted to post those results for any of the doubters or those chatting shit about my progress.
1. Red cells / oxygen-carrying capacity
September → November:
- Haemoglobin: 160 → 150 g/L (normal both times; you’ve moved from upper-mid to mid-range)
- Haematocrit: 0.489 → 0.451 L/L (also a step down but still within range)
- RBC count: 5.31 → 4.98 ×10¹²/L (both normal)
- MCV: 92 → 90.4 fL (normal)
- MCH/MCHC: essentially unchanged and normal.
- RDW: 14.6 → 16.0% (now just above the upper limit of 15%)
Interpretation
- Hb/Hct have come down a bit from near the top of the range. For someone on TRT with clotting history, this is not a bad thing – it means less erythrocytosis risk while still having perfectly adequate oxygen-carrying capacity.
- RDW going from normal to mildly high suggests your red cells are a bit more variable in size. In practice this can:
- Be a transient lab artefact
- Or hint at early iron/B12/folate issues or other “mixed” states even when Hb is still normal
Given:
- Hb/Hct are fine,
- Ferritin is still decent (see below),
this is a “watch” not a “panic”. I’d just make sure that on a future panel you get iron studies + B12 + folate if not already done with your GP.
2. White cells / infection / inflammation
September → November:
- WCC: 12.0 → 10.2 ×10⁹/L
- Sept: mildly high
- Nov: back within reference but at the upper end
- Neutrophils: 8.8 → 7.7 ×10⁹/L
- Both above the stated upper limit of 7.5, but November is closer to normal
- Lymphocytes, monocytes, eosinophils, basophils: all within range on both, with trivial shifts.
With your URTI on the November morning:
- You’d actually expect neutrophils and total WCC to go up with an acute infection.
- Despite that, both WCC and neutrophils are lower than they were in September.
So overall:
- September: looks more like a neutrophil-driven bump – could have been low-grade infection/inflammation or even handling artefact (they even warn EDTA storage can distort counts).
- November: improved and more reassuring, and the slight neutrophil edge is easily explained by your URTI on the day.
Nothing here screams chronic pathology; trend is
towards normal, not away.
3. Platelets / clotting
September → November:
- Platelets: 324 → 321 ×10⁹/L (basically identical and comfortably normal)
- MPV: 9.9 → 9.5 fL (normal)
No concerns. Given your DVT history and Apixaban use, it’s good that platelets are rock-steady mid-range.
4. Kidney function
September → November:
- Urea: 5.9 → 4.8 mmol/L
- Creatinine: 92 → 91 µmol/L
- eGFR: 90 → 90 mL/min/1.73m²
Essentially unchanged, all
normal. No sign of deterioration.
5. Liver function
September → November:
- ALT: 38 → 18 U/L (dropped from the upper half of normal to the low–mid range)
- GGT: 46 → 22 U/L (big improvement; from mid-range to low)
- ALP: 112 → 113 U/L (stable normal)
- Bilirubin: 8 → 7 µmol/L (stable normal)
This is one of the
most positive shifts:
- Your November liver profile looks cleaner – especially the GGT drop, which often tracks hepatic stress, fatty liver, alcohol, and some drugs.
- In the context of your weight loss and regime, this looks very much like genuine improvement, not random variation.
6. Glucose control (HbA1c)
September → November:
Both are in the “non-diabetic” range, but:
- 39 is at the top of normal.
- 31 is firmly in the lower half.
That’s a
major improvement in average glycaemia and absolutely matches what you’d expect from the fat loss + ketogenic pattern you’ve been running. Metabolic risk is moving in the right direction here.
7. Lipids
September → November:
- Total Cholesterol: 5.54 → 5.03 mmol/L (both just above the ideal cut-off; improving)
- LDL: 3.96 → 3.78 mmol/L (still above the <3.0 target; modest improvement)
- Non-HDL: 4.83 → 4.31 mmol/L (still above <4.0, but clearly improved)
- HDL: 0.71 → 0.72 mmol/L (both low; essentially unchanged)
- Triglycerides: 1.92 → 1.18 mmol/L (nice improvement; first result was upper-normal, second is comfortably low)
- Total Chol/HDL ratio: 7.78 → 7.01 (still above the <6 target; trending better)
Net picture:
- Direction: clearly better – TC, LDL, non-HDL and TG all improved.
- Absolute risk: still atherogenic:
- HDL is low in both panels.
- The ratio remains high even after improvement.
Given your other risk factors (history of obesity, DVT, TRT, etc.), lipids are still a
key area to optimise further with your prescriber: diet, weight loss (already ongoing), maybe pharmacologic lipid lowering if not already addressed in the rest of your care.
8. Proteins & iron stores
Proteins:
- Total protein: 73 → 66 g/L (both normal)
- Albumin: 45 → 40 g/L (normal, slightly lower on the November test)
- Globulin: 28 → 26 g/L (normal)
These small downward shifts can reflect differences in hydration and acute-phase status – and you were mildly ill on the November draw. Well within normal; nothing worrying.
Ferritin:
- 237 → 147 µg/L (both within range; now mid-range rather than high-normal).
That’s a
healthy direction overall – excessively high ferritin can be inflammatory or iron-overload territory. Combined with the slightly raised RDW, I wouldn’t assume iron deficiency, but I would:
- Log the trend.
- If RDW stays high or you develop symptoms / Hb falls further, get full iron studies (ferritin, transferrin saturation), B12, folate.
9. Thyroid
September → November:
- TSH: 2.38 → 1.85 mIU/L
- Free T3: 4.8 → 4.2 pmol/L
- Free T4: 18.5 → 18 pmol/L
All
solidly euthyroid on both panels. The micro-changes are trivial and well within what you’d expect from day-to-day variation. Nothing here suggests under- or over-replacement compared to before.
10. Sex hormones, prolactin & SHBG (TRT context)
September → November:
- Total Testosterone: 18.5 → 16.9 nmol/L
- Both comfortably mid-range for a male on TRT.
- Free Testosterone (calc): 0.5462 → 0.5158 nmol/L
- Both close to the top of the reference range.
- Free Androgen Index: 130 → 104%
- Both above the upper ref (92.6%); i.e. androgen status still on the highish side, but less extreme than September.
- SHBG: 14.2 → 16.2 nmol/L (still low vs reference, but slightly improved)
Oestradiol:
- 167 → 76.7 pmol/L
- September: just above the male upper limit (159)
- November: comfortably mid-range for a male (ref 41.4–159)
FSH / LH:
- FSH: 0.3 → 0.3 IU/L
- LH: 0.3 → 0.3 IU/L
Both suppressed on both panels – exactly what you’d expect on exogenous TRT.
Prolactin:
- 369 → 157 mIU/L
- September: mildly above the upper limit (324).
- November: well within normal.
Takeaways:
- Androgen status: very similar overall; a slight drop in total and free T, but still in a strong replacement range, not sub-physiological by any stretch.
- Oestradiol: this is a big, and frankly very helpful, improvement: you’ve gone from slightly supraphysiologic E2 (which can tie into gyno, mood, fluid retention) down to a very normal level. Given your known AI adjustments, this matches what we’d expect.
- Prolactin: clearly normalised – that’s a win in terms of libido, mood, and gyno risk.
The combined hormone picture is
cleaner in November: T is still good, E2 is now tidy, and prolactin is no longer an outlier.
11. PSA / prostate
September → November:
Both are
low; November is even lower. No concern here.
