new blood work and need some advice

[jrctherake]

I've been on trt for little over three years.

What got me to trt originally was low t and several of he downs that come with it such as depression, lack of sex drive, losing muscle, no energy etc..

My original t and e numbers from very first blood test before starting trt was:

TT 280 (75 to 800)
FT .325 (.7 to 1)
E 65 (< 50)

I weighed 198 lbs @ around 20% body fat, 5' 9" tall and was 43 at the time.

The doc then put me on test cyp @ 200mg ew and 1/4 tab of a 1mg arimidex tab every third day.

Six months later my blood work came in with TT 1100 (150 to 850)...FT 2.3 (.7 to 1) and E 10 (<50)

Lots of my other stuff came in way out of range as well with the second blood. My hdl fell very low and my ldl went up. My shbg went up too. I cannot remember exact numbers for those but they were a lot higher than before starting trt.

Fast forward:

After a lot of trial and error I am at 80 mg of test cyp ew and 1/8 of dex tab twice a week and this is the blood work I got back:

HEMTOLOGY:

WBC 6.5 (4.8 to 10.8)
RBC 5.01 (4.7 to 6.1)
HGB 16.1 (12 to 16)
HCT 46.7 (37 to 47)
MCV 93.2 (80 to 97)
MCH 32.2 (27 to 31)
MCHC 34.5 (33 to 37)
RDW 14.5 (11.5 to 17.3)
PLT 211 (130 to 400)

AUTO DIFF:

GRAN# 4.1 (1.4 to 6.5)
LYMPH# 1.8 (1.2 to 3.4)
MID# 0.6 (.1 to .6)
GRAN% 63.1 (42.2 to 75.2)
LYMPH% 28.5 (20.5 to 51.1)
MID% 8.4 (1.7 to 9.3)

COMPREHENSIVE METABOLIC PROFILE

GLUCOSE 99 (70 to 105)
BUN 19.0 (7.0 to 25.0)
CREATININE 1.1 (.6 to 1.4)
eGFR (African American) 87
eGFR (non African American) 72
BUN/CREAT RATIO 17.3

SODIUM 137 (136 to 145)
POTASSIUM 4.1 (3.6 to 5.5)
CHLORIDE 102.0 (98 to 107)
CARBON DIOXIDE 30.5 (21.0 to 31.0)
ANION GAP 5
CALCIUM 9.6
TOTAL PROTEIN 6.4 (6.0 to 8.3)
ALBUMIN 4.3 (3.5 to 5.7)

COMMENTS: estradiol (257.2)

A/G RATIO 2.0
GLOBULIN 2.1
ALK. PHOS. 45 (40 to 115)
ALT (SGPT) 44 (7 to 52)
AST (SGOT) 30 (13 to 39)
TOTAL BILIRUBIN 0.5 (0.3 to 1.0)

LIPID PROFILE

CHOLESTEROL 221 (125 to 200)
TRIGLYCERIDES 167 (0 to 150)
HDL 38 (>40)
LDL (direct) 122 (0 to 130)
LDL (CALCULATED) 150 (0 to 100)
HDL RISK FACTOR 5.8
NON-HDL 183

THYROIDS

TSH, 3RD GENERATION 1.34 (0.34 to 5.60)

SPECIAL CHEMISTRY

SEX HORMONE BIND GLOB 20.0 (10.0 to 80.0)
TESTOSTERONE 302.00 (175.00 to 781.00)
ANDROGEN INDEX 0.5240 (0.7000 to 1.0000)

SEND OUT TEST

ESTRADIOL (257.2)
ESTRADIOL 41 (<40)

I took the blood test in fasted state in the a.m. I took the blood test 7 days after my last shot (the day I was suppose to take my next shot). I took the first blood test in same manner.

I now weigh 207 lbs @34% body fat, still the same 5' 9" tall. My food and exercise has stayed pretty close to same all the while.

All of the weight I gained is from neck to belly button. I literally got skinny everywhere but between neck and belly button area.

My gut is hard as a rock. I would think that fat would be soft and giggly not hard. I look as if I'm pregnant. What is going on with that? Is it visceral fat or what?

Is the trt protocol I'm on causing this?

What to you guys think I should ask my doc to do?

Also, should I ask about HCG?

I'm sure I'm forgetting a ton of stuff so anything you want to add please feel free.

Thanks so much for your time and input.

 

[cvictorg]

I've been on trt for little over three years.

What got me to trt originally was low t and several of he downs that come with it such as depression, lack of sex drive, losing muscle, no energy etc..

My original t and e numbers from very first blood test before starting trt was:

TT 280 (75 to 800)
FT .325 (.7 to 1)
E 65 (< 50)

I weighed 198 lbs @ around 20% body fat, 5' 9" tall and was 43 at the time.

The doc then put me on test cyp @ 200mg ew and 1/4 tab of a 1mg arimidex tab every third day.

Six months later my blood work came in with TT 1100 (150 to 850)...FT 2.3 (.7 to 1) and E 10 (<50)

Lots of my other stuff came in way out of range as well with the second blood. My hdl fell very low and my ldl went up. My shbg went up too. I cannot remember exact numbers for those but they were a lot higher than before starting trt.

Fast forward:

After a lot of trial and error I am at 80 mg of test cyp ew and 1/8 of dex tab twice a week and this is the blood work I got back:

HEMTOLOGY:

WBC 6.5 (4.8 to 10.8)
RBC 5.01 (4.7 to 6.1)
HGB 16.1 (12 to 16)
HCT 46.7 (37 to 47)
MCV 93.2 (80 to 97)
MCH 32.2 (27 to 31)
MCHC 34.5 (33 to 37)
RDW 14.5 (11.5 to 17.3)
PLT 211 (130 to 400)

AUTO DIFF:

GRAN# 4.1 (1.4 to 6.5)
LYMPH# 1.8 (1.2 to 3.4)
MID# 0.6 (.1 to .6)
GRAN% 63.1 (42.2 to 75.2)
LYMPH% 28.5 (20.5 to 51.1)
MID% 8.4 (1.7 to 9.3)

COMPREHENSIVE METABOLIC PROFILE

GLUCOSE 99 (70 to 105)
BUN 19.0 (7.0 to 25.0)
CREATININE 1.1 (.6 to 1.4)
eGFR (African American) 87
eGFR (non African American) 72
BUN/CREAT RATIO 17.3

SODIUM 137 (136 to 145)
POTASSIUM 4.1 (3.6 to 5.5)
CHLORIDE 102.0 (98 to 107)
CARBON DIOXIDE 30.5 (21.0 to 31.0)
ANION GAP 5
CALCIUM 9.6
TOTAL PROTEIN 6.4 (6.0 to 8.3)
ALBUMIN 4.3 (3.5 to 5.7)

COMMENTS: estradiol (257.2)

A/G RATIO 2.0
GLOBULIN 2.1
ALK. PHOS. 45 (40 to 115)
ALT (SGPT) 44 (7 to 52)
AST (SGOT) 30 (13 to 39)
TOTAL BILIRUBIN 0.5 (0.3 to 1.0)

LIPID PROFILE

CHOLESTEROL 221 (125 to 200)
TRIGLYCERIDES 167 (0 to 150)
HDL 38 (>40)
LDL (direct) 122 (0 to 130)
LDL (CALCULATED) 150 (0 to 100)
HDL RISK FACTOR 5.8
NON-HDL 183

THYROIDS

TSH, 3RD GENERATION 1.34 (0.34 to 5.60)

SPECIAL CHEMISTRY

SEX HORMONE BIND GLOB 20.0 (10.0 to 80.0)
TESTOSTERONE 302.00 (175.00 to 781.00)
ANDROGEN INDEX 0.5240 (0.7000 to 1.0000)

SEND OUT TEST

ESTRADIOL (257.2)
ESTRADIOL 41 (<40)

I took the blood test in fasted state in the a.m. I took the blood test 7 days after my last shot (the day I was suppose to take my next shot). I took the first blood test in same manner.

I now weigh 207 lbs @34% body fat, still the same 5' 9" tall. My food and exercise has stayed pretty close to same all the while.

All of the weight I gained is from neck to belly button. I literally got skinny everywhere but between neck and belly button area.

My gut is hard as a rock. I would think that fat would be soft and giggly not hard. I look as if I'm pregnant. What is going on with that? Is it visceral fat or what?

Is the trt protocol I'm on causing this?

What to you guys think I should ask my doc to do?

Also, should I ask about HCG?

I'm sure I'm forgetting a ton of stuff so anything you want to add please feel free.

Thanks so much for your time and input.

1) What is your diet like? What did you eat yesterday and is that a typical day?

2) Your trigs are too high and your HDL is too low!

 

[idmd]

I've been on trt for little over three years.

What got me to trt originally was low t and several of he downs that come with it such as depression, lack of sex drive, losing muscle, no energy etc..

My original t and e numbers from very first blood test before starting trt was:

TT 280 (75 to 800)
FT .325 (.7 to 1)
E 65 (< 50)

I weighed 198 lbs @ around 20% body fat, 5' 9" tall and was 43 at the time.

The doc then put me on test cyp @ 200mg ew and 1/4 tab of a 1mg arimidex tab every third day.

Six months later my blood work came in with TT 1100 (150 to 850)...FT 2.3 (.7 to 1) and E 10 (<50)

Lots of my other stuff came in way out of range as well with the second blood. My hdl fell very low and my ldl went up. My shbg went up too. I cannot remember exact numbers for those but they were a lot higher than before starting trt.

Fast forward:

After a lot of trial and error I am at 80 mg of test cyp ew and 1/8 of dex tab twice a week and this is the blood work I got back:

HEMTOLOGY:

WBC 6.5 (4.8 to 10.8)
RBC 5.01 (4.7 to 6.1)
HGB 16.1 (12 to 16)
HCT 46.7 (37 to 47)
MCV 93.2 (80 to 97)
MCH 32.2 (27 to 31)
MCHC 34.5 (33 to 37)
RDW 14.5 (11.5 to 17.3)
PLT 211 (130 to 400)

AUTO DIFF:

GRAN# 4.1 (1.4 to 6.5)
LYMPH# 1.8 (1.2 to 3.4)
MID# 0.6 (.1 to .6)
GRAN% 63.1 (42.2 to 75.2)
LYMPH% 28.5 (20.5 to 51.1)
MID% 8.4 (1.7 to 9.3)

COMPREHENSIVE METABOLIC PROFILE

GLUCOSE 99 (70 to 105)
BUN 19.0 (7.0 to 25.0)
CREATININE 1.1 (.6 to 1.4)
eGFR (African American) 87
eGFR (non African American) 72
BUN/CREAT RATIO 17.3

SODIUM 137 (136 to 145)
POTASSIUM 4.1 (3.6 to 5.5)
CHLORIDE 102.0 (98 to 107)
CARBON DIOXIDE 30.5 (21.0 to 31.0)
ANION GAP 5
CALCIUM 9.6
TOTAL PROTEIN 6.4 (6.0 to 8.3)
ALBUMIN 4.3 (3.5 to 5.7)

COMMENTS: estradiol (257.2)

A/G RATIO 2.0
GLOBULIN 2.1
ALK. PHOS. 45 (40 to 115)
ALT (SGPT) 44 (7 to 52)
AST (SGOT) 30 (13 to 39)
TOTAL BILIRUBIN 0.5 (0.3 to 1.0)

LIPID PROFILE

CHOLESTEROL 221 (125 to 200)
TRIGLYCERIDES 167 (0 to 150)
HDL 38 (>40)
LDL (direct) 122 (0 to 130)
LDL (CALCULATED) 150 (0 to 100)
HDL RISK FACTOR 5.8
NON-HDL 183

THYROIDS

TSH, 3RD GENERATION 1.34 (0.34 to 5.60)

SPECIAL CHEMISTRY

SEX HORMONE BIND GLOB 20.0 (10.0 to 80.0)
TESTOSTERONE 302.00 (175.00 to 781.00)
ANDROGEN INDEX 0.5240 (0.7000 to 1.0000)

SEND OUT TEST

ESTRADIOL (257.2)
ESTRADIOL 41 (<40)

I took the blood test in fasted state in the a.m. I took the blood test 7 days after my last shot (the day I was suppose to take my next shot). I took the first blood test in same manner.

I now weigh 207 lbs @34% body fat, still the same 5' 9" tall. My food and exercise has stayed pretty close to same all the while.

All of the weight I gained is from neck to belly button. I literally got skinny everywhere but between neck and belly button area.

My gut is hard as a rock. I would think that fat would be soft and giggly not hard. I look as if I'm pregnant. What is going on with that? Is it visceral fat or what?

Is the trt protocol I'm on causing this?

What to you guys think I should ask my doc to do?

Also, should I ask about HCG?

I'm sure I'm forgetting a ton of stuff so anything you want to add please feel free.

Thanks so much for your time and input.

Sounds like visceral fat to me. One of the biggest problems I see with new people who come here and are new to TRT (I know you're not but still worth saying) is this expectation that TRT is going have some magical or profound effect - especially on weight. In the end a bad diet can undo all the benefits of TRT IMO. Your lipid profile is not good and I will defer to our diet experts for further info.........

 

[zkt]

Not sure if I am a diet expert or not, but Ive managed to keep myself alive for 15 years despite the first fifty years being spent in every imaginable sort of depravity and self destructive behavior.

Agree with my two estemed collegues; Your diet is what need to be discussed first.
You appear to have a bit of insulin resistance, a good bit. This is often brought on by chronic over comsumption of sugar, simple carbs, and/or alcohol.
Might as well fess up now or otherwise we will rip it out of you sooner or later.

 

[idmd]

Just wondering zkt - what is tipping you off to IR in his lab results?

 

[zkt]

Just wondering zkt - what is tipping you off to IR in his lab results?

I draw up a mental image of a pear. Thats the poster child of insulin resistance. !
Lacking a Hx of diabetes odds are good that he has had dietary issues.
How otherwise to explain it?
Welll, there is this:
"My gut is hard as a rock. I would think that fat would be soft and giggly not hard. I look as if I'm pregnant. "

 

[cvictorg]

I draw up a mental image of a pear. Thats the poster child of insulin resistance. !
Lacking a Hx of diabetes odds are good that he has had dietary issues.
How otherwise to explain it?
Welll, there is this:
"My gut is hard as a rock. I would think that fat would be soft and giggly not hard. I look as if I'm pregnant. "

Bingo - plus high trigs and low hdl

 

[Dr JIM]

How about a frontal and lateral pic of your body type, as an ectomorph, I suppose.

 

[idmd]

I draw up a mental image of a pear. Thats the poster child of insulin resistance. !
Lacking a Hx of diabetes odds are good that he has had dietary issues.
How otherwise to explain it?
Welll, there is this:
"My gut is hard as a rock. I would think that fat would be soft and giggly not hard. I look as if I'm pregnant. "

Yeah I didn't miss that part...just wondering if you were able to see something in his labs. While you're giving a good guess as to his IR based on his description of his belly that's not exactly quantifiable. I for instance still have a hard belly (although getting better) with no quantifiable lab result to suggest I still have IR.

 

[jrctherake]

Here are the pictures someone ask for in case it can be of help.

As far as my diet goes, I normally eat subway (turkey foot longs once a day) for lunch.
Breakfast is usually- large bowl of presweetened oats or raisin bran for breakfast. Sometimes I will have 4 or 5 eggs over easy with one or two strips of bacon.

Dinner- what ever wife cooks. usually chili, chicken soup (homemade not out of can), meatloaf with green beans and the like.

I do have a sweet tooth from time to time but I do not eat sweet on a regular basis by any means. I use to work out on regular basis up until back surgery three years ago.

Anyways here are the pics I hope they upload correctly as I am not exactly good with computers.

 

[jrctherake]

here are from pics from front and side relaxed.

 

[jrctherake]

I tried to edit my op but it would not let me so I had to post again.

Someone ask about other things or reasons.

Well, I used aas for three cycles in my early 20's. I ran 800mg test cyp ew, 25mg dbol ed and 400mg EQ ew for 16 weeks or so each cycle. Like I said I did three cycles and then stopped.

I was a bodybuilder from 19 to 25.

At 26 I continued to work out but did so naturally but my diet was what most call KETO. I ate nothing but lean red meat and very few veggies (green beans mostly) and drank nothing but water. I did that from 26 till age 35 and then broke my back in three places and stopped training altogether and started eating what ever when ever until I was 40 at which point I started trying to correct my diet and health again but have not been able to do so.

BTW, I take other meds every day. They are as follows and are from the same doc that gives me the trt:

two 10mg oxycodones ........one in morning and one at bedtime.
.5mg of clonazapam in morning and .5mg at bedtime.
ambien at bedtime.
prozac.........one at bedtime.

other than that I take my trt meds.

OK, you guys know all the dirt on me now.

What you think?

 

[idmd]

Yes sir....that dome shaped belly is caused by copious amounts of visceral fat packed in between your organs. It is sending a steady supply of FFA into your portal vein and fucking up your liver and metabolism.

Your diet is a mess. You say you don't eat sweet but raisin brand and foot long subs are about as sweet as it gets especially when you are in a constant caloric excess - and you are.

You may not be type 2 DM (yet) but you have a problem with chronic Hyperinsulinemia caused by your diet. It may not seem like a bad diet to you but the proof is your pics, history and labs - in other words what ever it is it is NOT good for YOU.

 

[idmd]

Yeah I didn't miss that part...just wondering if you were able to see something in his labs. While you're giving a good guess as to his IR based on his description of his belly that's not exactly quantifiable. I for instance still have a hard belly (although getting better) with no quantifiable lab result to suggest I still have IR.

Addendum after seeing pics: that is what my belly used to look like when I was IR....ok carry on!

 

[jrctherake]

Yes sir....that dome shaped belly is caused by copious amounts of visceral fat packed in between your organs. It is sending a steady supply of FFA into your portal vein and fucking up your liver and metabolism.

Your diet is a mess. You say you don't eat sweet but raisin brand and foot long subs are about as sweet as it gets especially when you are in a constant caloric excess - and you are.

You may not be type 2 DM (yet) but you have a problem with chronic Hyperinsulinemia caused by your diet. It may not seem like a bad diet to you but the proof is your pics, history and labs - in other words what ever it is it is NOT good for YOU.

Should I go back to low carb eating?

I was always around 7 ot 10% body fat duing my bodybuilding days but I ate only meat and green beans and drank water and that is very hard to do long term.



I did carb cycling years ago where you eat for example 300 gm carbs 1st day........250 gm 2nd day........100 gm 3rd day........0 carb 4th day........then start over.........repeat....and so on......and from time to time (every three weeks or so) have a high carb day of 500 to 700 carbs.

The above carb days would change depending on which day it was but the below for protein and fat would stay the same other than on high carb days (once ever few weeks). On the ever now and then high carb day I would drop my fat back low as possible (10 to 15 grams) but keep my protein the same.


Along with the above would be 1 to 1.5 grams of protein per lb of lbm (not body weight) and .5 to .8 gms of fat per lb of body weight (not lbm).

Does that sound like a good idea?

My doctor knows very little about trt and even less about diet.

Thanks

 

[jrctherake]

Addendum after seeing pics: that is what my belly used to look like when I was IR....ok carry on!

What did you do to take care of the problem? Is it just diet? If so, what did you change from and to as far as food?

Is there anything besides diet that can be done to help IR? I'm not saying that I do not want to eat healthy but I would like to know all the same.

Thanks

 

[idmd]

You and I are very similar except I was never a body builder - you have proven you were once very disciplined and I think this puts you ahead.

I'm currently carb cycling with high GOOD carb/low fat Sunday and Wednesday (corresponds to my heavy workout days) and high GOOD fat/VLC the rest of the days. I'm also at a caloric deficit since I'm try to lose 40lbs. This diet is easy to adhere to and hopefully those carb days with prevent the drop in T3 and slow down in metabolism.

LW64/zkt and others are very well versed in diet....but yeah you have a diet/eating problem IMO.

 

[idmd]

What did you do to take care of the problem? Is it just diet? If so, what did you change from and to as far as food?

Is there anything besides diet that can be done to help IR? I'm not saying that I do not want to eat healthy but I would like to know all the same.

Thanks

Yes, the beginning of 2012 I went on a LC diet and started exercising and lost 40lbs. With that ALL measurable indicators of IR went away. I'm now going for another 40lbs.

You have to lose weight and in particular lose the visceral fat...that is what is causing your IR....not your love handles, not your ass, not your upper arms, your belly.

 

[jrctherake]

You and I are very similar except I was never a body builder - you have proven you were once very disciplined and I think this puts you ahead.

I'm currently carb cycling with high GOOD carb/low fat Sunday and Wednesday (corresponds to my heavy workout days) and high GOOD fat/VLC the rest of the days. I'm also at a caloric deficit since I'm try to lose 40lbs. This diet is easy to adhere to and hopefully those carb days with prevent the drop in T3 and slow down in metabolism.

LW64/zkt and others are very well versed in diet....but yeah you have a diet/eating problem IMO.

Yes, the beginning of 2012 I went on a LC diet and started exercising and lost 40lbs. With that ALL measurable indicators of IR went away. I'm now going for another 40lbs.

You have to lose weight and in particular lose the visceral fat...that is what is causing your IR....not your love handles, not your ass, not your upper arms, your belly.

Thanks for the detailed info.

I will check back to see if one of the other guys you mentioned chimes in to give me advise as well.

Thanks again.

 

[Dr JIM]

Whats your percent BF. How often do you exercise?
How much beer do you drink?
What medications are you taking including OTC meds in the PAST year