Water retention, swollen lymph nodes - help needed!

[Achi112]

Hey guys,
Sorry to post here asking for help, but I've tried everything else, and I don't know where to turn next.

Stats: 175CM, 65KG, pretty lean.
Eat clean, low salt, mostly whole foods. Take vits everyday, NAC, fish oil etc.
Gym every morning, fasted cardio + training.
Get my 10k steps every day.

Been on TRT for about a year now, a super low dose (80mg cypionate/week) + HCG. Pin ED subQ.

I've always had issues with minor water retention and moon face and assumed it was E2 mismanagement. I've been working with my Dr to dial in my E2 with Aromasin (currently 1g E3D). My E2 has looked good for the last few months, but the issues remain.

In the last few weeks, I started primo at 200mg/week (Titan) to see if that would help stabilise the E2 and reduce the water retention. It did not. The water retention and moon face have become much worse, and the lymph nodes in my neck are pretty swollen.

I've stopped the primo, of course, but now I'm wondering if this reveals some more information about my initial issues.

I will get bloodwork done next week to see if that reveals any further info on the current e2.

Do you guys have any insights or anything I could try/get checked out?

At this point, I'm pretty desperate to get this sorted, and I'll try anything you would recommend.

last blood results:

Oestradiol: 38.1
Free-Testosterone: 13
SHBG: 76
Prolactin: 242
Testosterone: 982.26

The other thing to note is that I have had super low red blood cell counts for the year, but I'm not sure if this is related.

I hope I've covered everything but let me know if you need more info.

Thanks in advance

 

[IronMetal_2]

Can you post lab ranges and also your other lab values (red blood cells, white blood cells, etc.)?.

How is estradiol measured by the lab? ECLIA? LC-MS? ECLIA is very inaccurate unfortunately, I have not found it to be reliable at all.

SHBG is very high...

How do you dose the HCG?

 

[Achi112]

Thanks for the quick response!
Yeah, I figured the E2 reading might not be right in the past but I've tried upping my AI and crushing my E2 for a few weeks to see if it helped - it made no difference (except I felt like shit obviously).

HcG is 80IU per day (560 /week)

Here's the rest of my bloods:

	Value	Range
Haemoglobin:	129	130 - 170 g/L
Red Blood Cells	3.88	4.40 - 5.80 x1012/L
Haematocrit	0.375	0.380 - 0.500 L/L
Mean Cell Volume	96.8	81 - 98 fl
Red Cell Distribution	13.3	11.5 - 14.4 %
Mean Cell Hb	33.3	27.0 - 33.0 pg
MCHC	344	300 - 350 g/L
Platelets	181	150 - 400
MPV	11.10	7 - 13 fl
White blood cells	2.5	4.0-11.0
ALT	35	<50
ALP	34	30-130

My red/white count has been low for a few years; I've had it looked at, and a bunch of tests run, but nothing out of the ordinary.

At this point, I'm willing to get whatever tests could help so anything you recommend I'll look into.

cheers

 

[IronMetal_2]

The way you are feeling probably has more to do with your hematologic blood values. You have borderline anemia. No wonder you aren't feeling great.

What have you looked at regarding this? Iron (Ferritin, transferrin, CRP), b12?

I'd suggest go and see a good doctor and run the tests above.

 

[Achi112]

Hey Iron,
Thanks again for the response, appreciate the feedback already.

Yeah, I actually investigated the anaemia with haematology for about 6 months earlier last year. They ran a bunch of tests for everything you mentioned and more (MRI, full body CT, I even had a bone marrow biopsy which absolutely sucked.) nothing showed up. The thing is I feel fine both mentally and physically I just have moon face and oedema and now swollen lymph nodes.

Any chance my body could be treating the injections as an infection and going into defence mode?

here are some previous results for the above-mentioned tests:

Hi sense CRP	0.2	0-5
B12	1476	145 - 569
Serum Folate	20.90	8.83 - 60.8
Serum ferritin	132.1	24-337

The B12 is blown because I take a b12 supp every day.

 

[IronMetal_2]

Wow, I'm glad that you are with a doctor and got serious stuff ruled out. What was their recommendation going forward?

Since when do you have oedema and swollen lymph nodes? Have these issues started with TRT or been there before?

Really need more information on your issues, timeline, other blood values, doctors recommendation/diagnosis. The anemia would be my number 1 concern. Also SHBG is crazy high. Your total T is great, but your shbg messes things up quite a bit.

Thyroid labs?

 

[Achi112]

Yeah I was concerned about it for a while but not so much anymore. Haematology recommended that we continue to monitor it (I have another appointment and of Feb). I was upfront with them about the TRT from the beginning, but they didn't think it would be the cause of the issues.

The oedema and moon face started a couple of months after starting TRT which is why I've always assumed it was E2. The lymph nodes and worsening of symptoms are new and I assume a reaction to the primo which is making me reconsider everything.

the SHBG might have been a one-off, previous values were a little lower at 54 and 39

I also thought thyroid as my thyroid has been out of whack for a while.
I've been on 75mg T4 for 3 years. I got my levels checked recently and everything seemed normal:

TSH	3.45	0.27 - 4.20
Free T4	16.2	12.0 - 22.0

In the past I've tried upping my dose of T4 to see if that made a difference and even ran 50mg T3 alongside it for a few weeks - no changes .

 

[IronMetal_2]

do you have free T3 values too?
If you're medicating with thyroid hormones, you generally aim for lower TSH (like <2). fT4 looks good, but I would want to see it in the context of free T3. Could well be that you are still hypo, especially with your TSH being relatively high. Some people do not convert T4 -> T3 well.

Drop the primo if you haven't already and go back on your TRT only protocol. I would drop any AI too. How do you respond to the carrier oil of your test cyp? I had issues in the past when using a different lab and felt bad even though blood values looked ok.

What I would not recommend you doing is just taking a bunch of stuff and see if there are any changes. That won't work well with hormones. Slowly need to adjust before adding different things.

Sorry I don't have more input for you.

TL;DR: Get thyroid checked with free T3 next time, drop any AI, maybe use a different lab for your testosterone and see if any change. Stay consistent for a couple weeks before adjusting anything.

PS: What is your body temperature like (Morning, mid-day, evening)?

 

[Rido]

Your leukopenia is what I am looking at over everything else.

I highly doubt t3 has a role to do with this


I am not sure if that's related for he enlarged lymph nodes. Could be inflammatory based though...

The bmbx would have explained it but some people are leukopenic/anemic of unclear etiology. There are people that have erythrocytosis too with no clear reason.


Is titan the brewer?

 

[HB_22]

Upping your test from 80 to 100mg could help with your blood values. When I went down to 105mg per week I had similar blood work, but not as bad.

 

[IronMetal_2]

Your leukopenia is what I am looking at over everything else.

I highly doubt t3 has a role to do with this


I am not sure if that's related for he enlarged lymph nodes. Could be inflammatory based though...

The bmbx would have explained it but some people are leukopenic/anemic of unclear etiology. There are people that have erythrocytosis too with no clear reason.


Is titan the brewer?

I agree. Would still be beneficial for him to sort out his hormones.

 

[Rido]

I agree. Would still be beneficial for him to sort out his hormones.

Yea..


You know what.. op... Have you had a CT scan of your neck??....