Labs - Help

[Cajun]

[[ edited by chilln: removed the therapy ]]

Questions:
1. How do levels look in reference to HC > still tired in early afternoon.

2. Thyroid test TSH 3rd Generation 0.63 range 0.4 - 4.5 mIU/L > Numbers look good but lack of absorption of Testosterone would possibly indicate Thyroid issue??? What other testing should be done to rule out Thyroid issue or is it apparant that it an Adrenal issue and NOT a Thyroid issue?

3. Any other suggestions / concerns based on these numbers

Related Post regarding DHEA and Depression I have experienced : http://musclechatroom.com/forum/showthread.php?t=3068

[pmgamer18]

I would get your thyroid tested TSH, Free T3 & 4, Total 3 & 4. Some men with a Thyroid problem end up with thicker skin forgot the name for this but gels and creams don't get through the skin. You might need to switch to shots if you do start at 100 mgs every week. Get your Dr. to show you how to do them your self.

[chilln]

Questions:
1. How do levels look in reference to HC > still tired in early afternoon.

2. Thyroid test TSH 3rd Generation 0.63 range 0.4 - 4.5 mIU/L > Numbers look good but lack of absorption of Testosterone would possibly indicate Thyroid issue??? What other testing should be done to rule out Thyroid issue or is it apparant that it an Adrenal issue and NOT a Thyroid issue?

3. Any other suggestions / concerns based on these numbers

Related Post regarding DHEA and Depression I have experienced : http://musclechatroom.com/forum/showthread.php?t=3068


[[edited by chilln: removed commentary on therapy ]]

[Cajun]

[[ edited by chilln: removed details re therapy ]]

I was doing 24 hour Rhein but I understand now will be going to serum testing. Are there any other items (labs) that are of concern OR do I need to wait to get blood testing and wait to testosterone levels are stable and in range.

[hardasnails1973]

People with normal serum testosterone and low urine out put have something binding it up or they have a rare condition known as androgen insensitivity that may require more testoseterone then normal.

[JanSz]

I was doing 24 hour Rhein but I understand now will be going to serum testing. Are there any other items (labs) that are of concern OR do I need to wait to get blood testing and wait to testosterone levels are stable and in range.


On weekly schedule, by definition, you are not going to have stable testosterone or E2 levels.

Reason why people have success on transdermal testosterone is not because it is transdermal but because it is applied daily, sometimes 2x/day.

Different people have different rate of metabolizing testosterone or e2.
That is not as important when new testosterone is delivered every 24 or 12 hours.

Rate of metabolizing becomes of paramount obsticle when dealing with weekly testosterone delivery.

That obsticle prevents proper evaluation of average testosterone and E2 levels.
Add to that infrequent testing and large %% of errors in testing and you may get the picture.
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Long explanation on why you should do you t-shots every other day.

I do my T and HCG shots on same day, next day without shots.
I draw blood 48hrs after the shots.
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There were complaints about quality of needle/syringe assemblies.
In last over 2 years I used only these, no complaints.

http://www.hocks.com/Merchant5/merchant.mvc?Screen=PROD&Product_Code=A910291
BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b Price: $27.80
.
.

[asdf]

I was curious if you started TRT without any actual bloodwork (just urinary)? Did you figure out the reason for your low test before starting TRT?

[Cajun]

I was curious if you started TRT without any actual bloodwork (just urinary)? Did you figure out the reason for your low test before starting TRT? YES

3-31-08 (Around 1:00pm)
Total Testosterone 234 241 – 827 ng/dL
LH 2.1 mIU/ml
FSH 1,5 mIU/ml
Prolactin 6.3 ng/ml
PSA 1.0 ng/ml.

(Various TRT Treatments - Mainly Pellets and Shots as needed)

Stopped TRT from August to September and did blood test around October
Fasting 7:30 am
Total Testosterone 450 241 – 827 ng/dL

Rhein confirmed Low Testosterone over 24 hour period vs single blood draw.

Wow why the change - 234 to 450 > Dr. Crisler then did 24 hour Rhein and said that some people get boost of Testosterone overnight and then whamo no more throughout the day.

*** Did not see Dr Crisler until 11-08 ***

[chilln]

Wow why the change - 234 to 450


Either:

a) The T boost triggered a lot of healing, so your body recovered to its genetic maximums.

and / or

b) You dumped a lot of physical and / or mental stressors.



Dr. Crisler then did 24 hour Rhein and said that some people get boost of Testosterone overnight and then whamo no more throughout the day.


Can't answer that question until you spell out the month of the Rheins test, so we can see whether the Rheins was before, during, or after, the Testosterone hiatus.

[Cajun]

Rheins are listed in first post november - 1 month after serum labs.

[chilln]

Rheins are listed in first post november - 1 month after serum labs.

Sorry but I don't have time to create a mental picture over time of your serum and urinary results, from the JPEG images plus your multiple posts.

You may want to collate them yourself into a single table, on a larger sheet.

Or you may want to present only the highlights in a single table.

But in the end you're going to need a small table, with a date for each test.

[Cajun]

But in the end you're going to need a small table, with a date for each test.
Thought the jpg would be the simpliest way to show data (You may want to suggest a template for urine and serum data).

3-31-08 (Around 1:00pm)
Total Testosterone 234 241 – 827 ng/dL
Started TRT

9-1-08
Stopped TRT

10-30-08 (Fasting 7:30 am)
Total Testosterone 450 241 – 827 ng/dL
NOT on TRT

11-3-08
Trip to see Dr. Crisler

11-11-08 (24 Hour Urine) -- NO TRT
Testosterone 19 45-85

11-12-08 Started TRT Transdermal

12-10-08 (24 Hour Urine)
Testosterone 27 45-85

1-21-09 (24 Hour Urine)
Testosterone 32 45-85

3-13-09 (24 Hour Urine) >> Switched Vendor on Compounded Testosterone
Testosterone 22 45-85

[JanSz]

You are seeing Dr Crisler since Nov/08

Had some blood tests and four Rhein urine tests that are shown on post #1.
You are not absorbig Testosterone transdermally.
Dr John put you on weekly testosterone shots.
You have a problem accepting DHEA.
All in all not much progress.

You are lucky that you are able to get the best help available, that is dr John's expertise.

Since you have been thru number of variations in theraphy...
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I suspect that dr John put you on weekly shots because he is afraid that you will have a hard time to comply to daily (DAILY) (T & HCG) shots.
Think it thru, you are not an easy case, you have to give up on some comfort to possibly gain something.
I would run your TRT totally by numbers and make changes only if your situation is highly un-acceptable.
I would do only blood tests, at least untill there is a good reason to have additional urine test.

Any changes must always be as requested in detail by dr John.
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Thorough Adrenal and Thyroid testing is of paramount importance.
Not only basic direct analytes but all related minerals and vitamins.
Consider additionally Hair Analysis and Fatty Acid Analysis.
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I suggest that you edit post #1 on this thread,
Add all blood tests that you had done in last 5 years.
Group them by date, also group analytes by topic, as much as feasible.
Best would be if you could do that in tabulated fashion, similar arrangement as you did for your urine testing.
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Good luck
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[chilln]

Thought the jpg would be the simpliest way to show data (You may want to suggest a template for urine and serum data).


The jpg was excellent for your urine data - best I've seen thus far.

And you even nailed it with your serum data too, but you've presented too little data.

I apologize in advance because you were probably trying to comply with my "highlights" in my previous post.

The reason why I wrote the word "highlights" in my previous post was because I suspected you had as much serum data as urinary data. But if you only have (say) 1 to 8 values for each serum test, then go ahead and add them all to your list.

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I believe I can see your trends clearly, but I would like to corroborate them with a few more of your serum values (eg: up to 8 values per test - if you even have that many)

[Cajun]

And you even nailed it with your serum data too, but you've presented too little data.

I understand now - I do not have any serum data as a patient of Dr. Crisler

The Serum data that I presented earlier is all I have (previous doctors before Dr. John) The doctor I was seeing said that he only need Total T Nothing Else - I have only done 24 Hour Urine testing up to this point. However, I will be doing a serum test in the next few weeks. Been on weekly Test Shots for 3 weeks now and will be testing in 2 weeks. I will post the data when it is availabe.

Again thanks to all for the feedback - there are ups and downs on the path I have taken - and now being close to a year in the journey I know that it is a journey and not a destination - bless all who have started on this journey because as you all know it can be difficult - I am fortunate to have the means to go forward and get the care that I need.

[chilln]

I had to go back and remove all of the details re the therapy which Dr Crisler prescribed for you.

Sorry Cajun but you've broken Man Law 17, ie:

"17. I really cannot have my patients discussing details of their individualized treatment in open Forum, for numerous reasons. To let all know how serious I am about this: I have dismissed a patient from my practice for repeated violations of this simple rule."

I wasn't watching the dates carefully as I was more concerned with seeing the format than the detail.

Now that we've got the format issues sorted, I've looked at the detail I see what you've done.

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In future please never post any details, not even "vague ones" re your Dr Crisler prescribed therapy, on this public forum.

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As to your labs, I suspect Dr Crisler will now investigate your thyroid hormones in more detail.

My version of a comprehensive thyroid expose is as follows:

a) thryoid antibodies
b) TSH receptor antobodies
c) T3 free
d) T4 free
e) T3 total
f) T4 total
g) reverse T3
h) TSH

Yes, we already know that the whole suite of thyroid hormones is relatively expensive to get tested, so you don't need to reiterate what we already know.

You need the antibodies to rule in or out autoimmune disease.
You need the free measurements to determine your short term thyroid behavior.
You need the total measurements to determine your long term thyroid behavior (your thyroid hormone reservoir).
You need TSH in case you may be able to use TSH later on, to monitor your thyroid hormones generally - but you can usually only do this after you've confirmed that TSH levels rise to a new stable value once your thyroid hormones improve. It's not always the case. If it turns out that your TSH is locked on "low", even when your thyroid hormones improve via nutrition and/or supplementation, then you can drop the TSH once you've shown that this is the case.

###

But I would assume you'll need to start out with T injections, just to get underway ASAP. Then if you and your medical professional adviser (we know who that is) sort out your thyroid hormones along the way, then you should be able to switch back to transdermals at a later date.

[Shootist]

Don't sweat it Cajun, you'll get to that "destination" soon enough.

[JanSz]

bless all who have started on this journey because as you all know it can be difficult - I am fortunate to have the means to go forward and get the care that I need.

I will concentrate on the "fortunate to have the means".

I suggest that you do my long list of blood tests,
between blue lines,
post #44 here:

http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

If you have insurance, we are talking $6.
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Please return favor, if you learn of suitable additions to this list.
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In case you would rather reach stability on your TRT sooner rather than latter, make sure that you use very frequent dosing.
7 shots in 7 days (or more not less).

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