Opinions on my labs and symptoms, please.

[aaron]

Hey Guys!

I'm age 23, 165lb, 5'11.

For at least a couple years I have accumulated many symptoms that vary in intensity day to day but long term seem to get slowly worse:
Weak erections, no morning wood, low sex drive, tired most of the time even when I wake up no matter how much sleep I get, stressed out not related to lifestyle, can't grow facial hair even though my dad sports a thick beard( testosterone helped VERY slightly), perpetual mild depression, no drive to do anything, sweat a lot for no reason.....

Another very serious one would be unbelievably tight muscles....I have muscle knots and myofascial trigger points absolutely infesting my body, I can work them out but they always come back. My muscles are tight, achy, they tick and spasm quite frequently. MY MUSCULAR RECOVERY IS JUST NOT THERE. I used to be able to work out HARD up to about age 17 or 18 with great recovery but now that's just a fantasy.


Here are my labs:

Taken 12/12/2008 at Gamma Dynacare Lab

Glucose Serum Fasting 4.9 mmol/L

Bilirubin Total 8 <23 umol/L

Cholesterol 4.03 <5.20 mmol/L

Triglycerides 0.61 <2.30 mmol/L

HDL Cholesterol 1.43 M: >=1.0 mmol/L
LDL Cholesterol Calc. 2.3
TC/HDL-C Ratio 2.8
Alkaline Phosphatase 64. 40-129 U/L

GGT 7. < 60 U/L

ALT 16. <46 U/L

sTSH 2.48 0.35-5. mU/L

LH 3. 1-9 IU/L

DHEAS 5.9 2.6-7.7 umol/L

Testosterone 23.2 M: 8-38 nmol/L

Prolactin 12 M: <18 ug/L

Estradiol 107 M: <161 pmol/L

Insulin 40 fasting: 40-190 pmol/L

Hemoglobin 154 M: 135 - 170 g/L
Hematocrit 0.45 M: 0.38 - 0.49 l/l
RBC 4.93 M: 4.20 – 5.70 x 10E12/L

RBC Indices: MCV 91.2 M: 80 – 97 fl
MCH 31.2 27 – 32 pg
MCHC 342 320 – 360 g/L

RDW 12.6 11.5 – 15.5
WBC 4.2 4 – 11 x 10E9/L
Platelets 309 145 – 400 x 10E9/L
MPV 7.5 7.4 – 11.3 fl

Differential WBC’s:

Neutrophils 1.85 1.8 – 7 x 10E9/L
Lymphocytes 1.72 1 – 3.2 x10E9/L
Monocytes .50 0 – 0.8 x10E9/L
Eosinophils 0.13 0 – 0.4 x10E9/L
Basophils 0.04 0 – 0.20 x 10E9/L



Started HCG 3x 350IU per week. Then a month later, 200 mg/1mL Test Enanthate every 2 weeks.



Taken March 6, 2009 at Gamma-Dynacare

Testosterone 64.5 M: 8 – 38 nmol/L

Estradiol 228 M: < 161 pmol/L


Dropped Test Enanthate to 120mg/0.6mL every 2 wks.



Taken April 3, 2009 at Gamma Dynacare

Testosterone 51.8 M: 8 – 38 nmol/L

Dropped to 100mg/0.5mL Test Enanthate every 2 wks.


I have not felt any different the entire time I have been on any of this medication.
I asked the doctor what the next option was and his response was " I don't know, I just deal with hormones".... :banghead:


So if you guys have anything to say I'd damn sure appreciate that! Thanks. :cheers2:

[JanSz]

Hey Guys!

I'm age 23, 165lb, 5'11.

For at least a couple years I have accumulated many symptoms that vary in intensity day to day but long term seem to get slowly worse:
Weak erections, no morning wood, low sex drive, tired most of the time even when I wake up no matter how much sleep I get, stressed out not related to lifestyle, can't grow facial hair even though my dad sports a thick beard( testosterone helped VERY slightly), perpetual mild depression, no drive to do anything, sweat a lot for no reason.....

Another very serious one would be unbelievably tight muscles....I have muscle knots and myofascial trigger points absolutely infesting my body, I can work them out but they always come back. My muscles are tight, achy, they tick and spasm quite frequently. MY MUSCULAR RECOVERY IS JUST NOT THERE. I used to be able to work out HARD up to about age 17 or 18 with great recovery but now that's just a fantasy.


Here are my labs:

Taken 12/12/2008 at Gamma Dynacare Lab

Glucose Serum Fasting 4.9 mmol/L

Bilirubin Total 8 <23 umol/L

Cholesterol 4.03 <5.20 mmol/L

Triglycerides 0.61 <2.30 mmol/L

HDL Cholesterol 1.43 M: >=1.0 mmol/L
LDL Cholesterol Calc. 2.3
TC/HDL-C Ratio 2.8
Alkaline Phosphatase 64. 40-129 U/L

GGT 7. < 60 U/L

ALT 16. <46 U/L

sTSH 2.48 0.35-5. mU/L

LH 3. 1-9 IU/L

DHEAS 5.9 2.6-7.7 umol/L

Testosterone 23.2 M: 8-38 nmol/L

Prolactin 12 M: <18 ug/L

Estradiol 107 M: <161 pmol/L

Insulin 40 fasting: 40-190 pmol/L

Hemoglobin 154 M: 135 - 170 g/L
Hematocrit 0.45 M: 0.38 - 0.49 l/l
RBC 4.93 M: 4.20 – 5.70 x 10E12/L

RBC Indices: MCV 91.2 M: 80 – 97 fl
MCH 31.2 27 – 32 pg
MCHC 342 320 – 360 g/L

RDW 12.6 11.5 – 15.5
WBC 4.2 4 – 11 x 10E9/L
Platelets 309 145 – 400 x 10E9/L
MPV 7.5 7.4 – 11.3 fl

Differential WBC’s:

Neutrophils 1.85 1.8 – 7 x 10E9/L
Lymphocytes 1.72 1 – 3.2 x10E9/L
Monocytes .50 0 – 0.8 x10E9/L
Eosinophils 0.13 0 – 0.4 x10E9/L
Basophils 0.04 0 – 0.20 x 10E9/L



Started HCG 3x 350IU per week. Then a month later, 200 mg/1mL Test Enanthate every 2 weeks.



Taken March 6, 2009 at Gamma-Dynacare

Testosterone 64.5 M: 8 – 38 nmol/L

Estradiol 228 M: < 161 pmol/L


Dropped Test Enanthate to 120mg/0.6mL every 2 wks.



Taken April 3, 2009 at Gamma Dynacare

Testosterone 51.8 M: 8 – 38 nmol/L

Dropped to 100mg/0.5mL Test Enanthate every 2 wks.


I have not felt any different the entire time I have been on any of this medication.
I asked the doctor what the next option was and his response was " I don't know, I just deal with hormones".... :banghead:


So if you guys have anything to say I'd damn sure appreciate that! Thanks. :cheers2:

Switch from once every two weeks to EOD routine.

T-shots and HCG shots on same day.

HCGshot--250iu
T-shot-- 14units=28mg
use 200mg/mL testosterone

Next time draw blood on the day of the shots, time of the shots, before shots.
................
I use these needles for both T & HCG shots, and it works for me:
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
----------------
.
.

[aaron]

Switch from once every two weeks to EOD routine.

HCGshot--250iu
T-shot-- 14units=28mg
use 200mg/mL testosterone

So now I just humor the Doc that I'm still on his protocol? I will run out of Test. at some point as the amount you state is twice what he has me on. Your way does make way more sense though, no doubt.


Next time draw blood on the day of the shots, time of the shots, before shots.


I'm not sure I understand the bold portion of that statement. I've been taking tests 3 days after Tshots, and day after HCG, just FYI.


Should I be concerned with my Estradiol levels? they seem pretty chunky, and could they be the reason I haven't felt a damn thing even when my TT levels were almost triple the range?

[asdf]

Why are you on TRT? Your problem is not low testosterone.
You should find a different doctor; seriously
Your T levels are way to high and you are going to find yourself having more problem then you started with. If I were you, I would do a restart with just HCG and find a doctor that that will look for your problem without throwing you on unessessary medications.
There are a lot of guys here that could help you with a restart (dosages and timing,etc)
JMHO

[crazycrew]

I'm not sure I understand the bold portion of that statement. I've been taking tests 3 days after Tshots, and day after HCG, just FYI.

Testing 3 days after T dose will show a high T level. If you were to test the day before your nest dose you would show a very low T level. (below normal range)



Should I be concerned with my Estradiol levels? they seem pretty chunky, and could they be the reason I haven't felt a damn thing even when my TT levels were almost triple the range?

You definatly without a doubt should dose much more fequently. At the least twice a week. This alone will help bring your E2 levels down. With the levels of E2 you have its no wonder you don't feel better . The E2 alone can cause the same symptoms as low T.
I started dosing EOD a month ago and have been doing great.

[pmgamer18]

Read the sticky TROT: A Recipe for Success copy this give it to your Dr. Do shots once a week to start test in the morning the day of your next shot. It's when you drop to low that you feel like crap. Try to get your levels up into the upper 1/3 of your labs range for both Total and Free T and test your Estrada E try to keep this between 10 to 30 pg/ml best for most at 20. When you get to the levels you feel best at then add in some CHG the 2 days each before your next T shot. This will keep you up in levels until your next shot and keep your testis working as best they can. I don't do CHG shot the week of my labs it will not give you a true picture of whats going on.

When you test 3 days after your shot your going to get the highest reading of your T levels. Dr.'s not up on this will lower your dose thinking your levels are to high and you will crash.

If your seeing a Dr. like Dr. John and he knows how to read labs for T then ask him when you should do your labs.

This link is old but a good read.
http://www.griffinmedical.com/male_hormone_modulation_therapy.html

[JanSz]

Switch from once every two weeks to EOD routine.

T-shots and HCG shots on same day.

HCGshot--250iu
T-shot-- 14units=28mg
use 200mg/mL testosterone

Next time draw blood on the day of the shots, time of the shots, before shots.
.


I'm not sure I understand the bold portion of that statement. I've been taking tests 3 days after Tshots, and day after HCG, just FYI.


Should I be concerned with my Estradiol levels? they seem pretty chunky, and could they be the reason I haven't felt a damn thing even when my TT levels were almost triple the range?

=======================
On routine I described (EOD) (post #2 this thread) you are doing both (T & HCG) shots at the same time, every 2 days, that is time beween shots is 48 hours.

When drawing blood for testing, you draw blood 47hrs and 59minutes after your (T & HCG) shots. Tolerance +- 1/2 hr.

Routine I described is estradiol friendly.
If you end up having high E2 make sure that using Anastrozole is your last option.

option #1- reduce HCG
option #2- reduce size of T shot
option #3- switch to daily shots
option #4- use Anastrozole

There may be debate about sequence of options 1, 2 & 3, option #4 is always last.

Look at my goals, specially study the BAT(BioAvailableTestosterone).
If you end up having high E2, aim at middle range for BAT (rather than top range).

My own Goals
DHEAs(500-640)mcg/dL------------------major player, 95% time overlooked
Progesterone(0.9-1.2)ng/mL
Pregnenolone(> 100ng/dL)
Estradiol, Ultrasensitive(25-29)pg/mL
Estrone, LC/MS/MS (23244X)
do not use Anastrozole if possible or minimize its use
BATest(342, 460-575)ng/dL------------stay around 342 if you need AI to control E2
DHT(60-90)ng/dL
FreeT3~400pg/dL
Body temperature (97.8° - 98.2°F) (36.56° - 36.78°C); (36.6-37C)(97.9-98.6F)

[crazycrew]

=======================
On routine I described (EOD) you are doing both (T & HCG) shots at the same time, every 2 days, that is time beween shots is 48 hours.

) Are you drawing both meds in the same syringe or two shots?

[pmgamer18]

Never do this do each shot in a diff. area like one thigh then the other.

Are you drawing both meds in the same syringe or two shots?

[asdf]

If you are going to continue with test shots, ensure you are testing halfway between shots; you want to get the mid-range not the low or high. Your last TT was 1470 ng/dl, which is causing your estradiol to go way too high. Shots should be more frequent to lessen the large spikes of Testosterone.

[chilln]

Should I be concerned with my Estradiol levels? they seem pretty chunky, and could they be the reason I haven't felt a damn thing even when my TT levels were almost triple the range?


Bingo.

And your E2 levels were too high even before you started boosting your T (testosterone), and then they would only have increased - ouch!

But your too high E2 is partly due to excessive T.

So you have to work on both together.

Since your E2 started out too high, you are most likely a high T->E2 converter, and you're most likely going to need an aromatase inhibitor even once your reduce your T to a more optimum level.

###

But this business of putting you on an injected T ester (with HCG), without confirming your thyroid hormones have tanked, is a joke.

ie: until your thyroid hormones are shown to be a problem, you should be on transdermal T (with HCG), not injected T ester (with HCG).

That way you can apply more or less transdermal T as necessary daily, and you can experience the usual youthful diurnal variation in testosterone.

At your age you want to try to mimic nature as much as possible, to minimize the longer term effects of flatlining your hormones.

It also allows you to boost your T quite high during the day, with some arimidex to suppress the T -> E2 conversion, and then allow your T to reduce at night to get to sleep. Then boost your T quite high again the next day, with some more arimidex to suppress T -> E2 conversion.

You need the T and DHT (which comes from transdermal T) for good sex, but you need the lower T and DHT at night to allow you to sleep and recover.

I think you get the picture.

[aaron]

Thanks, that's a lot of great info and help. You guys know your Sh*t.

So as well as switching to the EOD T/HCG routine that JanSz described and
in the future switching to gel as Chilln mentioned; Should I also be
getting anything else tested like adrenals, thyroid etc.
Do these numbers alone mean they are probably are fine?

sTSH 2.48 0.35 - 5 mu/L
DHEA 5.9 2.6-7.7 umol/L


On another note, I kinda thought taking blood testing when serum levels peak
was a bit strange, but went with it. As well, I just wanted to add that
I get my T shots at a walk-in clinic, and asked the nurse that does it
if any of the other people that come in do it weekly rather than every other
other week and she says "No, everyone comes bi-weekly".
So getting a huge T/E bomb for a day then crashing for a week, and repeat, seems
to be the norm....

[JanSz]

Are you drawing both meds in the same syringe or two shots?

No I do not mix, I use separate syringes for different medicines.

================================================== =====

I have seen some posts where people are mixing medicines in one syringe.
There were 3 mixed but I remember only HCG & GH.

I think that is bad paractice.

Bad because the medicines remaining in vials have a good chance at getting messed up.

I always pull about 5 units extra and then push it back into vial to get the bubble out.
When mixing different medicines I would not be able to do that.

HCG is a soapy, HCG bubbles are hard to remove.

Wonder what others think on this subject?

--------------------------------------------------------

[JanSz]

Thanks, that's a lot of great info and help. You guys know your Sh*t.

So as well as switching to the EOD T/HCG routine that JanSz described and
in the future switching to gel as Chilln mentioned; Should I also be
getting anything else tested like adrenals, thyroid etc.
Do these numbers alone mean they are probably are fine?

sTSH 2.48 0.35 - 5 mu/L
DHEA 5.9 2.6-7.7 umol/L


On another note, I kinda thought taking blood testing when serum levels peak
was a bit strange, but went with it. As well, I just wanted to add that
I get my T shots at a walk-in clinic, and asked the nurse that does it
if any of the other people that come in do it weekly rather than every other
other week and she says "No, everyone comes bi-weekly".
So getting a huge T/E bomb for a day then crashing for a week, and repeat, seems
to be the norm....

You are learning,
you are getting big bomb of Test one day
checking blood shortly after you have sky high everything (T & E2)
for the rest of the period only sky high is E2, your test level is too low after initial peak.

This is opposite of you should do.

When applying external testosterone one have to do it wery frequently.
Less frequent delivery are reason for raising E2.
To lower that E2 people use Arimidex
Nobody ever figured out steady Arimidex dose that would work for long time.
It is always either to high or too low, there is no middle.
It is much better to have theraphy that does not include Arimidex

Elegant solution to this cunundrum is daily or 2x/day applications of transdermal testosterone.

Transdermals solve one problem and brings 5 new problems, nothing is perfect.

Bottom line,

use transdermal-T when you need to raise DHT.
stay away from transdermal-T if it results in overly high DHT

If you have to use T-shots, use them frequently, at least EOD-every other day. Few may need daily shots.

Since no proper TRT is with out using HCG, I found that for me (T & HCG)-shots at the same time works best, then is day free of shots.
.
.

[chilln]

Should I also be
getting anything else tested like adrenals, thyroid etc.


The more debilitated you are when you start out, the more hormones you need to monitor until you've improved.

There are 4 hormone axes, and insulin, which interact quite significantly, but not always directly.

The 4 hormones axes are: growth hormone axis, the stress hormones axes, the sex hormones axis and the thyroid hormones axis.

To determine how extensively you need to test the hormones in each axis + insulin, your medical professional adviser needs to assess your symptoms.

We're very much limited to only being able to help you understand how to fine tune your therapy, here on the forum. That's because the forum post mechanism, and our limited time to read posts and respond, means we don't have the ability to fully assess your symptoms and labs, even if you wrote them all out.




Do these numbers alone mean they are probably are fine?

sTSH 2.48 0.35 - 5 mu/L
DHEA 5.9 2.6-7.7 umol/L


Not enough info there. The thyroid tests you need to do are:

a) thyroid 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 (reservoir).



On another note, I kinda thought taking blood testing when serum levels peak
was a bit strange, but went with it.


I recommend you get them at peak some days, and at minimums on others.

You do need the whole picture.

So mix it up a little.



As well, I just wanted to add that
I get my T shots at a walk-in clinic, and asked the nurse that does it
if any of the other people that come in do it weekly rather than every other
other week and she says "No, everyone comes bi-weekly".
So getting a huge T/E bomb for a day then crashing for a week, and repeat, seems
to be the norm.


Eating crap food is the norm too, that doesn't make it right.

But I do understand that you've raised this point to confirm that others don't necessarily agree with your views.

When you want leading edge therapy, you actually have to educate those around you, because health care absolutely must be a team effort. The therapies are too complex for any individual to diagnose and treat.

So you will need to become an educator like the rest of us.

[aaron]

Thanks again guys. I'll get on it. As well I will try to answer any questions on here my very limited knowledge allows. :cheers2:

[crazycrew]

The best thing to do is read, study, read, and ask. It can seem too complicated to start but if you'll stay with it the light at the end of the tunnel will eventualy shine dim. I have been researching the web a few hours a day for about a year and have only now gotten to the point I can almost understand what these guys are talking about.
Thats what this forum is about. So hang in there.