3 Months Lab Results....Doctor Problems...

[JonnyBravo22]

Hello guys so it has been three months on TRT. I can honestly say that in the past few weeks I have started feeling better. More energy and better overall mood. Not 100 percent better but an improvement none the less. Sex drive is up and down but higher than when I started for sure. But I feel like it peaked and then started dropping again. Only problems I have found are a little acne on shoulders but I have calmed it down with the Dawn soap trick.

So my info.

26 years old

Started TRT:
Total test was 248
1 Week later no treatment was 250
1 Month Later (taken 6 days after 3rd shot and 15 minutes after 4th shot) after 100mg once a week was 318 TT
Estradiol was 10.7 on Range from 7.63 to 42.63
Vitamin D was normal


3 Months Later on 80mg 2x a week.
Total Test - 696
Free Test - 212
Estradiol - 35.2
SHBG - Not in yet
Prolactin - Not in yet
Total blood count - All normal.


Now to the Doctor problems. Doctor argued with me on all my blood work that I asked for. Bascially saying all I need to test is total blood count and total test every 6 months. Practically had to beg him for the Estradiol, Prolactin, and SHBG. He then admitted that all of this surpasses his knowledge on TRT and that he would sign off on the labs but couldn't evaluate them. He has no idea what AI's are or Clomid.

Now with my numbers the way they are he didn't ask me if I was feeling better, better sex drive, etc.....He just wants me to space out injections to every 5 days and adjust nothing else. Basically from what I gather he is only aiming to get my Total Test in the dead normal range and doesn't care about anything else.

Any and all advice is appreciated as normal. Thank you guys.

 

[Alpin]

your numbers look decent. What day from shot were these labs drawn at?
I am also thinking of changing my shots to every 5 days....

 

[JonnyBravo22]

It was taken 3.5 days from my Sunday shot and 1 hour before my Thursday shot.

 

[JonnyBravo22]

Any advice at all?

Is my free T extremely high?

Should I listen to Doc and start doing once every 5 days?

Should I see an endocrinologist and get more opinions?

 

[71Avido]

Is my free T extremely high?

There aren't any reference ranges posted to know.

Should I listen to Doc and start doing once every 5 days?

That depends on the ester.
I'm assuming it's test cypionate?

Should I see an endocrinologist and get more opinions?

If you're not happy with the current doc, sure, it's your right as a patient.

 

[JonnyBravo22]

Yes Cypionate.

Edit:

Before TRT

Free Testosterone - 58.8 pg/mL

3 Months later

Free Testosterone - 212 pg/ML

 

[Megatron28]

Your current numbers look good. I would definitely not lower your dose. That's what he is telling you to do by saying take 80mg every 5 days instead of every 3.5 days. There is nothing in your numbers indicating that you need to lower your dose.

I would get a new doc. You should not have to fight your doctor every step of the way -- especially to do the basics like running labs. Do you live in the US?

Don't worry about your Free T. You're fine.

Are you donating blood to keep your hematocrit under control?

 

[JonnyBravo22]

Yes I live in the US

I am currently researching other Doctors in my area. We have an office that specializes in just TRT in my city. May look into that.

I have not donated any blood as I my CBC came back completely normal. I guess that is the correct test to tell me if my blood count is too high. How often should I check my blood count? My doctor said not to check that and if I do I only need to every 6 months.

So Megatron if I stay at my current dose of 80mg every 3.5 days how long should I wait to check labs again?

Also my Prolactin, SHBG, and Metabolic panel should be back end of this week beginning of next if that helps at all.

 

[Megatron28]

Yes I live in the US

I am currently researching other Doctors in my area. We have an office that specializes in just TRT in my city. May look into that.

I have not donated any blood as I my CBC came back completely normal. I guess that is the correct test to tell me if my blood count is too high. How often should I check my blood count? My doctor said not to check that and if I do I only need to every 6 months.

So Megatron if I stay at my current dose of 80mg every 3.5 days how long should I wait to check labs again?

Also my Prolactin, SHBG, and Metabolic panel should be back end of this week beginning of next if that helps at all.

Look for a new doc in your area, but I would really encourage you to call IMT. They sponsor the forum and you will find their ad to the right of your screen. They know what they are doing it won't fight you every step of the way. Doesn't hurt to call and talk to them.

The lab your want to look at is Hematocrit. That measure how "thick" your blood is. The more RBC's you have, the "thicker" your blood gets. Just simply plan on donating blood every 56 days. Not only will you be helping others, but you will be helping yourself. Extrogenous tesosterone increases your hematocrit.

I try to check my labs every 3-6 months. More frequently if I make any changes. Less frequently if everything stays the same. Once you are "dialed in" you should not have to check your labs as frequently.

Let us know when you get the rest of your labs results in.

 

[JonnyBravo22]

Thank you sir for all your help. I will find a new Doc asap as I really can't afford IMT right now even though my experience I had with them was awesome. I wish they worked with insurance companies!

I will get myself on a schedule to donate blood as well.

Will post back with the rest of the results.

Last question until then....Do you see any reason for an Aromatase inhibitor (AI) or HCG at this point?

 

[Alpin]

Yes I live in the US

I am currently researching other Doctors in my area. We have an office that specializes in just TRT in my city. May look into that.

I have not donated any blood as I my CBC came back completely normal. I guess that is the correct test to tell me if my blood count is too high. How often should I check my blood count? My doctor said not to check that and if I do I only need to every 6 months.

So Megatron if I stay at my current dose of 80mg every 3.5 days how long should I wait to check labs again?

Also my Prolactin, SHBG, and Metabolic panel should be back end of this week beginning of next if that helps at all.

80 mg every 3.5 days is not a bad dose bro...
that's 160 mg/week...but your T levels could be better.
a lot of docs don't go over this.
SHBG is not really needed while you are on TRT. Exogenous T suppresses it anyways.
SHBG is more for Natural T levels...it elevates as a male ages and sucks up BIO AVAIL. T

 

[Megatron28]

Thank you sir for all your help. I will find a new Doc asap as I really can't afford IMT right now even though my experience I had with them was awesome. I wish they worked with insurance companies!

I will get myself on a schedule to donate blood as well.

Will post back with the rest of the results.

Last question until then....Do you see any reason for an Aromatase inhibitor (AI) or HCG at this point?

I think your E2 looks good. Any symptoms related to high estradiol that you are experiencing?

Lots of people recommend taking hCG. It is supposed to give you a sense of well being. Lot's of guys wouldn't do TRT without it. You could take DHEA and Pregnenalone instead. Read the post I just put out there about it today.

 

[halfwit]

The way I see it you have two options:

1. Stick with this doc and run your own protocol by learning as much as you can and being possibly forced into purchasing AI's/HCG (if you decide you want to run HCG) from other sources than a pharmacy. This is the option I chose as I got tired of bouncing from doctor to doctor and finding out that I knew more than they did. I just let him check my Total test every 6 months, do a prostate exam, and off I go with my script.

2. Go doctor shopping. I started doing this but gave up as literally every doctor I interviewed was less qualified than the previous one. Hopefully you have quality endos in your area that you can run interviews with to get a feeling on how they run protocols. A GREAT first question would be what they feel about estradiol as part of a TRT protocol. You can then ask them about AI's and HCG supplementation if their answers sound good.

If they pass all your questions, you are very lucky and have found a new doctor to manage your TRT. If not, you still have option #1, and you will certainly learn more than you need to know on this very site. It's really quite staggering how much information is here just waiting to be learned. I do hope for your sake that you are able to find a qualified doctor that:

1. Asks you how YOU FEEL.
2. Doesn't go strictly by total test and recognizes the value of E2:TT ratios.
3. Isn't gun-shy when it comes to AI's.
4. Is open to the possibility of HCG.
5. Is willing to investigate any additional problems that may come with TRT such as hypothyroidism.
6. Doesn't make you feel guilty for being on "STEROIDS". (Give me a break, birth control pills are 'roids, yet nobody gives them grief. They're just not anabolic/androgenic. )

My .02c

 

[Alpin]

The way I see it you have two options:

1. Stick with this doc and run your own protocol by learning as much as you can and being possibly forced into purchasing AI's/HCG (if you decide you want to run HCG) from other sources than a pharmacy. This is the option I chose as I got tired of bouncing from doctor to doctor and finding out that I knew more than they did. I just let him check my Total test every 6 months, do a prostate exam, and off I go with my script.

2. Go doctor shopping. I started doing this but gave up as literally every doctor I interviewed was less qualified than the previous one. Hopefully you have quality endos in your area that you can run interviews with to get a feeling on how they run protocols. A GREAT first question would be what they feel about estradiol as part of a TRT protocol. You can then ask them about AI's and HCG supplementation if their answers sound good.

If they pass all your questions, you are very lucky and have found a new doctor to manage your TRT. If not, you still have option #1, and you will certainly learn more than you need to know on this very site. It's really quite staggering how much information is here just waiting to be learned. I do hope for your sake that you are able to find a qualified doctor that:

1. Asks you how YOU FEEL.
2. Doesn't go strictly by total test and recognizes the value of E2:TT ratios.
3. Isn't gun-shy when it comes to AI's.
4. Is open to the possibility of HCG.
5. Is willing to investigate any additional problems that may come with TRT such as hypothyroidism.
6. Doesn't make you feel guilty for being on "STEROIDS". (Give me a break, birth control pills are 'roids, yet nobody gives them grief. They're just not anabolic/androgenic. )

My .02c

I met an Endo that used HCG, T in his practice....but no AI.
When I showed him my AI....he could not stop blinking at the pack in arrogance as to why a doc would prescribe it.
He doesn't test for E2 in his blood work and/or measure Free T

 

[JonnyBravo22]

Rest of my results....don't know much about all these though.

Prolatctin - 20.470 ng/mL Expected 2.700 - 16.900

SHBG- 18.8 nmol/L Expected 00.0 - 48.4

The rest of them pictured below.

 

[JonnyBravo22]

He said that my liver enzymes are mildly elevated but probably because of the TRT and that is should be closely monitored??

Does that mean I should have this particular blood test done more than every 3 months??

He said he would not comment on my SHBG, Estradiol, or Prolactin as he does not know how to interpret them. Lol

Do you guys see anything extreme or out of whack?

Thank you again!!

 

[Megatron28]

Yeah! Are you diabetic? Your glucose is really low. Did you talk about that?

High prolactin is a problem. Could possibly indicate a pituitary peoblem or tumor. You need to look into that.

Your liver numbers are bad. Start taking 1000mg of NAC every day and follow up with your doc. Are you taking lots of Tylenol or some other medication? I really doubt TRT is doing that. I haven't seen that cause it before.

I think you need to run a thyroid panel. A full panel. Not just TSH. And you need a new doctor. Yours seems to be giving you more bad advice after bad.

 

[Megatron28]

Liver

Elevated liver enzymes: Causes - MayoClinic.com

 

[JonnyBravo22]

I am not diabetic that I know of and rarely take any medication.

I take TRT, Xanex (2x a month), Advil ( 2x a month if needed for headache) Multi Vs and Fish Oil.

But remember I still have the swollen lymph-nodes in my pelvis region...they have not gone down in almost 6 months. I had the catscan and they said everything looked normal.....what else should I do???

You just scared me...I think I need a xanex lol

 

[Megatron28]

You need a good doctor. Probably an endo who cares. Can you get recommendations from friends or family. You have a lot of things that are messed up right now. Hopefully there is a common cause. Perhaps hypothyroidism... This might be the root of your anxiety too. I have no clue about your lymph nodes -- sorry.

Prolactin
Liver
Hypogonadism
Glucose

That's a lot of serious things that need to be looked into.

I'm not trying to scare you. Just encourage you to look into this sooner rather than later.