39 year old male, low t and low estridial, HELP, Feel like crap

[jamhint]

LabCorp
SPECIMEN INFORMATION
SPECIMEN: 22717424600
REQUISITION: 9063406
LAB REF NO:
COLLECTED: 2013-08-15
RECEIVED: 2013-08-15
REPORTED: 2013-08-18
PATIENT INFORMATION

DOB: April 29, 1975
AGE: 38
GENDER: Male
FASTING: Yes
Clinical Info:
REPORT STATUS: FINAL
ORDERING PHYSICIAN

CLIENT INFORMATION
2013-08-18 17:06:00 -0700
MEDIVO, INC.
55 Broad Street
16th Floor
New York, NY 10004
Test Name Result Flag Reference Range Lab
CBC With Differential/Platelet
WBC 3.5 LOW 4.0-10.5 x10E3/uL BN
RBC 4.58 4.14-5.80 x10E6/uL BN
Hemoglobin 13.5 12.6-17.7 g/dL BN
Hematocrit 40.6 37.5-51.0 % BN
MCV 89 79-97 fL BN
MCH 29.5 26.6-33.0 pg BN
MCHC 33.3 31.5-35.7 g/dL BN
RDW 14.0 12.3-15.4 % BN
Platelets 227 140-415 x10E3/uL BN
Neutrophils 44 40-74 % BN
Lymphs 44 14-46 % BN
Monocytes 9 4-13 % BN
Eos 2 0-7 % BN
Basos 1 0-3 % BN
Neutrophils (Absolute) 1.5 LOW 1.8-7.8 x10E3/uL BN
Lymphs (Absolute) 1.5 0.7-4.5 x10E3/uL BN
Monocytes(Absolute) 0.3 0.1-1.0 x10E3/uL BN
Eos (Absolute) 0.1 0.0-0.4 x10E3/uL BN
Baso (Absolute) 0.0 0.0-0.2 x10E3/uL BN
Immature Granulocytes 0 0-2 % BN
Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL BN
Comp. Metabolic Panel (14)
Glucose, Serum 90 65-99 mg/dL BN
BUN 18 6-20 mg/dL BN
Creatinine, Serum 0.72 LOW 0.76-1.27 mg/dL BN
eGFR If NonAfricn Am 118 >59 mL/min/1.73 BN
eGFR If Africn Am 137 >59 mL/min/1.73 BN
BUN/Creatinine Ratio 25 HIGH 8-19 BN
Sodium, Serum 141 134-144 mmol/L BN
Potassium, Serum 3.9 3.5-5.2 mmol/L BN
Chloride, Serum 105 97-108 mmol/L BN
Carbon Dioxide, Total 24 19-28 mmol/L BN
Calcium, Serum 9.0 8.7-10.2 mg/dL BN
Protein, Total, Serum 6.8 6.0-8.5 g/dL BN
Albumin, Serum 4.2 3.5-5.5 g/dL BN
Globulin, Total 2.6 1.5-4.5 g/dL BN
A/G Ratio 1.6 1.1-2.5 BN
Bilirubin, Total 0.6 0.0-1.2 mg/dL BN
Alkaline Phosphatase, S 64 44-102 IU/L BN
AST (SGOT) 27 0-40 IU/L BN
ALT (SGPT) 36 0-44 IU/L BN
Lipid Panel
Cholesterol, Total 166 100-199 mg/dL BN
Triglycerides 38 0-149 mg/dL BN
HDL Cholesterol 54 >39 mg/dL BN
According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a
negative risk factor for CHD.
VLDL Cholesterol Cal 8 5-40 mg/dL BN
LDL Cholesterol Calc 104 HIGH 0-99 mg/dL BN
Thyroid Panel With TSH
1 of 2
TSH 1.080 0.450-4.500 uIU/mL BN
Thyroxine (T4) 8.2 4.5-12.0 ug/dL BN
T3 Uptake 37 24-39 % BN
Free Thyroxine Index 3.0 1.2-4.9 BN
Testosterone, Free/Tot Equilib
Testosterone, Serum 397 348-1197 ng/dL BN
Testosterone,Free 12.98 5.00-21.00 ng/dL BN
% Free Testosterone 3.27 1.50-4.20 % BN
Prostate-Specific Ag, Serum
Prostate Specific Ag, Serum 0.8 0.0-4.0 ng/mL BN
Roche ECLIA methodology.
.
According to the American Urological Association, Serum PSA should
decrease and remain at undetectable levels after radical
prostatectomy. The AUA defines biochemical recurrence as an initial
PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory
PSA value 0.2 ng/mL or greater.
Values obtained with different assay methods or kits cannot be used
interchangeably. Results cannot be interpreted as absolute evidence
of the presence or absence of malignant disease.
IGF-1
Insulin-Like Growth Factor I 165 69-226 ng/mL BN
Estradiol, Sensitive
Estradiol, Sensitive 5 3-70 pg/mL BN
Male Female
0- 6 yrs. 0 - 15 0 - 15
7-10 yrs. 0 - 15 0 - 70
11-12 yrs. 0 - 40 10 - 300
13-15 yrs. 0 - 45 10 - 300
>15 yrs. 3 - 70 See Below
Ovulating Female
Follicular Phase 9 - 175
Luteal Phase 44 - 196
Periovulatory 107 - 281
Oral Contraceptives 0 - 91
Postmenopausal
Treated 42 - 289
Untreated 0 - 19
.
Estradiol results obtained with different
assay methods cannot be used interchangeably.
It is recommended that only one assay method
be used consistently to monitor serial
patient results.
Performing Laboratory Information:
BN: LabCorp Burlington, 1447 York Court, Burlington NC, phone: 800-762-4344
Medical Director: MD William F Hancock
2 of 2

 

[jamhint]

Let me know what you think of these results. I have no labido, lots of brain fog, fatigue, soar joints and muscle pain, I do crossfit 4 times a week. Going to the doc this week, what should i be expecting.

 

[johnfromeurope]

well, I'm 384ng/dl, and E2 is 22; well i dont feel like crap, but i feel bad though. i also have brain fog. I have troubles gaining weight. For you, i think its best to see a doc, you are good candidate for testosterone replacement therapy (TRT), also because of your age. and if you do crossit, it would definitely give you a boost in energy, how much you can do etc.
and i see you have pretty low hematocrite and hemoglobin, that's connected with low testosterone and that is not good.
when you inject T, your E2 is also gonna rise and i think your joints and other problems should get better.

 

[Alpin]

I'm 291 ng/dl for Total T and 75 pmol/L for E2
I take 0.25 mg of ADEX E3D which keeps my E2 slightly less.
On this test above (with 75 pmol/L E2) I had taken the 0.25 mg of ADEX the day before the blood work...
so don't know if my E2 will possibly be a little higher till next dose.

 

[Megatron28]

A big part of your problem is that your E2 is way too low. Are you taking something to being it down? Typically guys like to have E2 in the 20-40 range. That is what is probably causing a lot of your symptoms.

Your TT could be better. But it isn't definitionally at the hypogonadism state yet.

 

[jamhint]

All these #s are natural.

 

[Alpin]

A big part of your problem is that your E2 is way too low. Are you taking something to being it down? Typically guys like to have E2 in the 20-40 range. That is what is probably causing a lot of your symptoms.

Your TT could be better. But it isn't definitionally at the hypogonadism state yet.

You're right!
Mainstream MD's will look away if Total T is at 384 ng/dl....
TRT doc's at aging clinic's are another story.... will jump on those levels aggressively treating them!

 

[jamhint]

So, if the doc says no to testosterone replacement therapy (TRT), what to do about low e2 levels.

 

[Megatron28]

All these #s are natural.

Yeah, but are you taking anything "natural" that is lowering your E2? For example zinc? Is there anything you are taking today -- even minerals and vitamins?

You need to check your LH and FSH. This will help determine if the problems with your Low T is due to your testicles or pituitary. Might as well check prolactin at the same time since your are getting blood taken.

What time of the day were your labs taken? When checking T you want to do it firth thung in the morning.

 

[jamhint]

labs where done at 10:00 am. All i take is carlsons fish oil.

 

[Megatron28]

So, if the doc says no to testosterone replacement therapy (TRT), what to do about low e2 levels.

You may have to look around a bit for a modern-thinking doc, but you will probably be able to find one to put your on testosterone replacement therapy (TRT). The test would increase your E2 which would solve that problem. I don't know how to increase it otherwise. I have always had to worry about how to lower it.

 

[Alpin]

labs where done at 10:00 am. All i take is carlsons fish oil.

that's too late...find a lab that opens up at 7AM and get blood drawn no later than 8 AM. Preferably earlier.
My testosterone replacement therapy (TRT) doc always looked at the time I went in...he stressed for before 8 AM tests.
What I don't know is does testosterone replacement therapy (TRT) need to be measured very early as well for maximum accuracy of peak levels?
For sure natty T needs to be measured before 8AM but testosterone replacement therapy (TRT) is administered....so I don't know if there is a difference.

 

[Mprtz]

that's too late...find a lab that opens up at 7AM and get blood drawn no later than 8 AM. Preferably earlier.
My testosterone replacement therapy (TRT) doc always looked at the time I went in...he stressed for before 8 AM tests.
What I don't know is does testosterone replacement therapy (TRT) need to be measured very early as well for maximum accuracy of peak levels?
For sure natty T needs to be measured before 8AM but testosterone replacement therapy (TRT) is administered....so I don't know if there is a difference.

I have read that the daily fluctuations in T levels are less pronounced as you age. I'm not sure that at 39 it makes as big a difference as you are assuming.
Certainly, once you are shut down and are measuring exogenous test the time of day is probably pretty much moot.

 

[tiredguy]

that's too late...find a lab that opens up at 7AM and get blood drawn no later than 8 AM. Preferably earlier.
My testosterone replacement therapy (TRT) doc always looked at the time I went in...he stressed for before 8 AM tests.
What I don't know is does testosterone replacement therapy (TRT) need to be measured very early as well for maximum accuracy of peak levels?
For sure natty T needs to be measured before 8AM but testosterone replacement therapy (TRT) is administered....so I don't know if there is a difference.

while i am sure the difference between 8 - 10am would make THAT big of a difference - not like if maybe he had worked out heavy just before going, or something. i wouldn't go for a retest just because of that.

 

[Alpin]

while i am sure the difference between 8 - 10am would make THAT big of a difference - not like if maybe he had worked out heavy just before going, or something. i wouldn't go for a retest just because of that.

My understanding is that doing blood work for T, BIOT e.t.c. is best done early in the morning upon awakening from a decent nights sleep.
I wouldn't recommend working out prior to getting blood work done, it might give a false reading.
You use T while working out....
As well, you need to be fasting for proper blood work, you will be checking for liver enzymes, cholestrerol e.t.c.

 

[jamhint]

Going to the doc on 8-29. What questions or demands should i have of him before he is fired or continued to serve me as a client.

 

[Megatron28]

Going to the doc on 8-29. What questions or demands should i have of him before he is fired or continued to serve me as a client.

In light of current posts in the testosterone replacement therapy (TRT) forum, maybe you need to try some Human Chorionic Gonadotropin (HCG) to get your test and estradiol up. Try it for a bit and see if you can go off and maintain higher levels naturally.

Honestly, you would probably save yourself a lot of time and frustration giving Todd a call over at IMT.

 

[jamhint]

went to doc today, he is more concerned with why my wbc and Neutrophils (Absolute) is low. he said he will talk to his buddy which is a urologist. Didnt think this was much of a problem. Never have infections and rarely get sick. Although i am tire a lot. Often look like a walking zombie. No mattger howmuch i sleep.

 

[Megatron28]

went to doc today, he is more concerned with why my wbc and Neutrophils (Absolute) is low. he said he will talk to his buddy which is a urologist. Didnt think this was much of a problem. Never have infections and rarely get sick. Although i am tire a lot. Often look like a walking zombie. No mattger howmuch i sleep.

Do you have a baseline to compare them too?

What about your test? Didn't you discuss hypogonadism?

 

[jamhint]

He started very willing to give me 200mg for 3 weeks after chking my prostate. I then stopped him and stated i wanted 100mg weekly split into 2 doses. He then replied he was going to talk to his buddy which is a uroligist. Although he had already told the nurse to prep for injection. He told me he would call and let me know about it soon as he talks to the urologist.