Aussie needs help (have bloods)

[Kane07]

Hi all

Looking for some advice before my follow up doc app. My story 34 years old very low energy, moody, major trouble sleeping, very hard to drag myself out of bed (morning), anxious etc.
So I went to the Doc last march 2010 and got bloods done Total test came back 9.9 pmol, range 10.00-33.00 equates to about 340 ng/dl preety low.Sorry dont have other numbers

Any way rather then jumping straight on testosterone replacement therapy (TRT) I wanted to give myself a chance to try and fix it through diet and exerice, so past 12 month clean diet approx 3200 calories, 1.5g protein p/p, 1 g fat per lbm, and balance carbs, gym 3-5 days per week I have lost some fat and toned up btw im 190cm 102kg and about 18% bf ( carry extra fat around midsection), but still all previous symptons have not really improved.Plus I find it very hard to maintain muscle had 3 weeks off with elbow injury and have lost alot of gains

Current blood test taken April 2011

Total test 15 nmol (520 ng/dl) Improvement
Free Test 43 pmol - range (60-130) well below
Oestradiol 51 pmol/l
SHBG 20nmol/l
LH 5u/l
Prolactin 4 ugl
FSH 7 u/l
TSH 2.2 mu/l

My doc is very open minded, listens and seems like he wants to help. So my question any ideas why my free test is so low? is my estrogen to high?, my SHBG seems in range, would I be a good canditate for trt/hrt? Sorry for the long first post.

 

[BBE]

The first that jumps out to ME anyways is that your TSH is fairly high.

 

[Kane07]

I cross referenced some of my number against a reference chart I found in another post

Oestradiol 51 pmol (50 - 200) low
SHBG 20nmol (20 - 60) low
Free Test 43 pmol (60-130) very low

Weird my free test, shbg and estrogen all low

Anyone any futher thoughts? Maximus Guys

 

[JOWS6]

What conversion calculation are you using? I'm using: nmol/L divided by 0.0347 = ng/dL.

Which would be: 432ng/dL Total Testosterone

 

[Kane07]

Opps my mistake I hit the times buton on the calculator not division.

So total test 432 getting towards the lower end

Thanks for your reply any further thoughts

 

[JOWS6]

First off, I want to commend you for taking a conservative approach and waiting 12 months to work on your overall health before venturing into testosterone replacement therapy (TRT).

But what specifically are you looking for as far as comments? Testosterone is in the low range and the more important marker, (free testosterone) is off the chart and is in line with your symptoms: low energy, moody, etc. Your case is a classic model of hypogonadism given your labs and symptoms.

E2 is low because you have a low production of testosterone. However, since you state you have some belly fat, I wonder why your E2 is at the bottom of the range? There is a condition where there is an aromatase-deficiency but we are jumping ahead here.

What's the range for LH and FSH? Any other conditions that you are excluding? Sleep apnea, hypothyroidism, etc? What's your cholesterol levels at? Cholesterol is a precursor to testosterone so having low cholesterol can have an impact on the synthesis of testosterone. I have to look more into this subject as I am not too familiar with this process.

 

[Kane07]

JOWS6

Man im confused I looked back through my test and will now include my labs reference ranges for estrogen and shmg which originally I crossreferenced against a ref range I found in another post.

Oestradiol 51pmol/L (< 150 )
SHBG 20nmol/L (13-71)
LH 5 U/L (3-20)
FSH 7 U/L (3-20)
TSH 2.2mU/L (.40-4.00)
Cholesterolol 4.5nmol/L (3.6-6.7)
Albumin 45g/L (35-50)
My original ranges for total and free are accurate.

As far as comments I guess I was just looking for some reassurance before I started and maybe a good starting protocol

As i said my doc is preety open minded and listens I was thinking

150mg test e
2 x 250 iu HCG
Arimidex on hand for estro

 

[JOWS6]

JOWS6

Man im confused I looked back through my test and will now include my labs reference ranges for estrogen and shmg which originally I crossreferenced against a ref range I found in another post.

Oestradiol 51pmol/L (< 150 )
SHBG 20nmol/L (13-71)
LH 5 U/L (3-20)
FSH 7 U/L (3-20)
TSH 2.2mU/L (.40-4.00)
Cholesterolol 4.5nmol/L (3.6-6.7)
Albumin 45g/L (35-50)
My original ranges for total and free are accurate.

As far as comments I guess I was just looking for some reassurance before I started and maybe a good starting protocol

As i said my doc is preety open minded and listens I was thinking

150mg test e
2 x 250 iu HCG
Arimidex on hand for estro

Well again, you're most important marker, free testosterone is low so testosterone replacement therapy (TRT) would help boost that and relieve your symptoms.

Your protocol looks good. Personally, I take a different approach to testosterone replacement therapy (TRT). The best way I can explain it is the appropriate method for selecting audio levels. Start at a low volume and turn it up to the point where you can hear it comfortably. This reduces the chances of unneeded decibel levels that may damage your ears long-term. That's the approach I take with testosterone replacement therapy (TRT). Front-load the first week to boost testosterone levels significantly and start at a low dose, maybe 75-100 mg's per week, 1mg of Aromatase inhibitor (AI) per week and 500 IU's of Human Chorionic Gonadotropin (HCG) per week. Evaluate after a few weeks and take a blood test to see where you stand and adjust accordingly. It jus' seems like people start off too high. The key is the lowest possible dose that relieves your symptoms.

 

[JOWS6]

Oh, I forgot to add that before diving into testosterone replacement therapy (TRT), it would be a good idea to rule out any possible conditions that may have lowered your testosterone.

Also, if you were to receive a diagnosis of primary hypogonadism as opposed to secondary hypogonadism, HcG would be worthless depending on the level of testicular dysfunction.

So you want to rule out things like pituitary tumors, sleep apnea, etc., etc.

 

[Kane07]

Thanks for all your advice JOWS6.

Will take all points into consideration before jumping in.

 

[cjw2021]

Your estrogen is 51 and your total and free test are below range. This is a simple problem Chip can fix. You will not solve this problem any other way than jumping all in. Give Chip a call, and get started feeling better. The longer you wait, the more life you waste feeling like crap. Stay away from tall bridges and buildings until then.

 

[Kane07]

Your estrogen is 51 and your total and free test are below range. This is a simple problem Chip can fix. You will not solve this problem any other way than jumping all in. Give Chip a call, and get started feeling better. The longer you wait, the more life you waste feeling like crap. Stay away from tall bridges and buildings until then.

I am based in Australia I thought Maximus only dealt domesticlly?, it would be great if our local clinics were as good as chip.

Also I thought my estrogen was in range based on my labs reference range, im at 51 (range <150)

 

[THE-DET-OAK]

Well again, you're most important marker, free testosterone is low so testosterone replacement therapy (TRT) would help boost that and relieve your symptoms..

exactly