BLOOD WORK, some advice please.

[DeadliftDOMS]

Hey guys, this is one of my first posts here I've been researching through these forums for a LONG time and have learned a lot, thank you to all the knowledgeable members here, this is a great place. Moving on, here's a little about me. I'm 28. I was diagnosed with Low T in May 2013. I had a laundry list of symptoms as many do. I finally found a group of doctors where I live that were well recognized in testosterone replacement therapy (TRT), and who I believe to be(so far) knowledgeable about this subject. Since starting my therapy my symptoms have greatly improved but I am still dialing myself in of coarse.

I'm currently on 160mg TEST CYP a week. I got my Doc to switch me to twice a week injects in order to control E2 at Peak levels with out the use of an Aromatase inhibitor (AI), and keep more stable levels.

I'm mainly concerned about Hematocrit, E2, and DHT.

My Most recent Blood work taken(BEFORE just switching to twice a week injections) I've been injecting twice a week for only a week now.

TROUGH LEVELS Quest Diagnostics

Total Test 710(300-1000)ng/dl
Free Test 1.14(0.95-4.30)ng/dl
Estradiol 36.3(20.0-75)pg/ml( Yes its not a sensitive test, as far as I know Quest doesn't do that other than ULTRA sensitive.
Prolactin 15(3.3-20.8)ng/ml
TSH 1.1(0.5-6.0) uIU/ml
Cortisol total 9.4(mcg/dl)
Cortisol Free 0.23(mcg/dl)
Hematocrit 50.5(38.5-50) We talked, my Doc doesn't get to concerned unless its gets to 53%..(NOT sure I agree)..ill probably be donating regardless.
Progesterone 0.4(0.0-0.6)ng/ml
PSA 0.6(0.0-4.0)ng/ml
DHEA 294 (61-1636)ng/dl
SHBG 31 (10-50_nmol/L
DHT FREE 7.02 ( 1.0-6.2)pg/ml ( He told me he would rather not touch this unless it got REALLY high, as many of the things to control it have side affects that of which im actually tring to fix, so I kind of agree with this.)
DHT Total 66( 16-79) ng/dl


Here are my questions

Question 1.
I just switched to twice a week injections in hopes to keep my E2 down and stabilize levels. I can ASSUME that my TEST levels will have higher troughs and less of peaks. Now, can I also assume that E2 will have a higher than preivious trough and lower peak. So, if it WERE 36, would it now be higher consistently?


Question 2.
Should I be worried about my Hematocrit, E2, DHT or anything else. As said ill most likely donate any ways.

Thanks Guys!

 

[halfwit]

I'm not a doc, but:

1. Your E2 should actually DROP a little, as it is a spike in testosterone that causes the aromatase enyzme action to start. Once this stabilizes, your body will reach homeostasis and be happy with a proper E2 level. You definitely still want to keep tabs on it, but shots twice a week will certainly help here.

2. Yes, you most certainly should be concerned with hematocrit and should donate ASAP (and every 56 days after that). I HATE how doctors like to wait until it's TOO LATE to take preventative measures, and just let folks rely on therapeutic (script required $$$) blood draws. In fact, I'd look into apheresis to bring those numbers down faster if you're concerned. E2 was mentioned above, and it should be definitely monitored -- as you're not in a bad spot now, I can't see it getting any worse. Remember to go by how you feel though; sluggishness/lack of sex drive/emotional/acne/bloating can all be attributed to an increase of E2, even if it's still within "range". DHT total is what I've always been told to worry about, but as that one fluctuates, I'd just keep an eye on it. Besides, as long as you have an output for the increased sex drive, I can't see it being an issue.

My .02c

 

[DreDay187]

Halfwit coming through as usual

 

[DeadliftDOMS]

I'm not a doc, but:

1. Your E2 should actually DROP a little, as it is a spike in testosterone that causes the aromatase enyzme action to start. Once this stabilizes, your body will reach homeostasis and be happy with a proper E2 level. You definitely still want to keep tabs on it, but shots twice a week will certainly help here.

2. Yes, you most certainly should be concerned with hematocrit and should donate ASAP (and every 56 days after that). I HATE how doctors like to wait until it's TOO LATE to take preventative measures, and just let folks rely on therapeutic (script required $$$) blood draws. In fact, I'd look into apheresis to bring those numbers down faster if you're concerned. E2 was mentioned above, and it should be definitely monitored -- as you're not in a bad spot now, I can't see it getting any worse. Remember to go by how you feel though; sluggishness/lack of sex drive/emotional/acne/bloating can all be attributed to an increase of E2, even if it's still within "range". DHT total is what I've always been told to worry about, but as that one fluctuates, I'd just keep an eye on it. Besides, as long as you have an output for the increased sex drive, I can't see it being an issue.

My .02c

Good info here Halfwit, thanks! On second thought, how about my free t levels. I understand that was a trough level and I will now most likely have a higher trough. Should I be aiming to get this to the higher end of the normal range since this is what really counts as far as Test? I also understand that may present other problems as well. How about supplementing vitamin d3 or Zinc ect to free t and lower shbg?

 

[SolomonGrundy]

splitting the dose so that no single shot exceed 150 mg is the best thing you can do, you will greatly reduce the effect on bone marrow and its generation of red blood cells, and in turn Hematocrit will drop significantly, like 2 points or more
Naturally you can expect a more stable blood serum level as you're dosing at half the half life and your E2 will be lower as the spike is greatly reduced

Be well

 

[Mprtz]

At 53% I would donate ASAP. That's not too far off from where they will turn you away. I did my first blood donation at 53% and it took a whole blood and 2 platelet donations to really bring it down. I would not count on splitting the dose dropping your hematocrit on it's own.
You are likely to show a much higher trough on a 2x weekly split dose, something to think about if you want to avoid possibly being down-dosed.
On 200mg 1x/week my trough was in the 800s. On 160mg 2x/week it was in the 1100s.

 

[Alpin]

Before you deal with E2 go book an appointment to donate blood next week....
Don't listen to that doc....thick blood is a killer!!!
bring that HCT down...
It might even be too late, as your HCT was elevated by a half percentage point over the limit....
depending on the lab...they might turn you away.
around here you are good till 53% I think
So what is your docs game plan? wait till the HCT continues to build?
You are on T...it aint going to go down....only up!!!

 

[DeadliftDOMS]

This is all very helpful, thank you very much guys!

 

[DeadliftDOMS]

Thanks for all the great advice guys!. Also, seeing as my DHEA is a little on the low side, would supplementing with 25mgs or so help to boost levels and or even backfill some other hormones?. Im a little hesitant as i don't want it to metabolize into any excess estrogen. Im also taking Zinc, b12, and VD3. Any other supplements that would complement my protocol?.