Dihydrotestosterone is too high.

[medvetz63]

I began TRT on November 27th 2014 using two tubes of Testim gel per day.
This past week I had my first blood work done since beginning TRT. Here are the results:

Total Testosterone: 748
Free Testosterone: 15.34
Estradiol (E2): 18.8
Dihydrotestosterone: 133.2
PSA: 1.030
Total Cholesterol: 102
HDL: 19
LDL: 68
Triglycerides: 74
C-Reactive Protein: 0.2
Hematocrit: 40.8
Hemoglobin: 13.7
Red Blood Cell: 4.50
White Blood Cell: 5.7
Total T3: 111.0
Total T4: 7.7
TSH: 1.920

All the numbers look good according to the reference ranges except the Dihydrotestosterone is high. What can this mean?

My testosterone before TRT was 242. I'm 51 years old. I used Testim once before, from 2012 to 2013, but I quit because the doctor prescribing it did NO follow ups at all, he just prescribed it and nothing else. I now have a doctor who will do regular check ups.

 

[Megatron28]

Can you please edit the post to include reference ranges?

Are you taking an aromatase inhibitor? Your estradiol looks like it is on the low side.

 

[medvetz63]

Can you please edit the post to include reference ranges?

Are you taking an aromatase inhibitor? Your estradiol looks like it is on the low side.

No, just the Testim. I take zinc supplements and I've heard that it acts as a natural AI.

 

[halfwit]

That's common with transdermals unfortunately. I'm surprised that your estradiol isn't higher to be honest. Unless that's a sensitive assay.

 

[newtohrt]

Your PSA is good and low, so while your DHT might be a bit higher than the reference, it may not be cause for alarm. We need a decent DHT level for libido so I will be curious to hear what your Doc says? That's my 2-cents anyway.

 

[Mprtz]

HDL is pretty low and HCT is surprisingly low, but then I guess you've only recently started.

 

[medvetz63]

View attachment 560319View attachment 560320View attachment 560321

No, just the Testim. I take zinc supplements and I've heard that it acts as a natural AI.

Here's the results with the reference ranges that were requested.

 

[medvetz63]

HDL is pretty low and HCT is surprisingly low, but then I guess you've only recently started.

I started TRT on November 27th 2014. I have been a regular blood donor for years, that could be why the hematocrit is so low. My HDL is always low, but so too is my total cholesterol and LDL. I eat a mostly vegetarian diet, so I'm don't consume a lot of saturated fat.

 

[Mprtz]

I started TRT on November 27th 2014. I have been a regular blood donor for years, that could be why the hematocrit is so low. My HDL is always low, but so too is my total cholesterol and LDL. I eat a mostly vegetarian diet, so I'm don't consume a lot of saturated fat.

Makes sense. Did you notice your ferritin is in the tank? Any concerns about that on your or your doctors part? Pretty normal for a regular blood donor, but I'm trying to figure out how much of a problem this is.

On the whole, from one 51 year old to another - pretty nice blood work.

At the risk of adding the obvious - if you have male pattern baldness your high DHT may accelerate your hair loss. High DHT is common with transdermals because of conversion in the skin.

 

[Megatron28]

I have never seen an HDL that low. And your LDL is really low too. I wouldnt be surprised if that contributed to your hypogonadism.

Have you ever checked your vitamin D?

As mprtz pointed out, keep an eye on your ferritin. You could probably skip a blood donation and let that replenish itself. Do you supplement iron at all or have a good dietary source?

 

[medvetz63]

Makes sense. Did you notice your ferritin is in the tank? Any concerns about that on your or your doctors part? Pretty normal for a regular blood donor, but I'm trying to figure out how much of a problem this is.

On the whole, from one 51 year old to another - pretty nice blood work.

At the risk of adding the obvious - if you have male pattern baldness your high DHT may accelerate your hair loss. High DHT is common with transdermals because of conversion in the skin.

I lost most of my hair by my mid-thirties and have been shaving my head since then.
As per the ferritin, it's probably caused by the blood donations since I've never had this problem before. I've been donating every two months as a way of avoiding policithemia from the TRT. I feel perfectly fine, though, with plenty of energy.

 

[IMT staff]

That's common with transdermals unfortunately. I'm surprised that your estradiol isn't higher to be honest. Unless that's a sensitive assay.

^^^ yup

 

[Black Beard]

I have never seen an HDL that low. And your LDL is really low too. I wouldnt be surprised if that contributed to your hypogonadism.

Have you ever checked your vitamin D?

As mprtz pointed out, keep an eye on your ferritin. You could probably skip a blood donation and let that replenish itself. Do you supplement iron at all or have a good dietary source?

Ouch, my thoughts exactly on that HDL. That's not a good sign for your cardiovascular health. Things that might help ; Strength training, aerobic exercise, moderate red wine consumption, moderate fat intake. Fat intake might be hard on a veggie diet. Cholesterol is the pre-cursor aka raw material for all your hormones. Cholesterol is converted into testosterone in the leydig cells of the testes. Without the raw material, you can't make the final product. Vegetarian diets are notorious for this kind of stuff , anecdotally of course. (besides low fat diets, which are scientifically proven to serum androgen levels and cholesterol/lipids)








@megatron , These are definintely the lowest HDL levels I've ever seen. My dad has the highest. He hovers around 85 HDL. The guy never misses a workout. Strength training, running, lots of steak and red wine. He also takes fish oil.

 

[medvetz63]

Ouch, my thoughts exactly on that HDL. That's not a good sign for your cardiovascular health. Things that might help ; Strength training, aerobic exercise, moderate red wine consumption, moderate fat intake. Fat intake might be hard on a veggie diet. Cholesterol is the pre-cursor aka raw material for all your hormones. Cholesterol is converted into testosterone in the leydig cells of the testes. Without the raw material, you can't make the final product. Vegetarian diets are notorious for this kind of stuff , anecdotally of course. (besides low fat diets, which are scientifically proven to serum androgen levels and cholesterol/lipids)








@megatron , These are definintely the lowest HDL levels I've ever seen. My dad has the highest. He hovers around 85 HDL. The guy never misses a workout. Strength training, running, lots of steak and red wine. He also takes fish oil.

I exercise like a fanatic and always have since I was a teenager. I lift weights, bodyweight calisthenic circuits, brisk walking, kettlebell workouts, etc.
I have always had low HDL for years in spite of all the exercise. The ONLY times I have seen my HDL hit the low end of normal is when I went through a period of NOT watching my diet and my LDL went through the roof with my HDL finally reaching 41 which is one point above the lowest acceptable reading (40).
Most doctors have told me that if the LDL is very low the low HDL means nothing because there is not much bad cholesterol for it to clean up with such low LDL numbers.

 

[Slhardee]

Supplement Niacin @ 250mg 4x per day. This will help bring your HDL cholesterol up.

 

[3J]

do you suffer from male pattern baldness?
hows your sex drive?

 

[scorob777]

There's a three year span on these posts, are you still having the same issues OP?