Finally Got Real Blood Tests. Can You Help Decipher Them?

[sqidd]

I asked my DR. to order blood tests that matched the suggested list in the “TRT Basics” thread but she wouldn’t because I quote, “I wouldn’t know how to read those”. So I did the Private Lab MD thing. And I just got my results back. Firstly I need some help deciphering these. Secondly I’m shocked at my T level. Here is my dosage/T-level history:

.2ml 2x/wk = 434 tested on 8/1/14

.4ml 2x/wk = 597 tested on 10/1/14

.7ml 2x/wk = 817 tested on 11/7/14

.7ml 2x/wk = 1144 tested on 12/11/14

How did I go from 817 to 1144 using the same dosage and the exact same protocols? Can different labs test different ways? The first three tests show the top end of the spectrum being 758. Is it a scaling thing? How do you know what your real T level is then? I’m confused.

Here are the rest of the results. If you guys could take a look at them and let me know what you think I would appreciate it.

My Testosterone Free is high. What does that mean?

My % Free Testosterone is high. What does that mean

My Insulin-Like Growth Factor I is high. What does that mean?

My Chloride, Serum is low. What does that mean?

My Monocytes (Absolute) is high. What does that mean?

My MCV is high. What does that mean?

My Hematocrit is high. What does that mean?

Here are the actual test results. I had a hard time formatting them to work in a post. Sorry for all of the……………………………

Thanks!


Test Name……………. Result…………. Flag…………….……….Reference Range

CBC With Differential/Platelet

WBC………………………………..8.3……………………………………………………………3.4-10.8 x10E3/uL
RBC………………………………. 5.33………………………………………………………..4.14-5.80 x10E6/uL
Hemoglobin……………………17.5…………………………………………………………………12.6-17.7 g/dL
Hematocrit…………………… 52.8………………….HIGH………………………………………..37.5-51.0 %
MCV ……………………………….99…………………….HIGH……………………………………………….79-97 fL
MCH……………………………….32.8…………………………………………………………………….26.6-33.0 pg
MCHC……………………………..33.1………………………………………………………………..31.5-35.7 g/dL
RDW……………………………….12.4…………………………………………………………………….12.3-15.4 %
Platelets………………………….245……………………………………………………………150-379 x10E3/uL
Neutrophils……………………..61……………………………………………………………………………………….%
Lymphs…………………………….21………………………………………………………………………………………%
Monocytes……………………….13……………………………………………………………………………………….%
Eos…………………………………….5……………………………………………………………………………………….%
Basos…………………………………0……………………………………………………………………………………….%
Neutrophils (Absolute)…….5.0…………………………………………………………….1.4-7.0 x10E3/uL
Lymphs (Absolute)………....1.8…………………………………………………………….0.7-3.1 x10E3/uL
Monocytes(Absolute)…….. 1.1…………………HIGH………………………………….0.1-0.9 x10E3/uL
Eos (Absolute)………………….0.4…………………………………………………………….0.0-0.4 x10E3/uL
Baso (Absolute)………………..0.0……………………………………………………………0.0-0.2 x10E3/uL
Immature Granulocytes…….0……………………………………………………………………………………….%
Immature Grans (Abs)……. 0.0……………………………………………………………0.0-0.1 x10E3/uL

Comp. ********* Panel

Glucose, Serum………………….96…………………………………………………………………..65-99 mg/dL
BUN…………………………………….19…………………………………………………………………….6-24 mg/dL
Creatinine, Serum…………… 1.23………………………………………………………….0.76-1.27 mg/dL
eGFR If NonAfricn Am…………72………………………………………………………….>59 mL/min/1.73
BUN/Creatinine Ratio………….15……………………………………………………………………………….9-20
Sodium, Serum…………………..139………………………………………………………….134-144 mmol/L
Potassium, Serum……………….3.8…………………………………………………………….3.5-5.2 mmol/L
Chloride, Serum…………………..95……………….LOW…………………………………….97-108 mmol/L
Carbon Dioxide, Total………….24……………………………………………………………….18-29 mmol/L
Calcium, Serum…………………..9.3……………………………………………………………8.7-10.2 mg/dL
Protein, Total, Serum………….6.8………………………………………………………………..6.0-8.5 g/dL
Albumin, Serum…………………..4.5………………………………………………………………..3.5-5.5 g/dL
Globulin, Total……………………..2.3………………………………………………………………..1.5-4.5 g/dL
A/G Ratio……………………………..2.0………………………………………………………………………..1.1-2.5
Bilirubin, Total……………………..0.3……………………………………………………………..0.0-1.2 mg/dL
Alkaline Phosphatase, S……….72………………………………………………………………….39-117 IU/L
AST (SGOT)………………………….22………………………………………………………………………0-40 IU/L
ALT (SGPT)…………………………..25……………………………………………………………………..0-44 IU/L

Lipid Panel

Cholesterol, Total………………..117……………………………………………………………100-199 mg/dL
Triglycerides………………………….95………………………………………………………………..0-149 mg/dL
HDL Cholesterol…………………….41…………………………………………………………………..>39 mg/dL
VLDL Cholesterol Cal…………….19………………………………………………………………….5-40 mg/dL
LDL Cholesterol Calc……………57……………………………………………………………………0-99 mg/dL

Thyroid Panel With TSH

TSH……………………………………..2.820…………………………………………………0.450-4.500 uIU/mL
Thyroxine (T4)…………………….4.7……………………………………………………………..4.5-12.0 ug/dL
T3 Uptake…………………………….29…………………………………………………………………………24-39 %
Free Thyroxine Index…………..1.4…………………………………………………………………………1.2-4.9

Testosterone, Free/Tot Equilib

Testosterone, Serum…………..1144…………………………………………………......348-1197 ng/dL
Testosterone,Free………………..52.74……………...HIGH………………………….5.00-21.00 ng/dL
% Free Testosterone…………….4.61………………..HIGH………………………………….1.50-4.20 %

Prostate-Specific Ag, Serum

Prostate Specific Ag, Serum…..1.0………………………………………………………….0.0-4.0 ng/mL

IGF-1

Insulin-Like Growth Factor I….287………………….HIGH………………………………75-216 ng/mL

Estradiol, Sensitive

Estradiol, Sensitive………………..30…………………………………………………………………3-70 pg/mL

 

[Megatron28]

This is hard to read. Can you just post a picture of your results with your personal info removed?

Also, how many milligrams of test were you taking? Volumes don't tell us a whole lot. We would have to guess what your testosterone concentration is.

When did you change the testosterone dosage?

Are you using an AI or hCG? If so, when and how much (not in volumes though)?

 

[sqidd]

This is hard to read. Can you just post a picture of your results with your personal info removed?

Yeah, I can scan it in and post it. I didn't think that would show up real well but it's worth a shot.

Also, how many milligrams of test were you taking? Volumes don't tell us a whole lot. We would have to guess what your testosterone concentration is.

I'm not sure how to do the conversion. I'm looking at the box that the Cyp comes in and here is what it says:

Testosterone
Cypionate
Injection USP

2,000mg/10ml
(200mg/ml)

So if my math is right a .7ml injection is 140mg. Is that correct?

When did you change the testosterone dosage?

Assuming my above math is correct I started hitting myself with 140mg 2x/wk on 10/1/14.

I was tested on 11/7/14 and it was 817 (old lab). Then tested again 12/11/14 and it was 1144 (new lab). Between these two tests my dosage and testing protocols did not change.

Are you using an AI or hCG? If so, when and how much (not in volumes though)?

I don't know what those are so I'm guessing I'm not using them.

Next post will have a scan of the results.

Thanks a lot for your help!

 

[IMT staff]

It is because of the ester and the half-life of the medication. It builds over time. A single injection can dispense T for like 6 weeks.

Also make sure your testing on the day of your injection before you take it.

Might need to titrate down just a bit.

Also are your taking an AI? Seems like you don't need it or are already on one.

 

[sqidd]

Scans. I hope these look ok.

 

[sqidd]

It is because of the ester and the half-life of the medication. It builds over time. A single injection can dispense T for like 6 weeks.

Ok, that makes sense. So my first test at 140mg may have not given it enough time to "settle in". And by the time my second test came around that same dosage "settled" and that is my true reading? Do I have that right?

Also make sure your testing on the day of your injection before you take it.

Oh yeah, I'm super OCD testing dork (I do R&D for a living). All tests are taken on injection day (Thursdays) before I inject. They have all even been within an hour of each other.

Might need to titrate down just a bit.

I don't know what this is? Do you mean drop my dosage?

Also are your taking an AI? Seems like you don't need it or are already on one.

I'm not taking anything else. I guess I am one of the lucky ones???

Thanks guys!

 

[Mprtz]

So 280mg per week? That's a very high dosage for TRT. You might very well have low SHBG, hence the high percentage free test.
Testosterone raises hematocrit, especially at higher doses. You should donate blood very soon if you can.

I'm surprised your E2 is so low, especially at that dose.

Elevated IGF-1 is generally a good thing... mine is similarly up (not quite as much) over my age range. I imagine we are getting at least some of the benefits that people get from using growth hormone. Some people beleive that elevated IGF can activate or accelerate dormant cancers, I'm not sure if this is a consensus though.

 

[sqidd]

So 280mg per week?

If my math is right yes. I've always thought about it as ml so the mg conversion is new to me. Here is my math:

I'm not sure how to do the conversion. I'm looking at the box that the Cyp comes in and here is what it says:

Testosterone
Cypionate
Injection USP

2,000mg/10ml
(200mg/ml)

So if my math is right a .7ml injection is 140mg. Is that correct?

That's a very high dosage for TRT.

I was thinking the same but it only got me to 800 on my 2nd to last test so I thought I was resistant somehow. But this latest test has me at 1144. Which is probably more accurate because I have given it more time to settle in my system. Does 280mg/wk seem high for a score of 1144? I know 1144 is on the high side for a TRT goal. Not that I'm complaining.

You might very well have low SHBG, hence the high percentage free test.

I'm on the edge of getting lost here.

Is SHBG Sex hormone-binding globulin? I just did a quick scan on wiki and kinda get it. But that doesn't mean I understand what to do about it. Or if anything needs to be done at all. Is it just "a thing"?

Is there other problems associated with low SHBG? Is there an issue with having too much free test? Any negative side effects? Or is it just an indicator of something else?

Testosterone raises hematocrit, especially at higher doses. You should donate blood very soon if you can.

I was reading about this in the basic TRT overview. So go donate blood every couple of months?

I'm surprised your E2 is so low, especially at that dose.

Me too. Am I some sort of one in a million situation or can that be an indication of something else being goofed up?

Elevated IGF-1 is generally a good thing... mine is similarly up (not quite as much) over my age range. I imagine we are getting at least some of the benefits that people get from using growth hormone. Some people beleive that elevated IGF can activate or accelerate dormant cancers, I'm not sure if this is a consensus though.

Cool, I'll back burner that for right now then.

What are your thoughts on holding steady at 1100 and my current dose? On the surface it doesn't appear that I am causing anything negative, at least nothing that can't be managed easily. I certainly enjoy where I'm at, that's for sure. I of course could back down, but if it won't solve anything and will most likely reduce my ability to recover I don't see much point.

Your input is very much appreciated. I am very, very new to this. I am the type of person who likes to understand all of the intricacies of what I am doing no matter what it is. I would like to understand this process in detail and I think I will only be able to get the tutoring I want only from people like yourself.

Thanks a lot!

 

[Alpin]

How long have you been on 280 mg a week?
I would hit 2000 ng/dl TT at that dose. Lol
DONATE BLOOD. DO NOT UNDERESTIMATE OR NEGLECT TO DO THIS. The levels of T you are at you are a RBC producing machine.
Estradiol sensitive at 30 pg/ml how many days from shot?
What a range going up to 70 pg/ml

 

[Alpin]

Staying at 1100 over the long run may feel ok to you but for some it is too much and raises HCT( faster), PSA, DHT and not really a sustainable long term dose.
How did you feel at 800 ?

 

[Alpin]

Before starting TRT its best to understand what you are getting yourself into. When you ask: "my hematocrit is high what does that mean:?
Tells me you are not too familiar with the side effects of the drug you are using.
To answer your question, high HCT means THICKER BLOOD with more RBC's.
Heart works harder to pump blood.

 

[sqidd]

How long have you been on 280 mg a week?

10 weeks

I would hit 2000 ng/dl TT at that dose. Lol

Yeah, what's up with that. Could something be wrong with me? Or is that just a case of everyone being different?

DONATE BLOOD. DO NOT UNDERESTIMATE OR NEGLECT TO DO THIS. The levels of T you are at you are a RBC producing machine.

Copy that. As soon as I'm done typing this post I'm going to figure out where I can do that.

Estradiol sensitive at 30 pg/ml how many days from shot?

3.75 days

What a range going up to 70 pg/ml

You lost me there (new guy here). Can you elaborate?

Staying at 1100 over the long run may feel ok to you but for some it is too much and raises HCT( faster), PSA, DHT and not really a sustainable long term dose.

Cool, noted. I'm going to need to do some thinking about how to play this out over the long run.

How did you feel at 800 ?

I'm not sure. When I tested at 800 I was on the same dose I am now. I thought I felt pretty good. That was in comparison to being low previously low, so anything was good. Do I feel better now? Maybe? Could be? Probably yes. But I'm a data dork/tester at heart. I would have to drop back down and really pay attention to what was going on to make sure I'm not dealing with something psychosomatic.

I have 5 weeks left on my "gym cycle". I would like to be at peak till the end of that. Then I'll cut back and see what that gets me. If my Dr knew where I was at she would have a litter of kittens and then I would probably be looking for a Rx somewhere else.

 

[sqidd]

Before starting TRT its best to understand what you are getting yourself into. When you ask: "my hematocrit is high what does that mean:?
Tells me you are not too familiar with the side effects of the drug you are using.
To answer your question, high HCT means THICKER BLOOD with more RBC's.
Heart works harder to pump blood.

In my defense I knew that TRT causes blood to thicken. My biggest hurdle at this point is terms/names and acronyms. And after three years of useless or near useless Dr's it's time for me to help steer this bus and part of that is getting used to the environment/community. I'll be speaking the lingo in short order.

Thanks again

 

[Alpin]

Well if u did labs on the same day and at same dose....
The only logical explanation is T continues to build over time. The same dose can continue to increase T for a while till it plateaus.
heck 2 weeks into TRT I tested at 790 TT...E3D shots. Estradiol at 27 pg/ml....both measured 2 days from shot.
I bet I am over that now. Don't know how much...
8 weeks in now.

 

[Alpin]

Make sure you eat well 3-4 hours before going in to donate blood. Hydrate yourself well.

 

[Megatron28]

Some responses to your various questions throughout the thread:

- Numbers look good except for hematocrit. As mentioned, you need to donate blood regularly to keep thisbin check. Exogenous testosterone raises hematocrit.

- Titrate means, continuously measure and adjust the balance of (a physiological function or drug dosage).. In your situation it may mean lower your dosage.

- Your math is right. You have to understand that testosterone can be dosed differently by manufacturers. One may put 100mg in each ml. Others may put 200mg in each ml. Just like I can make a cup of juice sweeter by adding more sugar. You should start thinking in terms of mg because of this.

-AI is Aromatase Inhibitor and hCG is human chorionic gonadotropin which are covered in the Basic TRT Overview. You can look them up on the web too.

- 280mg/week in on the high side for a TRT dose. Most guys take between 100-200mg/week on TRT. How much do you weigh? Bigger guys often have to take higher doses.

- You don't have to do anything about your SHBG. It is meant to be an explanation for why your Free T is high. If the test in your bloodstream isn't bound to SHBG or Albumin that means it is available to go to its target tissue (I.e. muscle). That is generally a good thing.

- Yes, donate blood every 56 days which is the max frequency permitted.

- Some docs will have a problem with your TT being at the upper end of the normal range. I personally like to remind them that Normal is Normal regardless of where it falls in the normal range. You have to throw it back at them sometimes. Although you should keep an eye on things to make sure E2, BP and Hematocrit don't "take off" on you. If they do, back off a bit. Things do change over time with TRT.

 

[Alpin]

- Some docs will have a problem with your TT being at the upper end of the normal range. I personally like to remind them that Normal is Normal regardless of where it falls in the normal range. You have to throw it back at them sometimes. Although you should keep an eye on things to make sure E2, BP and Hematocrit don't "take off" on you. If they do, back off a bit. Things do change over time with TRT.

^ This


Very true. I've had a couple docs grimice for 830 TT.
Range here goes to 865 TT at its highest at one lab.
I was asked to come down to 600 TT....lol

 

[IMT staff]

I'm surprised your E2 is so low, especially at that dose..

We are as well

 

[sqidd]

Make sure you eat well 3-4 hours before going in to donate blood. Hydrate yourself well.

Cool, thanks for the heads up.

My diet guy has me eating every 2.5hrs and I drink 20oz/hr of water all day long.

Am I guessing correctly that I shouldn't mention that I'm donating because I want the get my RBC count down?

 

[sqidd]

Some responses to your various questions throughout the thread:

- Numbers look good except for hematocrit. As mentioned, you need to donate blood regularly to keep thisbin check. Exogenous testosterone raises hematocrit.

- Titrate means, continuously measure and adjust the balance of (a physiological function or drug dosage).. In your situation it may mean lower your dosage.

- Your math is right. You have to understand that testosterone can be dosed differently by manufacturers. One may put 100mg in each ml. Others may put 200mg in each ml. Just like I can make a cup of juice sweeter by adding more sugar. You should start thinking in terms of mg because of this.

-AI is Aromatase Inhibitor and hCG is human chorionic gonadotropin which are covered in the Basic TRT Overview. You can look them up on the web too.

- 280mg/week in on the high side for a TRT dose. Most guys take between 100-200mg/week on TRT. How much do you weigh? Bigger guys often have to take higher doses.

- You don't have to do anything about your SHBG. It is meant to be an explanation for why your Free T is high. If the test in your bloodstream isn't bound to SHBG or Albumin that means it is available to go to its target tissue (I.e. muscle). That is generally a good thing.

- Yes, donate blood every 56 days which is the max frequency permitted.

- Some docs will have a problem with your TT being at the upper end of the normal range. I personally like to remind them that Normal is Normal regardless of where it falls in the normal range. You have to throw it back at them sometimes. Although you should keep an eye on things to make sure E2, BP and Hematocrit don't "take off" on you. If they do, back off a bit. Things do change over time with TRT.

Thanks for the info. I'm trying to absorb as much of this as possible so I can take care of myself correctly. You guys have been a big help.

I thought my dose was high from what I had seen poking around. I'm 187lb at a 11% BF. I think I'm going to back it down a bit and see how I feel. I guess there isn't much point in running more than I need to feel right/recover.

How long do you think I should wait before doing another blood test? I have a shot due tomorrow, I will back down starting then. Maybe 4 weeks and then check the results?

Thanks again