Got lab results, don't know what to do

[CobraMustangSVT]

Hi,
I was contemplating a cycle and after doing my research, I decided to go with this:
Week 1-4: DBOL, 35mg, split up 3 times a day
LIV 52 6 times a day a week before and throughout the cycle
Milk Thistle 4 times a day a week before and throughout the cycle
Week 1-12: Test E, 300mg on Monday and Thursday for a total of 600mg a week
Week 1-17 aromasin 12.5mg every day (taking it a couple of weeks into post cycle therapy (pct))
Week 1-14 HcG 250iu every Monday and Thursday (I would run the HcG all the way up until 5 days before post cycle therapy (pct))

For the post cycle therapy (pct)
Week 15-16 Clomid 50mg once a day and Nolva 40mg once a day
Week 17-18 Clomid 25mg once a day and Nolva 20mg once a day

I decided to get some blood tests done so I could have a baseline for my natural test levels. This is when things went bad. I had this test done in April of this year:
LH = 4.1 Ref (1.5-9.3 mIU/mL)
FSH = 3.9 Ref (1.6-8.0 mIU/mL)
Prolactin = 11.6 Ref (2.0-18.0 ng/mL)
Estradiol = 23 Ref (< or = 39pg/mL)
Testosterone, Total, Males = 290 Ref (241-827 ng/dL)

Here's a little about me:
I'm 38 years old. 6ft tall, 206lbs and 18.5%bf. I've been training for a little over 2 years now. I run a typical bodybuilding split. Legs on Monday, chest and tris on Tuesday, rest on Wednesday, back on Thursday, and shoulders and biceps on Friday. I've never run a cycle and I don't smoke or drink.

I have now decided against the cycle (too bad I already wasted the money on the gear) and I went to another doctor to check my test levels again. It's still low. This doctor wants to put me on Test C at 400mg every 2 weeks. I told him to give me some time to think about it. I want to do some more research before I start the lifelong testosterone replacement therapy (TRT) committment.

I'll post my labs in the next post.

 

[CobraMustangSVT]

Here are my lab results from last year:

Collected 6/8/12
Recieved 6/9/12

Quest Diagnostics

Test: CS/HDL/AMY/CK/OSMOLALITY/T4/T3U/TSH/RPR/CBD/UA+ALB
CHEM-SCREEN PNL+HDL,TIBC
Glucose, fasting 82 REF 65-99 mg/dL
Sodium 141 Ref 135-146mmol/L
Potassium 4.9 Ref 3.5-5.3 mmol/L
Chloride 104 Ref 98-110 mmol/L
Carbon dioxide 27 ref 21-33 mmol/L
urea nitrogen 16 ref 7-25 mg/dL
Creatinine 1.10 ref 0.60-1.35 mg/dL

BUN/Creatinine Ratio NOT REPORTED WHEN VALUES ARE WITHIN NORMAL LIMITS ref 6-22

Uric Acid 5.2 Ref 4.0-8.0 mg/dL
Phosphorus 3.5 ref 2.5-4.5 mg/dL
Cholesterol, total 150 Ref 125/200mg/dL
HDL Cholesterol 59 ref >=40 mg/dL
Cholesterol/HDL Ratio 2.5 ref <= 5.0
LDL Cholesterol, calculated 83 ref <130mg/dL

Triglycerides 40 ref <150 mg/dL
Protein, total 7.0 ref 6.2-8.3 g/dL
albumin 4.6 ref 3.6-5.1g/dL
Globulin, Calculated 2.4 ref 2.1-3.7 g/dL
A/G ratio 1.9 ref 1.0-2.1
Bilirubin, total 0.4 ref 0.2-1.2 mg/dL
Bilrubin, direct 0.1 ref <=0.2 mg/dL
Alkaline Phosphatase 50 ref 40-115 U/L
GGT 19 ref 3-90 U/L
AST 22 ref 10-40 U/L
ALT 13 ref 9-60 U/L
LD 157 ref 100-220 U/L
Iron, total 86 ref 45-170mcg/dL
TIBC 330 ref 250-425 mcg/dL
Transferrin saturation 26 ref 20-50%
EGFR NON AFR American 88 ref >60 mL/min/1.73m2
EGFR AFR American 102 ref >60 mL/min/1.73m2

OSMOLALITY, serum 293 ref 275-295 mOsm/kg H2O

MICROALBUMIN, RANDOM
MICROALBUMIN 0.4 ref NOT ESTABLISHED mg/dL
MICROALBUMIN, RANDOM URINE 2 ref < 30 mcg/mg Creat

CREATININE, RANDOM URINE
Creatinine Random Urine 185 ref 20-370 mg/dL

TSH 0.68 ref 0.40 - 4.50 mIU/L

T4, Total 6.0 ref 4.5-12.0 mcg/dL

T3 Uptake 31 ref 22-35 percent
T4, free, calculated 1.9 ref 1.4-3.8 units

CK TOTAL 315 ref 44-196 U/L OUT OF RANGE

Amylase, Serum 70 ref 21-101 U/L

CBC INCLUDES DIFF/PLT
WBC 6.5 ref 3.8-10.8 Thous/mcL
RBC 4.92 ref 4.20-5.80 Mill/mcL
HEmoglobin 13.8 ref 13.2-17.1 g/dL
Hematocrit 42.1 ref 38.5-50%
MCV 85.5 ref 80.0-100.0 fL
MCH 28.0 ref 27.0-33.0 pg
MCHC 32.8 ref 32.0-36.0 g/dL
RDW 13.3 ref 11.0-15.0%
Platelet count 250 ref 140-400 Thous/mcL
MPV 8.8 ref 7.5-11.5 fL
Total neotrophils,% 54.1 ref 38-80%
Total lymphocytes,% 35.5 ref 15-49%
Moonocytes,% 9.0 ref 0-13%
eosinophils,% 1.1 ref 0-8%
Basophils,% 0.3 ref 0-2%
Neutrophils, Absolute 3517 ref 1500-7800 Cell/mcL
Lymphocytes, Absolute 2308 ref 850-3900 Cells/mcL
Monocytes, Absolute 585 ref 200-950 Cells/mcL
EOSINOPHILS, Absolute 72 ref 15-500 Cells/mcL
Basophils, Absolute 20 ref 0-200 cells/mcL
DIFFERENTIAL - An instrument differential was performed.
Urinalysis, Complete
Color Yellow Ref Yellow
Appearance Clear Ref Clear
Glucose, QL Negative ref Negative mg/dL
Bilirubin, Urine Negative ref Negative
Ketones Negative ref Negative mg/DL
Specific Gravity 1.020 ref 1.001 - 1.035
Blood Negative ref Negative
PH 6.0 ref 5.0-8.0
Protein, Total QL Negative ref Negative mg/dL
Nitrite Negative ref NEgative
Leukocyte Esterase NEgative ref negative
Squamous Epithelial Cells None Seen ref <or =5 cells/hpf
WBC None Seen ref <or =5 cells/hpf
Bacteria None seen ref none seen/hpf
RBC None seen ref <or =3 cells/hpf
Hyaline Casts None seen ref None seen /lpf

Cardio CRP (R) 0.5 ref <1.0 Lower relative cardiovascular risk
RPR w/titer + Conf RFX
RPR Screen Nonreactive ref non reactive

Vitamin D, 25-OH,LC/MS/MS
Vitamin D, 25-OH, TOTAL 33 ref 30-100ng/mL
Vitamin D, 25-OH, D3: 33
Vitamin D, 25-OH, D2: <4

 

[CobraMustangSVT]

Double post

 

[CobraMustangSVT]

THIS IS MY CURRENT BLOODWORK FROM 5/30/13

Glucose, 74 REF 74-106 mg/dL
BUN, 15 REF 9-23 mg/dL
Creatinine, 1.0 REF 0.7-1.3
BUN/Creatinine Ratio, 15 REF 8-28 Ratio
Calcium, 9.7 REF 8.7-10.4
Sodium Serum 144 Ref 132-146mmol/L
Potassium 5.0 Ref 3.5-5.5 mmol/L
Chloride 103 Ref 99-109 mmol/L
Carbon dioxide 29 ref 20-31 mmol/L
Protein, total 6.9 ref 5.7-8.2 g/dL
albumin 4.4 ref 3.2-4.8g/dL
Globulin, 2.5 ref 1.8-4.0 g/dL
A/G ratio 1.8 ref 0.8-2.7 Ratio
ALK.Phosphate, 77 REF 40-156 U/L
Bilirubin, total 0.4 ref 0.2-2.0 mg/dL
AST 22 ref <34
ALT 21 ref 10-49 U/L
Uric Acid 3.8 Ref 3.7-9.2 mg/dL
Cholesterol, total 137 Ref 100-200mg/dL
HDL Cholesterol 50 ref 40 -50mg/dL
VLDL Cholesterol, Cacl, 13 REF 0-38 mg/dL
LDL Cholesterol, Calc, 74 REF 70-130mgDL
Cholesterol/HDL Ratio 2.74 ref 0-4.97
LDL/HDL Ratio 2.74 ref 1.00-3.55
C-Reactive Protein (CRP), <0.4 REF <1.0
Glycohemoglobin (HbA1c), 5.2 REF <5.7
PSA (Prostatic Antigen), 0.89 REF 0.00-4.00 nG/mL
Estradiol, <20
TSH, 3rd Generation, 0.72 REF 0.51-6.27uIU/mL
Vitamin B12, 802 REF 211-911pg/ML
Ferritin, 69 REF 22-322ng/mL
Iron, 89 REF 65-175 ug/dL
Complete Blood Count
WBC, automated 5.0 ref 3.7-10.5 x10^3/uL
RBC 5.32 ref 4.6-6.2
HGB 14.0 ref 14.0-18.0 g/dL
HCT 48.0 ref 42-54%
MCV 90 ref 80.0-102.0 fL
MCH 26.3 ref 26.0-32.0 pg
MCHC 29.1 ref 30.0-36.0 g/dL OUT OF RANGE
RDW 13.7 ref 11.5-18.5%
Platelet, automated 237 ref 130-400
MPV 8 ref 6.8-12.6 fL
DIFFERENTIALS, AUTOMATED
Neotrophils % 46.5 REF 40-75
Total neotrophils # 2.33 ref 1.6-7.0
Lymphocytes,% 43.2 ref 15-45%
Lymphocytes # 2.16, REF 1-4.8
Moonocytes,% 7.2 ref 3-12%
Monocytes # 0.36 REF 0.00-1.2
eosinophils,% 2.6 ref 0-6%
Eosinophils # 0.13 REF 0.00-0.45
Basophils,% 0.6 ref 0-2%
Basophils # 0.03 REF 0.00-0.20
Sedimentation Rate, 2 REF 0-20
Testosterone, Total, 277 Ref 300-1000
Testosterone, Free, 59.8 REF 90-244pg/mL
SHBG 27 REF 13-71nmol/L
Vitamin D, 25-Hydroxy, 99 REF 30-100ng/mL

As you can see, the testosterone numbers have gotten lower. My vitamin D numbers improved over the past year though.

I don't have any of the problems I see in the commercials. My libido is fine (I always want sex), my erections are fine, my memory is good, I have energy, I sleep well, my mind is sharp, I work out well and add weight to the bar. I feel great so it's kind of disappointing to see the test numbers so low. I eat well, getting in at least 200g of protein, take Orange Triad multivitamins, fish oil and 6,000iu's of Vitamin D. I work out consistently. I'm pretty bummed out over these numbers.

I have one doc telling me the leave everything alone. I don't have symptoms and I add weight to the bar during my workout. I have another doc telling me that my numbers are low and to get on testosterone replacement therapy (TRT) to fix them.

I don't know what to do.

 

[Megatron28]

Even though you feel fine, there are health issues with having hypogonadism. Think of it like having high blood pressure. You may feel perfectly fine, but it is called the "silent killer" for a reason. Or do you have symptoms you can fell when your LDL is too high -- until it is too late? You need to increase your testosterone to a level that is normal for your age.

 

[CobraMustangSVT]

Megatron,
Thanks for the response. What you said is exactly what the testosterone replacement therapy (TRT) doc told me. I told him about my family history (father had a stroke a few years ago and is a diabetic, mother has high blood pressure) and he said that with these low levels and the family history, I run the same risks. The only thing is that my blood pressure is good (I just checked it now 120/83) and all my blood tests look ok.

Could I have something else? I was thinking maybe thyroid but the doc said my thyroid numbers look good too. I eat right, exercise with heavy, compound lifts in the 5 rep range, take my multivitamin, never did drugs, or drank, or smoked. It's really disappointing that this happened.

Can I do something else to raise the T level or should I just get the shot?

Thanks

 

[Megatron28]

Megatron,
Thanks for the response. What you said is exactly what the testosterone replacement therapy (TRT) doc told me. I told him about my family history (father had a stroke a few years ago and is a diabetic, mother has high blood pressure) and he said that with these low levels and the family history, I run the same risks. The only thing is that my blood pressure is good (I just checked it now 120/83) and all my blood tests look ok.

Could I have something else? I was thinking maybe thyroid but the doc said my thyroid numbers look good too. I eat right, exercise with heavy, compound lifts in the 5 rep range, take my multivitamin, never did drugs, or drank, or smoked. It's really disappointing that this happened.

Can I do something else to raise the T level or should I just get the shot?

Thanks

Your LH and FSH are normal so that indicates you have Secondary Hypogonadism. There are two things I can think of trying before going onto testosterone replacement therapy (TRT). 1) You could get an MRI scan of your pituitary to make sure you don't have a tumor. But odds are very low that you do have a tumor causing this problem. 2) You could try Dynamic Therapy which is often referred to as a Restart. You might be able to get your pituitary working again. But sadly, this often doesn't work. Sometimes your pituitary just stops working properly as you get older. But other than time and money, there is no harm in giving it a try first. Here is something you can read to learn more about hypogonadism and restarts. Go to the link and scrol down until you find the one on hypogonadism.

https://www.aace.com/publications/guidelines

You could also try getting a sleep study done. Poor sleep can make your T levels drop.

 

[CobraMustangSVT]

Thanks again Megatron.

The only thing I can think of is, back in 2000-2003, I was in the miliitary and I hurt my back. I also got prostatitis and epididimytis. I was treated for the prostatitis and epididymitis with ciprofloxacin, ibuprofin, and flomax. I still have a pain in my right testicle and after a few ultrasounds by different doctors, they said that I have a spermatocele but it shouldn't be a problem. Every doctor I've been too about the dull ache in my right testicle tell me that there's nothing wrong and that I should live with it.

About the back pain, I was given tons of medication over the 2000-2002 time period. I have a list of it here. Celebrex, ibuprofin, morphine, flexeril, naorpsyn, feldene, ultram, vicodin, valium, prednisone, robaxin, pamelor and neurontin. I spoke to a friend, who's a doctor, and he said that taking all of those medications, over that period of time, probably messed up my system and over the years, my body adjusted to the low t and that's why I don't have any symptoms but I do have low T.

I guess I have to take the plunge. It just sucks having to do this at 37. By the way, the testosterone replacement therapy (TRT) doc I'm seeing gives 400mg of test c every 2 weeks. He gives no Aromatase inhibitor (AI) or HcG. Is that a good protocol? He swears by it and says that he's been doing this for 44 years. He's pretty well known but during my research, I see that others follow a different protocol.

Thanks

 

[Megatron28]

Thanks again Megatron.

The only thing I can think of is, back in 2000-2003, I was in the miliitary and I hurt my back. I also got prostatitis and epididimytis. I was treated for the prostatitis and epididymitis with ciprofloxacin, ibuprofin, and flomax. I still have a pain in my right testicle and after a few ultrasounds by different doctors, they said that I have a spermatocele but it shouldn't be a problem. Every doctor I've been too about the dull ache in my right testicle tell me that there's nothing wrong and that I should live with it.

About the back pain, I was given tons of medication over the 2000-2002 time period. I have a list of it here. Celebrex, ibuprofin, morphine, flexeril, naorpsyn, feldene, ultram, vicodin, valium, prednisone, robaxin, pamelor and neurontin. I spoke to a friend, who's a doctor, and he said that taking all of those medications, over that period of time, probably messed up my system and over the years, my body adjusted to the low t and that's why I don't have any symptoms but I do have low T.

I guess I have to take the plunge. It just sucks having to do this at 37. By the way, the testosterone replacement therapy (TRT) doc I'm seeing gives 400mg of test c every 2 weeks. He gives no Aromatase inhibitor (AI) or HcG. Is that a good protocol? He swears by it and says that he's been doing this for 44 years. He's pretty well known but during my research, I see that others follow a different protocol.

Thanks

Given that new information I think you should try a restart first. What do you have to lose in trying to get you Natty T back? If you don't have to inject T for the rest of your life, that is preferred. BTW: it would have helped if you included that information up front. Anything else that we should know?

Now on to his protocol. Injecting T once every two weeks is a terrible idea. You will be on a huge roller coaster. And a 400mg injection is definitely going to shoot your estradiol through the roof (via aromatisation). Make sure the doc will let you self inject. Then you can split the dose into more frequent injections yourself. At a minimum inject once a week. And many guys prefer once every 5 days or once every 3.5 days. I do it every 3.5 days and I have seen it help me manage my estradiol numbers more easily. He should not care if you choose to inject more frequently. The key is he needs to allow you to self inject so you can control it -- and that is a perfectly reasonable expectation for you.

You will very likely need an Aromatase inhibitor (AI) at the dose of 200mg per week. But some guys don't need it. You may be one of the lucky ones. But have the conversation with your doc up front. Tell him you are going to check your estradiol levels periodically and you want to know how he would treat it if yours gets elevated. If you don't hear him say that he will give you an Aromatase inhibitor (AI) that is a problem.

I don't take hcg. But many guys do. There are lots of recent discussions on the testosterone replacement therapy (TRT) forum here about hcg. Go read those and decide for yourself if you think that needs to be part of you protocol.

 

[CobraMustangSVT]

Hi,
I apologize for not mentioning it. I didn't think it was relevant since it was so many years ago. Also, none of my doctors ever asked for that information so I just assumed that it wasn't relevant.

I have nolvadex, clomid and aromasin right here so I might just try my own restart. It can't hurt and I already have the stuff here.

 

[totalburnout]

Get some hCG to run for 2 weeks before you start the clomid, nolvadex and aromasin. That would be the ideal restart.

 

[CobraMustangSVT]

Get some hCG to run for 2 weeks before you start the clomid, nolvadex and aromasin. That would be the ideal restart.

Thanks. I have the HcG too. So I guess the restart protocol is clomid at 50/50/25/25 and nolva at 40/40/20/20.

I still haven't figured out the HcG and aromasin dosing yet.

 

[totalburnout]

Two week blast of hCG. People do up to 2500iu's in a shot.
Take the aromasin with the hCG. Not sure what dose as I use Arimidex, but you can research it on here. I think people are taking like 15mg.

Then cut off hCG and do the nolvadex and clomid along with your dose of aromasin for 4 weeks.