Lab Results 249; what to do?

[dallasite]

I've come prepared...

E2: 24 pg/ml [range <=63]
FSH: 2.6 miu/ml [range 1.3 - 11.4]
TT: 249 ng/dl [range 292-1052]
SHBG: 52 nmol/l [range 16-94]
FT: 3.6 ng/dl [range 4.8 - 25]

- 29 years old
- 6"2 height
- 36" waist
- 195 lbs
- decent body hair, never had baldness issues
- carry fat: like a bitch, love handles and hips like no tomorrow, almost impossible to get rid of
- conditions: ulcerative colitis, drug-free for almost three years now mostly managing by clean diet
- diet is on and off low-carb, last year experimented with 4000 kcals/day, this year been between 2000-3000 consistently trying to lean out
- no testes ache, I do suspect they have shrunk on a prior test cycle (dumb, young and willing)
- poor sex drive, very lethargic, easily depressed/demotivated

When I was 23-24 I had a first bout with test, thought it was cool etc did research and did a cycle of Test E for six weeks with Clomid/HCG post. Like I said in the summary I feel like my testes shrunk during that cycle and I suspect I might have fucked up the post-cycle on that one.

All in all I'm somewhat educated on the subject, but haven't brushed up on any knowledge ever since my UC diagnosis because I didn't want to introduce anymore variables. Now that I'm confident I have that under control I want to get back to being the best I am again, clearly that is going to need some work!

GP, as usual, prescribed some topical creams. Not holding my breath on that one.

I'm located in Dallas and have been trying to find a competent testosterone replacement therapy (TRT) doc. Been going through the Increase My T, Low T type of sites that do phone consultations but not sure if they are worth their salt or just incredibly overpriced.

 

[Megatron28]

I've come prepared...

E2: 24 pg/ml [range <=63]
FSH: 2.6 miu/ml [range 1.3 - 11.4]
TT: 249 ng/dl [range 292-1052]
SHBG: 52 nmol/l [range 16-94]
FT: 3.6 ng/dl [range 4.8 - 25]

- 29 years old
- 6"2 height
- 36" waist
- 195 lbs
- decent body hair, never had baldness issues
- carry fat: like a bitch, love handles and hips like no tomorrow, almost impossible to get rid of
- conditions: ulcerative colitis, drug-free for almost three years now mostly managing by clean diet
- diet is on and off low-carb, last year experimented with 4000 kcals/day, this year been between 2000-3000 consistently trying to lean out
- no testes ache, I do suspect they have shrunk on a prior test cycle (dumb, young and willing)
- poor sex drive, very lethargic, easily depressed/demotivated

When I was 23-24 I had a first bout with test, thought it was cool etc did research and did a cycle of Test E for six weeks with Clomid/HCG post. Like I said in the summary I feel like my testes shrunk during that cycle and I suspect I might have fucked up the post-cycle on that one.

All in all I'm somewhat educated on the subject, but haven't brushed up on any knowledge ever since my UC diagnosis because I didn't want to introduce anymore variables. Now that I'm confident I have that under control I want to get back to being the best I am again, clearly that is going to need some work!

GP, as usual, prescribed some topical creams. Not holding my breath on that one.

I'm located in Dallas and have been trying to find a competent testosterone replacement therapy (TRT) doc. Been going through the Increase My T, Low T type of sites that do phone consultations but not sure if they are worth their salt or just incredibly overpriced.

Did you get an LH number?

Given your age and medical history I think you may want to try and do a restart. See if you can get things fired back up. If that doesn't work then you could go on testosterone replacement therapy (TRT). Get off the gels. They cost too much, don't work well for most guys and there is risk of transfer to kids/women. Ask for injections. Demand them.

IMT has great reviews from a LOT of guys on this site. They really seem to know their testosterone replacement therapy (TRT) protocols. If you are having trouble finding someone to treat you, give them a call.

 

[dallasite]

I've asked for LH but I cannot discover it on my labs, doc wasn't very knowledgable so I think he did not order it correctly, is that a very important number in this context?

I'll do a search on here for "restart", I'm not sure what it exactly entails.

I did a consult with IMT yesterday and signed up for their starter package, I will continue to try and find a testosterone replacement therapy (TRT) doc locally because I'd be comfortable with someone I can visit regularly.

 

[Megatron28]

I've asked for LH but I cannot discover it on my labs, doc wasn't very knowledgable so I think he did not order it correctly, is that a very important number in this context?

I'll do a search on here for "restart", I'm not sure what it exactly entails.

I did a consult with IMT yesterday and signed up for their starter package, I will continue to try and find a testosterone replacement therapy (TRT) doc locally because I'd be comfortable with someone I can visit regularly.

Yes. LH is important because it helps determine if you have primary or secondary hypogonadism. Which in turn helps determine whether or not a restart might work.

A restart is basically running a PCT(post-cycle therapy). Maybe the one you tried after your cycle didn't take hold.

 

[dallasite]

Been on testosterone replacement therapy (TRT) for a moth now through IMT

Every 3.5 days
50mg Test Cyp
0.5mg anastrozole
500iu hCG

To be honest they prescribed me 200mg every week, but I wanted to start at the low end and work my way up if necessary.
So far results are mixed. Erections are off the charts, libido is up a little bit but still not spectacular. Energy and motivation hasn't changed and is at an all-time low.

I feel like my testes shrunk, this is also one of my biggest fears. Not sure what I can do since I think I'm already at the upper end of hCG dosage.
Some spots on my back, nothing to worry about (I'm used to the backne from my teen years, so I'm not easily worried).

Time for blood work this week (at least that's what I decided) to see where my levels are at and go from there.

 

[Megatron28]

Been on testosterone replacement therapy (TRT) for a moth now through IMT

Every 3.5 days
50mg Test Cyp
0.5mg anastrozole
500iu hCG

To be honest they prescribed me 200mg every week, but I wanted to start at the low end and work my way up if necessary.
So far results are mixed. Erections are off the charts, libido is up a little bit but still not spectacular. Energy and motivation hasn't changed and is at an all-time low.

I feel like my testes shrunk, this is also one of my biggest fears. Not sure what I can do since I think I'm already at the upper end of hCG dosage.
Some spots on my back, nothing to worry about (I'm used to the backne from my teen years, so I'm not easily worried).

Time for blood work this week (at least that's what I decided) to see where my levels are at and go from there.

Good luck! Let us know what your slabs look like.

 

[dallasite]

Three weeks ago I bumped my T to 100mg every 3.5 days since that was the original prescription and I wasn't too happy with results so far. 500 iu hCG every 3.5 days too.

Did a very elaborate test, haven't done a full checkup in a while so thought it'd be worth it and well... I can, so why not?

CBC and CMP I don't know how to read really, hoping there are people with more experience here. Other than that T and IGF-1 look great, E2 is low which I suspected since my elbows hurt like a mf for weeks now. I have been doing 0.5mg anastrozole every 3.5 days but I think it's safe to cut that in half, no?

View attachment 553157View attachment 553158View attachment 553159

Mucho gracias for any insights!

 

[IMT staff]

It looks like you need to drop anastrozole, and sub with Methylcobalamin, this will help ferritin. Also you have to do something to get your a1c down, it could be up cause of your E2 level though.

GH optimization is a great way to decrease inflammation in the body as well. I wouldn't give up yet, sometimes it is hard to tweak and get someone dialed in.

 

[Megatron28]

Three weeks ago I bumped my T to 100mg every 3.5 days since that was the original prescription and I wasn't too happy with results so far. 500 iu hCG every 3.5 days too.

Did a very elaborate test, haven't done a full checkup in a while so thought it'd be worth it and well... I can, so why not?

CBC and CMP I don't know how to read really, hoping there are people with more experience here. Other than that T and IGF-1 look great, E2 is low which I suspected since my elbows hurt like a mf for weeks now. I have been doing 0.5mg anastrozole every 3.5 days but I think it's safe to cut that in half, no?

View attachment 553157View attachment 553158View attachment 553159

Mucho gracias for any insights!

I would cut your Aromatase inhibitor (AI) dose in half like you said. But 3 weeks is not enough time for your higher T dose to fully kick in. So keep an eye one your E2. Maybe run a cheaper Female Hormone Panel in another 4 weeks to see how your TT and E2 are doing. Your hematocrit is likely yo start increasing too, but you have long way to go before it becomes a problem.

 

[dallasite]

Thanks for the feedback Mega, btw the blood was drawn 24 hrs before my next injection.

I do Sunday night and Thursday mornings and the sample was Wednesday morning. So the T is definitely in a good range (maybe even high?).

I'm having a dr. friend look at the CBC and CMP markers since I have no idea what those flags are all about.

edit:

Thanks to IMT of course too but they already knew since I'm a client

 

[willnorthwest]

dallasite....your Ferritin and Iron serum levels are dangerously low in my opinion. Have you been donating alot of blood lately? Alot of men on testosterone replacement therapy (TRT) donate blood to keep their Hematocrit down, however, if you donate too much or too often, you risk depleting your Iron levels. Ferritin is the best gauge of overall Iron health, as it measures the amount of Iron stores in your body. Depleting your body of Ferritin can and probalby will, result in Anemia. I would talk to your doctor about your Iron Serum levels and Ferritin levels. Each time you donate a pint of blood, your Ferritin can be reduced by 30-50 points. Dr. Mariano, a very respected authority on all things testosterone replacement therapy (TRT) related, recommends that Ferritin levels should be around 150.

I am personally suffering from low Ferritin levels, due to blood donation. My doctor has me on 65mg of Ferrous Sulfate a day, taken in conjunction with 500mg Vitamin C.

 

[dallasite]

dallasite....your Ferritin and Iron serum levels are dangerously low in my opinion. Have you been donating alot of blood lately? Alot of men on testosterone replacement therapy (TRT) donate blood to keep their Hematocrit down, however, if you donate too much or too often, you risk depleting your Iron levels. Ferritin is the best gauge of overall Iron health, as it measures the amount of Iron stores in your body. Depleting your body of Ferritin can and probalby will, result in Anemia. I would talk to your doctor about your Iron Serum levels and Ferritin levels. Each time you donate a pint of blood, your Ferritin can be reduced by 30-50 points. Dr. Mariano, a very respected authority on all things testosterone replacement therapy (TRT) related, recommends that Ferritin levels should be around 150.

I am personally suffering from low Ferritin levels, due to blood donation. My doctor has me on 65mg of Ferrous Sulfate a day, taken in conjunction with 500mg Vitamin C.

I have never donated blood before, I do have chronic inflammation in my bowel (ulcerative colitis) but I haven't lost blood through my stool in ages. A common thing with chronic inflammation in your colon is that there is a poor rate of absorption of nutrients though.

I'm definitely looking into iron supplementation to get this level way up. It does explain why I'm so tired an lethargic lately though lol.

 

[willnorthwest]

I have never donated blood before, I do have chronic inflammation in my bowel (ulcerative colitis) but I haven't lost blood through my stool in ages. A common thing with chronic inflammation in your colon is that there is a poor rate of absorption of nutrients though.

I'm definitely looking into iron supplementation to get this level way up. It does explain why I'm so tired an lethargic lately though lol.

If I was in your situation, I would start supplementing with Iron right away. Raising your Serum Ferritin is not easy, and it will take some time. The key is to not go overboard with your Iron supplementation, as Iron taken in excess can cause bad constipation. Ferrous Gluconate or Ferrous Fumarate are generally the easiest on the stomach. Ferrous Sulfate, which is what I take, can be notorious for causing constipation. Look into Floradix or Slow Fe.

And start cooking in a cast iron skillet....great for absorption!

 

[dallasite]

If I was in your situation, I would start supplementing with Iron right away. Raising your Serum Ferritin is not easy, and it will take some time. The key is to not go overboard with your Iron supplementation, as Iron taken in excess can cause bad constipation. Ferrous Gluconate or Ferrous Fumarate are generally the easiest on the stomach. Ferrous Sulfate, which is what I take, can be notorious for causing constipation. Look into Floradix or Slow Fe.

And start cooking in a cast iron skillet....great for absorption!

That's funny, I've been using a cast-iron skillet forever (Lodge) since I'm a huge health nut so was looking for the healthiest way to cook. Obviously didn't do much for me lol.

I just grabbed some iron tablets from Whole Foods, I took a brand with heme iron since I read a bit about superior absorption and less digestive issues (don't need that with my chronic inflammation). Will spend some time to research my best options online.

Are all those supps freely available or is the truly good stuff by script only?

 

[willnorthwest]

Most people just supplement with Iron pills to get their levels up. There is such a thing as an Iron Transfusion, however it has to be administered by a doctor. Iron transfusions will elevate your iron stores much faster than through pill supplementation alone. If you haven't already, I would definitely bring your most recent labwork to a physician and ask him about iron transfusions. They are usually only given when Ferritin and Iron Serum levels are critically low. In your case though, from what I see, you would probably qualify for it. Were these labs ordered by your general practitioner, or did you just order them yourself through privatemdlabs or a similar outfit? I dont see how a gp could overlook this.

Also, the iron I take is Nature Made Iron, its not prescription

 

[dallasite]

This was through privatemdlabs, I don't have a GP here yet but I have sent the results to some doctor friends to go over to get expert advice and if necessary I will take this to a GP.

 

[Hoodlum]

Erections are off the charts

There's a chart? Where is it - I want to see if mine are off it too

 

[dallasite]

There's a chart? Where is it - I want to see if mine are off it too

you'll know it when you get random erections at the possibly worst moments, don't think I have experienced that in a while!

 

[Hoodlum]

you'll know it when you get random erections at the possibly worst moments, don't think I have experienced that in a while!

Haha, I know what you mean - I've been the same since I started on testosterone replacement therapy (TRT) a few months ago. Stood up on the tube on the way into work in the morning is one of the more awkward situations - I have to kind of shuffle off sideways when I exit...

 

[dallasite]

Funnily enough now that we're talking about it. The last week or so has been very absent of erections, at all. I haven't changed a thing except for dropping the anastrozole.