Labs - would like opinions

[TrekB]

52 yr old 200 lb 5'10"
Started test cyp late march after first lab

First lab 3/22
Total test 293 (348-1197 ng/dL)
E2 not measured

4/24 different lab from first test
Total test 535 (241-827 ng/dL)
E2 33 ( < or = 39 pg/ml)

5/2 same lab as 3/22
Total test 1037 (348-1197)
E2 44.2 (7.6-42.6 pg/ml)
Was put on .05 arimdex once a week, one day after injection

Test cyp injections in order 220, 210, 200, 180, 180, 170 approx 8 days apart

Blood draw for lab work was done on the day before or right before my next injection.

Questions / feedback:
1037 total seems high and in relation to E2. Had libido issue before last injection and was put on Aromatase inhibitor (AI). Do others think the same?

FSH not measured - concerned on this. Comments?

.05 dosage of Aromatase inhibitor (AI) seems high compared to what I have seen in threads. Comments?

Can't lose weight even though dieting ( had worked in the past). Is this a symptom of high E2?

Why are the labs so different in their ranges of "norm" the 2nd lab was done by my PCP. Who yelled at me for being on testosterone replacement therapy (TRT) with a Men's health practice.

Thanks.

 

[halfwit]

Your total test is not high, it's actually at a respectable level in my opinion. I do think you may be sensitive to estradiol, which at 44.2pg/mL could cause some issues with bloat/libido. I do agree that .5mg of adex can be high, but that depends on the frequency. If he has you at once a week, that's actually about average. I would suggest splitting your testosterone dose into two injects per week as this will help with keeping those spikes down which can also lead to elevated estradiol levels.

Don't take your PCP's scolding to heart. I understand that vitality clinics have a bad rap, but if he was on top of things, you wouldn't have had to go there in the first place! In fact, I've found most PCP's don't have a clue when it comes to male hormone management - so it is definitely in your best interest in reading up on this stuff as much as you can to further educate yourself. You may find yourself in a situation where you are shopping for a new doctor if he continues to fail in seeing eye to eye with you.

FSH is most important when it comes to spermatogenesis, so if you're done with kids - I wouldn't worry too much about it. Note: FSH/LH will drop next to nothing while on exogenous testosterone as your body knows it no longer needs to make these hormones. With regards to E2 causing a difficulty in losing weight, that's more likely both a diet issue as well as one of the issues with low testosterone messing with your metabolism. Time will fix the issue with your metabolism as long as you keep your testosterone levels nice and healthy.

Lab ranges are unfortunately proprietary in how they are calculated and from what I understand are actually based on data from their sample of previous patient data as well as popular INSURANCE (gag!) information. I know that many are denied testosterone replacement therapy (TRT) if they fall in a "grey area" as insurance won't cover the office visits, and our dear beloved doctors of course must get paid for their efforts.

 

[TrekB]

Thanks for the input. I asked about splitting the test cyp to 2x per week and was told that was not an option. They do the injections with no option ( using them) to self- inject.

 

[halfwit]

Thanks for the input. I asked about splitting the test cyp to 2x per week and was told that was not an option. They do the injections with no option ( using them) to self- inject.

If they won't let you take control over your protocol, it's time to move on to a new doc. They do not have a legal right to prevent you from being able to inject yourself, and just the fact they're so unwilling to listen to you screams red flag to me. I have a feeling you're dealing with another glorified diabetes doctor that wants the extra business from messing with testosterone replacement therapy (TRT) and shouldn't be.

 

[TrekB]

The place I go specializes in testosterone replacement therapy (TRT) and is a vitality clinic. My guess is that they want the $$$ from doing the injects. Given the potential down sides if the testosterone replacement therapy (TRT) is not administered properly, I opted for clinic. However, given what I'm reading on this forum, I'm now re-thinking that.

 

[willnorthwest]

The place I go specializes in testosterone replacement therapy (TRT) and is a vitality clinic. My guess is that they want the $$$ from doing the injects. Given the potential down sides if the testosterone replacement therapy (TRT) is not administered properly, I opted for clinic. However, given what I'm reading on this forum, I'm now re-thinking that.

Maybe try and give IMT a call. I was using a general practitioner until i realized that he didnt have the first clue about testosterone replacement. The folks down at IMT (Increase My T) are all very knowledgeable about t-replacement and they will work WITH you to help get you dialed in correctly. Also, unlike GP's or even some other testosterone replacement therapy (TRT) clinics, you will get a personal advisor that you can call anytime you want to discusss your testosterone replacement therapy (TRT) related issues. My advisor's name is Eric, and I can "call him anytime, day or night".