My Recent Bloodwork-Opinions, Advice please

[KCinToronto]

I thought I'd start a new thread to post my bloodwork. As posted in earlier threads I have finally found a doctor in my area that will diagnose low T and prescribe TRT. Although I am skeptical of his treatment thus far, I am going to continue to go to him to try to get him to prescribe what may actually work.

Presently he has me on Testosterone Compound Cream for about 6 weeks. 150mg/ml and first 4 weeks was 30 mg/Day and last 2 weeks has been 60mg/day. I have found there to be no change except a slight strength increase in the gym, and some mid section bloating I am not happy with. (Also that numb hand feeling when waking up)

I'm hoping that some of the members on this Forum can take a look and see if they believe:
1: I should definitely be on TRT.
2: Any information of anyone close to my numbers of what treatment protocol is helping them.

Here is my bloodwork written out. I apologize in advance as the units of measure are what we use in Canada.

Vitamin B12: 746 pmol/L - Sufficiency: > 220 pmol/L
Ferritin: 112 ug/L - 80 - 300 Normal Iron Stores
TSH: 4.02 mIU/L - 0.35 - 5.00 mIU/L
FREE T3: 5.7 pmol/L - 2.6 - 5.7 pmol/L
LH: 7 IU/L - 2 - 9 IU/L
Cortisol AM : 496 nmol/L - 170 - 540 nmol/L
Cortisol PM: 238 nmol/L - 65 - 340 nmol/L
DHEAS: 5.4 uoml/L - 1.2 - 8.98 umol/L
FSH: 3 IU/L - 2 - 12 IU/L
Sex Hormone Binding Glob: 27 nmol/L- 19 - 76 nmol/L
Total Testosterone: 11.8 nmol/L - 7.6 - 31.4 nmol/L
Prolactin: 15 ug/L - < 18 ug/L
Estradiol: 84 pmol/L - < 157 pmol/L
FREE Testosterone: 20.9 pmol/L - 25.0 - 80.0 pmol/L
25 Hydroxy Vitamin D: 77 nmol/L - Sufficiency: 76 - 250 nmol/L
Dihydrotestosterone: 1533 pmol/L - 860 - 3406 pmol/L

Cholesterol: 4.89 nmol/L - Desired < 5.2 nmol/L
Triglycerides: .67 nmol/L - Desired < 1.70 nmol/L
HDL Cholesterol: 1.08 nmol/L - >= 1.00 nmol/L
LDL Cholesterol: 3.5 nmol/L - >= 1.00 nmol/L

Hemoglobin: 149 g/L - 135 - 170 g/L
Hematrocrit: 0.44 l/l - 0.38 - .49 l/l
RBC: 4.97 x 10E12/L - 4.20 - 5.70 x 10E12/L
RBC Indices: MCV: 89 fl - 80 - 97 fl
RBC Indices: MCH: 30 pg - 27 - 32 pg
RBC Indices: MCHC: 339 g/L - 320 - 360 g/L
RDW: 14.4 - 11.5 - 15.5
WBC: 6.1 x 10E9/L - 4 - 11 x 10E9/L
Platelets: 335 10E9/L - 145 - 400 x 10E9/L
MPV: 7.9 fl - 7.4 - 11.3 fl

Differential WBC
Neutrophils: 2.38 x10E9/L - 1.80 - 7.00 x 10E9/L
Lymphocytes: 2.75 x10E9/L - 1.00 - 3.02 x 10E9/L
Monocytes: .55 x10E9/L - 0.00 - .080 x 10E9/L
Eosinophils: .37 x10E9/L - 0.00 - 0.40 x 10E9/L
Basophils: .06 x10E9/L - 0.00 - 0.20 x 10E9/L

Thanks to anyone that can take the time to review this.

I really appreciate it.


KC

 

[methos0123]

I converted your testosterone to 340 ng/dl. That is low.

If you want to convert the other significant ones, I'll be happy to give my opinion.

 

[Megatron28]

You need to include reference ranges with your results. Every lab is different.

 

[bonexyster]

Glad you finally found a cool dr.

 

[jozifp103]

i honestly don't even know why creams are used at all. I swear i've never heard anything positive after six months of use. It always seems like it just stops working after a while. my levels were close to yours...346 and i'm starting 200mg/wk injections next week with 1000iu hcg/wk and adex.

 

[KCinToronto]

I converted your testosterone to 340 ng/dl. That is low.

If you want to convert the other significant ones, I'll be happy to give my opinion.

Thanks Methos. What ones are "significant"? I thought they all were since I was advised here and other TRT sites that I needed a lot more than Total Test, Free Test and Estodial. I'll try to find conversions but what ones do you think are specifically needing?

KC

 

[KCinToronto]

You need to include reference ranges with your results. Every lab is different.

Any reason you would need reference ranges for all the above? I will edit my post, but isn't it either low or not low? For instance, wouldn't Free Testosterone at 20.9 pmol/L be low regardless of what lab is used? I understand that labs have different ranges, but I don't think they change with regards to the person. I'm not sure you'll know what I mean.

Oh and in my case, the lab reference range for Free Testosterone is 25.0 - 80.0 pmol/L. So I know I have a problem here.

The only other thing not in reference range was HDL Cholesterol.

Let me know if you need me to write in all those references for your opinion. I don't mind, just need to find the time.

For some reason I was not able to figure out how to post pdf copies of the bloodwork.


KC

 

[Megatron28]

You don't have to convert them. Just include the normal ranges that came along with your lab results.

Not all of us have the normal ranges memorized. And yours are in different units than used in the US to boot.

Every lab does have different reference ranges though as it is adjusted to their equipment. It isn't by person -- it is by lab. I don't happen to know your lab's reference ranges.

 

[KCinToronto]

You don't have to convert them. Just include the normal ranges that came along with your lab results.

Not all of us have the normal ranges memorized. And yours are in different units than used in the US to boot.

Every lab does have different reference ranges though as it is adjusted to their equipment. It isn't by person -- it is by lab. I don't happen to know your lab's reference ranges.

Sorry about that, it hit me last night it was due to the unit of measure. I added the references above.

Any insight would be appreciated.

Looks to me like it is only FREE Testosterone that is out of range. Free T3 is borderline.

Thanks again,


KC

 

[Megatron28]

The first thing that jumps out is your TSH. While labs say the range goes up to 5, most endocrinologists actually put it at 3. You are in hypothyroid territory. And note that hypothyroidism can lower total testosterone. You should be talking to you doc about your thyroid first of all.

TT of 340ng/dl is low as said previously. lt doesn't look like you are actually doing TRT. Your testosterone cream is not working. I say this because your LH and FSH are not shut down -- far from it. If you were taking exogenous test they would both be effectively 0.

You need to supplement Vitamin D. 10,000iu/day.

 

[KCinToronto]

The first thing that jumps out is your TSH. While labs say the range goes up to 5, most endocrinologists actually put it at 3. You are in hypothyroid territory. And note that hypothyroidism can lower total testosterone. You should be talking to you doc about your thyroid first of all.

TT of 340ng/dl is low as said previously. lt doesn't look like you are actually doing TRT. Your testosterone cream is not working. I say this because your LH and FSH are not shut down -- far from it. If you were taking exogenous test they would both be effectively 0.

You need to supplement Vitamin D. 10,000iu/day.

Thanks Megatron, I'll ask him to look at that. Upon a quick look, it seems that TSH High and FREE T3 low would indicate hypothyroid. My Free T3 is on the cusp of high, so I'm not sure what that means. I read that aspirin can affect TSH. I tend to do the stack a bit too often, (ECA) almost daily. Can Ephedrine have a bad affect on TSH? (I did fast for 12 hours for the bloodwork)

As far as not being on TRT yet, I wasn't on it for that blood work. It was sort of my baseline. As much as I could convince him to do. That was done March 12 and I started my TRT the next day. I have new blood work to do in a few weeks. March 30th her bumped up my dosage to 60mg/day of 150mg/ml cream. Told me to do blood work 5 weeks from then.

He recommended vitamin D supplements now too. I should have been aware as winter in Toronto has been brutal. I also started tanning again, so that should help.

Now isn't Free Testosterone as important or more important than Total testosterone? This guy seems to focus on Free Testosterone more than anything.

Thanks again,


KC

 

[methos0123]

I concur with Megatron.

 

[Megatron28]

I don't know if that stuff affects your thyroid or not. Why don't you stop and see.

I would have tried to address your thyroid issues before hopping on TRT. That might have fixed your low T problem. Given the LH on the high end of the normal range, did you consult with an urologist to make sure your testicles are working OK?

You should also ask for an MRI of your pituitary and hypothalamus.

You need to look at TT and Free T. Both are important. Your TT was borderline hypogonadal. Couple that with your Low Free T though and that puts you in the hypogonadal diagnosis.

 

[methos0123]

I was close to your numbers, and my protocol is 56mg twice a week. I don't take an AI or HCG. This keeps me between 800-1100 or so. E2, and HCT is in range.

Thought I would throw that out there because you asked in your original post.

 

[KCinToronto]

i honestly don't even know why creams are used at all. I swear i've never heard anything positive after six months of use. It always seems like it just stops working after a while. my levels were close to yours...346 and i'm starting 200mg/wk injections next week with 1000iu hcg/wk and adex.

Took me awhile to get back on here. When you say you are starting that protocol. Were you prescribed that protocol or are you self medicating so to speak?

KC

 

[Alpin]

You are using the cream and have numbers like that on your labs?
Damn LH of 7 IU/L and low T...
Doesnt look like your balls or the cream are in good shape

 

[Alpin]

I don't know if that stuff affects your thyroid or not. Why don't you stop and see.

I would have tried to address your thyroid issues before hopping on TRT. That might have fixed your low T problem. Given the LH on the high end of the normal range, did you consult with an urologist to make sure your testicles are working OK?

You should also ask for an MRI of your pituitary and hypothalamus.

You need to look at TT and Free T. Both are important. Your TT was borderline hypogonadal. Couple that with your Low Free T though and that puts you in the hypogonadal diagnosis.

His low T could be caused by his years of cycling with exogenous "substances"

 

[KCinToronto]

You are using the cream and have numbers like that on your labs?
Damn LH of 7 IU/L and low T...
Doesnt look like your balls or the cream are in good shape

I have to be careful not to get too far off track here.

The above tests were done before I started anything for TRT. I had not started the creams. So it is somewhat of a true baseline.

This is all very confusing. Are all of the labs "Reference Ranges" simply wrong? And if they are all wrong, where are the "real" right ones? I understand that every country, Doctor, lab may have different approaches, but getting one of my Docs to look at something that, to them, is not showing a problem, will be difficult if not impossible.

LH of 7 seems well within the range of 2 - 9 IU/L (Yes on the high side)
FSH of 3 is certainly within the range of 2 - 12 IU/L (Yes on the low side)
So from my understanding, these two tests are to determine if my testicles are functioning properly. Considering I have such low T, they probably aren't, but do these numbers really indicate that?

Now as far as thyroid, TSH is definitely in the high range, I've read that TSH High and FREE T3 low would indicate hypothyroid. BUT my Free T3 is on the cusp of high, so I'm not sure what that means.

I'll definitely spend more time researching, and have an appointment with my GP who I am hoping can oversee all of these so called "specialists". And I'll ask to get the MRI as well.

Here's hoping I can figure this all out some day. LOL. Truth is, I feel really good, except for low libido and slightly lethargix. But at 51 years old, weight training 4 times a week with cardio, and playing somewhat competitive hockey twice a week, maybe I should be lethargic. LOL

Thanks Apollon.

 

[KCinToronto]

His low T could be caused by his years of cycling with exogenous "substances"

Also keep in mind "years" of cycling is a somewhat misleading concept. My first cycle ever was at 48. I've only done 3 cycles in my life that involved injectables. All were done with full PCT and the longest one (16 weeks) included HCG throughout.

Could 3 cycles in my last 3 years have had such a hard effect on my bloodwork? Testicles, Thyroid. I have no idea, but I would have thought it was not likely.

Oh, I did do a short bridge of SARMS in between (Ostarine & S4). And tried IFG1-LR3 (which seemed to do very little for me) I did like the SARMS though.

So I imagine all in all my body has been through a bit for 3 years. LOL

Thanks again Apollon. I just wanted to clarify, but as I wrote it, realized it could be a lot.


KC

 

[Megatron28]

Even one cycle is enough to mess up your HPTA. That is always a risk anytime your use AAS.