not happy w/DR's take on blood work! now what?

[gymrat2]

hi all

40yr male
5'8"
170
12-15%BF

Back history:

Year ago I went to the Dr with low libido, mood swings, abdominal fat and water retention, foggy head, just not feeling right and couldn't seem to get into the shape I was before. At this point I had been back at the gym for about 18 months after 3years off. Prior to that I had been training since I was 21 sitting at 185lbs 15-18%BF. My diet is spot on, training spot on, rest 8hr sleep a night. I knew something was up. Dr sent me to a HRT Dr and this is what the results of the first test were.

aug 20/13
total test 19 nmol/l
free test 44 pmol/l
progesterone 2.2 nmol/l
estradiol 135 pmol/l
TSH 1.81 mIU/L
FSH 4 IU/L
FREE T3 4.6 PMOL/L
DHEAS 6.0 UMOL/L
CORTISOL AM 530 NMOL/L
CORTISOL PM 300 NMOL/L
CRP 1.2 MG/L
VIT D 120 NMOL/L
IGF-1 150 UG/L

Dr said he was only concerned about E2 and to take zinc, magnesium, vit d before bed and come back in jan. So for the next 5 months I did and felt a little better but still off compared to three years prior. Saw some better results at the gym, in the mirror, on the scale and in the bedroom.

Jan 18/14 tests

Free Test 55.6 PMOL/L
progesterone 2.0 NMOL/L
Estradiol 102 PMOL/L

I was happier with these but Dr said he'd like to see Estradiol a little lower and the test a little higher and I should feel better. He prescribed me Arimidex 1mg per week split into 1/8mg eod.
So until the beginning of April I felt great, strength up, morning wood, libido so so, getting back to where I was. Then I started to drop off strength was down muscles smoothed out, no morning wood, no libido. I cut my dose to 1/8mg E3D and felt a little better but thought lets see what the tests show in a month.
Well was I in for a surprise!

May 5/14

total test 20 NMOL/L
FREE TEST 35 PMOL/L
PROGESTERONE 1.7 NMOL/L
ESTRADIOL 46 PMOL/L


To me this is nuts! Way too low across the board! What do you think?
The Dr said keep doing what I'm doing and come back in Aug.

Any and All your advice please???

 

[Megatron28]

You need to include reference ranges for each lab. Can't so much without those.

 

[gymrat2]

sorry about that.
ranges
total test 19 nmol/l 7 - 31
free test 44 pmol/l 31 - 146
progesterone 2.2 nmol/l .7 - 4.3
estradiol 135 pmol/l 0 - 157
TSH 1.81 mIU/L .35 - 5
FSH 4 IU/L 2 - 12
FREE T3 4.6 PMOL/L 2.6 - 5.7
DHEAS 6.0 UMOL/L 2.4 - 11.6
CORTISOL AM 530 NMOL/L 170 - 540
CORTISOL PM 300 NMOL/L 65 - 340
CRP 1.2 MG/L 0 - 8
VIT D 120 NMOL/L 76 - 250
IGF-1 150 UG/L 112 - 296


Free Test 55.6 PMOL/L 31 - 146
progesterone 2.0 NMOL/L .7 - 4.3
Estradiol 102 PMOL/L 0 - 157


total test 20 NMOL/L 7 - 31
FREE TEST 35 PMOL/L 31 - 146
PROGESTERONE 1.7 NMOL/L .7 - 4.3
ESTRADIOL 46 PMOL/L 0 - 157

 

[Alpin]

Whats going on here?
Why is this doc not testing LH?

 

[Alpin]

Estradiol is too low....

 

[gymrat2]

I have no idea. what should I be requesting and should I go back sooner than later?

 

[Alpin]

Request:
-SHBG
-Prolactin
-Bio Avail. Testosterone (done at 8 AM)
-Sleep Study
-Vit. B 12 (Doesnt hurt supplementing with Methylcobalamin)
-I would raise those Vit D levels a bit more. Close to 200 mmol is good then back off the supplements you could let it fall to 170 nmol a bit then back on vit d.
Your Test is not low....
But you would greatly benefit in getting a few baselines for Bio Avail Testosterone done....
Get them done with a good night's sleep and no later than 8:30 am.

 

[Alpin]

LH as well.

 

[Megatron28]

I agree with Apollon. Estradiol of 46pmol (or 13pg/ml) is too low. It used to be higher and at a good level. You should not be taking Arimidex. Although I have to admit I am surprised it did not increase your testosterone more.

Total Testosterone and everything else looks fine too. TT is at (576ng/dl) for all the Americans reading this.

Have you had a sleep study done? sleep apnea could be causing all your symptoms.

 

[Alpin]

I dont know why he would touch your Estradiol.
Where the hell did he want it to be?
It was 135 pmol/l on one lab and 102 pmol/l on the other.
Since you say u took 1/8th dose of Adex that would be 0.125 mg.
I have heard of worse cases where docs prescribed the stuff at 1 mg/day. Do not ever dose Adex like that. You will feel horrible.

 

[gymrat2]

Ok so I'll stop the adex. No sleep ap. And request my next tests have what you guys have suggested. Even though you say my test in normal, I feel its not optimal for me. I just don't feel right , like I did a few years ago. Always lean, strong and horny all the time.
I'll start b12....what dose? 1200mcg
Vit d..........what dose? 5000ui

 

[Alpin]

I like the shots for B12(Methylcobalamin) from a compound pharmacy. U can use sublinguals too at 5000 mcg a dose. I like 10 000 I.u. vit d3 gel caps personally.
Who knows man.....
Its very common and normal for your body to start slowing down as you get older....
Get Bio Avail T done and see.
Make sure you get enough animal fats and zinc in your diet. Take a good quality complete vit. E.

 

[Alpin]

Any steroid cycles in the past?

 

[gymrat2]

I take zinc, magnesium, fish oils, 1000iu vit D. I'll up the dose and pick up b12 sub tonight.
Haven't done a cycle but did do a cycle of prohormones in the mid 90's I would have been around 24/25. I'd like to plan a cycle to start in Oct if I can get my bloods in range first.

 

[Alpin]

So are you here to get help in restoring your natty T or is doing a cycle your end goal ?

 

[gymrat2]

I have a cycle planed for oct. For now restoring my natty test is more important. Do you agree?

 

[Megatron28]

I have a cycle planed for oct. For now restoring my natty test is more important. Do you agree?

Restoring your Natty T to what? What did it used to be at before? Because 576ng/dl is right about where you are supposed to be for you age.

 

[gymrat2]

My free test is almost half of what it was. So you think I gtg for a cycle?

 

[Megatron28]

My free test is almost half of what it was. So you think I gtg for a cycle?

You should probably be looking at bioavailable T instead.

And you do realize this is the TRT forum, right?

 

[Alpin]

My free test is almost half of what it was. So you think I gtg for a cycle?

Its probably going to get a lot worse and most likely never recover. Keep up the good work. Have fun after your "cycle" recovering. I'm guessing we will see you in here after the new year telling us about your TRT protocol.