A Few Lab Concerns (Cholesterol, ALT, MCH)

Pharma TRT
1

Getting labs done via Labcorp to get on Accutane. Here are my results:

Test | Current Result and Flag | Previous Result and Date | Units | Reference Interval
MCH |25.7 Low | 25.4 03/04/2023 | pg | 26.6-33.0
MCHC 30.7 Low | 31.4 03/04/2023 | g/dL | 31.5-35.7
RDW | 18.3 High | 17.9 03/04/2023 | % | 11.6-15.4

Cholesterol, Total | 150 | 138 03/04/2023 | mg/dL | 100-199
Triglycerides | 121 | 160 03/04/2023 | mg/dL | 0-149
HDL Cholesterol | 29 Low | 26 03/04/2023 | mg/dL | >39
VLDL Cholesterol Cal | 22 | 28 03/04/2023 | mg/dL | 5-40
LDL Chol Calc (NIH) | 99 | 84 03/04/2023 | mg/dL | 0-99

ALT (SGPT) | 47 High | 24 03/04/2023 | IU/L | 0-44

I’m currently on 175mg / wk., working out 5x a week. These were fasted labs. The new labs (leftmost results) were after a month of Accutane at 40mg / day.

I assume that most of the “concerning” results are owed to either exogenous testosterone and/or strenuous workouts.

What are your thoughts? Is anything really alarming if I’m feeling pretty good?

Any way I can work on that HDL cholesterol?

2

Your iron deficient, which can cause liver disorders. I expect ferritin and iron saturation to be suppressed. There’s actually a link between low-T and higher end ferritin and high testosterone and lower end ferritin.

That’s because, more testosterone, triggers the creation of hemoglobin, which uses up more iron.

TRT made me iron deficient, indicated by my labs showing low MCH, MCHC and high RDW, therefore I have to supplement 160 mg iron daily.

Accutane can cause liver abnormalities in 15% of people.

A reduction in DHT is linked to cognitive decline, dementia and Alzheimer’s disease. Robbing Peter to pay Paul doesn’t get you off the hook, you’ll pay for it later. Get off that shit!

Not for long.

3

I hear you, SL, but my acne is beyond terrible. My back was a minefield. It’s cystic and hormonal. Nothing else has helped. Diet, PanOyxl, Salycilic Acid, sun exposure, etc.

Doc even tried putting on me on dutasteride, and it didn’t affect it much.

Desperate times call for desperate measures. My back and shoulders have enough scarring. I’m done with that.

I started an iron supplement, but will bump it to 160.

From what I understand, working out hard causes iron deficiency / drops.

“Exercise, particularly high intensity and endurance types, increases iron losses by as much as 70% when compared to sedentary populations. Athletes lose more iron due to heavy sweating as well as increased blood loss in the urine and GI tract.”

4

That’s a maintenance dosage, I had to take 200-250 mg iron chelated to get my ferritin 100>.

I would take 50-75 mg three times a day until ferritin is 100>. Then you’ll have to figure out your maintenance dosage.

1 Like
5

That’s helpful, thank you.

Thoughts on this one?

NaturesPlus Hema-Plex Iron - 60 Fast-Acting Softgels, Pack of 3-85 mg Elemental Iron + Vitamin C & Bioflavonoids for Healthy Red Blood Cells - Vegan, Gluten Free - 60 Total Servings https://a.co/d/5SY6SPe

Edit: Nvm. That is 3 softgels for 85mg. Seems underdosed.

Let’s try this one?

Nutricost Chelated Iron, As Ferrochel, 36mg, 240 Capsules https://a.co/d/f2w7yZA

6

Drink orange juice with your iron supplements. I use the Vitamin Shoppe brand iron, 28 mg capsules. They even have the comfort iron for sensitive GI’s.

1 Like
7

@TestQuest22
Not a med pro but I have used accutane a couple of times as my skin gets very bad. First time (about 30 years ago as part of trial group) I was blood tested regularly and nothing showed, this time (started 3 weeks ago) no mention of possible liver issues other than what comes with the leaflet inside.

I had a quick look online at this now and from the fist result which mentions those numbers it says;

Isotretinoin may lead to higher levels on liver function tests.
Liver abnormalities on a liver test can occur in up to 15% Trusted Source of people who take isotretinoin. Isotretinoin may increase serum aminotransferase, which can be an indicator of liver damage.
There is no known reason why isotretinoin may elevate serum aminotransferase, but high dosages of the drug may have a toxic effect on the liver.
However, it is rare for isotretinoin to cause abnormally high results in a liver test, and it is rare for the drug to lead to liver injury.
Abnormal liver test results in people taking isotretinoin are usually temporary and may resolve while people are still taking the medication. Abnormal liver test results will usually not cause any symptoms.

next hit was;
Liver test abnormalities occur in up to 15% of patients on isotretinoin, although marked elevations above three times the upper limit of normal or requiring drug discontinuation are rare (<1%). The liver test abnormalities are typically asymptomatic and transient and can resolve even with continuing therapy. Clinically apparent liver injury due to isotretinoin is exceedingly rare. The acute liver injury with signs of hypersensitivity that occurs with etretinate and acitretin has not been described with isotretinoin therapy

Personally I’m not concerned after reading that but it may be worth you checking with your doctor if you have concerns.
I would also ask about supplementing iron as its normally not recommended for men so worth testing regularly when doing so I’d imagine? (I’ve tested levels at TRT levels of test and on blasts of 400mg and not seen any decrease. I’ve never supplemented and have been vegan for over 40 years so diet possibly low anyway).

1 Like