Feedback on Bloodwork

Pharma / TRT Testosterone Replacement
1

I’m a 29 year old male. 6’2. 192 lbs. Exercise regularly. Eat right. Checked out an anti-aging clinic due to always being tired/low energy. Did the blood work and the doc recommends 120mg test/week and HCG (forgot his amount). I would appreciate feedback on my bloodwork:

Progesterone- 0.74
Estradiol- 32.3
Testosterone (total) - 466
Testosterone (free)- 8.04
Bioavailable test- 189
IGF-1- 97.2
T4, Free- 0.86
Thyroid peroxidase- 1.3
ALT (SGPT)- 54
HDL cholesterol- 69

There are a bunch of other things on there. I don’t know if they need to be posted for the overall picture?

2

[quote]new111 wrote:
I’m a 29 year old male. 6’2. 192 lbs. Exercise regularly. Eat right. Checked out an anti-aging clinic due to always being tired/low energy. Did the blood work and the doc recommends 120mg test/week and HCG (forgot his amount). I would appreciate feedback on my bloodwork:

Progesterone- 0.74
Estradiol- 32.3
Testosterone (total) - 466
Testosterone (free)- 8.04
Bioavailable test- 189
IGF-1- 97.2
T4, Free- 0.86
Thyroid peroxidase- 1.3
ALT (SGPT)- 54
HDL cholesterol- 69

There are a bunch of other things on there. I don’t know if they need to be posted for the overall picture?
[/quote]

These are pre TRT? We also need ranges for each set of labs.

3

Yes pre-trt:

Progesterone- 0.74 (range 0.10-0.84)
Estradiol- 32.3 (range 0.10 - 0.84)
Testosterone (total) - 466 (range 348 - 1197)
Testosterone (free)- 8.04 (range 8.7 - 26.5)
Bioavailable test- 189 (range 131 - 682)
IGF-1- 97.2 (range 112 - 402)
T4, Free- 0.86 (range 0.8 - 2.7)
Thyroid peroxidase- 1.3 (range 0.0 - 9.0)
ALT (SGPT)- 54 (range 7 - 52)
HDL cholesterol- 69 (35-60)

4

Bueller?

5

Range for E2 is wrong. Probably <42
You are estrogen dominant. Lowering E2 with 0.5mg anastrozole per week in EOD divided doses may be helpful.
Labs for ALT/AST are useful. Your ALT=54 suggests that liver might not be clearing estrogens effectively.
any Rx or OTC drugs/supplements?

fT3, fT4 should be mid-range
fT4 should be 1.25, fT4=0.86 is low
Where is TSH data?

Diagnostic concerns:
IGF-1 is low for your age suggesting GH deficiency. At your age, this is not age related decline. A MRI might find an issue with your pituitary.

Testing LH/FSH will point to your pituitary [secondary hypogonadism] or testes [primary]. Is secondary, MRI may find a poroblem with your pituitary.

Please post more labs, there is more to your case than T etc. You need to find the cause of your low T.

You can test prolactin and if elevated, get an MRI.

With TRT, you will/would need anastrozole to manage E2 levels!

Read these stickies:

  • advice for new guys
  • thyroid basics
    – have you always used iodized salt and/or vitamins that list iodine? - else iodine deficient.

YOU MUST CHECK LH/FSH before starting TRT !!!

Action items:

  • post more labs
  • respond to iodine and body temperature issues
  • test LH/FSH
  • why is ALT elevated?
  • test prolactin and MRI if elevated
  • read those stickies
6


First off, thank you so much for such a detailed response! I will do my best to answer all your questions:

The rest of my lab results:
Glucose, Fasting- 72 (65-99)
Protein, total- 7.3 (6.1-8.3)
Albumin- 4.7 (3.5-5.7)
A/G ratio- 1.8 (1.1-2.2)
AST (SGOT)- 36 (3-39)
Bilirubin, total- 0.8 (0.0-1.0)
Alkaline phosphatase-51 (34-104)
Calcium-10.1 (8.6-10.6)
Bun (urea nitrogen)- 21 (7-25)
Creatanine- 1.1 (0.7-1.3)
Sodium- 139 (134-145)
Potassium- 4.6 (3.5-5.1)
Chloride-102 (98-107)
CO2- 32 (24-34)
Anion GAP- 10 (10-20)
GFR- 80 (greater than 60)
Lipid panel:
Cholesterol- 160 (less than 200)
Triglycerides- 49 (less than 150)
HDL Cholesterol- 69 (35-60)
LDL Cholesterol- 1 (less than 100)
LDL/HDL chol risk factor- 1.2 (less than 3.0)
I’ll post pictures of the rest and then answer all of your questions in another post

7

It would be better if your total cholesterol was a bit higher. Adjust diet a bit. Cholesterol is the foundation for all of your steroid hormones [which also includes cortisol].

Is this correct? "LDL Cholesterol- 1 (less than 100) "

8

Sorry, LDL cholesterol- 81 (< 100)

How would I adjust diet to increase cholesterol? Here are answers to your other questions:

Rx or OTC drugs/supplements:

  • No Rx
  • OTC: Fish oil, coq10, creatine, multi-vit, vitamin D, whey protein

I do not use iodized salt… I eat quite clean.

I used to use opiates heavily in the past, could this affect my liver function causing the increase in estrogen?

Body temperature issues: hands/feet always cold- poor blood circulation?

I will read those stickies…

9

Opiates are known to reduce TSH, T4, T3 etc. I have no idea if that can be persistent to some degree.

Without iodized salt, you are iodine deficient.

Your thyroid function may be weak, expecting low body temperatures and this can explain your low energy and can also lead to low testosterone.

You can increase cholesterol with eggs, cheese, red meat etc. Your diet may be too clean. 180 would be a good target. 160 and lower are associated with increased all-cause mortality. See the hormone cascades from cholesterol and your own vit-D3 production starts with cholesterol and ends up as vit-D25 an essential steroid hormone.

After you read the stickies, or while reading them, please go over my first post in this thread and note all issues there.