First Blood Results, Help Me Interpret

Pharma TRT
1

This is my first post on these forums so apologies if I leave out any information or do anything the wrong way!

I was having symptoms of low testosterone and after 4 years of feeling pretty down I finally went to a doctor about it. The tests indicate that I do indeed have low testosterone, but they also showed that I have elevated levels of Urea, Creatinine and Alkaline phosphatase.

On top of that I have very high blood pressure and wore a 24hr BP monitor on Wednesday to see what was going on. Peak value was 232/118 after I walked 200m quickly for the bus. I haven’t yet done enough research to see what the possible correlation between these is so I’d appreciate some input on the matter!

Results:
Sodium: 141 nmol/L (132-144)
Potassium: 4 nmol/L (3.5-5)
Chloride: 104 nmol/L (95-107)
Urea: 8.4 nmol/L (2.5-7.0)
Creatinine: 110 umol/L (64-104)
Albumin: 47 g/L (35-52)
ALT: 29 U/L (4-45)
Alkaline Phosphatase: 185 U/L (40-130)
Total Bilirubin: 12 umol/: (2-20)
Calcium: 2.54 mmol/L (2.1-2.62)
Cholesterol: 3.7 nmol/L (3.5-5)
Hemolysis index: 0 (0-2)
Testosterone 9.2 nmol/L (10-28)

WBC: 6.9x10^9/L(4.4-6.9)
RBC: 4.98x10^12/L (4.5-5.9)
HB: 15 g/dl (14-17.4)
HCT: .449 l/l (.42-.51)
Vitamin B12: 349 ng/l (120-650)
Serum Folate: 4.1 ng/ml (3.1-20)
Serum Ferritin: 68ng/ml (17-320)

As for the other details; I’m 20, try to maintain good health all the time. I almost never drink, don’t smoke, workout 3 times a week lifting heavy for the last 4 years, recently started doing sprinting 2x a week aswell. I’ve noticed that I can’t gain strength no matter how hard I try, I continually gain fat at a very slow rate when I attempt to put on muscle (which typically doesn’t happen.

I have low libido and low drive to go out and do anything in general. Walking for me is a nightmare despite the fact that I do it all the time. Feels like I’m going to die when I do. About the time I noticed the low testosterone symptoms first I had just lost about 25lbs in 2 months, and then taken hydroxycuts (without epehedra/ephedrine) for 3 weeks. I had also has surgery for an inguinal hernia just before this. Since then my eyes have also been over-dilated and this has never gone away. I had septicemia and encephalitis when I was 2 years old.

Age: 20
Height: 5’10’’
Weight: 185-190
Waist size: 35"
Plenty of facial and body hair
No AAS usage
Creatine supplementation for last 4-5 months

2

Read the stickies. You need more lab work. TSH, fT3, fT4, DHEA-S, E2-estradiol, LH, FSH

Where are you located?

You get cold easily? See the advice for new guys sticky, search for iodine or iodized

3

[quote]KSman wrote:
Read the stickies. You need more lab work. TSH, fT3, fT4, DHEA-S, E2-estradiol, LH, FSH

Where are you located?

You get cold easily? See the advice for new guys sticky, search for iodine or iodized[/quote]

Thanks for the reply! I’ve now read all the stickies and further bloods are scheduled to be taken in 2 weeks time. I also have an appointment with an endo in 6 weeks time.

The endo has requested that additional bloods be done, but my doctor was unspecific and mentioned only thyroid and the stipulation that the test be performed early in the morning. (This practice irks me as even if I return to “normal” range by doing this I know I will still have very low levels overall and throughout the day)

Located in Ireland, Cork specifically, Although i wouldn’t expect a large Irish presence here?

I rarely get cold. Our house stays around 13-15 degrees and I find that any warmer than that is a gigantic pain. Lecture theathres, busses etc that my friends can endure make me feel like passing out. Since this is (presumably) contra-indicative of hypothyroidism, is iodine/iodized salt still a reccommended protocol?

4

Just a quick update on my situation as of today:

The endo’s recommended tests were a full thyroid function test, prolactin, FT, LH and FSH tests so it seems as if he knows what he’s doing to a certain extent anyway.

I tried to ask the nurse if the test included estradiol but she seemed as if she had no idea and just fobbed me off with, “I’m sure that’ll be part of the prolactin test,” so I’ll have to wait and see if that gets done. I will be going into college tomorrow so I’ll pick up the results then.

As of today I’ve started taking apple cider vinegar in an attempt to lower my blood pressure, and that should hopefully have some sort of positive affect on my test levels aswell (wishful thinking?)

I’ve procured some test-e (20 1ml/250mg amps) from a source that I’m going to keep on hand in case the visit to the endo is fruitless. I will also be picking up the nescessary ancilliaries such as nolva and letro (to be replaced with aromasin at the nearest opportunity). This of course is a “last resort” and I don’t plan on self medicating unless it’s absolutely necessary.

One thing on my mind though is that I would like to enjoy this summer, seeing as I haven’t had a decent summer in around 4 years. To that end I don’t want to get caught up in endless visits to the doctor and tests when I could potentially help myself out. As a 20 year old I want to be out enjoying myself and not constantly in a low mood and unable to do physical activity at a moments notice. Would it be inadvisable to start medicating myself and return to the doctor to find the root cause at a later date? (somewhat rhetorical question)

5

[quote]Bigchrome wrote:
Just a quick update on my situation as of today:

The endo’s recommended tests were a full thyroid function test, prolactin, FT, LH and FSH tests so it seems as if he knows what he’s doing to a certain extent anyway.

I tried to ask the nurse if the test included estradiol but she seemed as if she had no idea and just fobbed me off with, “I’m sure that’ll be part of the prolactin test,” so I’ll have to wait and see if that gets done. I will be going into college tomorrow so I’ll pick up the results then.

As of today I’ve started taking apple cider vinegar in an attempt to lower my blood pressure, and that should hopefully have some sort of positive affect on my test levels aswell (wishful thinking?)

I’ve procured some test-e (20 1ml/250mg amps) from a source that I’m going to keep on hand in case the visit to the endo is fruitless. I will also be picking up the nescessary ancilliaries such as nolva and letro (to be replaced with aromasin at the nearest opportunity). This of course is a “last resort” and I don’t plan on self medicating unless it’s absolutely necessary.

One thing on my mind though is that I would like to enjoy this summer, seeing as I haven’t had a decent summer in around 4 years. To that end I don’t want to get caught up in endless visits to the doctor and tests when I could potentially help myself out. As a 20 year old I want to be out enjoying myself and not constantly in a low mood and unable to do physical activity at a moments notice. Would it be inadvisable to start medicating myself and return to the doctor to find the root cause at a later date? (somewhat rhetorical question)[/quote]

In my opinion you are best to try to find root cause from the get go. It might be cool and get you feeling great jumping on test, but you are just prolonging something you have to do anyway. Well you don’t have to but would be a lot better than committing to HRT for life if you don’t need it. See what the blood tests say and see how you go with the doctor.

Elevated creatine can also be caused by your creatine intake. It can also be higher to body composition properties, also if you are slightly dehydrated it can be higher I think too.

If the doctor or yourself is concerned with kidney function you are much better off getting Cystatin C tested.

It is good you have a source for test if all else fails but try do a few more tests to get a better picture of what is going on.

6

[quote]Bigchrome wrote:
Would it be inadvisable to start medicating myself and return to the doctor to find the root cause at a later date? (somewhat rhetorical question)[/quote]

You already know the answer

7

[quote]Bigchrome wrote:
Just a quick update on my situation as of today:

The endo’s recommended tests were a full thyroid function test, prolactin, FT, LH and FSH tests so it seems as if he knows what he’s doing to a certain extent anyway.

I tried to ask the nurse if the test included estradiol but she seemed as if she had no idea and just fobbed me off with, “I’m sure that’ll be part of the prolactin test,” so I’ll have to wait and see if that gets done. I will be going into college tomorrow so I’ll pick up the results then.

As of today I’ve started taking apple cider vinegar in an attempt to lower my blood pressure, and that should hopefully have some sort of positive affect on my test levels aswell (wishful thinking?)

I’ve procured some test-e (20 1ml/250mg amps) from a source that I’m going to keep on hand in case the visit to the endo is fruitless. I will also be picking up the nescessary ancilliaries such as nolva and letro (to be replaced with aromasin at the nearest opportunity). This of course is a “last resort” and I don’t plan on self medicating unless it’s absolutely necessary.

One thing on my mind though is that I would like to enjoy this summer, seeing as I haven’t had a decent summer in around 4 years. To that end I don’t want to get caught up in endless visits to the doctor and tests when I could potentially help myself out. As a 20 year old I want to be out enjoying myself and not constantly in a low mood and unable to do physical activity at a moments notice. Would it be inadvisable to start medicating myself and return to the doctor to find the root cause at a later date? (somewhat rhetorical question)[/quote]

I agree with the post above me. I’m sure you’ll feel good for a while if you jump on the juice. Extra testosterone usually makes us guys feel good. But you’re at a specific point in your life where what you find out now about your health, and what you do about it, will impact the rest of your life. It may suck to have another crappy summer, but if you get things squared away over the next few months you’ll be set to have 60+ more good summers to enjoy. If you “self medicate” you can skew your test results and maybe lead you and your doctor down the wrong trail. Get the tests done, if nothing else, as a baseline to compare to after whatever treatment you need has been going on for a while.

Think long term with this. Figure out what is causing your symptoms and work to correct it/them. I’ve been on TRT for 5 months now and am finally starting to get everything figured out and put in place. Sometimes you hit a streak in treatment where you feel awesome and indestructible, only to have something else go wrong a few weeks later. It can be a slow process, but it will be worth it once you are healthy! Once all the kinks are worked out, you’ll be on cruise control until you hit the grave (presumably while showing your harem of hot babes that an 87 year old man can still bench press 400lbs*).

Besides, you’re from Ireland. Don’t you guys utterly hate the Sun? j/k

*results not typical or guaranteed.

8

Thanks for the replies so far guys! Taking it all on board. Got the test results to day and lo and behold, no units, no ranges, and the nurse told me it was all “normal”. Here’s what I was given:

Free-T4: 17.0 pmol/l
FSH:4.5 IU/l
LHL:3.2 IU/l
Prolactin: 219 (84-360)
Testosterone : 11.6 nmol/l (10.0-28.0)
TSH: 2.56 (0.5-4.2)

These are my best guesses as to what the units would be:

Free-T4: 17.0 pmol/l
FSH:4.5 ie/l
LHL:3.2 ie/l
Prolactin: 219
Testosterone (doesn’t say free/total or anything): 11.6 nmol/l
TSH: 2.56 mU/l

looks to me as if everything is whacked to a certain degree.

9

[quote]Bigchrome wrote:
Thanks for the replies so far guys! Taking it all on board. Got the test results to day and lo and behold, no units, no ranges, and the nurse told me it was all “normal”. Here’s what I was given:

Free-T4: 17.0
FSH:4.5
LHL:3.2
Prolactin: 219
Testosterone (doesn’t say free/total or anything): 11.6
TSH: 2.56

These are my best guesses as to what the units would be:

Free-T4: 17.0 pmol/l
FSH:4.5 ie/l
LHL:3.2 ie/l
Prolactin: 219
Testosterone (doesn’t say free/total or anything): 11.6 nmol/l
TSH: 2.56 mU/l

looks to me as if everything is whacked to a certain degree.
[/quote]

You are entitled to your lab work. Demand the units and the ranges. If your doctor isnt going to help you, help yourself.

10

[quote]VTBalla34 wrote:

You are entitled to your lab work. Demand the units and the ranges. If your doctor isnt going to help you, help yourself.[/quote]

I will be in college again tomorrow so I’ll get them then. My doctor there seems great but the nurses and secretaries are completely incompetent. I think the receptionist just pulled the results from the computer to give to me and didn’t think units were important. The first lab results set I was given and discussed with the doctor had more than enough detail.

The endo I will be seeing is separate from the college but has just requested they do these tests for him. Have less faith in him being any good now given that he didn’t order t3/cortisol/estrogen etc. If and only if the endo ends up being useless or fails to diagnose any underlying cause I will treat myself.

I’m working with the theory that having a hernia/hernia surgery in 2007 damaged something down there. It’s only after reading about varioceles in the last few days that I quite possibly developed one at that time. That’s something I’m definitely not confident to diagnose myself though.

11

[quote]Bigchrome wrote:

[quote]VTBalla34 wrote:

You are entitled to your lab work. Demand the units and the ranges. If your doctor isnt going to help you, help yourself.[/quote]

I will be in college again tomorrow so I’ll get them then. My doctor there seems great but the nurses and secretaries are completely incompetent. I think the receptionist just pulled the results from the computer to give to me and didn’t think units were important. The first lab results set I was given and discussed with the doctor had more than enough detail.

The endo I will be seeing is separate from the college but has just requested they do these tests for him. Have less faith in him being any good now given that he didn’t order t3/cortisol/estrogen etc. If and only if the endo ends up being useless or fails to diagnose any underlying cause I will treat myself.

I’m working with the theory that having a hernia/hernia surgery in 2007 damaged something down there. It’s only after reading about varioceles in the last few days that I quite possibly developed one at that time. That’s something I’m definitely not confident to diagnose myself though.[/quote]

Not having ranges is kind of useless especially for lh fsh and prolactin and not to mention your thyroid panel.

Your testosterone is low no doubt. Your prolactin looks to be up there but with no range it is a guess at the moment.

I also have heard about varicoceles causing low testosterone but my Urologist seems to think otherwise. She thinks it can cause infertility issues more so than test levels. But ask 10 doctors and you will get a 50/50 response. I will say this, I tried a nolvadex restart and during the 10mg daily doseage I doubled my testostetone levels from 10 to 20nmol in 3 weeks.

I also have varicoceles and one is of a larger size. So if varicoceles were causing low testostetone then even by taking nolvadex my testosterone should have stayed low if varicoceles somehow hinder test output. That is just a thought maybe I am wrong and every case is different I guess.

I would not be rushing into surgery to treat the varicocele unless you are in pain. Look at other areas first.

Once you get the ranges post them up, then we will know if the prolactin is something to be concerned about.

12

[quote]iroczinoz wrote:

Not having ranges is kind of useless especially for lh fsh and prolactin and not to mention your thyroid panel.

Your testosterone is low no doubt. Your prolactin looks to be up there but with no range it is a guess at the moment.

I also have heard about varicoceles causing low testosterone but my Urologist seems to think otherwise. She thinks it can cause infertility issues more so than test levels. But ask 10 doctors and you will get a 50/50 response. I will say this, I tried a nolvadex restart and during the 10mg daily doseage I doubled my testostetone levels from 10 to 20nmol in 3 weeks.

I also have varicoceles and one is of a larger size. So if varicoceles were causing low testostetone then even by taking nolvadex my testosterone should have stayed low if varicoceles somehow hinder test output. That is just a thought maybe I am wrong and every case is different I guess.

I would not be rushing into surgery to treat the varicocele unless you are in pain. Look at other areas first.

Once you get the ranges post them up, then we will know if the prolactin is something to be concerned about. [/quote]

That’s extremely interesting! It seems like in your case it didn’t hinder them from producing when signalled, so maybe they don’t have as big an effect as we think? 10-20 is also a massive jump, I’d love to see something like that from taking nolva! Were you able to sustain that number afterwards or did it fall back down again?

I certainly wouldn’t rush into surgery on anything down there, as I’m sure most guys will understand! The pain after my hernia OP was bad enough!

Will try and get my ranges and units today!

13

[quote]Bigchrome wrote:

[quote]iroczinoz wrote:

Not having ranges is kind of useless especially for lh fsh and prolactin and not to mention your thyroid panel.

Your testosterone is low no doubt. Your prolactin looks to be up there but with no range it is a guess at the moment.

I also have heard about varicoceles causing low testosterone but my Urologist seems to think otherwise. She thinks it can cause infertility issues more so than test levels. But ask 10 doctors and you will get a 50/50 response. I will say this, I tried a nolvadex restart and during the 10mg daily doseage I doubled my testostetone levels from 10 to 20nmol in 3 weeks.

I also have varicoceles and one is of a larger size. So if varicoceles were causing low testostetone then even by taking nolvadex my testosterone should have stayed low if varicoceles somehow hinder test output. That is just a thought maybe I am wrong and every case is different I guess.

I would not be rushing into surgery to treat the varicocele unless you are in pain. Look at other areas first.

Once you get the ranges post them up, then we will know if the prolactin is something to be concerned about. [/quote]

That’s extremely interesting! It seems like in your case it didn’t hinder them from producing when signalled, so maybe they don’t have as big an effect as we think? 10-20 is also a massive jump, I’d love to see something like that from taking nolva! Were you able to sustain that number afterwards or did it fall back down again?

I certainly wouldn’t rush into surgery on anything down there, as I’m sure most guys will understand! The pain after my hernia OP was bad enough!

Will try and get my ranges and units today!
[/quote]

Not sure if my levels stayed elevated since I have not had them checked since. I am also on clomid at the moment so can’t say either. It did bring fsh up from 2 to 5 and as I said doubled my test and free test numbers.

I guess you could give Nolva a try at least it would tell you if your boys are able to produce.

14

Ok so I went to the endo today, was waiting for about an hour and a half which fairly sucked but at least he seemed fairly clued in. For the sake of brevity I’ll just give him a pros and cons list as describing a meeting like this can get exhaustive and boring otherwise.

Pros:
-Told me the standard ranges for T levels are trash (I knew we’d be somewhat on the same page then).
-Knew about the entire function of the HPTA, and had a pretty solid theory that it’s the hypothalamus in my case that’s lowered production, possibly due to overtraining and losing weight quickly when I first started lifting.
-Has booked me in for an MRI to check pituitary for tumours

Cons:
-Thinks the Free t4 test and TSH were adequate to essentially rule out hypothyroid. (I’d be 50-50 on that)
-Hasn’t expressed a desire to check cortisol or e2 yet
-Wants me to wait until July without doing strenuous activity to see if my production recovers enough to validate his theory (not so bad since I already haven’t lifted in almost 2 months)

I’m updating the 2nd set of blood results with the ranges as I remember them now.

[quote]iroczinoz wrote:
Not sure if my levels stayed elevated since I have not had them checked since. I am also on clomid at the moment so can’t say either. It did bring fsh up from 2 to 5 and as I said doubled my test and free test numbers.

I guess you could give Nolva a try at least it would tell you if your boys are able to produce. [/quote]

Thanks for letting me know how that was working for you! I actually have nolva on hand at the moment but I guess I’ll let the endo take a crack at the problem first before I go and obfusticate matters by throwing my lh/fsh around the place.

15

Dont update previous posts from the past! Create a new post with the added info. It gets too confusing to go back and forth trying to figure things out. Keep things in sequence.

Your TSH was 2.56. IMO that is a little on the high side and really not adequate to rule out a thyroid issue. I don’t know why docs are so hesitiant to do a proper panel–it aint that fucking expensive.

16

These are the results of my second blood test, now with ranges and most of the units. These bloods were taken on the 16th of april 2012.

Free-T4: 17.0 pmol/l
FSH:4.5 IU/l
LHL:3.2 IU/l
Prolactin: 219 (84-360)
Testosterone : 11.6 nmol/l (10.0-28.0)
TSH: 2.56 (0.5-4.2)

[quote]VTBalla34 wrote:
Dont update previous posts from the past! Create a new post with the added info. It gets too confusing to go back and forth trying to figure things out. Keep things in sequence.

Your TSH was 2.56. IMO that is a little on the high side and really not adequate to rule out a thyroid issue. I don’t know why docs are so hesitiant to do a proper panel–it aint that fucking expensive.[/quote]

Done! I think because thyroid numbers and symptoms can be so unspecific it’s probably unwise to go chasing after them before ruling other things out. At least that would be my take on it anyway. I certainly don’t “feel” hypothyroid, but it’s something I’ll take up with the doc at some point and I’ll try to get free t3, reverse t3 and cortisol done aswell.

I’ve been booked in for an overnight stay in hopsital in mid-June to check my heart and to do the pituitary MRI, so let’s hope that goes well!