Help Interpreting Blood Result (Total T too High? HDL too Low?)

Pharma TRT
1

Hi All,

I’m 34 and have been on Androgel for about 2.5 years. I have been on the max dose of 10g of cream (<100mg daily which equate considerably less than injections…).

I just got my latest blood work, and would appreciate some help to interpret it.

Everything else appears to be in the normal range except…

As of February 2023
Total T: 45.1 nmol/L (1301 ng/dL)
HDL: 0.62 mmol/L (18 ng/dL)

For comparison, as of July 2020 (pre TRT)
Total T: 7.62 nmol/L (220 ng/dL)
HDL: 0.59 mmol/L (17 ng/dL)

As you can see my HDL was already low pre TRT…

The main thing for me is I feel great, I’ve started working out again (after many years of poor life hygiene and sitting on my ass only playing video games…), I fast 16/8 everyday, I’ve cut all gluten (I’m intolerant), fixed my anxiety with various healthy methods and I’m now losing fat fast and I feel the best I’ve ever felt…

Now, I’m worried my doc wants to cut my Androgel level…

Is there any ill effect to staying in my current dosage long term?
Especially, if I managed to increase my HDL?
On that note, I’m starting Krill Oil and fast absorbing B3 to help… as well as cutting most of the bad food in my diet. I’m open to any other suggestion to help in that regard…

I don’t want to change anything, unless the T Level are considered dangerous, as I finally feel great, not depressed, I’m motivated. Libido is good, brain fog is gone, everything checks, etc.!

I’m excited to get in better shape and finally make the most out of those T level…

Any tips to convince the doc to not change a thing would be well appreciated.

2

You lab timing is critical, test shortly after application and levels are going to be high, test serveral hours after, and levels will be lower.

You want to test 4 hours after dosing.

The very short half-life topicals and oral formulations of TRT, levels need to peak higher so that you don’t drop too low later in the day.

If your doctor doesn’t understand, get a new one.

I peak at 1052 ng/dL, doctor isn’t concerned.

It’s highly unlikely this level is dangerous.

Exogenous T decreases HDL, mine as well. I don’t worry about it.

2 Likes
3

That’s great to know, I indeed got tested less than two hours after application. I didn’t know it could affect the result so much.

I’ll be sure to apply my androgel after the bloodwork next time!

4

Too early. If you think your doctor is the type to freak out over a tiny elevation, test at 6 hours which may actually be closer to your midpoint.

5

She will definitely freak out…
It took a lot of effort on my part to even get my T level checked before starting TRT.
She was arguing that it was not necessary at my age… When I got “in range” I was in the high 200’s… and she was arguing it was good because I’m in the normal range. Took lots of negotiation to eventually increase my dosage, so you get the picture…

Unfortunately, where I live it’s very difficult to get a doctor, so it’s not like I can easily get a new one.

I think I will completely stop T for a few days before going in for my next bloodwork.

Anyhow, I’m meeting with her tomorrow morning, so I’ll try to fight my case to “stay as is”, since I feel great and I finally have zero symptoms of low T (depression, foggy brain, no libido, no energy, etc.)

Regarding the gel, I can simply apply post bloodwork as the bloodwork needs to be done before 10am.

6

This doesn’t necessarily apply to men on exogenous T. My endo for the longest time told me the same thing, until I showed him clinical trial data showing hin he was wrong, only then did he listen.

7

What is total cholesterol and LDL

HDL that low is almost certainly pathological in nature. However you’ll note your HDL hardly differs pre vs post trt.

If you want to increase HDL artificially… niacin… the full flush kind…

However niacin can impair glucose tolerance. ER niacin poses a risk of hepatotoxicity.

What is FT… your total T is pretty high for TRT. Unless you have sky high SHBG or that reading is like literally an hour after you’ve applied your gel… i’d actually think about a slight decrease in dose

Think about it from a longevity standpoint. Above 1300ng/dl is really pushing it provided FT is also high

2 Likes
8

Just tell your doctor you tested too early, retest 4-6 hours.

1 Like
9

I’d be careful with this statement. Studies are not particularly conclusive. Some show increases. There are a lot of elements involved. How many decide, once making the decision to go on TRT, to do other healthy things? Diet, exercise, etc.? Decreasing total cholesterol will decrease HDLs. If anything, based on what I see in practice, I’d say HDLs are more likely to improve on TRT. My own increased from low 30s to mid 40s. No change in diet or exercise, n=1. What about others, they start TRT and increase exercise, lose visceral fat, eat better, increase estradiol, which is proven to be cardioprotective.

10

Lipid Profile
Total Cholessterol : 3.97 nmol/L (115 ng/dL)
LDL : 2.7 nmol/L (78 ng/dL)
Triglycerides : 1.44 nmol/L (42 ng/dL)

It would make sense that my low HDL is hereditary, Cholesterol (both good and bad are a known family issue, also arguable affected by poor lifestyle choices, which I am fixing…)

I’ve tried Niacin 500mg for the first time last night and the flush was bad. Red, Warm, not really feeling great. 5 minutes Cold Shower and chugging water did help though.

Now if Niacin may affect my glucose tolerance, that’s perhaps of concern for myself, I used to be in a Pre-Diabetic state a few years ago (Diabetic also a family heritage, lol). I’ve gotten out of that with a better life hygiene. My fasting glucose was still a bit high at 5.3 nmol/L (153 ng/dL), but at least not in the low to mid 6 like it was at one point.

My doctor didn’t test me for Free Testosterone… yeah I need a better specialist. Or at least someone that is willing to command a complete blood test. (Where I live, blood test needs to be ordered and defined by Doctors…)

1 Like
11

Update :
After talk with my doctor, she suggested we try a lower dose of Testosterone.

But after hearing my arguments, she was okay that we leave as-is for now and re-test in 3 months.
She agreed that testing so soon in between the application and bloodwork could affect the result.
During my next blood test, we will check Free T.

Thank you all for your help and comments! Much appreciated! :grinning: