Hormone and Metabolism issues

Pharma / TRT Testosterone Replacement
1

-age 57
-height 5’9"
-waist 32
-weight 176
-describe body and facial hair very little body hair, facial hair close to normal
-describe where you carry fat and how changed stomach, pecs - little change except some decrease in belly
-health conditions, symptoms [history] somewhat asthmatic ex-smoker
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever (flomax four years ago)
Buproprion XL 300 mg daily
Felodopine 10 mg daily
Alprazolam .5 - .75 mg daily - on rare occasions 1.0 mg
Fexofenadine 1 daily
testosterone Cypionate .75 ML (200 mg/ml) weekly
Anastrazole 1mg weekly
Cialis for daily use 5mg daily
Whey protein Powder 60 grams daily
alpha lipoic acid 800 mg twice daily
Beta-alanine 3.2 grams daily
l-carnitine 2000 mg daily
l-arginine 4000 mg daily
l-glutamate 4000 mg daily
BCAA powder 6 grams daily
Citruline maleate 4 grams daily
GABA 3 grams daily
l-lysine 1000 mg daily
Vitamin E 800 IU daily
Vitamin C 2000 daily
1 Men’s over 50 multi vitamin daily
B-Complex supplement 1 daily
B-6 50 mg daily
magnesium Oxide 1200 mg daily
zinc 50 mg daily
D-3 5000 IU daily
Omega 3 fish Oil 4800 IU daily

-lab results with ranges
7/19
Testosterone, Serum >1500 ng/dL 348-1197
Free Testosterone(Direct) 46.2 pg/mL
Estradiol 89 pg/mL 7.2-24.0

8/15
Testosterone 1368 ng/dL 168-758
LH <0.20 mIU/mL Note: Reference Range(s): Male: 1.24 - 8.62 mIU/mL
FSH <0.20 mIU/m Reference Range(s) Male 1.27 - 19.26 mIU/mL
Estradiol 43 pg/mL
Testosterone 1368 ng/dL 168-758
Prolactin 4.28 ng/mL
hTSH Reflex FT4 1.13 uIU/mL 0.34-4.50

10/31
Testosterone, Serum 1454 ng/dL 348-1197
Free Testosterone(Direct) 36.6 pg/mL 7.2-24.0
Estradiol 64 pg/mL
-describe diet [some create substantial damage with starvation diets]
very high protein (avg 150 grams per day, low fat, rarely any fried foods. mainly baked or broiled chicken or fish, eggs, low-fat cottage cheese, lowfat, low-sugar yocurt, fruit
-describe training [some ruin there hormones by over training]
strength - 45 minutes three X per week. 3.5 miles at 4.0 mph with 4-5 30 second sprints once or twice daily
-testes ache, ever, with a fever? no
-how have morning wood and nocturnal erections changed increased favorably in last 6-8 months

My history (sorry for wordiness):
Doctor started TRT 2 years ago ater free T tested somewhat low. Doc and PA seem to have undergone learning curve at my expense. Started 1 ML of 220 every three weeks, then increased to once per week. PA dropped me back to once per month, saying 985 was too high. went back Winter of 2013 and Doc said that wasn’t that high and put back to once per week. A couple of months later, I had stopped training and went lax on diet and put on 20 pounds. Started back rigorous training and diet and either did not lose weight or gained still. Finally went to Doc to find out why. in July Estradial at 86 and T off the charts. Stared Anastrazole 1 mg 1X per week, and cut T to .75 per week. Next lab in August, E was down to 43, T still high. After this weight started dropping some, but stalled again in September. October lab showed T still high and E up to 64. In email, Doc said “good report!” I pointed out my E was up and weight stalled and asked if I should drop T even more. He said “good thought - drop it to .5 ml.”

I decided to see an endocrinologist with high hopes. Big mistake. Obviously convinced I must have talked some doc into giving me T in the first place, she insisted I stop Anastrazole immediately and taper off to zero on T within a month, then she would start seeing me again in 2 months. Now I realize, I’m on my own here.

I have decided to go back to .75 ml of the 200 next week, but divide it into 3 injections per week. Doc claims cannot prescribe more that 4 pills of Anastazole per month, but pharmacy goofed and gave me 30 at last refill. Since they cant use them now, I kept them. Last week, Last two weeks I have taken a second 1 ml at mid-week and am starting to drop weight again. This week, I am dividing 2nd dose of Anastazole to two doses of 1/2, and will drop to three doses of 1/2 next week.

I am sure my doctor won’t prescribe HCG, but would like to give it a go when I go back to him next month if you think it would help. Would appreciate any advise at all - including info or tests I can ask him to do to indicate need for HCG. Will start taking temp tomorrow and maybe try Iodine supplements.

Thanks!

2

Ok. If I were you, I would drop the AI, and start 50mg every 3.5 days of test. This has been wonderful for me! My trough is at 663, and E is at 27. Plus, I feel great! Give this a try for 2-4 weeks and see how it treats you…I bet you will like the results!

the arimidex made me feel wierd, and it killed my dick for a couple days…That’s why I was determined to figure out how to get the E2 down without it.

My T levels are probably 700-1050 or so, depending on when I test it.

Hope it helps you.

3

I think we have similar cases. From what I’ve read you should just cut the AI for now, and dial that Test dose way back and retest in 4 weeks. From what I can tell, you will feel a lot better with TT at 550 at E2 in the 20s then having TT at 1000 and E2 above 40.

4

You will need the AI.

Please [re]read the advice for new guys sticky and protocol for injections.

What are your cholesterol levels?
What heart/pulse/pressure issues?

Buproprion can be very stimulating and after a while that can be fatiguing. Your allergy drug can cause some nervous issues. Is Xanax needed to deal with some of this. I always encourage guys to get off of Xanax if possible.

T and/or DHT are not the cause of BPH. Estrogens are thought to be the main problem. Lack of ejaculations allows semen to get old/rancid and that promotes chronic inflammation that then affects the prostate. It is important to lower your E2 level to near 22pg/ml

Please post more of your labs. What you have provided is too narrow.

Arimidex/anastrozole needs to be dosed every other day [divided doses].

Your lab work should be done half way between injections, always. If you change lab timing, you do not know if differences are from protocol, response or timing.

Do not understand: hTSH Reflex FT4 1.13 uIU/mL 0.34-4.50
Please post all thyroid related labs.
Read the thyroid basics sticky.

How do you feel?
Do you sleep well?
Snoring?
Feel cold easily?
Dry skin, before? now?
Acne?

Changes?

  • energy
  • libido
  • socialization/avoidance
  • temper/tolerance
  • noise sensitivity

Total T [TT] is SHBG bound T [SHBG+T}, albumin bound T and FT.
TT can be elevated if the liver is not clearing SHBG+T
SHBT+T is not bio-available T, just junk
Liver problems can increase TT
Liver problems can increase E2
Elevated E2 increases SHBG production in the liver, increasing TT and SHBG+T
High TT can be indicating liver clearance problems, not so much a dose driven issue
High E2 can be indicating liver clearance problems, not so much a dose driven issue
The TT and FT ranges are age adjusted. You should be looking at youthful levels.
I am not concerned with the TT and FT levels, I am very concerned with your high E2.
High E2 is having many negative mental/libido effects as well as arteries and prostate.

E2 is bad for your lining of your arteries - endothelial cells, one cell thick, aka endothelium

  • Endothelium protected by DHEA, FT, fish oil, B vits, CoQ10

Magnesium for foot cramps?
Do you use antacids that limit ability to absorb minerals and B12?

You can get [google] “liquid anastrozole as a research chemical” which will allow fine dose titration.

Use natural source vit-E

Amino acids: Are you trying to promote GH release? IGF-1?

5

Thanks for the replies.

What are your cholesterol levels?
All labs I have for last 2 years are at end.

What heart/pulse/pressure issues?
high blood pressure - controlled well with script and weight loss/exercise

Is Xanax needed to deal with some of this. I always encourage guys to get off of Xanax if possible. I’ve been seeing shrink for anxiety/depression issues (pre-date, but DEFINITELY aggravated by high estradiol levels). Use Xanax judiciously - cannot tolerate SSRIs and are ineffective anyway.

Please post more of your labs. What you have provided is too narrow.
All I have below

Arimidex/anastrozole needs to be dosed every other day [divided doses].
Will do

Your lab work should be done half way between injections, always. If you change lab timing, you do not know if differences are from protocol, response or timing.
will do

Do not understand: hTSH Reflex FT4 1.13 uIU/mL 0.34-4.50
Please post all thyroid related labs.
Sorry - all labs at bottom

Read the thyroid basics sticky.
working though it

How do you feel?
Mostly good. Anxiety and depression issues much worse when estradial is elevated. But I’m so much better than before testosterone therapy. Had sudden onset 2 years ago of severe confusion, inability to concentrate or perform simple tasks, and other issues. Tests doc did found no cause for them and I was finally resigned that it was either stress or early symptoms of Alzheimer’s. A few months months later, was started on TRT and did a complete 180.

Do you sleep well?
sometimes no - often up to late and wake up early

Snoring?
have used cpap for over 15 years
Feel cold easily?
Oh yeah

Dry skin, before? yes now?
yes - hands crack and bleed in winter if I forget lotion

Acne?
no

Changes?

  • energy – seems level
  • libido – increase last 6 months
  • socialization/avoidance – same - never been a real social animal
  • temper/tolerance – good usually - but have my moments when frustrated
  • noise sensitivity -= not really. Hearing not the best. sudden noises make me jump

Total T [TT] is SHBG bound T [SHBG+T}, albumin bound T and FT.
TT can be elevated if the liver is not clearing SHBG+T
SHBT+T is not bio-available T, just junk
Liver problems can increase TT
Liver problems can increase E2
Elevated E2 increases SHBG production in the liver, increasing TT and SHBG+T
High TT can be indicating liver clearance problems, not so much a dose driven issue
High E2 can be indicating liver clearance problems, not so much a dose driven issue
The TT and FT ranges are age adjusted. You should be looking at youthful levels.
I don’t understand that last part

I am not concerned with the TT and FT levels, I am very concerned with your high E2.
High E2 is having many negative mental/libido effects as well as arteries and prostate.

E2 is bad for your lining of your arteries - endothelial cells, one cell thick, aka endothelium

  • Endothelium protected by DHEA, FT, fish oil, B vits, CoQ10

Magnesium for foot cramps?
No, I read that it helped decrease estrogen
Do you use antacids that limit ability to absorb minerals and B12?
none

You can get [google] “liquid anastrozole as a research chemical” which will allow fine dose titration.
thanks!

Use natural source vit-E
I assume that means that found in foods?

Amino acids: Are you trying to promote GH release? IGF-1?
No, I’m a newbie to bodybuilding and may have overdone it :slight_smile:

Labs:

Testosterone,Free and Total 7/26/2011 7:50
   Panel/Test Value Unit Normal Range
   Testosterone, Serum 439 ng/dL 193-740
   Free Testosterone(Direct) 7 pg/mL 7.2-24.0

TESTOSTERONE TOTAL (84403) 11/1/2011 14:55
   Panel/Test Value Unit Normal Range
   Testosterone 515 ng/dL 168-758

CBC DIFF/PLT, Automated Differential (85025) 5/8/2012 10:20
   Panel/Test Value Unit Normal Range
   WBC 6.9 3/uL 3.8-10.8
   RBC 4.59 6/uL 4.20-6.10
   HGB 15.7 g/dL 13.2-18.0
   HCT 44.6 % 38.5-52.0
   MCV 97.1 fL 80.0-94.0
   MCH 34.1 pg 28.5-32.5
   MCHC 35.1 g/dL 32.0-36.0
   RDW 12.2 % 11.5-15.5
   PLT 250 3/uL 130.0-400.0
   NE% 65.6 %
   LY% 24.9 %
   MO% 8.8 %
   EO% 0.5 %
   BA% 0.2 %
   NE# 4.6 3/uL 1.5-7.8
   LY# 1.7 3/uL 0.9-3.9
   MO# 0.6 3/uL 0.2-1.0
   EO# 0 3/uL 0.0-0.5
   BA# 0 3/uL 0.0-0.2

METABOLIC PANEL, COMPREHENSIVE (80053) 5/8/2012 10:20
   Panel/Test Value Unit Normal Range
   Sodium 137 mmol/L 135.0-144.0
   Potassium 4.2 mmol/L 3.5-5.0
   Chloride 102 mmol/L 101.0-111.0
   CO2 28 mmol/L 22.0-32.0
   Anion Gap 7 mmol/L 3.0-11.0
   Glucose 105 mg/dL 65-99
   Calcium 9.4 mg/dL 8.6-10.3
   BUN 7 mg/dL 8.0-26.0
   Creatinine 0.75 mg/dL 0.60-1.30
   EGFR 114.9 >60.0
   Total Protein 7.6 g/dL 6.1-8.6
   Albumin 4.3 g/dL 3.5-5.0
   Globulin 3.3 g/dL 1.7-4.2
   A/G Ratio 1.3 calc 1.0-2.5
   T. Bilirubin 0.74 mg/dL 0.20-2.00
   AST 38 IU/L 12.0-41.0
   ALT 25 IU/L 8.0-63.0
   Alk Phos 62 IU/L 32.0-126.0

AMYLASE 5/8/2012 10:20
   Panel/Test Value Unit Normal Range
   Amylase 7 65 U/L 28-100

LIPASE 5/8/2012 10:20
   Panel/Test Value Unit Normal Range
   Lipase 24 U/L 22.0-51.0

PSA (PROSTATE SPECIFIC ANTIGEN) (84153) 5/8/2012 10:20
   Panel/Test Value Unit Normal Range
   PSA-Hybritech 0.135 ng/mL 0.008-4.000
   Note: PSA assay performed using Beckman-Coulter Hybritech chemiluminescence method.
Values from different assay methods cannot be used interchangeably.
PSA values, regardless of value, should not be interpreted as absolute evidence
of the presence or absence of disease.

CBC DIFF/PLT, Automated Differential (85025) 8/23/2012 10:35
   Panel/Test Value Unit Normal Range
   WBC 6.1 3/uL 3.8-10.8
   RBC 4.53 6/uL 4.20-6.10
   HGB 15.6 g/dL 13.2-18.0
   HCT 44.7 % 38.5-52.0
   MCV 98.6 fL 80.0-94.0
   MCH 34.4 pg 28.5-32.5
   MCHC 34.9 g/dL 32.0-36.0
   RDW 12.1 % 11.5-15.5
   PLT 238 3/uL 130.0-400.0
   NE% 71.4 %
   LY% 20.7 %
   MO% 7.5 %
   EO% 0.3 %
   BA% 0.1 %
   NE# 4.3 3/uL 1.5-7.8
   LY# 1.3 3/uL 0.9-3.9
   MO# 0.5 3/uL 0.2-1.0
   EO# 0 3/uL 0.0-0.5
   BA# 0 3/uL 0.0-0.2

METABOLIC PANEL, COMPREHENSIVE (80053) 8/23/2012 10:35
   Panel/Test Value Unit Normal Range
   Sodium 134 mmol/L 135.0-144.0
   Potassium 4.1 mmol/L 3.5-5.0
   Chloride 101 mmol/L 101.0-111.0
   CO2 25 mmol/L 22.0-32.0
   Anion Gap 8 mmol/L 3.0-11.0
   Glucose 100 mg/dL 65-99
   Calcium 9.3 mg/dL 8.6-10.3
   BUN 5 mg/dL 8.0-26.0
   Creatinine 0.87 mg/dL 0.60-1.30
   EGFR 96.5 >60.0
   Total Protein 7.7 g/dL 6.1-8.6
   Albumin 4.3 g/dL 3.5-5.0
   Globulin 3.4 g/dL 1.7-4.2
   A/G Ratio 1.3 calc 1.0-2.5
   T. Bilirubin 0.97 mg/dL 0.20-2.00
   AST 32 IU/L 12.0-41.0
   ALT 24 IU/L 8.0-63.0
   Alk Phos 58 IU/L 32.0-126.0

TSH W/REFL FT4 (84443) 8/23/2012 10:35
   Panel/Test Value Unit Normal Range
   hTSH Reflex FT4 1.34 uIU/mL 0.34-4.50

TESTOSTERONE 8/23/2012 10:35
   Panel/Test Value Unit Normal Range
   Testosterone 988 ng/dL 168-758

PROLACTIN 3/21/2013 8:40
   Panel/Test Value Unit Normal Range
   Prolactin 4.99 ng/mL 2.64-13.13

hTSH/ Reflex FT4 3/21/2013 8:40
   Panel/Test Value Unit Normal Range
   hTSH Reflex FT4 1.43 uIU/mL 0.34-4.50

ESTRADIOL 3/21/2013 8:40
   Panel/Test Value Unit Normal Range
   Estradiol 25 pg/mL
   Note: Reference Range(s):

Males                                     <20 - 47 pg/ml			
			
Non-Preganant Females:			
Mid follicular phase                   27 - 122 pg/mL			
Mid Luteal phase                      49 - 291 pg/mL			
Peri-ovulatory phase               95 - 433 pg/mL			
			
Postmenopausal Females:     <20 - 40 pg/ml

FSH (Male) 3/21/2013 8:40
   Panel/Test Value Unit Normal Range
   FSH 14.67 mIU/mL
   Note: Reference Range(s)

Male                                1.27 - 19.26 mIU/mL			
			
Female:			
Mid-Follicular Phase          3.85 - 8.78 mIU/mL			
Mid-Cycle Peak                 4.54 - 22.51 mIU/mL			
Mid-Luteal Phase              1.79 - 5.12 mIU/mL			
Postmenopausal             16.74 - 113.59 mIU/mL

LH 3/21/2013 8:40
   Panel/Test Value Unit Normal Range
   LH 4.58 mIU/mL
   Note: Reference Range(s):

Male:                                  1.24 - 8.62 mIU/mL  (<18 years)			
			
Female:			
Mid-Follicular Phase            2.12 - 10.89 mIU/mL			
Mid-Cycle Peak                 19.18 -  103.03 mIU/mL			
Mid-Luteal Phase                1.20 - 12.86 mIU/mL			
Postmenopausal               10.87 - 58.64 mIU/mL

TESTOSTERONE 3/21/2013 8:40
   Panel/Test Value Unit Normal Range
   Testosterone 182 ng/dL 168-758

PSA (PROSTATE SPECIFIC ANTIGEN) (84153) 3/21/2013 8:40
   Panel/Test Value Unit Normal Range
   PSA-Hybritech 0.09 ng/mL 0.008-4.000
   Note: PSA assay performed using Beckman-Coulter Hybritech chemiluminescence method.
Values from different assay methods cannot be used interchangeably.
PSA values, regardless of value, should not be interpreted as absolute evidence
of the presence or absence of disease.

Testosterone,Free and Total 7/19/2013 9:05
   Panel/Test Value Unit Normal Range
   Testosterone, Serum >1500 ng/dL 348-1197
   Free Testosterone(Direct) 46.2 pg/mL 7.2-24.0

LIPID PANEL (80061) 7/19/2013 9:05
   Panel/Test Value Unit Normal Range
   Triglycerides 57 mg/dL <150.0
   Cholesterol 192 mg/dL 125.0-200.0
   Chol/HDL Ratio 4.4 calc <5.0
   HDL Direct 43.3 mg/dL >40.0

LDL Cholesterol 7/19/2013 9:05
   Panel/Test Value Unit Normal Range
   LDL Cholesterol 137.3 mg/dL <130.0

CBC/PLT AUTO DIFF, Reflex Anemia Panel (85025) 7/19/2013 9:05
   Panel/Test Value Unit Normal Range
   WBC 6 3/uL 3.8-10.8
   RBC 4.95 6/uL 4.20-6.10
   HGB 16.3 g/dL 13.2-18.0
   HCT 48.3 % 38.5-52.0
   MCV 97.5 fL 80.0-94.0
   MCH 32.8 pg 28.5-32.5
   MCHC 33.7 g/dL 32.0-36.0
   RDW 12.6 % 11.5-15.5
   PLT 241 3/uL 130.0-400.0
   NE% 59.4 %
   LY% 29 %
   MO% 10.2 %
   EO% 1.4 %
   BA% 0 %
   NE# 3.6 3/uL 1.5-7.8
   LY# 1.7 3/uL 0.9-3.9
   MO# 0.6 3/uL 0.2-1.0
   EO# 0.1 3/uL 0.0-0.5
   BA# 0 3/uL 0.0-0.2

METABOLIC PANEL, COMPREHENSIVE (80053) 7/19/2013 9:05
   Panel/Test Value Unit Normal Range
   Sodium 139 mmol/L 135.0-144.0
   Potassium 4.3 mmol/L 3.5-5.0
   Chloride 104 mmol/L 98.0-111.0
   CO2 28 mmol/L 22.0-32.0
   Anion Gap 7 mmol/L 3.0-11.0
   Glucose 98 mg/dL 65-99
   Calcium 9.4 mg/dL 8.6-10.3
   BUN 6 mg/dL 8.0-26.0
   Creatinine 0.86 mg/dL 0.60-1.30
   EGFR 97.4 >60.0
   Total Protein 8.1 g/dL 6.1-8.6
   Albumin 4.5 g/dL 3.5-5.0
   Globulin 3.6 g/dL 1.7-4.2
   A/G Ratio 1.3 calc 1.0-2.5
   T. Bilirubin 0.73 mg/dL 0.20-2.00
   AST 32 IU/L 12.0-41.0
   ALT 24 IU/L 8.0-63.0
   Alk Phos 61 IU/L 32.0-126.0

ESTRADIOL (82670) 7/19/2013 9:05
   Panel/Test Value Unit Normal Range
   Estradiol 89 pg/mL

TESTOSTERONE 8/13/2013 9:50
   Panel/Test Value Unit Normal Range
   Testosterone 1368 ng/dL 168-758

LH 8/13/2013 9:50
   Panel/Test Value Unit Normal Range
   LH <0.20 mIU/mL
   Note: Reference Range(s): Male: 1.24 - 8.62 mIU/mL (

FSH (Male) 8/13/2013 9:50
   Panel/Test Value Unit Normal Range
   FSH <0.20 mIU/mL
   Note: Reference Range(s) Male 1.27 - 19.26 mIU/mL Female: Mid-Follicular Phase 3.85 - 8.78 mIU/mL Mid-Cycle Peak 4.54 - 22.51 mIU/mL Mid-Luteal Phase 1.79 - 5.12 mIU/mL Postmenopausal 16.74 - 113.59 mIU/mL

PSA-Hybritech 8/13/2013 9:50
   Panel/Test Value Unit Normal Range
   PSA-Hybritech 0.14 ng/mL 0.008-4.000
   Note: PSA assay performed using Beckman-Coulter Hybritech chemiluminescence method. Values from different assay methods cannot be used interchangeably. PSA values, regardless of value, should not be interpreted as absolute evidence of the presence or absence of disease.

ESTRADIOL 8/13/2013 9:50
   Panel/Test Value Unit Normal Range
   Estradiol 43 pg/mL
   Note: Reference Range(s): Males

PSA-Hybritech 8/13/2013 9:50
   Panel/Test Value Unit Normal Range
   PSA-Hybritech 0.14 ng/mL 0.008-4.000
   Note: PSA assay performed using Beckman-Coulter Hybritech chemiluminescence method. Values from different assay methods cannot be used interchangeably. PSA values, regardless of value, should not be interpreted as absolute evidence of the presence or absence of disease.

TESTOSTERONE 8/13/2013 9:50
   Panel/Test Value Unit Normal Range
   Testosterone 1368 ng/dL 168-758

LH 8/13/2013 9:50
   Panel/Test Value Unit Normal Range
   LH <0.20 mIU/mL
   Note: Reference Range(s): Male: 1.24 - 8.62 mIU/mL (

PROLACTIN 8/13/2013 9:50
   Panel/Test Value Unit Normal Range
   Prolactin 4.28 ng/mL 2.64-13.13

FSH (Male) 8/13/2013 9:50
   Panel/Test Value Unit Normal Range
   FSH <0.20 mIU/mL
   Note: Reference Range(s) Male 1.27 - 19.26 mIU/mL Female: Mid-Follicular Phase 3.85 - 8.78 mIU/mL Mid-Cycle Peak 4.54 - 22.51 mIU/mL Mid-Luteal Phase 1.79 - 5.12 mIU/mL Postmenopausal 16.74 - 113.59 mIU/mL
hTSH/ Reflex FT4 8/13/2013 9:50
   Panel/Test Value Unit Normal Range
   hTSH Reflex FT4 1.13 uIU/mL 0.34-4.50

CBC/PLT AUTO DIFF, Reflex Anemia Panel (85025) 8/13/2013 9:50
   Panel/Test Value Unit Normal Range
   WBC 4.5 3/uL 3.8-10.8
   RBC 4.93 6/uL 4.20-6.10
   HGB 16.2 g/dL 13.2-18.0
   HCT 48.3 % 38.5-52.0
   MCV 97.9 fL 80.0-94.0
   MCH 32.8 pg 28.5-32.5
   MCHC 33.5 g/dL 32.0-36.0
   RDW 12.3 % 11.5-15.5
   PLT 254 3/uL 130.0-400.0
   NE% 54 %
   LY% 30.9 %
   MO% 13.4 %
   EO% 1.7 %
   BA% 0 %
   NE# 2.4 3/uL 1.5-7.8
   LY# 1.4 3/uL 0.9-3.9
   MO# 0.6 3/uL 0.2-1.0
   EO# 0.1 3/uL 0.0-0.5
   BA# 0 3/uL 0.0-0.2

Testosterone,Free and Total 10/31/2013 9:10
   Panel/Test Value Unit Normal Range
   Testosterone, Serum 1454 ng/dL 348-1197
   Free Testosterone(Direct) 36.6 pg/mL 7.2-24.0

ESTRADIOL (82670) 10/31/2013 9:10
   Panel/Test Value Unit Normal Range
   Estradiol 64 pg/mL
   Note: Reference Range(s): Males

6

KSman, why would you say that he’s going to need the AI before he actually switches his shot frequencies?? That doesn’t make any sense…he may not need any after he injects more fequently…the less drugs you have to add in the better.

7

Last couple of days, body temp has been 97.4 to 97.5 on waking and the highest I get to during the afternoon is 97.9. The sticky on this got me thinking - I can’t remember my temp taken at the doctor’s office being 98 or above in many years. I used to always think that a bit odd. My TSH numbers last three tests have been 1.14 to 1.43, which if I read KSMAN’s posts right, is close to where I want it? But I am cold all the time. I have attributed it to my weight loss in the past (I was a morbidly obese 265 in spring of 2008). Would it be a good idea to try iodine supplements?

8

Your skin, body temperatures and feeling cold indicates a real problem. TRT improves skin. But I suspect a deep thyroid problem.

What is your history of using iodized salt and/or vitamins listing iodine?

It is zinc that helps with axiomatization of T–>E2. But only to a small extent, better when resolving a zinc deficiency. But zinc is really not going to be useful in your situation. When you take a lot of one mineral, you can block the absorption of other minerals.

Natural vitamin E is a spectrum of related substances, the label will state natural source. Otherwise it is synthetic, containing only one type of molecule.

Yes, TSH looks good, but your body is acting very hypothyroidic.

Please get a thyroid panel:

  • TSH, fT3, fT4 plus rT3
    Do not do T3, T4, get fT3, fT4
9

No vitamins containing iodine that I am aware of. I purposely buy iodized salt for the home, but wouldn’t say I’m currently a heavy user. BUT, up until about 3 years ago (when I quit drinking alcohol of any type) I was a HEAVY beer drinker, using lots of beer salt daily. Unable to verify, but I would guess that “Twang” is iodized.

I’m going to stop taking the zinc and magnesium supps.

Made appointment for just after New Year and will get the TSH, fT3, fT4 plus rT3.
A BIG thank you for your time and all your help!

10

At Christmas, my (half)-brother reminded me his thyroid was removed years ago - Hashimotos. Saw Doc on Tuesday as planned. Body temp was 96.6 at the office which we discussed, along with other issues. Surprisingly, was able to get script for HCG - has to go through our ins. mailorder pharmacy, so will take a couple weeks. Labs came back today - below. E2 went down some along with total T. Despite asking specifically though, it doesn’t look like they checked rT3 or DHEA or TgAb.

Thyroid Peroxidase (TPO) Ab 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
Thyroid 8 IU/mL 0-34
Peroxidase (TPO) Ab

ESTRADIOL 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
Estradiol 45 pg/mL

TESTOSTERONE 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
Testosterone 824 ng/dL 168-758

PROLACTIN 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
Prolactin 3.99 ng/mL 2.64-13.13

LH 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
LH 0.20 mIU/mL
Note: Reference Range(s): Male: 1.24 - 8.62 mIU/mL

FSH (Male) 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
FSH <0.20 mIU/mL
Note: Reference Range(s) Male 1.27 - 19.26 mIU/mL

hTSH 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
hTSH 1.48 uIU/mL 0.34-4.50

FT3 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
FT3 3.02 pg/mL 2.50-3.90

FT4 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
FT4 0.84 ng/dL 0.54-1.24

Magnesium, Serum 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
Magnesium, 1.9 mg/dL 1.6-2.6
Serum

Vitamin D, 25-Hydroxy 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
Vitamin D, 37.8 ng/mL 30.0-100.0
25-Hydroxy

FE % Saturation 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
FE % Sat 24.8 % 15.0-50.0

IRON PANEL (83540) 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
Iron 79.00 ug/dL 45.00-182.00
Transferrin 227.3 mg/dL 180.0-329.0
TIBC 318.22 ug/dL 261.00-478.00

FERRITIN (82728) 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
Ferritin 26.0 ng/mL 23.9-336.2

PSA-Hybritech 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
PSA-Hybritech 0.132 ng/mL 0.008-4.000

CBC Diff/PLT, Automated 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
WBC 4.0 3/uL 3.8-10.8
RBC 4.79 6/uL 4.20-6.10
HGB 15.9 g/dL 13.2-18.0
HCT 47.3 % 38.5-52.0
MCV 98.6 fL 80.0-94.0
MCH 33.1 pg 28.5-32.5
MCHC 33.6 g/dL 32.0-36.0
RDW 12.7 % 11.5-15.5
PLT 235.0 3/uL 130.0-400.0
NE% 56.2 %
LY% 28.3 %
MO% 13.2 %
EO% 2.0 %
BA% 0.3 %
NE# 2.3 3/uL 1.5-7.8
LY# 1.1 3/uL 0.9-3.9
MO# 0.5 3/uL 0.2-1.0
EO# 0.1 3/uL 0.0-0.5
BA# 0.0 3/uL 0.0-0.2

FOLATE (Folic Acid-Serum) (82746) 12/31/2013 8:34 AM
Panel/Test Value Unit Normal Range
Folate >20.00 ng/mL >5.90

11

fT3 is a little bit low. Low ferritin can limit your T4–>T3 conversion, selenium can be helpful, might be in your vitamins already

Twang does not contain iodine

TSH is showing something is going on. Is your thyroid enlarged, asymmetric or lumpy?

Your body temperatures are low, but fT3 does not seem low enough to explain that. However, elevated rT3 could be the explanation.

Vitamin D is low.

E2=45 is a problem

12

Thanks for looking labs over, KSMan! Yes, I’m shooting for 22 on my E2. Dropped 23 points since last lab. I think splitting the doses per the sticky is helping. Also changed T inj. to EOD. As far as I can tell, thyroid feels normal and doc did feel around on neck as well. Will try selenium.

This is second lab that my MCV and MCH have been above range. With Ferritin low, should I try an iron supplement? I am ordering Iodoral for the 750 mg IR - I’ll start at 12.5 per day. Would like to have gotten rT3 and other antibody results back, as well as DHEA-s. Thyoid Peroxidase is 8. I guess that’s OK? Gonna check out Wilson’s book on Adrenal fatigue. What I’ve read so far sounds so like me. Overwhelming succession of life changing and stressful events in the last 3-4 years.

I was taking 5000 IU of D, but dropped down to 2K because I thought that was too much. Guess I better go back to 5K? More? Is DHEA supplementation a good idea?

13

At your age your DHEA levels could easily be lower than optimal.

Yes, take some iron or get foods with higher iron levels.

When iron related blood markers are low, one can suspect poor absorption. That can result from low acid levels, antacids or proton pump inhibitors. Else one can have blood loss from a GI bleed. An occult blood test can rule that in or out.

Low acid levels are also suspected to affect other minerals, including iodine.

14

Just got back new labs. Estradiol is down finally - a little low, actually. Been taking 1/2 anastrazole EOD, so I’m going to switch to 1/4 EOD. I’m injecting 1.25 units Test Cyp EOD for a total of 100 MG/week and 250 HCG EOD. Free testosterone is REALLY low all of a sudden. Doctor said “will watch this and if persists consider change to bioidentical.” Not sure I like the sound of that. Thinking of bumping daily test to 1.75/day. Would appreciate comments/opinions on that. T3 is low. Doc wants to start me on low dose thyroid. As KSMAN told me a while back, I have shown obvious signs of hypo. Labs below. Still haven’t gotten any RT3 or RT4 results. Thinking about going to another doc I sent my wife too. Feedback welcome and appreciated.

Panel/Test Value unit Range
FT4 0.73 ng/dL 0.54-1.24
FT3 2.71 pg/mL 2.50-3.90
hTSH 3.22 uIU/mL 0.34-4.50
Testosterone, Serum 764 ng/dL 348-1197
Free Testosterone(Direct) 1.4 pg/mL 7.2-24.0
Estradiol <20 pg/mL not given
WBC 4.8 3/uL 3.8-10.8
RBC 4.98 6/uL 4.20-6.10
HGB 16.6 g/dL 13.2-18.0
HCT 47.9 % 38.5-52.0
MCV 96.2 fL 80.0-94.0
MCH 33.3 pg 28.5-32.5
MCHC 34.7 g/dL 32.0-36.0
RDW-CV 12.0 % 11.0-15.5
PLT 206.0 3u/L 130.0-400.0
NEUT% 61.8 %
LYMPH% 24.3 %
MONO% 12.3 %
EO% 0.8 %
BAS0% 0.8 %
NEUT# 2.97 3/uL 1.50-7.80
LYMPH# 1.17 3/uL 0.85-3.90
MONO# 0.59 3/uL 0.20-1.00
EO# 0.04 3/uL 0.00-0.50
BASO# 0.0 3/uL 0.0-0.2

15

That’s crazy low Free T for your Total T number. Probably a bogus result or calculation.