I Think My Dr. is an Idiot. Would You Check This Bloodwork?

Pharma / TRT Testosterone Replacement
1

Hey all,
My urologist seems to be a bit of an idiot where TRT is concerned and thought I’d ask you guys if you think my bloodwork needs more management. I’d really appreciate you taking a look. I should also say that I had a serum blood test a year earlier and had a serum test of 517. I’m 49 years old and suffered from low libido (even with over 500 tests). I took this guys first test unfasted and past noon and here were results:
T3(thyroid) :60 (which is low)
Free test: 1.89
Test serum: 196
First off, should I have even trusted this test given that it was unfasted and past morning? Maybe I should have tried to remedy low thyroid before doing trt? Especially since my test registered over 500 a year ago? Ok so here were my results after trt (.6mg 2xweek). In this case, he took my blood test the morning after I had an injection and I understand that’s not the way to do it. Anyway here’s the data:
Estradiol: 77 (0-47)
LH: 0.18 (1.24-8.62)
FSH: 0.26 (1.27-19.26)
Prolactin: 15.51 (2.64-13.13)
Free Test: 30.28
Serum Test: 839 (185-781)

My Libido is back.
Virtually all those besides the test are out of range, but are they out of range such that they require additional meds do you think? Thanks in advance!

2

How would we know if labs are out of ranges, you’ve provided no ranges. All labs have different ranges and measurements (pmol/L, nmol/L, pg/mL, ng/dL), with that said it’s difficult to know if FT is low or mid range without the ranges.

Taking bloods the morning after is stupid since you haven’t peaked yet. Insurance is almost useless for TRT, most of us pay out of pocket for proper care.

3

You going to be asked to post the ranges along side of your results, so you should just edit your post now and do that.

Fasting only affects lipid profile, I don’t think it affects thyroid or test levels. Your estrogen is way too high. You need an anti estrogen.

(.6mg 2xweek)

I’m assuming you mean 0.6 mL twice a week? What is the concentration of your Test? (i.e. 200 mg/mL)

Did they test for Thyroid Stimulating Hormone (TSH)?

4

Can you take a screen shot of your lab work and post that? Might be easier.

5

You can edit your post directly to add lab ranges. Look for the pencil icon below that post. We want to help.

Do not test LH/FSH on TRT as -->zero is expected.

Thyroid: TSH and T3 are not a complete picture. fT3 is the only active thyroid hormone. rT3 may be blocking some fT3 - need the ranges. Post both oral body temperatures, see below, as this is the best measure of your overall thyroid function. Also discuss your history of using iodized salt. Do you feel cold easily? Are your outer eyebrows sparse?

Few doctors are equipped do deal with these things. Reading the stickies is the one single most important thing to do right now.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

6

Sorry about not posting ranges. I’ve updated the intitial post with ranges for the second lab work. Yes my TSH was normal. I don’t see a fT3 test. The only symptoms of low hypo I have are lethargy and depression but I’ve had those for years. I’ll check temp. Also don’t forget that those lab numbers were taken the day after my Test injection. Thanks all for helping out. Nice community here.

7

Thyroid problems can definitely cause depression and anxiety. You’re likely peaking higher, run labs halfway between injections. TSH is a poor indicator of thyroid status, most doctors are unaware of that fact.

Is that E2 test sensitivity LC/MS/MS method? If not wrong E2 test.

8

You need to understand that lab “normals” for thyroid are quite meaningless, you need to start understanding “optimal”.

fT3: You have to ask for the labs that you want. Passive does not work.

Do not see a range for your T3. If T3 is low, you may be iodine deficient.

This can be fixed: "The only symptoms of low hypo I have are lethargy and depression but I’ve had those for years. "

  • and your acceptance of that too.

You need to discuss your history of using iodized salt or vitamins that list iodine+selenium. Iodine deficiency often affects everyone in a home.

9

I’ll check my BBT over the next few days but I think my t and e2 levels coupledwith my DR’s ignorance are making me unusually angry. Would you recommend I lower my t dose then do more labs or keep this dosage and add an AI? I’ve read all those recommended links and am now completely overwhelmed. I see I’m supposed to keep things in one thread so I’ll keep it here. As I said in the other thread, there’s a chance I’ll want to have a kid someday so want to add HCG. Really wish I started this with a doc that knew what he was doing