Labs and History

Pharma TRT
1

-39 years old, 5ft 8in, 150lbs, 5-7%BF
-Body hair everywhere : chest, back, shoulders, legs, etc
-fat accumulates in the belly, even when BF gets down to 5% with training, abs still barely defined
-no health conditions to speak of other than lack of libidio, fatigue, soreness, slower than typical recovery, irritability, on and off sleep issues
-OTC history: used to take Rogaine back in HS when I began losing hair, otherwise healthy. at times im sure i drink a little too much – off season 2-3 drinks a night

LABS: (9:29/2013)

Glucose: 90mg/dl (70-100mg.dl)

Free T4: 0.97ng/dl (0.59-2.19ng/dl)
TSH: 0.884uIU/ml (0.465-4.680)
T3 Free: 3.56 pg/ml (2.77-5.27 pg/ml)

Cholesterol: 116mg/dL (140-200 mg/dL)
Triglyceride: 53mg/dL (40-150mg/dL)
HDL: 57mg/dL (40-65mg/dL)
LDL: 49mg/dL (70-100 mg/dL)
LDL/HDL Ratio: 0.86 RATIO (1.00-3.64 RATIO)

Ferritin: 255.0 ng/mL (17.9-464.0 ng/mL)
WBC: 4.16 K/mm3 (3.83-9.22 K/mm3)
RBC: 4.60 M/mm3 (4.40-6.38 M/mm3)
Hemoglobin: 14.4 gm/dL (14.4-18.3 gm/dL)
Hematocrit: 43.4% (41.1-53.2%)
Platelet Count: 178 K/mm3 (174-412 K/mm3)
TT: 207 ng/dL (240-950 ng/dL)
FT: 5.4 ng/dL (9-30 ng/dL)

  • I eat well, but generally with all the daily training, I’m a furnace. Everything made at home. Low fats in general. Other than the 3xweekly dessert it’s a quality diet. Coffee.
  • I’m a cyclist…up to 20hours a week.
  • Testes never ache
  • I typically don’t have the morning wood, and usually have low libido .been this way for years. No ED though.

I went in to Dr. to get bloods done following a long race that I trained months for. After taking a few weeks off and gently trying to get back into training, my body simply said NO and it was like I was running on 1 cylinder. I keep the reality of overtraining very seriously and do my best with recovery days and only doing harder workouts twice a week. Despite doing everything intelligently with regards to this, I simply don’t get the recovery and am unable to compete in smaller races as they would send me into a training pitfall. I make a point of this as I know there arenâ??t many pure endurance athletes on here, and because I know I will easily get labeled as an overtrainer.

Although I do try to train a lot, I have always been a very low energy, depressed, and easily annoyed person. once I got these labs back, I began to think that my low T has been here all these years and I never connected the dots.
After getting the results back, Doc had to me do a precautionary brain MRI (a little over the top I thought given that all thyroid levels were in range, but it came back clean) He put me on Test Cyp 200mg every 2 weeks, which I have adjusted to doing a front load of 200mg and then 50mg e3d.

KSman is Here
2

Here has been my dosing schedule so far for the Test Cyp

week 1: 200mg front load
week 2: 100mg
weeks 3 and 4: 25mg e3d

I will have labs done next week (end of week 5) but at this point I have had no discernible effects from the treatment. Zero.

3

Please carefully read the advice for new guys sticky.

fT4 is low - read the advice for new guys sticky.
Using sea salt?
Check body temperatures ← seriously, this really is important

We see crashed hormones from

  • over training
  • extreme and low fat diets

Your cholesterol is low, should be near 180. Cholesterol is the foundation for all sex and adrenal hormones and vit-D3.
Study: Steroid hormone - Wikipedia
yes, may docs would say that your cholesterol is perfect, perfectly wrong!

Cholesterol levels below 160 are associated with increased all cause mortality.

  • eat animal fats
  • fish oil caps, nuts, flax seed oil/meal for EFA’s

Take 5000iu vit-D3 per day.

There is a lot more going on than T, do not have T tunnel vision.

Hair loss drugs can kill hormones and libido. What are the time lines of that and your hormone changes? Unrelated?

Your blood seems thin.

  • digestive problems or food sensitivities?
  • GI bleed? get an occult blood test kit from your doc

Next labs:

  • dhea-S
  • E2
  • rT3 if body temps are low, see the thyroid basics sticky.
    [extreme diets, training can increase rT3 and block action of fT3, body temperatures are he bottom line]

Assume that doc tested LH/FSH before the MRI and those were low.

4

KSman… very grateful for the input

Doc did MRI after those tests…which confused me and was the first sign of a bit of inexperience – but he at least seems on board with the protocol, so Im keeping at this point for that reason.

ill revisit the thyroid sticky again (ive read them all!)

im not shy about fats, diet just ends up being that way. Perhaps ill add some Omega 3-6-9 oils?

Cholesterol levels have been around 100-130 since I was a teenager despite eating whatever. at one point about 10 years ago i was around 180lbs and very out of shape, CHOL jumped to 200.

I live and train in N. Mex…plenty of sunshine here…still need to supplement with D-3?

Hard to tell if the Rogaine corresponded with all this… I took it for about a year when I was 19…so perhaps. I was losing the battle so gave up early :slight_smile:

NO G.I. issues…

IM adding E2 to the labs next week. and will post temps as well Why the DHEA-S?

again, many thanks…yes im sure i have a bit of tunnel vision at this point, but I also think an endo would confuse matters more at this point (Im sure youll agree)

5

We see a fair number of hypo cholesterol cases here. Seems hard to believe it is that common, but if a factor in your low T, that brings you here and what we see here is not typical of the general population.

Cortisol could also be affected, see if you can get an AM cortisol and test at 8AM. That is also a steroid hormone.

6

Greatly appreciated KSman,
I was thinking Cortisol as well given this really flares up during the heavy training/big athletic events.Although, from what I’ve read, those alone might lower T, but not bring it to very low levels (in my case, right around 200 TT and below.)

Last 4 days of morning and evening body temps have me at a pretty steady 96.8. I am still a weary of taking a massive amount of Iodine…perhaps there is a middle ground with IR dosages? Unsure of sides other than issues you presented in stickies.

Will the am blood cortisol be sufficient in this case, or is saliva the only way?

Labs Ill be getting later this week: TT, FT, E2 (and going to ask to have rT3, DHEA-s, Cortisol added)

Added a multi with Iodine (I know, not much) 5000iu D3, Fish caps, and 3x Omegna 3-6-9 oil daily to try and get the Cholesterol up as I now learning its the precursor to this whole crazy chain. Wonder how long before I can do bloods again to see where cholesterol is at? Again, ive been at around 100 mg/dL for cholesterol for my whole life, so itll be interesting to see if I can actually bump that up.

Another question: Considering in most cases that there is something else in the hormonal chain that triggers the low T, how can one really figure this out while taking T? I mean, ideally, you would do bloodwork and tweak this and that and see how that affects the whole hormonal chain before introducing anything unnatural. Perhaps by fixing these other parts of the chain, while taking ex. T you simply increase the effectiveness of what happens to that T?

The more I learn the less i understand, it seems.

7

AM cortisol is more cost effective, you can do salivary later if needed.

So you were not using iodized salt?

You can get the 12.5mg iodine tabs and start with 6.25 and work your way up and see what your tolerance is. As per the stickies, you can’t do a large IR total load with microgram dosing. In cay case, you will be watching body temperatures and noting how you feel. Larger doses can also displace bromine contamination and if that happens and is rapid enough, you can note bad odors, or others will. There would be some value to knowing if bromines were a factor.

You need to know if you can fix some problems with iodine before things get more medical.

Your fT3 would seem to be high enough to support body temperatures. So rT3 should be checked as a cause.

If you are iodine deficient, others in your household probably are too. Check temperatures.

8

blood drawn today, will post when i get it back. TT, FT, E2, DHEA-s, Cortisol, rT3.

i have ordered up the 24hr urine iodine test.

9

A labs back. 5 weeks into TRT (test cyp only, 25mg e3d)
8am draw (fasting)

DHEA-S: 111mcg/dL (48-244)
T3r: 14ng/dL (10-24)

FT: 40ng/dL (9-30) HIGH
TT: 945 ng/dL (240-950)
ESTRADIOL: 45.76 (5.37-65.90)

CORTISOL-AM: 10.8ug/dL (4.5-22.7)

Right now I am not feeling as good as I should given the T numbers. Bloat, weight gain, low libido, no morning erections. Im guessing the E2 is the culprit. Question is, do I simply lower the dose from 50mg e3d to say 30mg e3d, or do I try and get on an AI, or both?

10

Well, with noone chiming in from here I have decided to simply dial back the dosage for 4 weeks and retest. It seems crazy but, I think the smartest thing to do is to go from 50mg Test Cyp e3d to perhaps 25mg e3d (perhaps try subQ). Perhaps this will lower the E2 into the 20s and drop the TT and FT to midranges.

Anyone else out there find success with dropping the dose? I dont want to have to go the AI route unless I have to.

I have begun a little 2 week LugoTab (Iodine) IR as well for kicks.

11

No, that will not take E2 to near 22pg/ml.

Why are you not working with an AI as per the stickies?

Cortisol is near bottom end for 8AM lab work. When did you do the labs?

When were labs done relative to prior injection.

Have you ever had liver markers ALT/AST done?

12

I guess I would like to take it one step at a time see what I can do with T alone. If I can cut the dosage and get in the 20-30 range with E2 and see where the TT, FT is at I would like to see if there is any improvement there before adding anything new to the mix. I have read all the stickies and know the drill and the reasons behind it. Right now that FT was quite beyond the range.

The other aspect that I am concerned about is the Crit levels. I do lots of prolonged endurance and dont need that number to be too high for cardiac reasons. Seems like having a higher TT (greater than 750 say) and FT greater than 25 it just going to jack up the Crit levels too high.

Last time I got ALT/AST was 2011, and they were both midrange.

Cortisol was done at 8am, fasting. Blood test was 48 hours after injection (50mg e3d)