You’re metabolizing FT quickly, I would expect to see higher FT with a TT level at 712 and SHBG at 30. You don’t seem to be aromatising a lot, this is going to make dialing in rather easy. Your estrogen pre-TRT must have been very low and this would have made it an easy decision to increase the dosage because for you the penalty is nil.
I don’t think you’re iron deficient, I would expect to see MCHC, MCV to be suppressed and RDW to be above range. The high MPV platelet count and low total platelet count could indicate bone marrow is producing platelets and releasing them into circulation rapidly which would explain the low total platelet count.
Since the older platelet count is being destroyed, the bone marrow is trying to compensate.
Yes this was my thought too. should I increase the dosage further? I have noticed immediate symptom relief going to 75 mg but still very tired… I am thinking I will need higher to get to top of ranges… 50 mg only put me at 106pg/ml
What do you speculate is the cause of my low platelets, WBC, and high MPV? I am not anemic by any means… But truly I am suffering from severe tiredness and day time fatigue. There has to be more to this and a reason behind this. Alkaline Phosphatase and MPV, platelets seem to be interconnected.
I agree with this as well, my Estrogen is optimal and aromatization is not in excess… What are your recommendations?
Considering how you’re metabolizing FT quickly and the suboptimal FT at 712, you could probably handle quite a bit more testosterone than you’re on now, I mean your TT increased substantially, but your FT only moved 54->106 pg/mL which isn’t a big increase like I would expect to see.
You’ll probably need somewhere in the ballpark of 75-90mg twice weekly (150-180mg weekly) to be optimal. This is an educated guess and please note dosing isn’t linear, meaning once you get to a certain point in the FT range, the levels can increase substantially.
It could be a bone marrow disorder, it’s not an autoimmune disease because white cell is low. I’m willing to bet that these markers might also point to the underlying condition that led to low testosterone.
Ok I will stick with 75mg every 3.5 days and do labs in 5 weeks from now. Im expecting to see TT closer to 1000 and free T closer to the tops of the ranges, and hopefully given my T/E ratio from my last 2 labs my estrogen should stay in check since I aromatize little (no AI)
I too think that something is going on… and is the reason I had low T in the first place at 24… I just don’t know what these numbers translate to in terms of what disorder or disease I might be suffering from?
I am thinking maybe Epstein Barr, or something else… @systemlord please help me figure out what underlying condition I might have or what these numbers could indicate… I am willing to bet my doctor will be useless. I have an appt this upcoming week. I am just tired of being tired, I can sleep 24 hours and feel just as tired when I wake up. I know Testosterone plays a role but only to an extent. I am sure once my Free T is higher I will feel better but as I have said before, my Testosterone levels are not the only factor but instead are probably a result of something else going on.
Your estrogen is probably why you are tired. 22 is very low. I was 22 low t and felt horrid. You really need to realize the benefits of estrogen. You want it to be well above 30 with a free t above 20.
Your brain, penis, bones, heart and other tissues aromatizing estrogens and they stay in these areas. Meaning labs cannot detect how much is within. Your 22 tells me you prob don’t have enough in many areas of the body.
Watch the latest round table by the lifting dermatologist and listen to these doctors. Jordan speaks about estrogen being paricine or local to the tissue and undetectable in blood.
Of all the doctors I know and the one I have learned from directly would say e2 is very low.
I would stick to 200 and split it daily and later you can lose when you feel well.
Erethrocytosis is common in trt. It is an indicator of health , I will find a study that was recently shared by dr grant showing blood clots and shot is not gaueged by RBC. ITS due to other genetic and health issues.
Everyone sees an increase in hct and you be fit from extra o2 In blood.
Fiurthermorr you would experience symptoms s if hct being high was too high.
Get that e2 up and for thyroid freet3 should be top of range. If range is 1-4 you want to be between 3.5 and 4 it dose until symptoms resolve. I had brain fog and fatigue and trt Erin work until I starred thyroid. I’m on armour thyroid 2 grain am and pm. I feel wonderfully healthy.
Hang in there and don’t over complicate. Work on dose and thyroid until symtoms resolve. Once your tried a good dose and thyroid you will know if other issues need to be addressed. Until then don’t waste your time on other potential health problems.
Nope tsh is not an accurate indicator. Your ft3 can be very low/ the problem with most thyroid patients is the body doesn’t convert t4 to t 3 properly.
With your symtoms you need to get those tested ASAP.
Only a sick care doctor would not test these. They are ignorant fools.
Google stop thyroid madness and learn the truth . You’ll find tsh is a shitty way to operate.
This is true however, TSH and reverse T3 are related, TSH would most certainly be higher in the presence of high RT3. I can link studies here in a moment
TSH is not a good indicator for overall Thyroid function but in my case my body is pumping adquate T4… If T3 were low (due to poor conversion) or blocked by RT3 one would expect to see a higher TSH since the body is screaming for more Free T3. This is widely known when accounting for T4 and TSH levels in light of RT3.
The issue here is likely not my Thyroid, look at my Alkaline Phosphatase and platelet values… I have low Platelets, higher MPV, and LOW Alkaline Phosphatase. Something else here is going on that likely gave me low T in the first place. These CBC values also are not Thyroid related or markers of an inefficient Thyroid. I agree I need more T and E I have already upped my dosage. However I need to figure out what is going on behind the scenes.
I’m telling you that tsh can be 1.0 and free t3 can be low.
Any doctor who works in this field as an expert will tell you this.
Tsh is shit.
Studies are horrid. How many studies out there sat trt causes strokes and other cv events? Yet when an expert looks at it, they will clarify this is an observational study and other factors are not taken into consideration.
Thus the study is a pile of waste.
Please do your research. This is your health and I just gave you a golden nugget. You test it and if it’s not at the top start the thyroid meds.
Your symtoms are exactly those of what thyroid patients experience.
There is something else going on… are you choosing to ignore the CBC values?
There is some disorder/deficiency causing this and likely the reason my T was low in the first place.
Not common, most of the time TSH is higher. I will link studies now and subjective results based on the people who have posted their labs.
Buddy I am not trying to be rude. I am just telling you to test your thyroid if you have fatigue. Trust me… anybody who knows their thyroid values will agree and I have plenty of doctors who would tell you the same.
No don’t ignore CBC values, but don’t start freaking out if it hits 51. Like I said you don’t have anything to worry about if you don’t have underlying ailments.
I am not talking about hematocrit here or any of the values you are talking about… We are referring to my Alkaline Phosphatase, Platelet count, and Mean Platelet Volume (Size of my platelets). I have too few platelets and they are too big suggesting that my body is cranking out platelets quickly… most of the time this is indicated as a sign of something more serious. Nothing to do with RBC (hemoglobin and Hematocrit are fine for me )
No problem I understand this thread is confusing… however the above values I mentioned are screaming something more serious is wrong… and likely the reason for my Low T in the first place at 24 years of age. I am just trying to figure out what could be causing this.
here is an excerpt
“A high MPV means that your platelets are larger than average. … When someone has a low platelet count and a high MPV level, it suggests that the bone marrow is rapidly producing platelets . This may be because older platelets are being destroyed, so the bone marrow is trying to compensate.”
Here is an excerpt regarding my low ALP (Alkaline Phosphatase)
Low levels of ALP may be seen temporarily after blood transfusions or heart bypass surgery. … A rare genetic disorder of bone metabolism called hypophosphatasia can cause severe, protracted low levels of ALP . Malnutrition or protein deficiency as well as Wilson disease could also be possible causes for lowered ALP
The two seem to be interconnected. Liver function is ruled out by my other liver enzymes being healthy and normal.
I don’t want to lose your insight, you have a knack for researching like myself.
I am finding a lot of information on possibly being Zinc deficient, however it seems like it is rare. But my labs would indicate its possible… Also Zinc deficiency can cause Hypogonadism. What are your thoughts?
Zinc deficiencies may result in abnormal development, poor immune function, and hormone imbalances including Hypogonadism. Also platelet counts, and MPV match perfectly in the cases of being Zinc deficient.
I’m leaning towards a bone marrow disorder where platelets are being destroyed quickly forcing the body to compensate by creating more platelets. It could be hypophosphatasia, but there is no cure and you can only manage the symptoms.
I’m no doctor and can only offer advice, but I can’t diagnose you. I’ll leave the diagnosis to a properly educated and trained doctor. I would check all vitamins and minerals checking for deficiencies.