My Blood Work

Pharma / TRT
1

Hello everyone. Doc did my bloodwork and here are my results although he didn’t do everything I asked of him. I asked him to do both free and total test but he only did free.

Free test = 60ng

A little history. I will be 28 next month. I and 6’2 and 255. I am bulking, although if you read some of my very few post, I was going to cut and said fuck it. I have made some decent gains. Point is that I don’t free 100%, not even 90% of my earlier years. Doc is an internist and openly admits that he is not an expert on the matter. He said the normal range of free test is 47-244ng. He also suggests that 60ng is normal then. I said that I wasn’t happy with it and the way I feel and he said the he would recommend me to a endo. Do you guys think 60ng is normal?

Thanks in advance. I have also only been traning for one year so I wasn’t quite ready for a cycle, but I am sure you know it has crossed my mind. Any help will be app.

2

60 is light, but without further information it’s impossible to make an informed determination.

First of all, endogenous T is pulsatile, so if you check your levels at the wrong time of day, then your levels might appear low.

Second, without knowing your total T, it’s impossible to know if your body is producing insufficient T, or sufficient T but it’s getting all bound up to SHBG.

Third, are you exhibiting signs of low T/hypogonadism? If your body is rich in androgen receptors, you might be as biologically efficient at 60 as another man with few receptors is at 250.

My advice: go to an endo or urologist with experience in HRT, take more tests, and thus make yourself more informed.

Let me know if you need more.

BB67
Chicago, IL

3

So are you saying that without the total test then the free test doesnt really give enough info. I think that is what you said. Doc recommended me to an endo at the end of Jan. I guess we will see then. I plan on making some calls tomorrow to the doctors office and find out if they actually work with HRT.

I tried searching multiple post on this subject here and it seemed like when people posted their test results they were on a different scale than what was explained to me?

Anyone else have any results or confirm if the 60ng free test is low compared to your own numbers.

Thanks for replying…

4

You can’t come to any conclusions until the total test is run. 60 is low on a 47-244 scale. Your total may be a higher ratio.

5

If I were in your position I would definitely want to know the T Total in addition to the T Free.

It will help to have the reference levels for the lab that performed the test. They should be included on the lab report next to your results, and they will give you a better sense for what is ‘normal’ at that lab.

Also, you need to consider the time of day your test was taken. I’m unsure how T Free fluctuates during the day, but T Total pulses in the early am and declines throughout the day. A low T Total in the am is a reliable indicator of hypogonadism; low T Total late afternoon is not.

For clarification, T Total is usually expressed in nanograms/deciliter (ng/dl); T Free is picograms/deciliter (pg/dl). We’re talking vanishingly small amounts here.

Good luck!

6

Thanks for the reply.

I have confirmed my appointment with the endo doctor at the end of Jan. I also called the doctors office and asked if they have or treat HRT and they said no. Now this person whom I spoke to could have just been a receptionist or something so I asked to speak to a nurse and she also confirmed no on HRT. I hope that the Test is not low or off but would it be a good idea to go ahead and seek out a doctor that does HRT? How expensive is HRT and does health insurance cover it?

BTW, I had my blood work done around 9AM, so should have been at its highest from what you say and other posters.

I am supposed to go see my regular doc, the one who did the blood work, at the beginning of jan. I think I will call and see if I can get them to fax, or I will pick up, my blood work results. Maybe it will shed some more light on the subject as you suggested.

If insurance does not cover HRT, and I know we are not suppose to discuss prices on this board, but what would someone expect to pay for maybe test ent or cyp to self medicate? Say maybe 100-200mg twice a week.

Thanks in advance and also for reply to help at all.

7

Question about that…If someone is a late sleeper, say they wake up at noon everyday, and get tested right away, they will still get as an accurate test as someone who normally wakes up at 8 and gets tested right away?

[quote]toddberlin wrote:
If I were in your position I would definitely want to know the T Total in addition to the T Free.

It will help to have the reference levels for the lab that performed the test. They should be included on the lab report next to your results, and they will give you a better sense for what is ‘normal’ at that lab.

Also, you need to consider the time of day your test was taken. I’m unsure how T Free fluctuates during the day, but T Total pulses in the early am and declines throughout the day. A low T Total in the am is a reliable indicator of hypogonadism; low T Total late afternoon is not.

For clarification, T Total is usually expressed in nanograms/deciliter (ng/dl); T Free is picograms/deciliter (pg/dl). We’re talking vanishingly small amounts here.

Good luck![/quote]

8

[quote]Stiddy wrote:
Thanks for the reply.

I have confirmed my appointment with the endo doctor at the end of Jan. I also called the doctors office and asked if they have or treat HRT and they said no. Now this person whom I spoke to could have just been a receptionist or something so I asked to speak to a nurse and she also confirmed no on HRT. I hope that the Test is not low or off but would it be a good idea to go ahead and seek out a doctor that does HRT? How expensive is HRT and does health insurance cover it?

BTW, I had my blood work done around 9AM, so should have been at its highest from what you say and other posters.

I am supposed to go see my regular doc, the one who did the blood work, at the beginning of jan. I think I will call and see if I can get them to fax, or I will pick up, my blood work results. Maybe it will shed some more light on the subject as you suggested.

If insurance does not cover HRT, and I know we are not suppose to discuss prices on this board, but what would someone expect to pay for maybe test ent or cyp to self medicate? Say maybe 100-200mg twice a week.

Thanks in advance and also for reply to help at all.[/quote]

The actual drugs involved, believe it or not, are not that expensive at all. Very reasonable. Its the doctor visits and blood work that cost all the money. Now, depending upon how your insurance works and such will depend on how much of THAT you have to pay for.

And you can get anti estrogens extremely cheap, Stiddly PM me for the link if/when you need it.

9

I would assume so T-Nick. Seems reasonable that if a persons schedule is to get up at noon then that is when his test would be at it’s highest point throughout the day.

10

The test result definitely warrants further investigation.

Your Doc should have at least run the extra blood work, so he would have more results to send on to the endocrinologist.

11

Alright then, went to see the endo and here are the results of my test. I dont know what all are so i will post for input. Thanks in advance.

Test result range
Hemolglobin A1c 6.oH 4.8-5.9
Thyroxine 1.32ng/dl 0.61-1.76
Testosterone Serum 241ng/dl 241-827
C-Reaction Protein 4.84mg/L 0.00-3.00
FSH 1.1LmIU/ml 1.4-18.1
TSH 1.847uIU/ml 0.350-5.500
Cortisol 14.8ug/dL 3.1-22.4
DHEA 812 H ng/dL 208-771
Prolactin 7.1ng/mL 2.1-17.7
Estrogens, Total 131pg/mL 40-115

Well, low test after all. Dont know what all the others mean. Any ideas? I think that total estrogens number is not very promissing?

12

[quote]Stiddy wrote:
Alright then, went to see the endo and here are the results of my test. I dont know what all are so i will post for input. Thanks in advance.

Test result range
Hemolglobin A1c 6.oH 4.8-5.9
Thyroxine 1.32ng/dl 0.61-1.76
Testosterone Serum 241ng/dl 241-827
C-Reaction Protein 4.84mg/L 0.00-3.00
FSH 1.1LmIU/ml 1.4-18.1
TSH 1.847uIU/ml 0.350-5.500
Cortisol 14.8ug/dL 3.1-22.4
DHEA 812 H ng/dL 208-771
Prolactin 7.1ng/mL 2.1-17.7
Estrogens, Total 131pg/mL 40-115

Well, low test after all. Don’t know what all the others mean. Any ideas? I think that total estrogens number is not very promising?[/quote]

Your T is low and your E is high. If you get on TRT, then your E may remain high.

The E will give you fat patterns that you do not want and will interfere with the actions of the T that you do have.

Transdermal T tends to push E higher as well as DHT. Injections may be better for you in that regard. But transdermals with aromatase inhibitors (AI) might be effective as well.

Your FST is low, which indicates that the problem is likely that the problems is the lack of LH production, not that the teste cannot respond. But there could be two problems, not one. As you are young, taking HCG may get your testes working. HCG, 250iu SQ EOD * would be a good dose. HCG can be quite cheap. 10,000iu at Sam’s Club (USA) with a Business Membership costs $16.25, probably twice as much in other pharmacies).

If you do effective TRT, then your testes will shrink and fertility becomes an issue. Shrinking testes are a bit concern alone and the shrinkage can lead to pain for some. Many report an improvement in mood from HCG. It seems to have a direct effect on the CNS, and there are other beneficial effects on the body from having the testes working other than T and sperm.

  • there is good research to support that dosing

I would suggest the HCG and 100mg/wk of test cyp or eth per week and adjust based on BW after 2 months. And 1mg/wk of arimidex would also be a good idea. The arimidex will probably make you feel better.

So you have insurance for TRT? Some insurance will not pay for injectables, some only for transdermals. Some will not pay for HCG or arimidex. Arimidex is very costly as a drug, but is available otherwise in very inexpensive forms. Transdermals are way more costly than injectables if the costs are hot hidden by insurance.

Press your doc for these items and if he will not cooperate, search for a new doc. If you have to go elsewhere, then ask if he will start you that way one time then send you on your way to seek a new doc for continued care. You need to get copies of your blood work and keep those. Then as you go elsewhere, get copies for the new doc to see where you started.

13

Thank you very much for your reply. My endo suggested I start testim gel but I said i would prefer injections. He suggested 200mg/ml test cypionate of one ml every week. So I understand that 1cc = 1ml right?

So when I read post talking about first cycles being 500mg a week am i correct in saying that with 1 200mg vial of test one would inject 2 1/2 ml a week to equal 500mg? Sorry for the amateur question.

My endo says that, tomorrow morning actually, he wants me to go a get an MRI of my pituitary gland for possible tumors which my be inhibiting test production. What do you guys think. Just sounds like a lot more money out of my pocket.

BTW, I am at my heaviest right now. Been lifting and eating like a horse. I am 6’2 @ 263 with approx greater than 20% body fat. I would think this would change my blood work some. 225-235 in about ideal for me.

So, would the endo suggested test cyp work for me or just simply shut off my testes. Also BTW, i just had a son about 8 weeeks ago and have another child. I was actually considering getting fixed as I dont want more children at this time so I am not neccessary worried about not be able to reproduce at this time…

I also have not started any type of injections or gels until a little futher research and feedback from the forum members. Thanks alot.

14

Also, my insurance WILL pay for TRT.

15

[quote]Stiddy wrote:
Also, my insurance WILL pay for TRT.[/quote]

For prescribed testosterone, test cyp or test eth, the concentration is typically 200mg/ml. Yes, 1ml = 1cc.

The doc suggested 1ml/week. That is double the typical starting dose that is tried, then refined if needed after a couple of months and more blood work. That amount of T will take most well beyond physiological levels.

With high levels of T, or normal TRT amounts for many, there is more aromatization of T–>E. The E competes with T at T receptors and the E thus reduced the effects of the T. The E can also kill libido and energy. The E drives up SHBG and that soaks up more free T. It is the free T that helps you. T that is bound to SHBG does nothing for you; but is a primary BW marker for adjusting dosages.

So with higher T, you can get E problems. If E is high and your have the genetic disposition, you can get breast tissue development which is a major problem. So E is a serious component of your hormone state.

For your body weight, you might need more than 100mg/wk.

E also causes fat deposits patterns that are heavy on the belly and butt. Those are female fat patterns. Getting on T will help you loose that fat and re-proportion your body fat patterns as well. There are several kinds of fats. Fat tissue is, by those who know, no longer considered passive. Fat tissue is an organ and actively responds and released hormones. T–>E conversion primarily takes place in fat tissue. So once you get fat, that alters your hormones and traps you into that state.

Loosing muscle mass and gaining fat around the belly and butt is also one of the primary signs of syndrome-X or metabolic disorder. One becomes estrogen dominant. Insulin resistance starts to develop and blood sugars can increase as a pre-diabetic state. The insulin levels increase over time to try to drive down the blood sugars. Tissues defend themselves by reducing the number of insulin receptors and it spirals out of control. Eventually the pancreas burns out and one becomes insulin dependant. Injecting larger and larger amounts of insulin, but the insulin resistance does not go away. All of this can be reversed if one looses fat and gains muscle. Testosterone can be the big lever to move that situation.

While the above is going on, cholesterol goes out of control and endothelial dysfunction contribute to damage to the arteries. High blood pressure results. High levels of c-reactive protein (CRP) and homocysteine also result. These can be part of your blood work. These markers indicate that things are going wrong, well before physical problems result.

Your CRP is high. You need to take some action. Getting hormones right is probably the best first step. Diet and supplements are also important. CRP is a significant risk factor or predictor of risk.

There are also two types of fat that form around the organs. This visceral fat is a major risk factor for heart disease and stroke. Visceral fat is hard to loose. When you loose weight, the fat in the butt an belly will release lipids before the visceral fat will be affected.

All of this stuff is tied into one’s hormone balance. That also includes DHEA.

You are young and your testes should not be aged. Your pituitary may be at fault. But elevated E levels turn down the LH production of the pituitary. So perhaps you are trapped in estrogen dominance. But in any case, you need TRT to address the hormone issues as they cannot fix the pituitary if there is a problem there. But the MRI might be a good idea to see if there is something dangerous going on. If so, your HG and TSH could be affected now or in the future.

One can take a test where the testes are challenged with a large dose of HCG and blood work after that will show if the expected increase of testosterone occurs. If the testes are not working and the pituitary is ok, one expects to see TSH high or above normal. If the pituitary is not working, TSH will be low and test will be low.

Test will work for you and I think that you need AI to address your already high E levels. Any effective TRT will, by increasing the levels of T in the body, lead to low LH and shrinking testicles. HCG prevents or solves that problem. Many report improvements in mood from HCG. So don’t worry about that aspect.

You do not need to have shrinking testes and when the testes work, they produce things of benefit other than T and sperm. Some guys do not seem to care, but their wives might.

Your blood work does suggest that your doc does know what he is doing.

16

KSman

Thank you so much for taking time out of your schedule to help me. You suggested I look at Arimidex to possibly lower E. My wife is a pharmacy tech and seconds that Arimidex is very expensive. I am sure my insurance will cover some of the cost but what else can I ask my endo to prescribe? I have read on this forum about something called Nova?

Is HCG over the counter?

Yes, he suggested Test CYP 200mg/ml @ 1ML a week. I guess this should get thing going then. Hope I can get past the needle sticking. Always had a problem with them in the past but figured this was the right time to get over it.

Will the prescribed do anything for me in terms of building lean muscle. I train 5 days a week?

Thanks again…I really appreciate your time

17

Check for PM re anastrozole info.

HCG is a peptide hormone, as are insulin and HGH. You need a script. It is not a steroid or schedule III drug. It is injected under the skin (QC/SQ) with a 1/2 (or shorter) insulin syringe. Research shows that 250iu SQ EOD (every other day) maintains testicular function in normal men who where repressed with 200mg/wk of test cyp.

Print this, read and get to your doc:

http://dspace.hsl.washington.edu/dspace/bitstream/2012/52/1/JCEM_2005_Low_Dose_Human.pdf

That is the first research based info for HCG dosing.

Nolvadex is a SERM, which blocks the effects of E, does not decrease E, may actually increase E. Selective Estrogen Receptor Modifier?Modulator. Anastrozole and femara are AI’s Aromatase Inhibitors that reduce E levels by reducing how much T converts to E.

Arimidex/Anastrozole dosing for TRT is typically 1mg/week. For high doses of tests (body builders can use 10-20 times more than typical TRT amounts, the anastrozole doses have to be higher to be effective.

100mg of test cyp or test eth would create fat loss and muscle gains. 200 a lot more I would expect. You need to do some resistance training, low reps, high resistance and expect some sore muscles at the outset. High rep low resistance is exercise that will tone muscles but not get a good anabolic response.

It seems that the best way to go with TRT is the test, plus the AI, and HCG to keep your testes working. Many docs will not do the full kit. If you can get it all, you will do much better and that will be all that you will need in the long run.

The HCG will also get your testes producing T, so that will add to what you inject. So you would get 200 plus what you make.

You will need blood work every 3 months for 6 months, then if you are stable with the BW, try to get on 6 month visits to reduce cost and bother.

You need to log how you feel, whats better, whats worse, whats missing and have this written when you visit your doc. BW is not enough.

Needles: The HCG is into the belly fat, at a 45ish degree angle. Tiny prick on the skin and no feeling in the fat under that. For test, that is injected into muscle (IM). Again some sensation at the skin and almost no feeling past that. Injecting IM into the butt requires a long needle. That takes some courage to learn. Gave me the willies, but I told my doc that I wanted to start that way as many others manage, so I can too. I later discovered that I could inject test cyp with 1/2" #29 .5ml insulin syringes. It is slow, but you can inject in the upper leg (u need more details of that). So that is much easier. But… you need to have thin skin/fat there. If that is a problem, you could use 1" #25 needles until you slim down.

Prices: If you can get a Sam’s Club Business Membership, 10ml 200mg/ml Watson’s test cyp costs $42, ($100 or more at Walgreen’s) 10,000iu of HCG costs $16.25 at Sam’s. Insulin needles are $12 per 100 and #23 1.5" 3ml are $18 per 100 (Walgreen’s charged me over $1 each!!). So that is an option, but if insurance takes care of things, no problem. Some insurance may choke on HCG, so Sam’s might be better. And syringes at Sam’s may cost less than co-pays for syringes if they are rationed out by the month at a typical pharmacy.

Some do not do well on weekly injections at the level crashes and they feel bad. Done that. I now inject every other day (EOD) for my T and HCG. That is a bit extreme for some, but having hormones go way up and down can be extreme too. Many also inject twice a week.

This is a lot of learning. Many of us did not get smooth starts. Hope that this is a good launch for you.

[quote]Stiddy wrote:
KSman

Thank you so much for taking time out of your schedule to help me. You suggested I look at Arimidex to possibly lower E. My wife is a pharmacy tech and seconds that Arimidex is very expensive. I am sure my insurance will cover some of the cost but what else can I ask my endo to prescribe? I have read on this forum about something called Nova?

Is HCG over the counter?

Yes, he suggested Test CYP 200mg/ml @ 1ML a week. I guess this should get thing going then. Hope I can get past the needle sticking. Always had a problem with them in the past but figured this was the right time to get over it.

Will the prescribed do anything for me in terms of building lean muscle. I train 5 days a week?

Thanks again…I really appreciate your time[/quote]

18

Most of the posts on TRT are on the over 35 lifter forum.