Need Some Help (Blood Work Icluded)

[quote]KSman wrote:

Your LH/FSH suggests that your hypothalamus and pituitary are working OK and that your testes are the problem.[/quote]

KSman, I went to the Uro yesterday and to be honest I had no hope since most could care less about what I think or what you and others think. So I went in and was honest with him and had all my talking points. I told him I didn’t want to do his job for him just wanted to present some info and see if it makes sense or if it sparks thoughts about how to fix me or at least make me happier/healthier.

So he was really cool right off the bat, I went over my blood work and he seemed to think everything was fine, didn’t have an answer to IGF-1 or GH since he didn’t have a back ground in it. He did state the test is in the normal range, but I felt better in the past with a higher level then who is he to say that 471 should be sufficient for me. He said everyone is different. He also stated that there is some issue with my hormones and their function that could have been from past AAS and GH use or Chemotherapy for treating the Hodgkins. Either way something is out of wack, since I carry the fatty tissue in my mid-section.

The interesting part is about 3/4 of the way through the visit he states LH/FSH are fine and working, but there may be an issue with the pituitary singling the testes! No shit! So I pulled out this post that I printed and read him your reply. I followed that by I know the internet is a great tool, but it probably pisses him off when people do this, but that I just want to do the best for myself and fix my issues. He was really cool about it.

So for now he wanted to start the TRT, I chose Andro-gel over the other options and he was fine with that and also gave me a card for $20.00 discounts on prescriptions fills. My co pay was $10 which is a plus. He did agree that free test is a number and may not show the whole picture, I could have poor reception and not utilizing the hormone like I should or using as much as I could. Either way he is going to check SBHG, T3/T4 and free test in three weeks to see where we are. Then go from there. He wasn’t convinced that my Thyroid had issues, but he also wasn’t going to rule out that it may be sending mixed signals.

Here’s the strange part, my temp has been below 97 all week, until this morning it was 97.9 and 98. I checked it twice to make sure and also ran it under hot water to see if it was working, it was working ran up to 103 then showed a nice big “H” for call the amber lamps to come get you. So I know it’s functioning, also to note I started my gel last night at 8 pm and took my temp at 8:30 am the next morning. You think that could have made that change? I have also been doing the Vit D, DHEA, CoQ, Salmon oil, 3,6,9 oil since last Sunday.

Long post but wanted to touch base after the visit.

96.9 for a morning temp

So the gel blows, it’s a bigger pain in the ass then I thought it would be. I put it on in the AM, come home and want to swim, but not sure how long I need to leave it on my body to get the full benefit. I’ve read the damn packet several times and it only states if you have skin to skin to was the area with soap and water. I’ll see how the next 3 weeks go and probably go back to shot.

KSman, do you know if they’d let me do a Sustanon 250 and deca? Not sure about the deca, but the Sustanon has a nice blend.

You do not need a blend. That is an attempt get smoother T levels, just inject more often and be done with it.

Deca? You are insane!

Not sure, I used it when I was younger (of course not by prescription) and had decent results. Although this may be the reason I’m supplementing hormones now after using at a young age and over dosing on everything I took.

I’ll see what my blood work looks like by the end of 3 weeks and go from there. I just don’t like putting the gel on in the AM and then by noon the family wants to jump in the pool, I feel it didn’t have time to do its job so I end up wasting it by getting in the pool.

I could do the cyp in 2 shots over the week, I really need to look into insulin needles if I go the shot route again. I could do it in the delts and quads to lessen the abuse to my cheeks.

Thanks again for the replies KSman, I really do appreciate the help and you obviously know what you are talking about, since the Uro mentioned the same stuff you did in your first reply.

[quote]Braunbeck wrote:
So here is what is up, I’m 5"11 and currently 320, graduated high school at 265-275. I’ve been heavy my whole life, always been semi strong, agile, mobile and hostile. Was a good runner for a fat guy, could jump for a fat guy, etc. I’ve always been into powerbuilding lifting heavy is fun, cardio blows so it’s not something I can say I like doing and do/did it often.

I started using AAS in my late teens, early 20’s and late 20’s (did GH late 20’s). Well over a year ago I start feeling really run down (sleeping 1-3 hours daily after work), not recovering as well as I used to and my weight got up to 353 and it was really difficult to drop weight. I had my test levels checked several times over the years since I was diagnosed with Hodgkin’s Lymphoma back in 2000 (did 6 months of Chemo).

After chemo I got my test levels checked and they were 290 and I was told that was good, I was 30-31, then I did a few more checks over the years and it slowly decreased to 262, so I started therapy. I was doing 1 cc/ML a week of cyp 200 mg. I did this for 46 weeks and my levels were up to 1158, doc pulled me back to 3/4 cc/ML a week, I did that for 10 weeks and then decided I was sick of sticking my self in the ass and that I wasn’t seeing the weight loss and body comp I thought I should be seeing. So I wanted a better picture of my hormones. I went to an ENDO and did a full run down…

Here it is:

IGF-1 89 ng/ml range: 106-255

Comprehensive Metabolic:

Sodium 142 meq/l range: 133-145
Potassium 4.3 meq/l range: 3.3-5.3
Chloride 102 meq/l range: 93-108
Carb Dioxide 26.5 meq/l range: 23.0-33.0
Bun 13.1 mg/dl range: 6-20
Serum Creat 1.0 mg/dl range: 0.7-1.2
SGOT (AST) 44 iu/l range: 0-40
SGPT (ALT) 48 iu/l range: 0-41
ALK Phosphatase 78 iu/l range: 40-129
Bilirubin Tot 0.5 mg/dl range: 0.1-1.0
Calcium 9.7 mg/dl range: 8.4-10.2
Protein/Total 7.2 g/dl range: 6.0-8.4
Albumin-Serum 4.6 g/dl range: 3.5-5.2
eGFR, non-african > 60 ml/min range: >60
eGFR, afric/amer > 60 ml/min range: >60

Lipid Profile:

Cholesterol 209 mg/dl range: 0-200
Triglycerides 112 mg/dl range: 35-200
HDL 54 mg/dl range: 35-55
VLDL 22 mg/dl range: 0-75
LDL-calc’d 133 mg/dl range: 0-130
CHOL/HDL Ratio 3.9 -------> see line below
Range: Danerous = >13.5, High Risk = 6.5-13.4, Average Risk = 4.5-6.4, Below Average Risk = 3.5-4.4, Low Risk = <3.5

TSH 1.180 uIU/ml range: 0.270-4.200

Glucose/Fast 95 mg/dl range: 70-99

FSH 7.1 mIU/ml range: 1.5-12.4
LH 9.5 mIU/ml range: 1.7-8.6

Cortisol Random 12.8 ug/dl range: 4.0-22.0 (8:00 am - 10:00 am)

DHEA Sulfate 273 ug/dl range: 120-520

Estradiol 26 pg/ml range: 8-43

Testosterone 471 ng/dl range: 250-1100

Free Test % 1.26% range: 1.5-2.2
Test, Free 59.5 pg/dl range: 35.0-155.0

Vitamin D 25-oh 38 ng/ml range: 20-100
Vitamin D3 38 ng/ml
Vitamin D2 <4 ng/ml

I don’t have the other test results since I left them with my primary care doctor. I should have just stuck with the cyp or asked for gel and some anti-est to help out. As you can see everything is clinically NORMAL. I hate to use this word, but FUCK! I was thinking it was thyroid or something that could be out of wack. The only thing that is below it IGF, the Endo thinks it could be pituitary issue, whether that be a tumor or damage from using GH back in 1999! I’m not sure, but she wants and MRI, I don’t really think it’s useful at this time, because if they find it’s low/not producing and nothing else is the cause, then I’m stuck with doing GH therapy, but since I’ve had cancer in the past it’s a no go! I asked her about clomid, I read it can help bump the pituitary production (not sure on this though).

Anyway any help is appreciated and welcomed. I’m going to my primary again to see about getting on the gel or back on cyp, I just felt better daily and felt like I could function normally without feeling run down and coming home to take a nap everyday after work.

[/quote]

In order to know where to begin with anything there needs to be a complete medical history to rule out potential health issues. Your levels are actually fine, but since your thyroid and adrenals are probably out of balance it will make your body not utilize testosterone properly.
I think you are shooting you self in the foot taking TRT when other factors have not been ruled out. I have seen many patients use the same mentality and end up making them selves worse not knowing how interactions of how T levels will lower thyroid and drop cortisol levels making their symptoms worse then what they where. If I were you I would have not gone to TRT right way but look deeper into thyroid with TSH,ft3, ft4, TPO,TGAB,rt3 panel along with cortisol saliva test 24 hour. Your cortisol lvel of <16 is a red flag for potential adrenal issues as well as blood sugar imbalances. One would need to look at your lifestyle, current stress factor and when these symptoms started in order to get a full understanding on what route to take. Testosterone will make you feel good in the long run, but may not be a long termn solution eventually causing more issues down the road as I have seen it cause my self and many patients I deal with on a daily basis.

Hardasnails, your statement is exactly what I’m looking to do. I want to fix the whole issue, but it’s like taking your car to the mechanic and trying to educate him. I have yet to find a doctor that will represent me in the long run. I have always been big, I have a picture of me at 3 with a half shirt (those where cool at one time!) and my little belly wash hanging out the bottom, I was 210 pounds at 8th grade graduation (1987) (never touched a weight and frankly was weak for my size), although I was very active and had been my whole life.

I was always into bmx bikes, skate boarding, recreational basketball, baseball, football and honest I was good at whatever I did. I started high school around the same weight since I was pretty active with karate that summer (was going 2-3 hour plus classes a day and I was good at for a big fella). Got up to 240 starting sophomore year, broke ankle and gained about 15 more pounds, junior year was 270 and senior year I started at 275, but dropped to 235 for wrestling and graduated (1991) around 260.

This whole time I was heavy in the midsection, but ran a 4.9 forty at 280 pounds starting college, don’t remember what my jump was, but benched 345, squatted 520, hang cleaned 315, etc… The second year of college (1992) I was 285-290, weights were way up, I remember squatting 585 for 5 reps to prove to the coaches that I didn’t lay on the couch all summer, bench was around 365 (never my strong lift), hang clean 365, etc…

I quite school after that, but still lifted, worked and played in a local indoor football league, although around this time I dabbled in AAS. I always lifted for strength and in 1994 I hooked up with a local powerlifting group that trained westside. After a year of training I squatted 960, benched 440 and deadlifted 675 for reps (that was with the cheap Inzer blast shirt and squat suit), BUT I was at a bodyweight of 340 and had to back down.

I ended up quiting the powerlifting team and going back to playing in a local football league. I dropped down to 310 and by the next season I was at 260. I still trained 4 days a week, plus did a few days of racket ball, nothing special. I still carried my weight in my gut this whole time. Fast forward since nothing happened other than getting older, working, kids, first marriage, still lifting heavy, no real diet in place… In 1999 I got separated, had 2 kids to help raise as a part time father.

I still lifted heavy, but would do a lot of outdoor activities with the kids, hiking, walking, parks, etc… I was about 320 at first, but jumped on some halotestin, Rev B, GH to help with getting my body weight back down. Up to this point never did blood work or went to the doc, I was using Dan D’s Body Opus for a diet and got down to 230 ish from 320. Fast forward August of 2000, I actually took about 6-8 months off from training 'cause I bought a new house with my current wife, had my kids full time and had been working as a stock broker since 1996.

Got back to a local guy and right back into the swing of lifting heavy, I was still around 300 pounds even with the layoff. In 2002 I was diagnosed with Hodgkins Lymphoma, did 6 months of chemo, had a mediasteinoscopy, portable cath, blood clot in my right arm and dropped from 320 to 230 and yo yo back to 320, but it was all muscle that I lost since I didn’t train and all fat I gained since I didn’t train. I took about 4 months just to get up the ability to walk around the block and start getting active.

I started training in November and started to focus on a powerlifting meet that January 2004, still at 300 plus pounds with a fat belly, infact the fat belly was still there at 230 pounds during chemo. Any way during the next year I trained with a partner, fathered a third child and did a meet in April '05. Squatted 875 (easy), benched 520, dead 630 (easy), had way more left in me, but it was my first meet back in 10 plus years.

Since then I’ve trained heavy, light, GVT, EDT, OTS BBB, DC, WS, MM you name it. I’ve gotten up to 353 pounds and now down to 320, but been as low as 310. It’s the same thing, blood work is normal, fat in midsection and no-one can understand why I can’t drop fat faster.

As for me, I’m easily pissed off! No real stress, more anger than anything. I don’t really worry about anything since after being sick not much get to me, I’ve had to tell my kids daddy might die so not to many things can get to me. Relationship is fine, kids are healthy, my work is still a stock broker and I don’t really get stressed since I just take orders and do paperwork, I don’t advise.

The reason I started TRT is I was very fatigued. I don’t have a demanding job physically, but I would come home and sleep for 2-3 hours, get up go to the gym, eat dinner and go to bed. This started about 1.5 years ago, I’d sleep all weekend in an attempt to catch up for whatever reason. I had no sexual desires, no dysfunction though, just didn’t feel like it. I sleep/slept atleast 7-8 hours a night.

My diet isn’t bad, although currently it’s not to strict, the last 5 months were beef and rice, chicken and rice, with yams as another carb source and I stayed right at 315 the whole time. We go to the park still, play basketball with the kids (nothing to crazy though), go for walks (still to big to run for distance). I drink a lot of iced tea, green tea, water and diet soda occasionally. I take the normal fish oil, Vitamins, DHEA (about a week now), CoQ10 (about a week now), Beta Alanine, Creatine, protein shakes, gatorade.

I think that should sum things up, I don’t think I’m that abnormal at all. The TRT seemed to help in the beginning, but didn’t proved the longer solution even with elevated numbers (over 1000 at one point).

Let me know if you need other info, although you probably didn’t want as much as I provided, but I want to get to a solution and need the help/guidance from professionals.

TRT will restore thyroid function in some cases. I think the concern is when TRT increases metabolism, low levels of thyroid or cortisol cannot sustain the demands of the increased metabolic demands.

I stress that guys ensure that their iodine intake is reasonable. Often it is not.

With adrenal fatigue, demands for higher metabolic function from TRT can act like a chronic stress that can make the AF worse.

T, thyroid hormones and cortisol are all links in a chain. If there is more than one weak link in the chain, then fixing one does not solve the problem.

TRT is interesting as it can have the ability to motivate men to address other health and behavioral issues, creating improvements that go beyond bio-response to T.

And for other complicating factors, we need to consider and look for the effects of Rx and OTC drugs, steroid use, hair loss drugs, stresses from past illnesses or surgeries, mechanical or adinoma damage to the pituitary, insulin resistance.

Many things can lead to a reduction in libido, the answer is not always low T.

When a highly virilized male has T drop to a low level, the effects can be very negative. Males who have low amounts of body and facial hair, may function quite well at the same levels that cause major problems for males who matured with high T levels. Lab numbers are not enough to state that a guy has enough T.

I have picked out a number of thyroid cases here and some adrenal fatigue as well. Some guys will follow these possibilities and do some research. Some are not really listening.

Yes, this is all very complex. On the other hand, the guys who come to this site have mostly landed from doing web searches for testosterone and can have a narrow focus. This is different from a guy landing in your office with general health problems.

Temp has been 96.4 to 97 over the last few days. Not sure where it supposed to be for a normal reading.

[quote]Braunbeck wrote:
Temp has been 96.4 to 97 over the last few days. Not sure where it supposed to be for a normal reading.[/quote]

98.6 deg. F

Get some iodine intake. Many suggest that waking temps can be a guide to thyroid med dosing. Optimal waking temp? I do not know that. I have seen suggested temps but I did not memorized that.

Prehaps one would start to correlate how they feel through the day to body temp and then use that to determine what temp seems to be optimal for them. That could vary with BMI. If you are snoring before you wake, your oral body temp reading might be bogus from mouth breathing.

Just found: “If your waking temperature averages from 97.8 to 98.2 degrees it is normal.”, you can search for more.

[quote]KSman wrote:
Get some iodine intake. Many suggest that waking temps can be a guide to thyroid med dosing. Optimal waking temp? I do not know that. I have seen suggested temps but I did not memorized that.

Prehaps one would start to correlate how they feel through the day to body temp and then use that to determine what temp seems to be optimal for them. That could vary with BMI. If you are snoring before you wake, your oral body temp reading might be bogus from mouth breathing.

Just found: “If your waking temperature averages from 97.8 to 98.2 degrees it is normal.”, you can search for more.[/quote]

After seeing people from arizona, texas and the florida region. I have seen a high incidents of low vitamin D levels that are atrocious <15 and as low as 4 !! for a girl in florida. you can get a simple 10 ml iodine random spot urine done at quest to see where you are.

[quote]captainbrent wrote:

[quote]Braunbeck wrote:
Temp has been 96.4 to 97 over the last few days. Not sure where it supposed to be for a normal reading.[/quote]

98.6 deg. F[/quote]

Concept: Normal waking temperature is not the same as “normal temp” during the day.

[quote]KSman wrote:
Concept: Normal waking temperature is not the same as “normal temp” during the day.[/quote]

Understood…thank you! I will be starting to take my morning temps so this info is useful.

Cheers!

97.3 today, so for the most part it seems my temps are lower in the AM since I’ve had one below 97, with a few above. I may start to take my temp through out the day to see what my ranges are to see if it even gets up to 98 area.

As for iodine, i just use sea salt with iodine everyday with food, would it be smart to just take a teaspoon by itself please the small usage with food?

Just use normal amounts of salt. If you need more iodine, you can find some supplements that have significant amounts.

So read this (info below) in another post and agree with the frequent dosing, although not sure about the sub cutaneous injections.

“”“”“Injecting every 2, 3 or 4 weeks is horrible. You need to self inject and inject frequently. With frequent injections the volumes are very small and one can inject in the quads [vastus lateralis] with #29 0.5ml 0.5” [50iu] insulin syringes.

These are slow to load but injection times are reasonable as the small plunger diameters create very high pressures. Do not use 1.0ml syringes. This same size syringe can be used for hCG injections, which are also SC.

Small needles will reduce muscle damage. Some use #25 1" needles, but this may not be any “faster” than the above 50iu insulin needles.

You do not need to inject into your gluts with 1.5" needles!

Canadian clinical research has demonstrated that TRT by SC [under the skin injections into body fat] produce steadier testosterone levels and improves sense of well-being. Feel free to find out what is more comfortable for you.“”“”“”

I have been debating about using the insulin needles, but I’m going to pick up a few and give it a shot (literally). Right now the doc wrote 200 mgs Cyp every other week, so I do a half or quarter spread out over the course to even things out.

29 gauge 1/2 inch is IM not suq Q
Sub Q can cause major estrogen issues because it gets trapped in the skin where the aromitase is greatest.
We do not use sub Q with patients because of this issue.

[quote]Hardasnails wrote:
29 gauge 1/2 inch is IM not suq Q
Sub Q can cause major estrogen issues because it gets trapped in the skin where the aromitase is greatest.
We do not use sub Q with patients because of this issue. [/quote]

Is this opinion or fact? The amount of aromatase near the injection deposit is small. Many are doing this and not reporting negative effects. And in the longer term, labs and anastrozole dose refinement would manage any such effects.

And there are reports that high concentration T creams applied to small areas of skin create few dermal T–>E2 issues as the amount of aromatase in the limited amount of skin limited amounts of E2. Same argument.

I don’t think that you should be making this statement.

When you say “29 gauge 1/2 inch is IM not suq Q” - you imply that your statement is specific to this needle, probably not your intent.

I tried a 27 gauge, 1/2 inch today and it was so much easier. I did it in the shoulder and may try other areas. My script says 1 ml every 2 weeks so I was going to do 1/2 ml weekly, but may go to 1/4 bi weekly and see if it helps even things out. Anyway wanted to post my initial trial and will monitor to see how it’s going. Have labs again next week.