Lab Results Drawn 08/07/2013
HEMATOLOGY
WBC…7.3
LYMPHOCYTES…35.1
MID CELLS…6.7
POLYS…58.2
RBC …4.09L (4.2-6.1)
HGB…12.8L (14.0-18.0)
HCT…39.5L (42.0-52.0)
MCV…96.5
MCH…31.4H (27.0-31.0)
MCHC…32.5
RDW…13.1
PLATELETS…164
COMP METABOLIC PANEL
SODIUM…139
POTASSIUM…3.8
CHLORIDE…101
CO2…21.0L (22.0-29.0)
GLUCOSE…94.0
BUN…12.5
CREATININE…1.00
BUN/CREA RATIO…12.5
eGFR…81.9
CALCIUM…9.7
ALBUMIN…4.7
ALK PHOSPHATE…58.4
AST(SGOT)…38.0
ALT(SGBT)…29.0
TOTAL BILIRUBIN…0.4
TOTAL PROTEIN…7.40
GLOBULIN…2.70
A/G RATIO…1.7
SPECIAL CHEMISTRY
VITAMIN D 25 OH…36.4
ANEMIA PANEL
IRON…97
TIBC…334
UIBC…237
%SATURATION…29.0
TRANSFERRIN…284
FERRITIN…63.9
VITAMIN B12…430
FOLATE…>24.6H (5.9-24.6)
LIPID STUDIES
CHOLESTOROL…182
TRIGYLCERIDES…54
DIRECT LDL…98
HDL CHOLESTEROL…73
CHOL/HDL RATION…2.4
THYROID STUDIES
TSH…1.21
T4, FREE…0.72
T3, FREE…3.40
HORMONAL STUDIES
LH…1.39 (1.2-8.6)
FSH…5.66 (1.27-19.25)
ESTRADIOL…20 (20-75)
PROGESTERONE…0.61 (.10-.84)
PROLACTIN…29H (2.6-13.13)
TESTOSTERONE…152.9 (175-781)
LIMITED RESULTS 08/29/2013 just over 3 weeks later
ESTRADIOL…29 (20-75
TESTOSTERONE…563.8 (175-781)
PSA, TOTAL…19 (.00-4.00)
-age…34 YEARS OLD
-height …6’0"
-waist …33"
-weight …209
-describe body and facial hair …sparse thin facial and body hair
-describe where you carry fat and how changed …ALWAYS CARRIED FAT IN THE ABDOMEN, SIDES, AND LOWER BACK. ALSO IN THE CHEST. WHILE I APPEAR TO LOOK STOCKY AND A LITTLE BUFF I THINK ITS BECAUSE OF MY FRAME. I CARRY A GOOD LAYER OF FAT IN THESE AREAS, HOWEVER, I DO NOT LOOK LIKE AN OVERWEIGHT PERSON. BAD COMPOSITION IS WHAT IM TRYING TO SAY.
-health conditions, symptoms [history] …IN MY TEENS I NEVER REALLY DEVELOPED AS MUCH AS OTHER PEOPLE. I HAD LITTLE BODY AND FACIAL HAIR AND MY TESTICLES SEEM SMALL. IVE HAD MORE THAN ONE PHYSICIAN TELL ME THE SIZE IS AVERAGE BUT I FEEL THEY ARE ON TEH SMALL SIDE. IVE ALWAYS BEEN ABLE TO PERFORM AND HAD A HIGH LIBIDO. DEPRESSION, ANXIETY, LOSS OF DRIVE AND ATTITUDE ABOUT LIFE IN GENERAL. LOW SELF-CONFIDENCE, SITUATIONAL DEPRESSION. VERY SENSITIVE
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever…LONG HISTORY OF OPIATE USE, CURRENTLY SUBOXONE 4MG DAILY. NO OTHER DRUGS CURRENTLY. PAST USE OF ALL RECREATIONAL DRUGS.
-lab results with ranges…SEE ABOVE
-describe diet…chicken, egg whites, pasta, fruit, vegetables. some take out food due to current living situation but I try to order smart. (chinese…chicken w vegetable, brown rice, etc.)multivitamin but no supplements.
-describe training…workout about every other day. free weights and push ups, sit ups. haven’t been going to the gym lately but when I do I run a few miles at a time. have always lifted on and off since teens.
-testes ache, ever, with a fever? …never
-how have morning wood and nocturnal erections changed …although I get random erections during the day, I wake up a lot of mornings with no morning wood …prior to TX. Since TRT I’ve been getting morning wood and erections all day. Libido is huge but wasn’t ever a problem.
I went to the doctor about five weeks ago and since it was the first time I had been to this physician he decided to draw blood as he also performed a routine physical exam. When I inquired with the nurse about what they were going to test my blood for, in the course of naming off different things she said “testosterone.”
I was very happy to hear that because I’ve always suspected Low T. My main suspicion came from the size of my testicles and the volume of my ejaculation. They have always been small and I don’t grow much body or facial hair. It has always troubled me psychologically, but I never really associated any of the other symptoms I have with having Low T. I’m speaking of the depression, anxiety, loss of wanting to interact socially, lack of self-confidence, over thinking absolutely everything, etc. etc. etc.
When the doctor came back in the room I expressed my concern about my testosterone levels. He said, “Yeah, we’re big on testosterone here.” It was something I had planned on checking out, but never dreamed I would be killing two birds with one stone. If anyone has any experience with addiction, I’m sure they know addressing that has been more important than the testosterone issue. In retrospect, I think much of my addiction may have had to due with the feelings I was having as a result of Low T.
I returned to the doctor the following week to go over the results. I asked the nurse to bring me a copy while I waited for him and was pretty shocked when I saw the number 152.9L (175-781). Now I obviously was expecting a low number, but the results were quite shocking. He also told me that was anemic which was something I had been told recently by another doctor. I understand this can be a result of low T and another cause of lethargy.
My Prolactin was also VERY high. The number is 23.97 (2.64-13.13) I did a lot of research on my own and realized I may have some type of pituitary problem. My FSH and LH are low, but in normal range, technically. While I have not confirmed my diaqnosis with my doctor, I am assuming it is secondary hypogonadism based on my low FSH, LH, and T levels. I think a major contributing factor is the high prolactin.
After my suggesting it, my dotor ordered an MRI of my brain including my pituitary gland. I realize the high prolactin could be a symptom of a pituitary adenoma. He also wanted to start me on Androgel, but I told him I would prefer IM injections. He agreed and we started on that day with Testosterone Cypionate 200mg/ml. 1ml bi weekly. He also prescribed the topical, but I opted to go with Axiron, one pump under each side, axillary. This was to avoid transfer to my loved ones. While I was excited, part of me wishes I had explored other options such as HCG before jumping into the Testosterone. I was just so desperate because of the way I felt I wanted to get something done.
I returned to the doctor after two weeks and we did another blood draw, at which time I also received my second IM shot. When I went back for my third shot, it had been a total of four weeks since induction of exogenous testosterone and my blood test results had shown an increase from 152 to 563. My estradiol went from 20 to 29.
While I feel remarkably better mentally and physically, I haven’t noticed much difference in my body composition. However, I do realize it has not been very long and that my take more time. I actually gained almost ten pounds between my second and fourth week on the therapy. I have some questions, and would appreciate any feedback or reply.
- Does anyone have any input on high prolactin and the cause of it? I realize it could be a pituitary adenoma. I have also read that some medications can increase prolactin, but none that I have taken. Any other reasons that have been discovered?
- My estradiol started at 20 and has gone to 29. Since the reference range is 20-75 my doctor doesn’t feel I need an AI. Does anyone disagree? Is 29 low given the reference range or is that not of importance? I’m still a little unclear on how the reference range affects the result. I get that it’s a range of the people that particular lab has tested, but im confused about whether or not the result would be the same number if a different reference range was used. Can anyone explain if that is the case?
- If my level was 563 ten days after my injection what can I expect it was say three days after my injection. How fast and how drastically does it drop off. I’m going to change the frequency to weekly starting this week and I’m wondering if I should increase my dose considering that I stopped the Axiron. From what I have read the bio-availability of Axiron is very low. If I do increase should I go from 100mg to 200mg or step it up slower. I’m worried at 200mg that my Estradiol would rise greatly. How long can I expect it to take before I notice a considerable change in body composition or would I have already if it was going to happen with my current living habits and dosage.
- HCG My doctor doesn’t seem to be well informed about HCG. He’s unwilling to prescribe it in an IV form. He went as far as to say it would be mal-practice. He did offer the sublingual version at $125 for 1000iu from a compounding pharmacy he “has a relationship with”. He orders it mostly for women interested in weight loss. He was pretty adamant about the fact that he felt I would be wasting my money. He said this form that is taken under the tongue and is a “watered down version.” Has anyone used the sublingual form? Can you inject the sublingual form? I have read that 500iu a day before your shot and a day after bi weekly is sufficient. Any ideas on what would be good FOR me? Given my situation and labs.
I realize answers to these questions can be found in various threads which I have been reading through for weeks. I still have these questions and would appreciate any direct feedback or conversation. Like often stated each situation is different, and I’m hoping to gain some insight from someone more experience regarding my case specifically.
thank you in advance for your time and consideration.