Recommended Blood Tests - How To Justify?

Hey Guys,

I’m a 36 year old male - about 210 pounds. Between 15 and 20% bf. Did one botched cycle of Test Cyp early in 2009. Realized I had pubertal gyno (didn’t recognize it as such until I started reading and saw that it seemed to be getting worse on the Test Cyp). Did another cycle with ancillaries and just finished weaning off of AI following Nolva PCT.

That was just some background.

I am going in to see my doctor later this week to ask for some blood tests. Haven’t seen him in a very long time so I am going to request the following:

complete blood count
chemistry profile (to include liver-kidney function, glucose, minerals, lipids, thyroid (TSH) etc.)
Free and total testosterone
Estradiol
Progesterone
DHEA
LH
Homocysteine
Prolactin
FSH
GNRH
C-reactive protein

My first question is: am I missing anything in my list? Should I be more specific about the thyroid or liver enzymes or is it sufficient to just ask for the “panel”?

My second question is: if (when) she asks me why I want all these tests and to justify them, does anybody have any suggestions as to what I should say? I don’t really have much of a libido so that could justify the testosterone for example but how do I justify asking for prolactin levels for example?

Of course, I really shouldn’t have to justify any of this and I will become insistant with her if necessary but it could help to have some kind of answer ready…

Thanks,

Die

Anyone? KSMan, are you out there? :wink:

It seems awkward to describe all possible symptoms of hypogonadism for you to cherry pick. What problems are you having?

brain fog
libido
ED
muscle wasting
thin inelastic skin
dry skin
insulin resistance
generalized cardiovascular problems
cholesterol
loss of hair on lower legs
moody/grumpy/short tempered
small things are annoying can can set you off
intolerant of noise
lack of joy or satisfaction - [getting into dopamine issues]
social withdrawal
gyno
passivity
low energy, no ambition
slower hair and nail growth, thinner and brittle nails
attractive girls become objects of beauty and not object if lust
changes to size of testes and how they hang

If you have good muscle mass you can’t really argue that you are in a catabolic state from low T levels.

Many of these problems are common to low thyroid levels and many docs are not very useful with subclinical hypothyroidism. Many of these things will not be specific to hormone problems for most doctors. Thyroid levels are not part of CBC or chemistry. TSH, fT3, fT4. You should be first aware of your iodine intake.

Never test DHEA as is is pulsatile. DHEA-S levels are quite steady and what should be tested.

Skip GNRH and progesterone. These are for followup if at all.

What are you seeking? Prescribed gear? Treatment for gyno? Do you want to be on TRT? If you get on TRT and can’t get hCG… then what?

If you are doing gear, then taking some adex should be an easy step.

Thanks.

You’re right. I guess there is a list a symptoms that could be related to use of gear or not.

Actually I was most interested in “what a 36 year old guy (who has done gear) should have tested to cover his bases”. Granted some of the tests are related to the fact that I experimented with steroids, others are just general health precautions I suppose (like C-reactive protein), not directly related to prior use.

It’s just that I don’t want to admit prior use (so it does not go on my medical record) but I’m afraid that she might look at me funny when I hand her this laundry list of blood tests! Anyway, I have had lowering libido through my 30’s (even before use so that should be reason enough) and when I did use, I felt pretty damn good libido-wise and in general.

Bottom line: First and foremost I want to be healthy. I want to monitor my health. I want to correct any deficiencies (if necessary). And I would like have my gyno surgically treated once I have some answers.

It’s more of a rhetorical rant - thanks for helping me adjust the list.

Die

Hey KSMan - I finally got my lab results back. This is about 3 months post cycle. I couldn’t get everything I wanted because my doctor gave me a hard time that I need to have a reason to get the tests done. I had to twist his arm for the estradiol.

Anyway, could you (or anyone else) please comment on these results? I’m going in for a checkup in a few weeks but if there is something that needs to be addressed urgently, I will insist that I see him sooner. Also, in a lot of cases below the values seem to technically be within ‘normal’ range for my age (36) but that’s not good enough for me. I don’t want to be on the low side or on the high side if you know what I mean. For example, my estradiol is at 99 and the reference range they give is 0-161. This seems high to me (even though it may not be high for a 36 year old man). If there is a way to rectify these things (HCG, aromatase inhibitor for example) I would like to have your advice. Going to re-read the TRT stickies now…thanks.

Hemoglobin 175 G/L
Hematocrit 0.515 L/L
WBC Count 6.4 X10 9/L
RBC Count 5.54 X10 12/L
MCV 92.9 FL
MCH 31.6 PG
MCHC 340 G/L
RDW 12.8 %
Platelet Count 209 X10 9/L
Absolute Neutros 2.9 X10 9/L
Absolute Lymph 2.5 X10 9/L
Absolute Mono 0.6 X10 9/L
EOS 0.3 X10 9/L
Baso 0.0 X10 9/L

Glucose Fasting-Ser 4.9 MMOL/L
Creatinine 80 UMOL/L
eGFR 95

Sodium 141 mmol/L
Potassium 4.1 mmol/L
Alk Phos 91 U/L
AST 71 U/L
ALT 78 U/L
CK 1659 U/L
Gamma GT 36 U/L
Cholesterol 4.3 mmol/L
Triglycerides 0.62 mmol/L
HDL Cholesterol 1.15 mmol/L
LDL Cholesterol 2.87 mmol/L
Chol/HDL Ratio 3.74

TSH 2.17MU/L
Vitamin B12 1109 pmol/L
Ferritin 257 UG/L
LH Serum 10.4 IU/L
FSH Serum 11.5 IU/L
Testosterone 17.7 nmol/L EDIT ----> 510 ng/dL

Free Testosterone PND (I called the lab and they said this means it has ‘not been done yet’)

Estradiol 99 pmol/L EDIT ----> 27 pg/mL

EDIT I just did the conversions above to make the numbers more user friendly for this forum.

Not familiar with mol units, need ranges.

Hematocrit is getting high. You look to be at risk if on TRT. Can you donate blood?

E2 99 pmol/L / 3.671 → 27pg/ml . Not so bad, but I found E2=27 would be a problem for me.

Your TT = 510ng/dl

http://www.unc.edu/~rowlett/units/scales/clinical_data.html

You may get a free testosterone index instead of absolute.

How do you feel?

Thanks KSMan. Please see OP for EDIT.