High HGB/HCT

[GreenMachineX]

@Nelson Vergel could you also look at this last post?

 

[tareload]

Well, roughly 6 weeks into 10mg daily I was at 550 total at trough. Then 2-3 weeks later, I was at 664 about 5 hours after injection. So, I don't know exactly where my trough was at that point, but if guess somewhere around there. That was 2 months ago. Since then, I had a month at 7mg, and then 3 weeks at 5mg. 2 weeks into 5mg, my total T was 414. Then about 10 days later, it's up to 766. For the complete picture, everything except the 766 was through quest MS or whatever with a range of 250-1100. The 766 was a different lab, range 168-758 and its not specified MS or whatever. Could it just be a huge error? I don't quite feel the same as when I was on 10mg. Definitely sleeping better, I think slower facial hair growth, less anxiety and less *negative* energy.

Other factors I've changed from the 414 would be dropping DHEA shortly before, dropping Thorne multivitamin for just using Hydroxocobalamin B12 and niacin. I've stopped telmisartan because my blood pressure was dropping too low, but blood pressure yesterday morning was still 120/78. So, now, I wonder what my hct and hgb are doing again if that's accurate. I'm hoping it was just a huge error.

I should also mention my total T on 25mg EOD was 537. 50mg twice per week was also 550 at trough. 5mg daily can't result in higher total T lol. I'm flabbergasted.

Dude. Make a table and list out the dosage, frequency, days/hours post injection you tested, test result, test type, test provider, and reference range. How is anyone supposed to follow all this with your chaotic paragraphs? You make your readers do double the work because you don't methodically summarize the data.

Yes its very explainable for ED trough reading to be higher than the trough twice per week on the same weekly equivalent dosage as I've shown here many times. Now be disciplined and make the table.

Also explainable when the tested daily trough is for lower weekly equivalent dosage than the twice per week trough at higher weekly equivalent dosage.

 

[GreenMachineX]

Dude. Make a table and list out the dosage, frequency, days/hours post injection you tested, test result, test type, test provider, and reference range. How is anyone supposed to follow all this with your chaotic paragraphs? You make your readers do double the work because you don't methodically summarize the data.

Yes its very explainable for ED trough reading to be higher than the trough twice per week on the same weekly equivalent dosage as I've shown here many times. Now be disciplined and make the table.

Also explainable when the tested daily trough is for lower weekly equivalent dosage than the twice per week trough at higher weekly equivalent dosage.


View attachment 20609

I don't recall you asking for tables before and this is the first I'm hearing my paragraphs are chaotic. I'm not saying they aren't, but it's never been said before. And...undisciplined...?

Otherwise, my point with the dose comparison was ED at 5mg vs 25mg EOD, not really about the 50mg twice per week. But, sure, I'll make a table in a few.

 

[GreenMachineX]

Quest Diagnostics
10mg daily trough, total T, MS 550 (250-1100)
10mg daily 5 hours post, total T, MS 664 (250-1100)
5mg daily trough, total T, MS 414 (250-1100)

Military Lab
5mg daily trough, total T, unknown type 766 (168-758)

 

[GreenMachineX]

Quest Diagnostics
10mg daily trough, total T, MS 550 (250-1100) 6 weeks
10mg daily 5 hours post, total T, MS 664 (250-1100) 9w
10mg daily...3 weeks
7mg daily...no test 4w
5mg daily trough, total T, MS 414 (250-1100) 2w

Military Lab
5mg daily trough, total T, unknown test 766 (168-758) 2w

The last part is how long I was on each in weeks to account for the timeline and to show that it's been plenty of time total that the last test, the Military base Lab shouldn't be going up anymore...right?

 

[Cataceous]

I'd discount that last measurement. It doesn't make much sense. With your lower dose it is possible that SHBG is rising, which could increase total testosterone at the same dose. But I doubt it would be that dramatic. I expect a retest with Quest would be lower and more in line with the previous numbers.

 

[GreenMachineX]

I'd discount that last measurement. It doesn't make much sense. With your lower dose it is possible that SHBG is rising, which could increase total testosterone at the same dose. But I doubt it would be that dramatic. I expect a retest with Quest would be lower and more in line with the previous numbers.

Thanks. I just purchased another free t and total and cbc I'll get drawn tomorrow. I would also imagine, given my history, with a total test level like that, my free T would be astronomical and I would feel likely similar to the day I went to the ER, but I don't. I'm not well by any means and struggling on a daily basis, but not ER-ready like that awful night on 13mg. Thanks again.

 

[tareload]

I expect a retest with Quest would be lower and more in line with the previous numbers.

Agreed.

@GreenMachineX you are trying to getting an accurate dose response estimate and you switched horses mid-stream so to speak by switching to another TT assay with another lab with another reference range.

At this point stick with your historical relative reference method via Quest and then line them all up. Best wishes.

 

[GreenMachineX]

Agreed.

@GreenMachineX you are trying to getting an accurate dose response estimate and you switched horses mid-stream so to speak by switching to another TT assay with another lab with another reference range.

At this point stick with your historical relative reference method via Quest and then line them all up. Best wishes.

Good points. Sometimes free isn't worth it I guess.

 

[GreenMachineX]

It is still shocking though, that my total test 2 weeks prior went from almost hypogonadal to above range. It's concerning especially because I wonder how many people go to that lab and are also getting huge errors but basing treatment on it since they don't have other references. Or, do errors happen often and I've just been super lucky the past 8 years?

 

[tareload]

It is still shocking though, that my total test 2 weeks prior went from almost hypogonadal to above range. It's concerning especially because I wonder how many people go to that lab and are also getting huge errors but basing treatment on it since they don't have other references. Or, do errors happen often and I've just been super lucky the past 8 years?

VA/military lab brought up a huge red flag for me. Let's go find out the last time they calibrated the RIA/chemiluminnescence method. Daily check samples and weekly calibration? Do they regular do gauge R&R with the technicians.

Ignorance is bliss. Check out this comparison plot:

Detecting Total Serum Testosterone by Chemiluminescence Immunoassays, Radioactive Assays, and Liquid-Chromatography Tandem Mass Spectrometry: A Comparative Study| Crimsonpublishers.com

Testosterone (TES), a C19 steroid hormone with a molecular weight of 288 Dalton, is a vital androgen in mammals [1]. It is mainly secreted by testicular interstitial...

crimsonpublishers.com

Bless @madman / @Cataceous for continuing to bring awareness for standardization/harmonization of TT/SHBG/fT so that laypeople don't continue to lose sleep and be thoroughly confused over all this.

Discussion​

Clinical detection of tTES and other steroid hormones are essential for the diagnosis, treatment, and prevention of many diseases. But the analytical performance of individual assays may not meet the needs of all clinical applications [13], especially when dealing with low concentrations, such as tTES in women and estrodiol in men and postmenopausal women [14]. In the present study, we analyzed the analytical sensitivity in detecting tTES using four platforms. The detected values were higher when using the RIA platform than LC-MS/MS platform, both in males and females (Figures 1 & 2). The values detected by platforms Beckman and the Simens2000 revealed good correlation coefficients with those detected by LC-MS/MS platform when the values were higher than 0.69nmol/L; yet, the Simens2000 platform was more consistent with LC-MS/MS than DXI800. Our data suggested that Simens2000 platform represents a better and more accurate choice for tTES detection. The RIA uses radioactive materials in the detection process; thus, it is suitable for clinical use but has danger to human body. The most common tTES detection methods are chemiluminescence and enzyme-linked immunosorbent assay. Yet, their sensitivity may be affected by different work environments, races, etc. [15,16]. For the past ten years, the LC-MS/MS has been considered the gold standard for detecting steroid hormones; this method offers high separation efficiency, high selectivity, and structural specificity for complex samples [17]. Although LC-MS/MS has the most accurate results using gas-phase liquid chromatography, the test is time-consuming and strict on operation conditions and operators. Besides, its equipment is expensive. In this study, we used LC-MS/MS as the standard.


Check this out:

And guys wonder why one lab has 700 ng/dl at top of range and another lab is 1100 ng/dl.

 

[tareload]

Measurement of Total Serum Testosterone in Adult Men: Comparison of Current Laboratory Methods Versus Liquid Chromatography-Tandem Mass Spectrometry

The diagnosis of male hypogonadism requires the demonstration of a low serum testosterone (T) level. We examined serum T levels in pedigreed samples taken

academic.oup.com

 

[GreenMachineX]

VA/military lab brought up a huge red flag for me. Let's go find out the last time they calibrated the RIA/chemiluminnescence method. Daily check samples and weekly calibration? Do they regular do gauge R&R with the technicians.

Ignorance is bliss. Check out this comparison plot:

Detecting Total Serum Testosterone by Chemiluminescence Immunoassays, Radioactive Assays, and Liquid-Chromatography Tandem Mass Spectrometry: A Comparative Study| Crimsonpublishers.com

Testosterone (TES), a C19 steroid hormone with a molecular weight of 288 Dalton, is a vital androgen in mammals [1]. It is mainly secreted by testicular interstitial...

crimsonpublishers.com

View attachment 20613


Bless @madman / @Cataceous for continuing to bring awareness for standardization/harmonization of TT/SHBG/fT so that laypeople don't continue to lose sleep and be thoroughly confused over all this.

Discussion​

Clinical detection of tTES and other steroid hormones are essential for the diagnosis, treatment, and prevention of many diseases. But the analytical performance of individual assays may not meet the needs of all clinical applications [13], especially when dealing with low concentrations, such as tTES in women and estrodiol in men and postmenopausal women [14]. In the present study, we analyzed the analytical sensitivity in detecting tTES using four platforms. The detected values were higher when using the RIA platform than LC-MS/MS platform, both in males and females (Figures 1 & 2). The values detected by platforms Beckman and the Simens2000 revealed good correlation coefficients with those detected by LC-MS/MS platform when the values were higher than 0.69nmol/L; yet, the Simens2000 platform was more consistent with LC-MS/MS than DXI800. Our data suggested that Simens2000 platform represents a better and more accurate choice for tTES detection. The RIA uses radioactive materials in the detection process; thus, it is suitable for clinical use but has danger to human body. The most common tTES detection methods are chemiluminescence and enzyme-linked immunosorbent assay. Yet, their sensitivity may be affected by different work environments, races, etc. [15,16]. For the past ten years, the LC-MS/MS has been considered the gold standard for detecting steroid hormones; this method offers high separation efficiency, high selectivity, and structural specificity for complex samples [17]. Although LC-MS/MS has the most accurate results using gas-phase liquid chromatography, the test is time-consuming and strict on operation conditions and operators. Besides, its equipment is expensive. In this study, we used LC-MS/MS as the standard.


Check this out:
View attachment 20614

And guys wonder why one lab has 700 ng/dl at top of range and another lab is 1100 ng/dl.

So RIA detects basically other things to give an artificially inflated hormone level?! Ugh...that's crazy that that info is out there and still using it. Well, I retested at quest this morning, and I'm praying my levels look just about identical to what they were 2 weeks ago at 5mg as that would be perfect (for now).

Thanks for posting all that. Definitely helpful.

 

[GreenMachineX]

Got my cbc back!

Rbc 5.68 (.01 increase in 2 weeks)
Hemoglobin 17.2 (hasn't changed)
Hematocrit 50.4 (.6 increase in 2 weeks)
MCV 88.7 (.9 increase in 2 weeks)

I believe this confirms the error at the military/VA lab or the increase would've been more pronounced. I won't change anything on my protocol (other than missing today's dose) until i get the free and total T back but I'm guessing my current symptoms and deterioration is due to continued lowering of e2, or possibly free T. Praise God something is going right.

 

[GreenMachineX]

@Cataceous @readalot @Nelson Vergel
I got the labs back from Monday...keep in mind this is still 5mg on average. So sometimes a little closer to 6 and sometimes a little closer to 4 since there's no line for 5mg. 3459 was my total testosterone and 1232 was my free testosterone! Below are the labs and ranges.

Quest Diagnostics
10mg daily trough, total T, MS 550 (250-1100) 6 weeks
10mg daily 5 hours post, total T, MS 664 (250-1100) 9w
10mg daily...3 weeks
7mg daily...no test 4w
5mg daily trough, total T, MS 414 (250-1100) 2w
5mg daily trough, total T, MS 3459 (250-1100) 2w

For reference, below are the free testosterone results corresponding with the above dose.

Quest Diagnostics Dialysis
10mg daily trough, 147 (35-155)
10mg daily trough, 174 (35-155)
5mg daily trough, 105 (35-155)
5mg daily trough, 1232 (35-155)

As previously mentioned, I only changed my type of b12 and dropped telmisartan, dhea and the multivitamin. I promise to all of you this is the real results. What do I do? Is this an error? Do I have to pay to get it redrawn?

Is there a chance that previously the methylcobalamin and methylfolate increased methylation so fast that's why I was dropping my levels so rapidly day to day? I realize this is a stretch but I don't know what else to think. I've shown Cataceous my labs where my test levels dropped 50% in 24 hours when I was on EOD.

If this is accurate, how long until my levels are back to where they should be if my last injection was Sunday morning, 3/27?

Also, regarding the military/VA labs. These results were drawn 5 days before my astronomical testosterone results from Quest above. Those results are below:
Testosterone, total 766 (158-768)
Testosterone, Free 11 pg/mL (8-25)

More reason to believe the Quest results are an error?

Thanks in advance.

 

[tareload]

More reason to believe the Quest results are an error?

Absolutely! My sympathies. I use Labcorp myself

You aren't holding out on us are you? No secret blasts?

 

[GreenMachineX]

Absolutely! My sympathies. I use Labcorp myself

You aren't holding out on us are you? No secret blasts?

I promise, no blasts. I'm too scared of a heart attack or something. I'm freaking out right now about this.

 

[tareload]

I promise, no blasts. I'm too scared of a heart attack or something. I'm freaking out right now about this.

Don't. The result is erroneous.

 

[GreenMachineX]

Don't. The result is erroneous.

Thanks. What's the next step though? Contact discountedlabs for a redraw?

Just for kicks and giggles, how long would it take for results like that to become normal or even hypogonadal? About 2-4 weeks?

 

[GreenMachineX]

I also just had the labs redrawn. Discounted Labs gave me a refund already. Are those numbers blast numbers or even higher than cycle numbers?