Labs at Six Weeks: Little Total T Improvement

[rhino5169]

The only thing I might add, how do you sleep. Are you getting enough sleep. A good night's sleep makes a big difference in a way I feel.

It'sIt's notnot thethe bestbest butbut notnearlynot nearly asas badbad asas itit usedused tobe.

wow, I'm still getting weird website spelling vodoo.

it's not the best but not nearly as bad as it used to be. Its been about the same though for the last couple months so I don't think that is anything of much consequence with these issues.
I really feel its a matter of getting these hormones adjusted.

 

[Vince]

I read that creatine will help raise your DHT, other ways increase your testosterone, lose weight and workout.

 

[rhino5169]

Ok guys,

I was / am having some issues and got lab work done. Posted are the results, some of which I did not expect, but it seems adjustments are necessary and hopefully i'm getting closer to feeling like I should.

PLEASE let me know your thoughts.
Vettester...Vettester....

Protocol:
HCG m/w/f 30iu
Test Cyp m/w/f 30ml = 180mg / week
Testosterone Cream 2 clicks daily (30ml- 50mg/ml)
DHEA 50mg daily
NP Thyroid 1 grain daily

VIT B12 inj. - 200iu once a week
Lipo-c 100iu daily

 

[rhino5169]

Help a brotha out guys.

Here's a nutshell:

High - Free T (surprised)
High - Estradiol (hesitantly suspected)

Good to High - DHT
Good to High - DHEA
Good to High - Total T (shocked, never been so high in my life afaik)
Good - SHBG (right in the middle)
Good - TIBC

Low - Ferritin
Low - Iron serum
Low - Iron saturation

Not sure how to take the thyroid numbers.

Not sure why I feel no better than when I had low T, low E and wasn't on np thyroid.

Not sure why when T and Estradiol went from the basement to the penthouse I didnt at least feel good while it was rising through the "zone".

WTH is going on.
Won't have another consult for ~2 months.
Help.

 

[rhino5169]

Been investigating T to E ratio and going by that and my TT number I am low e. I should be 54 to 77.
Wondering how much this is playing a part.
Also wondering how my thyroid numbers look.

 

[CoastWatcher]

I don't look at the T/E ratio as an absolute, as a hard and fast indicator of anything. My doctor says it's one value that is certainly worth considering, but it has become an exercise in number chasing for too many guys. It is suggestive, not diagnostic. I would certainly not argue that your estradiol is "low" at this point.

 

[rhino5169]

I'm trying not to be a symptom chaser but it's something im looking at because i've always had symptoms of low E. Now that my T number is up there, I thought things would improve but their exactly the same.
Thanks for responding. Looks like everyone else bailed on this thread.

 

[Vettester Chris]

Rhino, were you 'fasting' at the time of the labs? Glucose seems a bit high for fasting purposes ...

Again, sticking more on the thyroid side ... Both Free T4 and Free T3 are hovering in the low 40% percentile of their respective reference ranges. I don't see a current Reverse T3, so I can't comment on it or its ratio comparison with FT3. However, "if" everything is/was working just right, you would probably want to see that Free T3 sitting in the 50% to 80% side of the reference range, say like 3.2 to 3.8pg/nl give or take ...

Now, I wish it was that simple, then it would be as easy as just titrating your NDT grain dosage. Unfortunately, it's not that simple. Your iron and ferritin levels as you can see are super low. Much too low for T3 to work effectively at the cells. So, if you titrate your NDT, FT3 is going to increase, but so will RT3. With your iron & ferritin at those levels, FT3 will pool. The body will pick up on this and turn up the demand for T4 to convert higher levels of RT3.

That is a great natural regulation switch, which picks up when we are sick, overly stressed and fatigued, etc., conserving resources and energy as the body repairs. Pooling becomes a bit more problematic in this case, because you're administering exogenous thyroid meds, which have both T4 and T3 (plus T2 and T1 if you get technical lol). Unfortunately, thyroid medication can be counterproductive in certain instances, and this is one of those instances. This is just my .02 my friend, I'm not a doctor, and others will have opinions. Just do your research and get familiar with how the pathways really function, and what their purposes are (?).

If you're doing a lot of donating of blood, I'd suggest stopping for a bit, but you really need to have a physician give you some direction on this(?). Some serious elemental iron would be in order, but you also need to factor in adequate supplementation of Vitamin C and other items to make this work ... First, try to determine why these levels are so low. If it's just continuous donations, easy peasy. If it's some other metabolic condition, work close with a good physician to find the root and get your program on track.

 

[rhino5169]

Rhino, were you 'fasting' at the time of the labs? Glucose seems a bit high for fasting purposes ...

Again, sticking more on the thyroid side ... Both Free T4 and Free T3 are hovering in the low 40% percentile of their respective reference ranges. I don't see a current Reverse T3, so I can't comment on it or its ratio comparison with FT3. However, "if" everything is/was working just right, you would probably want to see that Free T3 sitting in the 50% to 80% side of the reference range, say like 3.2 to 3.8pg/nl give or take ...

Now, I wish it was that simple, then it would be as easy as just titrating your NDT grain dosage. Unfortunately, it's not that simple. Your iron and ferritin levels as you can see are super low. Much too low for T3 to work effectively at the cells. So, if you titrate your NDT, FT3 is going to increase, but so will RT3. With your iron & ferritin at those levels, FT3 will pool. The body will pick up on this and turn up the demand for T4 to convert higher levels of RT3.

That is a great natural regulation switch, which picks up when we are sick, overly stressed and fatigued, etc., conserving resources and energy as the body repairs. Pooling becomes a bit more problematic in this case, because you're administering exogenous thyroid meds, which have both T4 and T3 (plus T2 and T1 if you get technical lol). Unfortunately, thyroid medication can be counterproductive in certain instances, and this is one of those instances. This is just my .02 my friend, I'm not a doctor, and others will have opinions. Just do your research and get familiar with how the pathways really function, and what their purposes are (?).

If you're doing a lot of donating of blood, I'd suggest stopping for a bit, but you really need to have a physician give you some direction on this(?). Some serious elemental iron would be in order, but you also need to factor in adequate supplementation of Vitamin C and other items to make this work ... First, try to determine why these levels are so low. If it's just continuous donations, easy peasy. If it's some other metabolic condition, work close with a good physician to find the root and get your program on track.

Thanks a bunch Chris.
Yes I was fasting, however I am diabetic with dawn phenomenon plus a level of 130 is better than somewhere in the 150s or 160s which isn't was previously and isn't had an a1c of 6.6, so Im guessing that will be even lower now.

I have not donated blood for years.

I'm not really educated on the thyroid tests and I'm not really sure how to find out what is causing these numbers. I guess I'll wait and see what the dr says at my next consult.

Thanks again.

 

[rhino5169]

Side question:
I know you're not giving medical advice but in your opinion would some form of ED be caused by the low e to t ratio or the low iron and ferritin or the thyroid numbers?

 

[Vettester Chris]

Side question:
I know you're not giving medical advice but in your opinion would some form of ED be caused by the low e to t ratio or the low iron and ferritin or the thyroid numbers?

IMO, it's about finding balance. 48 on an E2 Sensitive scale would not bode well for me in the ED department. Personally, I think you have too much going on with your protocol, but maybe I tend to be on the conservative side of things. Your Cyp and HCG combined is more than I do for my protocol by itself, but then you add the Test Cream and it's quite a bit of compound taking place. With everything described above, it just sounds like you have a lot of stuff going on, and stress is evident based on your cortisol circadian profile.

 

[rhino5169]

Prolactin is 13.4 <4.0 - 15.2>

So it's in the 'normal' range but at the upper end.
Thoughts?

 

[CoastWatcher]

Prolactin is 13.4 <4.0 - 15.2>

So it's in the 'normal' range but at the upper end.
Thoughts?

My doctor and I have discussed prolactin, in a general fashion as my own isn't a presenting problem. She has said that she never treats "elevated" prolactin until it is really, truly, elevated. Over enthusiastic suppression can lead to problems. Now, having said that, there are other schools of thought, guys who add cabergoline to their protocol when in range.

 

[CSI007]

I jut realized that you first test was on a Monday 2 days following your last injection. Personally if I ever skipped a day I bet I would feel it. Maybe EOD would be best and test after 6 weeks?

 

[rhino5169]

I jut realized that you first test was on a Monday 2 days following your last injection. Personally if I ever skipped a day I bet I would feel it. Maybe EOD would be best and test after 6 weeks?

The injections are m/w/f but the cream is every day.
Would that extra day really make any difference?

I'm thinking at this point my E needs to come down. 2 out of 3 theories, or formulas tell me it's too high. It's 48 and my ratio is 22. I know a few have said don't put too much thought into the ratio but I have to in order to figure this out. I think the ratio is supposed to be 30 - 50 which means my E should be somewhere around 30, which makes total sense now.

Also, another thread made me realize how important important iron and ferritin could be. Both of mine are very low so I'll try to get those up too.
Anyway, I need to go in around dre direction and I think that's the more logical place to start.
Thanks, I'll keep this updated.

 

[rhino5169]

What frustrates me is the time lag of 4-5 weeks after lab work to have a consultation with defy. When protocol changes are needed waiting those 5 weeks plus another week to receive the meds really, really sucks.

 

[Vince]

What frustrates me is the time lag of 4-5 weeks after lab work to have a consultation with defy. When protocol changes are needed waiting those 5 weeks plus another week to receive the meds really, really sucks.

It's because there aren't very many good TRT doctors or clinics, so Defy's very busy.

 

[rhino5169]

It's because there aren't very many good TRT doctors or clinics, so Defy's very busy.

I know. When there's a 5 week backup though things need to be revamped to be more efficient. Growing a business or practice too fast can be detrimental. They need either more resources or a better plan to treat their clients in a timely manner.
A week is timely, 5 weeks isn't.

 

[CoastWatcher]

I know. When there's a 5 week backup though things need to be revamped to be more efficient. Growing a business or practice too fast can be detrimental. They need either more resources or a better plan to treat their clients in a timely manner.
A week is timely, 5 weeks isn't.

There are few specialty practices that can routinely offer patients an appointment within a week. Demand simply exceeds capacity to schedule in that fashion. Unfortunately.

 

[Vince Carter]

Prolactin is 13.4 <4.0 - 15.2>

So it's in the 'normal' range but at the upper end.
Thoughts?

PRL test strategy: sex/orgasm within 12-24hrs can skew a prolactin result and make it look elevated.