Latest Blood work - Comments Welcome

[tom1959]

Lab Receipt: 7/7/2014 12:47:00 PM Collection: 7/7/2014 7:37:00 AM Results: 7/9/2014 6:05:00 PM

WBC
RBC
Hemoglobin
Hematocrit
MCV
MCH
MCHC
RDW
Platelets
Neutrophils
Lymphs
Monocytes
Eos
Basos
Immature Cells
Neutrophils (Absolute)
Lymphs (Absolute)
Monocytes(Absolute)
Eos (Absolute)
Baso (Absolute)
Immature Granulocytes
Immature Grans (Abs)
NRBC
Hematology Comments:
Glucose, Serum
BUN
Creatinine, Serum
eGFR If NonAfricn Am
eGFR If Africn Am
BUN/Creatinine Ratio
Sodium, Serum
Potassium, Serum
Chloride, Serum
Carbon Dioxide, Total
Calcium, Serum
Protein, Total, Serum
Albumin, Serum
Globulin, Total
A/G Ratio
Bilirubin, Total
Alkaline Phosphatase, S
AST (SGOT)
ALT (SGPT)
Testosterone, Serum
Comment:
Free Testosterone(Direct)
LH
FSH
Estradiol
Prostate Specific Ag, Serum
Estradiol, Sensitive

[TH="width: 35%"]Description[/TH]
[TH="width: 15%"]Out-of-Range[/TH]
[TH="width: 15%"]In-Range[/TH]
[TH="width: 10%"]Units[/TH]
[TH="width: 20%"]Expected[/TH]
[TH="width: 5%"]Status[/TH]

[TD="colspan: 5"][/TD]

[TD="colspan: 6"] Patient is Fasting [/TD]

[TD="colspan: 6, align: left"]005009 - CBC With Differential/Platelet[/TD]

[TD="align: center"]6.8[/TD]
[TD="align: center"]x10E3/uL[/TD]
[TD="align: center"]3.4-10.8[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]4.88[/TD]
[TD="align: center"]x10E6/uL[/TD]
[TD="align: center"]4.14-5.80[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]15.2[/TD]
[TD="align: center"]g/dL[/TD]
[TD="align: center"]12.6-17.7[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]44.2[/TD]
[TD="align: center"]%[/TD]
[TD="align: center"]37.5-51.0[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]91[/TD]
[TD="align: center"]fL[/TD]
[TD="align: center"]79-97[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]31.1[/TD]
[TD="align: center"]pg[/TD]
[TD="align: center"]26.6-33.0[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]34.4[/TD]
[TD="align: center"]g/dL[/TD]
[TD="align: center"]31.5-35.7[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]13.6[/TD]
[TD="align: center"]%[/TD]
[TD="align: center"]12.3-15.4[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]268[/TD]
[TD="align: center"]x10E3/uL[/TD]
[TD="align: center"]150-379[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]54[/TD]
[TD="align: center"]%[/TD]
[TD="align: center"]40-74[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]32[/TD]
[TD="align: center"]%[/TD]
[TD="align: center"]14-46[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]9[/TD]
[TD="align: center"]%[/TD]
[TD="align: center"]4-12[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]4[/TD]
[TD="align: center"]%[/TD]
[TD="align: center"]0-5[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]1[/TD]
[TD="align: center"]%[/TD]
[TD="align: center"]0-3[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"][/TD]
[TD="align: center"][/TD]
[TD="align: center"][/TD]
[TD="align: center"]X[/TD]

[TD="align: center"]3.6[/TD]
[TD="align: center"]x10E3/uL[/TD]
[TD="align: center"]1.4-7.0[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]2.1[/TD]
[TD="align: center"]x10E3/uL[/TD]
[TD="align: center"]0.7-3.1[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]0.6[/TD]
[TD="align: center"]x10E3/uL[/TD]
[TD="align: center"]0.1-0.9[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]0.3[/TD]
[TD="align: center"]x10E3/uL[/TD]
[TD="align: center"]0.0-0.4[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]0.1[/TD]
[TD="align: center"]x10E3/uL[/TD]
[TD="align: center"]0.0-0.2[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]0[/TD]
[TD="align: center"]%[/TD]
[TD="align: center"]0-2[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]0.0[/TD]
[TD="align: center"]x10E3/uL[/TD]
[TD="align: center"]0.0-0.1[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"][/TD]
[TD="align: center"][/TD]
[TD="align: center"][/TD]
[TD="align: center"]X[/TD]

[TD="align: center"][/TD]
[TD="align: center"][/TD]
[TD="align: center"][/TD]
[TD="align: center"]X[/TD]

[TD="colspan: 6"][/TD]

[TD="colspan: 6, align: left"]322000 - Comp. Metabolic Panel (14)[/TD]

[TD="align: center"]104[/TD]

[TD="align: center"]mg/dL[/TD]
[TD="align: center"]65-99[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]19[/TD]
[TD="align: center"]mg/dL[/TD]
[TD="align: center"]6-24[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]1.32[/TD]

[TD="align: center"]mg/dL[/TD]
[TD="align: center"]0.76-1.27[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]61[/TD]
[TD="align: center"]mL/min/1.73[/TD]
[TD="align: center"]>59[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]70[/TD]
[TD="align: center"]mL/min/1.73[/TD]
[TD="align: center"]>59[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]14[/TD]
[TD="align: center"][/TD]
[TD="align: center"]9-20[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]141[/TD]
[TD="align: center"]mmol/L[/TD]
[TD="align: center"]134-144[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]4.2[/TD]
[TD="align: center"]mmol/L[/TD]
[TD="align: center"]3.5-5.2[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]100[/TD]
[TD="align: center"]mmol/L[/TD]
[TD="align: center"]97-108[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]28[/TD]
[TD="align: center"]mmol/L[/TD]
[TD="align: center"]18-29[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]9.2[/TD]
[TD="align: center"]mg/dL[/TD]
[TD="align: center"]8.7-10.2[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]6.2[/TD]
[TD="align: center"]g/dL[/TD]
[TD="align: center"]6.0-8.5[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]4.3[/TD]
[TD="align: center"]g/dL[/TD]
[TD="align: center"]3.5-5.5[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]1.9[/TD]
[TD="align: center"]g/dL[/TD]
[TD="align: center"]1.5-4.5[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]2.3[/TD]
[TD="align: center"][/TD]
[TD="align: center"]1.1-2.5[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]0.3[/TD]
[TD="align: center"]mg/dL[/TD]
[TD="align: center"]0.0-1.2[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]68[/TD]
[TD="align: center"]IU/L[/TD]
[TD="align: center"]39-117[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]29[/TD]
[TD="align: center"]IU/L[/TD]
[TD="align: center"]0-40[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"]23[/TD]
[TD="align: center"]IU/L[/TD]
[TD="align: center"]0-44[/TD]
[TD="align: center"]F[/TD]

[TD="colspan: 6"][/TD]

[TD="colspan: 6, align: left"]140103 - Testosterone,Free and Total[/TD]

[TD="align: center"]1327[/TD]

[TD="align: center"]ng/dL[/TD]
[TD="align: center"]348-1197[/TD]
[TD="align: center"]F[/TD]

[TD="align: center"][/TD]
[TD="align: center"][/TD]
[TD="align: center"][/TD]
[TD="align: center"]F[/TD]

[TD="colspan: 6"] Adult male reference interval is based on a population of lean males [/TD]

[TD="colspan: 6"] up to 40 years old. [/TD]

[TD="align: center"]41.8[/TD]

[TD="align: center"]pg/mL[/TD]
[TD="align: center"]7.2-24.0[/TD]
[TD="align: center"]F[/TD]

[TD="colspan: 6"][/TD]

[TD="colspan: 6, align: left"]004283 - Luteinizing Hormone(LH), S[/TD]

[TD="align: center"]0.1[/TD]

[TD="align: center"]mIU/mL[/TD]
[TD="align: center"]1.7-8.6[/TD]
[TD="align: center"]F[/TD]

[TD="colspan: 6"][/TD]

[TD="colspan: 6, align: left"]004309 - FSH, Serum[/TD]

[TD="align: center"]0.3[/TD]

[TD="align: center"]mIU/mL[/TD]
[TD="align: center"]1.5-12.4[/TD]
[TD="align: center"]F[/TD]

[TD="colspan: 6"][/TD]

[TD="colspan: 6, align: left"]004515 - Estradiol[/TD]

[TD="align: center"]17.7[/TD]
[TD="align: center"]pg/mL[/TD]
[TD="align: center"]7.6-42.6[/TD]
[TD="align: center"]F[/TD]

[TD="colspan: 6"] Roche ECLIA methodology [/TD]

[TD="colspan: 6"][/TD]

[TD="colspan: 6, align: left"]010322 - Prostate-Specific Ag, Serum[/TD]

[TD="align: center"]1.7[/TD]
[TD="align: center"]ng/mL[/TD]
[TD="align: center"]0.0-4.0[/TD]
[TD="align: center"]F[/TD]

[TD="colspan: 6"] Roche ECLIA methodology. [/TD]

[TD="colspan: 6"] . [/TD]

[TD="colspan: 6"] According to the American Urological Association, Serum PSA should [/TD]

[TD="colspan: 6"] decrease and remain at undetectable levels after radical [/TD]

[TD="colspan: 6"] prostatectomy. The AUA defines biochemical recurrence as an initial [/TD]

[TD="colspan: 6"] PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory [/TD]

[TD="colspan: 6"] PSA value 0.2 ng/mL or greater. [/TD]

[TD="colspan: 6"] Values obtained with different assay methods or kits cannot be used [/TD]

[TD="colspan: 6"] interchangeably. Results cannot be interpreted as absolute evidence [/TD]

[TD="colspan: 6"] of the presence or absence of malignant disease. [/TD]

[TD="colspan: 6"][/TD]

[TD="colspan: 6, align: left"]140244 - Estradiol, Sensitive[/TD]

[TD="align: center"]6[/TD]
[TD="align: center"]pg/mL[/TD]
[TD="align: center"]3-70[/TD]
[TD="align: center"]F[/TD]

[TD="colspan: 6"] Male Female [/TD]

[TD="colspan: 6"] 0- 6 yrs. 0 - 15 0 - 15 [/TD]

[TD="colspan: 6"] 7-10 yrs. 0 - 15 0 - 70 [/TD]

[TD="colspan: 6"] 11-12 yrs. 0 - 40 10 - 300 [/TD]

[TD="colspan: 6"] 13-15 yrs. 0 - 45 10 - 300 [/TD]

[TD="colspan: 6"] >15 yrs. 3 - 70 See Below [/TD]

[TD="colspan: 6"] Ovulating Female [/TD]

[TD="colspan: 6"] Follicular Phase 9 - 175 [/TD]

[TD="colspan: 6"] Luteal Phase 44 - 196 [/TD]

[TD="colspan: 6"] Periovulatory 107 - 281 [/TD]

[TD="colspan: 6"] Oral Contraceptives 0 - 91 [/TD]

[TD="colspan: 6"] Postmenopausal [/TD]

[TD="colspan: 6"] Treated 42 - 289 [/TD]

[TD="colspan: 6"] Untreated 0 - 19 [/TD]

[TD="colspan: 6"] . [/TD]

[TD="colspan: 6"] Estradiol results obtained with different [/TD]

[TD="colspan: 6"] assay methods cannot be used interchangeably. [/TD]

[TD="colspan: 6"] It is recommended that only one assay method [/TD]

[TD="colspan: 6"] be used consistently to monitor serial [/TD]

[TD="colspan: 6"] patient results. [/TD]

 

[Gene Devine]

Your testosterone dosage needs to be less as you are in the supraphysiological range.

Stop your AI as your E2 is very low.

If you reduce your dosage and inject twice a week (assuming you are injecting) you may not even need an AI to control E2.

Tell us more about your protocol.

 

[tom1959]

Hi Gene

I'm 6 weeks into my 2nd round of compounded pellets. I believe this is the peak and free test will drop off steadily over the next 6 weeks.

What does supraphysiological range mean?

I am on .25 mg Arimidex EOD. What is our target range on the e2 sensitive test?

Many thanks!

 

[Bass]

^^^ what he said. list your complete protocol.

 

[tom1959]

I've listed my protocol 1/2 dozen times, in previous posts. Working on fine tuning!

I do appreciate the valued feedback I have received over the past 6 months and have incorporated most all into my regiment.

-Pellets. 200 mg each. 11 total
-Last cycle was 4 months and it was to long.
- plan to shorten cycle to 12 weeks from 16, due to T crash at end of 16 weeks
- use Arimidex as AI. Tend to experience high E2 effects quickly without.
- target range for E2 is 6 on sensitive and 20 on non sensitive test
- 55 years old
- high stress work environment
- planning to begin including DHEA into regiment, after reading Gene's post and paper

Feedback?

 

[tom1959]

One more point. I'm 50% through this cycle

 

[Gene Devine]

Tom - It's impossible to remember your protocol from other posts. I probably respond to a few dozen posts on a daily basis and I can't remember them all. It's why it's best to stick to one post when responding in here that way there is a history for us to follow.

Supraphysiological simply means your serum levels are at a level that would never be achieved in a normal biological state...in the range of a bodybuilder using Testosterone in a AAS cycle if you will. It's not good for it to be at that level for any duration as it can have some negative side effects.

As you noted, you are peaking on your pellets so serum levels will probably subside as the drug wheres off.

Your sensitive E2 levels are low:

Estradiol, Sensitive 6 pg/mL 3-70 F

Ideal is 25 - 35 pg/ml. You are almost tanked and I can tell you the negative side effects at these levels suck. You can probably reduce your AI by 50% to get some rebound but it's not good where you are Tom.

Add in 50 mg of micronized slow release DHEA and Pregnenolone and take them both in the morning upon waking...these will help backfill your pathways and support your other metabolic pathways as well. As we age we produce mush less of these important pro hormones and they are just good for any TRT protocol anyway.

 

[Bass]

there is nothing I can add to what GD stated. this is why I prefer injection, you can almost immediately adjust your does if needed, with pellets you're stuck until next administration.

 

[tom1959]

Gene

Many thanks.... Again!

I really apprecaite the time you invest to respond. Very informative.

I will incorporate all recommendations.

tom

 

[tom1959]

Thank you Bass

 

[Gene Devine]

there is nothing I can add to what GD stated. this is why I prefer injection, you can almost immediately adjust your does if needed, with pellets you're stuck until next administration.

I agree on your point bass; I am not a big fan of pellets for just the reason you state. Plus, it's an invasive procedure every time they are inserted and I am not big on that as well.

But to each their own I guess.

 

[Nelson Vergel]

Tom

Nice numbers, man! Probably the best I have seen in a man your age.

I would stop anastrozole and retest 4 weeks later via ultrasensitive E2 done with liquid chromatography, not immuno assay.