My latest blood test results. Some questions

[Nixter]

This is also my introductory thread so... Hello! Some background.. 42yrs old, 6'4, 215lbs, 12% BF. Blood pressure just slightly on the high end of normal.
Been on TRT since early 2017. I did do a 12wk blast early 2017. Cutrent TRT is 150mg test e and 1mg adex split into twice weekly injections/doses, monday night and friday morning. Draw was taken right between, mid-day Wednesday. Some results might be off because I wasn't fasting (forgot) even though I told them I was for fear they'd tell me to come back (labcorp). I have to drive 1.5hr across the border for blood work. I live in Vancouver BC.

I have a few questions.

Creatinine and BUN are just over range so im curious what to make of that. Ratio is just inside range which I've heard is more telling than BUN/creatinine separately. True? Regardless, ratio is still highish and I'd like healthy kidneys! I do train a lot and consume whey protein, both of which can affect numbers. Had a shake the morning of the draw in fact. Thoughts?

Another reason im concerned about kidneys is that i get really deep, long lasting sock marks on my ankles, (edema). Moreso on the left due to a reduced circulation issue i have on that side. I don't seem to have edema issues elsewhere. I was in Vietnam and philipnes earlier this year and both my ankles were swollen the entire 3 weeks. Returned to normal once home.

Another issue is some slight ED. I feel like i have some trouble maintaining erections. Estradiol looks good though so not sure. I'm not ruling out it being mental as i know that just worrying about things not working can cause them to not work. Libido might be down a bit too.
My total test is over range but i *think* blood was drawn at peak, (about 36hrs post injection) correct me if I'm wrong.

I was on 750ui hcg split 3x/wk up until May. I stopped because I'm not concerned with fertility and my boys haven't really shrunk much anyways. I've read mixed things about hcg and libido/ED. Thoughts?

Anyways, sorry for the long first post. Hopefully you guys can help with some insight. Im adding a selfie as i know muscle mass can be taken into account with certain panel numbers.

 

[Nixter]

After reading some other threads here, I'm wondering if my E2 could actually be causing the libido/ED problem. Before TRT my e2 was high normal and libido/erections were fine. Now my e2 is low normal. Should i try cutting adex in half to 0.5mg/wk?

 

[MarkM]

Welcome to the forum! Vancouver is a beautiful place.

Our belief is that blood work should be drawn just prior to next injection so you see the trough verse in between your two weekly injections as you indicate. Having the blood drawn when you did is going to put that pretty close to your peak.

Your Creatinine and BUN are probably high due to working out and taking whey protein. Are you also taking creatine? When creatine enters the muscle some of it converts to creatinine. Normally it is best not to work out or have creatine and whey protein 48 to 72 hours prior to having blood work done. Otherwise you can see these areas elevated. THis has happened to me numerous times over the years. I would not be concerned. Next time drop the workout and why/creatine for 2 to 3 days ahead of blood and I htink you will see them drop back down into normal ranges.

I think your ED issues you are experiencing are from low Estradiol. Sounded like you are taking the AI the same time you inject your test. With an E2 of 16 that is a pretty low. Not terrible but everything effects everyone differently. I bet you would do better with higher E2 and I'm thinking I would drop the AI. If not, reduce the 1 mg a week to at least half of that. If you feel an improvement, reduce it more or drop it. You can always add it back.

The flight to Vietnam probably caused your ankles to swell while you were their. That is a long flight. Mine swell every time I fly. Your poor circulation you have doesn't help that and while your Hemoglobin and Hematocrit are in range, they are in the upper quartile and that viscosity along with your admitted poor circulation might be enough for some swelling after a long day on your feet. i don't see anything that would lead me to think you have a kidney problem but your eGFR at 63 is on the low end of the range. Swelling of the feet and legs and cause that to be lower. I notice mine eGFR gets in that same range as your when my BUN and Creatinine gets higher than normal and I am not well hydrated.

Staying well hydrated will help the swelling and will also help the BUN and Creatinine.

Many men who are not concerned about testicular atrophy and or fertility don't utilize HCG. I currently do but considering dropping it because I don't feel like it is doing anything for me. I supplement with DHEA and Pregnenolone.

Hope this helps Nixter.

 

[Nixter]

Thanks for the detailed response Mark! I do not take creatine as I'm a non responder to it

Ok i will half my adex and see how that goes. Its there a better time to take it other than at injection time?

I will also try and get much more water. I'm a single guy with a very active social life so i consume a decent amount of alcohol but nothing crazy. However this probably means i need more water than most.

Next time I'll get bloods just before injection.

 

[MarkM]

You’re welcome.

The alcohol will dehydrate you quickly. I’d just take the AI at injection time. I think you will see a positive response by reducing it.

 

[Nixter]

I also just discovered that low e2 could be a contributing factor in the tendonitis im having in my right elbow. Im almost tempted to drop adex altogether just to see what happens. Hmmm.

 

[MarkM]

I think you’d be fine without the AI. Try it. You can always bring it back if needed.

 

[Nixter]

I'll do it! Damn i wish i hadnt just taken a dose this morning

 

[MarkM]

It will take 10 days to get the AI completely out of your system.

 

[Nixter]

First pin yesterday morning with no accompanying adex. It's probably too soon to tell but i swear i feel a difference already.

Also considering lowering T dose to try and kick the bit of bacne 150mg gives me. My SHBG is low so i think i should be ok.

 

[Nixter]

Adex should be completely out of my system now. We'll see how things go!

 

[MarkM]

Glad you are feeling better. Keep us posted. Good luck!

 

[Nixter]

So i seem to be having worse ED issues now. Perhaps cutting out adex completely was not ideal. I *think* things were in a sweet spot a week or so after stopping when there was probably still a little adex in my system. Im trying .25mg 2x/wk now.

Is there anything else about my blood work that could be an issue for ED? I dropped HCG earlier this year, could that be an issue? The boys shrunk only a little and it took quite a while for that to happen.

 

[MarkM]

Your E2 of 16 was pretty low on your labs. Low E2 can cause libido and ED issues more so than higher levels of E2. What is your Free T, I don't see it on your labs. Other than your E2 of 16 I can't see anything else on your labs that would cause ED.

So you went back to .5 mg of AI a week like you were before. I thought that was causing you some ED issues and with the lower E2 of 16 that was kind of why you dropped it.

If it makes you feel better than you do without it then by all means go back to it. Be careful that you do not crash your E2.

Your SHBG is on the lower side which means it is not grabbing a bunch of T or E. Your Total T is very high and you probably have high Free T as well as high Free E. That high Free E could be casuing you libido and erection issues. With already low E2 you probably need to bring your dose of tetosterone way down to bring the Free T down to more normal levels (I am guessing it is real high since I can;t see it) and it would bring down your Free E as well.

Discounted Labs has a Free Estradiol test that you may want to take.

 

[Nixter]

Thanks Mark.

Original adex was 1mg/wk. I'm doing half that now.

Is there a specific blood test panel from one of the labs that covers everything i need to properly diagnose this?

I used a calculator to get the other test values.