New blood work in. Asking for comments and suggestions.

[FeelingLost]

First blood test Dec 2016 This was a standard annual checkup blood test. I did NOT fast and bllod was drawn at 1PM in afternoon.
PCP wanted blood that day did not care about A1C and blood glucose measurements.

I was complaining to my PCP of mild Anxiety and feeling completely apathetic toward everything in my life.

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Order: Triiodothyronine (T3) Total - LC 002188

Name Date Value Units Range Source
Triiodothyronine (T3) 12/13/2016 127.00 71-180

Order: Prostate-Specific Ag, Serum - LC 010322

Name Date Value Units Range Source
Prostate Specific Ag, Serum 12/13/2016 0.60 0.0-4.0

Order: Tsh, 3rd Generation - LC 004259

Name Date Value Units Range Source
TSH 12/13/2016 1.43 0.450-4.500

Order: Thyroxine (T4) Free, Direct, S - LC 001974

Name Date Value Units Range Source
T4, FREE(Direct) 12/13/2016 1.26 0.82-1.77

Order: Testosterone,Total, Serum - LC 004226

Name Date Value Units Range Source
Testosterone, Serum 12/13/2016 173.00 348-1197


Order: Comp. Metabolic Panel (14) - LC 322000

Name Date Value Units Range Source
Glucose, Serum 12/13/2016 151.00 65-99

BUN 12/13/2016 23.00 8-27

Creatinine, Serum 12/13/2016 0.82 0.76-1.27

eGFR If NonAfricn AM 12/13/2016 94.00 >59

BUN/Creatinine Ratio 12/13/2016 28.00 10-22

Sodium, Serum 12/13/2016 140.00 134-144

Potassium, Serum 12/13/2016 4.50 3.5-5.2

Chloride, Serum 12/13/2016 101.00 96-106

Carbon Dioxide, Total 12/13/2016 25.00 18-28

Calcium, Serum 12/13/2016 8.70 8.6-10.2

Protein, Total, Serum 12/13/2016 6.90 6.0-8.5

Albumin, Serum 12/13/2016 4.20 3.6-4.8

Globulin, Total 12/13/2016 2.70 1.5-4.5

A/G Ratio 12/13/2016 1.60 1.1-2.5

Bilirubin, Total 12/13/2016 0.20 0.0-1.2

Alkaline Phosphatase, S 12/13/2016 57.00 39-117

AST (SGOT) 12/13/2016 18.00 0-40

ALT (SGPT) 12/13/2016 33.00 0-44

Order: CBC With Differential/Platelet - LC 005009

Name Date Value Units Range Source
WBC 12/13/2016 5.40 3.4-10.8

RBC 12/13/2016 5.27 4.14-5.80

Hemoglobin 12/13/2016 15.90 12.6-17.7

Hematocrit 12/13/2016 47.60 37.5-51.0

MCV 12/13/2016 90.00 79-97

MCH 12/13/2016 30.20 26.6-33.0

MCHC 12/13/2016 33.40 31.5-35.7

RDW 12/13/2016 14.20 12.3-15.4

Platelets 12/13/2016 239.00 150-379

Neutrophils 12/13/2016 44.00

Lymphs 12/13/2016 44.00

Monocytes 12/13/2016 9.00

Eos 12/13/2016 3.00

Basos 12/13/2016 0.00

Immature Cells 12/13/2016

Neutrophils (Absolute) 12/13/2016 2.40 1.4-7.0

Lymphs (Absolute) 12/13/2016 2.40 0.7-3.1

Monocytes(Absolute) 12/13/2016 0.50 0.1-0.9

Eos (Absolute) 12/13/2016 0.20 0.0-0.4

Baso (Absolute) 12/13/2016 0.00 0.0-0.2

Immature Granulocytes 12/13/2016 0.00

Immature Grans (Abs) 12/13/2016 0.00 0.0-0.1

I would also like to note I live at 6200ft above sealevel which migh effect my Hematocrit #s

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Second blood test to check T lvls after 4 week of Testim 50mg. applied to shoulders once per day.
This blood test was required by my insurance to back up my PCP's diagnosis of male hypogonadism before they would cover the T-gel.

I did not expect these numbers to be so high 5 weeks into my simple protocal and I wonder what my PCP will do next?
Any suggestions of what I could recommend to him would be greatly appreciated.

PS- before CW asks the E2 was a standard test YES I asked for sensitive and they said no and I can't wait to rub that in and ask for a sensitive now.

 

[CoastWatcher]

You clearly responded to the topical testosterone, but you noted that you didn't expect these results. So the question is, how do you feel? A total testosterone value such as you posted, for a man on androgen replacement, would disappoint many (perhaps most) patients. Not because there's anything to be gained by chasing a specific number, but because there is a pretty clear pattern that the benefits of TRT don't assert themselves until higher levels are achieved. How would you rate your libido, erectile issues, fatigue, endurance, and physical/gym performance now as opposed to when you began therapy? Having made those points, it's important to note that with TRT nothing should come as a surprise; you may be feeling remarkably better with the lab profile you posted. You have an excellent free testosterone level - I did not see your SHBG, was it run? I'm asking because it would be interesting to know if the free testosterone is misleading due to rapid clearance.

On a pragmatic level, how experienced is your doctor in managing protocols? Given that you did respond, from 173 to over 600 in terms of your testosterone, how likely is it that you'll be considered "cured" - no matter how you subjectively feel? Given that you respond to topical delivery, one course of action might be to visit a compounding pharmacy and have a higher concentration testosterone cream prepared. That would be a better approach, I feel, than simply increasing the amount of Testim (something a lot of doctors would be inclined to order).

 

[Zooka15]

Actually The 632 is not that bad. One, since his free T is high. Also his blood draw was at 1PM, So more than likely the total testosterone was actually a little higher in the morning since he is on a transdermal. I am not a firm believer that total T needs to be near a 1000.

 

[CoastWatcher]

Actually The 632 is not that bad. One, since his free T is high. Also his blood draw was at 1PM, So more than likely the total testosterone was actually a little higher in the morning since he is on a transdermal. I am not a firm believer that total T needs to be near a 1000.

As I wrote, the important question is how he feels.

 

[FeelingLost]

You clearly responded to the topical testosterone, but you noted that you didn't expect these results. So the question is, how do you feel?

Not like I though I would feel with a T lvl over 600.
Remember I was in for a normal yearly checkup and told my PCP about having anxiety, panic attacks, and feeling completely apathetic.

My PCP put me on antidepressants. I hated them, that drugged feeling, and I asked if we could pursue the low T in my blood work and he said yes. So here I am 6 weeks later putting my gel on every morning and trying to step up my daily exersize.

I do feel a little bit better but I am still not myself. Little things aren't getting on my nerves as much, I have had no panic attacks. I used to get morning anxiety every morning now it is 1 -2 times a week and thru self talk I can talk myself down much easier.

A total testosterone value such as you posted, for a man on androgen replacement, would disappoint many (perhaps most) patients. Not because there's anything to be gained by chasing a specific number, but because there is a pretty clear pattern that the benefits of TRT don't assert themselves until higher levels are achieved.

Right now I don't have any of the wants or needs most of your guys have. I just want the old me back. I have no reference to what T lvl will be therapeutic for me. I feel a little better but I am not healed. My uneducated arbitrary number was 500-550 ng/dL. But only because my Pharmacists said 400 is about right for a guy 63 years old. don't laugh I know I KNOW, hehe

How would you rate your libido, erectile issues, fatigue, endurance, and physical/gym performance now as opposed to when you began therapy? Having made those points, it's important to note that with TRT nothing should come as a surprise; you may be feeling remarkably better with the lab profile you posted. Some certainly do.

I developed ED in my early 50s and did not care about sex. My wife had early menopause and sex hurt. We were flower children we screwed our asss off for 30 years.
How is my ED now? Pertty much the same. 1/2 wood in the morning before none still not enough to do anything with but again I don't think I care. SEX is not my goal. I want my fight back and if I get layed on that journey OK. haha

On a pragmatic level, how experienced is your doctor in managing protocols? Given that you did respond, from 173 to over 600 in terms of your testosterone, how likely is it that you'll be considered "cured" - no matter how you subjectively feel? Given that you respond to topical delivery, one course of action might be to visit a compounding pharmacy and have a higher concentration testosterone cream prepared. That would be a better approach, I feel, than simply increasing the amount of Testim (something a lot of doctors would be inclined to order).

I think I've pretty much explained my situation with my PCP above. He is very open to my suggestions and I am not sure a TRT program is all I need to fix my issues. I'm pretty sure if I wanted to try a TRT protocal of >1000 ng/dL he will bow out.

In 4 weeks I plan to get new blood work done with Nelson's DiscountLabs. I want a complete set of test this time including certain vitamins and minerals as well as other harmones.
I have a lot of research to do on what can my blood tell me. I am hoping like my low T I can locate something else I am lacking that could help my condition. I need to think out of the box and refuse to go back to Antidepressants.

Thanks CW for offering your ideas and advice your input is important to me.

 

[Vince]

It's too bad they gave you the standard estradiol test. I do think the rest of your numbers look pretty good. How do you feel and how do you feel about your results.

 

[FeelingLost]

It's too bad they gave you the standard estradiol test. I do think the rest of your numbers look pretty good. How do you feel and how do you feel about your results.

Hi Vince thanks for joining in.
If I think back 2-3 years ago before I had this brain fog and associated issues I'd say I was feeling about 1/4 of the way back to my old self.

It is still very early in my TRT so I am hoping time on this protocal will bring on more healing. I am not quite ready to try HCG yet for its mood improving properties. But maybe in my future. I do wish there was a pill for that. Since T-gel works so well for me I'd prefer to not get involved with needles.

I am doing small suppliment experiments. I tried Prostacet(saw palmetto) for 60 days to try and improve my urine stream strength. It did nothing.
I did 60 days of Lipo-Flavonoid Plus for Tinnitus thinking ringing in my ears could be a reason for some of my symptoms. It did nothing.

While I'm giving my TRT more time I read a good post here by Nelson on Nootropics so I thought I'd give the Aniracetam Choline nootropic stack a try.
From what I read it is a very common combination of brain enhancing supplements that's suppose to improve cognitive ability, memory, focus and mood.

https://www.excelmale.com/forum/sho...ts-and-medications-to-increase-focus-and-mood

 

[Vince]

If you do try Aniracetam Choline nootropic stack, please give us a review, improving our health and well-being is lifelong process.

 

[FeelingLost]

Actually The 632 is not that bad. One, since his free T is high. Also his blood draw was at 1PM, So more than likely the total testosterone was actually a little higher in the morning since he is on a transdermal. I am not a firm believer that total T needs to be near a 1000.

Hi Zooka, Thanks for looking at my post. I still have so much to learn.
I thought guys raised their TT up for the sole reason of getting their Free T up.
That Free T is what everyone was after. Everything else the body is locking up or converting to other harmones.

An the reason I ask this is my free T is over the top of the LabCorp range why would I ever want or need to increase my TT more?

 

[Zooka15]

I would give your body time to adjust and settle in for maybe another 4-6 weeks. Your body is still adjusting to the new hormones. Your Total T and Free T , Is fine ....will you feel better a little higher....maybe. Just food for thought, I have searched all these forums for the last 4 years looking for answers. The problem becomes we start chasing numbers rather than how we feel. To be honest most guys seem to do well in the 600-800 total T range. Some guys need close to 1000. The issue is when you get to high for your body you run in to problems with other hormones and the tricky one neurotransmitters can go haywire when you T is to high.

 

[FeelingLost]

So my PCP office called last night.
I was notified by LabCorp a week ago on my latest blood test, posted above. The docs assistant pretty much read what was on the LabCorp report. TT in range, this high, that low blaw blaw blaw and the doc wants to see me!?! Please make an appointment at your earliest convience. AH what? I wasn't scheduled for another visit for 3 months for blood work and discussion.

I am worried he wants to do something about my high E2. I really want to just wait a few months and see how things settle out.
Why else would he want to talk?
Any suggestions, words of encouragement, advice, possible things I might bring up to make the appointment more productive?

 

[FeelingLost]

So post doc visit today. He had additional bloodwork to show me. I though the list was kind of short compared to the list I asked for. Anyway here is the new measurements that was part of the March 2017 draw..

He also gave me a copy of all bloodwork for the entire year (Jan and March) and wants me to go to a urologists for a second opinion. He said if the urologists signs off on his treatment we can continue or I can work with the urologists.
He did not flag any of my readings or prescribe any additional prescripts for bloodpressure, or cholesterol. He just said lets take a look at everything in 3 months. We don't want to be chasing numbers that are in flux.