Test Results Analysis

[croaker24]

Hi -

These results are after starting 4 pumps of Androgel in July 2013. My initial overall T was 137. While I feel much
better now than I did before - I still have my doubts as to using Androgel over the long-term. I have an upcoming
physical with a new PCP - and I plan to take Dr Crisler's paper + some graphs produced by Nelson (and I have his
book on order) and take a more assertive involvement in my treatment. When they put me on Androgel, I was in bad
shape and just in such a mental funk I passively went along with whatever they were doing at that time.

I'm currently seeing an endocrinologist - who had diagnosed me as primary. While this endo is fairly on the ball,
from my questions, I think he may be too orthodox for the long-term (e.g. will not prescribe arimidex if my E2 was
to go too high) and I'm hoping to find a hormone specialist for a thorough sanity check.

My wife completely supports my efforts, and I may even go see Dr Crisler if I cannot find someone more local.

Appreciate any comments on these results.

Thanks,
Jeff


[TABLE="width: 714"]
[TR]
[TH="bgcolor: #B4D8F3"]Component[/TH]
[TH="bgcolor: #B4D8F3"]Standard Range[/TH]
[TH="bgcolor: #B4D8F3"]Your Value[/TH]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]Dihydrotestosterone[/TD]
[TD="class: infoCol"][/TD]
[TD="class: importantCol"]155[/TD]
[/TR]
[TR="class: tableRowMessage comments odd"]
[TD="class: srchbl, colspan: 3"]Reference Range:
16-79[/TD]
[/TR]
[/TABLE]


[TABLE="width: 714"]
[TR]
[TH="bgcolor: #B4D8F3"]Component[/TH]
[TH="bgcolor: #B4D8F3"]Standard Range[/TH]
[TH="bgcolor: #B4D8F3"]Your Value[/TH]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]Testosterone[/TD]
[TD="class: infoCol"]250 - 1100 ng/dL[/TD]
[TD="class: importantCol"]497[/TD]
[/TR]
[TR="class: tableRowMessage comments odd"]
[TD="class: srchbl, colspan: 3"]For more information on this test, go to
http://education.questdiagnostics.com/faq/
TotalTestosteroneLCMSMS[/TD]
[/TR]
[TR]
[TD="class: nameCol srchbl"]Testosterone, Free[/TD]
[TD="class: infoCol"]46.0 - 224.0 pg/mL[/TD]
[TD="class: importantCol"]48.8[/TD]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]Testosterone, Bioavailable[/TD]
[TD="class: infoCol"]110.0 - 575.0 ng/dL[/TD]
[TD="class: importantCol"]96.2[/TD]
[/TR]
[TR]
[TD="class: nameCol srchbl"]Sex Hormone Binding[/TD]
[TD="class: infoCol"]10 - 50 nmol/L[/TD]
[TD="class: importantCol"]48[/TD]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]ALBUMIN,SERUM[/TD]
[TD="class: infoCol"]3.6 - 5.1 g/dL[/TD]
[TD="class: importantCol"]4.3[/TD]
[/TR]
[/TABLE]

[TABLE="width: 714"]
[TR]
[TH="bgcolor: #B4D8F3"]Component[/TH]
[TH="bgcolor: #B4D8F3"]Standard Range[/TH]
[TH="bgcolor: #B4D8F3"]Your Value[/TH]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]Estradiol[/TD]
[TD="class: infoCol"]0.0 - 39.8 PG/ML[/TD]
[TD="class: importantCol"]20.7[/TD]
[/TR]
[/TABLE]


[TABLE="width: 714"]
[TR]
[TH="bgcolor: #B4D8F3"]Component[/TH]
[TH="bgcolor: #B4D8F3"]Standard Range[/TH]
[TH="bgcolor: #B4D8F3"]Your Value[/TH]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]WBC[/TD]
[TD="class: infoCol"]3.3 - 10.5 K/CUMM[/TD]
[TD="class: importantCol"]3.1[/TD]
[/TR]
[TR]
[TD="class: nameCol srchbl"]RBC[/TD]
[TD="class: infoCol"]4.15 - 5.75 M/CUMM[/TD]
[TD="class: importantCol"]5.22[/TD]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]Hemoglobin[/TD]
[TD="class: infoCol"]12.8 - 16.9 G/DL[/TD]
[TD="class: importantCol"]15.6[/TD]
[/TR]
[TR]
[TD="class: nameCol srchbl"]Hematocrit[/TD]
[TD="class: infoCol"]38.8 - 50.2 %[/TD]
[TD="class: importantCol"]45.8[/TD]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]MCV[/TD]
[TD="class: infoCol"]78.0 - 100.0 FL[/TD]
[TD="class: importantCol"]87.8[/TD]
[/TR]
[TR]
[TD="class: nameCol srchbl"]MCH[/TD]
[TD="class: infoCol"]27.0 - 31.0 PG[/TD]
[TD="class: importantCol"]30.0[/TD]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]MCHC[/TD]
[TD="class: infoCol"]32.0 - 36.0 G/DL[/TD]
[TD="class: importantCol"]34.1[/TD]
[/TR]
[TR]
[TD="class: nameCol srchbl"]RDW[/TD]
[TD="class: infoCol"]11.5 - 14.5 %[/TD]
[TD="class: importantCol"]13.0[/TD]
[/TR]
[TR="class: odd"]
[TD="class: nameCol srchbl"]Platelets[/TD]
[TD="class: infoCol"]150 - 450 K/CUMM[/TD]
[TD="class: importantCol"]88[/TD]
[/TR]
[TR]
[TD="class: nameCol srchbl"]MPV[/TD]
[TD="class: infoCol"]7.7 - 11.2 FL[/TD]
[TD="class: importantCol"]13.4[/TD]
[/TR]
[/TABLE]

 

[Gene Devine]

You're not absorbing well.

Total is fair at best and Free and Bio are low...and these two need to be optimum.

E2 is ok but don't want to go much higher.

How did this Doc determine you were Primary and not Secondary?

Dr. Crisler is a great choice if you are seeking expert care in my opinion...I hold him in high regard.

 

[GettingAnswers]

I may be wrong but looks like you are converting a good bit to DHT. Where do you apply on your body? Perhaps the heavy conversion to dht is why you t levels seem to say you don't absorb well.

 

[croaker24]

Thanks for the replies. First - the endo did perform tests and could not find any markers pointing to secondary, so he implied it was primary. As for applying the gel - I apply on my shoulders, down the back a little, to my upper arms. I'm also a very lean guy, with a BMI of 21 - if that has any relevance. I thought my DHT was very high, but was not sure if it was an issue or not.

 

[croaker24]

A kind of query here - would going to injections be possibly a recommended alternative? I know everyone is different - but my understanding is that injections do not drive DHT up as much as gels do.

 

[Gene Devine]

Thanks for the replies. First - the endo did perform tests and could not find any markers pointing to secondary, so he implied it was primary. As for applying the gel - I apply on my shoulders, down the back a little, to my upper arms. I'm also a very lean guy, with a BMI of 21 - if that has any relevance. I thought my DHT was very high, but was not sure if it was an issue or not.

What were your LH/FSH labs before you started on TRT?

 

[Gene Devine]

A kind of query here - would going to injections be possibly a recommended alternative? I know everyone is different - but my understanding is that injections do not drive DHT up as much as gels do.

You are correct; injections do not elevate DHT like transdermals do.

IMO, injections are the best protocol for TRT...but that's just my opinion.

 

[croaker24]

They did not perform any labs prior to starting TRT - they basically said - "Whoa dude - your overall is only 137" and started Androgel right away. I had no idea that my issues could be to low T - and I was such a trainwreck at that time - I just went along with their recommendations - I was just barely functioning. So I think that the endo's assumption may be erroneous in that testing LH/FSH well after the fact? That such testing nearly 6 months into TRT may be pointless?

I'm unable to find what negatives/consequences there are in maintaining such a high DHT. My endo does not seem to think the lower bio/free are a huge concern at this time.

 

[Keith Willse]

IMO, if you switch to injections your DHT will reduce more into the normal range. In terms of the negative/consequences, you might want to read the following information and share it with your endo.

http://www.townsendletter.com/July2012/anticancer0712.html

 

[croaker24]

Thanks Keith - definitely will show my endo. He does seem open-minded to tests that I suggest.

 

[Vettester Chris]

They did not perform any labs prior to starting TRT - they basically said - "Whoa dude - your overall is only 137" and started Androgel right away. I had no idea that my issues could be to low T - and I was such a trainwreck at that time - I just went along with their recommendations - I was just barely functioning. So I think that the endo's assumption may be erroneous in that testing LH/FSH well after the fact? That such testing nearly 6 months into TRT may be pointless?

I'm unable to find what negatives/consequences there are in maintaining such a high DHT. My endo does not seem to think the lower bio/free are a huge concern at this time.

That's real unfortunate that they didn't nail down the diagnosis better, beyond just calling it "Low T" and put you on medication. 137ng/dl is quite low, and it just seems more times then not that I've noticed the 'Primary' group of men posting on the forums tend to report the lower values ( <150ng/dl) on average, compared to the 'Secondary' posters. That's just a personal observation that I have noticed over the years and by no means is scientific. At this point you have been taking exogenous test for 6 months, so your LH would have likely dropped if indeed you were primary.