PLEASE HELP - Free T & E2 over ref range

[soa700]

Guys,

your help & advice in interpreting my test results below would be much appreciated as I am in Australia & do not have access to a knowledgeable TRT specialist.

A quick background & profile summary:

Age: 36
Height: 6' 4''
Weight: 215 lbs - lean & muscular (+/-7% bodyfat)

I have been very physically active (natural bodyuilding, motocross & cross country MTB racing, distance running) for 20-25 years. Never touched AAS. I shattered my ankle 11 years ago & have suffered chronic pain ever snce. I use analgesics to get to sleep every night (800 mg ibuprofen, 50mg codeine, 50 mg tramadol).

I have been suffreing low T symptoms increasingly since approx 30 years old. After seeing an endo & having some blood work & pturitary MRI performed I was cleared of primary hypogonadism but secondary hypoganadism was not investigated further. My total T was 7.2 nmol/L, calculated free T was 159 pmol/L & SHBG 26 nmol/L. As a result, I was just prescribed T (gels initially unsuccessfully i.e.switched to 125 mg enth every 5 days).

I am looking at incorporating 250 iu HCG on each of the 2 preceding days of the T admin but will have to order from the U.S as my Dr wont prescribe it.

I have just received results from my 2 month follow up labs since starting the enth (Primoteston) treatment.

I requested follow up tests specific to what Dr Crisler recommends but my Dr would only agree to those which he understood. See below: (out of range results in bold)

Hormones:
Total T: 43.5 nmol/L (ref range: 9.5-35)
SHBG: 26 nmol/L (ref range: 13-71)
Calc. free T: 1242 pmol/L (ref range: 225-725)
Sensitive Estradiol (E2):189 pmol/L ((ref range: 50-150)
FSH: <1 iu/L (ref range: 1-10)
LH: no result (ref range: 1-10)
Prog: no result (ref range: 1-10)
Lipids:
Total Chol: 3.5 nmol/L (ref range: 0-5.5)
Triglyceride: 1.6 nmol/L (ref range: 0.5-2)
HDL Chol: 1.4 nmol/L (ref range: 0.9-2.2)
LDL Chol: 1.4 nmol/L (ref range: 0-3.4)
Chol/HDL Ratio: 2.5 (ref range: 0-5)

Biochemistry:
Sodium: 140 mmol/L (ref range: 136-146)
Potassium: 4.7 mmol/L (ref range: 3.5-5)
Chloride: 104 mmol/L (ref range: 95-110)
Bicarbonate: 29 mmol/L (ref range: 22-31)
Est. GFR 68 mL/min (ref range: >60)
Creatine: 107 umol/L (ref range: 60-110)
Total Bilirubin 20 umol/L (ref range: <20)
Urea: 8.8 nmol/L (ref range: 2.3-7.6)
AST: 68 U/L (ref range: <40)
ALP: 116 U/L (ref range: 35-110)
GGT 16 U/L (ref range: <40)
Total Protein: 71 g/L(ref range: 65-85)
Albumin: 46 g/L (ref range: 38-50)
Globulin 25 g/L (ref range: 22-38)
Platelets: 146 (ref range: 150-450)

I know there may not be as great a knowledge on the biochemistry results on this forum (I may need to see a urologist for those out of range biochemistry results as I suspect I may have kidney issues from the analgesics) but any help in the hormone results would be greatly appreciated as I know that there are some very well informed & researched members on this forum.

Cheers guys & looking forward to your thoughts, suggestions etc.

[soa700]

Originally Posted by soa700

Guys,

your help & advice in interpreting my test results below would be much appreciated as I am in Australia & do not have access to a knowledgeable TRT specialist.

A quick background & profile summary:

Age: 36
Height: 6' 4''
Weight: 215 lbs - lean & muscular (+/-7% bodyfat)

I have been very physically active (natural bodyuilding, motocross & cross country MTB racing, distance running) for 20-25 years. Never touched AAS. I shattered my ankle 11 years ago & have suffered chronic pain ever snce. I use analgesics to get to sleep every night (800 mg ibuprofen, 50mg codeine, 50 mg tramadol).

I have been suffreing low T symptoms increasingly since approx 30 years old. After seeing an endo & having some blood work & pturitary MRI performed I was cleared of primary hypogonadism but secondary hypoganadism was not investigated further. My total T was 7.2 nmol/L, calculated free T was 159 pmol/L & SHBG 26 nmol/L. As a result, I was just prescribed T (gels initially unsuccessfully i.e.switched to 125 mg enth every 5 days).

I am looking at incorporating 250 iu HCG on each of the 2 preceding days of the T admin but will have to order from the U.S as my Dr wont prescribe it.

I have just received results from my 2 month follow up labs since starting the enth (Primoteston) treatment.

I requested follow up tests specific to what Dr Crisler recommends but my Dr would only agree to those which he understood. See below: (out of range results in bold)

Hormones:
Total T: 43.5 nmol/L (ref range: 9.5-35)
SHBG: 26 nmol/L (ref range: 13-71)
Calc. free T: 1242 pmol/L (ref range: 225-725)
Sensitive Estradiol (E2):189 pmol/L ((ref range: 50-150)
FSH: <1 iu/L (ref range: 1-10)
LH: no result (ref range: 1-10)
Prog: no result (ref range: 1-10)
Lipids:
Total Chol: 3.5 nmol/L (ref range: 0-5.5)
Triglyceride: 1.6 nmol/L (ref range: 0.5-2)
HDL Chol: 1.4 nmol/L (ref range: 0.9-2.2)
LDL Chol: 1.4 nmol/L (ref range: 0-3.4)
Chol/HDL Ratio: 2.5 (ref range: 0-5)

Biochemistry:
Sodium: 140 mmol/L (ref range: 136-146)
Potassium: 4.7 mmol/L (ref range: 3.5-5)
Chloride: 104 mmol/L (ref range: 95-110)
Bicarbonate: 29 mmol/L (ref range: 22-31)
Est. GFR 68 mL/min (ref range: >60)
Creatine: 107 umol/L (ref range: 60-110)
Total Bilirubin 20 umol/L (ref range: <20)
Urea: 8.8 nmol/L (ref range: 2.3-7.6)
AST: 68 U/L (ref range: <40)
ALP: 116 U/L (ref range: 35-110)
GGT 16 U/L (ref range: <40)
Total Protein: 71 g/L(ref range: 65-85)
Albumin: 46 g/L (ref range: 38-50)
Globulin 25 g/L (ref range: 22-38)
Platelets: 146 (ref range: 150-450)

I know there may not be as great a knowledge on the biochemistry results on this forum (I may need to see a urologist for those out of ra range biochemistry results as I suspect I may have kidney issues from the analgesics) but any help in the hormone results would be greatly appreciated as I know that there are some very well informed & researched members on this forum.

Cheers guys & looking forward to your thoughts, suggestions etc.

BTW: Please note that I am looking at keeping my Free T around this level if I can get away with it & just addressing the high E2 levels. Let me know your thoughts on if my T levels will become a problem as I do not currently suffer any negative symptoms.

[JanSz]

Originally Posted by soa700

BTW: Please note that I am looking at keeping my Free T around this level if I can get away with it & just addressing the high E2 levels. Let me know your thoughts on if my T levels will become a problem as I do not currently suffer any negative symptoms.

Attached chart is marked to reflect your situation.
Red line, present FreeT
Green lines, desirable range.

Estradiol,
on Quest or LabCorp tests we want to have E2(20-30)
below is conversion to your units.

pmol/L ------ pg/mL
189 = 51
110 = 30
92 = 25
73 = 20

189/3.671=51

[soa700]

Thanks JanSZ.

I will endevour to get my E2 down to +/- 110 pmol/L. Can you suggest the best way to do this without lowering my T dosage? DIM/Indolplex or Arimidex/Liquidex?

Also, can you forsee me having problems if my Calc Free T is marginally above top of ref range? (DR Crisler & Marianco suggetst the sample ref range subjects are probably hypogonadal to some degree anyway)

My lipids levels are good with my Free T at 1242 nmol/L but I'm guessing that you are probably going to tell me that I will have problems with my other estrogens with my T levels at 1242 nmol/L?

If not, I would really like to stay arround this level with my Free T if I can control my E2 to 110 pmol/L as I enjoy the anabolic benefits it brings with me being very active/athletic.

One other question - Will increasing my anerobic workload call for a higher administration of T to keep me at the same T levels as a sedentary individual?

Or otherwise, with my Free T at 1242 pmol/L, will a high anerobic workload help to control sides as I'm suspecting my body will be needing the increased T levels to recuperate from the exercise?

Also, in addition to my background/profile description above, I need to mention that I have never had labs run for thyriod or adrenals i.e. DHEA's, Cortisone, fasting bood sugar, T3, T4 etc. Should this be the starting point to addressing my symptoms (low libido, constant fatigue, diminishing lean body mass etc) as Dr Marianco suggests that this is where the majority of these problems stem from?

Once again, thanks & looking forward to your responses.

[hardasnails1973]

Reduce the testosterone thats a no brainer ..
Make sure the lab was taken on day before the injection to get a mid line
When was blood drawn?

Why does this seem like dejavu ?

[soa700]

Blood was drawn on morning of (just before) injection which is 125 mg enth every 5 days.

I try my best before I post to research other threads for answers relevant to my specific position so apologies if it seems like de ja vu to you but it is obviously all new ground to me.

Re; your comment that lowering T dosage is a no brainer, I currently have no real negative sides (sexual, gyno etc.) so my queries put to you were, is it feesable to sustain my free T level at 1242 nmol/L & address the E2 with AI's or DIM? Or will I create other estrogen, thyriod, adrenal etc. problems with this level of free T?

[Matt Muscle]

Originally Posted by soa700

Blood was drawn on morning of (just before) injection which is 125 mg enth every 5 days.

I try my best before I post to research other threads for answers relevant to my specific position so apologies if it seems like de ja vu to you but it is obviously all new ground to me.

Re; your comment that lowering T dosage is a no brainer, I currently have no real negative sides (sexual, gyno etc.) so my queries put to you were, is it feesable to sustain my free T level at 1242 nmol/L & address the E2 with AI's or DIM? Or will I create other estrogen, thyriod, adrenal etc. problems with this level of free T?

Hi Mate,
Sorry I havnt replied to your email yet..been so busy!
Your T dose is too high. 125mgs every 5 days is way too much. 80-100mgs every 7 may be alot better.
It may work ok sexually etc for you for awhile then problems will most likely set in.
Your receptors will get used to it. This happens not only in guys taking large doses for bodybuilding, but also with guys using just a little too much in TRT.
The body secretes testosterone in a daily fluctuation. In the morning it is high(in young men) and it tapers off at night. This may ensure that our receptors always stay fresh and receptive to our naturally produced testosterone.
Your liver function may be affected by the high T levels.
Plus your blood pressure may go up.
You may also get quite a bit of fluid retention.
T levels like this are not so bad in the short term, but not good in the long run.
Trying to sustain T levels like this by fighting the bodies reaction to it(which is converting excess T into other hormones) will only cause you more problems down the track.
Remember you cannot trick your body long term. It is far to smart for that. The T level natural for your body is set in your DNA. So no changing that!
You need to find the dose of T that most closely puts your T levels where "your body" is comfortable. Total T test results aproximating 22 nmol/l will be a good start., not 43 nmol/l !
When you find that level you wont need much if any estrogen control.
You need to decide if you are taking the testosterone for your health or for enhancing your athletic performance past your genetic limits. You will get a great "normal boost" with the lower level I have mentioned considering you were at 7 nmol/l to begin with.

Also in regard to your PM: Dont try and import HCG as our customs will only permit it if you have an import permit which has been authorised by your doctor. Plus the medication needs to be not available already in Australia to qualify for this. Its called the special access scheme.
So your only hope with that is a script with a doctor here. You need to find another doctor who will understand that you want your balls functioning whilst on TRT. What man wants to see them shrink up and they sure do on T injections.

[hardasnails1973]

milk thistle and sam-e has been shown to lower liver enzymes as well as proper nutrient defifiency ex mg is a big one that sticks out here

[JanSz]

Originally Posted by soa700

Blood was drawn on morning of (just before) injection which is 125 mg enth every 5 days.

I try my best before I post to research other threads for answers relevant to my specific position so apologies if it seems like de ja vu to you but it is obviously all new ground to me.

Re; your comment that lowering T dosage is a no brainer, I currently have no real negative sides (sexual, gyno etc.) so my queries put to you were, is it feesable to sustain my free T level at 1242 nmol/L & address the E2 with AI's or DIM? Or will I create other estrogen, thyriod, adrenal etc. problems with this level of free T?

125mg/e5d=125*7/5=175mg/week

This is exactly the dose that I use.

Your E2 is high, but I suggest that you attack this problem differently.
Use EOD schedule, again this is what i do.
Estrodial raises more when you have a ups and downs in blood test levels.
If you go on EOD schedule after a while you may not need Arimidex=Liquidex=Anastrozole
or jus a very small amount.

It is not fun to have EOD shots with needles that most men around here use.
For the last 2 years I am using 31Ga-5/16" inch long insuline syringes.
Shoot it into any location at any angle, use one hand only, sink needle until plastic on syringe hits the skin then another 1/4 inch, so you have slight indentation.
My blood test results speak, thay are steady and predictable.
I draw blood 24hrs after the T-shot.
So, unless you have an itching nipples and need to use Anastrozole right away,
do not use now any AI untill you test again, 2-3 months after being on EOD schedule.

Unless you have fertility plans it looks like you may have an up hill battle getting HCG.
May not be worth the effort.
I understand, I was ball-less for over two years.
I like being with balls, better.
--------------------------------------------------------------------------
If you want to do any additional testing,
look at my list, post #44
Jan's BloodTest April13/2007 - Page 4

Ask questions;
Good luck;
.
.

[soa700]

Originally Posted by Matt Muscle

The T level natural for your body is set in your DNA. So no changing that! You need to find the dose of T that most closely puts your T levels where "your body" is comfortable.

That's how I understood it to be. I guess it will just take some adjustment untill I find the 'ideal' range for me.