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Question re: Bloodwork/DHT levels

spitboy2000

Board Supporter
I am unhappy with my trough levels of total and free test and wanted to increase dosage, but my doc says my DHT level is on the high end and he doesn't want to increase. He also put me on DIM for high estrone. Thoughts?

(OCTOBER 2008)

DHT 66 (25-75)
TOTAL TEST 383 (250 - 1100)
% Free 2.39 (1.5 - 2.2) (HIGH)
FREE TEST 91.7 (35 - 155)
ESTRADIOL 27 (13 - 54)
ESTRONE 81 (25 - 75) (high)
PSA Normal
 
I am unhappy with my trough levels of total and free test and wanted to increase dosage, but my doc says my DHT level is on the high end and he doesn't want to increase. He also put me on DIM for high estrone. Thoughts?

(OCTOBER 2008)

DHT 66 (25-75)
TOTAL TEST 383 (250 - 1100)
% Free 2.39 (1.5 - 2.2) (HIGH)
FREE TEST 91.7 (35 - 155)
ESTRADIOL 27 (13 - 54)
ESTRONE 81 (25 - 75) (high)
PSA Normal

Your DHT is not out of line, actually you could be quite ok with DHT say 90

Just do not mess with Transdermal testoterone, that increases DHT.

You should raise your Testosterone, it is low now.

First get better tests, at least

LH, FSH, prolactin.

If LH & FSH are low, you are probably secondary (good testis but no signal to make them work)

If LH & FSH are highish, you are primary.

If secondary, first attempt, try to make testicle produce, use HCG.

E3D, HCG(1000-1250)

If primary, use injectable testosterone (and some HCG).
Make sure that you do frequent injections, 2x/week or more often. EOD, E3D.
Use 31Ga insuline needle to be able to live with frequent injections.

Goals:

BAT~575
FreeT~300
E2(20-30)
DHT~90

Tests to use;
Quest Diagnostics, blood drawn at Quest, 48hrs after T-shot

Estradiol, Ultrasensitive, LC/MS/MS (30289X)
Estrone, LC/MS/MS (23244X)
Testosterone, Free, Bio/Total (LC/MS/MS)
Dihydrotestosterone (204X)


------------------------
Highly adviced,
you better also test adrenals and thyroid

41 T3 Free
42 T4,Free
43 reverse T3 (rT3)
44 Ultrasensitive TSH
45 Thyroid Peroxidase and Thyroglobulin Antibodies (7260X)
(iodine, selenium, zinc, copper)

50 IGF Binding protein-3
51 IGF-1
52 Aldosterone
53 Cortisol AM/PM
54 DHEA sulfate
55 Prolactin
 
Your DHT is not out of line, actually you could be quite ok with DHT say 90

Just do not mess with Transdermal testoterone, that increases DHT.

You should raise your Testosterone, it is low now.

First get better tests, at least

LH, FSH, prolactin.

If LH & FSH are low, you are probably secondary (good testis but no signal to make them work)

If LH & FSH are highish, you are primary.

If secondary, first attempt, try to make testicle produce, use HCG.

E3D, HCG(1000-1250)

If primary, use injectable testosterone (and some HCG).
Make sure that you do frequent injections, 2x/week or more often. EOD, E3D.
Use 31Ga insuline needle to be able to live with frequent injections.

Goals:

BAT~575
FreeT~300
E2(20-30)
DHT~90

Tests to use;
Quest Diagnostics, blood drawn at Quest, 48hrs after T-shot

Estradiol, Ultrasensitive, LC/MS/MS (30289X)
Estrone, LC/MS/MS (23244X)
Testosterone, Free, Bio/Total (LC/MS/MS)
Dihydrotestosterone (204X)


------------------------
Highly adviced,
you better also test adrenals and thyroid

41 T3 Free
42 T4,Free
43 reverse T3 (rT3)
44 Ultrasensitive TSH
45 Thyroid Peroxidase and Thyroglobulin Antibodies (7260X)
(iodine, selenium, zinc, copper)

50 IGF Binding protein-3
51 IGF-1
52 Aldosterone
53 Cortisol AM/PM
54 DHEA sulfate
55 Prolactin

In your opinion, at what level should one worry about DHT?
 
In your opinion, at what level should one worry about DHT?

I do not have (personal solidified) opinion about too high level of DHT.
But I think that we should have all hormones as high as advisable (but no more).

LEF in their November magazine have artice about E2 & DHT.

They advice using Avodart to control DHT.

I used to use Avodart.
On transdermals with Avodart DHT~29 (ok but v close to low range)
While on transdermals (short time experimentally) no Avodart, DHT=3x top range
I was contemplating doing once a week Avodart,
but then switched to injections.
Currently on injections my DHT=69(25-75 )

But, I started Avodart and Rogaine and Proscar before I knew about their dangers,
and I got within 95% majority that are not adversely affected.
 
I do not have (personal solidified) opinion about too high level of DHT.
But I think that we should have all hormones as high as advisable (but no more).

LEF in their November magazine have artice about E2 & DHT.

They advice using Avodart to control DHT.

I used to use Avodart.
On transdermals with Avodart DHT~29 (ok but v close to low range)
While on transdermals (short time experimentally) no Avodart, DHT=3x top range
I was contemplating doing once a week Avodart,
but then switched to injections.
Currently on injections my DHT=69(25-75 )

But, I started Avodart and Rogaine and Proscar before I knew about their dangers,
and I got within 95% majority that are not adversely affected.

I've had DHT levels over slightly over 100 when I used higher doses of HCG, but my doctor wasn't concerned. I was curious if you had seen any research on the dangers of DHT. I thought there might be a tipping point, or a point of real concern above the conventional high range.
 
I've had DHT levels over slightly over 100 when I used higher doses of HCG, but my doctor wasn't concerned. I was curious if you had seen any research on the dangers of DHT. I thought there might be a tipping point, or a point of real concern above the conventional high range.

Before I started TRT my DHT was on low side. I actually like compounded cream because of the rise in DHT.

HCG monotherapy got my TT up, but it wasn't until I added transdermal T that my DHT went up which made such a difference for me. Libido, energy, workouts are like 20 year old (I'm 52) and my doc and I attribute this (especially the unbelievable libido) to the DHT rise as much as the testosterone increase. I really have to be aware of CNS burn out and force myself to take days off from the gym because I have actually injured joints from overtraining or lifting too heavy.

Libido is the biggest difference with high DHT. It's crazy. If I'm not hooking up with my wife every day I'm in trouble.

DHT before T Cream = 32, after = 110-120
TT before T Cream = 300's, after = 900's

As like Colkurz, my doctor (Shippen) is not really concerned about the DHT though we do track the DHT regularly and PSA occasionally (BTW, my PSA actually went down, from 0.4 before treatment to 0.3 today). I use Nizoral shampoo to counter potential DHT hair loss.

Shippen also points out that the DHT reading, like the TT reading, is most likely he highest of the day as we do BW a few hours after transdermal application (of course the blood draw is nowhere near the application site). Therefore my average DHT in a 24 hour period may actually be in the normal range, though certainly in the "high normal".

In my case, I would not trade my transdermal T for injections and lose that DHT boost. But we are all different and this is just what works for me - and my wife ;)
 
Before I started TRT my DHT was on low side. I actually like compounded cream because of the rise in DHT.

HCG monotherapy got my TT up, but it wasn't until I added transdermal T that my DHT went up which made such a difference for me. Libido, energy, workouts are like 20 year old (I'm 52) and my doc and I attribute this (especially the unbelievable libido) to the DHT rise as much as the testosterone increase. I really have to be aware of CNS burn out and force myself to take days off from the gym because I have actually injured joints from overtraining or lifting too heavy.

Libido is the biggest difference with high DHT. It's crazy. If I'm not hooking up with my wife every day I'm in trouble.

DHT before T Cream = 32, after = 110-120
TT before T Cream = 300's, after = 900's

As like Colkurz, my doctor (Shippen) is not really concerned about the DHT though we do track the DHT regularly and PSA occasionally (BTW, my PSA actually went down, from 0.4 before treatment to 0.3 today). I use Nizoral shampoo to counter potential DHT hair loss.

Shippen also points out that the DHT reading, like the TT reading, is most likely he highest of the day as we do BW a few hours after transdermal application (of course the blood draw is nowhere near the application site). Therefore my average DHT in a 24 hour period may actually be in the normal range, though certainly in the "high normal".
In my case, I would not trade my transdermal T for injections and lose that DHT boost. But we are all different and this is just what works for me - and my wife ;)

Blood draw few hours after transdermal application,
is this dr Shippen's request or you are doing it based on your own logic?

Looking at androgel.com charts,
I would guess that about 2-3 hours after Androgel application there is a 30% peak.
That is, if you read TT=1000 at the peak the rest of the 24 hours you really are TT~700.
Why would we be more interested in a state that exists 10% of the time and not a state that lasts 90% of the time?


--------------------------------
Glad to see your in great shape.
.
 
Blood draw few hours after transdermal application,
is this dr Shippen's request or you are doing it based on your own logic?

Looking at androgel.com charts,
I would guess that about 2-3 hours after Androgel application there is a 30% peak.
That is, if you read TT=1000 at the peak the rest of the 24 hours you really are TT~700.
Why would we be more interested in a state that exists 10% of the time and not a state that lasts 90% of the time.
.

Shippen has always told me that the day of BW apply the T Cream to your abdomen instead of forearms and get the blood tested within about 3 hours.

Good question. I'll have to ask him his thoughts next time I see him. Maybe he assumes a higher level later in the day and takes that into account. In any event I am always consistent with these BW instructions and he is very strict about that.
 
Shippen has always told me that the day of BW apply the T Cream to your abdomen instead of forearms and get the blood tested within about 3 hours.

Good question. I'll have to ask him his thoughts next time I see him. Maybe he assumes a higher level later in the day and takes that into account. In any event I am always consistent with these BW instructions and he is very strict about that.

Way back then I got form one of dr Shippen's patients a marked chart which shows his preferences for FreeT.
I posted that chart on post #41 (top chart).
http://anabolicminds.com/forum/male-anti-aging/66268-jan-s-bloodtest-2.html

Those marks on a chart are for the guy who have given me his chart (TT~550, SHBG~15).
I newer mention his name, plus I blocked personal info when making copy.

But the marks for FreeT are of general usefulness (100, 160, 250).

Wonder what values dr S is using today?

If you do not wish posting those values, you may want to PM them to me.

Thank you.

.
 
Way back then I got form one of dr Shippen's patients a marked chart which shows his preferences for FreeT.
I posted that chart on post #41 (top chart).
http://anabolicminds.com/forum/male-anti-aging/66268-jan-s-bloodtest-2.html

Those marks on a chart are for the guy who have given me his chart (TT~550, SHBG~15).
I newer mention his name, plus I blocked personal info when making copy.

But the marks for FreeT are of general usefulness (100, 160, 250).

Wonder what values dr S is using today?

If you do not wish posting those values, you may want to PM them to me.

Thank you.

.


JanSz,
The chart he uses today is exactly the same.

For me with TT=980 and SHBG=28 my Free T is about 240 per chart.
 
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