aaronexists
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Hello,
I'd be interested in any feedback on all of this information. I was trying to be thorough. Now, I feel like I've gone overboard putting all of this in a post. So, sorry for overwhelm.
A little about me: 40 y.o. white male. 5'10, generally moving between 175 and 185 lbs. Probably moderate in fitness (cardio) and diet. Tried several different times over the years to put on muscle, but always very challenging (impossible), even using personal trainers, the right diet, etc, etc. Felt generally run down for several years; low libido; doc would find nothing, but very conservative doc who I stayed with too long. Eventually, I ordered my own sleep study, which came back with apnea diagnosis (see below). Continued to feel run down and looked into HRT in 2010. In hindsight, not sure I approached it all very wisely... not much mental energy and concentration to think at that point.
As I look back at the baseline data, I do wonder about the low-normal LH and FSH, meaningful? And I'm not sure we ever really followed up on cortisol issues (saliva panel below).
Working with HRT doc, was put on compounded T Gel, HcG, Arimidex (low dose 1x/week) and Vitamin D (I avoid sun exposure due to over exposure in my youth). Unfortunately, my record keeping of dose, schedule, etc wasn't good during this initial period. My T scores actually dropped in the first two months; T Gel dose raised after the even lower T levels came back from the lab. Things seemed to stay the same and really get worse, energy and mood wise on this treatment.
Then, moved to T Cyp 200 mg/week in June. I'd read enough negative things about T Gel at this point that I told doc I wanted a change and would do my own IM injections. Taking all that T Cyp at once made me feel high, buzzed, anxious... and probably put on ~10 to 15 lbs very rapidly. T levels way up and Free T off the chart, estradiol levels much higher than baseline. Was moved down to 150 mg/week. Moved myself to twice weekly injections split in half, based on what I've read here (made that adjustment a week ago). Not sure about the twice weekly injections split in half, now feel too low. Figure that balance will come in time.
My general questions are: What to look for and investigate? What to do next? What's missing? What deeper issues might exist? I know I've learned a lot by seeing other people's results and reading the ensuing dialogue. So, hope to learn something and help others by throwing this out there.
Thanks for any thoughts or insights.
All blood work is LabCorp, with blood drawn between 8:30am and 9:15am.
Other Medical Diagnostics:
Sleep Apnea: Severe, 30+ events per hour. Never oxygen deprived, but very disturbed sleep architecture. No snoring. Turned out throat was obstructed by tonsils and tongue, which were out of proportion to my throat. Had surgery in 2009 to correct; sleep had seemed of poor quality for many years. Follow-up in 2011 showed reduction to moderate sleep apnea but revealed frequent pre-ventricular contractions.
Frequent Heart Arrhythmias: ~500 pre-ventricular contractions detected in one 24 hr period; heart checked by echocardiogram and nuclear stress test. Overall was normal. Achieved 95% max heart rate on treadmill, which ended test. Ejection fraction at high end of normal range. Cardiologist concluded heart is overall healthy and no issues. This was recently, in 2011; I had felt arrhythmias for many years and doctors previously disregarded during routine check-ups.
Blood Pressure: In the pre-hypertensive range for many years; rarely over, rarely under.
I'd be interested in any feedback on all of this information. I was trying to be thorough. Now, I feel like I've gone overboard putting all of this in a post. So, sorry for overwhelm.
A little about me: 40 y.o. white male. 5'10, generally moving between 175 and 185 lbs. Probably moderate in fitness (cardio) and diet. Tried several different times over the years to put on muscle, but always very challenging (impossible), even using personal trainers, the right diet, etc, etc. Felt generally run down for several years; low libido; doc would find nothing, but very conservative doc who I stayed with too long. Eventually, I ordered my own sleep study, which came back with apnea diagnosis (see below). Continued to feel run down and looked into HRT in 2010. In hindsight, not sure I approached it all very wisely... not much mental energy and concentration to think at that point.
As I look back at the baseline data, I do wonder about the low-normal LH and FSH, meaningful? And I'm not sure we ever really followed up on cortisol issues (saliva panel below).
Working with HRT doc, was put on compounded T Gel, HcG, Arimidex (low dose 1x/week) and Vitamin D (I avoid sun exposure due to over exposure in my youth). Unfortunately, my record keeping of dose, schedule, etc wasn't good during this initial period. My T scores actually dropped in the first two months; T Gel dose raised after the even lower T levels came back from the lab. Things seemed to stay the same and really get worse, energy and mood wise on this treatment.
Then, moved to T Cyp 200 mg/week in June. I'd read enough negative things about T Gel at this point that I told doc I wanted a change and would do my own IM injections. Taking all that T Cyp at once made me feel high, buzzed, anxious... and probably put on ~10 to 15 lbs very rapidly. T levels way up and Free T off the chart, estradiol levels much higher than baseline. Was moved down to 150 mg/week. Moved myself to twice weekly injections split in half, based on what I've read here (made that adjustment a week ago). Not sure about the twice weekly injections split in half, now feel too low. Figure that balance will come in time.
My general questions are: What to look for and investigate? What to do next? What's missing? What deeper issues might exist? I know I've learned a lot by seeing other people's results and reading the ensuing dialogue. So, hope to learn something and help others by throwing this out there.
Thanks for any thoughts or insights.
All blood work is LabCorp, with blood drawn between 8:30am and 9:15am.
Test | Reference Interval | Units | Dec-10 | Mar-11 | May-11 | Jun-11 | Jun-11 |
| Comp T Gel | Comp T Gel | ||||||
| Baseline | HcG | HcG | Trough T Cyp | Peak T Cyp | |||
| 118 Hrs Post Injection | 31 Hrs Post Injection | ||||||
| TSH+T4F+T3Free | |||||||
| TSH | 0.450 - 4.500 | uIU/mL | 2.95 | 2.54 | |||
| Triiodothyronine, Free, Serum | 2.0 - 4.4 | pg/mL | 2.9 | 3.4 | |||
| T4, Free (Direct) | 0.82 - 1.77 | ng/dL | 1.1 | 1.01 | |||
| CBC with Differential/Platelet | |||||||
| WBC | 4.0 - 10.5 | x10E3/uL | 8.3 | 6.4 | 8.3 | 8.7 | |
| RBC | 4.10 - 5.60 | x10E6/uL | 5.17 | 5.59 | 5.6 | 5.4 | |
| Hemoglobin | 12.5 - 17.0 | g/dL | 16.2 | 17.4 | 17.3 | 16.5 | |
| Hematorcrit | 36.0 - 50.0 | % | 47.9 | 51.7 | 49.3 | 47.5 | |
| MCV | 80 - 98 | fL | 93 | 93 | 88 | 88 | |
| MCH | 27.0 - 34.0 | pg | 31.3 | 31.1 | 30.9 | 30.6 | |
| MCHC | 32.0 - 36.0 | g/dL | 33.8 | 33.7 | 35.1 | 34.7 | |
| RDW | 11.7 - 15.0 | % | 13.4 | 13.1 | 13.5 | 13.5 | |
| Platelelets | 140 - 415 | x10E3/uL | 265 | 259 | 277 | 250 | |
| Neutrophils | 40 - 74 | % | 58 | 57 | 54 | 60 | |
| Lymphs | 14 - 46 | % | 34 | 34 | 37 | 30 | |
| Monocytes | 4.0 - 13.0 | % | 6 | 7 | 7 | 8 | |
| Eos | 0 - 7 | % | 2 | 2 | 2 | 2 | |
| Basos | 0 - 3 | % | 0 | 0 | 0 | 0 | |
| Neutrophils (Absolute) | 1.8 - 7.8 | x10E3/uL | 4.7 | 3.7 | 4.4 | 5.5 | |
| Lymphs (Absolute) | 0.7 - 4.5 | x10E3/uL | 2.8 | 2.2 | 3.1 | 2.6 | |
| Monocytes (Absolute) | 0.1 - 1.0 | x10E3/uL | 0.5 | 0.4 | 0.6 | 0.7 | |
| Eos (Absolute) | 0.0 - 0.4 | x10E3/uL | 0.2 | 0.1 | 0.2 | 0.2 | |
| Baso (Absolute) | 0.0 - 0.2 | x10E3/uL | 0 | 0 | 0 | 0 | |
| Immature Granulocytes | 0 - 1 | % | 0 | 0 | 0 | 0 | |
| Immature Grans (Abs) | 0.0 - 0.1 | x10E3/uL | 0 | 0 | 0 | 0 | |
| Comp. Metabolic Panel | |||||||
| Glucose, Serum | 65 - 99 | mg/dL | 95 | 98 | |||
| BUN | 6.0 - 20.0 | mg/dL | 17 | 15 | |||
| Creatinine, Serum | 0.76 - 1.27 | mg/dL | 1.02 | 0.96 | |||
| eGFR | >59 | mL/min/1.73 | >59 | 98 | |||
| BUN/Creatinine Ratio | 8.0 - 27.0 | 17 | 16 | ||||
| Sodium, Serum | 135 - 145 | nmol/L | 138 | 138 | |||
| Potassium, Serum | 3.5 - 5.2 | nmol/L | 4.4 | 3.9 | |||
| Chloride, Serum | 97 - 108 | nmol/L | 100 | 99 | |||
| Carbon Dioxide, Total | 20 - 32 | nmol/L | 22 | 27 | |||
| Calcium, Serum | 8.7 - 10.2 | mg/dL | 9 | 9.4 | |||
| Protein, Total, Serum | 6.0 - 8.5 | g/dL | 6.9 | 7.1 | 6.7 | 6.9 | |
| Albumin, Serum | 3.5 - 5.5 | g/dL | 4.3 | 4.3 | 4.3 | 4.3 | |
| Globulin, Total | 1.5 - 4.5 | g/dL | 2.6 | 2.6 | |||
| A/G Ratio | 1.1 - 2.5 | 1.7 | 1.7 | ||||
| Bilirubin, Total | 0.0 - 1.2 | mg/dL | 0.4 | 0.6 | 0.6 | 0.6 | |
| Bilirubin, Direct | 0.00 - 0.40 | mg/dL | 0.16 | 0.14 | |||
| Alkaline, Phosphatase, S | 25 - 150 | IU/L | 85 | 74 | 90 | 86 | |
| AST (SGOT) | 0 - 40 | IU/L | 29 | 25 | 27 | 21 | |
| ALT (SGPT) | 0 - 55 | IU/L | 60 | 50 | 37 | 36 | |
| Lipid Panel | |||||||
| Cholesterol, Total | 100 - 199 | mg/dL | 219 | 212 | 206 | ||
| Triglycerides | 0 - 149 | mg/dL | 128 | 145 | 125 | ||
| HDL Cholesterol | >39 | mg/dL | 44 | 41 | 49 | ||
| VLDL Cholesterol Cal | 5.0 - 40.0 | mg/dL | 26 | 29 | 25 | ||
| LDL Cholesterol Calc | 0 - 99 | mg/dL | 149 | 142 | 132 | ||
| FSH and LH | |||||||
| LH | 1.7 - 8.6 | mIU/mL | 2.2 | ||||
| FSH | 1.5 - 12.4 | mIU/mL | 2.2 | ||||
| Testosterone, Free and Total | |||||||
| Testosterone, Serum | 249 - 836 | ng/dL | 310 | 166 | 308 | 1349 | 1460 |
| Free Testosterone (Direct) | 8.7 - 25.1 | pg/mL | 9.3 | 3.8 | 7.3 | >55 | >55 |
| Bioavailable T (Calculated on ISSAM site) | ng/dL | 183 | 1079 | ||||
| Bioavailable T (Calculated on ISSAM site) | % | 59.2 | 73.9 | ||||
| Free Test. (Calculated on ISSAM site) | ng/dL | 7.82 | 46 | ||||
| Free Test. (Calculated on ISSAM site) | % | 2.52 | 3.15 | ||||
| Other/Misc. | |||||||
| Pregnenolone, MS | <151 | ng/dL | 31 | 40 | 69 | ||
| DHEA-Sulfate | 88.9 - 427.0 | ug/dL | 220 | 241 | 385 | ||
| Prostate-Specific Ag, Serum | 0.0 - 4.0 | ng/mL | 0.9 | 1.1 | |||
| IGF-1 | 109 - 284 | ng/mL | 158 | 142 | 210 | 315 | |
| Vitamin D, 25 Hydroxy | 32.0 - 100.0 | ng/mL | 21.8 | 41.3 | |||
| Lipoprotein (a) | 0 - 30 | mg/dL | 2 | ||||
| C-Reactive Protein, Cardiac | 0.00 - 3.00 | mg/L | 1.97 | ||||
| Estradiol, Sensitive | 3.0 - 70.0 | pg/mL | 19 | 14 | 18 | 66 | 66 |
| Estradiol | 7.6 - 42.6 | pg/mL | 73.9 | ||||
| Homocysteine, Plasma | 0.0 - 15.0 | umol/L | 10.6 | ||||
| Insulin | 0.0 - 24.9 | uIU/mL | 15 | ||||
| Sex Hormone Binding Globulin, Serum | 14.5 - 48.4 | nmol/L | 20.7 | 21.9 | |||
| Magnesium, Serum | 1.6 - 2.6 | mg/dL | 2.2 | ||||
| Saliva (Genova Diagnostics) | |||||||
| Cortisol 7am to 9am | 0.27 - 1.18 | mcg/dL | 0.16 | ||||
| Cortisol 11am to 1pm | 0.10 to 0.41 | mcg/dL | 0.24 | ||||
| Cortisol 3pm to 5pm | 0.05 to 0.27 | mcg/dL | 0.2 | ||||
| Cortisol 10pm to 12am | 0.03 to 0.14 | mcg/dL | < 0.03 | ||||
| DHEA 7am to 9am | 71 to 640 | pg/mL | 155 | ||||
| DHEA : Cortisol Ratio/10,000 | 115 to 1188 | 969 |
Other Medical Diagnostics:
Sleep Apnea: Severe, 30+ events per hour. Never oxygen deprived, but very disturbed sleep architecture. No snoring. Turned out throat was obstructed by tonsils and tongue, which were out of proportion to my throat. Had surgery in 2009 to correct; sleep had seemed of poor quality for many years. Follow-up in 2011 showed reduction to moderate sleep apnea but revealed frequent pre-ventricular contractions.
Frequent Heart Arrhythmias: ~500 pre-ventricular contractions detected in one 24 hr period; heart checked by echocardiogram and nuclear stress test. Overall was normal. Achieved 95% max heart rate on treadmill, which ended test. Ejection fraction at high end of normal range. Cardiologist concluded heart is overall healthy and no issues. This was recently, in 2011; I had felt arrhythmias for many years and doctors previously disregarded during routine check-ups.
Blood Pressure: In the pre-hypertensive range for many years; rarely over, rarely under.
