Jan's BloodTest April13/2007

[JanSz]

Link to (TT, SHBG, FreeT) chart
http://www.andropause.org.uk/nomo_tas.pdf

The Andropause Society Home


============================== ============================== ==========
Dr Shippen Chart

Testosterone Conversion Factor: pg/ml x 3.47 = pMol/L

Androgen deficiency in the adult ... - Google Books

Androgen Deficiency in the Adult ... - Google Book Search

This chart is from a book (second page from the top):

Androgen Defficiency in the
Adult Male
causes, diagnosis and treatment
by
Malcom Carruthers

printed by Taylor and Princes Group

search on keyword
nomogram androgen deficiency carruthers

[AnotherOldGuy]

Interesting....i applied my last two tests - used my shgb and TT and used this to calculate FreeT, and this chart resulted in almost 2x the Free t compared to my Quest results.

[JanSz]

Interesting....i applied my last two tests - used my shgb and TT and used this to calculate FreeT, and this chart resulted in almost 2x the Free t compared to my Quest results.

I am not surprised.
Was your FreeT assayed or calculated by Quest.
There is at least two ways (probably more) to get number that is called FreeT.
FreeT and BioAvailableT tests are notoriously inaccurate (grossly, over 200%).
The chart is a fall-back way out of this confusion.
Dr Shippen uses this chart (if that would help getting some confidence).

The chart is 1999 vintage, made based on science of about 1990.
To my knowledge there are at least two items that greatly influence results in rather uncontrolable ways;
recently discovered duality of SHBG
and
fact that age of person being tested influences results.

Wish Dr John had a time to discuss this issue.


AnotherOldGuy, hopefully this issue will bother you enough so you will dig deeper, if you find anything helpfull and relevant please post it right here or open new thread.
Not sure yet, but I think older guys are infueced more by this than younger whipper snappers.

In this post
Anabolic Steroids and Bodybuilding - View Single Post - Attention all those on Sub-q injections

I have made attempt at calculating FreeT using internet provided calculator.
Since results come widely scattered I no longer have confidence using it.

age-associated Bio-T
age-associated Bio-T

[JanSz]

My list for blood testing, long, for once/year testing.
Latter will add shorter list, for 2-3/year corrective action, tweaks.
Below are my ICD-9 codes that helps with insurance.

Also place to buy syringes for Testosterone and HCG.
(I modify this list as I learn about my preferences, if you follow this list, please check it shortly before you make test request)
Print from here down to the next blue text.
This list is meant to be done at LabCorp.com
============================== ==================

1 --------- Comprehensive Metabolic Panel w/EGFR
2 --------- CBC w/ diff/PLT
3 --------- VAP TM Cholesterol Test
4 --------- Selenium, Whole Blood
5 --------- Copper, serum
6 --------- Zinc
7 --------- Magnesium, RBC
8 --------- Potassium, RBC
9 --------- C-Reactive Protein (CRP), Highly Sensitive, CSF
10 --------- Fibrinogen
11 --------- Homocysteine, cardio
12 --------- Lipoprotein (A) Lp(A)
13 --------- Iron and Iron Binding Capacity
14 --------- Iron, Total
15 --------- Ferritin
16 --------- Transferrin
17 --------- Folate, RBC & Hematocrit
18 --------- Hemoglobin A1c
19 --------- Hemoglobin, Plasma
20 --------- VITAMIN A, E, B3, B12
21 --------- Vitamin D, 25-Hydroxy
22 --------- T3, Total
23 --------- T4, Total
24 --------- T3, Free
25 --------- T4,Free
26 --------- T3, Reverse
27 --------- Ultrasensitive TSH
28 --------- Thyroid Peroxidase and Thyroglobulin Antibodies
29 --------- Thyroglobulin
30 --------- Thyroxine-binding globulin
31 --------- Insulin, serum
32 --------- IGF Binding protein-3
33 --------- IGF-1
34 --------- DHEA Sulfate
35 --------- Aldosterone
36 --------- Renin Activity, Plasma
37 --------- ACTH, Plasma
38 --------- Cortisol Binding Globulin (Transcortin)
39 --------- 7:30AM/12PM/3:30PM---Cortisol, Free and Total
40 --------- Prolactin
41 --------- Progesterone
42 --------- Pregnenolone
43 --------- Androstenedione
44 --------- Estradiol, sensitive 140244 (3-70)
45 --------- Estrone, Serum
46 --------- Total Testosterone
47 --------- SHBG
48 --------- Albumin
49 --------- Dihydrotestosterone
50 --------- 3a-Androstanediol Glucuronide
51 --------- Ceruloplasmin
52 --------- Coenzyme Q10
--------------------------------------------------------------------------------------------------
244.9 ----- 257.2 ----- 780.79
250.00 ----- 272.4 ----- 788.41
250.01 ----- 601.9 ----- 253.3
255.4 ----- 780.4 ----- 255.8
783.9 -----
--------------------------------------------------------------------------------------------------

============================== ============================== ===============
End of list =========see another lis of ICD-9 codes on the bottom of this post ======
(I modify this list as I learn about my preferences, if you follow this list, please check it shortly before you make test request)

ICD9Data.com - Free 2007 ICD-9-CM Medical Coding Database

244.9 Unspecified acquired hypothyroidism
250.00 Diabetes mellitus without complication type ii or unspecified type not stated as uncontrolled 2009 ICD-9-CM Diagnosis 250.00 - Diabetes Mellitus Without Complication Type Ii Or Unspecified Type Not Stated As Uncontrolled
250.01 Diabetes mellitus without complication type i not stated as uncontrolled 2009 ICD-9-CM Diagnosis 250.01 - Diabetes Mellitus Without Complication Type I Not Stated As Uncontrolled
255.4 Corticoadrenal insufficiency 2009 ICD-9-CM Diagnosis 255.4 - Corticoadrenal Insufficiency
783.9 Other symptoms concerning nutrition metabolism and development 2009 ICD-9-CM Diagnosis 783.9 - Other Symptoms Concerning Nutrition Metabolism And Development
257.2 Other testicular hypofunction 2007 ICD-9-CM Diagnosis 257.2 - Other Testicular Hypofunction
272.4 Other and unspecified hyperlipidemia 2007 ICD-9-CM Diagnosis 272.* - Disorders of lipoid metabolism
601.9 Prostatitis unspecified 2007 ICD-9-CM Diagnosis 601.* - Inflammatory diseases of prostate
780.4 Dizziness and giddiness 2007 ICD-9-CM Diagnosis 780.4 - Dizziness And Giddiness
780.79 Other malaise and fatigue 2007 ICD-9-CM Diagnosis 780.79 - Other Malaise And Fatigue
788.41 Urinary frequency 2007 ICD-9-CM Diagnosis 788.41 - Urinary Frequency
253.3 Adult Onset Growth Hormone Deficiency
255.8 Other specified disorders of adrenal glands 2007 ICD-9-CM Diagnosis 255.8 - Other Specified Disorders Of Adrenal Glands

Anabolic Steroids and Bodybuilding - View Single Post - Adrenal fatigue, does it really exist?
255 Disorders of adrenal glands
For coding adrenal fatigue, I just use the code for Other Specified Disorders of the Adrenal Glands - which I call Adrenal Fatigue
255.8 Other specified disorders of adrenal glands 2007 ICD-9-CM Diagnosis 255.8 - Other Specified Disorders Of Adrenal Glands
HGH and Insurance Coverage
Dr. John 12-17-2006, 06:25 AM
ICD-9 253.3 Adult Onset Growth Hormone Deficiency
============================== ============================== =========================
Spectracell codes
244.90 Unspecified acquired hypothyroidism
264.00 Vitamin a deficiency
268.00 Vitamin d deficiency
269.90 Unspecified nutritional deficiency
780.79 Other malaise and fatigue
799.81 Decreased libido
------->add something for lipids

============================== ============================== ===========
EstroEssence

that I send for on Monday Oct1/2007 had the following
ICD-9 codes
600.0
606.1
257.2
253.4

Genova Diagnostics EstroEssence

The EstroEssence check the following 11 (eleven) indicators:

Estrone (24hr urine)Male 3.00-12.00 mcg/24 hr
Estradiol (24hr urine)Male1.50-6.00 mcg/24 hr
Estriol (24hr urine)Male 3.00-28.50 mcg/24 hr

2-Hydroxyestrone (24hr urine) 0.26-13.68 mcg/24 hr
2-Methoxyestrone (24hr urine) 0.34-9.03 mcg/24 hr
16α-Hydroxyestrone (24hr urine) 0.25-7.89 mcg/24 hr
4-Hydroxyestrone (24hr urine) 0.33-1.95 mcg/24 hr
4-Methoxyestrone (24hr urine) 0.40 0.20-1.60 mcg/24 hr
2-Hydroxyestrone/16α-Hydroxestrone Ratio (24hr urine)0.94-1.56 Ratio
2-Methoxyestrone/2-Hydroxyestrone Ratio (24hr urine) 0.11-4.00 Ratio
4-Methoxyestrone /4-Hydroxyestrone Ratio (24hr urine) 0.18-3.60 Ratio
============================== ============================== =============
The Metabolic profile that I send for on Monday Oct1/2007 had the following
ICD-9 codes
536.8
579.8
558.3
783.2
009.1
---------------------------
Hair Tissue Mineral Analysis (HTMA)
Hair Analysis

At Genova they need 1" of hair from the back of head,
approx 2 months growth,
last 2 weeks wash hair with Johnson baby shampoo.
Today I go to Kim for haircut, 11/16/2007, last time I had hair colored Oct12/2007
Use stainless steel scissors
500 milligrams has been recommended.
minimum sample of 250 milligrams (0.25 g) for analysis
Genova Diagnostics - Home
-------------------------------------------------------
Assessment Categories
GDX Laboratory Assessment Categories
---------------------------------

EstroEssence --(Cost $384.99 out of pocket $27.49)-- Genova Diagnostics EstroEssence

EstroEssence Complete (24hr) this is the one to do next
Check differences on taking samples NutrEval and NutrEval-NEW, want the one with 24 hr urine if there is such


============================== ==========================
JanSz-Metabolic Analysis and Cellular Energy

Jan's BloodTest April13/2007

Magnesium, how to increase

Endocrinological charts
Endocrinological charts

Bill for my blood test at Quest

Perfect way of finding right doctor

Jansz - more infor on methy estrone imbalnace

GLA but AA below range

Quality supplements (Wise Guy et alii)

-------http://mus--clecha---troom.com/forum/showthread.php?t=395&page=2

Symptoms, Diseases and Diagnosis - WrongDiagnosis.com

Example of logic algoritm when using Genova tests
Genova Diagnostics - Anti-Aging Digest

possible underlying causes and contributing factors
GDX Chronic Fatigue Syndrome (CFS)

Comprehensive Nutritional Assessment
nutritional supplement program customized to individual requirements
https://secure.customvite.com/cvite/default.asp

A Canary's-Eye View — Introduction

Enzymes & Methylation
Nutri-West Articles: HOMOCYSTEINE REDUX vs MSM
----------------------------------------------
One can order over internet many/most tests, if not directly available, send e-mail, ask for it.

Welcome to Integrative Psychiatry Mental Health Testing and Treatment

Also interpretation of tests and some follow up actions can be discussed over telephone:
15 minutes $45
30 minutes $75
Telephone Consultation
.
.

Use the A4M's directory to search for anti-aging physicians, clinics, spas and products.
Anti-Aging Physicians, Clinics & Products - WorldHealth.net


====================

Jan, where do I go to do this? If it is an imbalance will the test results suggest what I do to correct it? Thank you for your help.

Please do not use full name of GD labs.
Dr John in the past was objecting.
He does not object to discussion on health topics that the cover.
--------------------------------------------------------
On e-mail request include your zip code and ask for 25 or 50 miles radius, they will send you a list of doctors that have accounts with them.
--------------------------------------------------------

Essential & Metabolic Fatty Acids Analysis (EMFA)

http://www.genovadiagnostics.com/ind...&nav=doc&id=47

Sample Report:
http://www.genovadiagnostics.com/fil...MFA_report.pdf

Interpretation Guide;
http://www.genovadiagnostics.com/fil...nterpGuide.pdf

/
============================== ============================== ====
Matrix journal

Explanation of codes posted by HAN.
have it with you always when in doctor's office.

Jan's BloodTest April13/2007
---------------------------------------------------------------------

244.9 ========== Unspecified acquired hypothyroidism
250.0 ========== Diabetes mellitus without mention of complication
253.2 ========== Panhypopituitarism
255.5 ========== Other adrenal hypofunction
257.0 ========== Testicular hyperfunction
259.9 ========== Unspecified endocrine disorder
272.0 ========== Pure hypercholesterolemia
275.1 ========== Disorders of copper metabolism
440.0 ========== Atherosclerosis
600.0 ========== Hyperplasia of prostate
611.1 ========== Hypertrophy of breast
799.81 ========== Decreased libido

http://forum.bodybuilding.com/showth...hp?t=116624451
============================== ====================
http://www.icd9data.com/2007/Volume1/default.htm
Unspecified acquired hypothyroidism ========== 244.9 ========== Unspecified acquired hypothyroidism
Diabetes mellitus without mention of complication ========== 250,0 ========== http://www.icd9data.com/2007/Volume1.../250/250.0.htm
Panhypopituitarism ========== 253.2 ========== http://www.icd9data.com/2007/Volume1.../253/253.2.htm
Other adrenal hypofunction ========== 255.5 ========== http://www.icd9data.com/2007/Volume1.../255/255.5.htm
Testicular hyperfunction ========== 257 ========== http://www.icd9data.com/2007/Volume1.../257/257.0.htm
Unspecified endocrine disorder ========== 259.9 ========== http://www.icd9data.com/2007/Volume1.../259/259.9.htm
Pure hypercholesterolemia ========== 272 ========== http://www.icd9data.com/2007/Volume1.../272/272.0.htm
Disorders of copper metabolism ========== 275.1 ========== http://www.icd9data.com/2007/Volume1.../275/275.1.htm
Atherosclerosis ========== 440 ========== http://www.icd9data.com/2007/Volume1...48/440/440.htm
Hyperplasia of prostate ========== 600 ========== http://www.icd9data.com/2007/Volume1...08/600/600.htm
Hypertrophy of breast ========== 611.1 ========== http://www.icd9data.com/2007/Volume1.../611/611.1.htm
Decreased libido ========== 799.81 ========== http://www.icd9data.com/2007/Volume1...799/799.81.htm

=======================
When ordering HCG

ICD-9 608.3 Atrophy of testis
Of note, it is also cleared for treatment of secondary hypogonadism.
http://musc lechatroom.com/forum/showpost.php?p=78139&postcount =222
=========================

[JanSz]

Hardasnails notes of dr Marianco's posts.
first posted here:
Avoiding excess conversion of testosterone into estradiol during testosterone treatme
.
.

[hardasnails1973]

Hardasnails notes of dr Marianco's posts.
first posted here:
Avoiding excess conversion of testosterone into estradiol during testosterone treatme
.
.

This should be a sticky !!

[JanSz]

The Durk Pearson & Sandy Shaw® Life Extension News July 2004

Excess amounts of prolactin could also be a hazard because prolactin is known to play a major role in the growth of certain tissues (breast, prostate4).


---------------------------------------------------------
June 1999 Le Magazine: In The News: Elevated Prolactin Linked To Breast Cancer




LE Magazine June 1999
Late-breaking brief news items to life extensionists, as well as anyone interested in living a longer healthier life.

In The News


Elevated Prolactin Linked
To Breast Cancer


In last month's issue of Life Extension magazine, we repeated our recommendation that prostate cancer patients should have there prolactin blood levels checked, as excess amounts of this hormone can promote prostate cancer cell proliferation and prevent successful treatment.

A new study indicates that high levels of prolactin predispose healthy women to an increased risk of breast cancer. Prolactin is produced by the pituitary gland and, along with other hormones, stimulates the growth of the mammary glands and the production of milk after childbirth.

Postmenopausal women who had blood prolactin levels in the upper 25% of the reference range had about twice the risk of breast cancer compared with those in the lower 25% of the distribution, according to a report in the April 7th issue of the Journal of the National Cancer Institute.

The size of this association is similar to that observed between breast cancer and estrogen levels, report Dr. Susan E. Hankinson of Harvard Medical School in Boston, Massachusetts, and colleagues. The study included 306 women who were healthy at the time blood samples were obtained, but went on to develop cancer. Those women were compared with 448 healthy women who did not develop cancer. This new analysis is part of the ongoing Nurses' Health Study, the largest ongoing study of women's health in human history.

There are similarities to breast and prostate cancer cells, and prolactin seems to be a common growth factor in these two cancers. Based on the new report showing that women with high levels of prolactin have twice the risk of breast cancer, it would appear prudent for healthy women to lower their prolactin levels. Here are the standard laboratory reference ranges for blood prolactin levels:

Female
- Non-pregnant 2.8 to 29.2 ng/ml
- Pregnant 9.7 to 208.5 ng/ml
- Postmenopausal 1.8 to 20.3 ng/ml

Male
- 2.1 to 17.7 ng/ml

Evidently, prolactin levels have a very wide range that conventional doctors would consider "normal." The problem is that few doctors are aware of the dangers of elevated prolactin, and if their healthy patients are in the high "normal" range, they would do nothing to treat this condition. A "normal" range often means a person has a "normal" risk for contracting a disease. Since members of The Life Extension Foundation don't want to have "normal" risk factors, here are some guidelines for those to follow who care about optimal health:

Healthy Female
- Non-pregnant - Prolactin level no higher than 7.3 ng/ml
- Postmenopausal - Prolactin level no higher than 5.0 ng/ml

Female - Breast Cancer Patient
- Prolactin level no higher than 1.8


Male - Prostate Cancer Patient
- Prolactin level no higher than 2.0
There are three FDA-approved drugs that suppress prolactin secretion. If a blood test reveals prolactin levels are elevated, ask your doctor to prescribe one of the following drugs:

- Bromocriptine (2.5 mg one or more times a day)
- Pergolide (.25 mg to .50 mg twice a day)
- Dostinex (.5 mg twice a week)

Check prolactin levels again in 30 days to make sure the drug you choose is suppressing prolactin release from the pituitary gland into the blood.

Dostinex is the newest and cleanest drug to use. Dostinex has fewer side effects than the older drugs, is more effective in suppressing prolactin than the older drugs, and requires only twice a week dosing. It should be noted that Durk Pearson and Sandy Shaw recommended bromocriptine as a prolactin suppressing agent back in 1982, and the FDA spent millions of taxpayer dollars keeping Americans from accessing this drug for the purpose of disease prevention. Since 1982, about 700,000 American women have died of breast cancer.
============================== ============================== =======
============================== ============================== =======
Posted by cpeil2
Lab Results In, Need Help

More info: pergolide has been voluntarily withdrawn from the market.


Also re: Dostinex - the risk of valve disease is considerably lower in those taking to lower prolactin because the typical dose is much lower.
============================== ==

Yes, good news. The dose for pituitary problems is so much lower than for Parkinson's that the risk of heart problems appears negligible.


Bromocriptine - There have been isolated reports of valve disease after long-term use for Parkinson's. Again, though, it appears that the risk is dose-related

[phatkid77]

according to shippens chart my free t was 80 or 275ish...what would that be...good, bad???

phats

[JanSz]

according to shippens chart my free t was 80 or 275ish...what would that be...good, bad???

phats

Post SHBG, specify units
Post TotalT, specify units

[phatkid77]

shbg 28nmol
total t-11.4 nmol/L

[JanSz]

My little Adrenals study posted here:

http://forum.mesomorphosis.com/554378-post13.html

===========================
Summary,
when testing Adrenals ask for following Quest tests

Sodium
Potassium
Cortisol not sure yet which one, so many tests but noted that AM/PM is not available from Nichols Institute, probably of low value.
The VA location have 2,3,4,5,6 specimens, possibly those.
http://cas2.questdiagnostics.com/scr...&tmradio=title

http://cas2.questdiagnostics.com/scr...SearchString2=

Aldosterone, LC/MS/MS, Serum http://cas2.questdiagnostics.com/scr...&tmradio=title
Aldosterone, 24-Hour Urine (19552X) - (7062N) http://cas2.questdiagnostics.com/scr...&tmradio=title
Aldosterone (LC/MS/MS)/Plasma Renin Activity Ratio - (11183Z) http://cas2.questdiagnostics.com/scr...&tmradio=title
Plasma Renin Activity (10537X) Code: 10537N http://cas2.questdiagnostics.com/scr...&tmradio=title
============================== ============================== ============================== ====================
http://www.endocrine.niddk.nih.gov/p...on/addison.htm
Addison's disease
Causes
Symptoms
Diagnosis
Other Tests
Treatment
Special Problems
Patient Education
For More Information
=========================
========
http://www.endocrine.niddk.nih.gov/info/index.htm

Information About Endocrine and Metabolic Diseases
Acromegaly
Addison’s Disease
Cushing’s Syndrome
Cystic Fibrosis (from NHLBI)
Endocrine and Metabolic Diseases Organizations
Graves’ Disease
Human Growth Hormone and Creutzfeldt-Jakob Disease
Hyperparathyroidism
Hyperthyroidism
Hypothyroidism
Multiple Endocrine Neoplasia Type 1
National Hormone and Pituitary Program: Information for People Treated with Human Growth Hormone (Comprehensive Report)
National Hormone and Pituitary Program: Information for People Treated with Human Growth Hormone (Summary)
Organizations, Directory of
Pregnancy and Thyroid Disease
Prolactinoma
Turner Syndrome (from NHGRI)

[JanSz]

Copied from:
What is considered high levels of prolactin?

Prolactin secretion is stimulated by sleep, stress (physical and emotional), and the hypothalmic hormone (TRH). Prolactin secretion is decreased by dopamine analogs such as bromocriptine.
Hypersecretion of prolactin can be caused by pituitary tumors, hypothalmic disease, breast or chest wall stimulation, hypothyroidism, renal failure, acute excercise, stress, eating, and several medications(eg; pheno-thiazines, metoclopramide). Hyper-prolactinemia inhibits gonadothropin secretion and can produce hypogonadism in men and women with accompanying low or inapropriedly "low normal" LH and FSH levels.

Quest Diagnostics
EndoManual_3rdEd_2004 page 311

Prolactin have no known role in male. page 205

Eating, or having sex, can bring PRL to 30. Did you eat within two hours of the draw? How does midrange PRL look now?

PRL of 300 (!) is pathognomic of a pituitary tumor.

I hope this FINALLY gives you guys some perspective. Some of this stuff gets just plain silly: manipulating hormones for no reason whatsoever, when they are well within healthy level. Any time you alter a hormone, you are asking for trouble. THAT is how Interventional Endocrinology should be viewed.

My take home message:
as long as Prolactin is within range it should be ignored and not manipulated.

If it is within range then: Prolactin have no known role in male. and that includes effects on sex.

This message is copied to my diary as my current view on Prolactin.

Thank you Dr John for your persistence thru many posts when holding your view on Prolactin.

[JanSz]

What I have learned about TRT (under construction)

When on TRT your goal is to keep your FreeT in upper range but not over it.
FreeT tests are unreliable, possibly except at Quest Diagnostics and only the one that is on my list of blood tests, post #44
If you have that test available, look also at BAT level, keep it in upper range.

Other choice (supposedly used by Dr Shippen) is to use a chart, post #41
On that chart desirable range is (160-250), 100 being really the lowest with any hope.

FreeT level depends on
Total Testosterone
and
SHBG
and Albumin to some extent, we are not going to worry too much about Albumin.

Total Testosterone depends on
testicles production
and
Testosterone injections ( I consider transdermals as rather overly variable specially since many people have some or heavy thyroid problems)

Testicles may be able to produce T (Secondary) or not (Primary)
Testicles that are able to produce but do not have enough signal (LH, FSH) are induced to production by using HCG.
Use of HCG while on T is always recomended because it keeps testicles full (otherwise they will shrink).
Sometimes HCG may be used as sole TRT, but it rarely works.
Ideal dose of HCG is 100-250iu daily, not practical.
Someone who likes to keep their sperm fertile should probably use E2D, every two days schedule, 250iu-dose.
If fertility is or is not at issue E3D schedule is also acceptable, every three days, 500iu-dose.
Someone who is not able to get HCG should not worry too much, yes his testicles will shrink and stop any production.
Testicles can be brought back to size latter on when HCG became available, not sure about fertility.
When fertility is at issue (in the worst way), use daily (hcg-100iu and HMG-75iu) for three months to a year while trying to conceive.

When there is a need for testosterone injections use cypionate or enanthate.
Assuming that testcles are absent or adding (some) correction when indigenous production is known, preliminary dose of testosterone can be

calculated
when SHBG and last Total T is known.
Use chart post #41, and table post #40
table gives weekly dose (XXX mg/week)
that dose have to be converted to volume, cc or/and units (on insuline syringe)
Density of testosterone need to be known. Most often 200mg/mL is used but also 100mg/mL is available.
Weekly volume need to be converted to a volume for each shot for E2D or E3D routine of injections.
I do not consider weekly or less often injections, specially for those with low SHBG since the TT variability is a frequent source of emotional stress.
Example,
calculate size of individual shot
weekly dose 130mg
200mg/mL testosterone density
E3D routine
(130mg)/(200mg/mL)=0.65mL/week
0.65mL/week=0.65cc/week=65 units/week
65/7*3=27.9~28 units each shot

E2D or E3D routines that is a lots of shots, specially when considering large needles that are customarily used.
Also with large needles injections are very quick causing additional tissue damage and pain lasting sometime days.
For this and other reasons I prefer SubQ shots around navel using smallest available needle.
It takes 4 minutes to get the testosterone into syringe and then a minute to inject it in.
I consider that time well spend, any sorenes last no more than 10 minutes after the shot.
I curently use 5/16" long needle, but am considering change to 1/2" long since tiny bit of oil escapes after about every other shot.
Not sure if it is worth the effort since going to 1/2"long needle would mean also going to thicker (39ga) needle.
There are at least two suitable types of syringes available for purchase:
http://hocks.com/Merchant2/merchant....Category_Code=
BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b Price: $25.95
and
http://hocks.com/Merchant2/merchant....Category_Code=
BD Pen Needle Short 31 Gauge 3/16inch 100/box

Bottom line, E3D routine
both T&hcg shots on same day, then two days free of shots
--------------------------------------------------------------------------------------------------
While on TRT estrogens have to be monitored, all estrogens, as in blood test list post #44
I use LEF life Extension Foundation products
DualAction 5 pills ( for cruciferous, I3C & DIM content)
TMG 2 pills

I also use Arimidex or actually the liquid version for ease of use.
I use insuline syringe with cut off needle to get my dose.
I use Arimidex on E3D schedule, same as my T&hcg for simplicity.
I use 0.5cc=50units=1/2pill eact time, dosing must be verified by testing.

------------------------------------------------------------------------------------------------
I do blood tests once/year per my list, post #44
also 2-4 tests thruout the year on as need basis.
Full test is fully paid by my insurance (Medicare) when supported bt ICD-9 codes (provided in post #41)

[cpeil2]

I consider transdermals as rather overly variable specially since many people have some or heavy thyroid problems)

But many professionals in the field consider them a first-line option, and many man who use them are entirely satisfied with the result. Our own Dr. Crisler believes that TD's are preferable to injections because they mimic normal physiology more closely than injections.

Sometimes HCG may be used as sole TRT, but it rarely works.

hCG can produce a good result in properly selected individuals. It is best-suited to men in early middle age having relatively modest secondary hypogonadism.

[JanSz]

Dr Marianco on low SHBG

[JanSz]

--------------http://anabolicminds.com/forum/962870-post13.html

estrone to e2 convresion

I forget people outside pharmacy don't always know RPh is the designation for registered pharmacist. I do quite a bit of compounding bio-identical HRT (mostly for women). Obviously, I don't know their case details, but many women present with anxiety/panic attack type symptoms (who have previously never had them) duing the peri-menopausal timeframe. Normally this is due to a drop in progesterone/estrogen dominance and normally associated neurotransmitter levels falling. As you probably know heart racing, breathing problemss, and chest pain are common with this, so maybe that could be what is going on. This would not likely show up on any of the typical ER labs either. Many drs won't test actual hormone levels. We all know this should be standard practice, but it is not. Many will test LH/FSH and say they are "fine", but those levels don't generally change much duing peri-menopause as progesterone is the primary problem. To find a good HRT dr. work backwards. Go to a compounding pharmacy with a good reputation and ask them what dr to see. You can go through a group called IACP (International Acadamy of compounding pharmacists) to find a compounding pharmacy.

Compounding Pharmacist Locator
International Academy of Compounding Pharmacists:

International Academy of Compounding Pharmacists: Home

If you are unable to locate a compounding pharmacist within a 100 miles radius, please contact our toll-free referral line at 800-927-4227.
============================== =================
The Medicine Shoppe
146 Us Highway 206
Andover, NJ 07821-4518
(973) 786-5300
Henry Gialanella
146 Main St

20 miles from ZIP 07054
Company Name The Alchemist Shoppe
Pharmacist Linda Witzal R.Ph.
Address 3175 Route 10 E.
Denville NJ 07834
Phone (973) 328-4477
URL scream and cream alchemist chris at alchemistshoppe.com
Distance Approx. 5 Miles

Company Name Pharmacy Creations

Pharmacist Scott Karolchyk "R.Ph., FIACP"
Address 540 Route 10 West
Randolph NJ 07869
Phone (973) 328-8756
URL Pharmacy Creations News Items
Distance Approx. 8 Miles



Company Name Pompton Pharmacy

Pharmacist David Stahlberger "R.Ph., FIACP"
Address 558 Newark Pompton Turnpike
Pompton Plains NJ 07444
Phone (973) 839-4200
Distance Approx. 9 Miles



Company Name Sheefa Pharmacy & Wellness Center
Pharmacist Ashraf Latif R.Ph.
Address 405 Central Avenue
East Orange NJ 07018
Phone (973) 673-6800
URL Welcome To Sheefa Pharmacy
Distance Approx. 11 Miles



Company Name Clifton Pharmacy & Compounding
Pharmacist Howard Bleznick R.Ph.
Address 595 Van Houten Avenue
Clifton NJ 07013
Phone (973) 777-2428
Distance Approx. 12 Miles


Company Name Medicine Shoppe
Pharmacist Jillian Hocking Pharm. D.
Address 36-A Main Street
Bloomingdale NJ 07403
Phone (973) 838-0909
Distance Approx. 12 Miles


Company Name Medicine Shoppe
Pharmacist Daniel Albizati R.Ph.
Address 559 Franklin Avenue
Nutley NJ 07110
Phone (973) 235-0909
Distance Approx. 13 Miles



Company Name Belvidere Pharmacy
Pharmacist George Grumet R.Ph.
Address 349 Somerset Street
North Plainfield NJ 07060
Phone (800) 322-1302
Distance Approx. 15 Miles



Company Name Millers of Wyckoff
Pharmacist David Miller R.Ph.
Address 678 Wyckoff Avenue
Wyckoff NJ 07481
Phone (201) 891-3333
URL Millers Pharmacy
Distance Approx. 15 Miles



Company Name Belvidere Pharmacy

Pharmacist Shara Rudner "R.Ph., FIACP"
Address 349 Somerset Street
North Plainfield NJ 07060
Phone (908) 756-6695
Distance Approx. 15 Miles



Company Name Rock Ridge Pharmacy

Pharmacist Matthew Kopacki "R.Ph., FIACP"
Address 191 Rock Road
Glen Rock NJ 07452
Phone (201) 444-4190
Distance Approx. 16 Miles


Company Name Town & Country Pharmacy

Pharmacist John Herr "R.Ph., FIACP"
Address 60 E. Ridgewood Ave.
Ridgewood NJ 07450
Phone (201) 447-2020
Distance Approx. 17 Miles

============================== ============================== =======================

Company Name Dorneyville Pharmacy

Pharmacist Tom Silvonek "R.Ph., FIACP"
Address 3330 Hamilton Blvd.
Allentown PA 18103
Phone (800) 850-2196
Distance Approx. 2 Miles



Company Name "Hartzell's Pharmacy, Inc. Home Heal"
Pharmacist Robert Hartzell R.Ph.
Address 300 American Street
Catasauqua PA 18032
Phone (610) 264-5471
Distance Approx. 3 Miles



Company Name DelPrete's Pharmacy
Pharmacist Keith Delprete R.Ph.
Address 3437 Rt. 309
Orefield PA 18069
Phone (610) 395-2602
Distance Approx. 7 Miles



Company Name Medicine Shoppe
Pharmacist Phillip Bennett R.Ph.
Address 1408-2 W. Broad Street
Quakertown PA 18951
Phone (215) 536-5595
Distance Approx. 12 Miles



Company Name Professional Pharmacy
Pharmacist David Stone Pharm.D.
Address 931 Main Street
Pennsburg PA 18073
Phone (215) 679-9700
Distance Approx. 14 Miles

============================== ============================== ===============

also

American Osteopathic Association

and

American Osteopathic Association

Find an Osteopath : General Osteopathic Council

healthfinder.gov - Osteopath

Stop The Thyroid Madness » ADRENALS FAQ–the most frequently asked questions

Stop The Thyroid Madness » How to find a GOOD DOC

Thyroid Disease Information Source -- Bestselling Books, News, Information on Living Well With Hypothyroidism, Autoimmune Disease, Thyroid Diet, Home Page of Mary Shomon

Physician that use ArmourThyroid
============================== ============================== =====================

You have some great pharmacists in your area. Scott Karolchyk, Matt Kopacki, and John Herr are ones I have spoken with at conferences before and all of them really know their stuff. Any of the ones with FIACP after their names are fellows in IACP which is an accomplishment.

============================== ==
============================== ============================== =======================
The World Health Network - Anti-Aging and Longevity
look under directory
============================== ============================== =================
============================== ===
---------------------------------------------
Aleksandr Martirosov, DO
31-00 Broadway
Fair Lawn, New Jersey 07410
(210) 475-5006
aleksandrmartirosov@yahoo.com
---------
Family Medicine
Addiction Medicine
Anti-Aging Medicine
Ostheophatic Medicine
---------------------------------------------
Forward J Brent MD
195 US Hwy 46
Mine Hill, NJ 07803-3163
(973)366-8884
------------------------
Patrick Barrett DO
(631)472-6000
4568 Sunrise Hwy Oakdale, NY 11769-1012
in case I need new doc, good one to ask for reference,
(84.8 mi – about 1 hour 42 mins (up to 2 hours 20 mins in traffic)
he works with a lot of bodybuilders, hes a DO and hes a GP

------------------------
Anti-Aging Medicine

Jeffrey Dach MD Bio-Identical Hormone Blog

Find a Doctor
Anti-Aging Physicians, Clinics & Products - WorldHealth.net
=====================
very nice search engine:

Integrative Medicine Physicians - American College for Advancement in Medicine
============================== ============

Doctor Referral List

http://ucprx.com/doctor_referral_list


........
http://www.osteopathic.org/osteopath...s/default.aspx

http://www.osteopathic.org/osteopath...s/default.aspx

[JanSz]

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EDUCATIONAL THREADS
----------http://forums.steroid.com/forumdisplay.php?f=12]EDUCATIONAL THREADS - Anabolic Steroids - Steroid.com / Anabolic Review Forums

[JanSz]

http://anabolicminds.com/forum/male-...tml#post991716

============================== ============================== ============
I am posting this response here and on the thread where dr Delgado made his statement.
Hopefully we will get some words from him.

http://anabolicminds.com/forum/991716-post165.html
http://anabolicminds.com/forum/991863-post166.html

I will also suggest that aging is going to include a decline of hormones,
within genetic differences, expect to augment back Testosterone,
I keep mime and my clients under doctors monitoring,
around 1000 to 1,200 ng/ml Total T,
and Free T at upper range of 200 to 300 (or 20 to 40 pg/mldepending on the nomenclature)
Aldosterone is best at 10 to 40 ug/24 hr,
IGF-1 around 250 to 400 ng/ml.
DHT 60 to 70 ng/dl,
DHEA 300 ug/dl,
insulin under 5,
SHBG 10 to 30 nmol/l,
Estradiol 35 pg/ml,
with about 20 (2OHE) to 1 -16aOHE.

[plymouth city]

JansZ
I noted that you take high dose Chrysin now via lef products.

You jumped from 1 - 2 pills to 7 pills right in between BW?

Take note that Chrysin might not be an effective form of T boosting or E control

I have had discussions with Eric over at PP about this.

They removed Chrysin and reworked Dermacrine Sustain - "Basically, we removed chrisin to make room for more resveratrol and 7,8 benzoflavone. Plus there is some research showing that high-doses of chrysin can inhibit the enzyme which converts Adione to Test (17HSD) so we removed it to make room for the more effective T boosters."

Primordial Performance - Dermacrine, hormone precursors and estrogen reducers

There is also another thread floating around here that has a MD backed study showing Resveratrol to be much more superior than chrysin for controlling E.

I would dump the product your taking and just go for straight RSV. Check out this thread, pages 3 in specific Resveratrol really cheap

I noted that you cannot go transdermal form, so look for revgentics which sells massive doses of RSV, specifically the X500. 500mg pure RSV. Cut pill in half

[JanSz]

JansZ
I noted that you take high dose Chrysin now via lef products.

You jumped from 1 - 2 pills to 7 pills right in between BW?

Take note that Chrysin might not be an effective form of T boosting or E control

I have had discussions with Eric over at PP about this.

They removed Chrysin and reworked Dermacrine Sustain - "Basically, we removed chrisin to make room for more resveratrol and 7,8 benzoflavone. Plus there is some research showing that high-doses of chrysin can inhibit the enzyme which converts Adione to Test (17HSD) so we removed it to make room for the more effective T boosters."

Primordial Performance - Dermacrine, hormone precursors and estrogen reducers

There is also another thread floating around here that has a MD backed study showing Resveratrol to be much more superior than chrysin for controlling E.

I would dump the product your taking and just go for straight RSV. Check out this thread, pages 3 in specific Resveratrol really cheap

I noted that you cannot go transdermal form, so look for revgentics which sells massive doses of RSV, specifically the X500. 500mg pure RSV. Cut pill in half

Thanks for your concern.
I stopped using Chrysin over two moths ago.
Looking at my April's test, I came to conclussion that I should reduce pressure on my SHBG.
Specially that I am aiming at TotalT~(1100-1200) and FreeT~300 per Nick Delgado rather than previous FreeT~250 per dr Shippen.
There is two SHBG positions on that test, 20 and 24.
I was getting Chrysin from LEF's
Super MiraForte with Maximum Strength Chrysin
Super Miraforte With Max Strength Chrysin, 120 Caps
that product contains Nettle (Urtica dioica) which lowers SHBG.

I also take 200mg resveratrol, separately, this is on top of resveratrol that I am getting with DualAction.

When I changed from Tcream to Deopo-Testosterone shots on june 19/2007 I added Liquidex 0.5cc with each shot, I use E3D schedule.
=====================
I had doctor visit tonight.
I will be doing Metabolic Analysis Profile.
Genova Diagnostics

I have seen (partial) results from my last blood test.
Pregnenolone is on the bottom of range
I am increasing from 1gram to 2 grams preg cream

DHEAs is below range, I will start using DHEA again, probably 100mg

Do not know what to think (could use help) about my (blood serum) Aldosterone=1.0ng/dL(<or=28)
In April it was=4
Quest Diagnostics: Test Menu

I thought that Aldosterone should be in high teens or even 20's

Should I reduce salt, increase Potassium, what to do???
Lately I use more salt then I used to use in my life (taste good, not sure if I need the salt).
----
Note on Quest web site.
Because
serum aldosterone concentrations vary due to dietary sodium
intake and body position, some physicians prefer
measurement of 24-hour urine concentrations for
aldosterone.