Steve's Lab Result History

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    Steve's Lab Result History


    I thought I'd post a short history of lab results and other history for general comments/suggestions:

    Thyroid TSH levels showed high (6.74 and 5.71, range of 0.54-5.7 uIU/mL) as far back as 1998, but my doctor at the time didn't think that was unusual and I seemed okay. I was 29 at that time, did a lot of long distance running (including a couple of marathons) and seemed to feel okay.

    Fast forward to 2004 and my TSH level tested 6.98 on a range of 0.35-5.5 uIU/mL, and I was feeling a bit tired. Retest showed 4.664 ad 4.442, but at that point I had less trust in general docs. So I started seeing an endocrinologist who started me on Levoxyl and TSH has been hovering around 1 for the past few years.

    From mid-2006 to late 2007 I was under a *lot* of stress at home and work, which really took a toll on me both mentally and physically. The final solution was to dump the emotionally messed up long-term girlfriend and quit the job with the foolish boss. I haven't missed either or the stress they caused.

    I switched to a different endocrinologist in early 2008 due to moving for the new job. He ran a blood panel in April 2008 that showed not so great cholesterol levels (and I eat fairly well and exercise) and a total Testosterone level of 332 (range 200-1200 ng/dL). I had a new girlfriend at that point (very smart and pretty triathlete) and had been having some ED problems, so I was concerned about the Testosterone number. I had never had my Testosterone checked before, so my previous baseline is unknown.

    I asked my endo to run a more extensive Testosterone panel. Results showed:

    *FSH = 1.7 mIU/mL (range 2-12)
    *LH = 2.3 mIU/mL (range <10 whatever that means)
    *Testosterone = 380 ng/dL (range 200-1200)

    The test results immediately above are from Stanford Clinical Laboratory.

    *Testosterone, total, S = 250 ng/dL (range 240-950)
    *Testosterone, free, S = 6.3 ng/dL (range 9-30)
    *Testosterone, bioavailable, S = 53 ng/dL (range 72-235)

    The test results immediately above are from the Mayo Clinic.

    My endo doubted the ED issue was due to my Testosterone levels and said he considered hormone therapy for me to be optional. I told him I would like to try it to see if there were any positive effects, so he started me out on Androgel 5g/day, which I've been on for about 5 weeks now. I seemed to notice some positive changes the first 2-4 weeks (more energy, greater sex drive, etc.).

    For my next blood panel, the endo is measuring Prolactin, total Testoserone, bioavailable Testosterone, and Ferritin.

    After reading information on this board and other sources, I'm having second thoughts about my endocrinologist. He seems like a nice fellow, but he's kind of young, and my guess is he spends most of his time treating diabetics. So I'm investigating other local docs. I found 2-3 promising candidates from the Life Extension Foundation web-site, so I'll have to investigate those in greater detail.

    Any thoughts, suggestions, or comments on my history and treatment options are appreciated!

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    Quote Originally Posted by steve999 View Post
    I thought I'd post a short history of lab results and other history for general comments/suggestions:

    Thyroid TSH levels showed high (6.74 and 5.71, range of 0.54-5.7 uIU/mL) as far back as 1998, but my doctor at the time didn't think that was unusual and I seemed okay. I was 29 at that time, did a lot of long distance running (including a couple of marathons) and seemed to feel okay.

    Fast forward to 2004 and my TSH level tested 6.98 on a range of 0.35-5.5 uIU/mL, and I was feeling a bit tired. Retest showed 4.664 ad 4.442, but at that point I had less trust in general docs. So I started seeing an endocrinologist who started me on Levoxyl and TSH has been hovering around 1 for the past few years.

    From mid-2006 to late 2007 I was under a *lot* of stress at home and work, which really took a toll on me both mentally and physically. The final solution was to dump the emotionally messed up long-term girlfriend and quit the job with the foolish boss. I haven't missed either or the stress they caused.

    I switched to a different endocrinologist in early 2008 due to moving for the new job. He ran a blood panel in April 2008 that showed not so great cholesterol levels (and I eat fairly well and exercise) and a total Testosterone level of 332 (range 200-1200 ng/dL). I had a new girlfriend at that point (very smart and pretty triathlete) and had been having some ED problems, so I was concerned about the Testosterone number. I had never had my Testosterone checked before, so my previous baseline is unknown.

    I asked my endo to run a more extensive Testosterone panel. Results showed:

    *FSH = 1.7 mIU/mL (range 2-12)
    *LH = 2.3 mIU/mL (range <10 whatever that means)
    *Testosterone = 380 ng/dL (range 200-1200)

    The test results immediately above are from Stanford Clinical Laboratory.

    *Testosterone, total, S = 250 ng/dL (range 240-950)
    *Testosterone, free, S = 6.3 ng/dL (range 9-30)
    *Testosterone, bioavailable, S = 53 ng/dL (range 72-235)

    The test results immediately above are from the Mayo Clinic.

    My endo doubted the ED issue was due to my Testosterone levels and said he considered hormone therapy for me to be optional. I told him I would like to try it to see if there were any positive effects, so he started me out on Androgel 5g/day, which I've been on for about 5 weeks now. I seemed to notice some positive changes the first 2-4 weeks (more energy, greater sex drive, etc.).

    For my next blood panel, the endo is measuring Prolactin, total Testoserone, bioavailable Testosterone, and Ferritin.

    After reading information on this board and other sources, I'm having second thoughts about my endocrinologist. He seems like a nice fellow, but he's kind of young, and my guess is he spends most of his time treating diabetics. So I'm investigating other local docs. I found 2-3 promising candidates from the Life Extension Foundation web-site, so I'll have to investigate those in greater detail.

    Any thoughts, suggestions, or comments on my history and treatment options are appreciated!
    Best to do full long list of blood tests that I posted.
    or with info that you provided do these:
    ============================== =================
    Iodine
    Copper
    Selenium
    Zinc
    Ferritin
    T3 Free
    T3,Total
    T4,Free
    T4,Total
    reverse T3 (rT3)
    Ultrasensitive TSH
    Thyroid Peroxidase and Thyroglobulin Antibodies (7260X)
    Glucose, fasting
    Insuline, serum
    PSA, Total
    PSA, %, free
    IGF Binding protein-3
    IGF-1
    Aldosterone
    Cortisol AM/PM
    DHEA sulfate
    Prolactin
    FSH
    LH
    Progesterone, LC/MS/MS
    Pregnenolone
    Estradiol, Ultrasensitive, LC/MS/MS (30289X)
    Testosterone, Free, Bio/Total (LC/MS/MS)
    Dihydrotestosterone, Free, Serum (36168X)
    ============================== ==============


    Androgel (5grams) specially Androgel alone is wrong choice for you.
    It will shut down whatewer little T you were making, you will be worst than when you started.

    You will most likely need 10grams.

    But Androgel is all together a poor choice in your situation.

    LH = 2.3 mIU/mL
    Your LH is low, your testis are (were by now) most likely in good shape and could produce what you need if you stimulate them with HCG.

    Usually 1000-1250iu E3D, every third day is where you will end up.
    But you could go up to 6000iu/week or 10000iu.

    Your dose of HCG is driven by:
    reaching desirable BAT (BioAvailableTestosterone)
    excessive E2 raise that can not be controlled with 2mg arimidex (max)
    Stick to E3D schedule.

    There is couple guys posting about their HCG theraphy.

    colkurtz_spf
    jinxie

    read on their experience:

    TRT WORKS, My results have been amazing!!

    hCG Monotherapy Success Story -- Staggering Numbers
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    Thanks. After reading through some of the posts on this forum, I was thinking starting with HCG would have been better than jumping onto Androgel. I'd rather stick myself with a needle every few days than have to deal with the gel every morning, and possible contamination risks with my girlfriend, dog, etc.

    I'll talk to my endocrinologist. If he won't go that route, I'll find somebody who will.
    •   
       

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    Second round of blood test results are partially in:

    Testosterone: 233 ng/dL (range 200-1200)
    Prolactin: 6 ng/mL (range 2.2-18.5)
    Ferritin: 18 ng/mL (range 8-282)

    Testosterone Free, Free S, Bioavailable S tests are still pending. Judging from the total testosterone results, my guess is these will be low.

    The second round results are after being on Androgel 5g/day for about 6 weeks, feeling better for a few weeks and then noticing the effects dropping off. I stopped taking the Androgel after the second round of tests as I want to switch to HCG and from what I've read here, staying on the Androgel any longer would just make switching to HCG more difficult.

    The ferritin level is a concern. Apparently low ferritin is common for hypothyroid folks like me.

    I'm really starting to think I need to find a good local osteopath who is better capable of offering treatment advice for low testosterone plus hypothyroid issues.
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    Post Dr. M Appointment Blood Work


    Results from bloodwork ordered by Dr. M are posted below. Values within range but close to range limits are shown in bold. Values out of range are shown in red.

    I'm currently on HCG, 1000 units every-other-day. Also Levoxyl for hypothyroidism.

    Looks like my Levoxyl dose is a little too high based on the TSH number. Not sure what's up with the low Vitamin D and high Vitamin A. My diet is actually pretty good.

    Any comments would be appreciated.

    Comp. Metabolic Panel
    Glucose, serum 86 mg/dL [65 - 99]
    BUN 11 mg/dL [5 - 26]
    Creatinine, Serum 1.24 mg/dL [0.76 - 1.27]
    Glom Filt Rate, Est >60 mL/min/1.73 [60 - 137]
    BUN/Creatinine Ratio 9 [8 - 27]
    Sodium, Serum 140 mmol/L [135 - 145]
    Potassium, Serum 4.6 mmol/L [3.5 - 5.2]
    Chloride, Serum 98 mmol/L [97 - 108]
    Carbon Dioxide, Total 27 mmol/L [20 - 32]
    Calcium, Serum 9.5 mg/dL [8.5 - 10.6]
    Protein, Total, Serum 6.8 g/dL [6.0 - 8.5]
    Albumin, Serum 4.6 g/dL [3.5 - 5.5]
    Globulin, total 2.2 g/dL [1.5 4.5]
    A/G Ratio 2.1 [1.1 2.5]
    Bilirubin, Total 0.8 mg/dL [0.1 1.2]
    Alkaline Phosphatase, S 43 IU/L [25 - 150]
    AST (SGOT) 27 IU/L [0 - 40]
    ALT (SGPT) 26 IU/L [0 - 55]

    5-HIAA Qn, Random Urine
    Creatinine, Random U 26.4 mg/dL [undefined]
    5-HIAA, Urine 1.2 mg/L [undefined]
    5-HIAA, Qn, Random, Ur 4.5 mg/g Creat [1.8 5.5]

    Vitamin B12 and Folate
    Vitamin B12 364 pg/mL [211 - 911]
    Folate (Folic Acid), Serum 16.1 ng/mL [> 5.4]

    Pregnenolone, MS 108 ng/dL [< 20 - 150]

    TSH 0.300 uIU/mL [0.450 4.500]

    Prostate-Specific AG, Serum 1.1 ng/mL [0.0 4.0]

    Estradiol, Sensisitve 24 pg/mL [3 - 70]

    Dehydroepiandrosterone Sulfate
    DHEA-Sulfate 227 ug/dL [120 - 520]

    Thyroxine (T4) Free, Direct, S
    T4, Free (Direct) 1.39 ng/dL [0.61 1.76]

    Vitamin D, 25-Hydroxy 22.3 ng/mL [32.0 100.0]

    Testosterone, Serum 470 ng/dL [241 - 827]

    Thyroxine (T4) 7.6 ug/dL [4.5 12.0]

    Triiodothyronine (T3) 117 ng/dL [85 - 205 ]

    Magnesium, Serum 2.1 mg/dL [1.6 2.6]

    Progesterone 0.8 ng/mL [0.3 1.2]

    Insulin 4.3 uIU/mL [0.0 29.1]

    Triiodothyronine, Free, Serum 3.3 pg/mL [2.3 4.2]

    Vitamin A, Serum 113 ug/dL [30 - 90]

    Cortisol AM 14.7 ug/dL [4.3 22.4]
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    Just checking back in on my earlier post.

    I would have thought that 1000 units of HCG EOD would put my testosterone above the 470 ng/dL [241 - 827] indicated?
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    Latest Blood Test Results


    I'm currently on HCG, 1200 units every-other-day. Also Levoxyl for hypothyroidism.

    My latest bloodwork results as ordered by Dr. M are as follows:

    estradiol, sensitive: 36 pg/mL (reference 3-70)

    testosterone, serum: 633 ng/dL (reference 241-827)

    DHEA-Sulfate: 160 ug/dL (reference 120-520)


    ED and low libido problems persist.

    Dr. M. says my estradiol has increased above desirable levels, but rather than prescribing something to lower that, he wants me to stop taking HCG and switch to direct testosterone injections (100-160 mg IM each week).

    I think his game plan is to get me to > 80% of the testosterone reference range with lower/normal estradiol levels to see if that helps the ED/libido issues. Im currently at about 67% of the reference range on HCG (with not so great estradiol), and it looks like thats as far as the boys are going to go on HCG alone. If being at > 80% on direct testosterone replacement doesnt fix things, then well look into other possible factors.

    Im thinking this might be a good plan, at least short term. I can always go back to a combination of HCG + testosterone at a later date.

    Any comments would be appreciated.
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    Quote Originally Posted by steve999 View Post
    I'm currently on HCG, 1200 units every-other-day. Also Levoxyl for hypothyroidism.

    My latest bloodwork results as ordered by Dr. M are as follows:

    estradiol, sensitive: 36 pg/mL (reference 3-70)

    testosterone, serum: 633 ng/dL (reference 241-827)

    DHEA-Sulfate: 160 ug/dL (reference 120-520)


    ED and low libido problems persist.

    Dr. M. says my estradiol has increased above desirable levels, but rather than prescribing something to lower that, he wants me to stop taking HCG and switch to direct testosterone injections (100-160 mg IM each week).

    I think his game plan is to get me to > 80% of the testosterone reference range with lower/normal estradiol levels to see if that helps the ED/libido issues. Im currently at about 67% of the reference range on HCG (with not so great estradiol), and it looks like thats as far as the boys are going to go on HCG alone. If being at > 80% on direct testosterone replacement doesnt fix things, then well look into other possible factors.

    Im thinking this might be a good plan, at least short term. I can always go back to a combination of HCG + testosterone at a later date.

    Any comments would be appreciated.
    Sorry I must have missed your post #5
    10-29-2008, 09:30 PM
    From that post:
    Take
    5mg Methylcobalamin
    6000iu Vit D
    get your DHEAs(500-640) eat as many pills as it take (I have to take 400mg/day)
    -----------------
    You are taking too much HCG
    500-750iu/EOD
    should most likely do the same for yout TotalTest level but would be easier on your E2
    You may still need some testosterone (latter on).
    If DHT is ok (DHT(60-90) then use injections
    if DHT is low, use transdermal T.

    Best to test at Quest, these tests:
    42 DHEA sulfate
    43 Prolactin - (746X)
    46 Progesterone, LC/MS/MS - (17183X)
    47 Pregnenolone, LC/MS/MS (31493X)
    48 Estradiol, Ultrasensitive, LC/MS/MS (30289X)
    49 Estrone, LC/MS/MS (23244X)
    50 Testosterone, Free, Bio/Total (LC/MS/MS) Code: 14966X
    51 Dihydrotestosterone (204X)

    Goals

    DHEAs(500-640)
    E2(25-29)
    DHT(60-90)
    BAT(460-575)
    BAT-BioAvailableTestosterone
    ============================== ====================

    I would prefer if you did one good thyroid (and adrenals) test and then go from there:
    7 Iodine Panel - (2503)
    8 Selenium
    9 Copper, serum
    10 Zinc
    17 Iron and Iron Binding Capacity (7573X) - (356N)
    18 Iron, Total (571X) - (24984P)
    19 Ferritin (457X) - (22764P)
    20 Transferrin (891X) - (30346P)
    21 Folate, RBC & Hematocrit - (1768N)
    22 Hemoglobin A1c (496X) - (45484P)
    23 Hemoglobin, Plasma (514X) - (7211P)
    27 T3, Total (859X)
    28 T4, Total (Thyroxine)
    29 T3 Free
    30 T4,Free
    31 T3, Reverse (967X)
    32 Ultrasensitive TSH
    33 Thyroid Peroxidase and Thyroglobulin Antibodies (7260X)
    37 IGF Binding protein-3
    38 IGF-1
    39 Aldosterone
    40 Cortisol Binding Globulin (Transcortin) (37371X)
    41 Cortisol AM/PM
    42 DHEA sulfate
    ============================== ============================== ============
    .
    .
    I feel that dr M will oblige you if you ask for the above.

    Good luck
    .
    .
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    Thanks Janz.

    I've been taking B-12 sublingual and 15,000 units/day of Vitamin D for a couple of months now, along with some other vitamin supplements.

    What do you recommend for increasing DHEA?

    Dr. M has not tested for DHT and many of the other tests you recommend.

    I'm considering scheduling a visit with Dr. Crisler as a second opinion to Dr. M.
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    Quote Originally Posted by steve999 View Post
    Thanks Janz.

    I've been taking B-12 sublingual and 15,000 units/day of Vitamin D for a couple of months now, along with some other vitamin supplements.

    What do you recommend for increasing DHEA?

    Dr. M has not tested for DHT and many of the other tests you recommend.

    I'm considering scheduling a visit with Dr. Crisler as a second opinion to Dr. M.
    I am taking DHEA pills from LEF.org
    4 pills each 100mg=400mg/day

    Start slowly, adjust per test results, my previous dose was 300mg/day


    .
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    Quote Originally Posted by JanSz View Post
    I am taking DHEA pills from LEF.org
    4 pills each 100mg=400mg/day

    Start slowly, adjust per test results, my previous dose was 300mg/day


    .
    Dr M has a good approach for some people hcg will cause automatic increase in e2 for some unknown reason, but also hcg stimulates other pathways that testosterone does not and can have a positive effect on LH receptors all through out the body..some people feel great on just testosterone and not have a problem with it. When i was on just test alone and no hcg I did not need adex since switching over to hcg I need an armidex so if you feel good with more testosterone then hcg stay the course because it is less variables to content with ..I know guys tha just do good on testosterone and have no issues at all with e2 even at 200 mgs per week. Less drugs the better !!
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
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    Quote Originally Posted by steve999 View Post
    Thanks Janz.

    I've been taking B-12 sublingual and 15,000 units/day of Vitamin D for a couple of months now, along with some other vitamin supplements.

    What do you recommend for increasing DHEA?

    Dr. M has not tested for DHT and many of the other tests you recommend.

    I'm considering scheduling a visit with Dr. Crisler as a second opinion to Dr. M.
    Either test your Vit D level now,
    or
    lower your intake below 10000iu,
    say 6000-8000iu

    .
    .
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    Quote Originally Posted by JanSz View Post
    Either test your Vit D level now,
    or
    lower your intake below 10000iu,
    say 6000-8000iu

    .
    .
    DR M is good for thyroid and adrenals, testosterone crisler may be little more open. Each of them have their strong points. We encourage clients to get a second opinon because it only makes what we are doing more credible. We have had a few people who went to other dr's and Dr would have followed the same form of treatment. It just varied that we were doing the right treatment all along.
    I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
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    Quote Originally Posted by JanSz View Post
    Either test your Vit D level now, or lower your intake below 10000iu, say 6000-8000iu.

    Going back to my earlier post, prior to starting the Vitamin D supplements, I was at 22.3 ng/mL [range 32.0 100.0]. Even after 15,000 units of Vitamin D per day for a couple of months, my latest test is only at around 65 ng/mL, or mid-range. That's kind of surprising given 15,000 units/day is a *lot* of Vitamin D. Maybe an absorption problem?
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    Quote Originally Posted by The Matrix View Post
    Dr M has a good approach for some people hcg will cause automatic increase in e2 for some unknown reason, but also hcg stimulates other pathways that testosterone does not and can have a positive effect on LH receptors all through out the body..some people feel great on just testosterone and not have a problem with it. When i was on just test alone and no hcg I did not need adex since switching over to hcg I need an armidex so if you feel good with more testosterone then hcg stay the course because it is less variables to content with ..I know guys tha just do good on testosterone and have no issues at all with e2 even at 200 mgs per week. Less drugs the better !!
    I started on direct testosterone yesterday. Per Dr. Crisler's article, I frontloaded 200 units injected IM. Shots don't bother me, but sticking a 1.5-inch needle into my leg last night was kind of weird. There's some minor soreness in the area this morning, but less than I expected.

    From what I've read, testosterone levels should peak 48-72 hours after injection?

    I'll drop down to 100 units next week and we'll see how things go after a few weeks.
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    Quote Originally Posted by steve999 View Post
    Going back to my earlier post, prior to starting the Vitamin D supplements, I was at 22.3 ng/mL [range 32.0 – 100.0]. Even after 15,000 units of Vitamin D per day for a couple of months, my latest test is only at around 65 ng/mL, or mid-range. That's kind of surprising given 15,000 units/day is a *lot* of Vitamin D. Maybe an absorption problem?
    Possibly the brand that you are using is lacking.
    15000iu that is about 2x of whay one should need.

    I use this one:

    Amazon.com: Biotics Research - Bio-D-Mulsion Forte 1oz: Health & Personal Care

    NOWFoods and LEF are also good products.
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    Latest Blood Test Results


    Update on my most recent labs. See earlier posts for more extensive lab test and medication history.

    History: A couple of months ago Dr. M switched me from 1200 units subcutaneous injections of HCG EOD to 160mg intramuscular injections of testosterone cypionate 1x per week plus 250 IUs of HCG (subcutaneous) each day on the two days before my testosterone cypionate injection. The previous HCG alone regimen had bumped up my testosterone to 633 ng/dL, but estradiol also went to 36 pg/mL, so Dr. M wanted to give testosterone cypionate a try.

    I felt pretty good the first 4-6 weeks with better libido and okay morning erections. However, for the past few weeks libido has dropped and no morning erections.

    For the sake of brevity, I'm only posting a portion of my most recent lab results (bloodwork by Quest Diagnostics):

    Total testosterone is at 736 ng/dL [range 241-827 ng/dL] up from 633 ng/dL on HCG only. But see below for estradiol issues.

    Estradiol has dropped significantly to 16 pg/mL from 36 pg/mL after switching from HCG alone to testosterone cypionate + some HCG. Dr. M said he likes to see a total testosterone to estradiol ratio of somewhere between 20-30:1, so now my estradiol is actually too low. I guess I don't convert testoserone-cypionate to estrogen very well. More on how to deal with this below.

    Cholesterol levels have dropped quite a bit:
    Cholesterol: 153 mg/dL [down from a high of 226]
    Triglycerides: 115 mg/dL [down from a high of 161]
    VLDL Cholesterol: 23 mg/dL [about the same]
    LDL Cholesterol: 94 mg/dL [down from a high of 159]
    HDL Cholesterol: 36 mg/dL

    My dad and brother have good cholesterol numbers (no testosterone problems though) but their HDL is low like me. Dr. M said he liked to see total cholesterol above 140 mg/dL but with a higher HDL. My brother takes prescription time release niacin, but Dr. M didn't want me on that until we get other stuff balanced out. Overall my cholesterol numbers are good, so the HDL can wait.

    Vitamin D is at 66 ng/mL up from a low of 22.3 ng/mL [range 20-100 ng/mL]. I'm currently taking about 12,000 units of a high quality vitamin D supplement from Life Extension Foundation. Dr. M. says he likes to see a vitamin D level of at least 60 ng/mL, so I might bump up another 5,000 units on my daily vitamin D intake. Dr. M mentioned that he sees an awful lot of folks with vitamin D deficiency who take a vitamin D supplement (typically 1,000 units/day) but never actually measure their vitamin D levels, and they wind up being very low because 1,000 units isn't nearly enough - - - case in point I need at least 13x that amount.

    DHEA is too high at 669 mcg/dL [range 45-345 mcg/dL]. I've been taking 100 mg/day of DHEA from Life Extension Foundation, so I'll drop that down to 50-75 mg/day.

    Progesterone is high at 2.6 ng/mL [range < 1.4 ng/mL] up from the previous measurement of 0.8 ng/mL. I think Dr. M said this was a little odd given the low estradiol number. He guessed there might be a conversion pathway between DHEA and progesterone, so we'll see if this drops when I lower my DHEA intake.

    Ferritin is still low at 26 ng/mL [previous measurement 18 ng/mL, range 20-380 ng/mL] after taking 30 mg/day of a high quality iron supplement for several months now. I think Dr. M might have missed this previously as my earlier ferritin test was done by another doc and Dr. M probably didn't notice the low number when reviewing my lab history. Dr. M said this is a big problem and has instructed me to take 325 mg/day of ferrous sulfate or ferrous glutanate to raise my ferritin level. He said it will take approximately 6 months for this to happen, and that out of all my lab test results, the ferritin stood out as the worst problem. Apparently he sees a lot of iron deficiency in his patients.

    Cortisol is a little high at 17.8 mcg/dL, up from 14.7 mcg/dL.

    Vitamin A is at 56 mcg/dL [range 38-98 mcg/dL]. Dr. M said he thought this was low and recommended adding 10,000 units supplementation to whatever I am currently getting from the Life Extension Foundation multivitamin. My back and shoulders have been breaking out more lately, and Dr. M said increased vitamin A could help with that.

    Treatment changes:

    Keep testosterone cypionate dosage the same but increase dosage of HCG to 500 units 2x week to bring up estradiol levels to a range of 25-35 pg/mL. Dr. M recommended injecting the HCG on the same day as my testosterone-cypionate shot and then 4 days later. He said I might try splitting my testosterone cyptionate into (2) doses during the week to and adjust the HCG timing accordingly.

    Maybe increase vitamin D intake to 17,000 units/day.

    Lower DHEA supplementation to 50mg/day to lower DHEA and hopefully progesterone levels.

    Begin taking 325mg/day of ferrous sulfate or ferrous glutanate to bring up ferritin levels.

    Increase supplementation of vitamin A by 10,000 units/day.
  18. New Member
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    thanks for the profile steve - good to see another hcg profile making a difference. i'm eager to get my next round of bloodwork so i can take the next step myself!
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    Bump.

    I'm curious as to whether anyone else has experienced a big drop in estrogen levels (to below range) while on testosterone cypionate?
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    For a number or reasons I suggest that you change your (T & HCG) shots to EOD.
    There is two reasons why EOD schedule is better that your current or the new proposed schedule.

    #1, you are not able to reliably measure your TotalTestosterone or Estrodial levels when you are on shots that are spreaded over few days. Levels are fluctuating.
    At this moment this is the most important reason, If you will still have problems, I will suggest shots every day.

    #2 EOD schedule actually works better (good but secondary reason)
    I used EOD schedule for over two years myself. In last few weeks I modified my schedule.
    I do now (T & HCG) shots on one day, have shots free days, then (T + HCG) and so on.
    I do not see earth shattering changes, my testicles seems to be more steady in being firm, less fluctuations.
    But mostly, I think, this schedule will be even better to figure blod test. T draw on day of the shot, time of the shot, before shots.
    =======================
    I think that you have actually had your 633ng/dl while on 1200 units subcutaneous injections of HCG EOD
    but I do not think that 736ng/dL represents correctly your status while on 160mg/week + 2x 250iu-HCG.
    Same thing goes for your E2=16pg/ml
    Possibly you have had those numbers (instanteneously) but on the average you must have had (most likely) much highr TT & E2.

    The only way that you are going to get to the bottom of this is by changing to EOD schedule.
    Wery likely 160mg/week average is to high for you.
    I would be able to asses that number better if you had SHBG value. I was not able to find it on this thread.
    ============================== ==================
    I suggest that you do EOD schedule:
    day #1 T-shot=20units=40mg plus 250iu-HCG
    day #2 shots free
    day#3=day#1 and so on
    after 2-3 months draw blood on the day of the shots time of the shots before shots.

    Major objective in running TRT is to eliminate if possible, use of AI.
    Use of Arimidex newer gives steady results.
    One is newer able to live a life without constant checking of E2 levels and adjusting Arimidex.
    ============================== ==================
    Looking at your DHEAs numbers you are making mistake.
    Always disregard range given by laboratory.
    Your goal is to have a DHEAs(500-640)mcg/dL
    You are about there, only tiny bit over with your 669.

    One possible reason why your progesterone is high is because your DHEAs is high.
    So I think that you shoud reduce your DHEA pills to 75mg/day, because I hope that your progesterone will get little lower (not because your DHEAs is wery high.

    I would not worry about your ferritin.
    Looks good to me, do not eat iron.
    Read this, they like ferritin (5-50):
    http://www.ironoverload.org/anemia.htm
    .
    .
  

  
 

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