Secondary Hypogonadism Protocol

[Headdoc]

Mark, did the cholesterol ever come up?

 

[MarkLA]

Mark, did the cholesterol ever come up?

I don't know yet. I haven't been tested since I started the new regimen. I get a bunch of blood tests in about 3 weeks. These will include cholesterol as well as T, Estradiol, SHBG and the other usual suspects...

Mark

 

[MarkLA]

New bloodwork in

First, background. I'm feeling somewhat better. I have a little sex drive and before there was none. At the gym I seem to be lifting a little more weight. My mood is a little better.

My sh** is normal where before it was loose. My nuts which were aching a little (not enough LH?) now feel OK.

Quest lost my testosterone, but got the rest of the results which I am posting here. I expect that when I get new Testosterone results in a few days that it will have improved since my LH has go much better. I know there'll be a more full picture then, but I need some input now on how to deal with the Prolactin, etc. as my medical person doesn't have any ideas on this.

LH, DHT, Prolactin, Cholesterol all have interesting changes which I have commented below. I'd appreciate any advice, especially on the bolded items.

Old Values (where available are from June-August before treatment)
New Values (where available) are October.

Old:Glucose 86 mg/dL (70-110)………………..New:90
Old:Sodium 142 mmol/L (135-145)………………..New:139
Oldotassium 3.7 mmol/L (3.5-4.5)………………..New:4.9 Comments?
Old:Chloride 101 mmol/L (101-111)………………..New:103
Old:Carbon Dioxide 27 mmol/L (23-31)………………..New:25
Old:Anion Gap 14 mmol/L………………..New: (not retested)
Old:**UREA Nitrogen 35 MG/DL (range 5-25)………………..New:36 Is this OK? Is it due to eating protein and breaking down muscle when training?
Old:Creatinine 1.2 mg/dL (0.4-1.5)………………..New:1
Old:Calcium 9.8 mg/dL (8.3-10.7)………………..New:9.8
Old:Bilirubin, total 0.3 mg/dL (0.1-1.2)………………..New:0.8 What is this? It tripled.
Oldrotein Total 7.0 G/DL (6.0-8.5)………………..New:7.4
Old:Albumin 4.7 G/DL (3.5-5.5)………………..New:4.8
Old:Alkaline Phosphotase 82 U/L (<125) ………………..New:64 Liver better, was elevated before
Old:**Aspartate Aminotransfera 47 (range < 46 U/L)………………..New:37 Liver better, was elevated before
Old:**Alanine Aminotransferase 54 (range < 53 U/L)………………..New:44 Liver better, was elevated before


Old:**Testosterone 165 ng/dL (range 250-1100)………………..NewENDING, Quest lost the sample
Old:**Testosterone Free 20.7 pg/mL (range 35-155)………………..NewENDING, Quest lost the sample
Old:**Testosterone Free 1.25% (range 1.5 - 2.2)………………..NewENDING, Quest lost the sample

Old:Somatomedin-C (aka IGF-1) 239 ng/mL (range 106-255)………………..New: (not retested)
Old:**Cortisol 15.3 MCG/DL ………………..New: (not retested)
(range 6-19 MCG/DL Morning, 3-14 Afternoon. This was afternoon)

Old:FSH 5.6 MIU/ML (Males 1 to 8 MIU/ML)………………..New:4.7
Oldrolactin 10.5 NG/ML (range 3.0-14.7)………………..New:29.8 (range 2-18) WTF? This tripled. This suppresses sex hormones
Old:LH 2.3 MIU/ML (Males 2-12 MIU/ML)………………..New:6 Better and SHOULD mean more T.
Old:Thyroxine 6.5 MCG/DL (range 4.5-12.5)………………..New: (not retested)
Old:T Uptake 31.0% (range 25-35)………………..New: (not retested)
Old:Adjusted T4 6.7 MCG/DL (range 4.4-11.4)………………..New: (not retested)
Old:TSH 1.26 MCU/ML (range 0.39-4.60) ………………..New: (not retested)


Old: TSH 1.16 mIU/ml (0.35-5.5)………………..New: (not retested)
Old: Total T3 0.74 ng/mL (0.6-1.81)………………..New: (not retested)
Old: Free T4 1.32 ng/dL (0.72-1.56)………………..New: (not retested)


OldSA 0.12 ng/ML (0-4)………………..New: (not retested)

Old:WBC 5.2 (4-11) 1000/UL………………..New: (not retested)
Old:RBC 4.86 (3.97-5.65) MILL/UL………………..New: (not retested)
Old:Hemoglobin 15.4 (13-17) G/DL………………..New: (not retested)
Old:Hemocrit 47.1 (37.5-49.9) %………………..New: (not retested)
Old:MCV 96.9 (80-100) FL………………..New: (not retested)
Old:MCH 31.7 (27-33) PG………………..New: (not retested)
Old:MCHC 32.8 (32-36) %………………..New: (not retested)
Old:RBC Distribution Width 13.7 (11.5-14.5) %………………..New: (not retested)
Oldlatelet Count 156000 (150000-450000) /UL………………..New: (not retested)
Old:Mean Platelet Vol 9.4 (7.4-10.4) FL………………..New: (not retested)

Diffs Automated

Oldolys 53%………………..New: (not retested)
Old:Lymphs 28%………………..New: (not retested)
Old:Monos 7%………………..New: (not retested)
Old:Eos 12%………………..New: (not retested)
Old:Basos 1%………………..New: (not retested)
Old:ABS Polys 2.7 (1.8 to 2.8) 1000/UL………………..New: (not retested)
Old:ABS Lymphs 1.5 (1.0-4.5) 1000/UL………………..New: (not retested)
Old:ABS Monos 0.4 (<0.8) 1000/UL………………..New: (not retested)
Old:**ABS EOS 0.6 (<0.4) 1000/UL………………..New: (not retested)
Old:ABS Basos 0.1 (<0.2) 1000/UL………………..New: (not retested)
Old:RBC Morphology Normal………………..New: (not retested)



Old:Homocysteine 5.29 (umol/L 4-12)………………..New: (not retested)
Old:Ultra CRP 0 (mg/dl 0-4.94)………………..New: (not retested)

Lipid panel/Glucose (FASTING)

Old:Total Cholesterol 131 mg/dL………………..New:218 Too much steak and eggs
Old:Triglycerides 107 mg/dL………………..New:104
Old:Glucose 87 mg/dL………………..New:90
Old:HDL 48 mg/dL………………..New:69 More is better
Old:LDL 61 mg/dL………………..New:128 Too much steak and eggs
Old:VLD 21 mg/dL………………..New: (not retested)
Old:TC/HDL 2.7 md/dL………………..New:3.2

Old:Vitamin D 25 Hydroxy LC/MS/MS Total (ng/ml) range 20-100 (not tested)………………..New:24 I am going to add 2000 iu D3 oil based.

Old:Vitamin D3 (nd/ml) (not tested)………………..New:19
Old:Vitamin D2 (not tested)………………..New:5

Old:**DHT 107 (ng/dL range 25-75)………………..New:26 Wow 107 to 26?@!
Old:Estradiol 13 (pg/mL range 13-54)………………..New:13 Same
Old:SHBG 29 (nmol/L range 8-48)………………..New:26
Old:Estrone (pg/mL) (not tested)………………..New:40 ?

Old:Blood T3, Free 271 pg/dl (range 230-420) (Quest)………………..New: (not retested)


Saliva (NeuroScience/Pharmasan Labs)
Old: DHEA (free) 6:15am 420.8 (Male 250-450 Saliva )………………..New:175 (blood - range 110-370)

Saliva Cortisol
Old:6:15am 14.0 ng/ml range 7am 7.0-10.0………………..New: (not retested)
Old:10:35am 5.4 ng/ml range noon 3.0-6.0………………..New: (not retested)
Old:4:10pm 5.6 ng/ml range 5pm 2.0-4.0………………..New: (not retested)
Old:9:10pm 3.9 ng/ml range 10pm <1.5………………..New: (not retested)
Old:………………..New:
Old:Urine 8:15am………………..New:
Old:Epinepherine 4.6 ug/gCr (range 8-12)………………..New: (not retested)
Old:Norepinepherine 20.4 ug/gCr (range 35-50)………………..New: (not retested)
Old: Dopamine 116.8 ug/gCr (range 110-175)………………..New: (not retested)
Old:Serotonin 138.3 ug/gCr (range 150-200)………………..New: (not retested)
Old:GABA 4.3 umol/gCr (range 1.5-4.0)………………..New: (not retested)
Old:Glutamate 11.6 umol/gCr (range 10-35)………………..New: (not retested)
OldEA 271.8 nmol/gCr (range 175-450)………………..New: (not retested)
Old:Histamine 18.6 ug/gCr (range 10-20)………………..New: (not retested)
Old:Creatine 116.2 (mg/dL)Y (no range)………………..New: (not retested)

 

[JanSz]

First, background. I'm feeling somewhat better. I have a little sex drive and before there was none. At the gym I seem to be lifting a little more weight. My mood is a little better.

My sh** is normal where before it was loose. My nuts which were aching a little (not enough LH?) now feel OK.

Quest lost my testosterone, but got the rest of the results which I am posting here. I expect that when I get new Testosterone results in a few days that it will have improved since my LH has go much better. I know there'll be a more full picture then, but I need some input now on how to deal with the Prolactin, etc. as my medical person doesn't have any ideas on this.

LH, DHT, Prolactin, Cholesterol all have interesting changes which I have commented below. I'd appreciate any advice, especially on the bolded items.

Old Values (where available are from June-August before treatment)
New Values (where available) are October.

Old:Glucose 86 mg/dL (70-110)………………..New:90
Old:Sodium 142 mmol/L (135-145)………………..New:139
Oldotassium 3.7 mmol/L (3.5-4.5)………………..New:4.9 Comments?
Old:Chloride 101 mmol/L (101-111)………………..New:103
Old:Carbon Dioxide 27 mmol/L (23-31)………………..New:25
Old:Anion Gap 14 mmol/L………………..New: (not retested)
Old:**UREA Nitrogen 35 MG/DL (range 5-25)………………..New:36 Is this OK? Is it due to eating protein and breaking down muscle when training?
Old:Creatinine 1.2 mg/dL (0.4-1.5)………………..New:1
Old:Calcium 9.8 mg/dL (8.3-10.7)………………..New:9.8
Old:Bilirubin, total 0.3 mg/dL (0.1-1.2)………………..New:0.8 What is this? It tripled.
Oldrotein Total 7.0 G/DL (6.0-8.5)………………..New:7.4
Old:Albumin 4.7 G/DL (3.5-5.5)………………..New:4.8
Old:Alkaline Phosphotase 82 U/L (<125) ………………..New:64 Liver better, was elevated before
Old:**Aspartate Aminotransfera 47 (range < 46 U/L)………………..New:37 Liver better, was elevated before
Old:**Alanine Aminotransferase 54 (range < 53 U/L)………………..New:44 Liver better, was elevated before


Old:**Testosterone 165 ng/dL (range 250-1100)………………..NewENDING, Quest lost the sample
Old:**Testosterone Free 20.7 pg/mL (range 35-155)………………..NewENDING, Quest lost the sample
Old:**Testosterone Free 1.25% (range 1.5 - 2.2)………………..NewENDING, Quest lost the sample

Old:Somatomedin-C (aka IGF-1) 239 ng/mL (range 106-255)………………..New: (not retested)
Old:**Cortisol 15.3 MCG/DL ………………..New: (not retested)
(range 6-19 MCG/DL Morning, 3-14 Afternoon. This was afternoon)

Old:FSH 5.6 MIU/ML (Males 1 to 8 MIU/ML)………………..New:4.7
Oldrolactin 10.5 NG/ML (range 3.0-14.7)………………..New:29.8 (range 2-18) WTF? This tripled. This suppresses sex hormones
Old:LH 2.3 MIU/ML (Males 2-12 MIU/ML)………………..New:6 Better and SHOULD mean more T.
Old:Thyroxine 6.5 MCG/DL (range 4.5-12.5)………………..New: (not retested)
Old:T Uptake 31.0% (range 25-35)………………..New: (not retested)
Old:Adjusted T4 6.7 MCG/DL (range 4.4-11.4)………………..New: (not retested)
Old:TSH 1.26 MCU/ML (range 0.39-4.60) ………………..New: (not retested)


Old: TSH 1.16 mIU/ml (0.35-5.5)………………..New: (not retested)
Old: Total T3 0.74 ng/mL (0.6-1.81)………………..New: (not retested)
Old: Free T4 1.32 ng/dL (0.72-1.56)………………..New: (not retested)


OldSA 0.12 ng/ML (0-4)………………..New: (not retested)

Old:WBC 5.2 (4-11) 1000/UL………………..New: (not retested)
Old:RBC 4.86 (3.97-5.65) MILL/UL………………..New: (not retested)
Old:Hemoglobin 15.4 (13-17) G/DL………………..New: (not retested)
Old:Hemocrit 47.1 (37.5-49.9) %………………..New: (not retested)
Old:MCV 96.9 (80-100) FL………………..New: (not retested)
Old:MCH 31.7 (27-33) PG………………..New: (not retested)
Old:MCHC 32.8 (32-36) %………………..New: (not retested)
Old:RBC Distribution Width 13.7 (11.5-14.5) %………………..New: (not retested)
Oldlatelet Count 156000 (150000-450000) /UL………………..New: (not retested)
Old:Mean Platelet Vol 9.4 (7.4-10.4) FL………………..New: (not retested)

Diffs Automated

Oldolys 53%………………..New: (not retested)
Old:Lymphs 28%………………..New: (not retested)
Old:Monos 7%………………..New: (not retested)
Old:Eos 12%………………..New: (not retested)
Old:Basos 1%………………..New: (not retested)
Old:ABS Polys 2.7 (1.8 to 2.8) 1000/UL………………..New: (not retested)
Old:ABS Lymphs 1.5 (1.0-4.5) 1000/UL………………..New: (not retested)
Old:ABS Monos 0.4 (<0.8) 1000/UL………………..New: (not retested)
Old:**ABS EOS 0.6 (<0.4) 1000/UL………………..New: (not retested)
Old:ABS Basos 0.1 (<0.2) 1000/UL………………..New: (not retested)
Old:RBC Morphology Normal………………..New: (not retested)



Old:Homocysteine 5.29 (umol/L 4-12)………………..New: (not retested)
Old:Ultra CRP 0 (mg/dl 0-4.94)………………..New: (not retested)

Lipid panel/Glucose (FASTING)

Old:Total Cholesterol 131 mg/dL………………..New:218 Too much steak and eggs
Old:Triglycerides 107 mg/dL………………..New:104
Old:Glucose 87 mg/dL………………..New:90
Old:HDL 48 mg/dL………………..New:69 More is better
Old:LDL 61 mg/dL………………..New:128 Too much steak and eggs
Old:VLD 21 mg/dL………………..New: (not retested)
Old:TC/HDL 2.7 md/dL………………..New:3.2

Old:Vitamin D 25 Hydroxy LC/MS/MS Total (ng/ml) range 20-100 (not tested)………………..New:24 I am going to add 2000 iu D3 oil based.

Old:Vitamin D3 (nd/ml) (not tested)………………..New:19
Old:Vitamin D2 (not tested)………………..New:5

Old:**DHT 107 (ng/dL range 25-75)………………..New:26 Wow 107 to 26?@!
Old:Estradiol 13 (pg/mL range 13-54)………………..New:13 Same
Old:SHBG 29 (nmol/L range 8-48)………………..New:26
Old:Estrone (pg/mL) (not tested)………………..New:40 ?

Old:Blood T3, Free 271 pg/dl (range 230-420) (Quest)………………..New: (not retested)


Saliva (NeuroScience/Pharmasan Labs)
Old: DHEA (free) 6:15am 420.8 (Male 250-450 Saliva )………………..New:175 (blood - range 110-370)

Saliva Cortisol
Old:6:15am 14.0 ng/ml range 7am 7.0-10.0………………..New: (not retested)
Old:10:35am 5.4 ng/ml range noon 3.0-6.0………………..New: (not retested)
Old:4:10pm 5.6 ng/ml range 5pm 2.0-4.0………………..New: (not retested)
Old:9:10pm 3.9 ng/ml range 10pm <1.5………………..New: (not retested)
Old:………………..New:
Old:Urine 8:15am………………..New:
Old:Epinepherine 4.6 ug/gCr (range 8-12)………………..New: (not retested)
Old:Norepinepherine 20.4 ug/gCr (range 35-50)………………..New: (not retested)
Old: Dopamine 116.8 ug/gCr (range 110-175)………………..New: (not retested)
Old:Serotonin 138.3 ug/gCr (range 150-200)………………..New: (not retested)
Old:GABA 4.3 umol/gCr (range 1.5-4.0)………………..New: (not retested)
Old:Glutamate 11.6 umol/gCr (range 10-35)………………..New: (not retested)
OldEA 271.8 nmol/gCr (range 175-450)………………..New: (not retested)
Old:Histamine 18.6 ug/gCr (range 10-20)………………..New: (not retested)
Old:Creatine 116.2 (mg/dL)Y (no range)………………..New: (not retested)

Oldrolactin 10.5 NG/ML (range 3.0-14.7)………………..New:29.8 (range 2-18) WTF? This tripled. This suppresses sex hormones

Watch that Prolactin.
Look at my post #47
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html
Increases chances for breast cancer.

- Dostinex (.5 mg twice a week)
------------------------------------------------------------------------------------------
Old: Total T3 0.74 ng/mL (0.6-1.81)………………..New: (not retested)
Old: Free T4 1.32 ng/dL (0.72-1.56)………………..New: (not retested)


Old:Blood T3, Free 271 pg/dl (range 230-420) (Quest)………………..New: (not retested)


Get FreeT3 and FreeT4 tested. Your TotalT3 does not look promissing.
Your old FreeT3 is very low.
You are good for about 4 grains of Armour.
but
give priority to Synthroid (T4) or generic T4, if your body is able to make conversion T4-->T3 you will be better off (stable, not dependent on frequent pills). Or aim at as much T4 as possible then add Armour to get FreeT3 to the top range.

Due to the long half-life of levothyroxine, the peak therapeutic effect at a given dose of levothyroxine sodium may not be attained for 4-6 weeks.

The average full replacement dose of levothyroxine sodium is approximately 1.7 mcg/kg/day (e.g., 100-125 mcg/day for a 70 kg adult).
Invalid Link Removed
------------------------------------------------------------------------------------------
Old:Vitamin D 25 Hydroxy LC/MS/MS Total (ng/ml) range 20-100 (not tested)………………..New:24 I am going to add 2000 iu D3 oil based.

Consider taking 2 or 3 pills for couple of months, probably 2 pills latter on.

http://anabolicminds.com/forum/male-anti-aging/70698-vitamin-d-d2.html
-------------------------------------------------------------------------------------------
Old: DHEA (free) 6:15am 420.8 (Male 250-450 Saliva )………………..New:175 (blood - range 110-370)

Get 100mg/day DHEA
LEF recomends: 500-640 ug/dL
========================================================

Old:**DHT 107 (ng/dL range 25-75)………………..New:26 Wow 107 to 26?@!
Old:Estradiol 13 (pg/mL range 13-54)………………..New:13 Same
Old:SHBG 29 (nmol/L range 8-48)………………..New:26
Old:Estrone (pg/mL) (not tested)………………..New:40 ?

DHT=26 Wow is right.
hopefully you will not be forced to use transdermal testosterone.

Estradiol is nice because
you must be low on TT and when you start using injectale testosterone your E2 will raise. With luck, only to the right level.

SHBG=29
table on post #40
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

160 1115 28.4 300 xx40 250

You need 160mg/week T injection
E3D schedule
add HCG to that protocol.
Keep LiquiDex at hand

 

[MarkLA]

Argh!

I just heard from my physician:

Total T 207 (250-1100 range.) up from 165
Free T 24.3 (35-155 range) up from 20

I'm pretty surprised. I was expecting to see a higher number.

My LH has gone from 2.3 to 6 (through diet/supplements). Strange that did not have more effect on T.

My cholesterol went from 130 to 218 (diet). My DHT went from 107 to 25 (should have resulted in more T). And of course my Prolactin went WAY up.

I have been feeling better. Occasional morning wood (versus never). I've been lifting more weight at the gym after not making gains for a long time. Maybe this is all placebo effect. Maybe it's the 25% increase in Free T.

I know JanSz (and others) prefer the shots, but I'm thinking it might be good that my DHT is low now so that I can do transdermal.

I also found a study of hyperprolactinemia which found that of men who had elevated prolactin, about 50% were normal when retested. Perhaps I'll be one of those and not need Dostinex/Bromocriptine.

Any thoughts, please share.

Thanks
Mark

 

[MarkLA]

From JanSz PDF:

"Hyperprolactinemia inhibits gonadotropin secretion and can produce hypogonadism in men and women with accompanying low or inappropriately "low normal" LH and FSH levels"

As my LH and FSH are now mid-range (not low), I deduce that hyperprolactinemia is not the cause of my hypogonadism.

I was hoping by increaingg LH to midrange, I could increase T to midrange and be cured. I've increased LH but T has not moved enough.

As LH is now 6 (mid-range now and before it was 2.3) it would appear that maybe I am secondary and primary?

SERMs do not make sense as my LH is now healthy.

I think I have exhausted the possibilities and T replacement is the only alternative.

Mark

 

[JanSz]

From JanSz PDF:

"Hyperprolactinemia inhibits gonadotropin secretion and can produce hypogonadism in men and women with accompanying low or inappropriately "low normal" LH and FSH levels"

As my LH and FSH are now mid-range (not low), I deduce that hyperprolactinemia is not the cause of my hypogonadism.

I was hoping by increaingg LH to midrange, I could increase T to midrange and be cured. I've increased LH but T has not moved enough.

As LH is now 6 (mid-range now and before it was 2.3) it would appear that maybe I am secondary and primary?

SERMs do not make sense as my LH is now healthy.

I think I have exhausted the possibilities and T replacement is the only alternative.

Mark

Real nice analysis.

Hope that your iteration on testosterone delivery are quick.

My experience, I was up in heaven when my T rose up,
regardles of delivery system.
As my situation got better, I started appreciate the pluses and minuses of different delivery systems.

 

[MarkLA]

I spoke with my physician today. She is prescribing compounded gel. 25 mg of T per ml. I will start on 2 ml per day (50mg) applied to arms and lower abdomen. It is supplied to me syringes for easy measuring.

I figure I'll start with the 2ml dose, then if I start to crash I will ask her if OK to increase the dose. Her hunch is that I will ultimately need a higher dosage because of my low T level. Once I feel OK and have found a stable dose I figure she'll retest me and make sure my levels are all ok.

Cost from her recommended pharmacy is $90 which is fine. I figure once we have my dosage dialed in after a few months, I can ask to be switched to injection or pellets if applying the gel (and paying for it) is too annoying.

Mark

 

[JanSz]

I spoke with my physician today. She is prescribing compounded gel. 25 mg of T per ml. I will start on 2 ml per day (50mg) applied to arms and lower abdomen. It is supplied to me syringes for easy measuring.

I figure I'll start with the 2ml dose, then if I start to crash I will ask her if OK to increase the dose. Her hunch is that I will ultimately need a higher dosage because of my low T level. Once I feel OK and have found a stable dose I figure she'll retest me and make sure my levels are all ok.

Cost from her recommended pharmacy is $90 which is fine. I figure once we have my dosage dialed in after a few months, I can ask to be switched to injection or pellets if applying the gel (and paying for it) is too annoying.

Mark

What is your opinion on the desired goal for
FreeT

If you have your goal in mind and know your SHBG level,
it is all rather mathematical problem from there on.

 

[MarkLA]

What is your opinion on the desired goal for
FreeT

If you have your goal in mind and know your SHBG level,
it is all rather mathematical problem from there on.

I know what you're saying. I know that some people advocate free T of 200, someone else (Shippen?) likes to see 300. I'd like to know what these goals are based on. I do want to be completely healthy, but I'm not (yet) convinced that everyone's healthy number is the same. I'd like to hear more of your thoughts on that.

Also, the Quest test shows a "normal" range of 35-155 pg/mL. I think we agree that 35 isn't desirable. However I think if I turned up 200 on a scale of 35-155, my physician for one would want to tell me I'm too high. If the Free T goal is based upon a healthy 25 year old I think that would be a reasonable basis, but I don't see how it can be higher than the top of the range?

If there is not a known good figure, then starting with a low dose and increasing seems like conservative way to go -- to find the minimum dose which is subjectively effective.

Mark

 

[JanSz]

I know what you're saying. I know that some people advocate free T of 200, someone else (Shippen?) likes to see 300. I'd like to know what these goals are based on. I do want to be completely healthy, but I'm not (yet) convinced that everyone's healthy number is the same. I'd like to hear more of your thoughts on that.

Also, the Quest test shows a "normal" range of 35-155 pg/mL. I think we agree that 35 isn't desirable. However I think if I turned up 200 on a scale of 35-155, my physician for one would want to tell me I'm too high. If the Free T goal is based upon a healthy 25 year old I think that would be a reasonable basis, but I don't see how it can be higher than the top of the range?

If there is not a known good figure, then starting with a low dose and increasing seems like conservative way to go -- to find the minimum dose which is subjectively effective.

Mark

There is only one good test for FreeT that I know of.
It is not actually test it is calculation.
Testosterone, Free, Bio/Total (LC/MS/MS)
Invalid Link Removed

As result of that test I got

/------------------------------------ 1151 (250-1100) ng/dL Testosterone Total
/------------------------------------ 248.5 (46-224) pg/mL Testosterone Free
/------------------------------------ 456.9 (110-575) ng/dL Testosterone Bioavailable
/------------------------------------ 26 (17-54) nmol/L SHBG
/------------------------------------ 4.0 (3.6-5.1) g/dL Albumin, serum

After this test (Blood drawn 8/30/07 reported 9/10/07) I increased my T dose.

I am shooting for
FreeT~300
or top of range on BAT

I talk about it in my post #62
----------------------------------------------------------
People who are not able to get this test I refer to dr Shippen's chart on my post #41
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

or internet calculator
Invalid Link Removed
but only for FreeT
the BAT calculated there is not correct.

 

[MarkLA]

I started the gel today. How long does it typically take to "feel" different?

 

[JanSz]

I started the gel today. How long does it typically take to "feel" different?

Depending on a problem.
I was after erection only, when I started Androgel.
I did not knew that my depression was due to low T.
Erection was improved within few days to a week.
Depression took about 9 months.
Do not know exactly, I did not knew I had depression and was not expecting relief. Only when it went away I realized that I do not carry a millstone with me any more.

I started with one packet, 5grams.
Within couple of months, honeymoon was over.
But it came back when I added another 5grams.
I also learned that I should look about e2.
Was getting Arimidex from all kind of places because my doc then was good only for Androgel and blood test.
I had to tell him what to test.
So it was learning curve.
-----------------------------------
Basically I am still learning.
I am doing research on tests from Genova Diagnostics and have a high hopes about it.

 

[MarkLA]

Update..

I felt some benefit from the low dose gel for the first week.. more confidence, energy, harder erections. I'd judge them as relatively mild effects, not as significant as I would have liked, but I'm not sure how to judge. Libido perhaps slightly enhanced.

After about 10-12 days, I'm not feeling the benefit anymore. This is not surprising as my endogenous production is probably shut off.

My physician is prescribing me double strength gel. This gel is 50mg/ml versus 25mg/ml currently. I take 2 ml. I think this is roughly equivalent to the higher dose androgel.

Mark

 

[JanSz]

Update..

I felt some benefit from the low dose gel for the first week.. more confidence, energy, harder erections. I'd judge them as relatively mild effects, not as significant as I would have liked, but I'm not sure how to judge. Libido perhaps slightly enhanced.

After about 10-12 days, I'm not feeling the benefit anymore. This is not surprising as my endogenous production is probably shut off.

My physician is prescribing me double strength gel. This gel is 50mg/ml versus 25mg/ml currently. I take 2 ml. I think this is roughly equivalent to the higher dose androgel.

Mark

Devil is in details,

2 packets 1% Androgel=10grams= 100mg testosterone

2mL of 50mg/mL=100mg testosterone


100mg of Androgel worked for me

200mg but in form of 10% cream, did not
======================================
but Androgel put me 3x over the top range on DHT

 

[MarkLA]

I talked to my physician last week. I had done the test 4 hours after gel application. She actually wanted it done 2 hours after application, but said 4 hrs is probably OK.

Here's the info, as of 12-10-2007. All data is Quest.

Total T 463 (250-1100)
% Free 1.72 (1.5-2.2)
Free T 79.4 (35-155)
DHEA 225 (110-370) (Not sure why this is here as we didn't order it)
Prolactin 3.5 (2.0-18) what a drop! I guess the last test was probably erroneous.
SHBG 24
DHT 103 (25-75)
Ultrasensitive Estradiol (missing. either late or skipped)

I don't really see any surprises here. DHT is high due to transdermals. T is higher than before. SHBG declined slightly as T increased. I feel somewhat better, but my libido is still almost nonexistant.

I'm going to bring up the idea of shots when I talk to her on Thursday - from a cost, efficacy and convenience perspective and see what she thinks.

Mark

 

[MarkLA]

To add to the list:

Estradiol 15 (pg/mL range 13-54) up very slightly from 13 despite T more than doubling.
Estrone 18 (pg/ml ) down from 40 (good)

I asked my physician about shots and I received an OK to start. 1cc 200mg/ml initial dose. Then .5cc per week. Test again after 3 weeks or so at trough (right before injection).

I asked about twice-weekly but she didn't want to do that for now. No AI (I didn't bring it up). We'll see how I do. If I have any breast tenderness, I will call and ask for it.

I've read how to inject and I have an MD friend who will show/watch me the first time or two so that I get it right.

Mark

 

[JanSz]

To add to the list:

Estradiol 15 (pg/mL range 13-54) up very slightly from 13 despite T more than doubling.
Estrone 18 (pg/ml ) down from 40 (good)

I asked my physician about shots and I received an OK to start. 1cc 200mg/ml initial dose. Then .5cc per week. Test again after 3 weeks or so at trough (right before injection).

I asked about twice-weekly but she didn't want to do that for now. No AI (I didn't bring it up). We'll see how I do. If I have any breast tenderness, I will call and ask for it.

I've read how to inject and I have an MD friend who will show/watch me the first time or two so that I get it right.

Mark

Do not rush with AI, you may not need it.
===============================================
I am looking for ways that infuences Estrone levels.
(8/30/07) Estrone, serum=24(< or =68)pg/mL looks normal

(12/13/07)Urine test Estrone very high

what makes it go low????

so far I am thinking of reducing DHEA.
other suggestions??

 

[MarkLA]

I am looking for ways that infuences Estrone levels.
(8/30/07) Estrone, serum=24(< or =68)pg/mL looks normal

(12/13/07)Urine test Estrone very high

what makes it go low????

so far I am thinking of reducing DHEA.
other suggestions??

The variables that changed since the last test:
1. Added D3 oil based 2000iu
2. Added transdermal T
3. Reduced cholesterol intake. 1 egg per day not 3. Also 700mg Niacin up from 500.

I'm not sure which of those might have done it or if it's incidental...

Also FYI: My physician commented that Estrone is the breast cancer hormone in women and probably the prostate cancer hormone in men (as opposed to T which is conventional wisdom). This may not be news to us here, but I'm glad I'm working with someone who is current and cutting edge.

Mark

 

[MarkLA]

CVS $97 10 ml 200mg/ml Sandoz Test Cypionate. Not covered by Blue Cross because it is "140 days" supply. I suppose I can contest this because:

1. It doesn't come in a smaller size than 10 ml and
2. My physician wants me to use it for a month or so and then throw it out.

I was given four syringes 3ml 22G1.5 and 10 extra needles which are 18G 1.5.

I think the idea is that I am supposed to draw with the 18G and inject with the 22G. Why I have 10 of the 18G's I'm not really sure.

Any ideas?

I have an MD friend who is going to watch me do my first shot on Monday, then I'll do the rest myself.

Mark

 

[phatkid77]

ahhhhh, injections with the 'ol HB2 pencil.....youch!@

 

[JanSz]

ahhhhh, injections with the 'ol HB2 pencil.....youch!@

Pencl is too thick, but try huff nail

I am a chicken, I use 31Ga for either T & hcg
about size of mosquito's tongue.

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

 

[MarkLA]

Yes, they do look like nails

I'm going to keep following Dr. orders and do it IM not SubQ, but I can ask for an OK on this next time.

Since I have the syringes, I guess I will use the 22 for the first shot on Sunday or Monday.

However I will look for smaller and shorter sizes for the next time.

What smaller size works for IM? I would think that the 5/16 long needle is too short.

Thx
Mark

 

[JanSz]

Yes, they do look like nails

I'm going to keep following Dr. orders and do it IM not SubQ, but I can ask for an OK on this next time.

Since I have the syringes, I guess I will use the 22 for the first shot on Sunday or Monday.

However I will look for smaller and shorter sizes for the next time.

What smaller size works for IM? I would think that the 5/16 long needle is too short.

Thx
Mark

Who said it have to be IM.
I am using 31ga 5/16"long shortest and smalles availale needle.
Doing it since June 19/07
My TT levels are the way I plan to have them,
anotherwise, by the book no surprises.

It is small needle, make sure you actually have oil in syringe when you do shots.
There were story that people shoot with syringes half filled with air and then wonder that they do not have expected levels of TT.

It takes about 4 minutes to fill the syringe in.
Hold it as in picture attached.
Walk around, do your chores.
It is not wasted 4 minutes.

 

[MarkLA]

JanSz,

I know you're having success with SubQ. From what I've read, I'm more or less convinced that SubQ and IM work exactly the same.

However, my physician told me to do IM and I agreed to do that. She's been great in working with me and I don't want to disrespect that by going against what she prescribed. I'm sticking with dose, schedule, etc even though I have other ideas.

I probably will ask about SubQ after we've got IM working for a month or few and she'll probably be open to it.

I am however, considering going with a skinnier needle as I'm not thinking of that as a significant change. Then again, at just once per week, maybe it doesn't matter much. My question was, what length do I need to reliably hit muscle?

Thanks,
Mark

 

[MarkLA]

I gave myself the first shot late last night. 1cc (initial dose is double the regular dose) with the 22 gauge needle. I found I could draw up the T and inject it pretty easily without having to use the 18 gauge. The pain was insignificant.

I had a buddy MD watch me do the shot and I ran the procedure by him first. Everything went smoothly. Per his suggestion I'm going to try a 25 gauge next time.

P.S. I mentioned to him about JanSz' 31s and he said that he wouldn't have believed you could pull up the T in two years with that needle. I assured him it would only take 4 minutes

Mark

 

[JanSz]

I gave myself the first shot late last night. 1cc (initial dose is double the regular dose) with the 22 gauge needle. I found I could draw up the T and inject it pretty easily without having to use the 18 gauge. The pain was insignificant.

I had a buddy MD watch me do the shot and I ran the procedure by him first. Everything went smoothly. Per his suggestion I'm going to try a 25 gauge next time.

P.S. I mentioned to him about JanSz' 31s and he said that he wouldn't have believed you could pull up the T in two years with that needle. I assured him it would only take 4 minutes

Mark

You can show him this picture nex time.
This is how I hold syringe and pull on it every so often.
That way, if I want to, I can walk around and do my chores with other hand free, so the 4 minutes, early in the morning are not blocked or wasted.

 

[vincentv]

bump to find out what happened in the end?????