Blood work is back - Now what?

[njmuscleguy]

Hey folks,

Ok, I got my blood work back... in a nutshell, my levels are all over the place and my doctor wants me to see an endocrinologist. Anyone who's knowledgeable about bloodwork values, I could use some help.

My last cycle ended in early March. PCT consisted of HCG, original Derma for 2 weeks, then Sustain for 4 weeks. IGF for 4 weeks.
Blood work was taken exactly 2 months after end of cycle.
Mind you, I've had bloodwork worse than this (if you can imagine!). Using Derma is the best PCT I've had so far, even if I couldn't recover any better.

Here are the levels that are out of range:

Testosterone, Total 178 L (260 - 1000 ng/dL)
Testosterone, Free 21.7 L (50.0 - 210.0 pg/mL)

LH 1.3 L (1.5 - 9.3 mIU/mL)

IGF-1 281 H (10 - 255 ng/mL)
This is to be expected, I finished IGF a week prior to bloodwork.

Cholesterol, Total 216 H (125 - 200 mg/dL)
HDL 37 L ( > /= 40 mg/dL)
Cholesterol/HDL Ratio 5.8 H (< - 5.0)
LDL 140 H (< 130 mg/dL)
Triglycerides 196 H (< 150 mg/dL)

Liver
AST 48 H (10 - 40 U/L)
ALT 99 H (9 - 60 U/L)
Iron 171 H (45 - 170 mcg/dL)
Uric Acid 3.9 L (4.0 - 8.0 mg/dL)

Thyroid
T3 Uptake 40.1 H (22 - 35)

CK, Total 381 H ( < = 200 U/L) - I take creatine daily

The following are all within range, but relevant:

FSH 4.1 (1.6 - 8.0 mIU/mL)
Prolactin 6.0 (2.0 - 18.0 ng/mL)
Estradiol <32 (< 52 pg/mL)
Estradiol, Ultra-sensitive 14 (10 - 50 pg/mL)
Cortisol 14.7 (4.0 - 22.0)
Insulin, serum 9 (< 17 micro IU/mL)
DHEA Sulfate 207 (110 - 370 mcg/dL)
SHBG 21 (5 - 49 nmol/L)

So test levels are shot, I'm not surprised... always struggled with this, even before AAS. LH is low, but FSH is normal. E2, prolactin, insulin, SHBG, etc. are all within range.

Any thoughts here? I'm wondering if I got blood work too soon?

More important, what do I say when I go to the endo? Do I mention AAS use? Will it be obvious from the bloodwork? If he asks, do I tell or deny? This is my first dealing with an endo and I could very well go on HRT after this, so it's a big deal for me. If I really do need HRT, I want the endo to take me seriously and not have his judgement clouded by previous AAS use.

Any thoughts / suggestions greatly appreciated folks!

 

[5x10]

Hey folks,

Ok, I got my blood work back... in a nutshell, my levels are all over the place and my doctor wants me to see an endocrinologist. Anyone who's knowledgeable about bloodwork values, I could use some help.

My last cycle ended in early March. PCT consisted of HCG, original Derma for 2 weeks, then Sustain for 4 weeks. IGF for 4 weeks.
Blood work was taken exactly 2 months after end of cycle.
Mind you, I've had bloodwork worse than this (if you can imagine!). Using Derma is the best PCT I've had so far, even if I couldn't recover any better.

Here are the levels that are out of range:

Testosterone, Total 178 L (260 - 1000 ng/dL)
Testosterone, Free 21.7 L (50.0 - 210.0 pg/mL)

LH 1.3 L (1.5 - 9.3 mIU/mL)

IGF-1 281 H (10 - 255 ng/mL)
This is to be expected, I finished IGF a week prior to bloodwork.

Cholesterol, Total 216 H (125 - 200 mg/dL)
HDL 37 L ( > /= 40 mg/dL)
Cholesterol/HDL Ratio 5.8 H (< - 5.0)
LDL 140 H (< 130 mg/dL)
Triglycerides 196 H (< 150 mg/dL)

Liver
AST 48 H (10 - 40 U/L)
ALT 99 H (9 - 60 U/L)
Iron 171 H (45 - 170 mcg/dL)
Uric Acid 3.9 L (4.0 - 8.0 mg/dL)

Thyroid
T3 Uptake 40.1 H (22 - 35)

CK, Total 381 H ( < = 200 U/L) - I take creatine daily

The following are all within range, but relevant:

FSH 4.1 (1.6 - 8.0 mIU/mL)
Prolactin 6.0 (2.0 - 18.0 ng/mL)
Estradiol <32 (< 52 pg/mL)
Estradiol, Ultra-sensitive 14 (10 - 50 pg/mL)
Cortisol 14.7 (4.0 - 22.0)
Insulin, serum 9 (< 17 micro IU/mL)
DHEA Sulfate 207 (110 - 370 mcg/dL)
SHBG 21 (5 - 49 nmol/L)

So test levels are shot, I'm not surprised... always struggled with this, even before AAS. LH is low, but FSH is normal. E2, prolactin, insulin, SHBG, etc. are all within range.

Any thoughts here? I'm wondering if I got blood work too soon?

More important, what do I say when I go to the endo? Do I mention AAS use? Will it be obvious from the bloodwork? If he asks, do I tell or deny? This is my first dealing with an endo and I could very well go on HRT after this, so it's a big deal for me. If I really do need HRT, I want the endo to take me seriously and not have his judgement clouded by previous AAS use.

Any thoughts / suggestions greatly appreciated folks!

it would be hard for an endo to diagnose a problem if he doesnt know your on juice

he might think theres something wrong with you, but in reality, u just came off a cycle
i dont know how to read bloodwork

just my .02

 

[r1]

How do you feel?

I have been on various HRT regiments and on one setup, it resulted in low levels of HDL. I felt like shit. Hard to concentrate, no sex drive, etc.

Your current numbers make a strong case for "secondary hypogonadism" evidenced by the low levels of T and low LH.

HRT is a big deal and you should go on it as a last resort. If it were me, I would have the doctor attempt to restart my system with a 12 week run of Clomid. If you bounce back, great. If not, then HRT is probably in your future.

In general, it is best to share your history with your doc, but the prejudice is definitely out there. If you don't get a good feeling from the Endo that you are about to see, I would recommend taking a look at having your primary care doc work with Dr John from http://www.allthingsmale.com

Just because he/she is an Endo does not mean he will he/she will have a lot of experience treating this. Ask about it. My first Endo (although well-intentioned) messed me up pretty bad.

"The Testosterone Syndrome" by Eugene Shippen is another good resource. If anything, you should read this book and use it as a benchmark to determine if the Endo that you are going to see knows anything at all.

A quick summary by a long time patient of Dr Shippen can be found here:
http://forum.mesomorphosis.com/mens-health-forum/david-z-s-primer-134235700.html?highlight=primer
http://forum.mesomorphosis.com/mens-health-forum/david-z-s-primer-134235701.html?highlight=primer

Good luck.

R1

 

[Svengali]

With test levels that low two months post cycle, I would consider running pct again.. Maybe looking at doing hcg for a couple weeks and then clomid. It seems that derma did not do much for you either. What did your test levels look like pre-cycle? Any Ideas?

BTW, my pre-cycle test levels were in the 320 range... and I had not been on a cycle in a decade.

 

[Nelson Montana]

Any thoughts / suggestions greatly appreciated folks![/QUOTE]

Eeks. It depends on what you want.

Big concerns are: The T is obviously low. Your LH is low. Your e is kinda high. And your HDL is too low. Tris ain't that good either.


First off, get some oils in you to get that HDL up -- extra vigin olive, and fish. Primrose oil is great for HDL but it's slightly estrogenic so I'd add a natty anti -e. (Naturally I'd suggest POST CYCLE).

For triglycerides add some TMG.

this also shows that prolactin is an overrated threat.

If you want to up the T and LH naturally, I'd suggest UNLEASHED for T and MyogenX for LH. Ask around. The feedback on these is excellent.

Now for the reality. Your endo doesn't have to know shit. If you're clinically supressed you're elligable for T replacement. Are you prepared to go on for life?

There isn't much you can do as a permanent solution to LH, but it won't matter much if you're on HRT. Still, it's best to produce a little. It's never good to be zero. My LH is only 2.5. It used to be 0.8 until I started taking UNLEASHED and MyogenX along with my HRT.


Be careful with the iron too. Were you taking orals? They boost red blood cells and lower HDL.

Your SHBG is pretty good but I'll bet that's because you're young.

That's about it. Obviously, you need to dry out for a while and get healthy. The numbers will be better next time if you take the right precautions.

How old are you? If you're under 35 you can probably recover and get "normal." If you're over 40 I'd say go on HRT and deal with it. But remember...they won't prescibe anti-e's or HCG so you're on your own with those and you'll still need them with HRT. I'd still take natty test boosters and anti-e's to help thing along. Don't use one of those Life Extention rip-off clinics. Get a legit script from a doc for the T and get the rest on your own. (Some "longevity" sites sell real a-dex).

Hope this helps. Get strong soon.

 

[njmuscleguy]

How do you feel?

I have been on various HRT regiments and on one setup, it resulted in low levels of HDL. I felt like shit. Hard to concentrate, no sex drive, etc.

Your current numbers make a strong case for "secondary hypogonadism" evidenced by the low levels of T and low LH.

HRT is a big deal and you should go on it as a last resort. If it were me, I would have the doctor attempt to restart my system with a 12 week run of Clomid. If you bounce back, great. If not, then HRT is probably in your future.

In general, it is best to share your history with your doc, but the prejudice is definitely out there. If you don't get a good feeling from the Endo that you are about to see, I would recommend taking a look at having your primary care doc work with Dr John from http://www.allthingsmale.com

Just because he/she is an Endo does not mean he will he/she will have a lot of experience treating this. Ask about it. My first Endo (although well-intentioned) messed me up pretty bad.

R1

I actually don't feel horrible at the moment... about a week ago things were very rough... I have my days, and when I do, they're pretty bad.

I really don't want to go on clomid for treatment....I've done PCT after PCT in the past with 4-8 weeks of clomid and I never recovered to "normal". Plus I hate the sides. I know HRT is for life, but I also see AAS, training, diet, etc as long-term lifestyle too. I want to feel good now, not in 20 years, ya know?

Thanks for the help and the info, will look into it!

 

[njmuscleguy]

With test levels that low two months post cycle, I would consider running pct again.. Maybe looking at doing hcg for a couple weeks and then clomid. It seems that derma did not do much for you either. What did your test levels look like pre-cycle? Any Ideas?

BTW, my pre-cycle test levels were in the 320 range... and I had not been on a cycle in a decade.

I've done that in the past... run 2, even 3 PCT's back to back because the first one didn't work. I've run HCG several times. I've run nolvadex, I've run clomid for 4-6 weeks. This time, though I didn't recover to what is considered "normal" for most guys my age, I at least didn't crash horrible with Derma... so I still think it helped and it should work very nicely for anyone else.

To answer your question, my test levels have been lower than normal since before my starting AAS, though it seems I'm not even recovering to as high as I used to a few years ago even. Before this cycle, I was in the low 200's.

 

[njmuscleguy]

Big concerns are: The T is obviously low. Your LH is low. Your e is kinda high. And your HDL is too low. Tris ain't that good either.

Yup, agreed.... my diet in the past couple weeks hasn't been stellar, so I'm thinking that's why my cholesterol / tri's are high. You think my E is high? It's pretty low in the reference range provided.

First off, get some oils in you to get that HDL up -- extra vigin olive, and fish. Primrose oil is great for HDL but it's slightly estrogenic so I'd add a natty anti -e. (Naturally I'd suggest POST CYCLE).

I do all this already, plus I take flax oil at night. I've been taking Sesapure and Glucorell naturally for some time now....in the past I believe they've helped me with recovering liver enzymes and cholesterol, but not this time...I'm a little disappointed.

For triglycerides add some TMG.
What's TMG?

this also shows that prolactin is an overrated threat.

If you want to up the T and LH naturally, I'd suggest UNLEASHED for T and MyogenX for LH. Ask around. The feedback on these is excellent.

Thing is, if my body's "normal" levels are just low (genetically), then I don't think any of these supplements will raise T and LH? I'm not disputing the products, just think they can't raise my levels beyond what my body will allow naturally.

Now for the reality. Your endo doesn't have to know shit. If you're clinically supressed you're elligable for T replacement. Are you prepared to go on for life?

Short answer? Yes... I HATE feeling this way... I've contended with it for years...and the only time I feel good is when I'm "on"... I'd rather do HRT for life than roller-coaster up and down like this for years.

There isn't much you can do as a permanent solution to LH, but it won't matter much if you're on HRT. Still, it's best to produce a little. It's never good to be zero. My LH is only 2.5. It used to be 0.8 until I started taking UNLEASHED and MyogenX along with my HRT.

Be careful with the iron too. Were you taking orals? They boost red blood cells and lower HDL.

I took dbol at the start of the cycle, which would've been in January. Would that still be affecting my iron? I take animal packs and they don't have any iron...not sure where else it would've come from.

How old are you? If you're under 35 you can probably recover and get "normal." If you're over 40 I'd say go on HRT and deal with it. But remember...they won't prescibe anti-e's or HCG so you're on your own with those and you'll still need them with HRT. I'd still take natty test boosters and anti-e's to help thing along. Don't use one of those Life Extention rip-off clinics. Get a legit script from a doc for the T and get the rest on your own. (Some "longevity" sites sell real a-dex).

I'm 32.... as I said, I think "recovering" for me means getting to levels lower than what is normal for everyone else.... my levels when I'm "off" and clean are between 200-300... that's why I think trying to raise them is just a waste of time.

Hope this helps. Get strong soon.

Thanks for your help, really appreciate it!

 

[Triple J]

what exactly was your cycle, what AAS and what dosage, and when were your last shots of long ester gear? what are your stats age, height, weight, body fat%. how is your sex drive? how are your workouts going?

the fact that LH is still low, HDL is still high, and liver values slightly high, indicates to me that the effects of the AAS lingered longer than you planned for. thus you need more time. plan your supplementation accordingly to address all those areas

 

[njmuscleguy]

what exactly was your cycle, what AAS and what dosage, and when were your last shots of long ester gear? what are your stats age, height, weight, body fat%. how is your sex drive? how are your workouts going?

the fact that LH is still low, HDL is still high, and liver values slightly high, indicates to me that the effects of the AAS lingered longer than you planned for. thus you need more time. plan your supplementation accordingly to address all those areas

Wks 1-4 Dbol 50mg ED
Wks 1-8 Test Enth 750mg /wk
Wks 5-8 NPP 200mg / wk
Wks 1-8 Proviron 50mg ED
Wks 1-9 Aromasin 12.5mg ED

Took Tylers for at least the first 4-5 weeks of the cycle.

Last test enth shot was 2nd week of March, so about 2 months ago.
I'm 32, 5'7, 185 lbs, 12-15% bf. Sex drive is pretty low, for obvious reasons. Workouts have been hit or miss in the past couple weeks, but I've been going. I use stimulants, creatine, etc. to keep me going. Some days I'm exhausted, some days not so much.

I'm surprised my cholesterol & triglycerides and liver enzymes are still not back to normal... those have typically recovered quickly in the past. I have also been taking Glucorell and Sesapure religiously, along with flax oil. I didn't expect to have a problem in this area.

I know how it looks, that maybe I haven't given myself enough time to recover. I just think that even in 1-2 months from now, though my liver enzymes and cholesterol would definitely recover, my test levels would only barely increase. The highest my test levels have ever been were in the 300's, before starting AAS. So even if I "recovered" to the 300's, that's still pretty pitiful.