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Newbie blood work, guidance needed please...

Acft90364

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Hello all,
I'm fairly new to TRT. My doc started me off with 200mg of test cop a week, with .5 arimidex twice a week. I've been on for about two and a half months now. I initially noticed a slight uptake in mood, sexdrive, wood etc, but all that went away. I've had blood work done a few times, and I've tried to control my E2, but still no sex drive, erections anything. Plus bloat and moodiness. I didn't feel my usual power in workouts either. Like an idiot I thought I should up my dose to 150mg twice per week, but after two weeks I just felt crappier. My latest bloods tell the tale. I could use some advice. Thank you in advance.
 

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That's with 1mg adex a week? Your prolactin is a bit high. That's rediculous testosterone for 200mg a week imo. What did you change, explain your diet. Need more info to get to the root of things.

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I would definitely include hcg, or clomid on if you have it for your Lh and fsh,I'm not expert, others will chime in. But something is going on here I don't quite understand. We're you fasting? How soon since pinning

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You got bigger problems than high RBC, estrogen and test levels. Your efgr is below 60 which is your kidney function indicating kidney disease. Yes, you need to donate blood (high rbc) but I'd suggest calling them within a week and saying you got the flu so they don't use. I'm guessing your dex dosage was played w as you said you tried controlling it on your own. You need to go down to a minimal dose of test and talk to your Dr about what adex dose he thinks you should use due to declined kidney function. Most importantly you need further kidney function test, urea, another efg to see if its still declining,monitor the high creation etc. Schedule a donation but get in on the kidney issue immediately to get a further diagnosis on what may very well be a long term kidney disease diagnosis followed by necessary lifestyle changes. Do not use any nsaid drugs like motrin or others at all right, no dark soda even as a cheat drink! Watch the caffiene as well. Stay safe and follow up on these! Are you diabetic by chance?
 
Very complete labs btw, nice! Lots of good info on thyroid stuff, lc/ms/ms assays for T & E2, etc.

If those concerns about kidney disease are legit I'd get back into the doc asap. Everything else is secondary.

So your 2660 ng/dl T level is after upping to 150mg 2x/wk? Immediately or a day after the last pin? I'm assuming so, given the strong levels. I'd drop right down to 150 or even 125mg/wk total, split in two doses. That should bring your peak levels into physiological range like 1200 and you'll decay to around 800 before your next bi-weekly pin. I usually advocate for higher T levels but your 300mg/wk "TRT" here is really a bodybuilder's cruise. And since you have other big issues and sides, and possible kidney disease, you gotta knock the dose down to normal. A doc might tell you to go cold turkey... that's another risk. :/ May as well give the lower dosage a go at the moment and see if that works. Dunno when you got those labs but I'd drop the pins for 12 days from the blood draw date to let the test-cyp decay to 600-800 or so. Then pin your 75mg or whatever you're doing for the new pin schedule to stay below 1,200 peak levels. If you've been pinning since, you'll have to adjust.

E2 is out of control but on the new pin schedule it may drop back to a sane level of 20-30. Research the sides of adex vs. aromasin and use that in discussions with the doc about what's safer for the kidneys. Might be no AI at all, dunno. These drugs are usually "well tolerated" but there are always exceptions. Prolactin is out of control but might be caused directly by E2. You're taking no other AAS? Normally a little caber will help with lowering it, but it causes mild kidney stress that normally is no issue to the vast majority of users but you're a special case. :) Get E2 down into the 20's and watch prolactin response.

E2 and prolactin levels are likely the main things making you feel like shit. Donating blood ought to help as well.
 
If your white your kidney function on that test is below 60%, African american the test is barely above that 60%. Good advice above me as I coming to expect from said member! Normally I'd suggest high dosage b6 for prolactin suppression & prevention but given the kidneys I'd check with the Dr before even researching the proper b6 to use. Your Dr may even consider drugs for the prolactin and the having a discussion on which ai pending kidney evaluation is is ideal. Since adex can mess with your cholesterol & you maybe a heavy aromatiser (I am & it sucks) he may opt not to maintain its usage. Don't be surprised if gyno creeps up on you! I just got a big lump of gyno and I've been cruising over a year now! After a few years on pinning I got lazy and went to once a week injections, boom, gyno. Even got a little dribble out the nipple so I've jumped on some prami. Round and round us gyno guys go!
 
Thank you so much for the replies guys, I really appreciate it. I'm going to definitely check in on this kidney thing, that's the last thing I need to fail on me...
 
My wife's kidney disease just hit stage 4, turning our lives upside down a good bit. Don't slow down on the water intake at all, more more more!
 
While I am not dismissing the importance of kidney health I want to point out some very important factors.

eGFR is ESTIMATED and based on creatinine values. The calculations (of which there are many) most of the time do not take into account lean muscle mass. Many of them will also often tack on an "obesity penalty" when you break a certain weight for your height.

Creatinine levels will always be higher in people with more muscle mass and those who partake in stenuous activity, which makes sense because Creatinine is a chemical waste molecule that is generated from muscle metabolism!

So with the above in mind people who carry around abnormal amounts of mass will have slightly elevated creatine levels. This elevated creatinine score, combined with overall increased mass, will further skew things when the numbers are used to estimate GFR.

Moral of the story is if you have above average mass amounts and perform regular intense exercise eGFR is very likely not be an accurate assessment of your kidney function.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2390952/
 
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Yea, dehydration drops the efgr a big amount as well. Another member on here whose test came back lower than this, his Dr thinks it was all dehydration while they await more bloods. Even still,
Kidney disease is for the most part a silent & symptomless disease for many. Often found during routine labs such as my wife's case. Elevated creatine we see often here, some much higher than others.
I'm sure often it turns out to be nothing and values return to normal, we see it a lot w orals. Best to be safe and followup though but thanks for further clarifying! I also wasn't aware of an obesity penalty!
Anyway, I didn't intend to freak anybody out, just want to be sure they keep an eye on it! Its when #s don't return to normal there's an issue 😃
 
Low in vitamin D, I would start supplementing with at least 5000iu a day.

Estrogen is a little elevated, but with me that number would be fine, you might be more sensitive and judging by your prolactin you should get it in range.

Testosterone is pretty high, your doc might see that and want to lower your dose depending on how aggressive he is.

Prolactin is elevated, possibly due to the high e2 number.

You need to donate blood soon, very important if you are going to be on TRT.

I'm assuming you weren't fasted and probably had some carbs before the blood draw?

Your kidneys are a little elevated, I would up the water intake and avoid things that can tax the kidneys.



Your prolactin and estrogen are likely the culprit when it comes to your libido. Get the e2 in check by upping the AI dose, and then see how you feel. If prolactin is still elevated then get it down with some caber or prami.
 
Donate blood, add another dose of arimidex in or lower your test dose a bit. Either you pulled blood on a peak or you are a high responder. Your numbers are WAY above trt. If you are doing one shot a week make it 2. It will
make e2 much easier to manage. Honestly your e2 is pretty nice compared to your TT. What is your free test and you aren't using any 5aR inhibitors for your hair are you?
 
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