Recent Bloodwork - What do you think?

[Chump16]

Hi,

61 yrs - male - 6' - 205 lbs

Started TRT Feb 2024 with online TRT clinic. I am doing dermal cream, I know that's not the preferred choice here, but it seemed to be working well for me.

As I worked with the clinic they had me doing between 166mg/day (2 pumps) and 198 mg/day (3 pumps).

Through the spring and summer I felt great, experienced the benefits good workouts, improved strength, increased

This is a summary of lab results over that time. The clinic uses LabCorp. I've been using PrivateMD Labs when I'm curious what levels are.

Date	Lab	Total Test	Free Test	Estradial	FSH	LH	Hemoglobin	Hematocrit
11/20/2023	PrivateMD	347 ng/dL		32 pg/mL	6.2 mIU/mL	4.5 mIU/mL	16.3 g/dL	46.30%
1/22/2024	Lab Corp	198 ng/dL	4.9 pg/mL			4.1 mIU/mL	14.6 g/dL	41.60%
3/20/2024	PrivateMD	978 ng/dL		114 pg/mL	.7 mIU/mL	.2 mIU/mL	14.7 g/dL	43.3%%
4/2/2024	Lab Corp	906 ng/dL	27.18 ng/dL	52.8 pg/mL			16.2 g/dL	47.40%
4/30/2024	PrivateMD	771 ng/dL	146.5 pg/mL				15.8 g/dL	46.80%
6/6/2024	PrivateMD	1022 ng/dL		66 pg/mL	<.7 mIU/mL	.2 mIU/mL	15.9 g/dL	45.7%%
7/9/2024	Lab Corp	>1500 ng/dL	>85 ng/dL	150 pg/mL			16.3 g/dL	48.20%
9/9/2024	Lab Corp	831 ng/dL	18.7 ng/dL	53.9 pg/mL			16.5 g/dL	47.70%

Over the last two months (my busiest time of year) diet and workouts have not been where the should be, but not terrible and over the last 3-4 weeks I've been at 166 mg/day (2 pumps). Had recent labs done. Any thoughts, opinions or is more info needed. Thanks

Date	Lab	Total Test	Free Test	Estradial	FSH	LH	Hemoglobin	Hematocrit
10/26/2024	PrivateMD	323 ng/dL		50 pg/mL	4.6 mlU/ml	3.3 mIU/mL	15.0 g/dL	44.2 %

 

[buck]

Without including the ranges, it is hard to say where you are at as different labs use different ranges. where one falls in a range tells more then the number for the blood work. I have had labs over the last 25 years having the top of the range be anywhere from 500- over 1100.

 

[Send0]

Without including the ranges, it is hard to say where you are at as different labs use different ranges. where one falls in a range tells more then the number for the blood work. I have had labs over the last 25 years having the top of the range be anywhere from 500- over 1100.

If every lab has a different range, then does it really matter if the range is included? While they tend to be close to one another, it's really just an arbitrary value set by each lab. You can pick ranges off your own lab to help put it into context.

Your own levels fluctuate and won't be consistent/exact even if you took two blood draws 10 minutes apart. Making the lab specific range even less important

 

[Send0]

Hi,

61 yrs - male - 6' - 205 lbs

Started TRT Feb 2024 with online TRT clinic. I am doing dermal cream, I know that's not the preferred choice here, but it seemed to be working well for me.

As I worked with the clinic they had me doing between 166mg/day (2 pumps) and 198 mg/day (3 pumps).

Through the spring and summer I felt great, experienced the benefits good workouts, improved strength, increased

This is a summary of lab results over that time. The clinic uses LabCorp. I've been using PrivateMD Labs when I'm curious what levels are.

Date	Lab	Total Test	Free Test	Estradial	FSH	LH	Hemoglobin	Hematocrit
11/20/2023	PrivateMD	347 ng/dL		32 pg/mL	6.2 mIU/mL	4.5 mIU/mL	16.3 g/dL	46.30%
1/22/2024	Lab Corp	198 ng/dL	4.9 pg/mL			4.1 mIU/mL	14.6 g/dL	41.60%
3/20/2024	PrivateMD	978 ng/dL		114 pg/mL	.7 mIU/mL	.2 mIU/mL	14.7 g/dL	43.3%%
4/2/2024	Lab Corp	906 ng/dL	27.18 ng/dL	52.8 pg/mL			16.2 g/dL	47.40%
4/30/2024	PrivateMD	771 ng/dL	146.5 pg/mL				15.8 g/dL	46.80%
6/6/2024	PrivateMD	1022 ng/dL		66 pg/mL	<.7 mIU/mL	.2 mIU/mL	15.9 g/dL	45.7%%
7/9/2024	Lab Corp	>1500 ng/dL	>85 ng/dL	150 pg/mL			16.3 g/dL	48.20%
9/9/2024	Lab Corp	831 ng/dL	18.7 ng/dL	53.9 pg/mL			16.5 g/dL	47.70%

Over the last two months (my busiest time of year) diet and workouts have not been where the should be, but not terrible and over the last 3-4 weeks I've been at 166 mg/day (2 pumps). Had recent labs done. Any thoughts, opinions or is more info needed. Thanks

Date	Lab	Total Test	Free Test	Estradial	FSH	LH	Hemoglobin	Hematocrit
10/26/2024	PrivateMD	323 ng/dL		50 pg/mL	4.6 mlU/ml	3.3 mIU/mL	15.0 g/dL	44.2 %

I don't understand what you're looking for an opinion on. You posted a bunch of stuff, but didn't outline it you actually have a problem.

Your last lab has low total test. This could be for a number of reasons. The fact that you use a dermal cream makes this even more difficult. The cream may not have been evenly mixed, and maybe you didn't actually get much testosterone in that dose. Or maybe you missed a dose or two.. you didn't say or even comment if you were concerned with the last lab results.

It would be better if you got on injectable testosterone. It's much more consistent. With creams and gels, there is so much that is variable that it's hard to troubleshoot things if you have a problem.

Lastly, this is just a hormone panel. There's so much more that should be evaluated beyond just hormones.

 

[Send0]

Do you have an actual problem, or are you just asking for opinions?

Is there a reason why you aren't talking to or asking the doctor you pay to prescribe you testosterone and monitor your blood work?

 

[Chump16]

You are right, after re-reading my post, I didn’t really ask a question. I am curious why the Total Test is so low. Also curios why FSH and LH elevated to levels close to before I started TRT.

I do understand the point you made about consistency, wondering if it would swing that much

Continuing to learn …. what else should I have evaluated besides hormones

Thanks, I do intend on talking to clinic, just thought I would bounce it here first

Thanks for help

 

[Send0]

You are right, after re-reading my post, I didn’t really ask a question. I am curious why the Total Test is so low. Also curios why FSH and LH elevated to levels close to before I started TRT.

I do understand the point you made about consistency, wondering if it would swing that much

Continuing to learn …. what else should I have evaluated besides hormones

Thanks, I do intend on talking to clinic, just thought I would bounce it here first

Thanks for help

Could be a bad lab measurement, or it could be that the test isn't mixed evenly and you only got a very small amount of hormone.

The only thing you can do is monitor how you feel, and get retested after a week or so and see if the result is still low.

Personally I'd wait to see if I was getting low testosterone side effects before I went to go get more lab work.

 

[Send0]

I should add that I don't actually know why your results came back as low (no one is going to actually know), my original assumption was that you had missed multiple doses before getting tested... and that's why that last result was so low.

But based on your response I'm now guessing you havent missed any of your doses? Is that correct?

 

[buck]

If every lab has a different range, then does it really matter if the range is included? While they tend to be close to one another, it's really just an arbitrary value set by each lab. You can pick ranges off your own lab to help put it into context.

Your own levels fluctuate and won't be consistent/exact even if you took two blood draws 10 minutes apart. Making the lab specific range even less important

The values that a lab can come up with can vary quite a bit. While many labs have similar ways of testing there can be differences depending on the machine used, reagents, testing group, the way they calibrate the machine etc. . Labcorp has an upper value of 916. Quest's value is 1100. So an almost 200 point differences. So a value of 1050 can be in range or signal out of range. I used a lab years ag that the top of the range was 500. So a reading at that lab of1050 would be twice the top of the range at that lab. Ranges are built from what 95% of those being tested at that lab came out as. Th eyop and bottom 2.5% are excluded and the 95% are considered normal. The result of many/most blood tests is not a heard number but derived from how the lab tests the blood sample.

Why Standard Reference Ranges Differ From Lab to Lab

Laboratory Reference Ranges | Functional Blood Chemistry Analysis | Testosterone | Thyroid

www.optimaldx.com

 

[Send0]

The values that a lab can come up with can vary quite a bit. While many labs have similar ways of testing there can be differences depending on the machine used, reagents, testing group, the way they calibrate the machine etc. . Labcorp has an upper value of 916. Quest's value is 1100. So an almost 200 point differences. So a value of 1050 can be in range or signal out of range. I used a lab years ag that the top of the range was 500. So a reading at that lab of1050 would be twice the top of the range at that lab. Ranges are built from what 95% of those being tested at that lab came out as. Th eyop and bottom 2.5% are excluded and the 95% are considered normal. The result of many/most blood tests is not a heard number but derived from how the lab tests the blood sample.

Why Standard Reference Ranges Differ From Lab to Lab

Laboratory Reference Ranges | Functional Blood Chemistry Analysis | Testosterone | Thyroid

www.optimaldx.com

You completely missed the point of what I was saying.

Labs having different ranges for the exact same test does not have a direct bearing on anything because they "derive" their own ranges. One lab can say you're over, where as another lab can say you're under for the exact same value.

Telling someone "I don't know because you didn't include ranges" is silly. We all know the ranges regardless of variability. If you don't then you can literally use your own range to get a sense of where they're at, because even though labs have different ranges... The difference between them is not so significant that you can't determine what's happening.

If someone who's been doing this for a long time needs ranges to form an opinion, then they probably shouldn't be offering said opinion to begin with.

 

[Send0]

If LabCorp says 916, and quest says 1100 you mean to tell me you're going to freak out of LabCorp says you're out of range but not freak out if quest says you're within range for the same biomarker value?

Again, those of us that have been doing this a while don't need ranges to make sense of blood work; we know what they are and their variances from lab to lab.

Depending solely on lab specific ranges to be able to understand blood work only proves that the person dependent on the ranges doesn't fully understand the lab tests or significance of the biomarker values on the first place.

 

[buck]

You completely missed the point of what I was saying.

Labs having different ranges for the exact same test does not have a direct bearing on anything because they "derive" their own ranges. One lab can say you're over, where as another lab can say you're under for the exact same value.

Telling someone "I don't know because you didn't include ranges" is silly. We all know the ranges regardless of variability. If you don't then you can literally use your own range to get a sense of where they're at, because even though labs have different ranges... The difference between them is not so significant that you can't determine what's happening.

If someone who's been doing this for a long time needs ranges to form an opinion, then they probably shouldn't be offering said opinion to begin with.

Well opinions differ. I included a reference to show what i used to form my opinion. Many other sources will back that up. Others should do as they think is best for them. I like having all the facts i can to decide what i am doing. If others are less concerned and having a rougher idea is what they want then they can do that. I don't tell others what they should do. I just give out the best data i can along with my own personal experience. So others can make the best decision of themselves.

 

[Send0]

Well opinions differ. I included a reference to show what i used to form my opinion. Many other sources will back that up. Others should do as they think is best for them. I like having all the facts i can to decide what i am doing. If others are less concerned and having a rougher idea is what they want then they can do that. I don't tell others what they should do. I just give out the best data i can along with my own personal experience. So others can make the best decision of themselves.

So if his reference range was different from your reference range, for a panel test that you both have done, that would change whatever feedback you would have given him?

I never said ranges didn't matter. I said because ranges differ from lab to lab, that they are only useful when viewed from a very general perspective. Where as you seem to be saying you can't give feedback without knowing a range because the lab specific range is super duper relevant... and you can't just refer to a range you have seen on your own bloodwork

What matters most are the issues/symptoms someone is complaining about, in relation to the biomarker results. I was able to easily give him feedback based on what he wrote and what his labwork showed... Where as you did not provide any feedback because you are stuck on needing a range.

Reference ranges are mostly only useful to newbies who don't understand what they're looking at to get a GENERAL sense of where they stand. Even then, ranges don't necessarily tell the full story.

Do what you like, but man you're so dogmatic about some stuff that it doesn't make any sense... especially since I know that YOU know better. I know you could have easily provided him feedback if you weren't hung up on ranges..his question didn't even require knowing what a range was on his labs. He just wanted a damn opinion on why his last hormone panel was so low compared to the previous one

 

[buck]

Yes ;looking back at some blood work i received from Laboratories Northwest where the top of the range is 600 for example. A reading of 601 would put me at around the 96 percentile of all people. Where as at labcorp or quest i would be middle of the pack. So knowing the range for me is important. Others can decide their own importances.

I find problems can be happening long before issues/symptoms occur. I prefer to be preventative not reactive. Others should do as they see fit for themselves. As symptoms/issues can be difficult to eradicate. and if long term damage is done then it is too late to be as healthy as i can.

Feel good levels of things can also happen when people are at far less then healthy levels. Many feel great on a gram or 2 of gear.

Yes i could have given feed back with making a general assumption. But that feed back could have also been entirely wrong with out the correct data.

I find the wider the range of feedback form various opinions the more people can learn from. I know i did over my decades of dealing with Dr prescribed TRT as well as the decades of cycles i have done.

I support you giving out the advice you do. As we all look through things from our own lens. And my ego is not such that i think my way is always the right or best way. It is just the opinion i have formed from my experience and what i have learned. And i hope as time goes buy and i learn more that my opinion will change and not just leave me set in my ways.

 

[Chump16]

I should add that I don't actually know why your results came back as low (no one is going to actually know), my original assumption was that you had missed multiple doses before getting tested... and that's why that last result was so low.

But based on your response I'm now guessing you havent missed any of your doses? Is that correct?

Based on the recommendation from the clinic I apply 2 pumps (132mg, typo above) in the AM and one pump (66mg) at noon to control estradial, for a total of 198mg/day. So, about 3-4 weeks age I went from 3 pumps to 2 pumps, just because I was a dumbass and got to busy during the day and forgot to apply the noon pump. After a few days I realized and decided to continue two pumps til end of October.

So to address missing pumps thats my situation. I know I always apply the two pumps in the morning. I'm just surprised the Total Test went from 831 ng/dL to 323 ng/dL and the FSH and LH levels went up.

Your point about consistency of the cream makes sense.

I am going to contact the clinic and get their take on it.

 

[Send0]

Based on the recommendation from the clinic I apply 2 pumps (132mg, typo above) in the AM and one pump (66mg) at noon to control estradial, for a total of 198mg/day. So, about 3-4 weeks age I went from 3 pumps to 2 pumps, just because I was a dumbass and got to busy during the day and forgot to apply the noon pump. After a few days I realized and decided to continue two pumps til end of October.

So to address missing pumps thats my situation. I know I always apply the two pumps in the morning. I'm just surprised the Total Test went from 831 ng/dL to 323 ng/dL and the FSH and LH levels went up.

Your point about consistency of the cream makes sense.

I am going to contact the clinic and get their take on it.

I should add that the reason why some of your lab results show higher test and others may also be due to how consistent the stuff is mixed.

Back in the very early 2000s, I played with dermal 1-AD, it was basically a lotion carrier with DMSO to allow absorption into the skin. I used it because I was young, too young to be messing with pro hormones or steroids, and I was worried about using needles. I quickly figured out that the number of pumps doesn't guarantee a dosage, because you have no idea how consistent the mixture is.

You could have portions of the mixture with lots of testosterone, and other portions with almost no testosterone.

The other reasons I don't like creams is because it can accidentally get on other people, or get wiped off in general and reduce how much you absorb. In addition, even in perfect conditions the absorption rate is not always the same or consistent.

 

[Send0]

@Chump16 if your doctor won't put you on injectables, then start shopping for another doctor.

Tell the new doctor that you don't feel great using the cream, that your libido is hit or miss, and that your lab work seems to be inconsistent... the last part is true, your LabCorp results do have a good amount of variability in them.

Doctors might try to put you on patches, I'd turn that down too. Other docs might try pellets; which I hear are good for like a month or two but that levels drop off after that since your body will have absorbed most of the test during the first few months.

Injectables may not be the most convenient, but they are the most reliable and most consistent. Lots of doctors will prescribe injectable testosterone without too much hassle.

 

[JeffGoldblumLips]

I don't understand what you're looking for an opinion on.

I'm guessing the drop in his test numbers and the fact that he's getting LH and FSH readings now.

 

[Send0]

I'm guessing the drop in his test numbers and the fact that he's getting LH and FSH readings now.

Yep, we got to that. Originally he didn't say what his question was, but he confirmed that was it in a follow up response

 

[buck]

From the early days of Androgel that i used which is pharmaceutically prepared and tested to the FDA's standards as opposed to how ever the over-the-counter manufacturer felt like having it mixed. I found the blood work pretty consistent. And my LH and FSH were crushed with even one packet, which should hav supplied 5mg in the blood stream every day. But i didn't absorb it all that well. Got a couple hundred more points. Went over to Dr Crisler as soon as he opened up for business and switched to injections which were easier to achieve high normal T levels.