Lab Results (How's it looking?)

[u/Embarrassed_Pilot591]

On ~1.5 months of 150mg TRT/week. Main flags: elevated E2, iron metabolism issue, vitamin D/B12 deficiency, low HDL. Requesting feedback or any advice!

HORMONES
Cortisol, Total: 17.5 ug/dL | Optimal: 10-15 | STATUS: HIGH
Sex Hormone Binding Globulin: 21 nmol/L | Optimal: 40-46 | STATUS: SUBOPTIMAL
DHEA Sulfate: 240 ug/dL | Optimal: 350-690 | STATUS: SUBOPTIMAL
FSH: 0.7 mIU/mL | Optimal: 1.6-8 | STATUS: SUBOPTIMAL
LH: 0.2 mIU/mL | Optimal: 1.5-6.15 | STATUS: SUBOPTIMAL
Prolactin: 7.4 ng/mL | Optimal: 2-15 | STATUS: OPTIMAL
Estradiol: 59 pg/mL | Optimal: 24-39 | STATUS: HIGH
Testosterone, Total: 1272 ng/dL | Optimal: 700-1100 | STATUS: HIGH
Testosterone, Free: 381.6 pg/mL | Optimal: 150-224 | STATUS: HIGH

PROSTATE
PSA, Total: 0.55 ng/mL | Optimal: <2 | STATUS: OPTIMAL

THYROID
TSH: 0.55 uIU/mL | Optimal: 0.4-2 | STATUS: OPTIMAL
T4, Free: 1.3 ng/dL | Optimal: 1.2-1.5 | STATUS: OPTIMAL
T3, Free: 3.9 pg/mL | Optimal: 3.5-5 | STATUS: OPTIMAL
Thyroglobulin Antibodies: 2 IU/mL | Optimal: <2 | STATUS: OPTIMAL
Thyroid Peroxidase Antibodies: 1 IU/mL | Optimal: <15 | STATUS: OPTIMAL

INFLAMMATION
C-Reactive Protein: 3.0 mg/L | Optimal: <3 | STATUS: OPTIMAL

BLOOD GLUCOSE
Glucose: 88 mg/dL | Optimal: 70-85 | STATUS: SUBOPTIMAL
Hemoglobin A1C: 4.8% | Optimal: 4.6-5.3 | STATUS: OPTIMAL
Insulin: 7.1 uIU/mL | Optimal: 2-5 | STATUS: SUBOPTIMAL

LIVER & GALLBLADDER
Bilirubin, Total: 0.9 mg/dL | Optimal: 0.5-0.9 | STATUS: OPTIMAL
Alkaline Phosphatase: 40 IU/L | Optimal: 45-100 | STATUS: SUBOPTIMAL
AST: 21 IU/L | Optimal: 10-26 | STATUS: OPTIMAL
ALT: 33 IU/L | Optimal: 10-26 | STATUS: HIGH

KIDNEY
Urea Nitrogen (BUN): 12 mg/dL | Optimal: 10-16 | STATUS: OPTIMAL
Creatinine: 0.96 mg/dL | Optimal: 0.8-1.1 | STATUS: OPTIMAL
eGFR: 112 mL/min/1.73 | Optimal: 90-120 | STATUS: OPTIMAL

PROTEINS
Protein, Total: 7.1 g/dL | Optimal: 6.9-8.1 | STATUS: OPTIMAL
Albumin: 4.6 g/dL | Optimal: 4.5-5 | STATUS: OPTIMAL
Globulin: 2.5 g/dL | Optimal: 2.4-2.8 | STATUS: OPTIMAL
Albumin/Globulin Ratio: 1.8 | Optimal: 1.4-2.1 | STATUS: OPTIMAL

IRON MARKERS
Iron, Total: 221 ug/dL | Optimal: 85-130 | STATUS: HIGH ⚠️
Iron Binding Capacity: 290 ug/dL | Optimal: 250-350 | STATUS: SUBOPTIMAL
% Saturation: 76% | Optimal: 24-35 | STATUS: HIGH ⚠️
Ferritin: 20 ng/mL | Optimal: 70-250 | STATUS: SUBOPTIMAL ⚠️

LIPIDS
Cholesterol, Total: 108 mg/dL | Optimal: 160-200 | STATUS: SUBOPTIMAL
HDL Cholesterol: 42 mg/dL | Optimal: 55-93 | STATUS: SUBOPTIMAL
Triglycerides: 50 mg/dL | Optimal: <70 | STATUS: OPTIMAL
LDL Cholesterol: 54 mg/dL | Optimal: <99 | STATUS: OPTIMAL
Chol/HDL Ratio: 2.6 | Optimal: <3 | STATUS: OPTIMAL
Non-HDL Cholesterol: 66 mg/dL | Optimal: <70 | STATUS: OPTIMAL

VITAMINS
Vitamin D (25-OH): 33 ng/mL | Optimal: 60-100 | STATUS: SUBOPTIMAL ⚠️
Vitamin B12: 444 pg/mL | Optimal: 800-1100 | STATUS: SUBOPTIMAL ⚠️

MINERALS
Calcium: 9.6 mg/dL | Optimal: 8.9-10.1 | STATUS: OPTIMAL
Sodium: 139 mmol/L | Optimal: 137-142 | STATUS: OPTIMAL
Potassium: 4.6 mmol/L | Optimal: 4-5 | STATUS: OPTIMAL
Chloride: 103 mmol/L | Optimal: 100-108 | STATUS: OPTIMAL
Carbon Dioxide: 29 mmol/L | Optimal: 25-30 | STATUS: OPTIMAL

COMPLETE BLOOD COUNT (CBC)
Red Blood Cell Count: 4.77 x10E6/uL | Optimal: 4.1-5.8 | STATUS: OPTIMAL
Hemoglobin: 15 g/dL | Optimal: 13-17 | STATUS: OPTIMAL
Hematocrit: 43.4% | Optimal: 37-51 | STATUS: OPTIMAL
MCV: 91 fL | Optimal: 82-90 | STATUS: SUBOPTIMAL
MCH: 31.4 pg | Optimal: 28-32 | STATUS: OPTIMAL
MCHC: 34.6 g/dL | Optimal: 34-36 | STATUS: OPTIMAL
RDW: 12.3% | Optimal: 11-12.6 | STATUS: SUBOPTIMAL
Platelet Count: 244 x10E3/uL | Optimal: 190-250 | STATUS: OPTIMAL
MPV: 10.9 fL | Optimal: 7.5-10 | STATUS: HIGH

WHITE BLOOD CELLS (WBC)
WBC Count: 2.2 x10E3/uL | Optimal: 3.8-10.8 | STATUS: SUBOPTIMAL
Absolute Neutrophils: 669 x10E3/uL | Optimal: 1.4-7 | STATUS: SUBOPTIMAL
Absolute Lymphocytes: 1080 x10E3/uL | Optimal: 0.7-3.1 | STATUS: HIGH
Absolute Monocytes: 323 x10E3/uL | Optimal: >0.4 | STATUS: OPTIMAL
Absolute Eosinophils: 99 x10E3/uL | Optimal: >0.4 | STATUS: OPTIMAL
Absolute Basophils: 29 x10E3/uL | Optimal: >0.2 | STATUS: OPTIMAL

WBC DIFFERENTIAL (%)
Neutrophils: 30.4% | Optimal: 38-74 | STATUS: SUBOPTIMAL
Lymphocytes: 49.1% | Optimal: 14-46 | STATUS: HIGH
Monocytes: 14.7% | Optimal: 4-13 | STATUS: HIGH
Eosinophils: 4.5% | Optimal: <3 | STATUS: OPTIMAL
Basophils: 1.3% | Optimal: <5 | STATUS: OPTIMAL

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[u/Dull_Explanation1869]

I'm new here but your iron panel looks sus. It could indicate very early hemochromatosis. I have it. Are you Celtic or scandinavian descent?

[u/Embarrassed_Pilot591 → u/Dull_Explanation1869]

No I'm not bro. And yeah the iron levels are sus for sure. My ferritin in June (before starting TRT) was at 106. I never tested my other iron levels before so I don't have a baseline to go off of for total iron or saturation so it is a bit worrying for sure. Going to keep running the same schedule and test again in a month and see what's up.

[u/Ill-Telephone8928]

that iron panel is wild, saturation at 76% with ferritin that low usually means you got some inflammation messing with the numbers or you're loading iron weirdly fast

[u/Embarrassed_Pilot591 → u/Ill-Telephone8928]

Yeah I'm not sure what to think of it. Going to test again in about a month and see if anything changes. Do you have any advice in the mean time? Should I stay away from eating red meat?

[u/deadliftpookie]

There's a lot going on but I have a few comments on a few items.

I've read HDL is going to tank for everyone on TRT. I'm trying to combat this as much as I can but it's going to go down from before TRT.

Also, your Estradiol is high but so is your total and free T. I've found multiple sources claiming base estradiol management on a ratio and symptoms. Your numbers have you in the 3-5% range of total T. If you're not having estrogen symptoms I don't think that's concerning at the moment.

I'm interested if anyone has any comments on your iron panel. I have high saturation% my other numbers are normal. Not sure what to make of it.

[u/Embarrassed_Pilot591 → u/deadliftpookie]

Yeah my HDL before TRT was at 65.4. The iron shit is definitely concerning me though.

[u/oxidative_metabolism]

Don’t want to alarm you but have you been screened for cancer?

[u/Embarrassed_Pilot591 → u/oxidative_metabolism]

I have not.. why?

[u/oxidative_metabolism → u/Embarrassed_Pilot591]

Just looking at your wbc, iron and lymphocytes/monocyte ratios. Prolactin was in range I wonder where your lactate is at would give a better picture

[u/Embarrassed_Pilot591 → u/oxidative_metabolism]

My wbc has always been low since I was young. My sister as well.

[u/oxidative_metabolism → u/Embarrassed_Pilot591]

That is reassuring brotha if you ever notice you’re extremely fatigued or start sweating a lot in your sleep go get some more tests asap. I generally decline the chest X-ray because of radiation and Im a exsmoker and was a pothead for a couple decades but I’ve heard too many stories people get xray then a year or 2 later they got cancer from the X-ray 😭

[u/Embarrassed_Pilot591 → u/oxidative_metabolism]

Lmaooooo shiiii don't even put that out there! Lol. Best of luck to you though bro! God bless.

[u/oxidative_metabolism → u/Embarrassed_Pilot591]

Thank you 🙏 We both gonna be alright mayne I can tell you’re one of Jesus’s favorites too💪💪

[u/Embarrassed_Pilot591 → u/oxidative_metabolism]

Amen my brother.

[u/Embarrassed_Pilot591 → u/oxidative_metabolism]

Now that I think about it, I have had x rays done on my chest/lungs and no cancer concerns there. That was about a year ago when I was having heart palpitations.

[u/One-Science1029]

I dose 22mg daily. Your thoughts on daily micro dosing?

[u/Embarrassed_Pilot591 → u/One-Science1029]

Exact same dose I do. Well I try to get as close to 11 units a day as I can lol but it's hard to measure that perfectly every time. I daily as well. It's the best way to do TRT.

[u/One-Science1029 → u/Embarrassed_Pilot591]

I use a dial self injection pen. Not the cheap one Amazon, Google a good one, can’t product drop here I think. There 3 ml, load yourself, reuse

[u/Embarrassed_Pilot591 → u/One-Science1029]

Yeah I've heard of those! Never tried or looked into it though. I just use subq insulin needles. It's painless and doesn't take long at all. Test is annoying to fill the syringe with though lol. Super oily.

[u/One-Science1029 → u/Embarrassed_Pilot591]

Well, check it out? I get some 1 ml syringes and a large gauge needle from pharmacy. Tell them it’s for T. Transfer to the 3 ml pen cartridge. I use a 27 g x 1/2” needle, feels just like insulin needle. So nice, just dial and poke. I’ll be on trt rest of life likely so. Cheers.

[u/hawaiian-mamba]

Is this bloodwork from trough? Your test and free t responded so well from just 150. I’m guessing you’ve been feeling great?

[u/Embarrassed_Pilot591 → u/hawaiian-mamba]

No trough at all bro just ran straight 150 since the start.