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Bulldog's Followup Labs

Discussion in 'Member Journals' started by Bulldog, Nov 16, 2009.

  1. Bulldog

    Bulldog Administrator Staff Member Administrator

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    It is my understanding that it is OK for Dr. John's patients to post their labs. If that is not the case then please delete this thread.




    New labs after 6 weeks of HRT.

    ------------------------------------------------------------------------------------

    COLLECTED: 10/09/2009 08:28
    RECEIVED: 10/09/2009 08:33
    REPORTED: 10/19/2009 06:01

    QUEST DIAGNOSTICS

    AGE: 40
    GENDER: M

    COMPREHENSIVE METABOLIC PANEL W/EGFR
    GLUCOSE 91 65-99 ng/dL
    UREA NITROGEN (BUN) 14
    FASTING REFERENCE INTERVAL
    7-25 ng/dL
    CREATININE 1.02 0.78-1.34 ng/dL
    eGFR NON-AFR. AMERICAN >60 > OR = 60 nL/nin/1.73n2
    eGFR AFRICAN AMERICAN >60 > OR = 60 rnL/nin/1.73m2
    BUNICREATININE RATIO NOT APPLICABLE 6-22 ( t a l c )
    BUN/CREATININE RATIO IS NOT REPORTED WHEN THE BUN
    AND CREATININE VALUES ARE WITHIN NORMAL LIMITS.
    SODIUM 142 135-146 nnol/L
    POTASSIUM 4.0 3.5-5.3 nnol/L
    CHLORIDE 107 98-110 nnol/L
    CARBON DIOXIDE 27 21-33 nnol/L
    CALCIUM 9.2 8.6-10.2 ng/dL
    PROTEIN, TOTAL 6.4 6 . 2-8. 3 g/dL
    ALBUMIN 4.5 3 . 6-5. 1 g/dL
    GLOBULIN 1.9 L 2 . 1-3. 7 g/dL (cal c)
    ALBUMIN/GLOBULIN RATIO 2.4 H 1 . 0-2. 1 (cal c)
    BILIRUBIN, TOTAL 0.8 0 . 2-1. 2 ng/dL
    ALKALINE PHOSPHATASE 50 40-115 U/L
    AST 19 10-40 U/L
    ALT 24 9-60 U/L

    ESTRADIOL, ULTRASENSITIVE
    LC/MS/MS 37 H pg/mL Reference Range: < OR = 29

    TESTOSTERONE, FREE,BIO
    AND TOTAL, LC/MS/MS
    TESTOSTERONE, TOTAL 960 ng/dL Reference Range : 250-1100

    TESTOSTERONE, FREE 201.5 pg/nL Reference Range: 46.0-224.0

    TESTOSTERONE,BIOAVAILABLE 414.4 ng/dL Reference Range : 110.0-575.0

    SHBG 23 nmol/L Reference Range: 9-45

    ALBUMIN,SERUM 4.5 g/dL Reference Range : 3 . 6- 5. 1

    CBC (INCLUDES DIFF/PLT) BH
    WHITE BLOOD CELL COUNT 5.7 3.8-10.8 Thousand/uL
    RED BLOOD CELL COUNT 4.58 4.20-5.80 Mil lion/uL
    HEMOGLOBIN 15.0 13.2-17.1 g/dL
    HEMATOCRIT 43.3 38. 5-50. 0 X
    MCV 94.7 80.0-100.0 fL
    MCH 32.8 27.0-33. 0 pg
    MCHC 34.7 32.0-36.0 g/dL
    RDW 14.0 11. 0-15. 0 X
    PLATELET COUNT 189 140-400 Thousand/uL
    MPV 8.6 7.5-11.5 fL
    ABSOLUTE NEUTROPHILS 3887 1500-7800 cells/uL
    ABSOLUTE LYMPHOCYTES 1345 850-3900 cells/uL
    ABSOLUTE MONOCYTES 353 200-950 cells/uL
    ABSOLUTE EOSINOPHILS 91 15-500 cells/uL
    ABSOLUTE BASOPHILS 23 0-200 cells/uL
    NEUTROPHILS 68.2
    LYMPHOCYTES 23.6
    MONOCYTES 6.2
    EOSINOPHILS 1.6
    BASOPHILS 0.4

    LIST OF RESULTS PRINTED IN THE OUT OF RANGE COLUMN:
    GLOBULIN 1.9 L 2.1-3.7 g/dL (calc)

    ALBUMIN/GLOBULIN RATIO 2.4 H 1.0-2.1 (calc)

    ESTRADIOL, ULTRASENSITIUE
    LC/MS/MS 37 H pg/mL Reference Range: < OR = 29
     
    Last edited: Aug 11, 2011
  2. pmgamer18

    pmgamer18 Prince of the Forums

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    Your doing great now just keep your Estradiol levels at about 20 pg/ml or what gives you good night time and morning wood and you have it.

    Some weeks I need .25 mgs of Arimidex every 2 days in the last weeks I have had to take it every 3 days it keeps changing and one needs to stay on top of this not just with labs. Learn about how you feel to high and go up on your dose if you keep track of your wood you can do great.
     
  3. chilln

    chilln Banned

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    All good, except E2 and reverse T3.

    But you're definitely on your way to hormone bliss!

    The important thing to note is that since you're still improving, this discussion is more addressing the future rather than the present.

    If your improvements start slowing down, then that's when the following measures may be of interest.

    ###

    Normally we don't start out on arimidex from day one, but you'll be supplementing with arimidex soon enough, if you're not already.

    If you find it difficult to dose arimidex, then request your medical professional adviser to issue you with a prescription for compounded arimidex. It's much easier to dose than the tableted form.

    With compounded armidex, at 0.05mg per cap (some buy 0.10mg per cap) I am able to dose my testosterone to suit my arimidex, not the other way around.

    In other words, if I increasing my T dose too much, then I need more arimidex than 0.10mg per day, but less arimidex than 0.15mg per day, then that's difficult to manage because I can only take my arimidex in 0.05mg, or 0.10mg, or 0.15mg.

    Perhaps discuss this concept with your medical professional adviser when you're (eventually) dosing your arimidex.

    My point is that optimum arimidex dosing comes from adjusting both your T (testosterone) (and HCG) doses, as well as your arimidex doses.

    ###

    I'm going to assume you're supplementing with thyroid hormone boosters, because you weren't able to absorb T gels / creams before switching to injected T esters.

    Everyone's optimal supplementary dose of the individual thyroid hormones T3 and T4 is different. Just like arimidex, you and your medical professional adviser are eventually going to need to adjust the fractions of T4 and T3 (via dosage-response trials) to work out what's best.

    Initially you and your medical professional adviser will probably run some dosage trials of a low cost thyroid hormone supplement, with a fixed ratio of T3 and T4 (armour / nature thyroid / et al..), and stabilize for several weeks, then re-measure your free T3 and reverse T3.

    Most likely you and your medical professional adviser will wind up increasing the fraction of your T3 and reducing the fraction of your T4, since your reverse T3 is still dominant.

    Also, you have plenty of free T4, so you may be able to benefit from converting that excess T4 into T3 (hopefully not reverse T3) by supplementing with Iodoral in addition to your existing thyroid hormone supps.

    ###

    Since you're not complaining of the afternoon "yawns" therefore your cortisol should be OK, but sometimes supplementing with thyroid hormones can show up a weakness in cortisol production, so you and your medical professional adviser may want to monitor your cortisol levels a little more closely, eg: via 24hr urinary cortisol, as discussed here:

    http://allthingsmale.com/forum/showpost.php?p=52999&postcount=6

    ...or via a 4-times-per-day salivary cortisol measurement as discussed here:

    http://allthingsmale.com/forum/showpost.php?p=54588&postcount=38

    .
     
  4. Bulldog

    Bulldog Administrator Staff Member Administrator

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    Thanks for the replies.

    The doc has not addressed thyroid yet. As you can see in my last set of labs he has not been testing it. I believe he is waiting until we get my T and E2 dialed in to address thyroid.

    I do occasionally get the afternoon yawns. I didn't even think about that when I listed my symptoms. It doesn't happen every day but I do get them quite often.

    In June, 2008 I also did a 4x saliva test for cortisol. I posted it on one of my other threads but I was not able to locate it when I looked for it the other day so I'll have to re-upload it. All four levels were in the normal range but the day I did the test I was on a vacation day and I also happened to be the only one home that day. So my stressors were not at their normal levels.
     
  5. Bulldog

    Bulldog Administrator Staff Member Administrator

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    I added my labs from 06/16/2009 to my original post. Those labs were after I tried T gel back in September of 2008 and decided I didn't want to do shots so I went off TRT. I had several months of slightly improved sleep as well as getting lots of vitamin D3, fish oil and other supplements. As you can see it didn't really improve anything. Right after these labs I tried T gel again with no improvements. I do not have a copy of those labs but I don't think it matters much since the T gel didn't work and I'm not using it now.
     
  6. hardasnails1973

    hardasnails1973 Banned

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    CBC are intidicating potential b-12, folate defieincy
    Adrenals need to be properly evaluated (secondary hypothyroidism to potentially adrenal insufficiency) Appears you are having cellular deficeincy of thyroid due to TSH >2, lack of cortisol to drive the t3 into the tissue to signal pituitary to lower the tsh. I am seeing this alot more in patients.
    In your case it may be a mistake treating thyroid with out ruling out adrenal insuffiency. Seen this happen time and time again setting back progression. ARe you on statin drugs because I am seeing a huge trend in people with low cholesterol having deficiency in ubiqunol as a cellular and functional issue. After speaking to one of the most knowledgeable person in manipulation of enzymatic he has also noted the same as also agrees that people with low cholesterol has a HMG coenyzme reductase imbalance that is mostly genetic or from enviromental toxins. We both feel that alot of people with low cholesterol have viral loads that may be residual effect from heavy metals or from vaccination from when we where in occulate as kids. People that are undermethylated have a tendency to have the inability to detoxify these and they get trapped in our tissues for upto several decades. Since focusing on open metabolic pathways and detoxifying the body mainly the gut our patience have noted no need for AI any more after being on them for years. By researching and studying autism one can start to understand these intricate metabolic pathways and circumvent them to get a clincal response.
    People with estrogen issue I see a upregulation in trans sulfuration pathway which needs to be address, but one needs to look up the chain to see where the blockage may occur.
     
  7. Bulldog

    Bulldog Administrator Staff Member Administrator

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    Thanks HANS. I'm not on any Statin drugs and my cholesterol has been around those levels for as long as I can remember....always low HDL and Total with borderline high TRIGS.
     
    Last edited: Dec 6, 2009
  8. hardasnails1973

    hardasnails1973 Banned

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    Look to toxic overload namely viral such as pneumonie, lyme, or other hidden infection, heavy metals, hidden food allergies, liver overload,leaky gut. Do you have tattoos? I just got 3 new cases of mercury toxicity due to toxicity in tattoss. Again look to the root cause. Coenyzme q10 is probably in the crapper as one might have genetic defect. I would have to do a full profile on you to determine probably cause and then go. Curious did you have a stuttering problem growing up ? or stuttering when understress as I find this is a high correlation with people with low cholesterol levels. By addressing adrenals and supplementing cholesterol I have had several young guys testosterone have gone from 200 to over 600 in less then 4 months. Near future i hope to work in tandem with Dr Shaw from great plains further explore this. On east coast I am on the main driving forces having dr's look at the current methods in a different light presenting new scientific information and what has worked for me in helping reduce the need for HRT in younger people.
     
  9. Bulldog

    Bulldog Administrator Staff Member Administrator

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    No tattoos and I have never had a stuttering problem that I can remember.

    I have pretty constant sinus congestion but it gets the worst in the spring and fall. I have never been tested to see what is causing the congestion. I have always just assumed that it was seasonal allergies. It has been this way my whole life.
     
    Last edited: Nov 18, 2009
  10. hardasnails1973

    hardasnails1973 Banned

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    Allergies are usually adrenal/thyroid related as well as imbalance in specific cytokins. They could also be indictive as imbalance in methylations and other liver pathways. With out cholesterol body can not protect its mucous membrane from infections and can not repair.
     
  11. Bulldog

    Bulldog Administrator Staff Member Administrator

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    I'm still waiting for my followup labs since addressing my high E2. However, the Doc doesn't think my E2 lab was accurate because it was at the top of range at a 28 but I had obvious low E2 symptoms (ED, no libido, joint pain). Since making an adjustment a week ago I'm feeling much better already.

    One thing to note is that since we addressed my high E2, I have not changed my diet or workout schedule in any way yet I have dropped 10 pounds and 2 inches off my waist over the last 8 weeks. It's a very good feeling!

    Once I get my lab copies I will post them and give an update on any symptoms I may have and how I'm feeling overall. But as of right now, I'm feeling pretty darn good and I'm making the wife happy again now that my E2 has come up a little bit (based on symptoms). As a matter of fact she has joked that she may need to hire a stunt double! :thumbup1:
     
  12. Bulldog

    Bulldog Administrator Staff Member Administrator

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    Latest Labs 5 weeks after addressing high E2.
    --------------------------------------------

    COLLECTED: 12/23/2009 08:49
    RECEIVED: 12/24/2009 02:43
    REPORTED: 01/06/2010 06:03

    QUEST DIAGNOSTICS

    AGE: 40
    GENDER: M

    COMPREHENSIVE METABOLIC PANEL W/EGFR
    GLUCOSE 106 H 65-99 ng/dL
    UREA NITROGEN (BUN) 14
    FASTING REFERENCE INTERVAL 7-25 ng/dL
    CREATININE 1.23 0.78-1.34 ng/dL
    eGFR NON-AFR. AMERICAN >60 > OR = 60 nL/nin/1.73n2
    eGFR AFRICAN AMERICAN >60 > OR = 60 rnL/nin/1.73m2
    BUNICREATININE RATIO NOT APPLICABLE 6-22 ( t a l c )
    BUN/CREATININE RATIO IS NOT REPORTED WHEN THE BUN
    AND CREATININE VALUES ARE WITHIN NORMAL LIMITS.
    SODIUM 141 135-146 nnol/L
    POTASSIUM 4.6 3.5-5.3 nnol/L
    CHLORIDE 105 98-110 nnol/L
    CARBON DIOXIDE 27 21-33 nnol/L
    CALCIUM 9.6 8.6-10.2 ng/dL
    PROTEIN, TOTAL 6.8 6.2-8.3 g/dL
    ALBUMIN 4.7 3.6-5.1 g/dL
    GLOBULIN 2.1 2.1-3.7 g/dL (cal c)
    ALBUMIN/GLOBULIN RATIO 2.2 H 1.0-2.1 (cal c)
    BILIRUBIN, TOTAL 1.0 0.2-1.2 ng/dL
    ALKALINE PHOSPHATASE 47 40-115 U/L
    AST 21 10-40 U/L
    ALT 23 9-60 U/L

    ESTRADIOL, ULTRASENSITIVE
    LC/MS/MS 28 pg/mL Reference Range: < OR = 29

    TESTOSTERONE, FREE,BIO AND TOTAL, LC/MS/MS
    TESTOSTERONE, TOTAL 934 ng/dL Reference Range : 250-1100

    TESTOSTERONE, FREE 235.1 H pg/nL Reference Range: 46.0-224.0

    TESTOSTERONE,BIOAVAILABLE 493.7 ng/dL Reference Range : 110.0-575.0

    SHBG 17 nmol/L Reference Range: 9-45

    ALBUMIN,SERUM 4.6 g/dL Reference Range : 3 . 6- 5. 1

    TESTOSTERONE, TOTAL 923 ng/dL Reference Range : 250-1100

    CBC (INCLUDES DIFF/PLT)
    WHITE BLOOD CELL COUNT 5.2 3.8-10.8 Thousand/uL
    RED BLOOD CELL COUNT 4.94 4.20-5.80 Mil lion/uL
    HEMOGLOBIN 15.8 13.2-17.1 g/dL
    HEMATOCRIT 45.5 38. 5-50. 0 X
    MCV 92.2 80.0-100.0 fL
    MCH 31.9 27.0-33. 0 pg
    MCHC 34.7 32.0-36.0 g/dL
    RDW 13.3 11. 0-15. 0 X
    PLATELET COUNT 184 140-400 Thousand/uL
    MPV 8.8 7.5-11.5 fL
    ABSOLUTE NEUTROPHILS 3240 1500-7800 cells/uL
    ABSOLUTE LYMPHOCYTES 1451 850-3900 cells/uL
    ABSOLUTE MONOCYTES 338 200-950 cells/uL
    ABSOLUTE EOSINOPHILS 151 15-500 cells/uL
    ABSOLUTE BASOPHILS 21 0-200 cells/uL
    NEUTROPHILS 62.3
    LYMPHOCYTES 27.9
    MONOCYTES 6.5
    EOSINOPHILS 2.9
    BASOPHILS 0.4

    LIST OF RESULTS PRINTED IN THE OUT OF RANGE COLUMN:
    GLUCOSE 106 H 65-99 ng/dL
    ALBUMIN/GLOBULIN RATIO 2.2 H 1.0-2.1 (cal c)
    TESTOSTERONE, FREE 235.1 H pg/nL Reference Range: 46.0-224.0

    -------------------------------------------------------------------------

    Some weird stuff here.....

    I did fast for this test and my glucose was high at: GLUCOSE 106 H 65-99 ng/dL

    I have never had high glucose before so I'm not sure if this is a fluke or if there may be a problem developing here.

    My previous labs were taken 5 days after my Test Cyp shot and my total T was: TESTOSTERONE, TOTAL 960 ng/dL Reference Range : 250-1100


    These labs were taken only 3 days after my Test Cyp shot and my total T was actually lower at: TESTOSTERONE, TOTAL 934 ng/dL Reference Range : 250-1100

    Or......

    TESTOSTERONE, TOTAL 923 ng/dL Reference Range : 250-1100

    ....depending on which test you want to believe (for some reason he ran two Total T tests). I guess maybe this shows the variability of the tests?


    My BAT and Free T are higher this time which I would have expected (free is actually a little too high).

    E2 is just within the top of range however I was having a lot of low E2 symptoms for a few weeks prior to this test. Doc said he thinks the test is invalid since my symptoms indicated I was obviously low. However, after thinking back to the day I had the blood drawn I felt pretty good on that day. My low E2 symptoms were occuring on certain days of the week but not every day. It is quite possible that this test was in fact valid as that day of the week was usually one of my better days.


    Here is a list of my symptoms at the time of the blood draw.

    Improvements:
    Itchy, sore nipples were gone at this time
    Exercise recovery is up
    Strength is up for the first time in years

    Symptoms I still have:
    Afternoon Yawns (not every day though)
    Brain fog
    Low tolerance for cold weather (hands and feet are always cold)
    Still not getting enough sleep (but I am sleeping much better than I was)
    Mild BPH

    New Symptoms:
    Libido was pretty much gone and I had mild ED at this time
    Losing a lot of hair from my scalp that I did not notice before
    Sore joints on some days of the week

    Since adjusting my protocol two weeks ago to address low E2 symptoms my itchy nipples are starting to come back on certain days of the week. I added Saw Palmetto and Pumpkin seed oil to address mild BPH two weeks ago, which pretty much cleared this problem up 100% within one week of starting this supplement. I have since stopped the saw palmetto and pumpkin seed oil supplement to see if the BPH symptoms return. I'm also still sheading hair from my scalp like crazy.

    Might it be worth reducing my Test Cyp dose a little bit to try and lower my E2 & DHT or would that be a waste of time?

    Any comments are appreciated.
     
    Last edited: Feb 16, 2010
  13. Bulldog

    Bulldog Administrator Staff Member Administrator

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    Any commets on my last labs?
     
  14. canthavetoomanytoys

    canthavetoomanytoys New Member

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    Some general layman's comments:
    It seems time to address the thyroid.
    Did you fast for at least 12-hours? I was under the impression that it was less but my lab says 12 - glucose level would be altered.
    Look at diet and consider hA1C to get a better picture of your status.
     
  15. Bulldog

    Bulldog Administrator Staff Member Administrator

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    Yes, I fasted for more than 12 hours, although my lab request said I didn't have to fast. Which is probably why the Doc didn't think much of my elevated glucose. Since I don't see my labs before we discuss them I had no idea to ask about this during my visit.

    The Doc has not said anything more about my thyroid yet. I'm guessing he will address that once we get my E2 dialed in.

    My diet has not been the greatest lately. I'm on the go so much for my son's sports that I end up eating out a lot more than I should be.
     
  16. Bulldog

    Bulldog Administrator Staff Member Administrator

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    I checked my blood pressure at Wal-Mart last night just to see what it was. It was 127/78 with a pulse of 79. Any idea how accurate these machines are? I never really pay attention to what my blood pressure is when I go to the doctor because they have always told me it was good. I checked my blood pressure back on Thanksgiving at my parents house with a small unit they use at home and it was 111/70 with a pulse of 68. I checked it again the next day and it was pretty much the same. I have felt like my pulse has been higher lately for some reason but I have no idea why it would be higher.

    So, I was just wondering if anyone knows how accurate the store units and small home units are? I guess I will have to pay more attention the next time I go to the doctors office and make note of what my blood pressure is.
     
  17. chilln

    chilln Banned

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    The after noon yawns are due to too low cortisol.

    If, by maintaining this more optimum T / E2 balance, your cortisol levels aren't improved, then most likely you and your medical professional adviser will have to seriously consider supplementing with some hydrocortisone / cortef (man made bioidentical cortisol), before you consider supplementing with any thyroid hormones.

    When your cortisol levels are eventually improved, your thyroid hormone T3 metabolism may also improve, if your current thyroid hormone T3 levels are fine, but you don't have enough cortisol to transport the T3 into cells.

    For some people, boosting thyroid hormone T3, while cortisol levels are low, does actually boost cortisol output, but it can go the other way, and boosting thyroid hormone T3, while cortisol levels are low, can degrade your cortisol metabolism even further. So if you and your medical professional adviser do consider boosting your thyroid hormone levels before considering boosting cortisol, then take it very very cautiously.

    .

    .
     
    Last edited: Jan 26, 2010
  18. hebsie

    hebsie Super Moderator Staff Member Super Moderator

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    ...I would think that they're reasonably accurate, but accurate to the situation at hand. Consider this, you've just driven your car to the store, parked, walked around the store, been confronted by crowds/whatever, you then sit down in a very public area and test your BP. I might expect my own (BP) to be typically higher in that scenario.

    As for the home units, I honestly believe them to be more accurate than what I get at the doctor's office. It's in a very controlled environment. I'm relaxed. There's precision accuracy with the digital reading, little chance for human error.

    Compare that to the doctor's office. I'm sure that you've heard of white coat hypertension -- it's often a stressful place. It's often taken at stressful times (like you're at the doctor's cause you're not feeling well, you're concerned about treatment protocols, etc...). And then there's the human error factor. Your doctor is watching a scale while listening to your heartbeat. It's all up to him to determine the actual figures. In case you didn't know, here's the actual process:

    ...and I do believe that this is why you never get readings like 123/74 from your doctor. It's always rounded up/down into numbers like 120/80, etc...hebs
     
  19. Bulldog

    Bulldog Administrator Staff Member Administrator

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    Thanks hebsie. That makes a lot of sense. I might have to pick up a home unit one of these days.
     
  20. Bulldog

    Bulldog Administrator Staff Member Administrator

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    Any thoughts on my quote above? My DHT must be crazy high because I'm shedding hair from my scalp like crazy. In the past (pre TRT) I would shed hair once in a while, but now it has been constant for 3 weeks. Should I talk to the Doc about possibly lowering my T dose a little bit to see if it gets rid of the high DHT symptoms?
     

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