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  1. #1
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    Default Testosterone and LDL Cholesterol

    I am 59 years old and have been following this forum for six months. Based on what I have learned here, I asked my PCP (internal medicine) to give me a testosterone test and an estrogen test (unfortunately I didn’t know enough to ask for an ultrasensitive assay), 8AM cortisol, and TSH, along with the customary blood tests during my birthday physical in November.

    I have been lifting for two years and lost 55 pounds during the first six months. I have put on 15 pounds since then while my body fat percentage has gone from “Oh My!” to 16.2. I lift 4 days and do cardio two days per week (treadmill at enough of an incline to get my heart rate up to age-adjusted maximum ~160bpm with an average of ~154 for the 35-45 minutes). I eat very clean with fish 2X/week, protein at about 1g/pound of body weight (170).

    First test:
    Hematology: All within range except MPV was low, 6.7 (8.2-13 fL)
    Chemistry: All within range.
    Fasting Lipid Profile:
    Cholesterol 184 mg/dL (50-200)
    Triglycerides 87 mg/dL (50-150)
    HDH Chol 44 mg/dL (40-60)
    LDL Chol, Direct 123 mg/dL (0-100) H *Near optimal/Above optimal*

    Quest Diagnostics: ACTH Plasma 14 pg/mL (7-50)

    Quest Diagnostics: 8 AM Cortisol 12.1 mcg/dL (4-22)

    Quest Diagnostics: Estradiol, Free, LC/MS/MS
    Estradiol, Free .21 pg/mL (< or = 0.45)
    Estradiol, % Free 2.08 H (1.25-1.85)
    Estradiol 10 (< or = 29)

    Quest Diagnostics: Testosterone, Free, BAT, Total, LC/MS/MS
    Testosterone, Total 197 L (250-1100 ng/dL)
    Testosterone, Free 32.8 L (46-224 pg/mL)
    Testosterone, Bioavailable 61.7 L (110-575 nmol/L)

    SBGH 23 (18-47)
    Albumin, Serum 4.1 (3.6-5.1)

    I was concerned about my LDL from the first test because of how much I exercise and how clean I eat. My PCP wanted to start slowly with T because he had a patient once (he doesn’t do much of this) whose LDL jumped 100 points when he first started T.

    He started with on a ridiculously low dose of Test-C (.5 cc of 200mg/ml Testosterone Cypionate/month). After 4 weeks I gave myself the second shot and 3 days later he ordered another Lipid profile (non-fasting). My LDL had increased to 170!

    To his credit, he didn’t pull me off the testosterone and actually increased my dosage to .5 cc every two weeks which I asked to administer at .25 weekly and he agreed.

    My Questions:

    Is it normal for LDL to temporarily increase when one first starts taking testosterone IM?

    Can high free Estradiol cause this increase?

    What the heck is going on?

  2. #2
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    Default Re: Testosterone and LDL Cholesterol

    Quote Originally Posted by ProfBush View Post
    I am 59 years old and have been following this forum for six months. Based on what I have learned here, I asked my PCP (internal medicine) to give me a testosterone test and an estrogen test (unfortunately I didn’t know enough to ask for an ultrasensitive assay), 8AM cortisol, and TSH, along with the customary blood tests during my birthday physical in November.

    I have been lifting for two years and lost 55 pounds during the first six months. I have put on 15 pounds since then while my body fat percentage has gone from “Oh My!” to 16.2. I lift 4 days and do cardio two days per week (treadmill at enough of an incline to get my heart rate up to age-adjusted maximum ~160bpm with an average of ~154 for the 35-45 minutes). I eat very clean with fish 2X/week, protein at about 1g/pound of body weight (170).

    First test:
    Hematology: All within range except MPV was low, 6.7 (8.2-13 fL)
    Chemistry: All within range.
    Fasting Lipid Profile:
    Cholesterol 184 mg/dL (50-200)
    Triglycerides 87 mg/dL (50-150)
    HDH Chol 44 mg/dL (40-60)
    LDL Chol, Direct 123 mg/dL (0-100) H *Near optimal/Above optimal*

    Quest Diagnostics: ACTH Plasma 14 pg/mL (7-50)

    Quest Diagnostics: 8 AM Cortisol 12.1 mcg/dL (4-22)

    Quest Diagnostics: Estradiol, Free, LC/MS/MS
    Estradiol, Free .21 pg/mL (< or = 0.45)
    Estradiol, % Free 2.08 H (1.25-1.85)
    Estradiol 10 (< or = 29)

    Quest Diagnostics: Testosterone, Free, BAT, Total, LC/MS/MS
    Testosterone, Total 197 L (250-1100 ng/dL)
    Testosterone, Free 32.8 L (46-224 pg/mL)
    Testosterone, Bioavailable 61.7 L (110-575 nmol/L)

    SBGH 23 (18-47)
    Albumin, Serum 4.1 (3.6-5.1)

    I was concerned about my LDL from the first test because of how much I exercise and how clean I eat. My PCP wanted to start slowly with T because he had a patient once (he doesn’t do much of this) whose LDL jumped 100 points when he first started T.

    He started with on a ridiculously low dose of Test-C (.5 cc of 200mg/ml Testosterone Cypionate/month). After 4 weeks I gave myself the second shot and 3 days later he ordered another Lipid profile (non-fasting). My LDL had increased to 170!

    To his credit, he didn’t pull me off the testosterone and actually increased my dosage to .5 cc every two weeks which I asked to administer at .25 weekly and he agreed.

    My Questions:

    Is it normal for LDL to temporarily increase when one first starts taking testosterone IM?

    Can high free Estradiol cause this increase?

    What the heck is going on?
    You have approached supplying testosterone in the wrong way.
    Always use HCG to support testis, from hour #1.
    Newer inject T-shots with less than 1 week frequency, more often is better.
    Use B3 to get your cholesterol right.
    Forget about your E2 test, in total.
    Good news, your SHBG is nice.

    Keep reading this board.
    My posts if you want to know my opinion.
    I post list of tests that I do for my self on post #44, between blue lines here:
    http://anabolicminds.com/forum/male-...april13-2.html

    May want to peruse that thread.
    .
    /
    Post all tests that you have done.
    Post all medicines that you are using.
    Any complaints?
    .
    /
    I am not a Dr, any opinion that I have is based on my own experience.
    Any changes in my regime are always discussed with and are approved by my doctor.

    Diabetes is not a disease. It is how mammals signal for the coming winter. You can cure it naturally.
    ...all legitimate rights have one thing in common: they are rights to action, not to rewards from other people."
    Failure is the spice that gives success its flavors………….If you don’t do the fear, you won’t get the courage.

  3. #3
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    Default Re: Testosterone and LDL Cholesterol

    Quote Originally Posted by JanSz View Post
    You have approached supplying testosterone in the wrong way./
    Always use HCG to support testis, from hour #1.

    I haven't convinced him of this yet.

    Newer inject T-shots with less than 1 week frequency, more often is better.

    The once a month protocol wasn't my idea. When he said every two week, I said split it and inject weekly.

    Use B3 to get your cholesterol right.

    I've been taking 500-1000 mg Inositol Hexanicotinate and I understand that this form of "flushless niacin" doesn't have the lipid beneficial effects. So, it's time for me to change to either nicotinic acid or niacinamide. Do you have a preference, and how much? Is 1000mg enough?

    Forget about your E2 test, in total.

    Is this because of you my test not using an ultrasensitive assay?

    Good news, your SHBG is nice.

    Keep reading this board.
    My posts if you want to know my opinion.
    I post list of tests that I do for my self on post #44, between blue lines here:
    http://anabolicminds.com/forum/male-...april13-2.html
    Thanks.
    May want to peruse that thread.
    .
    /
    Post all tests that you have done.
    Post all medicines that you are using.
    The only medication I am taking is the testosterone cypioate.

    Any complaints?
    All the standard andropause complaints are mine as well. ED, lethargy, falling asleep (dying) early and waking too early, concentration, irritability...

  4. #4
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    Default Re: Testosterone and LDL Cholesterol

    Quote Originally Posted by ProfBush View Post
    Always use HCG to support testis, from hour #1.

    I haven't convinced him of this yet.

    Newer inject T-shots with less than 1 week frequency, more often is better.

    The once a month protocol wasn't my idea. When he said every two week, I said split it and inject weekly.

    Use B3 to get your cholesterol right.

    I've been taking 500-1000 mg Inositol Hexanicotinate and I understand that this form of "flushless niacin" doesn't have the lipid beneficial effects. So, it's time for me to change to either nicotinic acid or niacinamide. Do you have a preference, and how much? Is 1000mg enough?

    Forget about your E2 test, in total.

    Is this because of you my test not using an ultrasensitive assay?

    Good news, your SHBG is nice.

    Keep reading this board.
    My posts if you want to know my opinion.
    I post list of tests that I do for my self on post #44, between blue lines here:
    http://anabolicminds.com/forum/male-...april13-2.html
    Thanks.
    May want to peruse that thread.
    .
    /
    Post all tests that you have done.
    Post all medicines that you are using.
    The only medication I am taking is the testosterone cypioate.

    Any complaints?
    All the standard andropause complaints are mine as well. ED, lethargy, falling asleep (dying) early and waking too early, concentration, irritability...

    It is not easy to find knowledgable doctor.
    You troubles could be over quickly if you could make a trip to see dr John in Lansing Michigan.

    Short of that, you may find local doctor that is willing but lack proper knowledge.

    Study this board, learn, your doc may be willing to go along with your ideas if you present it to him/her in a maner that is at least half way convincing.
    Many doctors really want to please their patients.

    Description of your complaints indicate that you may have a some sort of Adrenal fatigue, low thyroid is not far behind.

    What was your LH & FSH before starting Testosterone?

    Assuming that your doctor will agree, you may want to consider following:

    Switch to daily injections, T/HCG injections on alternate days.
    one day 35mg Testosterone Cypionate
    next day 250iu HCG
    (if LH & FSH were high-ish, use 40mg testosterone per shot)

    use this needles only:
    http://hocks.com/Merchant2/merchant....Category_Code=
    BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b Price: $25.95

    One a day
    Vitamin B3 Niacin 500 mg, 100 capsules Item Catalog Number: 00372
    http://www.lef.org/Vitamins-Suppleme...B3-Niacin.html
    Or
    one/day Slo-Niacin
    =====================
    After 2 months on above get blood test, the whole list between blue lines on the post #44 link as in previus post.

    add to that two more tests;

    saliva Cortisol/DHEA 4 points test, if you have $$ do it 3 consecutive days.

    glucose/insuline challenge test, 75gram glucose, 7points in 3 hrs
    0min
    30 min
    60min
    90min
    120min
    150min
    180min
    ================================================== ======
    Post results as soon as you have them.
    Tabular form, analyte name, value, units, range, laboratory.

    Do the testing (other than saliva) in Quest Diagnostics.
    Draw blood 40hrs after T-shot
    ================================================== ======
    ./

    Good luck;
    .
    .
    I am not a Dr, any opinion that I have is based on my own experience.
    Any changes in my regime are always discussed with and are approved by my doctor.

    Diabetes is not a disease. It is how mammals signal for the coming winter. You can cure it naturally.
    ...all legitimate rights have one thing in common: they are rights to action, not to rewards from other people."
    Failure is the spice that gives success its flavors………….If you don’t do the fear, you won’t get the courage.

  5. #5
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    Default Re: Testosterone and LDL Cholesterol

    Something is strange with your results

    My LDL dropped from 99 to 68 my first month on TRT.

  6. #6
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    Default Re: Testosterone and LDL Cholesterol

    Quote Originally Posted by BigJimcalhoun View Post
    Something is strange with your results

    My LDL dropped from 99 to 68 my first month on TRT.
    I was predicting a decrease of about 25% based on the reading I have done. That expectation, and your experience, contradicts the experience of my PCP. Could it be that he starts people out in such a conservative way that the little dab of T just messes with fat metabolism without allowing the full benefits to develop?

  7. #7
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    Default Re: Testosterone and LDL Cholesterol

    I agree with Jan that you need HCG, and definitely more T.

    As for your high LDL, IMO you should be on a low dose statin, Crestor is best. Also, the niacins you described suck and will not help you. Use Slo-Niacin only.

    Your LDL should be under 100, under 70 if you have plaque. Have you had a heart scan to determine calcium plaque burden in your coronary arteries? I'd get one. With LDL that high you may have plaque at your age. If you do, then you MUST get on a statin and take other measures like high dose fish oil, D3, etc. How is your BP and BG?

  8. #8
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    Default Re: Testosterone and LDL Cholesterol

    Quote Originally Posted by Greenie View Post
    I agree with Jan that you need HCG, and definitely more T.

    As for your high LDL, IMO you should be on a low dose statin, Crestor is best. Also, the niacins you described suck and will not help you. Use Slo-Niacin only.

    Your LDL should be under 100, under 70 if you have plaque. Have you had a heart scan to determine calcium plaque burden in your coronary arteries? I'd get one. With LDL that high you may have plaque at your age. If you do, then you MUST get on a statin and take other measures like high dose fish oil, D3, etc. How is your BP and BG?
    I started taking red rice yeast (a statin I understand) yesterday and have also been taking fish oil, flaxseed oil, and 1000mg D3 for several months.

    I was surprised that my LDL was high in the first test (123) because all my other lipids were good; all my other blood test were good except testosterone.

    My BP runs in the 1-teens to high 60s low seventies. Today it was 114/71 after a heavy leg workout. A heavy workout sometimes temporarily elevates my BP. What is BG?

  9. #9
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    Default Re: Testosterone and LDL Cholesterol

    Quote Originally Posted by ProfBush View Post
    I started taking red rice yeast (a statin I understand) yesterday and have also been taking fish oil, flaxseed oil, and 1000mg D3 for several months.

    I was surprised that my LDL was high in the first test (123) because all my other lipids were good; all my other blood test were good except testosterone.

    My BP runs in the 1-teens to high 60s low seventies. Today it was 114/71 after a heavy leg workout. A heavy workout sometimes temporarily elevates my BP. What is BG?
    Nice, your BP is great! BG is fasting blood glucose.

    As for RRY, it is generally worthless. It is now regulated by the FDA that it cannot contain any lovastatin. If your desire is to take a statin, then take a statin! You need it. Low dose is the key. 10mg of Crestor may be all you'll need. Get a script for 20mg and split them in half to get it more affordable and to also crack through the quite impervious coating.

    I would definitely get a simple heart scan if I were you, to see what you have or do not have. That will determine how aggressive you need to be with all the lipid stuff.

    Good luck.

  10. #10
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    Default Re: Testosterone and LDL Cholesterol

    Quote Originally Posted by JanSz View Post
    It is not easy to find knowledgable doctor.
    You troubles could be over quickly if you could make a trip to see dr John in Lansing Michigan.
    I would love to be able to do this and my PCP has even suggested that I might want to try to find a specialist if there even is one in Arkansas, but realistically I might need to ask Dr. Crisler to consult.

  11. #11
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    Default Re: Testosterone and LDL Cholesterol

    Quote Originally Posted by Greenie View Post
    Nice, your BP is great! BG is fasting blood glucose.

    As for RRY, it is generally worthless. It is now regulated by the FDA that it cannot contain any lovastatin. If your desire is to take a statin, then take a statin! You need it. Low dose is the key. 10mg of Crestor may be all you'll need. Get a script for 20mg and split them in half to get it more affordable and to also crack through the quite impervious coating.

    I would definitely get a simple heart scan if I were you, to see what you have or do not have. That will determine how aggressive you need to be with all the lipid stuff.

    Good luck.
    Fasting BG is 99; higher than I'd like but not terrible. I will talk with my PCP about the scan. I am not yet convinced that my LDL is not an anomaly or somehow related to the TRT. I will try dietary changes and the Slo Niacin I will be picking up on the way home and see how the retest goes in four weeks. If that doesn't work, it might be time for a real statin.

  12. #12
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    Default Re: Testosterone and LDL Cholesterol

    Quote Originally Posted by ProfBush View Post
    Fasting BG is 99; higher than I'd like but not terrible. I will talk with my PCP about the scan. I am not yet convinced that my LDL is not an anomaly or somehow related to the TRT. I will try dietary changes and the Slo Niacin I will be picking up on the way home and see how the retest goes in four weeks. If that doesn't work, it might be time for a real statin.
    My opinion is you will need a statin. Use Crestor if you do. As for the 99 BG, that is prediabetic. It should be in the 80s, so I would think your diet is in need of change. Eliminate sugars, wheat, snack foods, etc etc. You can also add cinammon and chromium to help with BG, and they work great! Even with diet changes, my BG was always in the 90 range. Then I added those supps to my program and now my fasting BG is in the mid 80s consistently. You may want to buy a glucometer for $50 and start to take your BG in the morning when you wake up to monitor that for a while. High BG and high LDL is a recipe for coronary plaque, so nothing to mess around with.

    Good luck Prof!
    Last edited by Greenie; 01-21-2009 at 12:33 PM.

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    Default Re: Testosterone and LDL Cholesterol

    ProfBush... I'd be looking at starting with around 100mg per week. Once a week is adequate to get "tuned up"; You can always split the dose later. Keep in mind that after a few weeks your T levels may not change. Your natural T will disappear at the same time your exogenous T climbs. Taking shots every 2 weeks or (god forbid) monthly is just torture with the hormone swings. It's also a total waste of time and beyond a monthly billable office visit I don't see the point. (I can tell you from experience that I notice a swing with my once a week shot.)


    Greenie....can you clarify that heart scan? I had an ultrasound of my heart done about a year ago. I think it was an echocardiogram. Is this what you had in mind?
    I''ve been trying to avoid that whole "drop dead" thingy and want to cover all the bases.
    Last edited by Shootist; 01-21-2009 at 10:08 PM.

  14. #14
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    Default Re: Testosterone and LDL Cholesterol

    Rerun the panel.
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    Default Re: Testosterone and LDL Cholesterol

    Quote Originally Posted by Shootist View Post
    Greenie....can you clarify that heart scan? I had an ultrasound of my heart done about a year ago. I think it was an echocardiogram. Is this what you had in mind?
    I''ve been trying to avoid that whole "drop dead" thingy and want to cover all the bases.

    OK, hope many here are listening because this is maybe THE single most important thing you can do to protect your life.

    A heart scan is a very simple, non invasive test that takes about 15 seconds. It is basically a high def x-ray of your coronary arteries, and shows how much coronary plaque you have and exactly where it is. The cost ranges from $200-400 and is often covered by insurance. If you have plaque, then it quantifies the plaque so you can take measures to lower LDL particles, trigs, homocystiene, etc. and get aggressive to stabilize the plaque and even regress it.....and most importantly avoid heart attacks and worse. Preventive care is always the way to go!!
    I get a heart scan every 12-15 months to see how I am doing, and it is working out very well and I am now in regression with my plaque. It's hard work but it can be done! Diet, exercise, vits, supps, and hormone balance are the keys to regression and a long and healthy life....of course you all know that.

 

 

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