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What Does My Blood Test Report Indicate?

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Posted on Sat, 6 Feb 2016
Question: Hello,

I'm 26 yo male.

All blood tests taken at 7am

About 2 years a go I did a course of superdrol (pro-hormone), during the superdrol and for 6 weeks after I took tamoxifen to stop gyno. since then i have completely lost my sex drive and ability to get and maintain an erection. 18 months after this problem started I went for blood tests and my testosterone was 14.5 nmol/L and plasma oestradiol was 256 pmol/L. To me my oestradiol was far too high and testosterone is quite low for my age. I started taking arimidex, 0.5mg a day for 10 weeks - new test results: testosterone 14 and my oestradiol 133. Then I bumped the arimidex up to 1mg a day for 3 weeks then dropped to 0.5mg for a further week - new test results: testosterone 13.5 and oestradiol 195. I then continued to take arimidex at 0.25mg daily for another 6 weeks - new test results testosterone 12.8 and oestradiol 125.

In your opinion could my problem be from my testosterone and oestradiol levels?

Please can you advise, I'm desperate to be back to normal with a healthy sex drive!

P.S. Tested liver, adrenal etc and all came back in range.

Thanks
doctor
Answered by Dr. Shehzad Topiwala (4 hours later)
Brief Answer:
Steroid abuse

Detailed Answer:
Your testosterone levels at baseline and now are considered within normal range. Exact age-specific ranges are yet to published and validated through large scientific studies.

Essentially what you have embarked upon is deemed steroid abuse. It is very unsafe.

Anabolic steroids are drugs that are chemically related to the main male hormone testosterone. They are best known for their effects on building muscle (called anabolic). Sometimes doctors prescribe anabolic steroids to help patients with AIDS gain weight and to treat certain types of severe anemia (low red blood cells) or other health problems.
Some people, though, use these drugs illegally to improve athletic performance or to get a more muscular look. Not only is this against the law, but many sports ban use of anabolic steroids as “performance-enhancing drugs.”

Improper use of anabolic steroids can have unhealthy side effects. These include changes in behavior, increased risk for heart and liver disease, and unwanted—sometimes permanent—changes in physical features.
Anabolic steroids come in various forms, including pills, creams, patches, tablets, injections (shots), or drops placed under the tongue. Veterinary steroids (those for animals) often contain the same components as human steroids, but are not as pure. People sometimes use these as well.


Steroid use by college athletes has increased as well. Also, some professional athletes continue to use these drugs, including star athletes.
Not just athletes are using anabolic steroids. Some young people take them to look more muscular or to lose body fat.

Anabolic steroids have dangerous physical, mental, and emotional side effects. These may be more dangerous in young adults because they can stop growth. In women, they can cause permanent changes in the voice and genitals.
After stopping these drugs, people can feel severe depression and moodiness.
Injections of anabolic steroids carry the risk of infection with AIDS or hepatitis if the drug users share needles. Also, anabolic steroids obtained without a prescription are unreliable. They may contain dangerous substances, or may not even contain steroids.

As you are using anabolic steroids without a doctor’s prescription, stop. You could be causing harm to your body that you cannot reverse. Instead, use healthy options such as good nutrition and exercise.


SIDE EFFECTS OF ANABOLIC STEROID USE
Breast growth
Shrunken Testicles
Severe acne
Baldness or hair loss
Liver abnormalities or tumors
Blood clots
Heart disease

Angry outbursts
Aggressive behaviour
Paranoia ('Fears that do not make sense')
Hallucinations ('Seeing or hearing things that are not there')
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (21 minutes later)
Hello thanks for your reply, however you haven't helped me at all, all you've done it explain steroids to me which wasn't my question!! I know about steroids. I haven't used them for 2 years as stated in my original email. I would like to know how to get myself back to normal (healthy sex drive). You say my testosterone levels are in range but from reading I'm in range for an 80yo man. And the fact my estrogen is way over the upper limit. Please advise me how to return back to normal. Is there anything I can take to maybe rule certain possibilities?

Thanks
doctor
Answered by Dr. Shehzad Topiwala (11 hours later)
Brief Answer:
Follow up

Detailed Answer:
Your most recently reported estradiol levels are also within normal limits for males.

Also you should not be meddling with your hormones by taking medication like arimidex (which is not an anabolic steroid per se).

In order to know with reasonable certainty whether or not you have 'androgen' deficiency at the moment, as the likely reason for your symptoms, you need to get your Free Testosterone levels checked in the blood by a special method called Equilibrium Dialysis. Because most labs do not offer this technique (and perform it by various other methods that are less accurate and hence not reliable), there is an alternative means to estimate Free Testosterone. Blood levels of Albumin and SHBG (Sex Hormone Binding Globulin) need to measured along with Total Testosterone, before 10 am in the morning. Then an online tool is available to indirectly compute the Free Testosterone using these results.

When I see someone like you in my practice, I typically order the following tests in addition to a detailed physical examination:

CBC
Electrolytes
Calcium
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests
Kidney function tests
TSH
Free T4
25 hydroxy Vitamin D
Prolactin
FSH
LH
Ferritin

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (8 hours later)
I accept that I probably shouldn’t be taking Arimidex off my own back but I felt as though I was all out of options, and from the tests I’ve had done, my oestradiol was out of the reference rage supplied by the lab that did the tests.

I did the 4 week superdrol course in December 2013 and didn’t take anything until I found out my oestradiol levels were high in my second test on the 4th Aug 2015, which is when I started the Arimidex and took every day until a week after my last test on the 24th Dec 2015 (oestradiol not tested in first test 6th XXXXXXX 2015). You can see how my oestradiol fluctuated from test to test whilst taking the Arimidex.

I found after starting the Arimidex I noticed I was one again able to get / maintain an erection and reach orgasm, I also noticed I started getting erections during the night again. Every few weeks I would have one day where my sex drive seemed to have returned slightly but only for one day and would take a few weeks for it to return again but only for one day, on these days I felt as though my oestradiol level had risen as I was a lot more emotional watching TV.

I’ve had a few tests done over the last year which I have written out below including the lab reference range, time and date of each test. If you could take a look at my test results and give me your opinion I would be grateful.

Thanks

Test Date: 6th XXXXXXX 2015 Time: 07:15am
TESTOSTERONE
Plasma testosterone level (XaltQ) - 14.5 nmol/L [6.0-27.0]

LH/FSH
Plasma LH level (XaElA) - 5.0 u/l [0.7-11]
Plasma FSH level (XaELZ) - 1.8 u/l [0.8-7.7]

SERUM SEX HORMONE BINDING GLOBULIN LEVEL (44CD.)
Serum sex hormone binding globulin level (44cd.) - 37 nmol/L [13.0-71.0]

PROLACTIN
Plasma prolactin level (XaELY) - 338mu/L [0.0-280.0]

BONE & LIVER PROFILE
Bone and Liver calcium (XalRk) - 2.35mmol/L [2.12-2.55]
Corrected calcium - 2.33mmol/L [2.12-2.55]
Plasma alkaline phosphate level (XalRj) - 48 iu/L [32.0-91.0]
Plasma total protein level (XE2eC) - 70 g/L [60.0-80.0]
Plasma albumin level (XalRc) - 41 g/L [35.0-50.0]
Plasma globulin level (XaltX) - 29 g/L [23.0-35.0]
Plasma total bilirubin level (XaETf) - 10 umol/L [7.0-35.0]
Plasma alanine aminotransferase level (XalRi) - 19 iu/L [17.0-63.0]

TSH
Plasma TSH level (XaELW) - 1.90 mu/L [0.3-5.6]

RENAL PROFILE (44J5.)
Plasma sodium level (XalRf) - 141 mmol/L [133.0-146.0]
Plasma potassium level (XalRI) - 4.7 mmol/L [3.5-5.3]
Plasma creatinine level (XaETQ) - 112 umol/L [57.0-113]
Plasma urea level (XaDvl) - 5.6 mmol/L [2.5-7.8]

PREDICTED GFR MALE
AGE 25
GFR calculated abbreviated MDRD (XaK8y) - >60 mL/min


NON FASTING LIPDS
Serum cholesterol level (XE2eD) - 3.36 mmol/L
Plasma triglyceride level (44e..) - 0.95 mmol/L

LIPID FRACTIONATION (XaJmA)
Plasma HDL cholesterol level (XaEVr) - 0.99 mmol/L
Plasma LDL cholesterol level (XaEVs) - 1.94 mmol/L
Serum cholesterol/HDL level ratio (XaEUq) – 3.4

Test Date: 4th Aug 2015 Time: 08:00am
TESTOSTERONE
Plasma testosterone level (XaltQ) - 15.5 nmol/L [6.0-27.0]

LH/FSH
Plasma LH level (XaElA) - 4.0 u/l [0.7-11]
Plasma FSH level (XaELZ) - 1.9 u/l [.08-7.7]

SERUM SEX HORMONE BINDING GLOBULIN LEVEL (44CD.)
Serum sex hormone binding globulin level (44cd.) - 32 nmol/L [13.0-71.0]

17 B ESTRADIOL
Plasma oestradiol level (XaEQo) - 235 pmol/L [male up to 73]

PROLACTIN
Plasma prolactin level (XaELY) - 125mu/L [0.0-280.0]

BONE & LIVER PROFILE
Bone and Liver calcium (XalRk) - 2.36mmol/L [2.12-2.55]
Corrected calcium - 2.30 mmol/L [2.12-2.55]
Plasma alkaline phosphate level (XalRj) - 57 iu/L [32.0-91.0]
Plasma total protein level (XE2eC) - 74 g/L [60.0-80.0]
Plasma albumin level (XalRc) - 43 g/L [35.0-50.0]
Plasma globulin level (XaltX) - 31 g/L [23.0-35.0]
Plasma total bilirubin level (XaETf) - 20 umol/L [7.0-35.0]
Plasma alanine aminotransferase level (XalRi) - 23 iu/L [17.0-63.0]

TSH
Plasma TSH level (XaELW) – 2.03 mu/L [0.3-5.6]

RENAL PROFILE (44J5.)
Plasma sodium level (XalRf) - 137 mmol/L [133.0-146.0]
Plasma potassium level (XalRI) - 4.1 mmol/L [3.5-5.3]
Plasma creatinine level (XaETQ) - 112 umol/L [57.0-113.0]
Plasma urea level (XaDvl) - 5.8 mmol/L [2.5-7.8]

FASTING GLUCOSE
Fasting blood glucose level (XE2mq) - 4.9mmol/L [3.6-6.1]

PROGESTERONE
Serum progesterone level (XE2dq) - < 2.0 nmol/L

B12 & FOLATE
Serum vitamin B12 level (XE2pf) - 449 pg/ml [180.0-914.0]
Plasma folate level (X76tC) - 7 ng/ml [4.0-20.0]

FULL BLOOD COUNT (424..)
Heamoglobin concentration (Xa96v) - 165.0 g/l [130.0-170.0]
Total white blood count (XaldY) - 6.3 10*9/L [4.0-10.0]
Platelet count – observation (42P..) - 211 10*9/L [150.0-450.0]
Heamatocrit (X76tb) - 0.484 l/l [0.4-0.5]
Mean cell volume (42A.) - 92.1 fL [83.0-101.0]
Mean cell haemoglobin level (XE2pb) - 31.3 pg [27.0-32.0]
Mean cell haemoglobin concentration (429..) - 340.0 g/L [315.0-345.0]
Red blood cell distribution width (XE2mO) - 14.3% [11.6-14.0]
Red blood cell count (426..) - 5.25 10*12/L [4.5-5.5]
Neutrophil count (42J..) - 4.0 10*9/L [2.0-7.0]
Lymphocyte count (42M..) - 1.8 10*9/L [1.1-3.5]
Monocyte count – observation (42N..) - 0.4 10*9/L [0.2-1.0]
Eosinophil count – observation (24K..) - 0.1 10*9/L [0.0-0.5]
Basophil count (42L..) - 0.0 10*9/L [0.0-0.1]
Percentage neutrophil count (XE2mP) - 63%
Percentage lymphocyte count (XE2mQ) - 28%
Percentage monocyte count (XE2mR) - 7%
Percentage eosinophil count (XaCJj) - 1%
Percentage basophil count (XE2mS) - 0%


Test Date: 12th Oct 2015 Time: 07:40am
TESTOSTERONE
Plasma testosterone level (XaltQ) - 14.5 nmol/L [6.0-27.0]

LH/FSH
Plasma LH level (XaElA) – 3.6 u/l [0.7-11]
Plasma FSH level (XaELZ) – 2.3 u/l [.08-7.7]

SERUM SEX HORMONE BINDING GLOBULIN LEVEL (44CD.)
Serum sex hormone binding globulin level (44cd.) - 23 nmol/L [13.0-71.0]

17 B ESTRADIOL
Plasma oestradiol level (XaEQo) - 133 pmol/L [male up to 73]

PROLACTIN
Plasma prolactin level (XaELY) - 208 mu/L [0.0-280.0]


Test Date: 9th Nov 2015 Time: 07:00am
TESTOSTERONE
Plasma testosterone level (XaltQ) – 13.7 nmol/L [6.0-27.0]

LH/FSH
Plasma LH level (XaElA) – 8.5 u/l [0.7-11]
Plasma FSH level (XaELZ) – 2.9 u/l [.08-7.7]

SERUM SEX HORMONE BINDING GLOBULIN LEVEL (44CD.)
Serum sex hormone binding globulin level (44cd.) - 28 nmol/L [13.0-71.0]

17 B ESTRADIOL
Plasma oestradiol level (XaEQo) - 195 pmol/L [male up to 73]

PROLACTIN
Plasma prolactin level (XaELY) - 274 mu/L [0.0-280.0]


Test Date: 24th Dec 2015 Time: 07:10am
TESTOSTERONE
Plasma testosterone level (XaltQ) – 12.8 nmol/L [6.0-27.0]

LH/FSH
Plasma LH level (XaElA) – 4.7 u/l [0.7-11]
Plasma FSH level (XaELZ) – 2.2 u/l [.08-7.7]

SERUM SEX HORMONE BINDING GLOBULIN LEVEL (44CD.)
Serum sex hormone binding globulin level (44cd.) - 28 nmol/L [13.0-71.0]

17 B ESTRADIOL
Plasma oestradiol level (XaEQo) - 125 pmol/L [male up to 73]

PROLACTIN
Plasma prolactin level (XaELY) - 173 mu/L [0.0-280.0]
doctor
Answered by Dr. Shehzad Topiwala (19 minutes later)
Brief Answer:
Second follow up

Detailed Answer:
I have reviewed these results.

An ultrasound examination of your testicles is in order to identify the source of excess estradiol.

I suggest you see an endocrinologist in-person who will have the opportunity to examine you , including a detailed genital examination.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Shehzad Topiwala (30 minutes later)
I went to see an endo in person a few days ago, he didn't help me at all. He told me Arimidex isn't for lowering oestradiol and to stop taking it (which I already had a week before as I felt my oestradiol was low for the first time as I felt really flat - no pump in the gym and no enthusiasm, which isn't like me). He also said to give myself 18 months off everything to let my hormones balance out. My argument is I had already given it 18 months from the superdrol to starting Arimidex, and couldn't understand how he could sit there and tell me Arimidex didn't lower oestradiol. Obviously I'm no doctor but physically my testicles feel fine - no lumps etc. The endo didn't seem worried that my oestradiol before the Arimidex was about 5 X my ideal level for a male, and dismissed me because my testosterone levels are in range but the range includes all ages fro 18-90, so it's rubbish to say I'm in range!! I've read studies testing age groups of men and I fall into about an 80yo for my testosterone and I've read that over and over in different studies. I don't know what to do as I thought him being the specialist was meant to be able to help me, when all I've been told is wait 18 months when it's been 2 years already.
doctor
Answered by Dr. Shehzad Topiwala (1 hour later)
Brief Answer:
Third follow up

Detailed Answer:
I can understand your frustration.

However, most endocrinologists go by general reference ranges for testosterone for adults, until more validated scientific literature comes out for age-specific reference ranges.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What Does My Blood Test Report Indicate?

Brief Answer: Steroid abuse Detailed Answer: Your testosterone levels at baseline and now are considered within normal range. Exact age-specific ranges are yet to published and validated through large scientific studies. Essentially what you have embarked upon is deemed steroid abuse. It is very unsafe. Anabolic steroids are drugs that are chemically related to the main male hormone testosterone. They are best known for their effects on building muscle (called anabolic). Sometimes doctors prescribe anabolic steroids to help patients with AIDS gain weight and to treat certain types of severe anemia (low red blood cells) or other health problems. Some people, though, use these drugs illegally to improve athletic performance or to get a more muscular look. Not only is this against the law, but many sports ban use of anabolic steroids as “performance-enhancing drugs.” Improper use of anabolic steroids can have unhealthy side effects. These include changes in behavior, increased risk for heart and liver disease, and unwanted—sometimes permanent—changes in physical features. Anabolic steroids come in various forms, including pills, creams, patches, tablets, injections (shots), or drops placed under the tongue. Veterinary steroids (those for animals) often contain the same components as human steroids, but are not as pure. People sometimes use these as well. Steroid use by college athletes has increased as well. Also, some professional athletes continue to use these drugs, including star athletes. Not just athletes are using anabolic steroids. Some young people take them to look more muscular or to lose body fat. Anabolic steroids have dangerous physical, mental, and emotional side effects. These may be more dangerous in young adults because they can stop growth. In women, they can cause permanent changes in the voice and genitals. After stopping these drugs, people can feel severe depression and moodiness. Injections of anabolic steroids carry the risk of infection with AIDS or hepatitis if the drug users share needles. Also, anabolic steroids obtained without a prescription are unreliable. They may contain dangerous substances, or may not even contain steroids. As you are using anabolic steroids without a doctor’s prescription, stop. You could be causing harm to your body that you cannot reverse. Instead, use healthy options such as good nutrition and exercise. SIDE EFFECTS OF ANABOLIC STEROID USE Breast growth Shrunken Testicles Severe acne Baldness or hair loss Liver abnormalities or tumors Blood clots Heart disease Angry outbursts Aggressive behaviour Paranoia ('Fears that do not make sense') Hallucinations ('Seeing or hearing things that are not there')