My blood test results

I took finasteride for 3.5 years and had a blood test in May 2005 - 2months after stopping:
Testosterone was 14 nmol/l (ref 8 - 32)

In december 2006 I had following results:
Testosterone 4.8 nmol/l
LH 1.6
FSH 2.2 u/l

This has all been done on the NHS here in UK (I don’t have private insurance) and it’s been hard getting them to test blood for anything.
I have been referred to Dr Minhas a urologist at UCHL London who has some experience of patients with finasteride side-effects - appointment is on 8 feb.
Although my problem has been muscle wastage - I have not really got a problem with erections. Minor problems with loss of concentration and chronic constipation.
Any comments are welcome, cheers.

How is your Free T? Thats really odd that your Total T is so low, yet youve got no erection problems.

Hello J89,
They didn’t test me for Free T, or at least haven’t told me the result.
I haven’t noticed a significant problem in erections, although there is a slight curve to the left which I don’t remember being there before.

I dug up some other results from May 2005, 2 mths after stopping fin:

Serum TSH level (Thyroid) 2.70 mu/l (0.35-5.5)
Erythrocyte sedimentation rate 5 mm/h (1-7)
Creatinine levels also OK.

Free testtosterone is not tested in the NHS or the UK generally.

You need to have the following test conducted and you need the reference ranges thta go with them;

LH
Testosterone
SHBG
Estradiol
Dihydrotestosterone (DHT)
Prolactin

We need to see LH and testosterone again, becuase we need to have them tested and compared to the other results- the comparison at the same time makes re-testing relevant.

You need SHBG because with that with can at least calculate your likely free testostreone level as it is SHBG that primarily binds testosterone in the blood and makes it inactive in the body.

We need etradiol tested because it is the most potent estogen, acts against the actions of testosterone in the body and cause independent based problems.

We need DHT tested because finasteride based products like Propecia’s principle mechanism of action is to reduce DHT. DHT is a very improtant androgen. To get these tested you require an endocrine referral from your gp. When you see the endocrinologist the onl;y way you will get DHT tested is if you explain that you took an antiandrogen that specifically targets and reduces DHT.

If you get those tests conducted and obtain a copy of them inclusive of their reference ranges and you pm them to me I will take a look at them for you.

Many thanks for your interest here Hypo;

I’ll have to wait to see the urologist/andrologist at UCHL on 8 feb and ask him for these blood tests you mention - I hope he co-operates.
I also contacted an endo at UCHL and just got a reply saying he knows of no connection between fin and muscle wastage and to tell my GP to write to the company -another helpful medical profesional !

I don’t know if DHT level is still a problem as since stopping fin my rate of hair loss has increased and body hair has increased significantly.

The test results are confusing as even when I still had Test. of 14 I had already been losing muscle for 2 yrs, even though I continued weight training.

I also tried anastrozole (arimidex) for 2 weeks last summer, but did not notice any change, apart from increasing erections - I felt like a 15 yr old again for a while with no self control !

Hopefully I can post the blood results in the not-too-distant future.
Again thanks for you help.

to.robin let me assure you, if your total testosterone level remains that low the NHS MUST treat you. They MUST treat at this level if there is no improvement.

If they do not;

I will write letters to your PCT (Primary Care Trust) on your behalf or to the scociety of endocrinology, to the chief executibe of your treating hospital etc and if need be help you prepare a legal case to sue anyone standing in the way of treatment.

This is no idle statement. Trust me, if your levels remain that low they must and WILL treat otherwise I WILL make them and you can regard that as a personal guarentee.

If things improve from a pathology point of view then hopefully symptoms and health will too. If your pathology improves, but your symptoms do not;

That is where it could become very difficult trying to help you and I might be somewhat hamstrung. Of course I will offer my help if this happens and still try and do anything I can to help.

I am away as of tomorrow- I will be back next week if you wsh to talk.

Well Hypo, you’re an inspiration!
I’ll do everything I can to get Dr Minhas to do those tests on 08 feb, and post them.

Also, as one of the other members has mentioned, I am curious about your opinions on Progesterone ?

Thanks for your advice.

I am not in favour of the use of progesterone as it has an estrogenic influence and helps ensure a poorer androgen to estrogen ratio- therby compounding problems.

Very few andrologists are in favour of progesterone use.

Of course truth and fact are not always static in medicine lol and for this reason if new evidence comes to light that alters the status quo and shows that this position is not correct I will be perfectly happy to move with that position.

Does that make me clever as opposed to dogmatic or a medical whore lol, I’m not sure. In any event it means that I follow the paradigm shift as does the entire medical world.

Well I got to see the urologist Dr Minhas at UCHL London on thurs 8th.
I saw him only briefly (I was warned of this) and passed onto his registrar/assistant. I was surprised to find they had received a letter from my doctor in the mean time saying the test done in Dec was incorrect -Test was in fact 14 not 4.8! What the hell was I supposed to say to that!
But they said they should repeat the test and were agreable to doing the tests you suggested Hypo as I showed them your list. Dr Minhas said he knew of no connection between fin and muscle wastage -OK, nothing new there - he has dealt with erectile dysfunction.
They said at first they couldn’t do DHT as it was an intracellular test ? but then said they might sort something out - I didn’t press them. They did some tests there which were not time sensitive (it was about 3pm), and said they would write to my doctor in Cambridge to get him to do the tests which need to be done am.
They checked my testicles and said they were OK - well I haven’t noticed any significant change.
Anyway, I have a follow up appt on 22 March at UCHL. Time seems to be just flying by as the weeks turn into months and then years, but I suppose I was happy they were taking me seriously.
I will post as soon as I get the new test results.

Cheers everyone.

Their error is a little unfortunate to say the least, but at least they are willing to repeat the test and look into matters further.

He is a silly soul isn’t he?

Remind him of the fact that Finasteride is a known anti-androgen that often lowers free testosterone and then remind him of the fact that testosterone is required in order to adequately maintain muscle mass. Inform him of the fact that even young hypogonadal men are well known to suffer from muscle atrophy (shakes head- what are they teaching them these days).

Total rubbish. Serum DHT assays do exist. Admittedly given the half life of DHT in the body they are not as accurate as one would like and it is better to have multiple tests over the course of an hour- but a single test is better than nothing and absolutely can be tested for. I have viewed hundreds of such tests and have had such tests undertaken on myself at private clinics in the UK.

Did they indeed, well all the androgen related do indeed require morning pathology. Let me know what they say on the matter.

The problem is though that A) hypogoandism does not necessarily result in abnormal testicular size and B) what they define as normal testicular size might not be normal at all. I have heard of people with Klinefelters Syndrome being told that they had normal testicular size. Testicular size can give an indication of some causes of hypogonadism but not much more than that. Finasteride based problems would be unlikely to manifest themselves in testicular changes so significant as to be noted by some of these endocrinologists.

Sometimes you have to win little victories in order to get where you want to be. I think you have won a small victory in so much as they are listening to you and it looks as though the tests are going to be undertaken (fingers crossed).

Hypo,
This really makes you wonder where you can go for professional help.

Minhas is regarded as one of the leading ‘experts’ in the UK.

I am glad you found someone here who could test DHT, I practically gave up.
Have just had a set of tests done this morning (including DHT) in Gibraltar (for those across the pond, the warmer part of Britain on the south coast of Spain) at 08.45. Get the results in 10 days - the tests were one third the cost of private tests in the UK.

Hi reason, out of interest, exactly what tests did you get and what was the cost?

Total T
Free T
SHBG
Estradiol (E2)
T3
T4
DHT

£100 all in. In the UK you can pay £40 just for T test (with BUPA), which was £11 in Gibraltar. Saves enough money to have a few days in the sun (just don’t let the apes bite you!)

I have just had DHEA (slightly above range) 4-point Cortisol (starts off well but drops off steeply during the day), T & E2 results back, so am building up my profile - will post all when the above come back.

It turns out urologist Dr Minhas tested me for Serum Test, SHBG and Estradiol, when I saw him, at 3pm - aren’t these time sensitive ?
I have been invited by my local doctor for an am Test sample.

Well I just had the results from my local doctor for Serum Test: 14.2 the range is 8 -29. It turns out the test in Dec showing 4.8 was wrong. I’ll have to wait till 22 March for the other results when I see Dr Minhas in London.
Cheers

Yes they are time sensitive- he doesn’t know what he is doing.

The amount of times I have heard people say that a given endocrinologist or urologist is supposed to be the best…I have a funny feeling that they don’t go around telling anyone if they are the worst :slight_smile:

I must have heard of hundreds of these people that are supposed to be the very best…not possible methinks.

Post your results inclusive of lab reference ranges from morning tests and we can have a look through them.

Even just from your testosterone results, you are low on T and probably hypogonadal.

Hello everyone,

I was thinking of visiting my father in Spain in a couple of weeks and I found a clinic there on the net that does blood tests.
I phoned them and asked for tests for: Testosterone, Free Testosterone, LH, SHBG, Estradiol and Prolactin for which they quoted me a price of 120 Euros - about £80 all included.
But the girl on the phone didn’t have DHT on her list. She mentioned something about a test for androstestosterona? and something with and without sulphate or sulphur? I don’t remember exactly.
She didn’t understand ‘Dihidrotestosterona’ as I think it is in spanish.
I need to phone again to see if there is anyone else there I can speak to.

I should go to Spain for family reasons, but do people think it is worth taking these tests there, and, will the urologist I am seeing in London take these results into consideration anyway?

I’m still waiting for the blood results from Feb 8th.
OH, and I received a letter saying my follow up appt in London has been put back to April 12th - just pisses me off!

Your Spanish is correct - Dihidrotestosterona.
This is what I got tested for, just across the border.
I don’t know anyone else who has had tests in Spain, but have no reason to doubt the validity - the results I had had definite correlations with each other (my total T still rising, SHBG and E2 reducing…)

OK, I finally got those test results taken at 3pm on 08 feb, for what they’re worth - I don’t know.

Testosterone 15.6 nmol/L range: (9.9-27.8)
SHBG 37 nmol/L (10-80)
Oestradiol 71 pmol/L (44-156)
LH 4.6 IU/L (1.7-8.6)
FSH 2.8 IU/L (1.5-12.4)
Prolactin 256 mIU/L (86-324)

Thyroid Panel
TSH 1.64 mIU/L (0.27-4.20)
Free-T4 13.6 pmol/L (12.0-22.0)

Blood Renal/Liver Profile
Urea 7.1 mmol/L (1.7-8.3)
Creatinine 82 umol/L (66-112)
Sodium 139 mmol/L (135-145)
Potassium 4.3 mmol/L (3.5-5.1)
Bilirubin (Total) 7 umol/L (0-20)
ALT 43 IU/L (10-50)
Alk.Phos. 70 IU/L (40-129)
Albumin 48 g/L (34-50)

There is also a series of Routine Haematology differential and full blood count results I can post if anyone thinks they are relevant - they all seem to follow the same patten; low/borderline normal.

Again, no DHT results. I get the feeling the urologist is going to tell me there’s nothing wrong with you, go away.
I spoke to that clinic in Spain again. The girl on the phone mentioned something like ‘deshidro/epitestosterona’ saying that was DHT? Now I’m even more confused than I was before.

I have noticed lately sensitivity in the penis has decreased. Body hair is increasing on back/shoulders -however it is falling off the legs.
Also my face has become markedly less ‘masculine’ over the last 3 yrs.

For me the key has to be the relationship DHT - stress, or at least this is where it all started to go wrong.
Cheers.