I had my 2nd appointment with my Endocrinologist on Tuesday (June 3rd). This is where I got the results from the blood draw I had back in mid-May. I had quite a bit of work done (I had to get blood drawn to 8 tubes!), and the results show that:
Comprehensive Metabolic Panel:
Glucose: 93 mg/dL
Urea Nitrogen (BUN): 11 mg/dL
Creatinine: 0.58 mg/dL
eGFR Non-Afr. American: 130 mL/min/1.73m2
eGFR African American: 151 mL/min/1.73m2
BUN/Creatinine Ratio: 18.9
Sodium: 141 mmol/L
Potassium: 3.5 mmol/L
Chloride: 104 mmol/L
Carbon Dioxide: 23 mmol/L
Calcium: 9.7 mg/dL
Protein, Total: 8.0 g/dL
Albumin: 4.9 g/dL
Globulin: 3.1 g/dL
Albumin/Globulin Ratio: 1.6
Bilirubin, Total: 0.3 mg/dL
Alkaline Phosphatase: 63 U/L
AST: 14 U/L
ALT: 10 U/L
Estradiol, Ultrasensitive LC/MS/MS: 251 pg/mL
17 Hydrodyprogesterone, LC/MS/MS: 81 ng/dL
Androstenedione, LC/MS/MS: 215 ng/dL
DHEA, LC/MS/MS: 471 ng/dL
Dihydrotestosterone, LC/MS/MS: 18 ng/dL
DHEA Sulfate: 338 mcg/dL
FSH: 4.0 mIU/mL
LH: 22.9 mIU/mL
Prolactin: 15.2 ng/mL
T4, Free: 1.1 ng/dL
TSH: 1.27 mIU/L
Testosterone, Free: 2.6 pg/mL
Testosterone, Total, LC/MS/MS: 29ng/dL
CBC (Includes DIFF/PLT):
White Blood Cell Count: 8.1 Thousand/uL
Red Blood Cell Count: 4.31 Million/uL
Hemoglobin: 12.9 g/dL
MCV: 91.7 fL
MCH: 29.9 pg
MCHC: 32.6 g/dL
Platelet Count: 192 Thousand/uL
MPV: 97 fL
Absolute Neutrophils: 5840 cells/uL
Absolute Band Neutrophils: DNR cells/uL
Absolute Metamyelocytes: DNR cells/uL
Absolute Myelocytes: DNR cells/uL
Absolute Promylocytes: DNR cells/uL
Absolute Lymphocytes: 1110 cells/uL
Absolute Monocytes: 494 cells/uL
Absolute Eosinophils: 616 cells/uL
Absolute Basophils: 41 cells/uL
Absolute Blasts: DNR cells/uL
Absolute Nucleated RBC: DNR cells/uL
Band Neutrophils: DNR%
Reactive Lymphocytes: DNR%
Nucleated RBC: DNR/100 WBC
So as you can all see from that extensive list, I had a lot of work done, but I think it was well worth it (and is required for successful TRT). Now, lets go over some of the numbers on the list. Be warned that this is going to be a pretty lengthy post, since there’s quite a bit to cover, so get ready to devote quite a bit of time to reading this.
If you look at my (Total) Testosterone levels above and if you remember the results from my last blood test, you’ll see that my T levels have actually gotten worse. My T levels from last time was 36. This time around its 29 (ouch!) (I think that a cold/cough that I had during that time might have contributed to my lower T levels this time around). My Free T levels are low too (obviously). My Estradiol (E2) levels have also gotten worse. My levels from the last blood test was 192. This time around its 251 (yikes!).
My FSH levels haven’t changed much from the last time. Although it seems like my FSH has dropped a bit from the last time (from 5.3 to 4.0). This isn’t surprising as my my low T levels and high E2 levels are very likely compromising my fertility (my FSH also seems to be on the low side). Plus, my T levels dropped a bit and my E2 levels went up from the last time, so its only natural that my FSH would drop as result of this. This time around I was able to get my LH levels checked. The result I got was 22.9. This is a high number and is very typical of somebody with 17B-HSD, as well as a male with primary hypogonadism (high LH is an indication of primary hypogonadism). This is something I was expecting – I guessed that it would happen and I was right.
This time around, I also got my Androstenedione (A) checked. The result? 215. This is pretty high and is just above normal (normal is under 151 – although just like every other hormone range, there is no definite range). This, along with low T levels and high E levels, is very typical of somebody with 17B-HSD (characterized by a high A:T ratio, in my case 215:29) – and I’m betting that the number would be higher if I had taken an HCG stimulation test.
I got my Dihydrotestosterone (DHT) checked this time around as well. The result was 18. This is a low number (it needs to be 30-85), but seems normal for someone with my T levels (29). Obviously, the T:DHT ratio (mine is 29:18) isn’t high enough to indicate 5-Alpha Reductase Deficiency. I knew that the result would be something like this, and this indicates that I was right about having 17B-HSD.
My Prolactin fortunately wasn’t ultra high (which I knew), so there’s nothing indicating a possible tumor :D (something my Endo was worried about). However, my Prolactin is on the high-normal side, almost above normal – which isn’t surprising considering the fact that I have Gynecomastia. But the good thing is that it’ll be easy to manage and get it to be lower – more towards the middle of the scale.
My white and red blood cell counts are in range, although it looks like my RBC is on the lower end of normal (does not seem uncommon with Low T). My Hemoglobin and Hematocrit seem to be on lower end of normal (which is normal for Low T guys) – . The rest of the numbers from this blood draw are all in range (except for a couple or so, which are slightly above normal, but not a big deal). My Thyroid is all good (which I suspected). Although, my Creatinine is below normal. Additionally, Glucose seems to be on the high end of normal (which I don’t think is surprising for a guy with Low T). My Liver and Kidneys also appear to be working well.
The only results I didn’t get back was from the Sex Chromosome test – this was due to an error. I really have no problem with that. I don’t need a Chromosome test to tell me I’m 46,XY – my physical characteristics tell me that, as well as the results from my bloodwork (but really, why should it matter? Here’s a very insightful article that deals with this). I don’t plan on re-taking that test, simply because of the fact that the evidence that I have already tells me that I’m biologically male. I don’t need this test to ‘validate’ me (I rather take a semen analysis). I know what I am and I know how my body works – it is after all, my body, and nobody knows my body better than me. Intersex people are already medicalized enough and this just contributes to it, in my opinion.
See, the thing that bothers me about this is that they’re (the medical establishment) are trying to mythologize us and basically are trying to tell us that either we don’t exist or that we are ‘hermaphrodites’ (with two sets of working testes and ovaries). I mean, if the testes are palpable down there, despite the fact that the person (in this case, that would be me) has ‘ambiguous’ genitalia, then that should tell you that there are no ovaries – especially if those “lumps” are adult-sized (i.e. adult-sized testes). I mean, what else could they possibly be? Its humanly impossible to have a working set of testes and a working set of ovaries. I think that right there should tell you something. All in all, I don’t care what my chromosomes are because it doesn’t matter (and chromosomes actually don’t matter).
Now at this point, you may be asking yourself why I’m putting a spotlight on the ‘medical’ side of intersex, if I’m against the medicalization of intersex. The answer is because I want people to see that intersex folks have differing hormonal (and other) profiles, even within their own variations (if that makes any sense). This also helps people to see that overall, intersex people tend to be healthy just like everyone else, and that when it comes to health, we basically face the same challenges like everyone else. I’m simply educating people on this stuff in a way everyone can understand (I’m trying to make everyone understand how diverse intersex and everyone else’s bodies really are). The rest of this series will be focusing more on my treatment of and recovery from Low Testosterone – from the perspective of an intersex person :D. Overall, this shows that we’re no more different from non-intersex people, and that’s the message I’m trying to get across here.
I think you can all see from my blood draw results that I’ve got the green light to go on T. Unfortunately, there’s another hurdle I have to get through before I can get T: I need to update my gender with the Social Security Administration (SSA) before I can get T. The reason for this is because my Endo said that because my gender on my insurance (which is connected to my Social Security number/records) is still female, I need to provide proof that I got therapy for Gender Dysphoria (GD) – this will also require changing the diagnosis from Hypogonadism to GD. I need to provide my Endo the notes from that therapy session I had with my then-psychologist, so he can submit them to my insurance company, so they can approve my TRT. If can’t track them down, then I will need to go to therapy for GD all over again, and I will not have that (I mean, why do I need to do this again? I’ve been living as a man for 2 years now with great results). This has already consumed a lot of my time (I’ve started this journey early last year), and I just want to get this over with so I can go back to living my life.
Getting those notes has already proven difficult to do. This is obviously already wasting my time. So as a solution to this problem, I made an appointment to see my Primary Care Physician (PCP) on Monday morning. Hopefully, everything goes well and I get my note to take to my local SSA office later that same week. I personally think everything’s going to go well. My PCP is very understanding and laid-back, so I trust him with this (as he was going to do it the first time around but unfortunately ran out of time). But, I’m still going to be a bit cautious – I don’t want to get my hopes up only to have them crushed. Hopefully with this done, my Endo will be able to keep the Hypogonadism diagnosis (he’ll have to or else the insurance company will think I’m a TransWoman and deny my request to cover my TRT) – since I won’t have to go through that ordeal with my insurance – and make my next appointment to finally get my 1st prescription for T very soon.
I’ll keep everyone posted on this situation. Expect an update on this on or after Monday.