Phillip Engel
Collected: 2026-07-30
Reported: 2026-08-06
Lab: LabCorp · Fasting: Yes
Ferritin (ng/mL)
HDL Cholesterol (mg/dL)
Hemoglobin (g/dL)
ApoB (mg/dL)
Total Cholesterol / LDL / Triglycerides
Estradiol Sensitive (pg/mL)
Creatinine (mg/dL) & eGFR
Testosterone — Total (ng/dL)
| Test | Result | Previous | Reference | Status |
|---|---|---|---|---|
| WBC | 5 | 5.5 (03/2026) | 3.4-10.8 | Normal |
| RBC | 5.17 | 5.51 (03/2026) | 4.14-5.80 | Normal |
| Hemoglobin | 16.2 | 13.8 (03/2026) | 13.0-17.7 | Normal |
| Hematocrit | 48.2% | 44.8% (03/2026) | 37.5-51.0 | Normal |
| MCV | 93 | 81 (03/2026) | 79-97 | Normal |
| MCH | 31.3 | 25 (03/2026) | 26.6-33.0 | Normal |
| MCHC | 33.6 | 30.8 (03/2026) | 31.5-35.7 | Normal |
| RDW | 14.9% | 16.1% (03/2026) | 11.6-15.4 | Normal |
| Platelets | 172 | 228 (03/2026) | 150-450 | Normal |
| Neutrophils % | 64% | 57% (07/2024) | Not Estab. | Normal |
| Lymphs % | 24% | 29% (07/2024) | Not Estab. | Normal |
| Monocytes % | 9% | 10% (07/2024) | Not Estab. | Normal |
| Eosinophils % | 2% | 3% (07/2024) | Not Estab. | Normal |
| Basophils % | 1% | 1% (07/2024) | Not Estab. | Normal |
| Neutrophils Absolute | 3.1 | 3 (07/2024) | 1.4-7.0 | Normal |
| Lymphs Absolute | 1.2 | 1.5 (07/2024) | 0.7-3.1 | Normal |
| Monocytes Absolute | 0.5 | 0.5 (07/2024) | 0.1-0.9 | Normal |
| Eosinophils Absolute | 0.1 | 0.1 (07/2024) | 0.0-0.4 | Normal |
| Basophils Absolute | 0.1 | 0.1 (07/2024) | 0.0-0.2 | Normal |
| Immature Granulocytes % | 0% | 0% (07/2024) | Not Estab. | Normal |
| Immature Granulocytes Absolute | 0 | 0 (07/2024) | 0.0-0.1 | Normal |
| Test | Result | Previous | Reference | Status |
|---|---|---|---|---|
| Glucose | 74 | 83 (03/2026) | 70-99 | Normal |
| BUN | 16 | 21 (03/2026) | 6-24 | Normal |
| Creatinine | 1.39 | 1.42 (03/2026) | 0.76-1.27 | Creatine |
| eGFR | 58 | 57 (03/2026) | >59 | Creatine |
| BUN/Creatinine Ratio | 12 | 17 (07/2024) | 9-20 | Normal |
| Sodium | 134 | 137 (03/2026) | 134-144 | Normal |
| Potassium | 4.8 | 4.7 (03/2026) | 3.5-5.2 | Normal |
| Chloride | 99 | 101 (03/2026) | 96-106 | Normal |
| CO2 | 21 | 24 (03/2026) | 20-29 | Normal |
| Calcium | 9 | 9 (03/2026) | 8.7-10.2 | Normal |
| Protein, Total | 6.5 | 6.7 (03/2026) | 6.0-8.5 | Normal |
| Albumin | 4.4 | 4.5 (03/2026) | 3.8-4.9 | Normal |
| Globulin | 2.1 | 2.2 (03/2026) | 1.5-4.5 | Normal |
| Bilirubin, Total | 0.6 | 0.4 (03/2026) | 0.0-1.2 | Normal |
| Alk Phosphatase | 54 | 54 (03/2026) | 47-123 | Normal |
| AST (SGOT) | 48 | 28 (03/2026) | 0-40 | High |
| ALT (SGPT) | 34 | 27 (03/2026) | 0-44 | Normal |
| Test | Result | Previous | Reference | Status |
|---|---|---|---|---|
| Total Cholesterol | 112 | 170 (03/2026) | 100-199 | Normal |
| Triglycerides | 62 | 91 (03/2026) | 0-149 | Normal |
| HDL Cholesterol | 32 | 38 (03/2026) | >39 | Low |
| VLDL | 9 | 15 (03/2026) | 5-40 | Normal |
| LDL Calculated | 71 | 117 (03/2026) | 0-99 | Normal |
| LDL/HDL Ratio | 2.2 | 3.1 (03/2026) | 0.0-3.6 | Normal |
| Apolipoprotein B | 61 | 92 (03/2026) | <90 | Normal |
| Lipoprotein(a) | 23.4 | 37.6 (03/2026) | <75.0 | Normal |
| hs-CRP | 0.57 | 0.62 (03/2026) | 0.00-3.00 | Low Risk |
| Homocysteine | 13.5 | 3 (06/2024) | 0.0-14.5 | Normal |
Lipid Context Note
These lipids were measured ON treatment (Pravastatin 20mg + Ezetimibe 10mg). ApoB is 61 and LDL 71 on the 2026-07-30 panel — down from ApoB 92 in March, which had been drawn ~2 weeks off Pravastatin. With documented coronary artery disease (cath Aug 2025), the ApoB target is <80 mg/dL, ideally <70; at 61 he is under the aggressive target. Continue therapy and re-trend at routine panels.
| Test | Result | Previous | Reference | Status |
|---|---|---|---|---|
| Testosterone, Total | 1351 | 1165 (03/2026) | 264-916 | TRT Expected |
| Free Testosterone | 40.4 | 32.7 (03/2026) | 7.2-24.0 | TRT Expected |
| SHBG | 15.9 | 16.8 (04/2025) | 19.3-76.4 | LOW (EXPECTED) |
| Estradiol, Sensitive | 38.2 | 30 (03/2026) | 8.0-35.0 | High |
| TSH | 1.7 | 1.98 (03/2026) | 0.450-4.500 | Normal |
| Free T3 | 2.7 | 3 (03/2026) | 2.0-4.4 | Normal |
| Test | Result | Previous | Reference | Status |
|---|---|---|---|---|
| Hemoglobin A1c | 5.1% | 5.4% (03/2026) | 4.8-5.6 | Optimal |
| Fasting Insulin | 1 | 4.9 (03/2026) | 2.6-24.9 | Low |
| Glucose | 74 | 83 (03/2026) | 70-99 | Normal |
| Test | Result | Previous | Reference | Status |
|---|---|---|---|---|
| GGT | 42 | 30 (03/2026) | 0-65 | Normal |
| AST (SGOT) | 48 | 28 (03/2026) | 0-40 | High |
| ALT (SGPT) | 34 | 27 (03/2026) | 0-44 | Normal |
| Ferritin | 63 | 12 (03/2026) | 30-400 | Normal |
| Iron | 117 | 69 (06/2024) | 38-169 | Normal |
| Iron Binding Capacity TIBC | 299 | 342 (06/2024) | 250-450 | Normal |
| UIBC | 182 | 273 (06/2024) | 111-343 | Normal |
| Iron Saturation | 39% | 20% (06/2024) | 15-55 | Normal |
| Vitamin D, 25-OH | 58.5 | 59.7 (03/2026) | 30.0-100.0 | Optimal |
| Vitamin B12 | 910 | 621 (03/2017) | 232-1245 | Normal |
| Folate | 17.2 | 16 (03/2017) | >3.0 | Normal |
| Test | Result | Previous | Reference | Status |
|---|---|---|---|---|
| PSA Total | 1.6 | 0.9 (03/2026) | 0.0-4.0 | Normal |
- 1. Iron — Repletion Complete, Now OFF Iron RESOLVED. The March "start iron immediately" order is complete and closed. Phil took a short course of Ferrex-type iron, then a multivitamin-with-iron, and is now on a plain multivitamin WITHOUT iron. The 2026-07-30 panel confirms full repletion: ferritin 12 → 63, iron saturation 20% → 39%, hemoglobin 13.8 → 16.2. Do NOT restart iron — with blood donations paused, additional iron risks overshoot. Monitor iron stores at routine panels only.
- 2. Statin + Ezetimibe — On Board and Working RESOLVED. The March "restart statin this week" order is complete. Pravastatin 20mg + Ezetimibe 10mg are on board and working: ApoB fell 92 → 61 and LDL 117 → 71 on the 2026-07-30 panel — both under the <70 target for documented coronary artery disease (cath Aug 2025). No change needed; continue the combination and re-trend at routine panels.
- 3. Fecal Immunochemical Test (FIT) — DONE, collected 07/24/2026 Completed. LabCorp ColoFIT (Occult Blood, Fecal, IA), collected 07/24/2026, reported 07/28/2026 — result NEGATIVE. No occult GI blood detected, so bleeding is not the obvious explanation for the declining ferritin. Original rationale: daily aspirin use raises GI microbleed risk, and a positive result would have warranted a GI referral. Nothing further to order on this line; iron repletion and the ferritin recheck stay in force.
- 4. Lipid + ApoB Recheck — DONE, Target Met DONE 2026-07-30. The post-statin lipid + ApoB recheck is complete: ApoB 61 (was 92 off-statin in March), LDL 71, total cholesterol 112, triglycerides 62 — all measured on Pravastatin + Ezetimibe. ApoB is under the <70 CAD target. No further recheck action on this line; continue therapy and re-trend at routine panels.
- 5. Ferritin Recheck — Done DONE 2026-07-30: ferritin rechecked at 63, above the >50 target. Iron supplementation confirmed working and the deficiency resolved. No further iron-specific action needed; monitor at routine panels given stopped blood donation + daily aspirin.
- 6. Estrogen Management — Review DIM 200mg + Calcium D-Glucarate 500mg were holding estradiol at 30.0 in March, but sensitive estradiol has now risen to 38.2 (2026-07-30), just above the 8-35 range, tracking the higher testosterone (1351). Not urgent, but worth a review of aromatase/estrogen management at the next check rather than "no changes needed." Rest of the protocol stable: TRT microdosing steady, D3+K2 on target, GGT 42 (normal). Note AST rose to 48 (likely muscle/creatine source given normal ALT) — recheck to confirm it settles.
- 7. TRT Reduced to 140 mg/week — Recheck Testosterone + CBC in 6–8 Weeks Total testosterone 1351 and free testosterone 40.4 came back above range on the 2026-07-30 panel (drawn at steady-state, morning dose held). Decision 2026-08-07: reduce TRT from 168 mg/week to 140 mg/week (10 units/day on a 200 mg/mL cypionate vial), effective 2026-08-08. Recheck in 6–8 weeks (~late Sept / early Oct 2026): total + free testosterone and a CBC (hematocrit), drawn before that day's injection (trough), with no hard resistance training in the 48 hours before the draw so the muscle-source AST reads clean. Goal: testosterone back into high-normal range with hematocrit easing off its climb (48.2% on 07-30 — in range, but trending up).
Interpretation Context
Creatinine / eGFR: Flagged values (1.39 / 58, 2026-07-30) remain artifacts of 10g daily creatine monohydrate supplementation, not true kidney dysfunction — essentially unchanged from March (1.42 / 57). BUN normal at 16, BUN/Creatinine ratio normal at 12. A Cystatin C test would give a creatine-independent kidney read if verification is ever wanted.
Testosterone / Free T: Flagged-high values are expected on an exogenous TRT protocol (daily cypionate microdosing, ~20–24 mg/day; HPTA fully suppressed after 15+ years, no diurnal variation, so levels reflect steady-state rather than a peak or trough). On the 2026-07-30 panel total T 1351 / free T 40.4 ran above range, so the daily dose was reduced from 168 to 140 mg/week effective 2026-08-08 — see the Action Item on the recheck. A follow-up panel in 6–8 weeks will show where the lower dose lands.
Previous Testosterone (448 ng/dL, 08/2025): That draw likely occurred during a protocol adjustment or missed doses. Current total testosterone 1351 (2026-07-30), up from 1165 in March, reflects the active daily microdosing protocol — supraphysiologic and expected on TRT.
Iron Depletion Pattern — Resolved: RESOLVED as of 2026-07-30. The prior early iron-deficiency pattern has corrected across the board: ferritin 12 → 63, hemoglobin 13.8 → 16.2, iron saturation 20% → 39%, and the three red-cell flags that defined it — MCH (25.0 → 31.3), MCHC (30.8 → 33.6) and RDW (16.1 → 14.9) — are all back inside range. Iron repletion worked. Worth continued monitoring at routine panels given the stopped blood donations (mid-2025) and daily aspirin, but the deficiency itself is corrected.
ColoFIT / Fecal Occult Blood (07/24/2026) — NEGATIVE: LabCorp ColoFIT, Occult Blood, Fecal, IA — collected 07/24/2026, reported 07/28/2026, result NEGATIVE (reference: Negative). Qualitative screen, so there is no number to trend; it is recorded here rather than in the marker tables. This is the FIT test ordered to rule out occult GI blood loss as the driver of falling ferritin: no blood detected in the stool sample on this collection. A single negative FIT does not close the question permanently — it is a point-in-time screen, and low ferritin with daily aspirin use still warrants the ferritin recheck below.