Executive Summary
Matt, this is your Longevity Audit, built from your March 5, 2026 bloodwork and our review call. The headline: the protocol changes we made between the February and March draws worked, and they worked fast. Insulin crossed into optimal range (5.2 down to 4.1), glucose fell from 104 to 94, and estradiol recovered to a healthy 38.5 after we stopped the anastrozole. Moving testosterone to a low daily dose is already pulling your hematocrit down (58.3% to 56.4%), thyroid normalized on 2 grains (T4 2.8 to 5.0), and inflammation is well controlled with CRP at 1.0 and PSA down 58% (7.2 to 3.0) on Retatrutide. The one thread to watch is recovery capacity: DHEA is drifting down (131 to 110) and IGF-1, while rising (140 to 166), is still short of where we want it. That, plus finishing the job on blood viscosity and hydration, is the whole focus for the next block.
- DHEA declining. Down from 131 to 110 and heading the wrong way. This is the raw material for recovery hormones, so we want it climbing.
- Hematocrit still elevated. At 56.4% it is trending down from 58.3% but not yet in the 52-54% target. Thick blood impairs circulation.
- BUN/Creatinine ratio high. At 25 against a 9-20 range, most likely dehydration. An easy fix with aggressive hydration.
- Metabolic efficiency dialed in. Insulin 4.1, glucose 94, HOMA-IR 0.95. You are insulin sensitive and can tap fat for fuel on long efforts.
- Hormones recovered. Estradiol back to 38.5 and thyroid normalized after stopping the estrogen blocker and adding a second grain.
- Inflammation controlled. CRP at 1.0 and PSA down 58% to 3.0. Retatrutide is doing its job.
Your Performance Verdict
| System | Verdict | Status |
|---|---|---|
| Metabolic Efficiency | Optimized | Insulin 4.1 (under 5 optimal). Glucose 94. HOMA-IR 0.95 (insulin sensitive). Foundation is solid. |
| Hormonal Balance | Dialed In | Testosterone stable, estradiol recovered (38.5), thyroid normalized. Protocol changes worked perfectly. |
| Recovery Capacity | Good | IGF-1 rising (140 to 166). Peptides working. Target 200-300+ for optimal recovery. |
| Inflammation Control | Excellent | CRP at 1.0 (optimal). PSA dropped from 7.2 to 3.0. Retatrutide effective. |
| Blood Viscosity | Improving | Hematocrit down from 58.3% to 56.4%. Right direction. Target 52-54%. |
Watch Items: Needs Attention
These are the markers we want to move over the coming months. None of them are emergencies; they're the difference between “healthy” and “optimized for performance.”
Detailed Biomarker Analysis
Below is the full panel from your March 5, 2026 fasting draw, reviewed against Christine's optimal ranges for an athlete, not just the lab's standard reference intervals. Where useful, the previous draw is called out in the analysis so you can see the direction of travel, because the trend matters more than any single number.
| Marker | Current | Optimal Range | Status |
|---|---|---|---|
| Hematocrit | 56.4% | 45-54% (TRT) | Above Range |
| Red Blood Cells | 6.03 | 4.14-5.8 | Above Range |
| Hemoglobin | 18.3 | 13.0-17.7 | Above Range |
| Platelets | 173 | 150-450 | Good |
Performance & Longevity Analysis
Hematocrit dropped 1.9 points, from 58.3% to 56.4%, which is exactly the direction we want. The move to daily TRT dosing is working. At 56.4% you are still slightly elevated, but the trend is clear and platelets have recovered from 147 to 173, which is what we expect to see as hematocrit normalizes. No blood donation is needed yet.
Watching for: hematocrit at the 52-54% target on the next draw. That high end of normal maximizes oxygen delivery without the blood viscosity problems that come from levels this high. We retest in 4-6 weeks to confirm the trend continues.
Hematocrit is the percentage of red blood cells in your blood. Too low reduces oxygen-carrying capacity (lower VO2, poor endurance, early fatigue); too high thickens the blood and impairs circulation. Your 56.4% is trending in the right direction. Optimal hematocrit at the high end of normal (52-54%) maximizes oxygen delivery without the viscosity penalty.
| Marker | Current | Optimal Range | Status |
|---|---|---|---|
| Glucose (Fasting) | 94 | 40-75 | Improved |
| Insulin (Fasting) | 4.1 | <5 | Optimized |
| HOMA-IR | 0.95 | <1.0 | Optimized |
| BUN | 29 | 6-24 | Above Range |
| BUN/Creatinine Ratio | 25 | 9-20 | Above Range |
Performance & Longevity Analysis
This is the big win of the draw. Fasting insulin crossed into optimal range at 4.1 (down from 5.2), and insulin is the master switch for metabolic health. Glucose improved from 104 to 94, confirming the dietary changes are landing, and a HOMA-IR of 0.95 means you are genuinely insulin sensitive. The foundation is solid. BUN at 29 and the BUN/Creatinine ratio at 25 are both elevated, and together they read as dehydration rather than a kidney concern, so the fix is aggressive hydration with a target of 100oz of water daily.
Fasting insulin controls metabolic flexibility and fat utilization. When insulin runs high, the body struggles to access fat stores on long rides, which drives energy crashes, bonking, and poor endurance. Insulin at 4.1 means you can now efficiently burn fat for fuel during aerobic efforts, the foundation for sustained endurance. Glucose at 94 supports steady mid-ride power without the crashes.
| Marker | Current | Optimal Range | Status |
|---|---|---|---|
| Estradiol | 38.5 pg/mL | 20-40 (TRT) | Optimized |
| Total T4 | 5.0 | 4.5-12.0 | Normalized |
| Free T4 Index | 1.5 | 1.2-4.9 | Good |
| DHEA | 110 | 150+ (target 250-350) | Watch |
| IGF-1 | 166 | 200-300+ (target) | Improving |
Performance & Longevity Analysis
The protocol changes landed cleanly here. Stopping anastrozole let estradiol recover from 16.4 to 38.5, right where we want it for a TRT athlete, which protects joints, libido, and mood. Adding a second grain of thyroid normalized Total T4 (2.8 to 5.0) and doubled the Free T4 Index (0.7 to 1.5), so energy and metabolic drive have real support again. Testosterone is stable on the daily dose.
Watching for: recovery capacity is the open thread. DHEA has slipped from 131 to 110 and needs to reverse, since it is the precursor for the hormones that drive repair. IGF-1 is rising (140 to 166) on the peptides but still short of the 200-300+ we are targeting, so we hold the CJC-1295 and Ipamorelin and give it another block.
| Marker | Current | Optimal Range | Status |
|---|---|---|---|
| hs-CRP | 1.0 | <1.0 | Optimized |
| PSA | 3.0 | <2.0 (target) | Improving |
Performance & Longevity Analysis
Inflammation is well controlled. CRP sits right at 1.0, which is where we want it, and low systemic inflammation is one of the biggest levers for both recovery and long-term health. PSA is the standout move: down 58% from 7.2 to 3.0 since adding Retatrutide. That is real progress. We keep the peptide going to bring PSA under 2.0 and hold CRP at or below 1.0.
Wins to Celebrate
Before we change anything, let's be clear about what's already working, because this is the foundation we want to protect.
Insulin 4.1
Crossed into optimal range (under 5), down from 5.2. The master switch for metabolic health.
Glucose 94
Down from 104. The dietary changes, lower carbs and post-meal walks, are working.
HOMA-IR 0.95
Under 1.0, which means you are genuinely insulin sensitive. Solid metabolic foundation.
Estradiol 38.5
Recovered from 16.4 to a healthy 38.5 after stopping anastrozole. Right where we want it on TRT.
Thyroid Normalized
Total T4 nearly doubled (2.8 to 5.0) and Free T4 Index doubled (0.7 to 1.5) on 2 grains.
IGF-1 Trending Up
Rising from 140 to 166 on the peptides. Recovery capacity is climbing toward target.
PSA Dropped 58%
Down from 7.2 to 3.0 after adding Retatrutide. A meaningful move in the right direction.
CRP at 1.0
Systemic inflammation controlled and holding at optimal. A major lever for recovery and longevity.
Your Action Plan
These are the highest-leverage moves for the next training block, in priority order.
The protocol changes are working, so the first priority is simply not breaking what is fixed. Hold the current stack and let the trends keep running.
How:
- Stay on daily TRT injections (0.1cc), which are pulling hematocrit and RBC down.
- Keep 2 grains of thyroid and the dietary changes: low carb after 7pm and post-meal walks.
Target: hold insulin under 5, glucose under 95, and estradiol in the 20-40 range on the next draw.
Recovery capacity is the one system still short of target. DHEA is declining (131 to 110) and IGF-1, while rising, is not yet where we want it. This is the primary focus of the block.
How:
- Increase DHEA to 50mg daily to reverse the decline and rebuild the precursor pool.
- Continue CJC-1295 plus Ipamorelin to push IGF-1 higher, and continue Retatrutide to keep driving PSA down.
Target: DHEA above 250, IGF-1 into the 200-300+ range, and PSA under 2.0.
BUN at 29 and a BUN/Creatinine ratio of 25 both read as dehydration rather than a kidney problem. This is the easiest fix on the list.
How:
- Hydrate aggressively with a minimum of 100oz of water daily, more on hard training days.
- Track intake for two weeks so the habit sticks before we retest.
Target: bring the BUN/Creatinine ratio back into the 9-20 range within 4-6 weeks.
Peptide Optimization Protocol
CJC-1295 + Ipamorelin Active
Goal: increase IGF-1 from 166 into the 200-300+ range. Dosing: CJC-1295 500 mcg plus Ipamorelin 100 mcg before bed, daily. Expected: an IGF-1 rise of 30-50+ points within 4-6 weeks.
Retatrutide Active
Goal: PSA trending down (3.0 toward under 2.0) with CRP stable at 1.0. Dosing: 3 mcg every 5 days, subcutaneous injection.
Next Steps & Retest Schedule
Recommended Retest Window
Retest in about 4 to 6 weeks (late April 2026). We stay on a monthly cadence while actively optimizing DHEA, IGF-1, and hematocrit, then move to every 3 months once all markers are holding in their optimal ranges. Your body responded quickly to the last round of changes, which is exactly why we test this often while dialing things in.
- CBC (hematocrit, RBC, platelets): confirm hematocrit is under 54% and still trending down.
- Hormones (testosterone, estradiol, DHEA, IGF-1): goal DHEA above 150 and IGF-1 above 200.
- Metabolic panel (insulin, glucose, BUN, creatinine): confirm the BUN/Creatinine ratio is back in the 9-20 range.
- Inflammation (CRP, PSA): goal CRP at or under 1.0 and PSA under 2.0.
Questions? Let's Talk.
This report is a starting point, not the last word. If anything here raises a question, or you want to talk through the peptide dosing or the hydration plan before the next draw, reach out. We test monthly while optimizing for a reason: your numbers move fast, and we adjust the protocol to keep them moving in the right direction. You are not just healthy, you are optimized, and the goal is to keep it that way.