Here is a breakdown of many labs over the past year. The actions taken after each one and the effects of those actions. Currently a bit confused as to what to do next and would love some insight.
I have taken much interest and allocated a lot of time to learning this stuff and accordingly my Dr’s have given me the freedom to pretty much choose what I want to do next. So I am hoping to source the wisdom of this community and your individual experiences to perhaps elucidate some things that I may not see.
| 5/2/2022 | 8/6/2022 | 9/23/2022 | 11/25/2022 | 2/6/2022 | 4/24/2023 | 4/25/2023 | 5/15/2023 | 6/15/2023 | 7/8/2023 |
|---|---|---|---|---|---|---|---|---|---|
| Total Test | 287 | 349 | 550 | – | 314 | – | 763 | 509 | 509 |
| Free Test | 69 | 96.8 | 141.7 | – | 91.6 | – | 167.9 | 143.35 | 509 |
| FTI % | – | – | – | – | 77% | – | – | 66% | 509 |
| E2 | 20.9 | 27.1 | 45.7 | – | 35.98 | – | 77 | 67.56 | 44.9 |
| TT/E | 13.73 | 12.88 | 12.04 | – | 8.73 | – | 9.91 | 7.53 | – |
| FT/E | 3.30 | 3.57 | 3.10 | – | 2.55 | – | 2.18 | 2.12 | – |
| SHBG | 15.1 | 17.9 | 23 | – | 14.4 | – | 34.82* | 18.07* | – |
| TSH | 1.87 | 1.6 | – | – | – | – | – | – | – |
| T4 Free | 0.81 | 0.79 | – | – | – | – | – | – | – |
| T3 Free | 3.4 | 2.7 | – | – | – | – | – | – | – |
| Ferritin | 117 | 143 | – | – | – | – | – | – | – |
| Prolactin | 9.38 | 8.53 | – | – | 8.25 | – | – | – | – |
| a1c | 5.7 | 5.2 | – | – | 5.3 | – | – | – | – |
| CRP | 34.22 | 10.23 | 21.51 | 39.7 | – | 10.5 | – | – | – |
| Insulin | 15.5 | 2.5 | – | – | – | – | – | – | – |
| LH | – | 4.7 | 7.9 | – | 6.9 | – | – | 22.3 | – |
| FSH | – | 5.7 | 7.8 | – | 5.44 | – | – | 19.85 | – |
| DHEA | 195 | 194 | 188 | – | 317 | – | – | – | – |
| PSA Total | – | 0.75 | – | – | 0.88 | – | – | – | – |
| PSA Free | – | – | – | – | 0.2 | – | – | – | – |
| 5/2/2022 | Baseline test - inquiring about low - T symptoms led to discovery of pre-diabetes. Prescribed Metformin 500 mg ER + started serious weight lifting |
|---|---|
| 8/6/2022 | 90 day follow up - Pre-diabetes reversed. CRP lowered. TT/FT increased. Symptoms better. Start CLOMID 25mg EOD |
| 9/23/2022 | 1 month CLOMID follow up. TT and FT increased, but E2 increased more. TT/E2 ratio worse and horrible E2 symptoms. I quit CLOMID shortly after. Discover RA factors |
| 11/25/2022 | Baseline CRP number for my RA specialist. Start Hydroxychloriquine for RA |
| 2/6/2022 | Baseline test with Urologist. 5 months off CLOMID and T is low with E2 still elevated. Horrible ratio. All the symptoms. Prescribed ENCLO 25mg EOD and .25mg Anastrazole 1x per week. Feel great for a week or two |
| 4/24/2023 | RA follow up after 5 months of Hydroxychloriquine. CRP way down as well as Arthritis symptoms |
| 4/25/2023 | I ordered my own labs bc I felt E2 symptoms. Sure enough, TT and FT are way up, but E2 is up more and the ratio and symptoms are bad. Doc increases Anasatrazole to 1mg 3x per week |
| 5/15/2023 | Urologist follow-up and labs. TT is down bc I went to 25mg E3D. Tell the doc that Anastrazole is not inhibiting aromatase in testicles. Switches to Letrozole 2.5mg 2x a week |
| NOW | Slight symptom relief with stronger AI, I still don’t think it does much for intratesticular aromatase inhibition. |
When I saw the most symptom improvement was actually on 8/6/2022 before any SERM deployment but as the result of reversing pre-diabetes. Gym + no gluten + cardio. The CLOMID was horrible. The ENCLO was great before my E2 went through the roof
It would appear that I am now a hyper aromatazer, but before CLOMID, it would appead that I wasn’t such an aromatizer … but maybe that was bc my TEST was very low too
Could Inflammation (CRP) be the culprit here? I would like for ENCLO to work so that I do not have to shut down my balls, but I am reaching the end of my patience here and would just like to feel normal
From my research there is a strong correlation between Testosterone, T/E ratio, and inflammation and the manifestation of auto-immune diseases… Insulin Resistance, Pre-diabetes, and RA
I am 38 and quite young for RA… Which leads me to believe that the inaction of my PCP for years set the stage for auto-immune problems
When I discovered Pre-diabetes, I was definitely overweight (225lbs @ 24% body fat… I am now 196lbs @ 17% body fat)
For the past 6 weeks I have cut gluten completely. RA is MUCH better. I quit taking metformin with the hope of that increasing T. Hard to tell tbh but the more I thought about it. If metrofin raises SHBG, obviously by promoting insulin sensitivity. Well I need that.
After the blood test in June, I stopped taking enclo all together. But stayed on the AI (letro) taking 5mg a week.
I was wondering why SERMs felt great for a week or two but quickly. In me. I get uncontrollable e2. ZERO libido. Brain fog. BLAH.
Always chucked it up that I was an “over aromatizer” which maybe… but not bc of adiposity. I took a lot of AI while on enclo - to no relief. As this aromatase was local in the balls.
Also in the best shape of my life… not saying a whole lot. But stay in the gym. What I’m saying here is that I’m not fat enough to be an over aromatizer from excess body fat.
I’m wondering if the latent inflammation from RA is just going to cuck my SHBG forever ?
I’m pretty sure the low SHBG is the reason for the extreme e2 issues.
I was prediabetic technically - def insulin resistant - but that has been reversed for over a year. I wear a cgm still and know this to be true.
All my liver markers are great. So still curious why I have a low SHBG still.
Appt in a few weeks w urologist. I can pick my poison so to speak.
Injection. Gonna be daily microdosing. I’m pretty confident in that
HCG as well.
Curious about Jatenzo.
Really would like to hear anyone’s opinion. Insight. Etc.
In general.
From people that have tackled hormone optimizations while having low SHBG and or autoimmune disease and or systemic inflammation and or had reversed prediabetes.
Thank you