Ah, The Joys of Aging

Pharma TRT
41

You mentioned you were getting a 4x cortisol test, but never posted the results.

FT4 below range is very troubling. It fits your high TSH… but the question is what happened between this recent test and the one you posted 5/11. Your TSH went from optimal to somewhat problematic.

FT4 below range is hypothyroid. Not sure if you have adrenal fatigue but suspect you do. I’ll be interested to see where your FT3/RT3 comes in. We can tell you some of what’s going on when those numbers are posted… but can’t paint the full picture without cortisol.

42

+1 for what SCJ said. You obviously have a thyroid problem if your T4 is that low. The question is whether it is thyroid induced or cortisol induced. Need cortisol results. I will be very surprised if T3 and RT3 are at all high.

ARe you still taking iodine? I have a hard time reading your posts and figuring out the length of time you were on meds before or after the blood was drawn.

Ever done anything about celiacs? From all the stuff you are on not corresponding to blood levels, it would appear you have a great degree of malabsorption. Elimination diet is also an option to see how you react, but I would get a celiacs panel done first.

Let’s wait on these other tests to come back and rediscuss.

43

I’m going in tomorrow to review numbers with doctor. got my cheat sheet with cortisol, thyroid, adrenal, and celiacs info ready.

I’ve been doing panels every two months right now and run sups/meds the whole 8 weeks (unless there is a reason not to).

I took iodine for the two months leading up to last panel, but maybe 25mg daily isnt enough reloading for me at this point.

I take inspra daily for hyperaldosteronism - so I wouldn’t be surprised at adrenal fatigue. I’ve been on inspra for the last two years. I had extremely low blood potassium levels and very high blood pressure (6 months after a good good checkup). mine’s a hyperplasia of both adrenal glands (based on MRI) called conn’s syndrome.

i’ll post the results up when i get them and appreciate the comments so far.

I have done some searching for a better lab as the last 4x cotisol results I got were a mess, so need to try again. I saw a recommendation for access labs here in florida on another forum. Are they any good or any other recommendations?

44

Heres the full thyroid panel

TSH 2.48 (0.45 - 4.5)
T4 10.3 (4.5 - 12.0)
T3 Uptake 33% (24-39)
Free Thyroxine index 3.4 (1.2 - 4.9)
FT4 1.52 (0.82 - 1.77)
FT3 3.1 (2.0-4.4)

I mistakenly used the FT3 range on the FT4 test results before.

Dr was concerned with increased TSH and not happy with FT3 and symptoms. He’s wanting me to start Cytomel (synthetic T3) ramping up to 25 mg BID.

He doesn’t want to do 4x cortisol since he’s not happy with saliva labs in general (especially since the last try was crap). He’s using Cytomel as a way to offset the low Cortisol/Ferritin impacts of dessicated thyroid, but personally, I’d like to try the 4x saliva test for cortisol and will continue to try and find a lab I can use (live in Florida if anyone has any ideas). I can do the lef am/pm blood cortisol + ferritin as a back up if anyone has an opinion between the two?

Waking temps this week so far continue to be low (95.8 and 96.2). no longer taking 25mg iodine daily, but do get 2mg per day with my d3 for maintenance.

still feeling sluggish, tired, weak.

45

[quote]islamorada wrote:
Heres the full thyroid panel

TSH 2.48 (0.45 - 4.5)
T4 10.3 (4.5 - 12.0)
T3 Uptake 33% (24-39)
Free Thyroxine index 3.4 (1.2 - 4.9)
FT4 1.52 (0.82 - 1.77)
FT3 3.1 (2.0-4.4)

I mistakenly used the FT3 range on the FT4 test results before.

Dr was concerned with increased TSH and not happy with FT3 and symptoms. He’s wanting me to start Cytomel (synthetic T3) ramping up to 25 mg BID.

He doesn’t want to do 4x cortisol since he’s not happy with saliva labs in general (especially since the last try was crap). He’s using Cytomel as a way to offset the low Cortisol/Ferritin impacts of dessicated thyroid,
[/quote]

Wait, are you on dessicated thyroid now? You didn’t mention that before. That makes a difference.

[quote]islamorada wrote:
but personally, I’d like to try the 4x saliva test for cortisol and will continue to try and find a lab I can use (live in Florida if anyone has any ideas). I can do the lef am/pm blood cortisol + ferritin as a back up if anyone has an opinion between the two?

[/quote]

I got some labs through Directlabs.com - no idea if it works in Florida. 8am blood draw for cortisol is a decent test though (better than PM by far). Go to labcorp.com and make sure there is a blood draw site in your area before you order the tests from directlabs.

[quote]islamorada wrote:

Waking temps this week so far continue to be low (95.8 and 96.2). no longer taking 25mg iodine daily, but do get 2mg per day with my d3 for maintenance.

still feeling sluggish, tired, weak.
[/quote]

Well, your T4 is much higher in the range than T3, suggesting your body is struggling with T4->T3 conversion. Most likely reason is you suffer from a degree of adrenal fatigue which has driven up RT3 production (the other product of T4). Alternatively, it could be caused by low ferritin/iron (full iron panel might be warranted, especially if RT3 and cortisol check out OK). Iodine deficiency is probably not the cause though I would use iodized salt on each meal just in case.

46

Thanks -

No, Not on desiccated (or any) thyroid med right now.

Looks like i can get blood cortisol (either am or am+PM) as well as ferritin through lef or direct labs. Both run at labcorp and I have two nearby (as well as i am 15 miles or so from LEF HQ and labs.) Not sure whats all in a iron panel, but i can get a combined serum iron, TIBC, and ferritin at directlabs. is that enough in case of false high ferritin due to inflammation or do i ned to find uibc and iron saturation as well?

47

[quote]islamorada wrote:
Thanks -

No, Not on desiccated (or any) thyroid med right now.

Looks like i can get blood cortisol (either am or am+PM) as well as ferritin through lef or direct labs. Both run at labcorp and I have two nearby (as well as i am 15 miles or so from LEF HQ and labs.) Not sure whats all in a iron panel, but i can get a combined serum iron, TIBC, and ferritin at directlabs. is that enough in case of false high ferritin due to inflammation or do i ned to find uibc and iron saturation as well?
[/quote]

Extra information is never bad… I won’t say no to any tests. I admittedly need to expand my knowledge on iron testing - I know IDEAL is getting all the tests you mentioned. But if constrained by budget, I’m not sure which would be easiest to get rid of.

As far as cortisol, here’s the hierarchy: (AM + PM test) > (standalone AM test) >>>>>>> (standalone PM test). In other words, AM is mandatory, you can add PM to give us some additional info but isn’t necessary if budget is constrained (and you don’t want to give blood twice in a day lol).

48

You say he doesn’t want to do 4x saliva cortisol because saliva tests aren’t good. That is true for every hormone EXCEPT cortisol (and maybe DHEA). The correlation between the saliva results and reality are very strong, and it is an excellent test.

Try to find more info on this and convince your doctor. Genova Diagnostics should have some info about it on their site.

Did he at least give you a serum cortisol blood test? I thought that’s what you had said in an earlier post.

It sounds like your doc is switched on with thyroid, and willing to treat subclinical hypothyroidism, but you really need the cortisol to figure out what is what. As SCJ said, your T4 may be converting to RT3 and could be corrected without thyroid meds and just using cortisol uspport.

49

I think I’ll try to get the 4x cortisol, even if the dr isnt game. sounds like if i add it to scj119 hierarchy 4x cortisol saliva > AM/PM blood cortisol > AM only blood cortisol >>>>>>>> PM blood cortisol.

Anyone tried ZRT labs 4x? seems to be one I can order. Dr is funny, pretty up on many things, but had such bad experiences with saliva testing when it wasn’t for cortisol he still has a hard time with it. otherwise, blood it is.

I’ll look through my book of labs tonight and see if there is a cortisol in there. seems that there should be, just dont see it in the office set.

50

[quote]islamorada wrote:
I think I’ll try to get the 4x cortisol, even if the dr isnt game. sounds like if i add it to scj119 hierarchy 4x cortisol saliva > AM/PM blood cortisol > AM only blood cortisol >>>>>>>> PM blood cortisol.

Anyone tried ZRT labs 4x? seems to be one I can order. Dr is funny, pretty up on many things, but had such bad experiences with saliva testing when it wasn’t for cortisol he still has a hard time with it. otherwise, blood it is.

I’ll look through my book of labs tonight and see if there is a cortisol in there. seems that there should be, just dont see it in the office set.[/quote]

4x saliva is the gold standard. I’m just really curious what you mean when you say your doc had “bad experiences” with it. What constitutes a bad experience with a test?

51

dr was doing a clinical study with LEF, and LEF went with saliva and blood for hormone level testing, both a male and female hormone panel. As we all know, but was news to him, the male saliva results rarely correlated with the blood work for Progesterone, Androstenedione, Estrone, Test, and DHT. Female had a similar issue. so its not an issue with cortisol saliva but saliva in general based on non-cortisol specific results.

End result is I’m having to try and educate him that saliva is good for cortisol, especially the 4x, even id it sucks for the others. or find a way to get it on my own to use, which is fine too, as long as I can use a legit lab.

52

If your doctor is in with LEF, I’m pretty sure LEF has some information on 4x saliva for cortisol. IIRC.

53

[quote]islamorada wrote:
dr was doing a clinical study with LEF, and LEF went with saliva and blood for hormone level testing, both a male and female hormone panel. As we all know, but was news to him, the male saliva results rarely correlated with the blood work for Progesterone, Androstenedione, Estrone, Test, and DHT. Female had a similar issue. so its not an issue with cortisol saliva but saliva in general based on non-cortisol specific results.

End result is I’m having to try and educate him that saliva is good for cortisol, especially the 4x, even id it sucks for the others. or find a way to get it on my own to use, which is fine too, as long as I can use a legit lab.[/quote]

Ha, he used a non-cortisol study to determine it sucks for cortisol, nice.

I’m pretty sure high calorie diets don’t work for building muscle because they don’t work for losing fat.

54

thats funny

If its one of the only hangups he has, i’ll be happy. At least he gets FT/TT and RT3, amongst other thing. I’ve sent /handed him a bunch on 4x saliva, including from the lef site. lets see if it works. if not, zrt here i come I guess.

55

Went round and round on cortisol tests with doc. Finally just paid for am/pm out of pocket since I couldn’t find an easy way for 4x saliva.

here’s the last pair of labs - and you guys were right on with checking cortisol, it is low.

1/4/12

am cortisol 5.2 r 6.2 - 19.4
pm cortisol 2.6 r 2.3 - 11.9

D-3 60 ng/mL

T Serum 530 r348-1197 (~peak - taken about 2 hrs after app of 12% cream)
FT 12.9 r6.8-21.5

DHT 115 ng/dL
T4 free 0.51 r 0.82-1.77
TSH 0.236 r 0.82 - 1.77
T3 free 5.5 r 2.0-4.4
E2 11.3 r 7.6-42.6

2/27/12

T serum 123 r 348-1197 (taken ~26 hours after dosing)
FT 3.1 r 6.8-21.5

DHT 20 ng/dL

Preg 35 ng/dL
DHEA 199.8 r 44.3-331

some questions I had going through these labs:

Whats the best approach to low cortisol?
Why do my test numbers change so much in ~24 hours? I’ve started considering cream to knees or top of foot instead of all on scrot.

Some areas still stuck after major diet changes (following UD2 for last 4-5 months and getting nicely lean).
HDL still in the 30’s with 6 caps LEF super omega-3, 9 caps LEF mix multi, 2 caps CVS b-150 and EVO on everything. whats next?
Glucose stuck at 100, hga1c 5.6 (top of range) with 2000 mg metformin daily.

Looking forward to feeling great again!

56

For TRT, do the swings mean i should either up the % from 12 to 15 or go from cream to inject? is it more indicative of a adrenal/thyroid issue where I have adrenal fatigue from Conn’s syndrome (high aldosterone) impacting my thyroid (low t3) and cortisol (low) levels?

Does my cortisol seem to be within the range that isocort would help raise it? it seems so low compared to a target of 75%+ of the range at the am. is the current plant based escort thought to be as effective as the prior animal derived one was?

I was looking at something like this from laroyal in another part of the forum:
"Another thing that is crucial for rebuilding the adrenals is Pantathine, I would take 250 mg with breakfast and lunch. I would also add Taurine in later in the day (somewhere around 3-5 grams taken after 2 PM) and glycine 3 grams under your tounge with each meal.

Keep Vit C high (about 1.5grams tid would be a good dose) and limit volume and duration of workouts. For thyroid, Armour is a great med…much better choice than synthroid that doctors usually Rx.

I will work best if you split the dose between breakfast and lunch and chew it up. To fix the gut I would recommend starting with an elimination diet (get rid of all allergens) you can determine allergic foods with the LEAP MRT test (your doctor can order this)

then 3x daily Have a coctail of aloe juice, glutamine, di-glycerated licorice and marshmellow root after a couple of weeks I would add in a good probiotic at night with your last meal then depending on if you test positive for metal toxicity (a common cause of thyroid disorders) begin a specific detox protocol to remove the metal causing the problem."

seems like I could apply this thinking to my current state, watch body temps at wake + 3hrs and + 6 hrs, and sup iodine following KSMANs Iodine thread.

Thoughts?