I think I use 500 mg/day of Niacin. I bought it at a CVS, but I’m sure European drug stores carry it.
Haven’t yet had my HDL rechecked since starting it about a month ago–hoping for a good improvement.
[quote]VTBalla34 wrote:
I think I use 500 mg/day of Niacin. I bought it at a CVS, but I’m sure European drug stores carry it.
Haven’t yet had my HDL rechecked since starting it about a month ago–hoping for a good improvement.[/quote]
I will be definitely interested to see your outcome with your levels. Monday I’ll go into the pharmacy and pick some up.
Saw the Uro today and unfortunately not all my tests have been completed. So they are supposed to come in on Monday. So I am to call on Monday and she will send a copy of the results to my email address.
But the only values that the nurse wrote down when she called to check the results was LH and FSH.
She wrote down on a piece of paper, values of 2.3 and 2.6. So if that is correct my LH and FSH has dropped a lot. But doctor said to wait and see once she gets the printed version. Again liver markers slightly elevated but they have been since I can remember, URO said nothing of great concern though.
So either the tests in July when my LH and FSH were very elevated was a LAB error or something funky is going on.
But I do have one question before I get my results back, is there any preferred or optimal LH and FSH values?
Uro said I have to see an Endo for blood tests E2,FT3,FT4,TSI. The Uro I was seeing is probably on holiday so I am seeing a different one at the office. She seems willing to help too, but a bummer about the tests she could not do.
[quote]iroczinoz wrote:
But I do have one question before I get my results back, is there any preferred or optimal LH and FSH values?
[/quote]
Optimal amount: whatever gets the job done.
You don’t chase optimal LH/FSH amounts, you chase improvement in symptoms (primary) and high Total T (secondary)
Well I just got my labs back and it looks interesting.
LH 2.38 (1.8 - 8.4)
FSH 2.3 (2.2-10)
Testosterone 15.82 nmol (6.1-27.1)
DHEA-S 3.55 (1.64 - 4.64)
So very likely the previous lh and fsh values were a lab error. Or, my testosterone drops so much by midday that things change so much with respect to lh and fsh.
Dhea-s levels look like they are topping up, and very well could have caused my testosterone levels to raise a bit.
Looking at things now, it would seem that lh and fsh are not getting the job done. They are very near the low range. It is a shame she did not do E2 as I would have liked to have seen the value and if it were higher maybe lowering it would also help testosterone levels.
I guess I have a couple of options.
-
keep supplementing Dhea for now and in 3 weeks I am supposed to see the endo. Ask to have E2 taken lh,fsh,testosterone. I don’t think I need anything else. Then go back and see Uro as she does not want to do anything until I get a report from the endo.
-
I have nolvadex on hand start on it now at 20mg day 1st week, 15mg 2nd,10mg 3rd, 5mg 4th. I wont get the 4th week done before blood test as I would have to postpone by a week or 2 if she has space. But I don’t have arimidex on hand if I get bad E2 rebound while on the restart test. Should this be a concern?
What do you think I should do? If I take nolva now it will skew my results when I see endo.
Should I just go down to the GP and pay out of pocket and get E2 taken now pay the $20 or what ever it costs and get it over and done with? That way I will know now what my E2 is and not mess around with endo in trying to convince her to run the blood test. I’ll just talk about my thyroid issue with her and see what other tests we can run to rule out hyper.
[quote]iroczinoz wrote:
So very likely the previous lh and fsh values were a lab error. Or, my testosterone drops so much by midday that things change so much with respect to lh and fsh.[/quote]
Hold on, are you saying that only your July blood tests (with high LH/FSH) were done at the proper times? The rest were done in the afternoon?
It is important to be consistent with lab timing–it changes enough on its own from day to day…no need to complicate things with inconsistent times of day.
Im still inclined to think the July tests were an error…I find it hard to believe your LH/FSH levels were that high in the morning and drop off so considerably a few hours later…please put this in perspective with lab timing…
[quote]
- keep supplementing Dhea for now and in 3 weeks I am supposed to see the endo. Ask to have E2 taken lh,fsh,testosterone. I don’t think I need anything else. Then go back and see Uro as she does not want to do anything until I get a report from the endo.[/quote]
I would go with this option probably. You do not have a full set of labs. Your E2 could be causing your symptoms.
SPeaking of symptoms, what are they now? Any improvement? This needs to accompany bloodwork.
Dude its $20? Go get it done!
[quote]VTBalla34 wrote:
[quote]iroczinoz wrote:
So very likely the previous lh and fsh values were a lab error. Or, my testosterone drops so much by midday that things change so much with respect to lh and fsh.[/quote]
Hold on, are you saying that only your July blood tests (with high LH/FSH) were done at the proper times? The rest were done in the afternoon?
It is important to be consistent with lab timing–it changes enough on its own from day to day…no need to complicate things with inconsistent times of day.
Im still inclined to think the July tests were an error…I find it hard to believe your LH/FSH levels were that high in the morning and drop off so considerably a few hours later…please put this in perspective with lab timing…
[quote]
- keep supplementing Dhea for now and in 3 weeks I am supposed to see the endo. Ask to have E2 taken lh,fsh,testosterone. I don’t think I need anything else. Then go back and see Uro as she does not want to do anything until I get a report from the endo.[/quote]
I would go with this option probably. You do not have a full set of labs. Your E2 could be causing your symptoms.
SPeaking of symptoms, what are they now? Any improvement? This needs to accompany bloodwork.
Dude its $20? Go get it done![/quote]
The July test if I remember correctly was around 1pm. The test at the kidney specialist was drawn at 10am with test levels of 10.71nmol. Keep in mind this was before starting DHEA supplementation.
After the 6 weeks of DHEA testosterone was 15.8nmol with DHEA-S levels topped up and this blood draw was around 8am.
So if my LH and FSH shoot up to high numbers because of Testosterone drop off around Midday then maybe only then the July test was not an error. My low test could very well be because of my shitty DHEA-S levels. Since test has risen now maybe the only other thing would be the E2 being higher too and having some negative effects.
Yeah I am kind of guessing the E2 tests costs $20 just by the way the kidney specialist threw around the costs of FT3. So I figure it might cost similar. Calling the GP on Monday as she is finding out what the exact cost is as she did not know.
I have an appointment with the Endo on the 2nd of December, the last meeting with her went pretty sour. So I am not counting on her doing any more tests for me, so might just go out of pocket for the E2 to see where it is at now with more than 7 weeks of DHEA supplementation.
This leads me to ask another question, say 8am blood draws show 16nmol/l testosterone levels. Blood draws at 2pm show 10nmol/l would this be classified as normal, should they really fluctuate that much?
I mean if my levels from midday are borderline but fine in the AM is this classified as normal? I would think you should have higher levels all throughout the day to be optimal?
Symptoms are still the same, feeling weak and not feeling refreshed in the morning. Might be worth while to get my snoring looked at, if any impact from that.
I am thinking the same though that the July tests were a lab error on the LH and FSH. Maybe the decimal in the wrong spot.
[quote]VTBalla34 wrote:
Dude its $20? Go get it done![/quote]
It ended up being $15 for the E2 test got the results back. A little pi$$ed that the results don’t quote an exact number, but anyway…
E2 - <73 pmol/l range 0-172
So at least it tells me that my E2 is below 73 pmol/l (which is 19.8 pg/ml)
Back in July it was 107 pmol/l (29 pg/ml)
So it has even gone down while being on 100mg DHEA daily for the last 8 weeks.
So all this mention in various articles that DHEA converts to Estradiol is either bogus or every case is different.
So I guess I will see the stupid endo in 2 weeks, tell her she gave me a nice run around because her lab stuffed the ranges on my LH or FSH most likely. Instead of throwing me out the room and saying she does not know what to do with me, she could have re tested to make sure they are correct.
Ask for a run of Tamoxifen, I leave for Australia again mid January so we could get in 4 weeks and see how it went. Or should I try HCG instead? Most likely I will get told to shut up and get my T3 and T4 meds and cya.
So if that happens will do a trial run on my own. If I do a trial run of Tamoxifen for 4 weeks and E2 rebounds after that should I really have something on board to combat it or will it sort itself out once I stop taking it?
I would most likely try HCG first since its more of a direct approach–either your balls respond and produce more T or they dont. There are more processes involved with a SERM, so more to go wrong and may leave you scratching your head if it doesnt work. HCG test will tell you if you are primary, then you can look at the SERM.
You probably will be fine estrogen wise if you taper off the SERM properly. Wouldnt be a horrible idea to have some arimidex/aromasin on hand though, but probably not a deal breaker if you dont.
Interesting E2 result, given the DHEA…like you I think most of the risks of DHEA converting to unwanted hormones is overblown.
[quote]VTBalla34 wrote:
I would most likely try HCG first since its more of a direct approach–either your balls respond and produce more T or they dont. There are more processes involved with a SERM, so more to go wrong and may leave you scratching your head if it doesnt work. HCG test will tell you if you are primary, then you can look at the SERM.
You probably will be fine estrogen wise if you taper off the SERM properly. Wouldnt be a horrible idea to have some arimidex/aromasin on hand though, but probably not a deal breaker if you dont.
Interesting E2 result, given the DHEA…like you I think most of the risks of DHEA converting to unwanted hormones is overblown.[/quote]
Thanks VT for the reply, I just want to say thanks for sticking with me through this long thread. I’ll push for the HCG not really too much can go wrong with it but the endo sure as hell is friggin conservative. If I have no luck with her I’ll also try the Uro. If no luck there I am stuck with Nolva.
Can’t take DHEA with me to Australia so will probably have to stop supplementing for the 3 months. I can ask for a permit to bring it in but will need the endo to sign a letter I prepare for her and then send it off to Australia. Don’t know if it is worth the hassle.
I have to ask the endo how she thinks I am supposed to treat my problem with DHEA. Since it is also banned in Czech and I was probably lucky to get it through. I might be able to get it from the UK since they are EU while I am in Europe.
I’ll read up on HCG what kind of dosages and how long to test it for and hope I get through to the endo.
Saw the Endo and it went exactly as expected. She started getting hysterical at me and yelling… The discussion was loud from her end I kept my tone normal throughout her rants.
I asked if we could trial HCG for say 4 weeks to see if my gonads are able to produce. Going by latest LH and FSH levels on the lower end. To this she said ABSOLUTELY NO WAY that I am crazy…
When I asked her about that I had a positive result supplementing DHEA with a noticeable increase in Testosterone she said DHEA-S has nothing to do with it.
She goes on to say that my test is on the low end scale, that my gonads are not able to produce enough which is just bad luck. People in 70-80’s might have higher testosterone than me which is just the way it goes. Bad luck you are aging and it is normal.
I asked if she tells that to her female patients once they go through menopause that it is bad luck and normal. She goes no we supplement. Is this bitch for real!!
But in your case you are trying for kid 2 so no point supplementing testosterone. I said rather than supplement testosterone why not 1st rule out if all I need is a kick start. She replied rubbish you will not kick start anything does not work that way, sorry NO HCG she calls it pregnenolene for you.
Go find another cowboy doctor who might do this but she will not. Called me crazy and said she does not want to see me again, that I am too difficult to deal with. Go find another Endo. I really did not care that was the last time I went to see her anyway I just needed my Thyroid meds for the next 6 months. I’ll find another endo next year.
You should have seen her, she was going nuts, not sure why since I was calm and just shaking my head inside with disbelief.
She did a blood draw at 2pm. TSH,FT4,T3, testosterone,LH,FSH.
At least I will see what happens in the PM stages of the day again.
Not to be discouraged by her rants and personal attacks, I asked can we test TSI to make sure I am not HYPER. She said what the hell is TSI she has no idea what TSI is. Then grabs a piece of paper that they do blood requests on, slams it in front of me and tells me find TSI it is not there.
We will tell if you are HYPER by TSH and FT4. I said but this just gives a snapshot of that specific time. This does not tell us if I have TSI present which if you do have present you are more inclined to be HYPER. Since HYPER and HYPO change throughout the day TSH is not a accurate measure. This was all read on the thyroid boards. SHe shakes her head and just moves on.
Well I guess the medicine in Czech is a little behind which I find hard to believe but anyway.
Getting TRT from her would be step in the wrong direction anyway. She does not control E2 and injects every 2 weeks. Waste of time anyway. Be better just to treat myself and not have to deal with an incompetent ENDO.
I also asked her that if in fact DHEA is a solution to my testosterone how am I supposed to make sure I have adequate supply all the time, since it is banned here and in Australia. She just said, oh well up to you.
She went on to say that I do not have erection issues or sexual dysfunction so I would not be a candidate for TRT anyway. So I guess to her not being able to have an erection is a greater priority than that of feeling tired and weak. If I felt great and strong but my erections were fucked she would put me on TRT. What a joke, I guess she thinks everything erection wise is contributed to Testosterone with no respect to DHT or E2.
Screw her she is pathetic and hardly knows what she is doing.
So I cannot expect help from her and I have run out of time to find an endo before I leave to OZ. So will do it once I return. I see the URO next week after my CT scan of my Kidney’s. Might talk to her how the situation is. I will ask for the previous URO I saw the 1st time as she was a little more open than the 2nd one.
The only other option is to take the TAMOXIFEN that I have and try a self trial. Will wait for results to come in and see how I end up at the URO.
I’ll post the results of the blood draw as soon as I get them.
PS. Sorry for the rant just very disappointed.
Damn
Yup at this point, I believe I would begin self-treatment…you seem to have the knowledge to ease into it…up to you
[quote]VTBalla34 wrote:
Damn
Yup at this point, I believe I would begin self-treatment…you seem to have the knowledge to ease into it…up to you[/quote]
I hear you about the DAMN!!
I will wait for the results to come back. No point in predicting the results, but if LH and FSH come back low but in range. Would you jump on Tamoxifen for 4 - 6 weeks?
I guess to be real safe I should just wait till we have success with pregnancy since we are trying now.
If my test comes back in the 450-500 range in the PM I could live with that, but no harm in trying to boost with Nolva if my boys are up to it. Since getting my hands on a constant supply of DHEA could become problematic.
Saw the uro today, unfortunately the uro I saw the 1st and 2nd time was not there. I thought I would see her today since she made the appointment with me.
CT scan came back the same so nothing to worry about, just a very slight abnormality.
No luck with HCG prescription, she is not as clued up as the other uro.
Told me to try a sexologist as they also deal with hormones and might be able to help. Will give it a last shot and after that I give up dealing with doctors. Been years of trying and not getting anywhere.
I give myself 1% chance with the sexologist.
Saw a throat specialist today regarding my snoring. He looked me over and said throat is good, nasal passage has a very slight deviation but removing this he said the chances of improvement are slim. He said he would not recommend any surgical treatment for me.
Gave me some nasal spray to try for a month and if I notice an improvement to let him know.
Even though my testosterone has increased morning sample (still waiting on afternoon numbers) I have not really felt any improvement. This is one of the reasons I am still going through doctors. I am the leanest I have been since I was in my 20’s. Abs visible, not carrying much fat at all, but the weakness, tiredness still exists. So either the 440ng/dl of Testosterone is not enough for me or something else an issue.
By the looks of it, HCG is a very bad drug since the doctors I have spoken too all get the shivers when I mention it. NO NO NO… When in my case it would be the perfect thing to try out for a month to see where I am at.
Doctors are just passing me along. Endo acknowledges I have an issue but will not help. She should be shot.
Got my lab results in the mail along with a report stating everything is normal.
Blood draw on these labs was around 2pm.
Testosterone - 348ng (212 - 879)
LH - 2.9 - (1.7 - 8.6)
FSH 2.7 - (1.5 - 12.4)
TSH - 4.00 (0.27 - 4.2) !!! WHAT THE HELL
FT4 - 18.50 (9.0 - 25.0)
T3 - 1.87 (1.3 - 3.1)
I was shocked to see TSH so high after it being 0.5 (morning draw and I did take my meds about 90mins before blood draw)the last time and around 1.5 in previous tests. I am on 90mcg T4 and 10mcg T3. I just take all medication in the morning. Which makes me wonder if I should be taking T3 multiple times a day instead of just once in the morning.
But I really want to get TSI tested to make sure nothing funky is going on.
Of course the Endo did not do FT3. To her this test is useless as she says.
FT4 has gone down when it has always been at the very top of the range or above it. Now it has had a significant drop.
So it looks like I might need to adjust the dosages maybe take more T3 throughout the day. I could take 80mcg T4 and 20mcg T3 since the pills are 40mcg t4 and 10mcg t3. One in the morning and one around 4pm.
I can see that my testosterone levels drop off quite a bit from the morning. I would hate to see my levels at 7pm.
Some of Endo’s notes:
- Drop in testosterone is probably age related
- No sign of Hypogonadism no sexual dysfunction
- If Hypogonadism does start & sexual dysfunction shows then she would THINK about TRT.
I love it, so I need to have both sexual dysfunction + Hypogonadism for her to even think about TRT.
I also love how she came to the conclusion to rule out Hypogonadism without even running tests to confirm/deny this.
I have read that TAMOXIFEN helps with sperm counts, these trials were longer ones 3+ months. So I really should not have anything to worry about by giving it a shot for a month or so. Small dosages show to have the same effect as higher dosages. So 10mg daily would be sufficient and then maybe a week of tapering off at 5mg. I was only concerned with taking it to not hinder our chances of having another baby, since my sperm counts are fine. But after reading various articles all it would do is help them anyway. So for me I just want to kick start my system and see what happens after 5-6 weeks.
So I think it is time for me to stop thinking about this and just do it. I am never going to get the green light from doctors or get the option of HCG. I should be glad I have some Tamoxifen on hand.
I’ll see if I can get in to see an Endo before I leave regarding my thyroid.
Real quick update since I am getting ready to fly out in the next 24hrs. I actually went to see a sexologist on the recommendation that I got from the Uro.
It went well the appointment, she heard me out what I wanted to say. Confirmed that my Testosterone levels suck for my age. She actually had a table of her own and said I should be in the 18-20 nmol region. This doctor actually keeps notes! Also my free androgen index of 35% she said is low, she likes to see it at 50%.
She knows most endos are not up to standard when it comes to Testosterone and other hormones. As she says they fix Swiss watches with a hammer. Although she herself is no professor she tries to educate herself.
Told her that I am on day 10 of my Nolva, she asked can I feel a difference? Well I can’t really tell at the moment since I am sick as a dog, probably a cold or maybe the flu.
She looked at my labs, we talked and she said she can’t prescribe me tamoxifen as it is expensive ( I thought it was a cheap drug) but she did prescribe me clomid for a test. Said to take 50mg daily for a month. She has seen good responses from it. She said to give it a try if I want.
The brand is called Clostilbegyt
Not going to get my hopes up though… Will see what happens over the next couple of months after I get some blood work to see if Nolvadex had any effect.
I asked if she does testosterone shots and she said yes. Most have them done in the office but she did say some do it themselves. Although there protocol in place is shitty (injection 1x every 2 weeks) I think with her she would be willing to listen.
Although it looks promising I am not holding my breath. I am still keen on finding out what the real problem with me is so not really thinking about TRT just yet.
I’ll report back after my next blood tests. She also goes to me keep reading/researching and come back. Looks like she wants to learn, maybe with my Tnation knowledge we can get this doctor up to speed.
mixed news, but better than average… I have ‘taught’ three doctors about HRT protocols… just go slow, and be patient… doctors are very resistant to change or ‘new’ ideas (like TSH of 3 is a bad thing).
speaking of which, did you ever do anything about your TSH?
[quote]PureChance wrote:
mixed news, but better than average… I have ‘taught’ three doctors about HRT protocols… just go slow, and be patient… doctors are very resistant to change or ‘new’ ideas (like TSH of 3 is a bad thing).
speaking of which, did you ever do anything about your TSH?[/quote]
Yeah I thought I had TSH under control until the last set of labs. Before my last set of labs tsh came back at 0.5 (on 90mcg t4 and 10mcg t3)
But all of a sudden tsh came back at 4. Wanted more tests especially Ft3, Rt3,TSI.
Also wanted to confirm hashi’s, since antibodies indicate hashi’s but not definitive.
Endo just said you have hashi’s and threw me out never wanting to see me again. That might be the case but I want to be 100% certain.
So hope to get some tests in OZ.
Sorry for the hi-jack, never took the time to read it from the start to see this was one persons ongoing post of their own matters. My bad!
[quote]La Crosse Grad wrote:
Posting up my results as this seems to be a very helpful place to garner feedback and support for what I have been dealing with for basiclly 11 months now with not much improvement.
Feb 28th 2011 (8:07am) as part of routine check-up I had labs of:
Total T 533ng/dl
Free T 77pg/ml
3 Gen TSH 1.62munit/ml
Prolactin 23ng/ml
SHBG 52nmol/L
HDL 110mg/dl
LDL 112mg/dl
Trig 86mg/dl
25 Hydroxy VD 25 ng/ml
Estrogen and E2 were never measured…being I have an HDL of 110 makes me think it “may” be higher then normal since both hormones are responsible for sustaining HDL levels in men and women.
My doc said my prolactin was high and so he gave me parlodel to handle that. It sucked ass! After 3 months I was super run down and lethargic as hell all the time. I said it was not going to happen so we swapped it for bromocryptine. 2 more months pass. It kinda worked! My numbers by late June were close to within range for normal prolactin levels. Sadly my total t and free t had dropped some! Not quite what was expected.
REFERENCE LABS_ (06/28/2011 8:05 AM CDT)
SHBG 67 nmol/L
Testosterone 517 ng/dL
Testost Free 62 pg/mL
Prolactin 17ng/ml
At this point he had me stay with bromo for 3 more months to assure the levels stayed down and that my t came up more. September comes and even I am noticing I am losing weight without dieting or adding more cardio?? 4-5lbs actually. Side effect of Bromo I start to think right…
Next labs has me at…
REFERENCE LABS_ (09/16/2011 8:20 AM CDT)
SHBG 62 nmol/L
Testosterone 492 ng/dL
Testost Free 62 pg/mL
Prolactin 3ng/ml
Ok great we have the prolactin well under control but now my T is lower then ever…shit! Not cool! Doc takes me off of bromo at this point since the prolactin is doing fine at this point. Doc has me take 1000IU of Vitamin D3 a day for the next 6 weeks and make sure I get at least 7 hours of sleep a night or as close to that as I can. Most nights I would get 7 hours(some nights each week I was getting 5-6 because of work shifts) so those nights I would take a nap the next day after work to get the 7 hours average every night. I also cut back to just 2 short 30 minute cardio sessions a week on days I did not lift.
Then comes November labs, weight loss has stopped but weight gain seems impossible yet. New labs show…
REFERENCE LABS_ (11/22/2011 8:03 AM CST)
SHBG 60 nmol/L
Testosterone 260 ng/dL
Testost Free 32 pg/mL
25 Hydroxy VD 36ng/ml
Still dropping! VD has climbed so it was not that. I am sleeping more then before and training a little less/recovery more. Now I am getting really pissed off and frustrated that despite treatment and meds I am dropping lower yet and faster then ever! But thats not all. At this point my doc has me set (after discussion with me and weighing my options) to go on TRT. 300mg of t enathate every 2 weeks and then every 3rd week after that. After 2 injections of 300mg and 5 weeks of being on the drug, we test again to see whats happening…
REFERENCE LABS_ (01/06/2012 8:35 AM CST)
SHBG 63 nmol/L
Testosterone 204 ng/dL
Testost Free 24 pg/mL
Still dropping! And even faster then any other 2 labs have shown to date! In 6 weeks my total and free have dropped and my SHBG is back up some! WTF is all I can think now???
My doc in the mean time having gotten the labs ups my dose to 400mg for the 3rd injection I just got on the 10th of this month. My next one is set for the 31st at the same dose.
I also have taken it upon myself to see a specialist. I have an appointment on Friday next week to go see an endocrinologist who deals specifically with male endocrine disorders.
I hope to god I can get some answers as to why my T levels continue to drop despite sleeping well, avoiding stress, eating very well (accounting for fat intake, eating lean red meats, good cholesterol intake from omega eggs, taking fish oils, no flour or sugars, ample calories etc…) not over training…4 days a week split, dropped out almost all cardio to be sure it was not OTS…VD supplementation…I cant see anything else that would cause this?
At 27 years old, non smoker, rarely drink, never used pro hormones or AAS of any kind I am really kinda lost on this one folks.
Friday I pray brings some answers to the table so I can pin point the issue at hand once and for all.
[/quote]
This is iroc’s case thread. Start your own.