Bloodwork, Low T

Pharma TRT
21

KSman, very glad to see you back in action, thanks for taking a look.

I had asked my regular doctor about the anastrozole and she said they only prescribe it when E2 levels are very high, as in outside of the range. She also said she knew nothing about hCG and is pretty much fired from this point. Depending on how things go next week, I might go with Dr. Overbeck in Philly.

I’ve got some DHEA and pregnenolone pills, I think 50mg a pill. How much would you recommend and how often? As for the fish oil, I’ve been taking about 8 of the costco brand fish oils a day. Also Will get some b-vitamins and the acetyl-l-carnitine and r-lipoic acid.

Not taking a single prescription. Will take a look at previous labs and see if there is any mention of the liver.

OTC pills are as follows:
2000mg of vitamin C
2 NOW Adam multivitamins
8000-10000 iu of Vitamin D
rhodiola rosea
600mg betaine hcl
8 costco fish oil pills

That’s it.

One more thing and not sure how significant it is, but when they took the blood, about 8 vials, I almost passed out and became very pale. Basically my lips turned the same color as my skin and I got real dizzy.

Thanks again for the input, I would like to try the HPTA restart, but it seems my struggle is finding a doctor willing to do it.

22

Your getting shocky during the blood draws would release cortisol and adrenalin.

Take 50mg/day of each.

23

Went to the endocrinologist today, he checked me over fairly thoroughly and said that all of these issues are likely from some genetic failure to produce the proper hormones. His issue with the total testosterone levels in my previous labs were that they were both taken later in the day. He wants me to get labs taken again around 8 am four weeks from now. He also said that the free testosterone levels were normal, which meant that everything is working ok.

When I told him about the DHEA and pregnenolone he said to stop taking both completely because over the counter DHEA is unregulated and could have anything in it. I also asked about what course of treatment he would consider in 6 weeks from now if the testosterone levels stayed low. He indicated that he would prescribe T and if at some point I wanted children he would add in HCG. I asked about the Clomid restart and he said that it wouldn’t be an option.

24

Avoid these research hospitals. They are uber-conservative. They have so many restrictions place on them by the university. Try a private practice doctor or an internist that specializes in hormones.

[quote]Groats wrote:
Went to the endocrinologist today, he checked me over fairly thoroughly and said that all of these issues are likely from some genetic failure to produce the proper hormones. His issue with the total testosterone levels in my previous labs were that they were both taken later in the day. He wants me to get labs taken again around 8 am four weeks from now. He also said that the free testosterone levels were normal, which meant that everything is working ok.

When I told him about the DHEA and pregnenolone he said to stop taking both completely because over the counter DHEA is unregulated and could have anything in it. I also asked about what course of treatment he would consider in 6 weeks from now if the testosterone levels stayed low. He indicated that he would prescribe T and if at some point I wanted children he would add in HCG. I asked about the Clomid restart and he said that it wouldn’t be an option.

[/quote]

25

Hello,

Have had some new labs and a new doctor.

Latest labs were taken earlier in the morning than the previous ones (around 9am).

Results are as follows:
Testosterone, Serum: 407 ng/dl, range 280-800
Testosterone, Free + Weakly Bound: 31.4%, range 9-46%
Testosterone, Free + Weakly Bound: 127.8 ng/dl, range 40-250
Estradiol, Sensitive: 12 pg/ml, range 3-70

I also did a 24 hour saliva cortisol test. The results started out in the low range in the morning and plummeted to almost nothing throughout the day. I’ll update the numbers when I get home, but basically the 2 afternoon and evening levels were well below normal.

The doctor’s recommendations are several products from Dr. Wilson’s adrenal fatigue lineup, which include HPA drops and the Adrenal Rebuilder. I’ve ordered those and will be givin them a try.

The plan is to take those and a few other supplements and see where things are going in a few months.

I was wondering, if in the meantime would a product like Tribulus or Alpha Male be of any use? I saw a recent article here that recommended those supplements for people with testosterone issues and am very curious if they work like they say.

26

DO NOT take anything containing tribulus, etc. Tribulus is what took my decent natural testosterone production and destroyed it. You never know what you are getting in these supplements. Take my advice. If somebody had told me to stay away from those supplements, I would be in much better health today.

27

supplements rarely work… check out stopthethyroidmadness for some good info on adrenals.

most end up on COmpounded Hydrocortisone or Cortef.

28

[quote]chemman wrote:
DO NOT take anything containing tribulus, etc. Tribulus is what took my decent natural testosterone production and destroyed it. You never know what you are getting in these supplements. Take my advice. If somebody had told me to stay away from those supplements, I would be in much better health today.[/quote]

That’s interesting - I had taken a bottle or two of tribulus products about a year or so ago and I wonder if that’s what got me into this whole mess in the first place.

29

[quote]PureChance wrote:
supplements rarely work… check out stopthethyroidmadness for some good info on adrenals.

most end up on COmpounded Hydrocortisone or Cortef.[/quote]

That site also recommends a product called Isocort which is OTC for mild adrenal issues. Isocort is made out of similar materials as Dr. Wilson’s Adrenal Rebuilder®, which is what my doctor recommended that I take along with HPA drops. The pills are made out of adrenal cortexes of sheep and pigs, which by the way sounds really disgusting to be taking. But at this point I’m desperate enough to try anything. Any thoughts on how useful that will be considering the numbers below?

My cortisol numbers looked like this:
7 am: 0.38, range 0.27-1.18
11 am: 0.07, range 0.10-0.41
4 pm: 0.03, range 0.05-0.27
10 pm: <0.03, range 0.03-0.14

30

a number of people have found that they can boost their cortisol by taking Lipid Matrix 100-300mg Pregnenolone - but it depends on what your pregnenolone levels were before(per a blood test) and how your body reacts.

I tried it but had unusual reactions.

supplements (other than pregnenolone) rarely work for cortisol issues.

31

[quote]PureChance wrote:
a number of people have found that they can boost their cortisol by taking Lipid Matrix 100-300mg Pregnenolone - but it depends on what your pregnenolone levels were before(per a blood test) and how your body reacts.

I tried it but had unusual reactions.

supplements (other than pregnenolone) rarely work for cortisol issues.[/quote]

My last pregnenolone test came out as: Pregnenolone: 34 ng/dl, range 13-208

So would taking the supplement above be good or bad?

My doctor has me taking the Dr. Wilson Adrenal Rebuilder (3x a day) http://www.adrenalfatigue.org/adrenal-rebuilder-formula.html
and the Dr. Wilson Herbal HPA drops.

The doctor was going to try doing the Clomid challenge, but since I haven’t had libido issues they decided not to, ultimately I was left with a laundry list of vitamins to take. The experience can pretty much be summed up by video below.

I think that they may be playing this conservatively - but I find that the low cortisol numbers I listed above were a little disturbing, especially as the fix isn’t from a prescription.

32

When dealing with adrenal issue the first course of action is to identify the stressors and to deal with them head on while supporting other hormones. It really depends on the age of the patient and many other factors. TRT is always last resort in younger people. Taking a consevative approach in today society for fear of medical malpractice is very common. As I tell our patients. “it did not happen over night and it will not get corrected over night” I am upfront and tell them it can take 6months to 2 years to recovery. They may feel better as time goes on but there is alot of damage to repair. Cortef seems to be the magic bullet for alot of other dr’s but we like to have people on it for a short amount of time 3-6 months then try to lean them off of it. First wave is lifestlye, and identifying the source of the stress then using nutracetuicals for a time frame of 8-12 weeks. If after this time there is no improvement then more aggressive means are needed. Medicine is always constantly evolving field so drs do have to proceed with caution because alot of what is done to try to help patients is medically out side the box. What we do has to be medical justifiable or our ass would be on a lawyers silver platter.

33

So after following the protocol above I had another set of labs done. My question to you all is: Am I fixed? Some days I feel slightly better, but mostly it’s pretty much the same as always.

Testosterone, serum: 418 ng/dl, range 249-836
Testosterone, % Free+Weakly Bound: 36.9, range 9-46
Testosterone, Free+Weakly Bound: 154 ng/dl, range 40-250

Estradiol, sensitive: 10 pg/ml, range 3-70
Pregnenolone, MS: 51 ng/dl, range <151

Corticosteroid Bind. Glob (CBG): 2.3 mg/dl, range 2.3-3.9

T4: Free Direct: 1.50 ng/dl, range 0.82-1.77
T4: 8 ug/dl, range 4.5-12
Reverse T3: 272 pg/ml, range 90-350
T3: 116 pg/ml, range 7-180
Triiodothyronine, Free, Serum: 3.8 pg/ml, range 2.0-4.4

Progesterone: 0.6 ng/ml, range 0.2-1.4
Ferritin: 198 ng/ml, range 30-400
SHBG: 14.5 nmol/l, range 14.5-48

FSH: 2.8, range 1.5-12.4
LH: 5.3, range 1.7-8.6
ACTH Plasma: 17.8, range 7.2-63

In addition a few parts of the blood panel came back as low:
Platelets: 135, range 140-415
Creatinine: 0.68, range 0.76-1.27

Cortisol (AM): 17 ug/dl, range 6.2-19.4
For reference on my previous 24 hour Cortisol test my AM cortisol levels were at 0.38, with a range of 0.27-1.18. It’s a slightly different test.

Would it be fair to say that adrenals are fixed?

For reference, below are my Testosterone levels from 4 months ago:

Testosterone, Serum: 407 ng/dl, range 280-800
Testosterone, Free + Weakly Bound: 31.4%, range 9-46%
Testosterone, Free + Weakly Bound: 127.8 ng/dl, range 40-250
Estradiol, Sensitive: 10 pg/ml, range 3-70

34

what were you taking at the time of blood test?

what are your current symptoms/issues?

RT3 is slightly high. Ideal is 100-130 and 300+ is a serious problem. So at 272, you are very high.
why wouldn’t your doctor run Free T3? Total T3 doesn’t help much, but Total T3 does look lowish which ties with the highish RT3 which means we can assum FT3 is low as well.

Cortisol looks good which is weird given your earlier test three months ago.

Estradiol is very very low.

need more information…

35

Thanks Purechance,

I may have missed the Free T3. Is it the same thing as
Triiodothyronine, Free, Serum?
In which case, the results are: 3.8 pg/ml, range 2.0-4.4
I’ll edit my post above to include this information

At the time of the blood tests I made sure to fast beforehand, but I was on no prescription medicine. Other than vitamins I was taking these:
http://www.adrenalfatigue.org/adrenal-rebuilder-formula.html
http://www.adrenalfatigue.org/herbal-hpa.html

Yeah the cortisol thing is strange. For what it’s worth when the test was taken a few months ago I was about to buy a house and was pretty stressed at work. Since then I’ve given up on buying any property in this area and have stopped letting work bother me so much.

Symptoms are still very similar to before: low libido, fogginess, very slow recovery from exercise, word searching, memory problems, skinny everywhere but abdominal area.

The Estradiol sensitive is a different range than when I used Quest for my labs. Both times with Quest my Estradiol was at 32 and 42, with a range 13-54.

36

yeah, Free Triiodothyronine = Free T3 which looks great.

so your thyroid seems to be humming along, your cortisol seems to have bounced back.

your t is still on the low side (but may be just fine for your system), and your estrogen results are weird. I wonder if it an invalid test for some reason. Quest Sensitive at 32-42 says high. LabCorp Sensitive with 10 results both times says low.

could be something else entirely like low Vitamin D (most people are), low ferritin, low B12, etc.

37

Vitamin D has been great for a while now. My previous test had the results higher than the range.
The latest tests had Vitamin D at 70, with a range of 32-100
I normally take about 6,000 iu of Vitamin D in a day, also am taking a B-12 vitamin every day, among other things.

Ferritin was at 198, with a range of 30-400. Seems ok.

My Dihydrotestosterone was actually low: 23, with a range of 30-85. Is this maybe a good thing? I have a full head of hair (knock on wood).

So what next?

Maybe the Clomid challenge to see if that does anything? Otherwise I’m totally at a loss.

Thanks again PureChance for your input.