Bloodwork & TRT Cheatsheet

Pharma TRT
61

I can’t speak for Brick, but I haven’t noticed an increase in anxiety with Welbutrin (I’m currently on 300mg, was on 450mg but ran out of 150mg tabs that I had left over, I have a prescription for 3x 150mg/day but Walgreens is taking forever to fill it).

Benefits: somewhat elevated mood/reduced depression, slightly more stable mood (though I would never use it as a primary line of attack against a mood disorder like bipolar) noticeably increased energy, reduced or more controllable hunger, improved sexual function.

Detriments: slightly elevated heart rate (actually a benefit for me as I’m borderline brachycardic), possibly some increased anxiety in certain situations but it’s hard to attribute it directly to the Welbutrin. For the first two weeks I noticed a massive increase in sweating (particularly palms of my hands), but that returned to normal as I got used to the drug.

62

[quote]Akaji wrote:
I can’t speak for Brick, but I haven’t noticed an increase in anxiety with Welbutrin (I’m currently on 300mg, was on 450mg but ran out of 150mg tabs that I had left over, I have a prescription for 3x 150mg/day but Walgreens is taking forever to fill it).

Benefits: somewhat elevated mood/reduced depression, slightly more stable mood (though I would never use it as a primary line of attack against a mood disorder like bipolar) noticeably increased energy, reduced or more controllable hunger, improved sexual function.

Detriments: slightly elevated heart rate (actually a benefit for me as I’m borderline brachycardic), possibly some increased anxiety in certain situations but it’s hard to attribute it directly to the Welbutrin. For the first two weeks I noticed a massive increase in sweating (particularly palms of my hands), but that returned to normal as I got used to the drug.[/quote]

Please, please, please do not confuse me with Brick!!!

I agree with your assessments for the most part…I think it is good for those that are slightly depressed but that’s all I can speak to, since that was the extent of my “depression”…and it was very slight…

Truthfully, I didn’t notice any of those side effects…maybe excess sweating, but I sweat a ton anyway and it was a very hot summer here in DC, plus I was on Cortef at the same time and could attribute it to that just the same…

I used it basically as a stop gap to improve mood while my other hormones were being restored, and had intended it all along as a short term measure…it was very good for that…

I seem to remember an increase in libido when I started it, but that seemed transient…you may be able to find more info about it in my thread here, as I’m sure I talked about it at some point…

I would say the most noticeable benefit was that it opened my eyes to the fact that I was slightly depressed before taking it! It was something that I was not in tune with before I saw the other side of the fence, so to speak…now that I remmeber what that elevated mood and life outlook feels like, I think I can continue on without it in the future…but I attribute it to getting me to that point…

63

[quote]VTBalla34 wrote:
maybe excess sweating, but I sweat a ton anyway [/quote]

VT - I can’t remember. Did you ever try the sea salt test (or get your Aldosterone levels checked)?

[quote]PureChance wrote:

Yes. I had the same thing. With low E2 readings as well. I couldn’t figure it out until I stumbled onto some information about Aldosterone. Aldosterone controls your sodium/electrolyte balance. If it is ‘off’ then you can have water retention, excessive sweating, excessive urination, absorbing water in the skin during showers etc then exuding it afterwards, higher blood pressure, higher heart rate (or palpitations), etc.

You may need to increase your sea salt intake to 1-3 teaspoons daily. Not with food, just water.

You can test Aldosterone in a blood test or you can try a couple of easy tests to see if you are out of balance:

  1. just toss 1/2 teaspoon of coarse (coarse = less taste) sea salt to the back of the throat followed by a full glass of water. wait 30 minutes and see if you notice any difference in mood, energy, etc.

  2. the pupil test per stopthethyroidmadness: This is called the Pupil test and primarily tests your levels of aldosterone, another adrenal hormone. You need to be in a darkened room with a mirror. From the side (not the front), shine a bright light like a flashlight or penlight towards your pupils and hold it for about a minute. Carefully observe the pupil. With healthy adrenals (and specifically, healthy levels of aldosterone), your pupils will constrict, and will stay small the entire time you shine the light from the side. In adrenal fatigue, the pupil will get small, but within 30 seconds, it will soon enlarge again or obviously flutter in itâ??s attempt to stay constricted. Why does this occur? Because adrenal insufficiency can also result in low aldosterone, which causes a lack of proper amounts of sodium and an abundance of potassium. This imbalance causes the sphincter muscles of your eye to be weak and to dilate in response to light.

  3. Or check out these sites for more sodium references:
    thyroid-rt3.com - This website is for sale! - thyroid rt3 Resources and Information.
    thyroid-rt3.com - This website is for sale! - thyroid rt3 Resources and Information.
    thyroid-rt3.com - This website is for sale! - thyroid rt3 Resources and Information. [/quote]

64

i filled my script for wellbutrin today.

it’s been a long road to getting my hormones in balance, and I did so in an extremely less-than-optimum fashion, tho it seems like most of us do. it’s still a work in progress.

because i found it more and more difficult to cope, i recently went back on the trusty ssri and found almost immediate resolution of some stuff, fogginess, depression, etc.

i think sometimes there will always be a need for brain health support in spite of even perfect hormones, and i am hoping wellbutrin can be taht bridge if there needs to be one.

65

[quote]PureChance wrote:

VT - I can’t remember. Did you ever try the sea salt test (or get your Aldosterone levels checked)?

[/quote]

I had my aldosterone levels checked as part of my first round of blood tests in June, and it was fine…19 ng/dL

Though I did do the pupil test at one point and my pupil seemed to flutter a bit…this was when I was still feeling the affects of adrenal fatigue even though I was on 10 mg/day of HC

Never tried the salt test, but I will give it a shot just for shits n giggles…though I really think I just sweat a lot cause I’m 285 lbs and train my ass off…

66

Neely: I feel you man…I hope you get that straightened out…

I agree that hormones aren’t the end of the story, even though they play a huge part…but some just need that extra help to get them over the hump…

67

Oops, sorry dude. You’re all the same crazy whackjobs to me (I kid, I kid! :slight_smile: )

Anyway - my experience with anti-depressants (and I have a looong history with them, I’ve been on one or the other pretty much since I was 13 years old) is that Welbutrin has by far the weakest side effects. It does have some seizure potential (up to 2% of patients @ 600 mg/day), but other than that the side effects are extremely mild. For effects, it sucks as a mood stabilizer, but works great as a mood stimulant (lifts your ‘average’ mood).

The way I see it, at least how it affects me, is this: imagine your mood like a sine wave (i.e. this: http://musikality.net/wp-content/uploads/2009/01/sine_wave.gif ). SSRIs and SNRIs reduce the amplitude, i.e. it makes the lows higher and the highs lower. Welbutrin increases the coefficient, i.e. it makes the baseline (average) higher. SSRIs and SNRIs are very important if your lows drop you in to the “so depressed I want to lay down and die” region, but I feel that Welbutrin is a better drug for people who generally feel just a bit down all the time (see: Dysthymia Dysthymia - Wikipedia ).

68

[quote]PureChance wrote:

You can test Aldosterone in a blood test or you can try a couple of easy tests to see if you are out of balance:

  1. just toss 1/2 teaspoon of coarse (coarse = less taste) sea salt to the back of the throat followed by a full glass of water. wait 30 minutes and see if you notice any difference in mood, energy, etc.
    [/quote]

I was having some brain fog tonight so I decided to give this a try and see what happened…1 hour later and no difference at all, feel exactly the same, only now im thirstier from the salt…it was rather unpleasant and I think I can conclusively say that there doesn’t appear to be any aldosterone issues…

69

yeah, it’s not that much fun… others mix their salt into the water, but I can’t stand that. just like drinking from the gulf.

it’s a quick easy test and glad to know that aldosterone problems don’t seem to be an issue for you.

70

[quote]PureChance wrote:
yeah, it’s not that much fun… others mix their salt into the water, but I can’t stand that. just like drinking from the gulf.

it’s a quick easy test and glad to know that aldosterone problems don’t seem to be an issue for you.[/quote]

You didn’t tell me I could mix it first, you cheeky bastard…some HR skills…

71

trust me… mixing it is worse… go ahead and try it if you don’t believe me.

72

I went and got a blood test today at the Pentagon…they run a free program for military called Fit To Win, and will do lipids tests, VO2 max, posture analysis, Bod Pod bodyfat tests, etc. It’s a pretty sweet deal…

My cholesterol values have always been a little on the bad side, but I pretty much attributed this to my hormone imbalance…I was hoping that since I am feeling a whole lot better right now on the pregnenolone and other support supplements that it would show a marked improvement in my lipids…instead, they were the worst they’ve ever been.

(all in mg/dL)
Total Cholesterol: 220 (<200)
LDL: 144 (<100)
HDL: 31 (>40)
Total/HDL Ratio: 7.1
Triglycerides: 226 (<150)
Glucose: 102 (<100)

Am I going to die soon?

73

Probably not. Look into options for lowering LDL/triglycerides and glucose.

Atorvastatin is an option: Atorvastatin - Wikipedia (see: clinical use, indication #1 for reduction of LDL and triglycerides with an increase in HDL)

Your glucose is elevated, but that lab range is a warning – if you’re above 100, it’s a possible sign of pre-diabetes. It by no means guarantees that you’ll end up with diabetes, especially if you take precautions.

Useful wiki articles for elevated glucose:

74

Thanks for the link, but I am strongly anti-med for reducing cholesterol…I don’t think that shit is natural, and I am a firm believer that all cholesterol problems are directly associated with other problems going on in the body…and if those are corrected, the lipids will take care of themselves…

The LDL is what is pissing me off the most…I was hoping now that I’m getting pregnenolone in my body, my body would wake up and start synthesizing preg directly from my own LDL stores…this doesn’t appear to be happening…and I have no idea why…maybe the supplemental preg is inhibiting this for now??

Its weird because I’m feeling better right now than I have in years…busting PRs nearly every time I step into the gym…being assertive with people…kicking ass at work…feeling a bit better sexually…just riding high right now man…damn this stuff is complicated

75

Niacin is good at lowering LDL and raising HDL. The no burn stuff doesn’t work, but the slow release stuff deos (or so I hear).

ACTH (and possibly LH/FSH to some extent for some) is the signal for the body to convert LDL to pregnenolone. issues with cortisol or external T supplements may suppress this function.

76

Pregnenolone is created in the mitochondria. As ACTH increases cortisol and that increases cellular metabolism, the relationship does hold, but perhaps as a secondary effect.

Mitochondrial function [MF] decreases with age, accumulated oxidative stress as the mitochondria stew in the free radicals that they produce. This is where ones long term use of antioxidants is critical. So a decline in pregnenolone is expected and is to then be expected to be a strong contributor to the age related decline in DHEA. Stating drugs reduce CoQ10 which damages mitochondria. Supplementing with CoQ10 is both preventative and restorative. Degraded cellular wall permeability also reduces MF. Fish oil and other EFAs support cellular wall permeability. Acetyl-L-carnitine and lipoic acid can also improve MF. In this regard, one can consider health at the cellular level to be the root of heath. You cannot be healthier than your cells. Much is known about all of these issues and a comprehensive supplement plan, and diet changes can be very useful. This may be inspiring, but is only the tip of the ice berg.

Edit:

See this link for things that deplete CoQ10, more than statin drugs. One needs to be aware of these things, if not for themselves, perhaps for others they care about.

77

VT,

I believe you are looking in the wrong place for the answers to the dyslipidemia. Cholesterol levels are more likely to affect downstream products such as the sTAR induced conversion of cholesterol into pregnenolone than the other way around. Websites like stopthethyroidmadness are incredibly inaccurate and in my medical opinion misinformation at best, extremely harmful at worst. If you would hear me out I do have a suggestion. You mentioned earlier in this thread that you are 285… medication and hormonal issues are not what is going on here. You mentioned your McDonalds habit earlier as well… The diet CONTENT is not the problem (studies confirm this relatively well although I’m sure you’re aware of the controversy of that statement) but the QUANTITY is at least contributable. All I mean to say is that if you were to loose about 30 lbs or so I could virtually guarantee that your lipid numbers would improve. You do not display the pattern of congenital dyslipidemia (at least none of the major lipoB phenotypes) and are lucky in that you actually have a good chance of permanently solving this problem with a reduction in bodyweight.

And let me emphasize before the discussion is derailed on a point I’m not making: eat whatever you want i.e. McDonalds, donuts, (twinkies…wink, wink) so long as you lose weight. Your numbers will improve. And I can guess that your weight has been fairly stable over the last several lab draws in which your cholesterol has come back fine…then a little worse…little better/worse…and then this leading one to think that the weight is not to blame since it was consistent and the lab values varied. This is a common pattern and is indicative of a self induced metabolic disease i.e being slightly overweight.

Please do not misread this as an indictment of laziness, etc. EliteFTS is full of very successful PL’s with crappy health because of their overall weight regardless of what they consider a solubrious diet.

78

[quote]VTBalla34 wrote:
Thanks for the link, but I am strongly anti-med for reducing cholesterol…I don’t think that shit is natural, and I am a firm believer that all cholesterol problems are directly associated with other problems going on in the body…and if those are corrected, the lipids will take care of themselves…

The LDL is what is pissing me off the most…I was hoping now that I’m getting pregnenolone in my body, my body would wake up and start synthesizing preg directly from my own LDL stores…this doesn’t appear to be happening…and I have no idea why…maybe the supplemental preg is inhibiting this for now??

Its weird because I’m feeling better right now than I have in years…busting PRs nearly every time I step into the gym…being assertive with people…kicking ass at work…feeling a bit better sexually…just riding high right now man…damn this stuff is complicated[/quote]

LDL are not a true indicator of CVD but rather good levels triglycerides and HDL are.
So do not sweat it. Dhea can cause LDL to drop. On your next blood test we will go over options to deal with this. If you are adex this can screw with your lipids as well.

79

Could you please expand on this point, or direct me to a post where you have previously? I’d appreciate an IM about it if you don’t want to post it openly - as we’re both aware, you’re probably going to be flamed (regardless of the veracity of your statement) for stating that. I’m not asking for the purpose of discounting you; I’d like more information as I go forward with seeking treatment, and considering I exhibit pretty much all of the symptoms popularly attributed to hypothyroidism, I could use as much thyroid info from as many sources as possible.

While this is certainly often true, it is not always true. I am morbidly obese and my cholesterol levels are far too low. Also, I get the feeling that VT’s weight is largely muscle, as he’s 6’ 5" and trains constantly.

80

I swear that Akaji is a long lost twin at times. several times when I am about to post a question or statement, he seems to beat me to it.

Tyson - I have the exact same question. can you please tell me what on STTM is inaccurate or malpractice? From what I can tell they are one of the few sites that seems to have their act together, and I have learned a lot from their main site and advice, and I direct people there all the time. I am always interested in other people’s point of view and would really like to know if there is something obvious that I am overlooking.