[quote]KSman wrote:
He is making some T now, so testes are working to some extent. If fertile now, hCG should maintain that sufficiently. But we really need LH/FSH numbers to know what the story is.[/quote]
I feel obliged to state that my already low sperm count went from 11 million with no therapy to less than 1 million on T/hCG/AI
While that may not be typical, if one already is testing sperm counts, one may have to involve low dose nolvadex or add HMG.
Alright…got the blood tests back. Saliva cortisol isn’t in yet.
I’ll recap some stuff. Chief complaint is fatigue (especially in afternoons/evenings - zombie like). Other complaints are irritability, mild depression at times, horrible memory, lowered libido (ok in morning - non existant at night). 34 years old, ~16% bf, 6’, 215 lbs. Lost 25 lbs last spring working on crohns disease/adrenal fatigue/insulin sensitivity), waist size 34 (was 38-40). Carry all my fat in chest and abdomen. Arms and legs are lean.
Fasted Test at 6:30 a.m. this week
Total T4 7.1 (4.5-12.0 ug/dL)
Free Thyroxine Index 2.6 (1.2-4.9)
Free T4 .93 (.7-1.53 ng/dL)
FSH 11.1 (1.5-12.4 mIU/mL)
T3 Uptake 37 (24-39%)
T3 Free 4.0 (2.0-4.4 pg/mL)
Total T3 132 (71-180 ng/dL)
SHBG 49.2 (14.5-48.4 nmol/L) ***outside range
Progesterone .8 (.2-1.4 ng/mL)
Prolactin 7.7 (4-15.2 ng/mL)
Testosterone Total Serum 612 (280-800 ng/dL)
% Free T 13.0 (9.0-46.0%)
T F+W Bound 79.6 (40.0-250.0 ng/dL)
TSH 1.82 (.35 - 5.50 uIU/mL)
Vitamin B12 788 (211-911 pg/mL)
Ferritin 90 (5-244 ng/mL)
PSA 0.17 (0.00-4.00 ng/mL)
E2 47 (11.6 - 41.2 pg/mL) ***outside range
Blood Work (6 months ago)
CRP .2 (0-.9 mg/dL)
TSH 2.19 (.35-5.5 uIU/mL)
Vit D 60.9 (32-100 ng/mL) - After supplementing 5000iu and being in sun b/t 2-5 hour previous 2 weeks.
Blood Work (11 months ago)
Vit D 37 ng/mL (20-100)
TSH 1.93 mIU/L (.4 - 4.5)
Testosterone 68 pg/mL (35-155)
Testosterone Total 407 ng/dL (250-1100)
Test Free 1.67% (1.5-2.2)
Saliva Cortisol Test (4 times - morning/noon/afternoon/night) (Tested 10 months ago)
Morning 26 nM(13-24)
Noon 8.4(5-8)
Afternoon 5.5(4-7)
Nighttime 2 (1-3)
SUM 38.2(23.0-42.0)
DHEA-S Avg 2.81 (2-10)
Cortisol to DHEA-S Ratio 13.6 (5-6)
Testosterone A.M. 47.7 pg/ml (40-130)
Salivary Progesterone 113 pg/ml (5-100)
Salivary Estradiol 2.4 pg/ml (1-3)
Salivary Estriol 1.9 pg/ml (.5-3)
Need to know what you guys recommend. My Dr. had agreed to start TRT. I’m afraid after he sees the new T number he may not? He was pretty much up for whatever I wanted to do (gel, cream, etc), didn’t discuss the other stuff, hCG, AI, etc. Wondering why my T number went up? I’m assuming it was due to adrenal protocol, healing gut, losing weight, testing in the morning, etc. Why is my E2 number so high? The DHEA I’m taking converting the wrong way? Let me know what you think. Thanks.
In general, E2 can be up from liver conditions or drugs [or other substances] that load up liver enzyme pathways that remove estrogens from your blood stream. What drugs with crohn’s disease?
What other blood count numbers? RBC? Hematocrit?
Ferritin can be a concern, I will let the thyroid guys comment.
Thyroid profile looks odd. Need you waking body temps.
Anastrozole might be useful in your current state.
Does a sweet drink or carbs pick you up during your afternoon slump? Caffeine?
Fat on torso and lean limbs. Are limbs thin and body round? Have you been taking cortisol or prednisone? Any drugs that you were taking that you are not taking now.
When did these problems start and what other health issues or events in the time frame when this all started?
any ache in your testes now or ever? Pain during a fever?
Crohn’s started around 5 years ago. Ok…for the Crohn’s drugs. Have been on Pentasa (mesalamine) since it started. Last flare-up (last february) doctor put me on Pentasa, prednisone, imuran (azathioprine), and flagyl (metronidazole) to calm it down. This lasted about 2 monts. GI felt best on prednisone, but it fucked me up big time…torn gastroc, torn labrum, wrist injury in one month on it. Tapered off as soon as i could. Dr. now has me on Remicade (infliximab) infusions.
Other blood numbers - Not sure on the latest test if he ordered them or if they aren’t in yet. Can’t remember on the orders. Here are the results from the previous lab work. This was done on orders from GI Dr prior to the remicade. The results may be off due to not fasted and a workout prior to going in.
WBC 5.9 (4-10.5 K/MM3)
RBC 4.49 (4.7-6)
Hemoglobin 13.2 (13.8-17.2 GM/dl)
Hematocrit 39.7 (42-52%)
MCV 88.4 (78-100 fl)
MCH 29.3 (27-31 pg)
MCHC 33.2 (32-36 g/dL)
RDW-SD 43.4 (35.1-43.9 fL)
RDW 13.5 (11.5-14.5%)
I’ll redo some waking temps…but I’ve tried it in the past and they are usually pretty low. Although (not sure if it matters) I sleep in a very cold room.
Try to stay away from caffeine and rarely have it in the afternoon so can’t comment. Don’t do well with sugars/carbs, make me feel like crap and make me fat. Do best on a very low carb diet. Have very strong sugar cravings though.
Never taken cortisol and took prednisone for around a month last spring. Not sure if I’ve taken it in the past but probably have (poor memory…haha).
I would say these health problems started maybe 10 years ago or so.
Never had any aches in the testes or pain during a fever.
Your blood is thin. Consistent with Ferritin=90. Low iron can reduce the effect of thyroid hormones. Blood loss from Crohn’s is a possibility. Higher free and weakly bound T levels would help with your blood. You may be iron deficient. Have you been using probiotics?
It would be good to have current CBC numbers.
Yes, I have been using probiotics.
KSman,
Yes…my limbs are fairly thin. Small ankles and wrists for my size.
Waking body temp today was 96.06 on one of those pharmacy digital thermometers. This is consistent with when I’ve measured in the past. Very low in the morning (not sure if it matters, but like it very cold when I sleep). Thanks
What does it/can it mean that my SHBG is high? Is this an issue/problem?
What do you think the next step is for me? The Dr. was going to write a script for trt, but I was going to get back to him early this week on what I wanted (told him needed to look deeper into it).
Thanks for the help.
Are you on TRT yet?
No.
You need to address the iron issue and it is not normal for males to have low iron, which brings us back to blood loss from the gut. Your higher TSH and fT3 is not normal. That suggests testing for rT3. Low body temps also suggest that possibility. If tT3 is the problem, that can be caused by low cortisol. However, cortisol profile and numbers do look very good and can be assumed to not be a cause of elevated rT3.
Your TT and FT do not seem low enough to be a primary cause of thin blood. So again, the low iron and suspected blood loss is a focal point.
Confirm that the thermometer does reach 98.6 for you or someone else during the day.
Drop the saliva tests and do everything with serum testing as that is where the body of knowledge is.
I’ll have to go back to the lab and check my results again. Pretty sure the Dr ordered the reverse T3…must not have had all the results in when I picked them up.
I checked my two thermometers over lunch hour a few different times and got readings between 96.8 and 97.7.
Went to the lab…they messed up. Tested progesterone instead of pregnenelone and didn’t do the reverse t3, both of which were ordered. Got those re-tested while there…will have results in a few days.
got my reverse t3 number back:
rt3 225 (90-350 pg/mL)
Morning temps are low, but so are afternoon and night temps. Haven’t had a reading over 97.5 or something like that (in the afternoon/night). Just using an older cheap digital thermometer from the pharmacy. Probably need to look at a better one.
I am not sure… your TSH is high, and your body temp is low which says you have a Thyroid problem but your detaild results don’t look bad??
check out these sites for some more information. I may be missing something in what you have already posted.
Latest Cortisol Saliva Test:
Cortisol
Morning 5.5 (13.0-24.0 nM)
Noon 5.0 (5-8 nM)
Afternoon 1.6 (4-7 nM)
Nightime 2.1 (1-3 nM)
Cortisol Sum 14.2 (23-42)
DHEA-S Average 1.7 ng/ml (2-10)
Total Cortisol / DHEA-S Ratio 8.4 (5-6)
Estrone .6 (1-3 PG/ML)
Estradiol 1.1 (1-3 PG/ML)
Estriol .6 (.5-3 pg/ml)
Progesterone 53 (5-100)
Testosterone (am) 33.0 (40-130 pg/ml)
Melatonin (pm) 18.7 (12-23 pg/ml)
so you see that you have a serious cortisol problem? one that needs to be fixed right away.
check out - How Adrenals Can Wreak Havoc - Stop The Thyroid Madness
Ya…been working on it for some time now. Not sure what the deal is?
working on it? as in taking hydrocortisone (starting at 5mg and then increasing to 20-30mg spaced out daily)to ensure that you don’t die? Cortisol is one of those things that is critical for survival. I have not heard of any supplements that have helped anyone overcome cortisol insufficiency. Personally, I would be scared #$@^less to have a 8am number that low.
did you read the STTM site about adrenals/cortisol?