Got a call from the doc’s office today. The 24 hr urine sample came back positive for elevated cortisol. Doc ordered an Overnight Dexamethasone Suppression Test for tomorrow night.
Any thoughts on what results we should expect if long term caloric restriction/ overtraining is to blame for the elevated cortisol?
I received my Iodoral in the mail, so I will begin IR protocol. My waking temps have consistently in the 96.6 range.
The suppression test came back negative for Crushings. The the doc is ready to begin discussion of T-replacement. I’m going to initiate the conversation by bringing up a SERM restart option.
Any thoughts from the peanut gallery?
ALT, AST are high range. What drugs are you using, OTC and Rx? Liver is stressed. SHBG is made in the liver. Probably some relationship there. Exposure to chemicals or fumes?
TSH is high.
fT3 is a little below mid range
Read the thyroid basics sticky and come back with history of iodine intake from using iodized salt.
Post waking and mid afternoon [not mid day] oral body temperatures. Please list in C and F degrees.
You state that you are sensitive to cold. Could be from low weight or hypothyroidism.
Please explain:
“”"
Had my first lab work done in 2012. Followed up with an endo, and after TT showing a positive response to weight gain in mid 2012, I thought we had found the culprit. 1 year later, and I’m still struggling with all the same symptoms, and have updated labs showing low t.
“”"
[quote]KSman wrote:
ALT, AST are high range. What drugs are you using, OTC and Rx? Liver is stressed. SHBG is made in the liver. Probably some relationship there. Exposure to chemicals or fumes?
TSH is high.
fT3 is a little below mid range
Read the thyroid basics sticky and come back with history of iodine intake from using iodized salt.
Post waking and mid afternoon [not mid day] oral body temperatures. Please list in C and F degrees.
You state that you are sensitive to cold. Could be from low weight or hypothyroidism.
Please explain:
“”"
Had my first lab work done in 2012. Followed up with an endo, and after TT showing a positive response to weight gain in mid 2012, I thought we had found the culprit. 1 year later, and I’m still struggling with all the same symptoms, and have updated labs showing low t.
“”"
[/quote]
I do not take any medications, and am not regularly exposed to chemicals or fumes. Supplements include fish oil, multi vitamin, Vit D3. Would my elevated liver markers be attributed strength training? http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2125.2007.03001.x/full
I started IR 8 days ago (25mg Iodoral per day) after finding waking temps avg 96.5/35.8 and mid-afternoon avg 97/36.1. Previous iodized salt intake was deficient due to use of sea salt. I will report back on changes in body temps once I get enough data.
‘’’
When I began reverse dieting, and packing on 10-15 lbs my endo ran blood tests. Total testosterone came back at 739 ng/dL, which was up from 273 ng/dL. Free T remained low, but the doc advised to maintain my weight and monitor my symptoms. A year later sitting at the same weight, my lack of energy, low labido, ED are still present.
I have an appt with my new endo on Friday to discuss next steps. So far I plan to inquire about the following:
*Is a cortisol saliva test in order to better understand time of elevated readings.
*Do we need to address the elevated cortisol before we address low t?
*Is Thyroid contributing to low t? Low body temps.
*Try a SERM restart?
Thanks KSman!
Scheduled a semen analysis for next week. Will also be testing salivary cortisol levels.
The doc will be touching base with a local fertility specialist to discuss SERM and HCG protocols.
My body temps haven’t responded to two weeks of IR (325 mg). I plan on stopping supplementation, as I don’t want to risk any negative implications. Today’s waking temp was still 96.5. Yesterday’s afternoon temp was 98.1.
Low cholesterol and/or very low fat diets can kill hormones.
We do see some depression of T levels with thyroid problems. Severity varies a lot.
TRT on top of thyroid and/or low cortisol can make some feel worse as body is not able to meet the restored metabolic demands from the TRT.
Did you read my “ksman has a thyroid problem” thread?
[quote]KSman wrote:
Low cholesterol and/or very low fat diets can kill hormones.
We do see some depression of T levels with thyroid problems. Severity varies a lot.
TRT on top of thyroid and/or low cortisol can make some feel worse as body is not able to meet the restored metabolic demands from the TRT.
Did you read my “ksman has a thyroid problem” thread?
[/quote]
Im haven’t been on a low fat diet in over a year. I eat eggs and meat daily.
The endo stated my thyroid labs were ‘very boring’ showing no concerns with the results. Unless I have something specific to request, I don’t know what to pursue in regard to a thyroid disorder being the cause of my low t?
We’ve already shown cortisol is in the high range, and am scheduled to take night time saliva readings soon.
Again, Iodoral didn’t improve any symptoms or increase body temps, so I’m cutting it out for now.
Today I start 25mg Clomid ED. This appears to be the max recommended dosage on the forums. Do you guys think I should dose lower or dose EOD? I’ll probably just run as prescribed, keep an eye on sides, and get blood work in 4 weeks.
How do you guys cut 50mg pills in half or quarters with any kind of accuracy/consistency?
Almost forgot. What labs do I test on clomid mono after 4 weeks? I’m thinking:
LH
FSH
TT
FT
E2?
SHBG?
You need to address the thyroid…
With high cortisol you should test rt3 I believe this is going to be a factor in your case
Tsh,ft3,ft4,tgab,tpo,tsi
And yes those labs should be good enough for clomid
Personally I would test after a few weeks and if lh and fsh are to high drop the dose.
u can use a pill cutter yes or you can dissolve the pill in vodka and maybe divide the dose with a dropper. Guys do this for AI dosing also so why wouldn’t it work with clomid 
[quote]iw84aces wrote:
You need to address the thyroid…
With high cortisol you should test rt3 I believe this is going to be a factor in your case
Tsh,ft3,ft4,tgab,tpo,tsi
And yes those labs should be good enough for clomid
Personally I would test after a few weeks and if lh and fsh are to high drop the dose.
u can use a pill cutter yes or you can dissolve the pill in vodka and maybe divide the dose with a dropper. Guys do this for AI dosing also so why wouldn’t it work with clomid :)[/quote]
I’ll try to get additional thyroid testing, although none of the docs I’ve seen have any concerns with the previous results.
I’ll report back after 4 weeks at 25mg daily.
Here is updated lab work after 32 days on 25mg clomid/day:
ALT 26 U/L [<45]
SHBG 61.5 nmol/L [14.5-48.4]
LH 11.3 mIU/mL [1.7-8.6]
FSH 14.3 mIU/mL [1.5-12.4]
TT 945 ng/dL [348-1197]
FT 18.1 pg/mL [8.7-25.1]
So my pituitary and testicles have clearly had a robust response to the clomid. Symptoms (fatigue, brain fog, low labido, ED) are showing some improvement, but nothing drastic. I’ve had no noticeable sides from the clomid.
Moving forward the doc ordered me to maintain the dosage at 25mg/ day, but I’m choosing to drop the dose down to 12.5mg/day since my LH and FSH were high. I’m scheduled to retest in December, and go from there. Maybe use this as a restart attempt or consider HCG mono?
What is your guys opinion? I know there are no Thyroid or E2 lab updates, but the doc didn’t call for the tests. Should I be concerned about the elevated SHBG? What can be done about it?
Thanks for taking a look.
You have two contributing factors to high shbg…
One is the thyroid which needs to be addressed as states
Two is the liver which ksman had mentioned earlier.
What steps have you taken in regard to these!?
I’m going to guess e2 is still a problem and can’t understand why we are checking shbg and not e2?
Good choice to lower the dose a bit!!
What’s up with the white blood cells? <<< doctor says what?
From what I see you have adrenal issues and need to fix that and everything else may follow suit… Trt may not feel good for you… I doubt you feel much of anything on the clomid.
[quote]iw84aces wrote:
You have two contributing factors to high shbg…
One is the thyroid which needs to be addressed as states
Two is the liver which ksman had mentioned earlier.
What steps have you taken in regard to these!?
I’m going to guess e2 is still a problem and can’t understand why we are checking shbg and not e2?
Good choice to lower the dose a bit!!
What’s up with the white blood cells? <<< doctor says what?
From what I see you have adrenal fatigue and need to fix that and everything else may follow suit… Trt may not feel good for you… I doubt you feel much of anything on the clomid.
[/quote]
My endo doesn’t agree that there is anything wrong with my thyroid or liver function. What definitive evidence can I use to convince him otherwise? Could my SHBG is still elevated from my long term calorie restriction? Doc seems to thing this may also play into why my thyroid is a bit sluggish.
E2 has never been a problem per say. I did request he check it, but again was overruled. I may go and do my own testing out of pocket on this one.
Once WBC came back into the normal range, we moved on. So no diagnosis there.
E2 was too low… Did you have joint pain or do you?
Western medicine is not in the business of optimal health and your endo is and idiot…
Ask the endo why shbg is high!! Shbg doesn’t lower thyroid function… Thyroid function affects shbg!! He is copping out…
Have you considered getting away from traditional medicine and going to a wellness centre?!
You have multiple issues and need to heal your body as a whole… This will take a lot of effort and determination but I believe is possible.
4 WBC tests low and one normal and we move on lol… This is why doctors are truly idiots…
Anyways I’m beat man… Good night and good luck with doctors…
Take some advice and become your own doctor… Educate and in lighten yourself to new things
I personally agree with IW 100% here. Your thyroid problems are a real issue. Natural dessicated thyroid will do the trick, you buy it over the internet if you find the right places … I found some that’s exactly the same as Armour thyroid, but by a company that does not claim medical benefits are allowed to sell the same product as a dietary supplement. I don’t want to post the website on here.
You NEED to see either a naturopath or a holistic GP so that they can get you on the right vitamins and minerals you need to get you back on track. In that period of losing all that weight, not only did you put massive strain on your body, you had eaten next to no amount of nutrients in your body due to calorie constriction. You would probably have a variety of vitamin and mineral deficiencies that are manifesting themselves. I can guarantee that mainstream medicine have no idea what the fuck they are doing with guys like us because they are not trained to do so. They are trained to treat disease and that’s it.
I do know that eurycoma longifloria decreases SHBG.
Dessicated thyroid will bring your TSH down, bring your fT4 and especially fT3 way up. If rT3 is high-very high then you’d probably have to go on only T3 medication for a while.
People don’t know how badly vitamin and mineral deficiencies can manifest themselves in ill health. Along with all the chemicals and oxidative stress put on a body, I am tempted to recommend everyone to go on n acetyl cysteine and astaxathine to remove all the toxins out fo your body and help your body rejuvenate, however I am not a professional so I do not know.
Educate yourself on whole body treatment and don’t take simplifications to your body. It’s a incredibly complex system of functions and many subtle changes can sometimes manifest themselves in debilitation.
New labs:
TSH 1.9 [.45-4.5]
fT4 1.07 [.82-1.77]
fT3 2.7 [2.0-4.4]
rT3 10.1 [9.2-24.1]
TT 1383 [348-1197]
LH 18.4 [1.7-8.6]
FSH 20.8 [1.5-12.4]
E2 73.2 [7.6-42.6]
We clearly need to cut back the 25mg/day clomid (ended up not adjusting dose after last lab). I’m still not sure if E2 testing while on clomid is a valid test or not.
So rT3 isn’t an issue, so not sure where to go with the thyroid investigation. Would I benefit from seeing a specialist with those thyroid labs?
Appointment with my endo next Monday. I’m going to request we taper off clomid and see where my natural levels go. Is an AI required to taper off a SERM to avoid estrogen rebound? I’d bet money my endo won’t think so. If I need it I’ll get some research anastrozole on order.