[quote]KSman wrote:
Energy drink: Do you feel a slump in energy at a particular time of day?[/quote]
I would have to say late afternoons. anywhere from 3-6pm. At these times i feel my lowest energy levels. Mornings i am usually great. Once i wake up i feel good. I usually cannot go back to sleep once i wake up. I start my day every morning at 6AM. Never feel to tired to get up.
To say that waking body temp is always an indicator of pure thyroid malfunctioning is absurd. You clearly need testosterone and should get some from your doctor in injection form. You should also monitor your E2 and SHBG and make sure the SHBG is low. Let’s just cut to the chase boys. Guys have kids on TRT still. Your kids would probably be healthier for it knowing that the DNA being encoded is no longer from a sluggish dude like we all are with 200 testosterone. Young guys left and right including myself have to get on T because the metabolism is basically genetically screwed…that is one reason…so insulin rises - opposes T etc… I wouldn’t worry about other hormones until you fix testosterone and then assess how you feel in a month on say 100mg/week without HCG. All HCG is going to do is produce more estrogen in your body. I apologize for my last derogatory post - my doctor has been screwing with my prescription and so I turn into a grumpy old man when I can’t get any. Luckily I have a new doctor who actually understands TRT. Be very cautious of putting your life in the hands of a doctor who has no idea what taking away testosterone or putting in too much of the wrong kind does to you.
I learned a lot today:
Insulin rises and opposes T, here I though that low T contributed to insulin resistance which then causes insulin levels to increase.
TRT alters ones DNA in their sperm, leading to genetically superior children, the TRT master race.
One can make sure that SHBG is low by monitoring it
hCG does nothing but produce estrogen, no other benefits
Waking body temp has nothing to do with thyroid status, when every other respected source states the opposite.
What is “pure thyroid malfunctioning”? How many kinds of thyroid malfunctions are are not pure?
CJ continues to be a cesspool of misinformation.
KSman,
Thx for the help. Is there a way i can test cortisol OTC?
You can order lots of blood labs [including cortisol] via LEF.com which uses labcorp. You can’t do 4 sample saliva tests from them [that I am aware of], but many sell that on the WWW. If doing a single test, you could do that at a time of the day when you typically feel run down. That might provide some good insight. Do testing on a typical stressful day, not a relaxed day off.
Good morning!
I will post my lab results before ym follow up summary.
TSH 3rd Generation 1.51 ( .40-4.50 )MIU/L
FSH 1.8 ( 1.6-8.0 )
LH 1.7 (1.5-9.3)
Prolactin 3.5 ( 2.0-18.0) ng/ml
Total Testosterone 211 (250-1100)
Free T 33.3 (35.0-155.0) pg/ml
Complete metobolic panel w/eGFR
Glucose 84 (65-99) mg/dL
Urea Nitrogen Bun 17 (7-25) mg/dL
Creatinine 0.88 (0.80-1.30) mg/dL
eGFR Non-AFR. American >60 (> or = 60) mL/min/1.73m2 ( Not sure what this was for?)
eGFR African American >60 (> or = 60) mL/min/1.73m2 ( Not sure what this was for?)
Sodium 139 (135-146) mmol/L
Potassium 4.0 (3.5-5.3) mmol/L
Chloride 99 (98-110) mmol/L
Carbon Dioxide 28 (21-33) mmol/L
Calcium 10.0 (8.6-10.2) mg/dL
Protein, total 8.1 (6.2-8.3) g/dL
Albumin 5.0 (3.6-5.1) g/dL
Globulin 3.1 (2.1-3.7) g/dL (Calc)
Albumin/Globulin ration 1.6 (1.0-2.1) (Calc)
Bilirubin, total 1.2 (.2-1.2) mg/dL
Alkaline Phosphatse 107 (-40-115) U/L
AST 32 (10-40) U/L
ALT 50 (9-60) U/L
Magnesium 2.1 (1.5-2.5) mg/dL
TSH, 3RD Generation 1.89 (.40-4.50) mIU/L
T4 (throxine), total 11.5 (4.5-12.5) mcg/dL
Free T4 index (T7) 3.5 (1.4-3.8)
T3 Uptake 30 (22-35%)
ACTH, plasma 20 (7-50) pg/mL
24 HR urine collection LC/MS/MS
Cortisol, Free, Urine 22.0 (4.0-50.0)mcg/24 H
Creatinine, Urine 1.73 (0.63-2.50) g/24 h
IFG I, ECL 340 (88-374) ng/mL
Iron and total iron
Binding capacity
iron total 70 (45-175) mcg/dL
iron binding capacity 411 (250-425) mcg/dL
% SATURATION 17% (20-50%)(calc) I asked the Dr. About this and she told me i need to talk to my PCP about this. which was werid… not sure why she even did the test
Estradiol 34 (13-54) pg/mL
Cortisol AM 15.3 reference range 8AM (7-9AM) Speciment: (4.0-22.0)
Ok now with that out of the way let me go over what the Endo told me. She told me that pretty much everything is normal…(Purechance you are a genius for predicting this LOL). She is now sending me for an MRI of the pituitary and sperm count (Per my request YAY she actually ALMOST listened to me HAH) The endo told me that my T levels could be MY Norm… i kept pressing her about the symptoms at this point and how is that suppose to be NORMAL… She ended up prescribing me AndroGel and to take four pumps and day and apply to the shoulders. When i asked her about HCG to maintain my fertility she said she didnt know anything about that and i should see a Fertility Specialist for that…(which i might actually do if i think they will give me the HCG). My next question to her was… When T levels rise dosnt E levels rise also? … Her simple answer… That is not your concern and that i shouldnt need to worry about that…
Anyway to make a LONG story short I took the scrip ( I dont think i will be using it )
I will be getting the MRI and sperm count. Once those are done i have found ANOTHER Endo through my local compounding pharmacy (Thanks to KSman) and i will be taking ALL my results there after i finish with all these tests…
Sorry for the long post, any feedback, help or suggestions would be GREATLY appreciated. Also i am sure i have left something out here but i cant figure out what… *(must be the brain fog)
sorry for the experience. 99% of us have been there and done that multiple times.
Don’t try to find an Endo - they are too much “in the box” thinkers. You need a good HRT doc one who knows about compounding pharmacies, T shots, estrogen control, thyroid regulation, cortisol-thyroid interaction, etc.
your cortisol looks good.
Thyroid seems a bit stressed - still need to get tested for Free T4 and Free T3 (not RT3 for now since your Cortisol level looks pretty decent).
Magnesium looks low. may want to start a supplement for that.
T is completely shut down with such low LH FSH numbers.
Estradiol is extremely high for such low T levels - very estrogen dominate. a short course of Arimidex might help keep you T around longer.
not sure what the iron test shows - need ferritin levels (male ideal around 150 I think).
Don’t wait for the tests to find a new doc. start now. It might take awhile to find one.
Yes, VERY estrogen dominant. Something is depressing LH, but it is not prolactin. So there will not be a prolactin producing adinoma
PureChance, did you misread something? “Magnesium 2.1 (1.5-2.5) mg/dL”
A hCG or SERM challenge followed by a TT/FT test would indicate if the testes are OK. With LH low for a long time, the challenge phase should be extended to allow for physical recovery of the testes before checking T levels. If that works, hCG could be used instead of T+hCG. Note standard warnings that high dose hCG or high LH levels from, by definition, too much of a SERM, can be harmful.
This might be an intractable case of secondary hypogonadism.
KSman thx for the suggestions. I definitly want to try the HCG combo with Armidex. Do you know anywhere i could get HCg or armidex from a good quality source?
My next thing i am going to do. I am scheduling an appointment with my pcp to check the iron issue and have him test Ferritin levels and possibly free t3 and t4 and E2 levels. Hopefully i can persuade him to do so.
My next step was. If i cannot find the HCG online or anywhere else i am going to schedule an appointment with the fertility Dr and show him my sperm count (havent taken yet). At that point i will try to get him to perscribe me HCG… however this would still leave me short of armidex…
if none of that works I have another Endo lined up who was recommened by my compounding pharmasist, i will schedule to see him and bring ALL my results.
Another thing… let me see if i am grasping this right. I apparently am very estrogen dominant. So for some reason my Estrogen is not getting converted to T and this is what i am trying to correct? So with HCG to help boost my Testes and Armidex to reduce Estrogen levels i might be able to restart normal production of T? if this is the case then this is very good news for me. I really appreciate the help guys.
We do not post sources here, for some good reasons.
E2 converts to T, not the other way around!!! hCG will do what your LH should be doing, everything after that is business as usual in most cases.
HPTA restart does not happen routinely. You can do the right things, then see what happens. A SERM challenge will indicate if there is any hope with the pituitary. If that works, then there are specific things to try.
according to the sticky i want my Estradiol levels to be around 15pg/mL? considering my age (25).
Follow up
Saw my GP regarding the Iron issue this morning. He is going to have my Ferritin checked. I tried to get him to check my free T 3 and free T 4, however he refused because according to my blood work everything else appears to be normal. I was able to get a copy of my blood work done on 7/17/10. These where taken at 11AM. I will be following up with him next week regarding the ferritin.
Vit D, 25-OH, 60 (30-100)ng/mL (I am currently taking 5,000UIâ??s a day of D3) (B4 was probably around2,000IUâ??s when this was taken)
B12 689 (200-1100)pg/mL
Next order of businessâ?¦ I tried to schedule an appointment with the fertility Dr., however they would not take me because me and my wife are not looking to conceive yet. They told me to schedule an appointment when we are ready to conceive. So that option is outâ?¦ I got the number to another fertility Dr (The only other one on my insurance) who also does Andrology… I saw another member mention a Urologist with a fellowship in Angrology… I wasnâ??t able to find any of them but I did find this. I will be giving them a call to see what I can do thereâ?¦ If anything
Had to cancel my MRI appointment due to the fact that my copay for that was around $420. Cant afford that at this time
After that point I called both Drâ??s that the Compounding pharmacy gave me and neither took my insurance. The copays for a visit was $200 each.(Not a bad price considering what I am going through) One of the Drs. they referred I checked out online and he did looked very promising. He was a Hormone Replacement Dr. Brian Yusem in FL. I would have to wait until I get my tax returns before I could see him though =/ â?¦. I will be prepared to bit the bullet and go it I have to.
My only other option at this point would be to try and find another urologist or Endo and get a second opinionâ?¦ Luckily specialists are pretty cheap with my insurance so this isnâ??t a problem. Other then that I am pretty depressed about this whole situationâ?¦ What a roller coasterâ?¦ keep running out of optionsâ?¦
what are your current symptoms?
what was your doctor’s advice on his treatment plan to address and eliminate those symptoms?
yes you are “normal” and “in range”… which is far from being optimal, plus with your initial symptoms all point to a thyroid issue.
I can’t find my source for “ideal” Magnesium levels, but I swear it was around 2.3-2.5.
Thx for the help Purechance. Let me kinda start over with a breif summery. of symptoms and such.
I went to the Dr origonally with little to no libido(THIS WAS THE MAIN COMPLAINT) also cronic fatigue (was tested for sleep Apnea and b12 but both where nromal), brain fog, unable to lose weight… GP test T… T was low sent me to Urologist…
Urologuist did some tests and pretty much said there was nothing he could do because i wanted to maintain my fertility. He refered me to Endo
Endo did more tests. Said everything looks normal aside from low T… Prescribed me Androgel for the low T however refered me to a fertility specialists (Who wont see me because we are not looking to conceive now) about what to do to “maintain” fertility. I am in the process of having a sperm count done this friday… However i do not beleive Androgel is the right treatment considering my numbers…
When she calls me with the follow up about my sperm count i will try and ask her about a HPTA restart…
This is kind of where i am…
low body temp = possible thyroid issue
inability to lose weight = possible thyroid issue
TSH > 1 = possible thyroid issue
hmmm, there seems to be a pattern here (in addition to your other symptoms and problems)
any chance you can talk with a compounding pharamcy and find a good Thyroid doctor (not an Endo)?
That would be a good idea. I will make the call tomorrow.
Couple updates…
The thyroid Drs referred by the compounding pharmacy are not covered by my insurance… I am getting used to this… LOL. They are extremely expensive… anywhere from 300-600$ per consult… Craziness… I was better off with the Hormone Dr for $200… I would like to see anyone of them but i just cannot afford that right now.
My Urologist who initially refused to treat me was able to refer me to good Fertility Dr thx to some pressure from my wife. This Fertility Dr does Andrology. So there is hope yet again. I will schedule the appointment as soon as they receive my referral
I found a great place where I can Buy Armidex 1MG tablets… And also Nolvadex… Not sure if I should get the 10mg or 20mg version. Anyway… I was planning on using these two products for a HPTA restart. Looking for additional feedback before I try this though.
Another update here.
I have found a place where i can get HCG however there are multiple choices between strength… its anywhere from 2,000 - 10,1000 IUs. Wonder which is best
at 10,000iu there is chance it could go bad before you can use the entire bottle (they last anywhere from 30-90 days depending on who you ask).
i still use the 10,000iu bottle since it is still cheaper, but throw ou what remains on day 80.
try other compounding pharmacies, or stopthethyroidmadness.com has a list of doctors (I think) - may be one in your area.
Purechance thx for the feedback. That is an excellent web site. I have a lot of reading to do there.
Couple Questions
Do I need to keep the HCG refrigerated?
Next… I am trying to figure out the difference between the following hcg brands and such. This is what i got
(fertigyn) 1 amp inj cheapest 2,000IUs
(fertigyn) 1 Ampoule reasonable 5,000IUs
(fertigyn)1 Vial Reasonable 10,000IUs
(Fertigyn) 10 amp inj ( expensive) 2000IU
What is the difference between Amp inj, vials and ampoulse? Very weird. Any help on this would be great.
I plan on doing the following protocol.
HCG 250IU SC EOD
1 MG Armidex per week (tablets i will be ordering come in 1MG tablets so i will try and break them into 4 each and does 4 times a week)
Hoping this will restart the testes and start to produce my own T. If not i have Androgel which i can start applying… Which due to my possible thyroid issue i am not sure if i can absorb.
I think I will try the HCG +Armidex for 2 months. Gets blood work done. Based on results my stop or add Androgel.
Other then that I am still waiting on the results of my sperm count and ferritin.