Was hoping the text, and lab pages would be ordered better. Sorry…
TT is OK. Many have FT over range and doing well. We do know that TRT can be a stress factor when other parts of the body are not up to the metabolic rates that come with TRT [normal youthful levels].
Your TSH levels over time seem to show your stopping iodine supplements. What is your iodine maintenance intake? Iodized salt? Vitamins that list iodine AND selenium? fT4 was a little low.
Vit-K1: Get from vitamins or green leafy veges. Can you get a K1+K2 supplement?
Your cholesterol profile is great. Don’t get distressed by voodoo.
You could do less DHEA-S. But earlier levels were good. What changed? Dose or brand? When you take DHEA and pregnenolone together, there might competition to get absorbed.
E2 might be a bit too low. If you make up a solution, 1mg/ml, with vodka and dispense by the drop, you can make fine adjustments. Count drops per ml and do the math. Change dose by a factor of 15/22
CoQ10: Is that ubiquinone or ubiquinol. “Ubiquitous” is sort of meaningless. Suggest that you uses ubiquinol which has much better absorption.
NOTE that “muscle fatigue and soreness” is a symptom of low mitochondrial function. [Which can be see with statin drugs that sometimes create CoQ10 deficiencies]
Fish oil is more cost effective than krill oil.
Are you confusing pregnenolone and progesterone? I have not come across a reference to having the pregnenolone issues that you read about. Pregnenolone [and progesterone] is poorly absorbed an an oral and that is why doses are typically high.
The precursor of cortisol is progesterone, not pregnenolone. You can get “KAL” brand [2%] progesterone cream from amazon.
Energy: The three legs of the tripod are T, cortisol and thyroid function. fT3 regulates mitochondrial metabolic rates and the control point is body temperatures. We need decent fT3 levels and the mitochondrial also need ample CoQ10, anti-oxidants, acyl-l-carnitine [ALC] and r-lipoic acid. There are some mitochondria support supplements that contain the last three. As f T3 and rT3 levels are healthy, its easy to focus on the other antimitochondrial requirements. Low rT3 suggests that stressors are low, but perhaps that is not the case. CRP levels can indicate inflammation, but if low grade, the indications may not be conclusive.
But what is missing from the above big three tripod is GH. Low GH can lower your energy and recovery. Get IGF-1 tested to evaluate GH levels. Do not test GH directly!
Cortisol: I do not know how to read your 4 sample without reference ranges. What you could do is ask for a lower support dose of Rx cortisone for a trial. If it resolves some symptoms, then we know that cortisol levels are a factor which is good diagnostic information. But if problem is another issue such as low GH, the results may be misleading because cortisol could still make you feel better.
Yes, your iron panel seems odd, but I can’t read. I lack the skills for that.
Try adding natural source vit-E. Iron binds vit-E in the gut. So do not take vitamin E with iron rich foods. Normally, males should not take any iron in supplements and iron fortified breakfast foods and commercial factor bread can be a problem [enriched for children].
How well do you avoid glutin?
Please describe diet.
Bun/cr… ratio seems to move around, you were at 20 once before and then were lower.
Zinc 50 mg may be excessive and can block absorption of other trace elements, copper deficiency is often cited.
You should take a high potency B-complex multi-vit with trace elements, including iodine and selenium with ZERO iron. You might be able to avoid taking some discrete supplements.
Any gum problems? Arthritis?
So there are a lot of complex issues in this post, please read more than once. This process is one of elimination of possibilities.
Thank you, KSman, for taking the time to review labs and respond. I’m very appreciative. Those lower TSH values from 2014 may be reflective of a period where I was using some sea salt. Can’t really explain it otherwise. I’m on plenty of iodized salt now. I did stop all iodine about two weeks prior to labs. Presently, I am taking 6 kelp capsules daily split between morning, mid-day, and before bed. They contain 360 mcg each so I’m taking 720 mcg three times a day. Plus my multivitamin has another 100 mcg. I take 200 mcg selenium (l-selenomethionine) at night along with some other things. My multivitamin has 100 mcg too.
K1 is low I think because I stopped eating as much spinach and other goitrogens because I thought maybe they were causing some thyroid issues. I normally consume quite a bit of fresh spinach. I also take 100 mcg K2 daily as a supplement.
That’s good to know about my cholesterol. I have read so much conflicting information on it and of course most docs want to treat it. I do worry about the LDL. Isn’t there a test to measure the size of those or something? I think my risk factors are low regardless.
DHEA-S may be up because I increased it to 25 mg daily. That was another one where I read can cause some heart palps in some people. This is what my doc wanted me to take but I think for a while I only took about 10 mg or I only took it eod. I know I eased into 25 mg. I do take it in the morning and the pregnenolone at night so I wonder if there is less competition between the two that way. I am considering stopping or lessening the DHEA while I increase the pregnenolone.
Yes I saw where e2 was a little low. It does seem to correlate well with total t. I see some earlier labs where total t was above 1000 and e2 looks better. That’s interesting about mixing up my own batch with the vodka. I also think some compounding pharmacies do the ones that dissolve under your tongue, but more expensive I’m sure. I have wanted the ability to fine tune that before.
I do take 100 mg of the ubiquinol coq10 daily as well as six 1000 mg fish oil. Yes, the fish oil seems like a better value. I have wondered before if the walmart fish oil is just as good as more expensive brands. I think they sell Spring Valley brand and I used to buy it. Something made me think it was inferior to other brands, but I don’t know if that is true or not. Can’t remember if it was because it also contained soybean oil. I’m out of that brand so I can’t say.
The place where I read about the heart palp issues for both pregnenolone and DHEA is raysahelian.com. He has written books on DHEA and maybe pregnenolone too. I believe years ago he promoted higher doses, but has since become more conservative. I respect the man, but he is quite cautious and recommends taking breaks in supplementation. A lot of good information about supplements on his site. I know at least one other site recommended 5 mg max for pregnenolone, but I do not know where that was now.
Very interesting on the energy. I used to take acetyl-l-carnitine and I thought it works well with alpha lipoic acid. Used to take them together, but I have been out of the former for some time. I do take 100 mg daily of alpha lipoid acid. Concerning stress: I won’t go into details but I have had my share of it.
I did go and read just a smidgen on the GH and IGF-1 and saw where it was recommended to test the IGF-1. I definitely need to read up on the GH. Isn’t it really expensive?
Yes, the cortisol readings are hard to interpret. Labcorp says all 4 are normal, but that can’t be accurate. The fact that my highest was in the afternoon bothers me since cortisol should be highest in the morning after waking. Although I woke way early that morning, so I don’t know how that plays into it. Not sure I can get a script for the cortisone or not. Possibly if I buy it through my doc that does the HRT. I am already fretting over the increase in other meds through them. They used to give me a script for t cyp where I could get it filled for $15 at CVS. I now have to buy a vial through them for $120.
I do need a better quality E supplement. The one I have presently is d-alpha (400 iu) which I have read can do more harm than good. I only take it eod. I also take a multivitamin that has 200 iu natural d-alpha with mixed tocopherols.
Gluten: normally do pretty well although I had a slice of pizza tonight. That might happen once a month. Oddly, I seem to have no problems with it when I do. Diet is pretty good otherwise. I do keep a bag of Doritos around the house which I wish I could quit buying. I eat no sugar because I have hereditary fructose intolerance. Eat small portions of rice and black beans with non-carb veggies such as tomatoes, onions, kale, spinach, olives, avocados and a meat. If you are familiar with burrito bowls from Chipotle, I try to mimic those a lot. I also eat eggs, perhaps too much cheese, milk, cottage cheese, Greek yogurt. I love dairy. I don’t know if that is bad or not. Use olive and coconut oil to cook with. Meats are typically fish, chicken, turkey burger, and some canned tuna.
Perhaps I am taking too much zinc. I am actually taking 100 mg at night before bed. Plus multivitamin has 12.5 mg I think. I take the zinc at night along with some other things like magnesium. I will post a new supplement schedule which shows what I have been taking for a few months. Some of the things I take, I may just be trying to get rid of them. I do take what I think is a quality multivitamin from Seeking Health. Will also try to post the label for that as well. Also take a Seeking Health B complex too mid-day.
I have a few places where my teeth are sensitive due to receding gum line. Don’t think I have arthritis, although I have had lower back pain for years. Not terrible, but I should do more stretches.
Hope I have answered everything. I do appreciate your time and expertise. I will continue to study all this.
tdsg
Supplements
Morning
2000 mg fish oil
550 mg ginger root
1000 mg l-arginine
600 mg aged garlic extract
5000 iu D3
100 mcg K2
50 mg pycnogenol
25 mg DHEA micronized
480 mg stinging nettle
1000 mg C
100 mg coq10 ubiquinol
100 mg alpha lipoid acid
720 mcg iodine (kelp)
4 capsules Seeking Health multivitamin (1/2 daily dose)
Mid-day
2000 mg fish oil
1000 mg C
720 mcg iodine (kelp)
B complex
4 capsules Seeking Health multivitamin (1/2 daily dose)
800 iu A (eod)
400 iu E (eod)
Evening (before bed)
2000 mg fish oil
100 mg zinc
2000 mg C
800 mg magnesium glycinate
720 mcg iodine (kelp)
200 mcg selenium (l-selenomethionine)
Hi all, I have a question for anyone with possible adrenal issues. I have been doing HRT for a few years now and initially felt great. Since then, I have suspected thyroid/adrenal problems due to feeling generally fatigued and sometimes depressed. But I don’t believe there was a smoking gun on the thyroid labs I had run 9 months ago. I did the salivary cortisol test below and after the low and irregular numbers in June 2015, on the recommendation of my doctor, I started taking 50 mg pregnenolone at night right before bedtime. Second set of numbers in December 2015 show some improvement. Does anyone take pregnenolone for adrenal issues, and if so, do you take it in the morning or at night? Anyone take it multiple times possibly tapering down in amount throughout the day? I’m just wondering whether my numbers could go up some more and whether that would help my mood and energy levels. I seem to stress out easily, both physically and emotionally. I am 49 years old. I know there is no magic pill for adrenal issues and that changes in lifestyle are needed. I have seen some improvement in sleep quality, but I do not ever get enough due to waking early.
Thanks, tdsg
Labcorp Salivary cortisol x4, timed, ug/dL 6/17/2015 12/23/2015
8:00 AM normal range (0.025 - 0.600) 0.024 (3:45 AM) 0.422 (5:15 AM)
Noon normal range (0.010 - 0.330) 0.124 (10:30 AM) 0.077 (11:15 AM)
4:00 PM normal range (0.010 - 0.200) 0.266 (3:30 PM) 0.050 (5:15 PM)
Midnight normal range (0.010 - 0.090) 0.045 (9:30 PM) 0.046 (11:15 PM)
Where did you get with thyroid levels, iodine and body temperatures.
Do you need to revisit:
"Thyroid: Please check and post oral body temperatures when you first
wake up AND mid-afternoon. This is the best measure of overall thyroid
function. Your above mid-range fT3 should provide good body
temperatures. If not, see references to rT3, stress, iodine and Wilson’s
book on ‘Adrenal Fatigue’. "
You can improve cortisol better with progesterone. I discussed that here earlier. You can get [USA] KAL brand progesterone cream at amazon.com.
Let me update this thread with new lab numbers. I had posted some stuff a while back about thyroid and iodine replenishment on the thyroid basics sticky, but I need to get everything up-to-date here.
I did try IR for about 20 days. Perhaps that was not long enough to see an increase in temps. I have continued taking 4 to 6 kelp capsules daily which contain 360 mcg iodine each. I also now get plenty of iodine in salt. I did buy Wilson’s book, read some, but have not finished it. Admittedly, I need to continue reading. I will have to read up on using progesterone.
My last set of labs in December show a decrease in DHEA sulfate. That was because I discontinued taking DHEA supplement until I knew what the pregnenolone would do. If I understand it correctly, some pregnenolone converts to DHEA and some goes to progesterone. I have since started taking 25 mg DHEA again since my number dropped.
Also, perhaps worth noting is that I am heterozygous for both the MTHFR 677 and 1298 gene. Supposedly, this can cause methylation problems which can interfere with B vitamin absorption and utilization, and optimal neurotransmitter production. Coupled with other genetic variations, it can also cause detox issues I think. I do take extra B vitamins, methylcobolamin and methyl folate. I believe the methyl folate is much better absorbed as folic acid can be problematic. I did also start taking Sam-e, a methyl donor. Not sure that any of these supplements have improved my mood or energy levels. Quality sleep on a regular basis might do more than anything.
Have looked these new posts over. The body temperatures are disappointing for you.
TSH was improved.
Any changes in vitality?
Progesterone is a short step away from cortisol.
Nice diagram! Vitality? Hmmm… I generally feel tired with brain fog. I tend to get a bit lazy in the colder months. Already a bit anxious about dusting off my bike because I know I’m not feeling my best and wondering how I will begin to work off the extra pounds. I don’t feel emotionally or physically strong, but rather unsure of myself and weak. Tired all the time. Not a good feeling.
Not sure if this is the kind of vitality you are asking about or not, but I do tend to achieve morning erections regularly now. This may have become more often after the pregnenolone or possibly when I upped my dosage of t cyp, or both. Wish the morning wood would continue on throughout the day, but that seems to go away rather fast. I do also take 5 mg tadalafil each night as a maintenance dose which may help with this a little.
If I wanted to try the over-the-counter progesterone cream, how would I use it? Morning or night? Once a day? How much? Should I add it to or replace the pregnenolone with it? I thought pregnenolone is reported to have some positive mental affects such as improving memory, possibly even providing some neuro-protection against oxidative stress, etc. I already have a terrible memory - always have. I think my anxiety gets in the way of normal brain function. You can’t remember anything when always under stress I think.
The more I think and read about it, the more I think stress and adrenal problems are the root cause of my problems. Not sure I have mentioned it before, but vision problems have become more and more pronounced for me. When driving at night, I think everyone has their high beams on. I can’t read any fine print anymore without reading glasses. It often feels like my eyelids are twitching constantly. I have got to get serious with more lifestyle changes. Trying to decide whether I would benefit more from increasing my pregnenolone dose or trying the progesterone cream. I want some relief from symptoms while I try to make changes in lifestyle. Overcoming the adrenal issues almost seems insurmountable. How does one overcome a lifetime of stress? It’s just so damn depressing.
tdsg, I really hope you can find the the cause of your problems.
I feel your pain, other than your ability to control E2, I am in exactly the same boat as you.
My anxiety and insomnia has gotten to the point that I am going to ask for some Ativan in the hope that I can at least get some temporary relief.
Hey Rednose! Not sure how old you are, but a lifetime of anxiety and stress apparently adds up. I have had stress all my life. Have been on my share of SSRIs over the years. They have helped in the past, but I keep thinking that messed up hormones are the root problem and if I can ever get those right, all will be good. Trying hard not to fall back into using them now. Kind of stinks paying out money for the T, HCG, anastrozole, labs, consults, etc. and still not feel well. Hope to solve this adrenal problem eventually. I have learned so much on this site. Do you know if your anxiety and insomnia are adrenal related? I usually don’t have much trouble going to sleep, but I can’t ever sleep long enough because I wake up too early and I’m always dead tired. The waking early seems to be at odds with adrenal issues. I have not figured that part out yet, but I still believe what I am going through is adrenal related. Decided I have to quit the coffee. Switching back to green tea tomorrow morning.