Decided to add last post to Estrogen - Why you should care thread.
Temps July 2017. Prior to starting natural dessicated thyroid. Will have to see if they improve down the road a bit.
Wellā¦ Itās been a while since I wrote - Iām still battling fatigue. According to doc, most hormone ranges are good and thyroid is dialed in. She says I should feel like superman. Below my lab numbers, I have a question about DHT which is high. Iām 51.
Latest protocol is 70 mg testosterone cypionate E3D, no aromatase inhibitor. Numbers below are the day after injection.
Testosterone, total = 1212 (264 - 916)
Testosterone, free = 34.8 (7.2 - 24)
Estradiol = 39.2 (7.6 - 42.6)
DHEA-S = 271.9 (71.6 - 375.4)
Thyroid protocol is Nature-Throid 130 mg daily.
T3 = 5.4 (2.0 - 4.4)
T4 = 1.04 (0.82 - 1.77)
Reverse T3 = 13.1 (9.2 - 24.1)
TSH = 1.250 (0.450 - 4.500)
Question: Doc started me on a supplement called ProState by Metabolic Maintenance. Has saw palmetto and stinging nettle and some other things in it. She thinks my DHT is too high. It is 133 (30-85). I believe I read on another site that a few people thought saw palmetto caused their libido to crash and ED issues. I have not done a lot of research on high DHT, but I do not feel aggressive, not really very hairy. Over the years, I have lost the hair on my head, but it runs in my family. Is DHT of 133 a problem?
Not to bore anyone, but Iāll add a few more bits of information just to update my profile. Did a mycotoxin profile test with the Great Plains Lab. Apparently, I have mold mycotoxins in my blood - several species. Not good. Likely responsible for my fatigue, along with unfavorable genetics with the MTHFR and other detox issues. According to Shoemaker (authority on mold stuff), 25% of the population cannot get mold out of their bodies very well, again due to unfavorable genetics (HLA genes). According to blood test, I am one of them.
Apparently, I have a fair amount of inflammation throughout my body. Did the NMR Lipoprofile test again. 3rd time. Two of the three tests show high numbers for small LDL-P. Not good. Doc says this is from the inflammation.
This weekend, Iām doing the Dutch Test (dried urine test) which may shed some light on the high DHT. Doc thinks some of my hormones are heading down a less than ideal path.
Will update later. All for nowā¦
I think you should lower dose. Bring down testosterone and free t within range. That may bring down dht.
Not too worried about total T. Labcorp upper range used to be 1197 a short while ago (2017). Plus my doc says the upper end was 2400 when she was in med school - something must be causing T to drop in men over the years. I give myself shots in the evening and these labs were run the very next morning.
Kind of interesting. In June, 2015 my protocol was the same at 70 mg t cyp E3D along with 250 IU HCG E2D, and 0.125 mg anastrozole E3D. 2 days after T shot, Total T was 892. Free T was 29. E was 15.9. DHT was 78.
In July, 2017 my protocol was 100 mg t cyp E3D, 150 IU HCG ED, 100 mg DIM ED. 2 days after T shot, total T was 955. Free T was 22.4. E was 51. DHT was 119.
A little hard to compare 1 day after versus 2 days after T shot I realize. Most labs I do 2 days after, but I do like to do 1 day after occasionally just to compare the numbers. Might even try to do 3 days after sometime in the future just to see the full fluctuation.
I am very surprised you can run this high a Free T for such an extended period of time and not have HCT issues.
Do you donate blood? If so do you have your ferritin regularly checked? Crashed ferritin sure can give you extreme fatigue.
@tdsg: have you had a sleep study done?
Since starting TRT (about 5 years), my hematocrit has remained in the 40s. It was 41.4 (37.5 - 51) in 2011 prior to starting and the highest it has ever been is 47.1 in 2016 when doing 100 mg E3D. I have not needed to give blood yet. Ferritin has been checked 3 different times over the years ranging from a low of 59 and a high of 86 on this last set of labs done in Nov 2018. Labcorp range is 30 - 400. It has been a while since I studied iron labs so I have forgotten where ferritin numbers should be in the range. Iām on the low end. Several of my iron labs are either on the absolute low end or high end of the ranges which puzzled me, but my doc has not mentioned anything on this. I remember a few years ago picking through all the different iron labs trying to understand what is good and what is bad. Iām a carrier of hemochromatosis I believe. Iām still confused, unfortunately.
I was about to do a sleep study, but only in the last few weeks, my sleep has improved. I have always had a problem with waking too early and feeling completely unrested upon waking in the last 3-4 years. Doc recommended I turn off WiFi in the overnight hours which may have helped. Also, bought a whole house hepa filter from BlueAir (very expensive), which may be helping some too. Iām not 100% sure either of these things are the reason for the improvement. Iām grateful for the improvement though.
Most on TRT that do not have to donate often do to high HCT donāt have to worry about ferritin.
If HCT is not an issue I see no reason to not stay at the high end of the TRT lvls. It feels better, right? An you are not having any E2/prolactin issues?
I also like running my Free T in the high 30 (labcorp range6.6-18.1) but high HCT prevents me from doing it for very long.
Estradiol was 11 (7.6 - 42.6) when total T was 381 (348 - 1197 old Labcorp range) for baseline pre-hormone replacement. Highest E has ever gotten is 51 when I stopped anastrozole and used DIM only. I have had prolactin checked twice. 4.1 and 7.1 with range of 4 - 15.2.
To be honest, I donāt think Iām very sensitive to hormone changes because of the fatigue. Fatigue seems to trump everything and makes me insensitive to everything else.
I hear you. I did not catch your age. Iām 65 so my goals are a bit different than many of the young guys on this forum. Fighting fatigue from 38 years at a desk job(high bucks high stress) that lead me into depression, anxiety and panic attacks was what got me into HRT. Iāve been retired since 55.
I really like your spreadsheet. Youāve been troubleshoot and testing since 2011. Good records to have. Itās hard to believe you have not found the cause of this fatigue.
Thanks on the spreadsheet! Itās getting too wide, ha. Might need to start only showing the more recent years only. Figure someone else may benefit from it. I like being able to see how numbers change over time and depending on the protocol being used. Helps take the guess work out of it.
Iām 51 and have had anxiety issues for all my life. The problem is finding a good doc that will run labs. I really like my current functional medicine doc. She works outside the insurance system which means I have to pay out of pocket, but at least labs are covered. I believe she is getting up to speed on mold issues so hope to eventually overcome it. Protocol for getting well from mold is to first remove yourself from it. I am renovating my house myself because remediation is too expensive. Once we began to suspect and prove (through labs) that mold is at least part of the problem, I basically went a year without an appointment with her because of having to renovate. I take as many precautions as I can by wearing resperator, clothing etc, but Iām sure I have exposed myself more to it. Kind of unavoidable unless you have tons of money or are willing to walk away from it all. I canāt and fortunately have not gotten too sick from it. Believe I have all active mold eradicated, but then there are the persistent spores. Hopefully hepa filter will help some with that. The fatigue issues only came about within the last 3 years. I believe I started hormones in 2013 with a round of pellets. What an expense! I do subq injections now which is so much better and less costly.
I will likely try to retire in the next 5 years if I can get a kid through school, and especially if my health does not improve. Health is everything!
hrdlvn,
Have you had any success with the anxiety, depression, and panic attacks? Iāve had my share of each of those at different times in my life. Been on several SSRIs for years. Seem to get by now with 200 mg 5HTP at night before bed.
2015 mid summer I sat down in my easy chair from my last bucket list adventure and did not leave that chair for 5 months. Something happened, blood clot in the brain? Who knows basicly over night I became a zombie, 1/10th of the man I was and I had total apathy for myself and the world.
My wife begged me to go to the doc. My PCP started me on Lexapro (ssri) My wife caught me holding my .45 in the bedroom.
The Lexapro made me not care that I did not care about anything anymore. On it I had convinced myself there was nothing more to do in this life and if Lexapro was all there was left it was not for me and I was read to leave.
Back to the PCP a huge battery of blood tests brain scans, etc were done and the only thing that came back bad was TT @ 173. SSRI in the trash Testim gel 1% ED. 3 month bloods had my TT to 650 and the light of day was coming back into my life. I found a therapist who specilized in EMDR and between the HRT and 6 months with the therapist we got to the bottom on my issues. Iām about 50% back and my .45 is safely back in the gunsafe.
I have spent the last 3 years educating myself on HRT and mens health in general.
Is your functional doc OK with Defy? You would not believe what I had to do to get my PCP to accept them as my HRT clinic.
That is some story, hrdlvn! Many, many years ago when I was about 10, my mom found my dad with a gun to his head. She talked him out of it thankfully. He had had a mental breakdown several months earlier, hospitalized, and eventually diagnosed with bipolar, then placed on some meds with horrible side effects and could not return to work. I guess he had reached the end of his rope. He passed through natural causes many years later. My older brother has battled bipolar his whole life too. Thankful bipolar bypassed me, but my Ex and I are both terrified it could get our son.
I had to google EMDR. Thatās good that you have had some success with that and the HRT. I had to leave DEFY. I liked them very well, but needed a doc to also help me get to the bottom of these other issues too. My spreadsheet of labs and past protocol really helped me with the new doc. Only thing, she does not think HCG or aromatase inhibitor is necessary when Testosterone is used at appropriate doses. Since I began using only testosterone, I have not really noticed any negatives, but I also have the fatigue which, like I said makes me insensitive to the fine-tuning I may eventually need to do to feel and perform my best. My plan is to try to overcome the mold mycotoxins, then see where Iām at after that.
If your not getting good sleep then everything will be fucked. Get a sleep mask to keep things dark. Get a sleep study to see how well you are sleeping. It could be due to poor sleep.