Low Free Cortisol, High Transcortin (CBG), Low T & Thyroid Connection?

Pharma TRT
1

First I want to point out I have a long thread open with all my case details here - Autoimmune, Fertility and Possible Hormone Issues, Help With Labs Needed Please

Rather than adding more to the above thread/topic I wanted to add some specific thing here. Thing seem to be getting buried becuase there’s so much Info posted there. I’ve added a link for reference purposes.

So, I started self medicating TRT on the 6th of March this year, following the standard 100mg a week + 250iu HCG. Started sub q T injections 50mg every three days. And EOD for HCG. (No AI becuase I am very low E2) After five weeks tested bloods and was shocked to see my levels were even lower than when I started.

Before TRT:

Free T = 0.296 nmol/L (Range: 0.30 - 1.00 nmol/L)
Total T = 14.4 nmol/L (Range: 9.00 - 31.00 nmol/L)
Oestradiol = 21.5 pmol/L (Range: 0.00 - 191.99 pmol/L)

  • Optimal number for E2 should be about 80 pmol/L

Five Weeks After Starting TRT:

Free T = 0.291 nmol/L (Range: 0.30 - 1.00 nmol/L)
Total T = 13.4 nmol/L (Range: 9.00 - 31.00 nmol/L)
Oestradiol = <18 pmol/L (Range: 0.00 - 191.99 pmol/L)

  • My E2 dropped off the scale.

So looks like I’m a hyper metaboliser, as the 100mg + HCG isn’t increasing my T… So now changed up my protocol to 300mg a week of Test e, injecting every day. Will do more bloods after about 5 weeks on this new protocol.

——————

I’ve been going over all my old bloods again seeing if there’s any other things I should look closer at and noticed a few interesting things. First is low Free cortisol which I read effects other hormones and thyroid. My transcortin is high which might be the reason why my free cortisol is low. Transcortin binds to cortisol. So I’m trying to investigate why my transcortin would be so high considering my E2 is very low. High oestrogens can cause an increase in transcortin… my bloods below

Cortisol (8h) 19.6 ug/dL (7-25)
Transcortine + 74 mg/L (20-50)
Cortisol Free (8am) - 6.4 ug/L (10-30)

So I’m wondering if the low cortisol is another factor in why I have and still feel crap. I wake every day and always feel tired and take me a good few hours to get going. I get a minimum of eight hours sleep a night, often ten, but still feel knackered. Still have bad brain fog and have been suffering from really stiff neck/shoulders, swollen glands in neck and tinitus since Christmas.

I also had some surprising news why I was at the IVF clinic with my wife. Was told by the nurse that I has tested positive for hepatitis b. Have no idea how/when/where I picked that up. And looking at my old bloods that might be one reason for the below blood results -

Potassium + 5.8 mmol/L (3.3-5.7
hs CRP + 1.16 mg/L (0-1.00)
Gamma-GT 59 U/L (8-61)
LDH + 458 U/L (240-420)
Amylase + 117 U/L (28-100)
Icteric Index + 1.7 (<1.6)
Bilirubin + 26umol/L (Range: <21.00 umol/L)

Thought I’d add my thyroid bloods too -

Thyroid:

TSH - 03/aug/2016 = 2.48 mU/L (Range: 0.27 - 4.20 mU/L)
TSH - 20/dec/2017 = 3.07 mU/L
TSH - 15/jan/2018 = 4.20 mU/L (This was raised due to iodine supplemention at the time)

Ft4 - 03/aug/2016 = 16.49 pmol/L (Range: 12.00 - 22.00 pmol/L)
Ft4 - 20/dec/2017 = 16.50 pmol/L
Ft4 - 15/jan/2018 = 13.50 pmol/L

Ft3 - 03/aug/2016 = 5.02 pmol/L (Range: 3.10 - 6.80 pmol/L)
Ft3 - 15/jan/2018 = 5.91 pmol/L

Rt3 - 15/jan/2018 = 15.00 ng/dL (Range: 10.00 - 24.00 ng/dL)

Rt3 Ratio - 25.65 (Range: 15.01 - 75.00)

————

So basically wondering if there might be a connection between low cortisol, low t and thyroid function? Oh and also being a hyper metaboliser.

  • Oh forgot to mention that I often get very sleepy after food. I know thats normal to a certain extent but its seems to have gotten much worse over the years. For example I will eat breakfast which might be some toast and eggs, then go walk the dog. Half way through the walk I start feeling very sleepy.
Autoimmune, Fertility and Possible Hormone Issues, Help With Labs Needed Please
2

You tripled your test dose? Have you had your levels tested again? What day are you pulling your bloods?

3

Yes thats correct… Started with 50mg every three days and now on 0.17ml (test e 250mg/100ml) ED + 250iu HCG EOD. (297.5 mg per week)

  • Bloods were done just before T injection to see how my levels were at the lowest point of the week.
4

Thats a huge jump but your total number does sound low. Will be interested to see where it lands you. If it does triple you’re looking at 1200+ on trough days which seems high.

5

Time will tell I guess…

KSman did say this with regard to Total T -

If free T calculates OK, you can disregard high TT. That could be from low clearance rates for SHBG+T and SHBG may also increase if E2 levels recover.

1 Like
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I have been reading some old posts from PKNY and he mentioned he is a hyper mataboliser and found using daily Test prop injections much better than using cypionate or enanthate. He said he had tried up to 350mg a week of the longer ester testosterones but smaller doses of Test prop seemed to work for him.

Just wondered why test prop would be so much better than say test c or e injected EOD?

7

Your T is fake?

What are your oral body temperatures?

Wife has been tested too?

8

“Is your T fake” - Though not from my doctor it’s from a trusted source. By trusted source I mean it’s ranks #3 on a very well know body building steroid review site. It was Bayer Test Depot. I’ve now switched labs to see if that makes any difference.

“What are your oral body temperatures?” - Below were my temps back in Jan. Was 97.2 this morning. I will re-check this week to see if anything’s has changed.

Morning = never above 97.3 (Ranged from 97.1-97.3)
Afternoon = never above 98.3 (Ranged from 98.1-98.3)

I did iodine replenishment months back and now use iodised salt.

Has your wife been tested - Yes as part of our IVF treatment she has. Will get the results next week.

When I was told I tested positive for hep b, the doctor said I had built up good antibodies to it which was good considering the fact I have an autoimmune disease.

—

l wondered what your view on the cortisol was? I’ve had a short synacthen test back in September and results said “test shows adequate adrenal response to synacthen with a basal cortisol of 459 and a 30 minute cortisol of 520.”

I wondered even with the above test saying cortisol was fine, that having high transcortin could tie up Free cortisol and still be making me feel crap?

I also wondered what you view was on using Test prop was in relation to being a hyper mataboliser? Why would PKNY feel so much better on a lower dose of test prop than higher dose of test c or e?

9

ACTH stimulation test - Wikipedia
A good result indicated that the adrenals are responsive. But that is only one component of the system, other aspects can be weak.
Hypothalamic–pituitary–adrenal axis - Wikipedia

Vit-D3 is an important factor for the immune system.

All T esters yield bio-identical T after the ester groups are removed by the body. Sometimes we see paradoxical results with some guys there is not compelling reason to read more into these results, sometimes data does not fit the models of understanding. Note that T can include different oils as well as increasing amounts of preservatives that are not needed. I think that some people at pharmacies are adding more things to justify their existence. I have never seen any info about how the body reacts to the ester groups as they are removed and perhaps there are some cases where non-benign things happen. Again, you need to just accept that some odd things can be going on.

10

Thanks KSman… Okay will stick with my existing testosterone protocol of 0.17ml (42.5mg of Test e 250mg/100ml) daily and 250iu HCG EOD. Then check bloods again next month to see if my levels have increased.