^^This is true…I think a lot of his supplement recommendations are a bit over the top, and don’t relly hold water…but overall a very good look at the condition and good tests to see if you may have it…
I don’t think the preg/prog supplementation chapter is all that good…if I were going to supplement with preg, I would get the Life-Flo brand with lipoderm base and start at 50 mg/day in divided dosese and monitor symptoms, increasing up to 100 mg a day depending on how things are improving…
Ok, and then eventually taper off or would it be for life? I’m wondering if my issues have been going on for too long be reversible. I know it’s not something anyone can answer on a forum, but it’s just what’s going through my mind at the moment…
It is impossible to say…if there was something that was wrong with you that threw off your hormone system, then its possible this will “reboot” you and you will be able to eventually taper off…such is the case with adrenal fatigue and illness-induced “crashes”…
But there are extremely knowledgeable people out there that I trust who feel that genetic downregulation of your body’s metabolic processes (specifically cortisol) begins much earlier than “middle age”…if such is the case, you would likely need to at least supplement for life (or adjust your energy expenditure to “age gracefully”)…at 25, you are likely not in this category, but it is really impossible to tell…
That said, there is no sense in worrying about the long term plan if you don’t implement the short term…don’t avoid taking the first step because a bridge may be out down the road…you’ve gotta get to your destination eventually…
I guess that makes sense, we’ll have to see how things turn out. Anyway, thanks for the information and support.
New test results below. Different labs so different ranges. I’ve converted to US units where possible, but I couldn’t find conversion factors for all tests.
2011-05-20, 8 AM:
S-Calcium: 10.04 mg/dL (8.6-10)
S-Iron: 89 mcg/dl (50-190)
S-Ferritin: 90 ng/mL (30-200)
S-Cortisol: 12.5 nmol/L (3.62-19.39)
S-25-Hydroxyvitamin D: 73 ng/ml (30-100)
S-1.25-Dihydroxyvitamin D: 67 pg/ml (15-50)
S-TSH: 2.46 mIU/L (0.2-4.00)
S-fT4: 0.93 ng/dL (0.70-1.71)
S-fT3: 188 pg/dL (162-364)
S-Testosterone: 375 ng/dL (>288)
S-SHBG: 33 nmol/L (11-55)
S-PTH: 1.3 pmol/L (1.3-6.8)
2011-05-25, 8 AM:
P-Glucose: 86.5 mg/dL (72-108)
B-Hemoglobin: 13.7 g/dL (13.4-17.0)
B-Erythrocyte sedimentation rate: 3 mm/h (0-20)
S-Sodium: 146 mEq/L (137-145)
S-Bilirubin: 1.52 mg/dL (0.13-1.23)
B-HbA1c (IFCC): 35 mmol/mol (27-42)
S-Testosterone: 208 ng/dL (288-865)
S-TSH: 4.2 mIU/L (0.4-4.7)
S-fT4: 1.09 ng/dL (0.93-1.79)
S-Ferritin: 107 ng/mL (30-350)
Vitamin B12 (cyanocobalamin): 1355 pg/mL (203-880)
S-Potassium: 4 mEq/L (3.6-4.6)
S-Creatinine: 0.96 mg/dL (<1.13)
S-Aspartate transaminase (AST): 0.68 mckat/L (<0.76)
fS-Iron: 67 mcg/dL (50-190)
Some thoughts:
I really doubt that your low T3 is caused by supplementing Iodine.
no idea about 1-D25-OH results. I had the same type of question, and did a little research on it, but never came to any hard conclusions.
I would go with dessicated thyroid or T3 medications myself. I would also confirm RT3 levels before starting any thyroid meds.
what time of day were the blood draws?
Sorry, forgot to print TOD. Post edited.
Not 100% sure about the effects of iodine supplementation but I did come across this from Dr Flechas: “While taking iodide, one may see an elevated TSH but we have to recognize that this is not a bad thing. TSH has many actions outside the thyroid that have been discovered?. Often a check of the patient?s T4, free T3 and TSH shows the T4 to go down, free T3 going down and TSH going up”
I did some reading about 1.25 D25 and I believe it is associated with calcium, phosphate and magnesium metabolism. I’ll have to do some more reading to determine if my value should be a cause for concern.
I might be able to get a combination of T3+T4 so I’ll have to look into that.
Iron levels are a bit problematic. They are lowish but not critically low, but I still suspect I could have some kind of intestinal pathogen or other gut issue. It’s difficult to get those tests done since iron levels have to be critically low for doctors to react…
12.5 Cortisol at 8am is not ideal.
15 is ideal
<10 is a problem
Yes, cortisol is indeed a problem for me. I’m hoping to improve levels if I can manage to start sleeping better. I don’t sleep well at all at the moment which is probably due to some kind of adrenal issue in combination with the stress of having to deal with incompetent doctors. I’ve started taking melatonin before so we’ll see if things improve after that…
In the meantime, the “leads” that I’m going to investigate are: low iron, high bilirubin, high 1,25(OH)2D. Have I missed anything else?
Your TSH isn’t just elevated; it’s fluctuating. From 2.46 to 4.2 in 5 days? Given that you tested for antibodies I have no idea why this is, but it’s troublesome.
As PureChance often says, >2 = problem, >3 = big problem. In other words, this is not a trivial jump
Apparently, TSH always rises when supplementing with iodine+iodide so I think that’s the explanation. As far as the fluctuation, the jump from 2.46 and 4.2 values came from two different labs so maybe that impacted to some degree. In any case, I am trying to get an MRI done to rule out a pituitary tumor which could be causing fluctuations.
I have had pretty much the same issues you have had for years, except I had normal thyroid and cortisol levels. I have worked with Dr. Overbeck and his assistant Sean Bean for a few years. They have helped me regain my T levels to near optimal. They are very good and easy to work with. They do pretty much any lab work I request. Despite me not having any cortisol or thyroid issues, my ferritin was very low, and through the months I was able to get that up to optimal by eating 1-2 lbs of beef per day, which along with liver is the best source of iron IMO.
I also did the clomid test about a year ago and responded very well, which meant that I was secondary hypogonad. Sean Bean and I have been working with natural supplements along with low dose clomid. Low dose clomid is freakin awesome and seems to work wonders. I get 50mg tabs and break them into 4 pieces. I then take 12.5 mg every 3rd day. This gets my T into the 700’s and once off I can hold without it until some shit in my life happens like working 2 jobs and going to school lowers my T again.
D aspartic acid works wonders as well and is very safe because it is simply the enantiomer of L aspartic acid and present in the lutenizing hormone, hypothalamus, and testes of all animals.
You have been talking a lot about thyroid and cortisol lately is some pretty complex realms, so I assume you are no newbie. However, dont forget to take the basics for boosting T, like zinc, vitamin D (which you are), DAA, and low dose clomid (optional)
You need to get your T up now if possible. A previous post explains the correct order of repairing systems going thyroid/adrenal, then hormones. This is true, but dont think that you will make the situation any better by having long term Low T. You have had your testosterone low for long enough, and I do see you are trying to experiment by seeing if your thyroid boosting/adrenal boosting plan will work, but IMO it is not worth it to keep your T low like this for a long time. Get ahold of some clomid for christ sake. Another option would be to try the GNRH analogue triptorelin, which is a 1 shot cure in some men with low T. It stimulates LH and FSH to get a permanent effect. Some steroid users who kill their HPTA are able to come back from the dead by taking triptorelin.
Sometimes it doesnt matter if you find the root cause or not, you need to retrain your body to have T again.
Most importantly, you need to go on a pro testosterone/thyroid diet, which means eating plenty of red meat, low PUFA foods, lots of saturated fat, coconut oil, and some good clean carbs. Going on a low carb diet will shut down thyroid function as well. You need glucose to be oxidized for your thyroid to work properly, which is why you need plenty of carbs and never eat foods high in PUFA (poly unsaturated fatty acid) content, which typically oxidize easily and prevent glucose oxidation. Look up Ray Peat, a biochemist who is a real authority on thyroid and he has extensive research on problems with PUFA and thyroid. Coconut oil helps thyroid greatly. Avoid grains and legumes like the plague as they often contain thyroid inhibitors/enzyme inhibitors and always have antinutrients. You really want to eat a paleolithic diet but include a little eggs and some milk, preferably raw milk.
I also failed to mention that I was able to boost my T through Clomid and natural therapies from a level of the mid 200’s which is like the levels of an 80 year old man. Your’s are in the 300’s so IMO if I can do it, you can too.
Excellent information, thanks! It’s always encouraging to read success stories such as yours.
Clomid: low dosing does sound promising indeed, but the problem is that I live in Sweden so it’s going to be difficult to get hold of Clomid. Will have to do some research on that.
D aspartic acid: this also sounds promising, but I’m surprised no one has mentioned this before. Sounds almost too good to be true. Will have to research that as well.
Diet: I think have most of my diet covered by now. I didn’t even realize I was eating like crap up until a few months ago. I’ve gone completely gluten free which has solved my digestive problems. I’ve also started eating eggs, more meat, seeds and nuts, more fats, more vegetables, fruit, saurkraut, different kinds of berries etc - all in line with the paleolithic diet. Avoiding grains and PUFA is new to me so I’ll have to look up Ray Peat that you mentioned.
Supplements: Currently I’m taking vit D (5000 IU), fish oil (800 mg EPA, 400 mg DHA), iodine+iodide (50 mg), magnesium (800 mg), selenium (200 mcg), zinc (30 mg), vit E (400 IU), vit C (3000 mg), vit B5 (1500 mg), licorice root (2000 mg) and melatonin (0,75 mg). In addition to the supplements you mentioned, I’ve also been advised to take manganese 30 mg day. I’ll have to read up on all of that first though.
Not to sound pessimistic but assuming I can’t get hold of Clomid, my only choice is to first raise cortisol levels by getting rid of my insomina (melatonin has helped), then maybe go on thyroid meds and just hope that T levels improve. If they dont… then I’ll have to evaluate my options and perhaps move the USA or something to get proper TRT.
Anyway, thanks for the advice and encouragement!
By the way, in the spirit of finding root causes of low T - may what the root cause was for you (assuming you discovered it)?
Clomid can have some estrogenic side effects for some. Nolvadex would avoid that, works just as well.
KSman, what’s your recommendation - start with Novaldex right now (if I can get hold of it) or hold off and see what happens if I’m able to fix adrenal and thyroid issues? I feel the low T, low cortisol and low thyroid must be related, but the problem is I have no idea what started what, i.e did low T cause low thyroid which caused low cortisol or vice versa. Those three parameters seem completely interchangeable to me…
^^^When in doubt (meaning you don’t have any obvious smoking guns such as blows to the nuts, whiplash, steroid use, goiters, adrenal fatigue, etc.) treat in the following order: Cortisol → Thyroid → Testosterone. There is a good discussion on this over on Crisler’s forum called Hormones 101 by poster chilln. I would link it but it would probably get removed.
Actually, the adrenals might be the smoking gun in my case. I posted the results from my insulin tolerance test on an Addison’s disease forum and one poster highlighted the disproportionate response between my cortisol and ACTH levels i.e the pituitary responded very well given the sharp rise in ACTH and GH but in proportion, cortisol response, while sufficient to pass the test (> 20 mcg/dL or 550 nmol/L), was not that strong. I hope to get more info on this if I get more replies on the Addison’s forum.
Got some liver function test results today. Seems there’s a problem with my liver too. Anyone care to chime in? Unfortunately, I don’t have all the ranges this time becuase the retarded doc didn’t send me the actual results, only his own notes from the medical journal. Idiot…
Bilirubin: 1.7 mg/dL (<1.52)
Bilirubin conjugated: 0.35 mg/dL (<0.23)
Aspartate aminotransferase (AST): 0.78 units/L (<0.76)
Hemoglobin: 14.3 g/dL
Orosomucoid: 0.48 (0.52-1.17)
Haptoglobin: 1 mg/dL (2.4-19)
Immunoglobulin A (IgA): 83 mg/dl (88-450)