i’m sure that almost any UK memebers posting here will verify that NHS treatment for any testosterone-related problems is laughable/non-existant! Interpretation of the test result ranges is a particular problem with the standard reply being " . . but you are within ‘normal’ range . . ."
out of interest, are there any UK members with positive experiences in this field?
has anyone had better success via a private referral?
Just to update my particular situation - had the iron labs and gene test back.
Haemochromatosis C282y Gene - Negative
Serum Iron 18 umol/l (10-30)
Serum TIBC 53umol/l (40-70)
Saturation Iron Binding Capacity 34%
Serum Ferritin 117 (30 - 330 ug/l)
Looks like its not haemochromatosis then. Iron levels fell as expected after giving blood once. Now waiting on the results of NutrEval to hopefully see what it actually IS.
My NutrEval has just come through! Would really appreciate everyones help with having a look at it.
I haven’t uploaded the FACT1 part as I have zero food allergies or even intolerences to report. I’m fine with wheat and dairy which are two things I’d cut out but may not need to have.
The main body of the report though suggests I have a serious Vitamin C deficiency, a-lipoic acid deficiency and Lead only just within the reference range.
I moved into a new flat 01/10/10 and began to get ill 25/12/10. I finally moved out of the new flat 25/02/12 as my job is under the threat due to illness. Blood for the Nutreval was drawn 13/04/12 giving a few weeks for levels to fall and be just within the reference range.
I don’t want to jump to conclusions but could this be the answer all along - lead poisoning. I eat 7 or 8 servings of fruit and veg per day so should be fine for Vit C, but doesn’t Vit C get used up removing heavy metals?
Download link to the report is below if anyone is good with them. There are some othere values slightly high and low but lead would seem to be the stand out one due to its toxicity - explaining the RT3?
http://www.4shared.com/get/Qxw1cbZ7/Qwertynutreval.html
Also, my second adrenal stress index came back (first one earlier in the thread was December when cortisol was low) and now cortisol is HIGH! if anything. Pours further fire on the idea of adrenal ‘fatigue’
Have just got my latest bloods back from my endo as well. Taken at 1:15pm which I know is not optimum for measuring testosterone but its rock bottom neverthless.
Cortisol over the top of the range which ties in with my salivary cortisol results. ACTH also firing to full capacity. So much for exhausted adrenals.
Endocrine
Testosterone 9.8nmol/l (9-40)
Cortisol 590 nmol/l (140-500) *
ACTH 11pmol/l (2.0-11)
SHBG 20 nmol/l (12-78)
IGF1 40nmol/l (15-64)
TSH 1.2 mU/l (0.3 -6.00)
FT4 15.6 pmol/l (10-22)
A?dione 3.4 nmol/l (1.0-8.5)
DHEAS 10.6umol/l (0.3-12.0)
LH 3.8 U/L (No range given)
FSH 5.7 U/L (No range given)
Progesterone 2.6 nmol/l (No range given)
Oestradiol <50pmol/l (No range given)
Prolactin 121 mU/l (<350)
Urea & Electrolytes
Sodium 142 mmol/L (133 ? 146)
Potassium 4.2 mmol/l (3.5 ? 5.3)
Chloride 102 mmol/l (95-108)
Bicarbonate 29 mmol/l (22-29)
Urea 7.8 mmol/l (2.5-7.8)
Creatinine 101 umol/l (50-130)
eGFR 77 ml/min1.73m^2>60
Anion Gap 15 mmol/L (6-16)
CMP
Total CK 137 U/L (40-320)
CRP <5 mg/L (<5)
Total LDH 311 U/L (0-450)
Albumin 50 g/l (35-50)
Total Pro 69 g/l (60-80)
Globulin 19 g/L (19-35)
Alk Phos?ase 56 U/L (30-130)
Bilirubin Total 7 umol/l (<21)
ALT 32 U/L (<35)
Gamma GT 13 U/L (<50)
FBC
HB 14.5 g/dl (13.0- 16.7)
Haematocrit 40.0 % (39-50)
Mean Cell Volume 95.5 fl (80-100)
Platelets 223 x10^9/l (150-400)
WBC 5.3 x10^9/l (3.5 -11)
Neutrophilis 2.6 x10^9/l (2.0-7.5)
Lymphocytes 1.9 x10^9/l (1.0-3.5)
Monocytes 0.5 x10^9/l (0.2-0.8)
Eosinophils 0.3 x10^9/l (0.0-0.4)
Basophils 0.0 x10^9/l (0.0 ? 0.2)
Guys - is anyone any good at converting units for tests?
On my nutreval it says my lead is:
0.042 mcg/g (Ref range <= 0.048 mcg/g)
Then I found on another site this guide:
Whole blood lead levels:
<10 μg/dL - normal.
>10 μg/dL - may cause impaired cognitive development in children.
>45 μg/dL - GI symptoms in adults and children.
>70 μg/dL - high risk of acute CNS symptoms.
>100 μg/dL - may be life-threatening
Can anyone convert 0.042 mcg/g to ug/dl ?
Thanks - I can’t even figure it out from that though - brain fog not helping.
Have posted it on an online conversion forum.
That unit doesn’t make sense. You are trying to compare weight per weight to weight per volume
Someone has just converted it for me, don’t ask me how!
"The density of blood is about 1.06 g/mL (sometimes rounded down to 1 g/mL, the same as water). A deciliter is 100 mL, so 106 g/dL
0.042 µg/g x 106 g/dL = 4.5 µg/dL, in the normal range
(mcg is just an improper abbreviation for the symbol µg, microgram) "
Which I initially thought would make it very low on that scale, <10.
Problem is that scale is for whole blood (serum) and my results are from red blood cell testing. I’ve no idea how you’d even go about converting that.
Any updates on your front mate? The state of NHS is really appalling… Is there any good private specialist that you know of? I described my own story here if you are interested Low T at 24, UK- Private Route - Testosterone Replacement - Forums - T Nation
Been meaning to update this for a while mate but I’m no better yet to be honest.
I’ve had the Metametrix GI Effects stool test done and no real problems were found there; no chronic infections etc I do have some malabsorption of fats.
I’ve had hair tissue mineral analysis and no real levels of toxic metals have been found.
I’ve also had Lyme testing done that was negative. Can’t really ever remember a rash or tick bite anyway.
I’ve had up to date endocrine bloods done and they look OK. Testosterone still on the low side but everything else fine.
Blood test 11/01/12
SHBG 23 nmol/l (13 - 71)
LH 7.60 iu/L
FSH 7.50 iu/L (No range given)
Total Testosterone 14.4 nmol/l (8.50 - 29.0)
FT4 15 pmol/l (8 - 21pmol/l)
FT3 4.8pmol/l (2.50 - 6.50pmol/l)
TSH 1.80 mu/L (0.4 - 4.5)
Oestradiol 20pmol/l (<80 in men)
AM cortisol 670nmol/l (0-700)
Reverse T3 0.36 pmol/ mL (0.15 - 0.54 - ideal less than 0.48)
Sample1: 22.4 nmol/l (12-22) 97.0F 60BPM
Sample2: 4.6 nmol/l (5-9) 98.2F 74 BPM
Sample3: 6.9 nmol/l (3-7) 97.9F 68BPM (Had 30 minute nap immediately after this sample)
Sample4: 2.3 nmol/l (1-3) 98.1F 80 BPM
DHEA Mean: 0.75 nmol/l (0.40 - 1.47)
DHEA : Cortisol Ratio: 2.07 (2-6)
Total daily cortisol 36.2 (21-41 nmol/l)
Notably my thyroid is fine, the RT3 has come down, which makes me wonder why I’m still experiencing low body temperature in addition to the rest of my symptoms.
Current symptoms are:
Low mood. This is not been a problem for the whole of the 18 months really but now starting to get tearful randomly and think pretty dark thoughts. Wouldn’t self harm but also feeling like I wouldn’t be too bothered if I didn’t wake up.
Agonizingly dry & photophobic right eye -specifically the right one, left seems ok.
Fatigue throughout the day and brain fog / difficulty concentrating. No exercise capacity.
Sinus congestion during the night. Wake up 3-30 -4 AM every night completely congested and incredibly thirsty. Pint of water eases the congestion.
Still no libido at all. Not even an inkling. No random erections, sporadic weak morning wood. Flaccid size is markedly reduced to the tune of less than half the usual size. Testicles also half the size they were before symptoms began 18 months ago.
My complete lack of libido despite a relatively normal testosterone level is making me think it is a neurotransmitter issue, with them possibly not being made properly due to dysfunctional methylation.
Symptoms have progressed to the point where I’m now off work, so in a way I’m glad theres not much left to test for.
I’ve just had some genetic testing back to look for possible problems with my methylation cycle.
Major ones being being heterozygous compound MTHFR mutation a heterozygous compound CBS mutation and homozygous compound COMT mutation.
MTHFR enzyme deficiency stops the body from converting folic acid to folate effectively and thus causing a potential block in the methylation cycle; neurotransmitters aren’t made properly, oxaditive stress isn’t managed effectively and the immune system doesn’t function well to name a few. It also means that the synthetic form of folate in multivitamins (folic acid) is not great for me and I’ve been taking 400mcg in a multivit and 400mcg in a b complex for the last year or more.
Problems with CBS pathway stop the body from processing sulfur properly when methylation cycle is impacted and the version of the COMT mutation I’ve got means that I would generally only feel good with higher levels of dopamine than average and break dopamine and adrenaline very slowly - which might explain the bouts of anxiety when problems first began. Thats briefly how its been explained to me anyway.
I’m now on a low sulfur diet for now (cut out onions, garlic, cruciferous veg, dairy) and been on a new supplement package for the last 5 days; few different things but major components are methylfolate and hydroxycobalamin. No changes as of yet but its early days.
I’ll be having my Testosterone levels checked next Monday, at which point I’ll have been on Test Cyp x 2 per week for just over 3 1/2 weeks. I decided to start it to put my levels at the top of the reference range to see if I’d feel different at a level of about 700-800 (25 - 28 UK units) as opposed to where I am on that latest blood test 420 (14.4 UK units)
Still no libido to report or any improvement in symptoms. Have got to imagine its going to come back high and confirm low T is not the real cause of my symptoms.
I did go for a short 1.5 mile jog outside today - first form of exercise I’ve tried in ages but don’t feel any more tired than usual for doing it and did feel good to do something.
Will try and post in your thread in a minute.
DHEA-S lab work is a better indicator of DHEA status.
MOOD and dopamine:
What you write really suggests dopamine deficiency.
trazodone for sleep if you need a sleep aid [time release melatonin too]
Wellbutrin , now generic, not like SSRI’s, can enhance libido, start with small dose, can take a few weeks to have its full effect. Too much can be overly stimulating [which would not play well with any adrenal fatigue.]
I also use:
cabergoline 0.5mg/week, lowers prolactin, increased dopamine
seleginine 5mg/week, a safe MAOI, keeps monoamine neural transmitter levels up, reduces
These two work the balance from both ends. With seleginine, you can use smaller amounts of traz and wellbutrin.
Rt3 blocks fT3 receptors and might ‘get stuck’ there with a lingering effect.
Bromine interferes with iodine metabolism. Iodine replenishment can displace bromine that then is excreted. During that phase, the free bromine can make one smell bad and/or feel bad, so one has to put up with that.
Note that a pituitary adinoma can create vision disturbances as the optic nerves pass right by the pituitary.
Thanks Ksman - definitely agree that it seems dopamine related. Especially seeing as I’ve been injecting Test Cyp x 2 per week and still have no libido at all.
However I’d have no chance getting wellbutrin or its ilk in the UK- only licensed for stopping smoking.
Interesting point about the pituitary adinoma - I’m seeing an opthamologist for the first time in December but I’ve already had an MRI of my pituitary and it was clear.
The problem then is why is dopamine low and what can I do to increase it naturally?
I watched this video today and it gives quite a brief but good overview of how improper methylation, specifically due to the MTHFR defect, causes an inability to produce neurotransmitters like dopamine properly and also an inability to produce suitable levels of gluthathione.
So my hope is now that I know what my genetic polymorphisms are - I can use supplements to try and lift the blocks in the methylation cycle.
It has been used in the USA for depression since 1985. It was at times prescribed in high doses, with a risk of seizure for those so disposed. And it was all fast acting then too. With the lower dosed and sustained release formulas, there really is not risk. That early reputation may have kept it out of the NHS.
In our situation, we are looking at smaller doses. I take 100 mg fast acting, once a day and not every day. I used to not want more than 50mg as it seems like too much, but now do not have that intolerance. And these statements need to be in the context of the other things that I do for dopamine. Note that those did not change.
I have read that it can be prescribed off-label there. However, most docs will not be willing. However, if a doctor is directed by a specialist in depression etc, one can get it. Sort of sucks, given that SSRI’s will kill libido.
There is the option of off-shore pharmacies.
Thanks for the suggestions. I’m hoping it won’t have to come to self prescribing AD’s though.
Had some new labs back which tend to support problems with my methylation and b-vitamin conversion, namely sky high serum B12 and over range Folate (Not entirely sure HOW high folate is as the lab doesn’t measure past 20). My iron also seems to be creeping up again after last giving blood to get it down in April.
Serum B12: 1940 ng/L (211 - 911)
Serum folate: >20 ug/L (4.6 - 18.7)
Ferritin 95 ug/L (30-330)
Serum TIBC 52 umol/L (40-70)
Serum iron level 30 (10-30)
Saturation iron binding capacity 58%
Haematocrit 40.0 % (39-50) looked a bit low, from blood removal?
Missed the lead thing. How you you think that you were exposed to lead? Near term and acute, or long term?
Have you looked onto ways to clear the lead? Might need bigger guns than vit-C
Are you eating any iron fortified foods?
Not eating Iron fortified food or supplementing it so think there is something going on. I’m negative for the HH gene so know it isn’t that.
Yeah I gave blood a couple of weeks before that Haemocrit. It has since risen to 44%
In terms of the lead - I’m not sure its such a problem for me. It is still in range on that urine test in the NutrEval and it didn’t show up at all in my more recent (September) hair analysis.
I’m getting my T results back at the end of the week to see where I’m at.
Had quite an interesting chat with the guy at the clinic doing the bloods - it was a steroid harm reduction clinic that do free bloods, so he tests upwards of 50 guys a week.
He said that hes got a couple of natty high level bodybuilders who test around 12nmol (350 US) and they don’t report any symptoms of low T, libido is fine etc and they carry a fair amount of mass.
Said hes tested himself multiple times when hes had odd symptoms, such as reduced libido and his T has always been a consistent 14-15 (406 - 450) and he feels fine tje majority of the time.
Just thought it was quite good food for thought - chasing the golden 700 - 800 might not be the magic bullet for some.
" chasing the golden 700 - 800 might not be the magic bullet for some"
This may be true for younger guys. But it seems like older guys need higher levels.
I’m wondering if a main problem for me really is low noepinepherine. Two of the markers for its urinary metabolites 3methyl-4-OHphenylglycol and vanillyl mandelic acid are both low on my nutreval and only just in range in comparison to the serotonin and dopamine ones which seem at good levels.
Low mood, no libido, low energy, difficulty concentrating, low body temperature in the prescence of goodl thyroid / adrenals, temperature that drops following exercise, mild hypotension on rising from a chair quickly, and sinus congestion could quite neatly fit under low NE symptoms could they not?
And just further to that I’m additionally thinking low NE over low dopamine due to the fact my prolactin is always in range and low - middle.
Update:
Got my T level results back over the phone from the clinic. Pretty confusing. Testosterone is only at 16 (464) after 3.5 weeks at injecting 50mg x 2 per week. Estrogen has risen but still in range 94 (28 - 156)
My LH and FSH have dropped but are still detectable and my nuts have shrunk further so I think it is genuine T.
Obviously I don’t feel any different so I’m wondering whats happening.
a) underdosed? should I increase to 75mg x 2
b) body chewing through Testosterone and using it up quickly?
c)???
The other part of me is thinking that I should just get off it and run a PCT as we think its unlikely T is the cause of my problems with a baseline of 417.