@martyrs @briggsey it would make sense if, like @ohiodude said, you had an underlying low cortisol issue and the nicotine was keeping the levels up. There is also a low cortisol → high E2 connection that i mentioned in my previous post. Google low cortisol symptoms and see if it fits, or do a cortisol lab test and go from there.
I did a cortisol test in July 2016, everything seemed fine. So I don’t think there is a connection there for me.
Here are the labs actually:
9AM Serum Cortisol = 498 nmol/L (133-540 nmol/L)
Midnight Salivary Cortisol = < 8 nmol/L (<13 nmol/L)
ACTH = 25 ng/L (10-60)
Still I find this very interesting. But it isn’t much to help to me. Let’s say the nicotine did screw my endocrine system up, or stopping abruptly after so many smoking years (6) caused an endocrine disruption how does that help me knowing that? Is my body just going to correct itself in time or what?
It might be even more interesting to note that in September 2015 I quit smoking for approximately 30 days in which case this is the time that the symptoms started, and when I got my first hormone panel ever - testosterone was high, docs asked me if I was on roids lol. Anyway I started back up in early November 2015 until March 2016 and during this time I actually had a libido it’s when I quit for good (I hope) is when everything went totally downhill. I’ve been quit for 10 months now, but the first few after quitting is when I had all my symptoms and I found I had the high E2.
Unfortunately I didn’t have any E2 labs while I was smoking, damn that would of been so interesting. I think people really underestimate what happens to your body when you quit smoking cold turkey. Your body repairs for AGES and doesn’t stop for a long time. So many things going on, lung repair, immune system, dopaminergic pathway repair etc etc
Martys if you do smoke, stop taking the AI and smoke as normal and get E2 bloods for us if possible. Then we can compare to your older bloods. Of course I don’t want you to start smoking again if you’ve quit, but if you have an opportunity it would be interesting.
I had a 9am Cortisol test that was fine too. Could be these stimulants affect the HPTA.
Your point is valid… that’s well and good but where do we go from here?
We read. Problem is I find all the medical jargon tough to decipher.
Aromatase inhibitors in cigarette smoke, tobacco leaves and other plants.
Tobacco alkaloid derivatives as inhibitors of breast cancer aromatase.
Would be good to have get someone who has High E2 with labs while they smoked and then labs after they quit (if they did). Not very likely.
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Well, here I am resurrecting an old thread.
Not much has changed, however I stopped Arimidex for 4 weeks because I was worried about the joint popping in my knees and legs (no pain) but turned out that my legs do that either way (maybe slightly more on the Arimidex), I just never took notice.
I have lost around 5kg since I had more energy on the Arimidex so went from 87kg down to 82kg and I feel like Arimidex has a small role in that even though I have honestly not taken it properly since last October.
@KSman I have new bloods now, could you please have a quick look over and decipher for me.
A MASSIVE discovery just recently is that I have low haemoglobin and also, low ferritin. I then did some digging in old bloods as far back as 2010 and remembered I had the same issue then, and I was on iron supplements - felt better for a while, then totally forgot about the issue altogether.
Could this be a big player in all of my issues? (fatigue, low libido etc)?
Labs 13/04/17
Testosterone = 34 nmol/L (8-30)
SHBG = 47 nmol/L (10-45) Never seen this that high before.
Free testosterone = 0.6 nmol/L (0.2-0.6)
Ferritin = 20 ug/L (30-300) When my problems began in 2015, my Ferritin was 30 ug/L
Iron = 23 umol/L (8-30)
Transferrin = 3.32 g/L (2-4)
Transferrin Saturation = 27% (10-55)
Oestradiol = 160 pmol/L (<250)
DHEAS = 6.9 nmol/L (2.5-13)
Labs 05/04/17
Haemoglobin = 127 g/L (130-180)
AST = 22 U/L (10-40)
ALT = 53 U/L (5-40)
TSH = 2.7 mU/L (0.5-5)
Free T4 = 16.7 pmol/L (11-21)
Free T3 = 4.1 (3.2-6.4)
LH = 7.2 U/L (1.5-8.5)
FSH = 5.2 U/L (1.5 - 12.4)
Testosterone = 32.1 nmol/L (12-32)
Free Testosterone = 606 pmol/L (260-740)
SHBG = 50 nmol/L (17-56)
Oestradiol = 101 pmol/L (99-200)
This is something I really need to discuss with someone, as these labs are different to the ones above. They come with a note that say “new Oestradiol assay introduced 2015. Results may be slightly lower than with the older assay.”
The Oestradiol reading above @ 160pmol/L was a week after the 100 pmol/L reading. The higher one has a stupid range of <250 pmol/L and the lower one also has a silly range IMO because if it was more sensitive are you telling me the range is 99 pmol/L (27 pg/ml) at the lowest point? If anyone has any suggestions here please chime in, this is all I have available where I am, my doctors don’t know shit.
If I had to go by how I feel, I honestly would say after 4 weeks of ceasing the Arimidex, I don’t feel like I am at 100 pmol/L (bloating, flushing around face, morning wood goes away, tiredness comes back) but then again, I am not an expert. But I will say this, after losing morning wood for the past 7+ days, one dose of 0.25mg Arimidex I took yesterday brought it right back, and also restored a type of fullness to my penis, hangs lower.
So just to summarise:
- I have anemia in some form and need to investigate the cause.
- I have low Iron Stores (Ferritin) as an ongoing issue pretty much all my life and have neglected it. Can these iron issues be the key to all or most of my issues?
- I need help figuring out what is happening with my E2 and these different labs. Why do I lose all wood and bloat and feel like shit on the low labs saying 100pmol/L but I take Arimidex and wood in the morning instantly shows up?
- Is my testosterone too high? Is this a problem and why I have high T>E conversion?
- Why could my SHBG have gone up? I still have really good free T levels though.
Supplements I am Taking Daily
NOW Foods Thyroid Energy (Tyrosine, Selenium, Iodine, Zinc etc)
Zinc Picolinate 50mg
D3 + K2 + 1000mcg Iodine
Maltofer Iron Liquid - Just started at 20ml daily = 200mg elemental iron
P5P (B6) + Magnesium
B12
If anyone could help out, especially overlooking my new labs that would be SO SO much appreciated. And I appreciate your time.
@ohiodude @nabitek @martyrs if interested in what is going on.
Weird you didn’t mention anything about the ALT = 53 U/L (5-40) which is one of your liver readings. Couldn’t this indicate a liver issue?
Also it’s my understanding that SHBG binds to the androgen receptors, so you’ve got that working against you even if your free T is high. High T is not useful if it can not bind.
Please correct me if I am wrong.
Edit: just ran into this quote by KSman in a different topic: “SHBG can be elevated by liver problems in some cases. Liver produces SHBG to scavenge sex hormones from the blood stream.”
Liver issue/disease can lead to more SHBG production by the liver. Liver markers can easily be elevated from sore muscles from training. Stop training to recover then retest AST/ALT.
Males typically do not need any added iron. You could have a GI bleed from gut, liver etc. Get an occult blood test done. This is not a blood loss that you could see, thus occult or hidden. I assume that you are not a blood doner.
Low ferritin can impede T4–>T3 conversion.
fT4 is good at mid-range
fT3 is not near midrange, as one might expect.
Please eval your overall thyroid function via last paragraph in this post.
When taking larger amounts of iodine, selenium is very important, hard can result if deficient.
The cause of your low iron is also leading to low thyroid function.
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
Thank you for this very much appreciated.
AST/ALT was taken after two very intense powerlifting days, this could be the cause. Not sure if drinking on the weekend could have affected these markers.
Yes, my doctors are saying I might be internally bleeding. Occult blood test is the next step, hopefully have that done soon and will report back. I am not a blood donor. For now obviously continue with the iron supplementation - this should still help, right?
Very interesting that low ferritin can impede T4–>T3 conversion, makes a lot of sense in my case.
Also RE higher SHBG in another thread you said “High SHBG with low E2 is not right. Something else is going on as you are suspecting. SHBG levels increase with estrogenic states…”. Is it possible SHBG has had time to increase along with my E2 these 4 weeks I have been off the arimidex?
Also anything to say RE those two different E2 labs? Because I am thinking of going back on Arimidex since I have a sex drive and morning wood when on, and I don’t feel like E2 = 101 (27 pg/ml) reflects how I feel at the moment, it is closer to the higher reading 160 (43 pg/ml) with the stupid range of (<250). Don’t understand how my doctors have no idea about E2, might directly call the labs next week to get more information. Arimidex has been started again 0.25mg E3D.
I do not understand timing of stopping anastrozole relative to lab results or why.
Try to get near E2=22pg/ml - 80 pmol/L
Well, I’m confused as to which labs to go with to keep my E2 in check.
One seems more sensitive than the other, however my symptoms indicate I relate more to the higher stated E2 test and starting anastrozole after 4 weeks off confirms this by giving me morning wood and libido back.
E2 = 100 (more sensitive test) and E2 = 160 pmol/L is a massive difference. Doctor can’t tell me which is more accurate/or what to dose my anastrozole based on.
We run into these issues with some USA labs and the issues are specific to the lab companies. Good to see that you feel the differences.
Any progress on what we have discussed?
Body temperatures?
Still getting iodine and selenium as above?
Thanks for checking in.
Not much progress apart from I seem to be less fatigued using the iron, but not sure what to do regarding E2.
When I stay off the Arimidex, I slowly go back to my old self. Which is not much morning wood, much lower sex drive - it’s hard to explain but it feels like I am robbed of that primal desire to have sex. I’m 23 with good T levels, what else could it be?
Can you try to explain why that every time I get on the Arimidex, I feel amazing about 3 doses in (sex drive has sky rocketed, erections are fantastic) then it slowly tapers off from there? Is that because I’m natural so my HPTA is just upregulating more T, or is it because I end up driving E2 too low?
Still taking iodine and selenium yes. I’ll need to locate my oral thermometer and get back to you on temps.
So stumped, not sure what else to do. I can’t work it out.
Not sure if it is worth noting that my PSA was high (tested as I was beginning anastrozole last year) I’ll have to dig up the actual number but the doctor exclaimed when he saw it, it was like 1.5 when it should be 0. Something.
I’ve also put a lot of work into losing fat. I’ve probably gone from near 20% body fat to 15% now and I’m going to keep going. At my heaviest and before I touched any arimidex, I was around 88kg. I am now just under 83 with more muscle than before. Can’t attribute it to the arimidex since I’ve effectively been cycling it, I’ve never taken it more than 3 weeks long before I lose erections and libido and stop.
I want to look into my liver more to see if poor liver clearance is causing high E2 seeing as my ALT levels were high but I have no idea where to begin.
Hey mate,
I have just received another oral thermometer (lost the last one) so I am going to get you my oral body temps in the mornings in the coming days.
It’s 3pm now and I am getting a reading of 97.7f so definitely not reaching 98.6f. I remember when I did my morning temps months ago I was under 97 so it will be interesting to see what I am. Will update.
I’m very convinced that I have some type of hypothyroidism, been doing a lot of research lately. I’ve supplemented with lugols at 50mg daily for 3 weeks or so late last year, and iodine + selenium daily for the past 3 months.
To be 100% honest I’m close to trying a therapeutic dose of synthetic T3 or natural desiccated thyroid to see if my symptoms alleaviate. I can’t get my doctors to look into my thyroid deeper, very frustrating.
do you have any thoughts of trying T3 only vs natural desiccated thyroid? I suspect I have ft4->ft3 problems.
I can get tiromel pretty easy and a T3 only cycle would be a good way to see if helps my symptoms. Just worried about how the thyroid will recover upon stopping T3. NDT is much harder to get for me.
Oh and if it makes any diff, my mum is hypo, one of my sisters is hypo… my mums sisters are hypo and one had her thyroid removed (not sure if due to hashimotos). I should’ve been focusing on my thyroid all along.
Waking Oral Body temp 8am this morning: 96.0f.
Hey @KSman, here are some waking and afternoon body temps over the past week.
8th Aug - 3PM 97.8f
9th Aug - 8AM - 96.0f, 3PM 97.8
10th Aug - 8AM - 96.5f
11th Aug - 8AM - 96.5f, 3PM 97.8f
12th Aug - 11AM - 97.0f, 3PM 98.0f
So I am consistently not hitting 97.8 in the morning or 98.6 in the afternoons.
What should my next step be? My TSH is consistently > 2.5. Next week I am getting fT3, rT3, fT4, TSH and Thyroid Antibodies done. I am almost convinced I have a sluggish thyroid.
If my doc prescribes T4, how do I tell him I want T3? Would natural desiccated thyroid be better?
My average morning temp = 96.5f
My average afternoon temp = 97.8f
My average morning resting heart rate = 56bpm
I have T3 on me and started dosing today. I have read that there is no need to ramp up, and the male body makes around 25-30mcg per day.
Today is day 1, and I am dosing 12.5mcg x 3 times daily (morning, arvo, then night). Don’t feel too much, but notice increased energy for a short while after dosing, and have have insanely hard erections twice shortly after taking a dose (I’m gonna write this off as a coincidence though).
@KSman any suggestions on my dosing. This is purely for a clinical trial, I don’t want to run at levels that BBers use. Is 37.5mcg a day split into three doses okay?
Day 3 and my temps are already coming up.
AM = 97.7
PM = 98.5
So almost there. Never seen those temps before in all the time I’ve monitored my Oral Body temp! Is it normal for temps to come up that fast after 3 days on the T3?
Noticed more energy, and a clearer head too. Not much else though. Hands and feet still cold.
New labs are in. Thyroid is getting worse (before I took any T3) and ferritin has gone DOWN despite taking liquid iron supplements these past months.
TSH = 3.3 mU/L (0.5-5)
Free T4 = 14.7 pmol/L (11-21)
Free T3 = 3.9 pmol/L (3.2-6.4)
Thyroglobulin Ab <20 IU/mL (0-40)
Peroxidase Ab 19 IU/mL (0-35)
TSH is creeping up, fT3 is going down consistently.
Iron = 18.5 umol/L (5-30)
Transferrin = 3.0 g/L (2-3.2)
Saturation = 28% (10-45)
Ferritin = 18 ug/L (30-500)
I note a correlation of hypothyroidism and low ferritin statuses. Serum ferritin as a marker of thyroid hormone action on peripheral tissues - PubMed
Serum ferritin as a marker of thyroid hormone action on peripheral tissues.
“Administration of 75 micrograms T3 daily for 1 week to 11 euthyroid subjects resulted in a 23-243% (mean +/- SD, 117 +/- 70%) increase in serum ferritin above basal values”