Need Help Desperately

[largeitalian]

Ok this is something I have been battling for 3 years now. I just wish I would have went to a TRT Clinic to start instead of wasting time and $$ with endos and family pracs. Heres lab history:

5/29/08
Free Test: 52 Range 47-244 pg/ml
Total Test: 245 Range 400-1080 ng/dl

6/18/08

Test Free: 103 Range 47-244 pg/ml
%Free: 2.4 Range 1.6-2.9
Sex Horm Bnd Glob: 19 Range 11-80 nmol/L
Total Test: 432 Range 400-1080 ng/dl
Prolactin: 18.6 Range 2.6-13.1 ng/ml
LH: 8.5 Range 1.2-8.6 mlu/ml
FSH: 8.9 Range 1.3-19.3 mlu/ml
Calcium: 9.3 Range 8.4-10.2
Glucose: 91 Range 75-99
Creatinine: 1.2 Range .7-1.3
BUN: 24 Range 10-25
Sodium: 138 Range 135-145
Potassium: 4.3 Range 3.5-5.1
Chloride: 101 Range 101-111
CO2: 30 Range 21-32


7/31/08

TSH: 4.42 Range .34-5.60
Free T4: 1 Range .58-1.64
Prolactin: 34.6 Range 2.6-13.1
Free Test: 82 Range 47-244
%Free Test: 2.1 Range 1.6-2.9
Sex Horm Bng Glob: 24 Range 11-80
Total Test: 383 Range 400-1080

9/23/08

Prolactin: 37.4 Range 2.6-13.1
Free Test: 127 Range 47-244
%Free Test: 2.5 Range 1.6-2.9
Sex Horm Bnd Glob: 17 Range 11-80
Total Test: 504 Range 400-1080

Started using cabergoline

12/3/08
Free Test: 112 Range 47-244
Prolactin: 15.8 Range 2.6-13.1
%Free Test: 2.5 Range 1.6-2.9
Sex Horm Bnd Glob: 18 Range 11-80
Total Test: 459 Range 400-1080


2/4/09
Prolactin: 32.8 Range: 2.6-13.1


29 Sep 2010
Have full labs, included what I felt important and anything out of normal ranges.

Test Serum 469 (200-800)
Estradiol....34.3...(7-42)
E2 Sensitive 13 (3-70)
TSH 2.6 (.4-4.5)
DHEA 179 (211-492)
FSH 8 (1-12)
Insulin 3 (0-24)
Billirubin 2.4 (0-1.2)

LDL-chol....109...[ 0 - 99 ]
----------------------------------------
T4 free.....1.17......[ 0.82 - 1.77 ]
RT3..........253......[ 90 - 350 ]
T3.............2.7.......[ 2.0 - 4.4 ]
TSH.........2.65.....[ 0.45 - 4.5 ]
----------------------------------------
LH..............7.4......[ 1.7 - 8.6 ]
T...............469......[ 280 - 800 ]
SHBG......29.6.....[ 14.5 - 48.4 ]
----------------------------------------
IGF-1.......265.......[ 116 - 358 ]


Then decided to get a 4x saliva test done

got cortisol results back

Morning 8.0 (3.7-9.5)
Noon 1.0 (1.2-3.0)
Evening 1.7 (0.6-1.9)
Night 0.4 (0.4-1.0)


Then they attached another sheet because I had filled out a symptom list, It listed a list of possible conditions, along with like a point system based on my responses (4 pts severe, 3 points i have this issue sometimes, etc.) it listed:

Low Androgens (DHEA/Test) 32.9
Low Cortisol 23.4
Metabolic Syndrome 23.1
Hypometabolism 20.8
High Cortisol 18.8
Estrogen Dominance/Progesterone Deficiency 16.5
High Androgens 10.4

Had more lab work done in May of 2011

Pregnenolone 175 (Male <151)
T4 1.32 (.82-1.73)
Test Serum 414 (249-836)
TSH 3.03 (.45-4.5)
LH 3.5 (1.7-8.6)
FSH 6 (1-12)
prolactin 8 (4-15)
DHEA 200 (160-449)
e2 sensitive 11 (3-70)
Progesterone .7 (.2-1.4)
Insulin 4 (0-24)
SHBG 23 (14-48)





Lastly, just had a testosterone test run last week and it came back at about 348 again.

Symptoms:
Tough to lose fat
Hard to gain muscle
erection issues
no libido
Foggy memory
feelin lethargic at times
tough to wake up in the morning

My endo isnt the type to perscribe TRT. He thinks everything is normal because my numbers are in the normal range. I dont feel normal for a 25 year old. I have tried a sleep apnea test, had a pituitary MRI, changed lifestyle and diet to more balanced. I have spent hours researching from this site and others. Does anything stick out about my labs? Does my low DHEA level throw up a flag as a precursor to the low T?

I lift weights heavily 3-4 times a week, but I have like 0 stress in my life. Dont believe I am overtrained/drained CNS.

I want to leave my endo, but I dont know where to go next. I live in North Dakota, so theres no local TRT clinics that i am aware of. I just dont know what to do next.

Any help would be greatly appreciated.

 

[hitest]

This in interesting. On your last test you have high pregnenolone but your progesterone is normal and DHEA is low normal. It seems like not enough pregnenolone is converting to DHEA which in turn means less testosterone and less estradiol. Your androstenadione and DHT are probably lowish too. I'm not sure what can be interfering with the pregnenolone -> DHEA step. Are you taking any other meds? I'd look for other ways to deal with this before taking DHEA or TRT.

 

[largeitalian]

Yea i know they baffle me as well.

My preg is high, almost like its built up and unable to convert to anything since DHEA and Test are low.

Looked over labs and dont have any DHT or Andro numbers, would that be something I should get tested? Or are you just saying you assume they would be low because they are correlated?

And no other meds are being taken.

 

[The Matrix]

Ok this is something I have been battling for 3 years now. I just wish I would have went to a TRT Clinic to start instead of wasting time and $$ with endos and family pracs. Heres lab history:

5/29/08
Free Test: 52 Range 47-244 pg/ml
Total Test: 245 Range 400-1080 ng/dl

6/18/08

Test Free: 103 Range 47-244 pg/ml
%Free: 2.4 Range 1.6-2.9
Sex Horm Bnd Glob: 19 Range 11-80 nmol/L
Total Test: 432 Range 400-1080 ng/dl
Prolactin: 18.6 Range 2.6-13.1 ng/ml
LH: 8.5 Range 1.2-8.6 mlu/ml
FSH: 8.9 Range 1.3-19.3 mlu/ml
Calcium: 9.3 Range 8.4-10.2
Glucose: 91 Range 75-99
Creatinine: 1.2 Range .7-1.3
BUN: 24 Range 10-25
Sodium: 138 Range 135-145
Potassium: 4.3 Range 3.5-5.1
Chloride: 101 Range 101-111
CO2: 30 Range 21-32


7/31/08

TSH: 4.42 Range .34-5.60
Free T4: 1 Range .58-1.64
Prolactin: 34.6 Range 2.6-13.1
Free Test: 82 Range 47-244
%Free Test: 2.1 Range 1.6-2.9
Sex Horm Bng Glob: 24 Range 11-80
Total Test: 383 Range 400-1080

9/23/08

Prolactin: 37.4 Range 2.6-13.1
Free Test: 127 Range 47-244
%Free Test: 2.5 Range 1.6-2.9
Sex Horm Bnd Glob: 17 Range 11-80
Total Test: 504 Range 400-1080

Started using cabergoline

12/3/08
Free Test: 112 Range 47-244
Prolactin: 15.8 Range 2.6-13.1
%Free Test: 2.5 Range 1.6-2.9
Sex Horm Bnd Glob: 18 Range 11-80
Total Test: 459 Range 400-1080


2/4/09
Prolactin: 32.8 Range: 2.6-13.1


29 Sep 2010
Have full labs, included what I felt important and anything out of normal ranges.

Test Serum 469 (200-800)
Estradiol....34.3...(7-42)
E2 Sensitive 13 (3-70)
TSH 2.6 (.4-4.5)
DHEA 179 (211-492)
FSH 8 (1-12)
Insulin 3 (0-24)
Billirubin 2.4 (0-1.2)

LDL-chol....109...[ 0 - 99 ]
----------------------------------------
T4 free.....1.17......[ 0.82 - 1.77 ]
RT3..........253......[ 90 - 350 ]
T3.............2.7.......[ 2.0 - 4.4 ]
TSH.........2.65.....[ 0.45 - 4.5 ]
----------------------------------------
LH..............7.4......[ 1.7 - 8.6 ]
T...............469......[ 280 - 800 ]
SHBG......29.6.....[ 14.5 - 48.4 ]
----------------------------------------
IGF-1.......265.......[ 116 - 358 ]


Then decided to get a 4x saliva test done

got cortisol results back

Morning 8.0 (3.7-9.5)
Noon 1.0 (1.2-3.0)
Evening 1.7 (0.6-1.9)
Night 0.4 (0.4-1.0)


Then they attached another sheet because I had filled out a symptom list, It listed a list of possible conditions, along with like a point system based on my responses (4 pts severe, 3 points i have this issue sometimes, etc.) it listed:

Low Androgens (DHEA/Test) 32.9
Low Cortisol 23.4
Metabolic Syndrome 23.1
Hypometabolism 20.8
High Cortisol 18.8
Estrogen Dominance/Progesterone Deficiency 16.5
High Androgens 10.4

Had more lab work done in May of 2011

Pregnenolone 175 (Male <151)
T4 1.32 (.82-1.73)
Test Serum 414 (249-836)
TSH 3.03 (.45-4.5)
LH 3.5 (1.7-8.6)
FSH 6 (1-12)
prolactin 8 (4-15)
DHEA 200 (160-449)
e2 sensitive 11 (3-70)
Progesterone .7 (.2-1.4)
Insulin 4 (0-24)
SHBG 23 (14-48)





Lastly, just had a testosterone test run last week and it came back at about 348 again.

Symptoms:
Tough to lose fat
Hard to gain muscle
erection issues
no libido
Foggy memory
feelin lethargic at times
tough to wake up in the morning

My endo isnt the type to perscribe TRT. He thinks everything is normal because my numbers are in the normal range. I dont feel normal for a 25 year old. I have tried a sleep apnea test, had a pituitary MRI, changed lifestyle and diet to more balanced. I have spent hours researching from this site and others. Does anything stick out about my labs? Does my low DHEA level throw up a flag as a precursor to the low T?

I lift weights heavily 3-4 times a week, but I have like 0 stress in my life. Dont believe I am overtrained/drained CNS.

I want to leave my endo, but I dont know where to go next. I live in North Dakota, so theres no local TRT clinics that i am aware of. I just dont know what to do next.

Any help would be greatly appreciated.

When dealing with these cases I see a few red flags which are sticking out.
1. Further evaluation of thyroid is needed. One can not make assumption just by using T4, but need ft3, and rt3, ferritin and vitamin D for the thyroid to properly function. T3 is also needed for the stimulation of the mitochondrion to fire up cellular function. In return if there is mitchondrion dysfunction then t3 will not have any cellular response since the mitochondrion can not tolerate the increase in metabolism. When dealing with thyroid one needs to look at the serum numbers, Tissue response, as well as ability of mitochondrion to handle the t3 itself. Your T is a little bit low e2 is as well. DHEA can help push up e2 a bit since you are low which can also push thyroid function.

2 You mention of proper lifestyles, but when examined I am sure there could be some imbalances with in this as well

As with any Dr I am consulting with. If the hormones are in check, thyroid been evaluated, adrenals are in line then the next area is the neurotransmitters, GI tract and the liver. When the answers are not found in the endocrine system then you look to GI and neurotransmitters next . There are also needs to be more testing to done to look into lipiids, and also nutrient metabolism and assimulation. When dealing with autistic cases they rarely have hormone issues, but have more hidden imbalances which make it a greater challenge to fine. Amazingly the same Biological principles of autism applies just about to any case I have dealt with the blood work looks good, but patient is feeling symptoms. By using these principles it allows me to help the Dr to narrow quickly to get to the root cause of the problem.
2.

 

[largeitalian]

When dealing with these cases I see a few red flags which are sticking out.
1. Further evaluation of thyroid is needed. One can not make assumption just by using T4, but need ft3, and rt3, ferritin and vitamin D for the thyroid to properly function. T3 is also needed for the stimulation of the mitochondrion to fire up cellular function. In return if there is mitchondrion dysfunction then t3 will not have any cellular response since the mitochondrion can not tolerate the increase in metabolism. When dealing with thyroid one needs to look at the serum numbers, Tissue response, as well as ability of mitochondrion to handle the t3 itself. Your T is a little bit low e2 is as well. DHEA can help push up e2 a bit since you are low which can also push thyroid function.

2 You mention of proper lifestyles, but when examined I am sure there could be some imbalances with in this as well

As with any Dr I am consulting with. If the hormones are in check, thyroid been evaluated, adrenals are in line then the next area is the neurotransmitters, GI tract and the liver. When the answers are not found in the endocrine system then you look to GI and neurotransmitters next . There are also needs to be more testing to done to look into lipiids, and also nutrient metabolism and assimulation. When dealing with autistic cases they rarely have hormone issues, but have more hidden imbalances which make it a greater challenge to fine. Amazingly the same Biological principles of autism applies just about to any case I have dealt with the blood work looks good, but patient is feeling symptoms. By using these principles it allows me to help the Dr to narrow quickly to get to the root cause of the problem.
2.

1) I have full labs I just didnt feel as if typing 14 pages of stuff was necessary as I assumed some of the stuff didnt matter.

2010 labs
RT3 253 (90-350)
Ferretin 306 (200-400)
FT3 2.7 (2-4.4)

2011
RT3 Not tested at this time
Ferretin 215 (30-400)
FT3 1.32 (.82-1.77)

You mention taking DHEA, is that something I could self-medicate as DHEA is sold OTC? or is that something I would want to have my doc give me?

2) I feel like I have a good lifestyle, but yes Im sure there is something to be found.

What would your advice be for my next step Mr. Matrix? Should I continue to try and find a new doctor? Perhaps go see Dr. John as MI is not far from ND?

 

[hitest]

Yea i know they baffle me as well.

My preg is high, almost like its built up and unable to convert to anything since DHEA and Test are low.

Looked over labs and dont have any DHT or Andro numbers, would that be something I should get tested? Or are you just saying you assume they would be low because they are correlated?

And no other meds are being taken.

I wouldn't go out of my way to test those but it is always nice to get confirmation of something expected. I'm not sure if there is much you can do about this conversion problem directly but maybe you will find something if you poke around.

 

[hitest]

1) I have full labs I just didnt feel as if typing 14 pages of stuff was necessary as I assumed some of the stuff didnt matter.

2010 labs
RT3 253 (90-350)
Ferretin 306 (200-400)
FT3 2.7 (2-4.4)

2011
RT3 Not tested at this time
Ferretin 215 (30-400)
FT3 1.32 (.82-1.77)

You mention taking DHEA, is that something I could self-medicate as DHEA is sold OTC? or is that something I would want to have my doc give me?

2) I feel like I have a good lifestyle, but yes Im sure there is something to be found.

What would your advice be for my next step Mr. Matrix? Should I continue to try and find a new doctor? Perhaps go see Dr. John as MI is not far from ND?

DHEA might make sense in your case but it tends to suppress your natural DHEA production. So I would try to consider as much as possible before starting that.

 

[The Matrix]

DHEA might make sense in your case but it tends to suppress your natural DHEA production. So I would try to consider as much as possible before starting that.

I am cringing at some suggestions people.were given on other board. With it out knowing your past medical history making.such crazy recommendations with either end you up in the hospital with clogged arteries or other medical issues. Why i am glad i got kicked off because some on over there is going to end up in the hospital withe.what they are recommending. When the other issues are.not even looked into. Why people.never get well because sometimes underlying cause is never addressed.or investigated. One day its one.thing another months its something.else. if dhea is low look into the immune system and hidden inflammation or insulin imbalance low thyroid. High.protecting would.red flag a few. Factors needing further investigation

 

[largeitalian]

I am cringing at some suggestions people.were given on other board. With it out knowing your past medical history making.such crazy recommendations with either end you up in the hospital with clogged arteries or other medical issues. Why i am glad i got kicked off because some on over there is going to end up in the hospital withe.what they are recommending. When the other issues are.not even looked into. Why people.never get well because sometimes underlying cause is never addressed.or investigated. One day its one.thing another months its something.else. if dhea is low look into the immune system and hidden inflammation or insulin imbalance low thyroid. High.protecting would.red flag a few. Factors needing further investigation

are you referring to the guy who told me to eat like 500 grams of fat a day?

im assuming you think thats asinine.

what would you recommend I do?

 

[The Matrix]

are you referring to the guy who told me to eat like 500 grams of fat a day?

im assuming you think thats asinine.

what would you recommend I do?

moderation is the key.
All that fat with out knowing the make up of cellular.membrane is just asking for problems. I.learned from the queen of lips herself about cell.membrane dynamics. Even on 3 tbsp a day.of evcco i was causing oxidation stress.pushing my self into insulin resistant state just doing 3 tbsp because there were.other factors out of balance.

I.recommend you break.this down.into.its.smallest.components working on seeing how each interact with another. Then take that data.to.give educated recommendations. Dealing this issues are.not tuff just need to properly approach. In.dept testing Is.some times.needed.to.know where.the imbalances.are in the systems other wise you are.just swinging it. With out full.medical history and other information you.may do.person.for harm.then good. When i consult.with Dr i.am not one who like to use people as human.lab rats, but use fact based information to come up with suggestions for dealing Drs patient.

 

[largeitalian]

matrix peek over into that other thread again, are those guys messing with me?

1 guy said i cant follow a certain program until my waist is 32"

 

[The Matrix]

matrix peek over into that other thread again, are those guys messing with me?

1 guy said i cant follow a certain program until my waist is 32"

No they are being serious !!
Why I just shake my head sometimes when the type of information should be censored is not. There is not clinical basis other then some guy said it then it because the only thing. One time its this person another time its that person. I prefer to take accumulation of what I know personally, through research, and also almost 5 years clinical experience under an MD supervision. How things are twisted around from what was originally said is just mind blowing sometimes.