High E2, High Progesterone, Low SHBG, need advice from experts!

ericren23

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I've been lurking around for a while now and i find the board to be very knowledgeable.

I posted my story on MesoEx on Men's Health/ Low Testosterone in 21yr old thread, but would like more advice from the members here.

My problem in short is after going on a crazy low cal diet trying to loose some weight(for at least 1/2 yr), i ended up trashing my endocrine system. Had bloodtests done and showed a VERY low testosterone. I was sent to an endo. He did some other tests including MRI on my pituitary, but couldnt find why it was that low so he put me on Andriol and then sustanon injections.

After a year or so he retested me and pronounced me as cured. At the time my T was 13 nmol/L (R.R 10-38)
No amount of reason can I convince him that I was NOT fine.

So I stopped everything for about a year, trying in vain to let my body right itself, but then I found MesoEx and AnabolicMinds, which opened my eyes to the real world.

I just saw an anti-aging specialist, but he was totally stumped by my blood works:

thyroid function
Free T3(FT3) 5.16 pmol/L (2.5-6)
Free Thyroxine(FT4) 14 pmol/L(8-22)
TSH 0.66 mIU/L(0.3 -4)
reverse T3(RT3) 556 pmol/L (170-450)

IGF-1 56 nmol/L (24-102)
Progesterone 2.1 nmol/L (0.5 -1.3)
Oestradiol (E2) 167pmol/L (<160) performed using Roche method

DHEAS 12.7 umol/L (2.2-15.2)
Testosterone 16.3 nmol/L (8-38)
SHBG 7 nmol/L (10-50)

1hr Glucose tolerance test:
with 75g glucose
Fasting 5.1 mmol/L
60min 11.8 mmol/L


Homocysteine 7.6umol/L (6-14)

A candida infection was tested and was NEGATIVE

There are a bunch of other results on the MesoEx thread.



I'm 21yrs old, 184cm tall and 74kg. My symptoms are:
Extremely cold hands and feet, I can be sweating in 30C hot weather and get icy cold feet.
Poor facial hair growth
Poor erections
Lack of energy
Cuts and bruises takes years to heal

Unable to find an answer, my doc decided the first approach is to lower my E2. He gave me a choice between tamoxifen and arimidex. I was under the impression from reading that tamoxifen was better so I chose that. But JanSz kindly said that arimidex is the way to go, so Im not too sure now.

I'm wondering can anyone shed some light on this strange mix of hormones?? High Progesterone, E2, low T and super low SHBG, what does it all mean?

On a side note, how does collaboration between Dr. John and my own doc work? I'm in Australia so I cant really see Dr. John, but I heard he can collaborate with my doctor via phone/internet.


Cheers everyone!
 

hardasnails1973

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I've been lurking around for a while now and i find the board to be very knowledgeable.

I posted my story on MesoEx on Men's Health/ Low Testosterone in 21yr old thread, but would like more advice from the members here.

My problem in short is after going on a crazy low cal diet trying to loose some weight(for at least 1/2 yr), i ended up trashing my endocrine system. Had bloodtests done and showed a VERY low testosterone. I was sent to an endo. He did some other tests including MRI on my pituitary, but couldnt find why it was that low so he put me on Andriol and then sustanon injections.

After a year or so he retested me and pronounced me as cured. At the time my T was 13 nmol/L (R.R 10-38)
No amount of reason can I convince him that I was NOT fine.

So I stopped everything for about a year, trying in vain to let my body right itself, but then I found MesoEx and AnabolicMinds, which opened my eyes to the real world.

I just saw an anti-aging specialist, but he was totally stumped by my blood works:

thyroid function
Free T3(FT3) 5.16 pmol/L (2.5-6)
Free Thyroxine(FT4) 14 pmol/L(8-22)
TSH 0.66 mIU/L(0.3 -4)
reverse T3(RT3) 556 pmol/L (170-450)

IGF-1 56 nmol/L (24-102)
Progesterone 2.1 nmol/L (0.5 -1.3)
Oestradiol (E2) 167pmol/L (<160) performed using Roche method

DHEAS 12.7 umol/L (2.2-15.2)
Testosterone 16.3 nmol/L (8-38)
SHBG 7 nmol/L (10-50)

1hr Glucose tolerance test:
with 75g glucose
Fasting 5.1 mmol/L
60min 11.8 mmol/L


Homocysteine 7.6umol/L (6-14)

A candida infection was tested and was NEGATIVE

There are a bunch of other results on the MesoEx thread.



I'm 21yrs old, 184cm tall and 74kg. My symptoms are:
Extremely cold hands and feet, I can be sweating in 30C hot weather and get icy cold feet.
Poor facial hair growth
Poor erections
Lack of energy
Cuts and bruises takes years to heal

Unable to find an answer, my doc decided the first approach is to lower my E2. He gave me a choice between tamoxifen and arimidex. I was under the impression from reading that tamoxifen was better so I chose that. But JanSz kindly said that arimidex is the way to go, so Im not too sure now.

I'm wondering can anyone shed some light on this strange mix of hormones?? High Progesterone, E2, low T and super low SHBG, what does it all mean?

On a side note, how does collaboration between Dr. John and my own doc work? I'm in Australia so I cant really see Dr. John, but I heard he can collaborate with my doctor via phone/internet.


Cheers everyone!
1. One hour glucose test is not long enough
2. insulin resistance seem to be prior suspect
3. check for cortisol imbalnaces suspect high
4. REverse t-3 is coming from estrogen imbalance most likely and elevated cortisol levels lwoing t4 to t-3 conversion, dur to prolong dieting and body never shifted over. To lower rt3 you need zinc and you need testosterone levels at good levels in order to absorb it. excess cortisol depletes zinc, magnesium, b-6, copper, chromium, and other minerals
5 excess aromatiase seems to be most likely your problem with estrogen high use zinc only 50-60 mgs no copper because estrogen will increase tissue copper.
6. looking to hidden fatty liver as well plenty of choline, inositol, biotin to flush it out.
7. progesterone is high because of the need for extra cortisol for what ever the reason (infection, stressful lifestyle, ect) after a while it will begin to decline and you will hit adrenal burn out and low cortisol levels.

Majority of estrogen problems stem from insulin resistance from build up of fat in your liver, plus vice versa as well.
 

ericren23

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1. One hour glucose test is not long enough
2. insulin resistance seem to be prior suspect
3. check for cortisol imbalnaces suspect high
4. REverse t-3 is coming from estrogen imbalance most likely and elevated cortisol levels lwoing t4 to t-3 conversion, dur to prolong dieting and body never shifted over. To lower rt3 you need zinc and you need testosterone levels at good levels in order to absorb it. excess cortisol depletes zinc, magnesium, b-6, copper, chromium, and other minerals
5 excess aromatiase seems to be most likely your problem with estrogen high use zinc only 50-60 mgs no copper because estrogen will increase tissue copper.
6. looking to hidden fatty liver as well plenty of choline, inositol, biotin to flush it out.
7. progesterone is high because of the need for extra cortisol for what ever the reason (infection, stressful lifestyle, ect) after a while it will begin to decline and you will hit adrenal burn out and low cortisol levels.

Majority of estrogen problems stem from insulin resistance from build up of fat in your liver, plus vice versa as well.
1,2 I guess the 1hr test is not long enough either but - insulin resistance is usually due to over weight. I had Lipid studies done too:

31-04-07
Cholesterol 3.3 (3.0-5.5) mmol/L
Triglycerides 0.72 (0.6 -2) mmol/L

31-03-07
Cholesterol 2.9
Triglycrerides 1.1
HDL cholesterol 1.1 (>1.0) mmol/L
LDL Cholesterol 1.3 mmol/L (0-3.5)

Also, I had heaps of normal glucose tests done before and they were never high its around 4.6 (3.0-5.5 Fasting) mmol/L

I was a bit dehydrated the day when i took the test. I had to fast from midnight and saw the doc around midday. Only had a sip of water in the morning. Forgot to add also - family history is really good. Grandparents on both sides are as healthy as u can get(grandpa on dad side has high blood pressure, but thats abt it), they are seem to be more energetic than me! My parents are pretty healthy too.

3,7 My cortisol is pretty high 631 (200-700)nmol/L at 8.40am,
however I dont have a stressful lifestyle at all.

4,5 I'm starting a zinc supplement now and hopefully that will show some results

6 I'll check that out too. I was on a high dose of Roaccutane for acne a year before the dieting craze. I know its not too kind on the liver but i dont know its relavence. my AST and LST levels are fine:
AST 20 (5-40)U/L
ALT 25 (5-40)U/L


Update, i was blind enough to not see my insulin levels on my blood results:

Fasting 4.8mU/L
60min 52.9mU/L


On the issue of fatty liver, doesnt fatty liver happen well, because if the individual was fat? I've never been fat in my life, and with those triglycerides levels it should indicate something else right?
 

ericren23

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My doc changed the Nolvadex to Arimidex and I have just started on it. trying 0.5mg every 2nd day.

Anyone else able to offer some insights?

Help!
 
JanSz

JanSz

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My doc changed the Nolvadex to Arimidex and I have just started on it. trying 0.5mg every 2nd day.

Anyone else able to offer some insights?

Help!
You posted:
Oestradiol (E2) 167pmol/L (<160) performed using Roche method

I suggest that you go to laboratory (afternoon, during low traffic hours) and ask head phlebotomist about types of estrogen tests that they do on blood samples.
The way your test have the range posted, looks very similar to the (useless for men) estrodial test that they do in LabCorp or Quest here in USA.
That (useless for men) type of the test is working ok for ladies as they have a higher E levels.

There is many more estrogen tests that you have to be concerned about. I will give you a list with names and ranges as done at Quest Diagnostics, so you have something to take with you for the conversation.
You can also study the estrogen tests in EndoManual here:
http://www.questdiagnostics.com/hcp/intguide/EndoMetab/EndoManual_3rdEd_2004.pdf
pages 61 thru 70
==========================================
Estradiol (<52) pg/mL wrong for men
Estradiol, Bioavailable (10-50) pg/mL
Estradiol, Free (0.3-0.9) pg/mL
Estradiol, Fractionated, serum (E1+E2+E3)
Estradiol, Ultra-sensitive (10-50) pg/mL
Estrogens, Total, Serum (130 or less) pg/mL
Estrone,serum <or=68 pg/mL
===========================================
If you study the above table carefully and compare it to EndoManual in the link posted, you will find some inconsistencies. I hope Quest will come with updated manual, it is 2004 vintage.
For example the Manual do not have the very valuable

(Testosterone, Free, Bio/Tot) that they acually are able to do on request.
=======================
There is also urine test, that tests estrogen fractions.
We are mainly concerned there about estrones 2/16 ratio (good/bad).
We do urine testing here:
Home
Hormone Profiling
bottom page of "hormone profiling"
To adjust that ratio in your favor people are trying mostly pure DIM (and have a problem in the process). What works for me is LEF DualAction, it contains few other important ingredients and also a small amount of DIM).
I use 6pills of DualAction and two pills of TMG
They are shipping supplements all over the world.
Dual-Action Cruciferous Vegetable Extract With Resveratrol & Cat's Claw, 60 Vegetarian Capsules
Tmg (Trimethylglycine), 500 Mg 180 Tablets
 

hardasnails1973

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1,2 I guess the 1hr test is not long enough either but - insulin resistance is usually due to over weight. I had Lipid studies done too:

31-04-07
Cholesterol 3.3 (3.0-5.5) mmol/L
Triglycerides 0.72 (0.6 -2) mmol/L

31-03-07
Cholesterol 2.9
Triglycrerides 1.1
HDL cholesterol 1.1 (>1.0) mmol/L
LDL Cholesterol 1.3 mmol/L (0-3.5)

Also, I had heaps of normal glucose tests done before and they were never high its around 4.6 (3.0-5.5 Fasting) mmol/L

I was a bit dehydrated the day when i took the test. I had to fast from midnight and saw the doc around midday. Only had a sip of water in the morning. Forgot to add also - family history is really good. Grandparents on both sides are as healthy as u can get(grandpa on dad side has high blood pressure, but thats abt it), they are seem to be more energetic than me! My parents are pretty healthy too.

3,7 My cortisol is pretty high 631 (200-700)nmol/L at 8.40am,
however I dont have a stressful lifestyle at all.

4,5 I'm starting a zinc supplement now and hopefully that will show some results

6 I'll check that out too. I was on a high dose of Roaccutane for acne a year before the dieting craze. I know its not too kind on the liver but i dont know its relavence. my AST and LST levels are fine:
AST 20 (5-40)U/L
ALT 25 (5-40)U/L


Update, i was blind enough to not see my insulin levels on my blood results:

Fasting 4.8mU/L
60min 52.9mU/L


On the issue of fatty liver, doesnt fatty liver happen well, because if the individual was fat? I've never been fat in my life, and with those triglycerides levels it should indicate something else right?
Low cholesterol can indicated adrenal imbalances and with that low level of cholesterol other homrones production as well as pregenelone production is reduced. It may appear you body is diverting other hormone pathways to cortisol for some parent reason possible an under lying infection or some other biologocal , enviormenmetal, mental stress..
 

ericren23

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Low cholesterol can indicated adrenal imbalances and with that low level of cholesterol other homrones production as well as pregenelone production is reduced. It may appear you body is diverting other hormone pathways to cortisol for some parent reason possible an under lying infection or some other biologocal , enviormenmetal, mental stress..
HardAsNails, i too suspect its a cortisol problem. As you've said before, the body never shifts over after prolonged dieting and over exercising. I'm taking 50mg of zinc and a vitamin B complex everyday in case of depletion.

What is the course of action to fix this cortisol problem? Im pretty sure i dont have any external stress right now. Is there anyway to shift the adrenal balance back?

Its strange that I have a low cholestrol now. I eat heaps of meat with all the trimmings, cheese and drink milk everyday. Maybe because of the dieting, my body thinks that this low level is optimal?

cheers
 

hardasnails1973

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HardAsNails, i too suspect its a cortisol problem. As you've said before, the body never shifts over after prolonged dieting and over exercising. I'm taking 50mg of zinc and a vitamin B complex everyday in case of depletion.

What is the course of action to fix this cortisol problem? Im pretty sure i dont have any external stress right now. Is there anyway to shift the adrenal balance back?

Its strange that I have a low cholestrol now. I eat heaps of meat with all the trimmings, cheese and drink milk everyday. Maybe because of the dieting, my body thinks that this low level is optimal?

cheers
More so lower cholesterol can come from 2 combined things I have found out excessive intake of soluable fiber (which binds with cholesterol in the gut) and also lack of insulin or malfunction of insulin. in many stages one can be insulin deficeint for a peroid of time before moving into inuslin resistance stage.

Priority would to be identify the imbalances
1. EFAS ratio omega 6:3 2:1 ratio will help cortisol control (fish oils)
2. mineral imbalances Too much calcium to low magnesium (hence ZMA is good here) also na:k ratio increae veggie intake greens
3. Cortisol imbalnces via salvia test
4. Inuslin imbalnaces via 2 our glucose tolerance with measuring insulin with glucose on each draw
5 examine sleep patterns and quality of sleep will affect your hormone out put. Practice mental relaxation exercises before bed and stay off computers late at night..
 

ericren23

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More so lower cholesterol can come from 2 combined things I have found out excessive intake of soluable fiber (which binds with cholesterol in the gut) and also lack of insulin or malfunction of insulin. in many stages one can be insulin deficeint for a peroid of time before moving into inuslin resistance stage.

Priority would to be identify the imbalances
1. EFAS ratio omega 6:3 2:1 ratio will help cortisol control (fish oils)
2. mineral imbalances Too much calcium to low magnesium (hence ZMA is good here) also na:k ratio increae veggie intake greens
3. Cortisol imbalnces via salvia test
4. Inuslin imbalnaces via 2 our glucose tolerance with measuring insulin with glucose on each draw
5 examine sleep patterns and quality of sleep will affect your hormone out put. Practice mental relaxation exercises before bed and stay off computers late at night..
Thanks HardAsNails

I will do another blood test in 2 weeks that will include:
saliva Cortisol
a proper 2 hr glucose tolerance test with insulin
an ultra-senstive E2 assay(hopefully the labs will have this, it seems Australia is behind in all tech areas)

Im now taking fish oil, zinc, vit C, selnium, and magnesium. Just incase im deficient in any of those.

The high amount of reverse T3 is really getting to me. I feel cold all the time, esp cold feet
I know cortisol increases conversion of T4 into rT3 instead of T3, but you mentioned that Estrogen also play a role too. Do you have a link that demostrate this link?

What is the link between E2 and Cortisol, It seems to be 2 fold. I have read the journal: Cortisol Abnormality as a cause of Elevated Estrogen and immune destablization, Alfred J. Plechner2003
Which suggests that high cortisol -> high E2
But, i have read else where that high E2-> cortisol.
If the latter is true, than arimidex will help, but if its due to high cortisol, then wouldnt arimidex be just masking the underlying problem?

Also, how long do you think i'll notice the effects of arimidex? I've actually started with 0.5mg everyday, because im sure Dr. John says its takes time for serum levels to build up and stablise and its prob better to take a higher dose in the first week to stablise the level before settling down to a normal dose. its been a week and there doesnt seem to be any difference.

Also, is Dr. John able to take a quick look and give me a hint or tip? I'm in Australia so its impossible to see THE man.

cheers!
 

ericren23

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Ok guys,

I had another Glucose tolerance test, this time for the full 2hrs

Glucose
Fasting 5.4 mmol/L
1hr 7.6
2hrs 6.8

Insulin
Fasting 9.0 mU/L
1hr 69.9
2hrs 51.3
Also had my E2, T, SHBG redone

E2 146 pmol/L (<160)
T 29.2nmol/L (8 -38) (i dont know if this is the total or free, just says testosterone)
SHBG 7 nmol/L (10-50)

The E2 test again is NOT sensitive assay because the labs in Australia dont have that test. very strange, maybe it has another name here in Aust?

From the GTT, it does show my glucose and insulin lvls are pretty high, but not over the limit. I think this is due to high cortisol.

My SHBG is still VERY low.

I have done the saliva cortisol test, but i am still waiting for the result as it takes quite a while here.

I'm currently on arimidex 0.5mg every 2 days. It doesnt seem to be doing much atm.

Any insights?
 
JanSz

JanSz

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Ok guys,

I had another Glucose tolerance test, this time for the full 2hrs

Glucose
Fasting 5.4 mmol/L
1hr 7.6
2hrs 6.8

Insulin
Fasting 9.0 mU/L
1hr 69.9
2hrs 51.3
Also had my E2, T, SHBG redone

E2 146 pmol/L (<160)
T 29.2nmol/L (8 -38) (i dont know if this is the total or free, just says testosterone)
SHBG 7 nmol/L (10-50)

The E2 test again is NOT sensitive assay because the labs in Australia dont have that test. very strange, maybe it has another name here in Aust?

From the GTT, it does show my glucose and insulin lvls are pretty high, but not over the limit. I think this is due to high cortisol.

My SHBG is still VERY low.

I have done the saliva cortisol test, but i am still waiting for the result as it takes quite a while here.

I'm currently on arimidex 0.5mg every 2 days. It doesnt seem to be doing much atm.

Any insights?
Concentrate on rising SHBG.
Do not take supplements that lowers it.
Let the E's run litter higher, it rises SHBG.
Stay little lower on T's, high T suppress SHBG.
 

pmgamer18

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Your E2 in my units is 42 pg/ml and you on .5 mgs 2x's a week you may need to up your dose to .5 every other day and see if this bring it down. Try it and see if you get some morning wood the kind that wakes you up then you at the right level.
Ok guys,

I had another Glucose tolerance test, this time for the full 2hrs

Glucose
Fasting 5.4 mmol/L
1hr 7.6
2hrs 6.8

Insulin
Fasting 9.0 mU/L
1hr 69.9
2hrs 51.3
Also had my E2, T, SHBG redone

E2 146 pmol/L (<160)
T 29.2nmol/L (8 -38) (i dont know if this is the total or free, just says testosterone)
SHBG 7 nmol/L (10-50)

The E2 test again is NOT sensitive assay because the labs in Australia dont have that test. very strange, maybe it has another name here in Aust?

From the GTT, it does show my glucose and insulin lvls are pretty high, but not over the limit. I think this is due to high cortisol.

My SHBG is still VERY low.

I have done the saliva cortisol test, but i am still waiting for the result as it takes quite a while here.

I'm currently on arimidex 0.5mg every 2 days. It doesnt seem to be doing much atm.

Any insights?
 

ItsHectic

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You posted:
Oestradiol (E2) 167pmol/L (<160) performed using Roche method

I suggest that you go to laboratory (afternoon, during low traffic hours) and ask head phlebotomist about types of estrogen tests that they do on blood samples.
The way your test have the range posted, looks very similar to the (useless for men) estrodial test that they do in LabCorp or Quest here in USA.
That (useless for men) type of the test is working ok for ladies as they have a higher E levels.
Roche method is not ultrasensative.
 
JanSz

JanSz

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I know its NOT ultrasensitive. But as i've said we DO NOT have ultrasensitive assay here in Australia. I cant do anything about that
#1 I seriously doubt it. If your doctor is not helpful, try to talk with somebody at few different laboratiries.

#2 Your E (howewer is measured) is about at upper range (E2 146 pmol/L (<160).
Your SHBG is very very low.
Do not touch E, that would drive down SHBG.
 

hardasnails1973

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#1 I seriously doubt it. If your doctor is not helpful, try to talk with somebody at few different laboratiries.

#2 Your E (howewer is measured) is about at upper range (E2 146 pmol/L (<160).
Your SHBG is very very low.
Do not touch E, that would drive down SHBG.
E is not always indicitive of shbg..My e2 was 17 but shbg was 39 so it always is not related to e2 like every one things but majority of the time shbg is a good incidicator of what e2 is doing, what tricky part is I do not think shbg flucuates as fast as e2 does and it makes it a challenge to drs to know what is really going and and should llook into other reasons why it is imbalanced..Something is causing body to pump out more progesteroene which may being diverted to more estrodial then normal. This could be indication of stage one adrenal dysfunction. Several people that have high RT3 have adrenal imbalnces (either high then going to low eventually)
 

ericren23

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JanSz,I'll ring up some labs and see if I can come up with anything.

E is not always indicitive of shbg..My e2 was 17 but shbg was 39 so it always is not related to e2 like every one things but majority of the time shbg is a good incidicator of what e2 is doing, what tricky part is I do not think shbg flucuates as fast as e2 does and it makes it a challenge to drs to know what is really going and and should llook into other reasons why it is imbalanced..Something is causing body to pump out more progesteroene which may being diverted to more estrodial then normal. This could be indication of stage one adrenal dysfunction. Several people that have high RT3 have adrenal imbalnces (either high then going to low eventually)

with my SHBG, it has been quite low for sometime, my first test , sep 2004, shows it at 12. It remained at 12 for a year or so. Only my recent tests shows its at 7. So it has dropped. But as you said, it does not fluctuate as fast.

I too suspect its an adrenal thing. Maybe my body never recovered from my initial dieting phase. Is this possible? As in because the fasting/dieting was quite prolonged, my body took the imbalanced levels as normal and will never try to right itself. In anycase, I'll post my cortisol results up as soon as i get them.

My dr. has also put me on slow release T3 to try and decrease the high RT3. But the thyroid could be due to an adrenal thing again. Are there any other reasons apart from adrenals for such a low SHBG? I might as well get everything checked.

What are your thoughts on my Glucose and insulin levels? From what I've found, they are a bit high. If this is all due to the insulin, which i really doubt, what are the ways to increase insulin sensitivity? I cant loose anymore weight or i'll soon be a stick. Diet wise i eat pretty good too, so im personally stumped.

I went through Low SHBG and Estradiol by Dr. Marianco. thread and something caught my attention. Androgens decrease SHBG. I was on TRT(sustanon) for about a year. Further more, i think James on the mesoEx board was on the money:

"you are right. AS SHBG decreases, FT increases. This is a very bad thing, however. It leads to:

- Excess FT
- Which, through negative feedback, slows down testosterone production. This leads to low TT.
- Low TT but increased FT leads to a rollercoaster-type situation because FT has a very short half life and easy converts into metabolites. After the FT is metabolized, there is an insignificant quantity of TT bound in the bloodstream to convert back to FT in a timley manner.
- Any excess FT is converted into estrogen and DHT.
- SHBG weakly binds to E2 and therefore, not only do you have excess FT, you also have excess free E2, even if your total E2 readings look midrange!

With low SHBG, you have a problems with low TT, excess FT, possible excess DHT, and excess free E2 creating an estrogen dominance situation. If you add exogenous testosterone, you can only make the problem worse! Yet, many of our "experts" are doing this anyway."
My theory based on that: low SHBG --> high FT ----> even lower SHBG

Going through a few SHBG threads, I dont see any definite ways to raise SHBG though, which is a bummer

On a side note, anyone know how I can get my doc to collaborate with Dr. John?
 

ericren23

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Hiya,

I finally got my adrenal results back. Its quite a shocker.
These are the saliva results:

Cortisol(nmol/L) target range
08:00 24 25
13:00 8 15
18:00 4 5-10
23:00 21 <5

Progesterone 461 (<300 pmol/L )
DHEAS 7.4 (5.0-30.0nmol/L)
Oestrone(E1) 4 (<5 pmol/L)
Oestradiol(E2) 2 (<10pmol/L)
Oestriol(E3) 9 (<5 pmol/L)

Testosterone 1393 (350 pmol/L)

Firstly, my morning cortisol seems to be ok, but I don’t really feel refreshed in the morning, i get rather cold in the morning too. My blood morning cortisol is high(I did that quite a while ago though). The afternoon cortisol is very low, and don’t really know why. And finally the night cortisol is super high, this is when I feel utterly tired.

Progesterone is high, just like the blood tests, and the Testosterone is high too(due to the low SHBG of 7 (rf range. 10-50) E3 is high, but E1,E2 are ok(I am on arimidex to control estrogen). DHEAS is low which contridicts the high in the blood test

I went through dr. Rind’s website and did the scorecard. The major things that pops out are:

I have very poor thermal regulation. I can be freezing and then sweating the next minute(sitting around is freezing cold, walk for 5min outside and I heat up) and when I stop, my body temp drops sharply.

My wounds heals very slowly, cut and bruise never seem to go away now days.
Cold hands + feet

They all point to an adrenal problem.

My doc is quite baffled by this and has put me on 20mg hydrocortisol /day in the morning(compounded). I will need to take this in the morning so it will be released in the arvo. The bad thing about this is that my blood sugar is quite high already so HC will prob increase it.

With regards to the T3, they seem to have stopped working again. I’m posting up a chart of my am and pm body temps.
http://img392.imageshack.us/my.php?image=tempmw9.jpg

Any input will be greatly appreciated!
 

ItsHectic

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The E2 test again is NOT sensitive assay because the labs in Australia dont have that test. very strange, maybe it has another name here in Aust?
I have called around there is no ultrasensative assay here, I even called the Anzac intitute.
 
JanSz

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Hiya,

I finally got my adrenal results back. Its quite a shocker.
These are the saliva results:

Cortisol(nmol/L) target range
08:00 24 25
13:00 8 15
18:00 4 5-10
23:00 21 <5

Progesterone 461 (<300 pmol/L )
DHEAS 7.4 (5.0-30.0nmol/L)
Oestrone(E1) 4 (<5 pmol/L)
Oestradiol(E2) 2 (<10pmol/L)
Oestriol(E3) 9 (<5 pmol/L)

Testosterone 1393 (350 pmol/L)

Firstly, my morning cortisol seems to be ok, but I don’t really feel refreshed in the morning, i get rather cold in the morning too. My blood morning cortisol is high(I did that quite a while ago though). The afternoon cortisol is very low, and don’t really know why. And finally the night cortisol is super high, this is when I feel utterly tired.

Progesterone is high, just like the blood tests, and the Testosterone is high too(due to the low SHBG of 7 (rf range. 10-50) E3 is high, but E1,E2 are ok(I am on arimidex to control estrogen). DHEAS is low which contridicts the high in the blood test

I went through dr. Rind’s website and did the scorecard. The major things that pops out are:

I have very poor thermal regulation. I can be freezing and then sweating the next minute(sitting around is freezing cold, walk for 5min outside and I heat up) and when I stop, my body temp drops sharply.

My wounds heals very slowly, cut and bruise never seem to go away now days.
Cold hands + feet

They all point to an adrenal problem.

My doc is quite baffled by this and has put me on 20mg hydrocortisol /day in the morning(compounded). I will need to take this in the morning so it will be released in the arvo. The bad thing about this is that my blood sugar is quite high already so HC will prob increase it.

With regards to the T3, they seem to have stopped working again. I’m posting up a chart of my am and pm body temps.
http://img392.imageshack.us/my.php?image=tempmw9.jpg

Any input will be greatly appreciated!
Are you supplementing with testosterone?

According to Dr John saliva tests were invented to confuse patients and doctors.

Consider to do my complete list of tests, post #44
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

Expand that list in area od
adrenals
metabolic syndrome.

definitely do the risk factors part.

Low SHBG is a syptom of a problems not a cause.

Whatewer you are going to do, do it wery gradualy, no shocks. With low SHBG you have a low reserves.



Use guidance frome one of Dr Marianco's posts:
----------------------------------------------------------
Focusing on increasing SHBG is like treating a lab value rather than treating a patient.

The question I would have for a person with low SHBG is: What problems does one have?

Is it low libido, high blood pressure, heart attack risk, depression, anxiety, lack of energy, impaired concentration, urinary frequency, gynecomastia, hot flashes, etc.?

By identifying one's problems, it will be easier to see whether or not SHBG level contributes to the problem.

SHBG has signaling properties of its own. It has its own receptors on cell membranes. When testosterone or estrogens are bound to SHBG, it can bind to its receptors and send its message to the cell. What happens afterwards is not clear. It may be related to the formation of more hormone receptors - but that is speculation at this point.

SHBG helps prolong the duration of action of testosterone, DHT, and estrogens. Low SHBG will increase the amount of free hormone.

Swings in hormone level may occur when low SHBG is present as destruction of the hormone is accelerated by having high free levels. This may cause problems experienced during testosterone replacement. For example, if estrogen is more quickly destroyed/metabolized and levels drop more quickly, one can get hot flashes or anxiety or hypertension, etc. If testosterone levels fluctuate from high to low, depression can occur as the day progresses.

SHBG is made in the liver in response to levels of many hormones:
1. Increasing Testosterone reduces SHBG
2. Increasing DHT lowers SHBG
3. Increasing DHEA lowers SHBG
4. Increasing Growth Hormone lowers SHBG
5. Increasing Insulin lowers SHBG
6. Increasing Estrogen increases SHBG
7. Increasing Thyroid Hormone increases SHBG

The SHBG level is determine by the balance of the hormone levels.

Given one's assumed goals in TRT (high libido, good energy, etc.), it may be difficult to increase SHBG without causing problems since SHBG is determine by a balance of hormones.

For example, having high Testosterone and high DHEA is not a situation where SHBG is going to be high without corresponding problems with estrogen or thyroid.

If anything, SHBG should be most often viewed as an indicator of a problem that needs to be solved - rather than as a problem itself.

For example, SHBG is most commonly an indicator of high insulin levels - i.e. insulin resistance or diabetes. It would be then far more important to address insulin resistance or diabetes in treatment than to focus on SHBG.

If low thyroid is a factor in low SHBG, addressing hypothyroidism is far more important.

If low estradiol is a factor in low SHBG, addressing this is more important.

If the low SHBG itself is a problem because it causes large swings in hormone levels, then working around this by achieving more stable hormone levels is indicated.

More frequent dosing of testosterone may be required to stabilize levels. With testosterone cypionate or enanthate injections, dosing twice a week would be better than once a week.

If frequent dosing of testosterone cannot be achieved with transdermals or injections, then a constant dose solution may be needed. This includes testosterone patches, the buccal system, or testosterone pellet insertions. Testosterone pellet insertions may be viewed as fairly drastic since it involves regular minor surgical procedures, but does give the most stable levels - so is a viable solution for the men with problems due to highly variable hormone levels resulting from low SHBG.

If one suspects swings in hormone levels as a cause of problems, one can look for the swings in hormone levels by obtaining a peak and trough level of the hormones (e.g. total testosterone, estradiol, DHT, etc.). For testosterone injections, this is a level about 24-48 hours after an injection and a level just before the next injection. One can also obtain a midpoint level to fill out the level curve.
__________________
 

ericren23

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I have called around there is no ultrasensative assay here, I even called the Anzac intitute.
exactly! no ultrasensitive assay at all. Even the royal collage of pathologist australia dont have such a test in there database.

Are you supplementing with testosterone?

According to Dr John saliva tests were invented to confuse patients and doctors.

Consider to do my complete list of tests, post #44
http://anabolicminds.com/forum/male-...april13-2.html

Expand that list in area od
adrenals
metabolic syndrome.

definitely do the risk factors part.

Low SHBG is a syptom of a problems not a cause.

Whatewer you are going to do, do it wery gradualy, no shocks. With low SHBG you have a low reserves.
I havent had any testosterone replacement for 2yrs now. atm my free T is through the roof cos of the low SHBG.

Can you point me to why the saliva test is confusing/bad. The results does seem to correlate with what i have atm. I feel the coldest in the afternoon(my feet would always been freezing) and that is when my cortisol is very low. After i have dinner i would not feel cold at all right till i sleep.

I'll talk to my doc and get other stuff tested. my lack of energy is in the form of cycles it seems. For a week i would be feeling fine, but then the next week i can be feeling like im 90. this would go on for a week or 2 and then the cycles repeats. Does seem to relate to adrenals. My adrenals would exert themselves, be depleted and then recharge.
 
JanSz

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exactly! no ultrasensitive assay at all. Even the royal collage of pathologist australia dont have such a test in there database.



I havent had any testosterone replacement for 2yrs now. atm my free T is through the roof cos of the low SHBG.

Can you point me to why the saliva test is confusing/bad. The results does seem to correlate with what i have atm. I feel the coldest in the afternoon(my feet would always been freezing) and that is when my cortisol is very low. After i have dinner i would not feel cold at all right till i sleep.

I'll talk to my doc and get other stuff tested. my lack of energy is in the form of cycles it seems. For a week i would be feeling fine, but then the next week i can be feeling like im 90. this would go on for a week or 2 and then the cycles repeats. Does seem to relate to adrenals. My adrenals would exert themselves, be depleted and then recharge.
Have you tried to get some help on STTM site.

I am not againt any testing that ends up helping.

IIRC Dr Johns opinion on saliwa tests is that they are erratic and when repeated eventually one finds one of them that fits preconceived idea.

The best woul be to

make hypothesis
test it
see if it works

do not dwell to long on something that does not work

low SHBG is an indicator that body is not working properly,
there are probably dozens of reasons why
 

ericren23

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Have you tried to get some help on STTM site.

I am not againt any testing that ends up helping.

IIRC Dr Johns opinion on saliwa tests is that they are erratic and when repeated eventually one finds one of them that fits preconceived idea.

The best woul be to

make hypothesis
test it
see if it works

do not dwell to long on something that does not work

low SHBG is an indicator that body is not working properly,
there are probably dozens of reasons why
Thanks JanSZ, i have a post on STTM, and val there is quite helpful. But no one is exactly sure why though.

Your theory of:
make hypothesis
test it
see if it works

Is just what i wanted the my doc to do. Right now the problem is that there are not that many hypothesis to make up. I think right now its adrenals ->thyroid -> other hormones

I'll get my hydrocortisone today or tommorrow and have my fingers crossed. Im also gonna email Dr. John to see if i can be his patient

on a side note i remember seeing a sticky on STTM about why saliva test is superior to other tests. strange. I guess its a debatable field.
 

pmgamer18

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Thanks JanSZ, i have a post on STTM, and val there is quite helpful. But no one is exactly sure why though.

Your theory of:
make hypothesis
test it
see if it works

Is just what i wanted the my doc to do. Right now the problem is that there are not that many hypothesis to make up. I think right now its adrenals ->thyroid -> other hormones

I'll get my hydrocortisone today or tommorrow and have my fingers crossed. Im also gonna email Dr. John to see if i can be his patient

on a side note i remember seeing a sticky on STTM about why saliva test is superior to other tests. strange. I guess its a debatable field.
I feel you see this at STTM because most of the people that post there are women and there Dr. mostly use saliva tests. I work there as a Co Mod on the Men's Thyroid Forum and am getting a lot of men there with Thyroid problems that a lot of them when they do the test have testosterone problems. The forum is getting a lot of hits now. I say this all the time sex hormones are not good tested by saliva. Yet we are finding the saliva Tests for just cortisol are close to what we are seeing on blood work.
 
JanSz

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Thanks JanSZ, i have a post on STTM, and val there is quite helpful. But no one is exactly sure why though.

Your theory of:
make hypothesis
test it
see if it works

Is just what i wanted the my doc to do. Right now the problem is that there are not that many hypothesis to make up. I think right now its adrenals ->thyroid -> other hormones

I'll get my hydrocortisone today or tommorrow and have my fingers crossed. Im also gonna email Dr. John to see if i can be his patient

on a side note i remember seeing a sticky on STTM about why saliva test is superior to other tests. strange. I guess its a debatable field.
Quote from:
http://www.ehealthspan.com/download/TestosteroneFtLauderdale.doc
Increases SHBG
l Thyroid
l Estrogen, Progesterone
l Aging
Decreases SHBG
l Testosterone
l Glucocorticoids
l Growth Hormone
l Insulin


====================================
I already knew that SHBG get higher with properly tuned thyroid, make it FreeT3 and FreeT4 as close to max as comfortable.

now add to that Estrogen and Progesterone.
That makes me to suggest once again my blood test, post #44
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

Progesterone is a "normal" test, but look and follow the suggested estrogene tests, they are the highest accuracy/quality as done by Quest Diagnostics.
They have other this type tests (of lesser quality).

Keep your estrogens as high as possible (but within range)
 

ericren23

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Quote from:
http://www.ehealthspan.com/download/TestosteroneFtLauderdale.doc
Increases SHBG
l Thyroid
l Estrogen, Progesterone
l Aging
Decreases SHBG
l Testosterone
l Glucocorticoids
l Growth Hormone
l Insulin


====================================
I already knew that SHBG get higher with properly tuned thyroid, make it FreeT3 and FreeT4 as close to max as comfortable.

now add to that Estrogen and Progesterone.
That makes me to suggest once again my blood test, post #44
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

Progesterone is a "normal" test, but look and follow the suggested estrogene tests, they are the highest accuracy/quality as done by Quest Diagnostics.
They have other this type tests (of lesser quality).

Keep your estrogens as high as possible (but within range)
I've got a sorta catch 22 situation here.
My estrogens were high, so im on airmidex to lower E, but that in turn probably lowered my SHBG further.

2nd. to optimise thyroid function i need to correct adrenals. to correct adrenals i need to be on hydrocortisone, which in turn lowers SHBG accordin to that link.
 
JanSz

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I've got a sorta catch 22 situation here.
My estrogens were high, so im on airmidex to lower E, but that in turn probably lowered my SHBG further.

2nd. to optimise thyroid function i need to correct adrenals. to correct adrenals i need to be on hydrocortisone, which in turn lowers SHBG accordin to that link.
I did not created that link.

For estrogen I suggest that you use this Quest Diagnostic test:

60 Estradiol, Free, LC/MS/MS (36169X) Quest Diagnostics: Test Menu
61 /------------------------------------ Estradiol, Free (Males (Adult): < or = 0.45 pg/mL )
62 /------------------------------------ Estradiol (Males (Adult): < or = 29 pg/mL)
63 Estrogens, Fractionated, LC/MS/MS (36742X) Quest Diagnostics: Test Menu
64 /------------------------------------ 968-1**Estrone, LC/MS/MS
65 /------------------------------------ 968-2**Estradiol, Ultrasensitive, LC/MS/MS
66 /------------------------------------ 968-3**Estriol
67 Estrogen, Total, Serum (439X)

==========================
You will be better informed on state of your estrogens and any need for adjustment.
----------------------
I would say that the better you are tunned the better chance you have at getting SHBG in better range as a bonus.
There goes catch 22.
 

ericren23

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I did not created that link.

For estrogen I suggest that you use this Quest Diagnostic test:

60 Estradiol, Free, LC/MS/MS (36169X) Quest Diagnostics: Test Menu
61 /------------------------------------ Estradiol, Free (Males (Adult): < or = 0.45 pg/mL )
62 /------------------------------------ Estradiol (Males (Adult): < or = 29 pg/mL)
63 Estrogens, Fractionated, LC/MS/MS (36742X) Quest Diagnostics: Test Menu
64 /------------------------------------ 968-1**Estrone, LC/MS/MS
65 /------------------------------------ 968-2**Estradiol, Ultrasensitive, LC/MS/MS
66 /------------------------------------ 968-3**Estriol
67 Estrogen, Total, Serum (439X)

==========================
You will be better informed on state of your estrogens and any need for adjustment.
----------------------
I would say that the better you are tunned the better chance you have at getting SHBG in better range as a bonus.
There goes catch 22.
hi JanSz, i value your input but you might have forgotten that i am in australia and that we lack the different types of tests that you guys have in the US. It would be impossible for me to get those tests done
 
JanSz

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hi JanSz, i value your input but you might have forgotten that i am in australia and that we lack the different types of tests that you guys have in the US. It would be impossible for me to get those tests done

Bad excuse:

Quest Diagnostics: Our Growing International Presence


Currently Nichols Institute performs specialized testing for hospitals and laboratories from the following countries:

North America - Canada, Mexico, Guatemala, Honduras, Panama, Dominican Republic
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=======================================================================================

Get more information here

Quest Diagnostics: Contact Us

Nichols Institute International
Juan Carlos Altieri
Manager, International Reference Sales
Contact


Quest Diagnostics: Contact Us
 

ericren23

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Hi everyone,

After a LONG hiatus I have finally returned to the board to give an update on my status. (I had exams and also, i have been waiting for my results, and also waiting for some improvements). Hopefully now i can contribute again.

I have been on the following combo for the past few month:
5mg HC BID
80mg Armour Thyroid BID
0.5mg arimidex every 2nd day

There has been a marked improvement in how i feel.
The most significant is the lack of cold feet anymore. Every afternoon at around 4pm my foot would start to get really really cold, it would only recitify itself after i have dinner at around 6.30pm. Now together with the warmer weather, It is very rare that i get cold feet. It would only come back to haunt me if im really tired or had a bad sleep the night before

2ndly, temperature wise again. I would no longer feel like a chameleon - before, i would get very cold if the environment is cold and then suddenly start sweating if i get into the sun or move around. Its basically hot cold hot cold for the entire day. There was no thermal regulation at all. Now i dont get a full head of sweat just by eating or moving and can tolerate temperature changes.

Other improvements include more energy and a better sense of wellbeing. Of course i have not fully recovered yet. Still get tired quite easily and libido is low still.

I have done an organic acids test in an attempt to get a complete picture. The results are attached.

There were quite a few abnormalities, however they dont add-up:

the elevated tartaric acid would suggest a yeast infection, but i had a candida test back in july and tat was negative. Could it be some other strain of yeast? I do have frequent stomach upsets and sometimes diharrea. i drink aloe vera juice and take probiotics to keep it running smoothly. My diet consist of mainly rice, im asian. hardly any bread. Also i dont drink wine or grape juice - very strange!

The high lactic acid would suggest i had been workingout on or before the test date. however i did not do ANY exercise before or on the test day. just sat around at home! what is going on? i have bought a bottle of CoQ10 as recommanded on the report

Dont know what to make out of the suberic and methylmalonic acid stuff. I had my B12 tested back in july and that was at a healthy level. Taking Bcomplex now just to make sure.

Dont know what to make out of the neurotransmitter stuff. HVA and 5HIAA is a bit low. what to take to make me feel happier with more energy(apart from antidepressants. hehe)

So thats it.

Dr. John suggested that HAN should take a look:p so thanks HAN!

Wish everyone a merry christmas and a happy new year!
 

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JanSz

JanSz

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Hi everyone,

After a LONG hiatus I have finally returned to the board to give an update on my status. (I had exams and also, i have been waiting for my results, and also waiting for some improvements). Hopefully now i can contribute again.

I have been on the following combo for the past few month:
5mg HC BID
80mg Armour Thyroid BID
0.5mg arimidex every 2nd day

There has been a marked improvement in how i feel.
The most significant is the lack of cold feet anymore. Every afternoon at around 4pm my foot would start to get really really cold, it would only recitify itself after i have dinner at around 6.30pm. Now together with the warmer weather, It is very rare that i get cold feet. It would only come back to haunt me if im really tired or had a bad sleep the night before

2ndly, temperature wise again. I would no longer feel like a chameleon - before, i would get very cold if the environment is cold and then suddenly start sweating if i get into the sun or move around. Its basically hot cold hot cold for the entire day. There was no thermal regulation at all. Now i dont get a full head of sweat just by eating or moving and can tolerate temperature changes.

Other improvements include more energy and a better sense of wellbeing. Of course i have not fully recovered yet. Still get tired quite easily and libido is low still.

I have done an organic acids test in an attempt to get a complete picture. The results are attached.

There were quite a few abnormalities, however they dont add-up:

the elevated tartaric acid would suggest a yeast infection, but i had a candida test back in july and tat was negative. Could it be some other strain of yeast? I do have frequent stomach upsets and sometimes diharrea. i drink aloe vera juice and take probiotics to keep it running smoothly. My diet consist of mainly rice, im asian. hardly any bread. Also i dont drink wine or grape juice - very strange!

The high lactic acid would suggest i had been workingout on or before the test date. however i did not do ANY exercise before or on the test day. just sat around at home! what is going on? i have bought a bottle of CoQ10 as recommanded on the report

Dont know what to make out of the suberic and methylmalonic acid stuff. I had my B12 tested back in july and that was at a healthy level. Taking Bcomplex now just to make sure.

Dont know what to make out of the neurotransmitter stuff. HVA and 5HIAA is a bit low. what to take to make me feel happier with more energy(apart from antidepressants. hehe)

So thats it.

Dr. John suggested that HAN should take a look:p so thanks HAN!

Wish everyone a merry christmas and a happy new year!
This is the problem with (even) good testing.
What to do with results.
Lots of words and scattered numbers is helpful but only to a point.
Personally I think that all this bs should be included for any additional evaluation,
but,
the lab should comit itself to giving much clearer advice.
By that I mean list of supplements and daily dose.


Because of the above I recomend Genova diagnostics

NutrEval
and
Estroessence

GDX ONE - Optimal Nutrition Evaluation
Genova Diagnostics EstroEssence

You will get this type of list from them.
=============================================
With that said here is number of hopefully helpful words:


====================================================
Lactic Acid
when High
Suspect
Hypoxia and/or zinc deficiency; OR
metabolic stress (e.g. alcohol, toxic
chemical exposure, or anemia); OR
possibly insignificant when pyruvic
acid is also high

Consider
(If pyruvate NOT high) – Correct hypoxia; remove
metabolic stress; correct anemia; zinc, possible
CoQ10, vitamins B2, B3
==================================================
Cis-aconitic Acid
when high
Suspect
Impaired metabolism due to toxic
metals (Fl, Hg, As, Sb) OR low
cofactors (Fe, GSH—depleted in
oxidative stress); OR high amounts
of dietary citric acid; OR metabolic
acidosis (if mildly increased cisaconitic
acid but markedly
increased citric acid)

Consider
Rule out toxic metals; glutathione, N-acetylcysteine,
Mg, or L-glutamine; consider anti-oxidants; rule out
pancreatic insufficiency (can lead to metabolic
acidosis from deficient bicarbonate)
==================================================

no interpretation neccesary;
it must be done by computer program, look at the amount of required Glycine and Glutamine (bottom)
sample of list that I got from Genova, it is a daily dosing:

Vit A & beta-Carotene 15000iu
Vit C 500 mg
Vit E & mixed tocopherols 400 IU
Alpha-Lipoic acid 100 mg
Vit B1 10 mg
Vit B2 Riboflavin 10mg
Vit B3 Niacin 10 mg
Vit B6 Pyridoxine 25 mg
Vit B9 Folate 1200mcg
Vit B12 Cobalamin 500 mcg
Magnesium 800 mg
Zinc 10 mg
Iron 20mg
Manganese 2 mg
Molybdenum 150 mg

Glutamine 96mg
Glycine 1002 mg
 

Kingston pt

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Just skimmed post, but you might be iron deficient anemic. Cold hands and feet, low energy. Does your heart ever skip beats? Search it check symptoms.
 

ericren23

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Lactic Acid
when High
Suspect
Hypoxia and/or zinc deficiency; OR
metabolic stress (e.g. alcohol, toxic
chemical exposure, or anemia); OR
possibly insignificant when pyruvic
acid is also high
hypoxia? that is a shortage of oxygen yes? what can cause something like that?

anemia - I dont think that is the cause as all my blood counts are normal

I dont drink, and i take 20mg zinc everyday. So it could a toxic chemical thing

Cis-aconitic Acid
when high
Suspect
Impaired metabolism due to toxic
metals (Fl, Hg, As, Sb) OR low
cofactors (Fe, GSH—depleted in
oxidative stress); OR high amounts
of dietary citric acid; OR metabolic
acidosis (if mildly increased cisaconitic
acid but markedly
increased citric acid)

Consider
Rule out toxic metals; glutathione, N-acetylcysteine,
Mg, or L-glutamine; consider anti-oxidants; rule out
pancreatic insufficiency (can lead to metabolic
acidosis from deficient bicarbonate)

can you expand on metabolic acidosis and pancreatic insufficiency?

again, i need to rule out toxic metals. I'll talk to my doc about that.

Just skimmed post, but you might be iron deficient anemic. Cold hands and feet, low energy. Does your heart ever skip beats? Search it check symptoms.
I dont know about that. I do remember getting iron tested at one stage or another. I eat quite a bit of red meat anyway. Could be an absorption thing though. I'll talk to my doc about that too.

Also, dont think ive mentioned it before, cuts and bruises heals very slowly - paper cut will take almost a week. Anything more severe will lead to an ugly scar. Given 20mg of zinc i take, i dont see how i can be deficient on it to cause all these problems.

The cold feet is really strange too. I get it when im tired, have a bad sleep, or feeling stressed. WHen it happens, i lay down and take a few minutes of break and i can literally feel blood coming back into my feet. It is quite weird.

On a side note, could it ever be a prostate problem? My ejaculations are pretty weak, sometimes pretty much trickles out. But i dont have any other symptoms like the need to urinate 5x in the middle of the night.

I have another batch of blood tests coming in anyday now i'll keep you guys updated!

Thanks!
 
JanSz

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I have another batch of blood tests coming in anyday now i'll keep you guys updated!

Thanks!
Think about
Genova diagnostics

NutrEval
and
Estroessence

tests.

Post results of what you have comming.
 

ericren23

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I manged to get my blood results back. finally! (the reverse t3 took more than a month.. pro due to the holidays!)

Thyroid:

FreeT3 4.7 (2.5-6.0 pmol/L)
FreeT4 10 (8-22 pmol/L)
TSH 0.30 (0.30-4.00mIU/L)
Reverse T3 420 (170-450 pmol/L)

Cholesterol 3.4 (3.9-5.5 mmol/L)
E2 79 Male (<160 pmol/L)
T 15.9 (12.0-32.0 nmol/L)
SHBG 10 (15-50nmol/L)

24hr Urine
Magnesium 6.2 (3.0-7.0 mmol/d)
Calcium 5.5 (2.5-7.5 mmol/d)
U-Zinc Excr. 11.6 (8.0-18.0 umol/d)

There hasnt been any improvements really to how I feel.
A number of things crossed my mind as I've read through this board.

My thyroid seems to be doing better, but my SHBG is doing worse!? What is going on? Better thyroid = increased SHBG, technically.

Should i MRI my pituitary again? my old report in 04 was quite inconclusive regarding a microadenoma. i've attached the report

Should I try out nolva/clomid? I have some nolva lying around. I ordered it in, but never took it, because at the same time, i found my current doc who gave me arimidex instead. There has been a few posts regarding kicking start the HPTA axis.

I have trouble upping my cholesterol, what would people recommend? I'm thinking of trying out coconut oil and ox-bile.

Lastly, JanSz, i might go get those tests you recommanded. You mentioned Quest and Genova, which one should i go for? I'm thinking of the NutrEval and Estroessence at Genova. Genova's Australia distributor is ARL pathology, I had my saliva cortisol done there.
 

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JanSz

JanSz

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I manged to get my blood results back. finally! (the reverse t3 took more than a month.. pro due to the holidays!)

Thyroid:

FreeT3 4.7 (2.5-6.0 pmol/L)
FreeT4 10 (8-22 pmol/L)
TSH 0.30 (0.30-4.00mIU/L)
Reverse T3 420 (170-450 pmol/L)

Cholesterol 3.4 (3.9-5.5 mmol/L)
E2 79 Male (<160 pmol/L)
T 15.9 (12.0-32.0 nmol/L)
SHBG 10 (15-50nmol/L)

24hr Urine
Magnesium 6.2 (3.0-7.0 mmol/d)
Calcium 5.5 (2.5-7.5 mmol/d)
U-Zinc Excr. 11.6 (8.0-18.0 umol/d)

There hasnt been any improvements really to how I feel.
A number of things crossed my mind as I've read through this board.

My thyroid seems to be doing better, but my SHBG is doing worse!? What is going on? Better thyroid = increased SHBG, technically.

Should i MRI my pituitary again? my old report in 04 was quite inconclusive regarding a microadenoma. i've attached the report

Should I try out nolva/clomid? I have some nolva lying around. I ordered it in, but never took it, because at the same time, i found my current doc who gave me arimidex instead. There has been a few posts regarding kicking start the HPTA axis.

I have trouble upping my cholesterol, what would people recommend? I'm thinking of trying out coconut oil and ox-bile.

Lastly, JanSz, i might go get those tests you recommanded. You mentioned Quest and Genova, which one should i go for? I'm thinking of the NutrEval and Estroessence at Genova. Genova's Australia distributor is ARL pathology, I had my saliva cortisol done there.
Start with NutrEval

Not sure what they will do in Australia.
In US they have two sub-types of this test.
If you have a choice then get the one that uses 24hr urine.

Your hormones are low over all.
Nutreval should give you a good start.
Do not do any supplementation until you do this test.
Then eat what will be recomended by that test.

Retest 4-6 months latter.
 

ericren23

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Start with NutrEval

Not sure what they will do in Australia.
In US they have two sub-types of this test.
If you have a choice then get the one that uses 24hr urine.

Your hormones are low over all.
Nutreval should give you a good start.
Do not do any supplementation until you do this test.
Then eat what will be recomended by that test.

Retest 4-6 months latter.
I've emailed their Australian representative, but no reply yet. I'll ring them up if they still dont reply in the next couple of days.

I'm thinking of taking ALC/ALA combo to see if it will lead to an improvement in overall wellbeing in the mean time.

What are your thoughts on this and also about the extra Nolva lying around in my drawers.
 
Gutterpump

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Its strange that I have a low cholestrol now. I eat heaps of meat with all the trimmings, cheese and drink milk everyday. Maybe because of the dieting, my body thinks that this low level is optimal?

cheers
I wish I had spotted this post before. I was vegetarian for years and vegan for part of that time. I now have low cholesterol no matter what I eat as well.

I am guessing the body becomes accustomed to various levels and gets stuck working a certain way. It's too bad we don't have reset buttons.
 

ericren23

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I wish I had spotted this post before. I was vegetarian for years and vegan for part of that time. I now have low cholesterol no matter what I eat as well.

I am guessing the body becomes accustomed to various levels and gets stuck working a certain way. It's too bad we don't have reset buttons.
Gutterpump, I'm with you on that one. The body certainly gets stuck with the hormones. I've been on Hydrocortisol + thyroid for over 1/2 year now, and my body is slowly adjusting to it. Talk about slow! Are you eating lots of dairy and meat now?

I'm stuck in a state of low cholesterol no matter what I do here. People all around me are having trouble lowering cholesterol. And i'm wishing they have cholesterol in a pill :p

I've seen this 'expert' doc who took a look at my cholesterol and said WOW thats great! you will have a great heart when you are 60. At that stage i was like ah. is that so? Thats before I took matters into my own hands and learnt everything about pathways.
 
Gutterpump

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I hear you on all accounts. My PCP says the same thing. " your cholesterol is great!"

I'm eating cheese, steak, 4-8 whole eggs per day, whole cream in large amounts (on a TKD right now, thought it might give me a boost in total CHOL). Also taking a multi-enzyme with betain HCL + ox bile. We'll see how things go over the next few months.
 
JanSz

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I've emailed their Australian representative, but no reply yet. I'll ring them up if they still dont reply in the next couple of days.

I'm thinking of taking ALC/ALA combo to see if it will lead to an improvement in overall wellbeing in the mean time.

What are your thoughts on this and also about the extra Nolva lying around in my drawers.
Use the time to clean up your system.
Do not take any supplements, vitamins, anything.
Just eat food and drink good water, remove anything special.
You will be in better position to get clean start for your
NutrEval test.

Request test results for Nutreval in two ways,
as a whole test
and as
individual tests,
as if you did them separately, each one at the time.

Nutreval is a combination of tests.

GDX NutrEval Profile
 

ericren23

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Use the time to clean up your system.
Do not take any supplements, vitamins, anything.
Just eat food and drink good water, remove anything special.
You will be in better position to get clean start for your
NutrEval test.

Request test results for Nutreval in two ways,
as a whole test
and as
individual tests,
as if you did them separately, each one at the time.

Nutreval is a combination of tests.

GDX NutrEval Profile
Dang. I had my hopes up and now its all crushed. I just phoned the Genova Aust. representative see there was no reply from the email I've sent. they DONT do Nutreval. apparently they only do a few genetic tests and some heomo stuff.

Any other ideas?

I'm eating cheese, steak, 4-8 whole eggs per day, whole cream in large amounts (on a TKD right now, thought it might give me a boost in total CHOL). Also taking a multi-enzyme with betain HCL + ox bile. We'll see how things go over the next few months.
I've tried eating tonnes of dairy and it would give me stomach upsets, so for me its just eggs and meat! I wish yo u luck with that new protocol. I'm thinking of getting oxbile myself. It sux to be in Aust. sometimes. We lack alot of stuff thats easily obtainable from the states.

With the ALA/ALC mentioned b4, its hardly in shops here, and the quality is dubious at best. So if I do want those. I will have to order them from LEF
 
JanSz

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Dang. I had my hopes up and now its all crushed. I just phoned the Genova Aust. representative see there was no reply from the email I've sent. they DONT do Nutreval. apparently they only do a few genetic tests and some heomo stuff.

Any other ideas?



I've tried eating tonnes of dairy and it would give me stomach upsets, so for me its just eggs and meat! I wish yo u luck with that new protocol. I'm thinking of getting oxbile myself. It sux to be in Aust. sometimes. We lack alot of stuff thats easily obtainable from the states.

With the ALA/ALC mentioned b4, its hardly in shops here, and the quality is dubious at best. So if I do want those. I will have to order them from LEF
Possibly they are doing individual tests that the NutreVal is made of.

Also they are in New Zealand,
all you have to do is ship samples.
 

ericren23

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Ok, I have found out that they do indeed do the NutrVal test here. My problem now is, its way too expensive. Its just over $1000 and is NOT covered by any form of insurance. I noticed that the Metabolic analysis test is pretty much EXACTLY like my organic acids tests that I have attached. If I would to do the remaining tests it would end up costing $690. I'm wondering is there another test that is not really needed? I know amino acids is quite important but what about the others? There are 2versions of amino acid too, blood is only $110 while urine is $330.

What do you think
 
JanSz

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Ok, I have found out that they do indeed do the NutrVal test here. My problem now is, its way too expensive. Its just over $1000 and is NOT covered by any form of insurance. I noticed that the Metabolic analysis test is pretty much EXACTLY like my organic acids tests that I have attached. If I would to do the remaining tests it would end up costing $690. I'm wondering is there another test that is not really needed? I know amino acids is quite important but what about the others? There are 2versions of amino acid too, blood is only $110 while urine is $330.

What do you think
Tests from Genova Diagnostics come with explanation and corrective action. Supplements name, daily dose, further suggestions for any other tests that may be usefull.

Do you have this in report from the test that you have already made?
 

ericren23

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Tests from Genova Diagnostics come with explanation and corrective action. Supplements name, daily dose, further suggestions for any other tests that may be usefull.

Do you have this in report from the test that you have already made?
Yes i know my pathlabs test did not come with any detailed corrective action. I did do it on the recommandation of Dr. John. However, the actual organic acids tested are the same as Genova. As I said, I simply do not have that much money on hand to go through the entire panel of tests.
 
JanSz

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Yes i know my pathlabs test did not come with any detailed corrective action. I did do it on the recommandation of Dr. John. However, the actual organic acids tested are the same as Genova. As I said, I simply do not have that much money on hand to go through the entire panel of tests.
Possibly ask dr John to interpret the test for you.
Test results without interpretation are of little value.
 

ericren23

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Possibly ask dr John to interpret the test for you.
Test results without interpretation are of little value.
Dr. John said he was quite new to this so it would be better if i posted it on the forum and see what others thinks.
 

bigironkiller

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ericrin23, ive been posting on here a while and i have to say, your story is what i have been experiencing over the past 2-3 yrs, only i never could get the detail you did. ive been on 150mg testosterone cyp every ten days and synthroid 100mcg every day for over 2yrs. i have felt better but recently my shbg has gotten even lower and my doc is now decreasing my test cyp shots because i have to much free testosterone. i still dont think im being treated right, and am still frustrated by lack of ideas from my endocrinologists.
 

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