Lab Results In, Need Help
- 07-24-2007, 05:39 PM
Lab Results In, Need Help
I have been reading these forums the last few months and decided to build up the courage to post.
I Currently suffering from very low libido, low energy or fatigue like symptoms, and slow metabolism. I have also recently had bouts where my body feels somewhat achy (inflamation?) and it takes longer to recover from workouts. I'm 30 and I'm in decent shape because I eat good & work out often. I feel that I'm suffering from some kind of hormonal imbalance along with either slight adrenal or thyroid problems despite having a healthy lifestyle. I abused marijuana for many years when I was younger and have never felt the same since. I think the exessive abuse messed me up internally and and the last few years I have had next to no sex drive and feel tired all the time. I also am very carb/sugar sensitive and will gain weight fast if I stray from the very clean diet I have now.
Here are my recent blood work results with ranges and would like some opinions on what I should do next in regards to seeing a doctor or trying out meds to see if they improve my situation.
Thyroid TSH 3.95 uIU/ml (.350 - 5.500)
Prostate Specific Ag .5 ng/ml (0.0 - 4.0)
Testesterone, Serum 479 ng/dl (241 - 827)
Free Testesterone 17.4 pg/ml (8.7 - 25.1)
LH 1.9 mIU/ml (1.5 - 9.3)
FSH .7 mIU/ml (1.4 - 8.1)
Progesterone 1.9 ng/ml (.3 - 1.2)
DHEA-Sulfate 471 ug/dl (120 - 520)
Estradiol 30 pg/ml (0-53)
DHT 27 ng/ml (30 - 85)
Cortisol 21.5 ug/dl (3.1 - 22.4)
Prolactin 19.9 ng/ml (2.1 - 17.7)
SHBG 13 nmol/L (13 - 71)
Albumin, Serum 4.5 g/dl (3.5 - 5.5)
There are a few things that look way off here, especially DHT, Prolactin & SHBG. I recently went to the doctor and he told me that these numbers were still within 'statistical' range and that I should be happy that I'm a young healthy adult. This is the second doctor that has told me this basically and I think they are full of crap. The way that I feel now compared to how I did before abusing drugs is night & day. I know for sure that something is obviously wrong and really want to find out and get the needed help to recover because I have hid my problems for the last few years thinking that I would get better, but so far I haven't. Any help would be greatly appreciated.
- 07-24-2007, 06:02 PM
If they are out of range they should be addressed END OF STORY !! This crap "oh your just alittle bit out of range, but your healthy as a horse" WTF do they know if you are fine just by looking at you. THAT is not answer..
TSH is possibly showing low thyroid which could be representing your low shbg which is common with underactive thyroid. DHT is given to increase libido why guys respond to tcreams when they have low DHT. Might want to look into insulin resistance as well to verify why shbg could be low, inuslin resistance and thyroid go hand and hand alot of times.
Need further blood work ft3, ft4 to answer thyroid question. Prolactin is a big problem ..Progesterone may being diverted to cortisol for some appreant reason (infection, trmatic event, over training, under eating, not enough sleep, chemical exposure, ect) again the idea is pin point exactly win this happen and when you started first feeling like crap and re examine 6 months back from then usually you find your answer...Mine was simple contest diet (minreal imbalances), under eating, over training, lack of sunlight, using an AI when not needed lowered e2, Excessive ALA w/o biotin, fatty liver lead to insulin resitance started the cascade of short circut of the HPTA axis plain and simple..
Lifestyle pattern are simpliest to address before jumping into tinkering with hormones
How are your sleep patterns?
what time you goto bed and wake up
do you work night shift or work at a night club late at night?
How much sun you get each day
Do you wake up feeling refreshed?
Do you sleep sound or toss and turn each night and have a
hard time getting to sleep
What is your eating habits like
what time do you workout and how long how often?
Do you take a good multivitamin (ZMA may help before bed time)
Are you happy with your life
Any family or stresful events in your life in past 6 months
have you had any infection in last 6 months
- 07-24-2007, 06:21 PM
High prolactin could potentially be signs of a prolacatinoma but usually they produce prolactins in the hundreds or more so this is prolly not the case but if u worry u could have that checked out.
I would test for TSH, Free T4, Free T3 and prolactin again at the same time if i were u. That would definatly give u a better picture of whats going on. TSH is just the signal to produce more thyriod hormones, u need free t4 and free t3 to know that they are actually beeing produced in the correct amount.
If it turns out u are low in free t4 and or free t3, then all u might need is thyriod meds.
07-24-2007, 06:31 PM
After is in range do all other.
June 1999 Le Magazine: In The News: Elevated Prolactin Linked To Breast Cancer
============================== ============================== ========
Male - Prostate Cancer Patient
- Prolactin level no higher than 2.0
There are three FDA-approved drugs that suppress prolactin secretion. If a blood test reveals prolactin levels are elevated, ask your doctor to prescribe one of the following drugs:
- Bromocriptine (2.5 mg one or more times a day)
- Pergolide (.25 mg to .50 mg twice a day)
- Dostinex (.5 mg twice a week)
Check prolactin levels again in 30 days to make sure the drug you choose is suppressing prolactin release from the pituitary gland into the blood.
Dostinex is the newest and cleanest drug to use. Dostinex has fewer side effects than the older drugs, is more effective in suppressing prolactin than the older drugs, and requires only twice a week dosing. It should be noted that Durk Pearson and Sandy Shaw recommended bromocriptine as a prolactin suppressing agent back in 1982, and the FDA spent millions of taxpayer dollars keeping Americans from accessing this drug for the purpose of disease prevention. Since 1982, about 700,000 American women have died of breast cancer.
07-24-2007, 07:46 PM
Last edited by cpeil2; 07-24-2007 at 07:46 PM. Reason: fix type
07-24-2007, 07:55 PM
- Pergolide (.25 mg to .50 mg twice a day)
More info: pergolide has been voluntarily withdrawn from the market.
Also re: Dostinex - the risk of valve disease is considerably lower in those taking to lower prolactin because the typical dose is much lower.
07-24-2007, 08:00 PM
07-24-2007, 08:48 PM
Bromocriptine - There have been isolated reports of valve disease after long-term use for Parkinson's. Again, though, it appears that the risk is dose-related.
07-25-2007, 12:06 AM
Thanks alot guys, this by far is most answers I have gotten in the last few years. I wish I would have known about this forum sooner. I was so sick of hearing the last two doctors I was seeing that I'm healthy and that I'm probably just a little depressed. I have never suffered from depression in my life! I wish they would be more open and proactive in trying to listen to the sympoms I'm suffering from.
Anyway, I will try the Dostinex to see if that improves my condition. I'm really hoping that it will improve my condition before I have to figure something else out if it doesn't work. I'm also going to get a full thyroid panel done since I suspect I have some problems in this area also. I'm also going to get an insulin resistance test also.
I have also heard that DHT is extremely important in regards to a mans sex drive and I noticed that mine is very low. Are there anyways to get DHT to a mid - level range?
Also, would TRT be beneficial in anyway to try to get my Test to around 600 from the 479 it's at currently, or do you think my levels are ok where they are at right now?
Also, I would be open to seeing someone like Dr. John. Does my situation seem complicated enough that it would be best to put myself under his care, or should I try to self - treat first & then consider more help later? Thanks again eveyone!
07-25-2007, 12:49 AM
If still low after dostinex and u want to try TRT, gels/creams will make more of a conversion to DHT than injections.
07-25-2007, 03:14 PM
^^Thanks for the above info.
Anyone else have any reccomendations on increasing DHT and it's effect on sex drive? Besides Prolactin, does anyone think that my very low DHT levels could be affecting my lack of sex drive?
07-26-2007, 09:08 AM
When you are on testosterone the TotalT values are only a guidance, main number is FreeT. You aim is to have it (160-250), closer to the top. The balance is higly dependent on SHBG. Your SHBG=13, that is low. Eventually T supresses SHBG if in excess, you do not have much room.
SHBG levels are connected to insuline, sugar and metabolic syndrome, check that area.
SHBG levels may change, but at your current level you would need
TT~500 to have FreeT~160
TT~750 to have FreeT~250
See if only HCG (no T) may give you enough in this area.
Do not worry about DHT, not yet.
Bottom line, from my previous post, Prolactin first.
The rest may fall into right place on its own.
07-27-2007, 04:31 PM
^^Thanks for the great advice. I posted in another forum and got similiar advice from someone else. The poster reccomended 100 IU's of HCG a day to increase levels. I think I'll try dostinex first to see what kind of response I get & then start with HCG.
Does anyone know typically how long it would take to see results from taking Dostinex if it works for me? Also, is HCG a safe longterm method to increase test levels & is it a more viable option that taking a Test gel?
I'm going to get a complete Thyroid panel & Insulin resistant tests done and will post results once labs are in. I'm sure I have a problem in this area because of fatigue and not being able to eat carbs without gaining weight fast. Thanks again everyone.
07-27-2007, 05:52 PM
Im agnostic about using scripts to lower prolactin. Prolactin is something that often corrects itself on a proper doctor monitered TRT program.
07-27-2007, 06:10 PM
You almost have enough Testosterone with your current very low SHBG level, increase T and your SHBG may go lower.
Clarify your situation about Thyroid.
One of the thyroid related problems is non-reliable testosterone cream penetration thru skin.
That would not stop me from trying compounded pregnenolone cream, I guess there is not much choice.
is probably the logical sequence of events for you.
07-28-2007, 03:12 PM
05-11-2008, 03:32 PM
Best choice see dr John.Originally Posted by health4life24
You are going to have to do some tests, with or without dr John, there is no other way.
Look into Thyroid and Adrenals.
You need good (Ultrasensitive) E2 test, off hand E2 is about right, was that with or without Liquidex?
Your DHT is rather low.
Looking at your LH & FSH I would say that you are secondary, you should give your testis a chance.
So going for HCG is a good way.
Use this guidelines I posted for someone in similar situation.
Bloodwork question? Androgel - MESO-Rx
When you will (hopefully arrive at better BAT and DHT levels, yore sex drive (usually) is acutely) proportional to correct E2 levels.
This can be achieved by testing and carefull observation.
Possibly/hopefully your higher Prolactin is not going to play too much in it.
Your energy or lack of it should be figured out by NutrEval testing.
If you do that test, make sure that you do not take any supplements, vitamins, minerals, similar for at least a month.
But do not stop HCG or Liquidex.
Just eat plain food, and drink plain water, totally nothing special.
People who go crazy with their diets, still are defficient somewhere, NutrEval will tell you what you need without going crazy.
Digestive juces are imortant.
No antacids or similar.
I eat 6 tabs with every meal:
Country Life Betaine Hydrochloride with Pepsin -- 600 mg - 250 Tablets - Vitacost
Country Life Betaine Hydrochloride with Pepsin -- 600 mg - 250 Tablets
Along same line, digestive enzymes and probiotics.
Post your body temperature.
Take thermometer with you to bed, keep it close to you, so you do not wake up too much trying to reach for it.
Measure yout body temp first thing when you wake up.
05-12-2008, 02:49 PM
why are we in a 10-month old thread?
and i think this fellow's condition is rather obvious....his testes obviously work rather well, if he can make that much test from virtually NO LH/FSH...his problem is at the hypothalamus; he's apparently suppressed from the very high cortisol, prolactin, and progesterone. this may be stress related, or maybe not. B6 is a start for the prolactin and progesterone...if no luck then bromo/caber...i would definitely try out some relaxation techniques too (or even pharmaceutical stress relievers, the herbal kind preferably)
wiki says that prescription drugs often cause high prolactin...what else is he taking? additionally, dopamine being a prolactin inhibitor means that depression could cause it, too.
05-12-2008, 03:55 PM
05-12-2008, 05:49 PM
05-13-2008, 12:07 AM
Jan, your tolerance for meds never ceases to amaze me.
05-13-2008, 02:09 AM
Thanks JanSz. I'm currently on my 3rd day of 200 IU's of HCG. Haven't felt much yet, maybe a little more energy. Nothing in the libido dept. yet though. This is very frusterating to say the least and it's ruining my life. All of my paychecks have gone into paying for labs and drugs that have done nothing for me so far. I have tried just about everything short of Test.
I did try dostinex and it didn't really do anything. I thought estrogen may have been a problem, but used liquidex from the AG Guys, which really had no effect at all. I tried Armour thyriod also, did nothing for libido. I guess I'll stick with HCG for the next few weeks and up the dose to see if it has any effect.
05-13-2008, 02:19 AM
Well, this all started after many years of heavy marijuana abuse( along with drinking allot as well). I totally lost my sex drive from it and and wonder if either my hormones or chemicals in the brain were effected from it. I'm guessing it could be a few things:
1. Low Test & (low dht?) My body needs to reach a certain 'threshold' in order to feel right again
2. Nuerotrasmitters/Chemical Imbalance
could it be something like oxytocin, or some other chemical I'm defficient in?
3. Some kind of suppression
As stated above, high cortisol or progesterone? Would these inhibit libido?
If you guys have any other insights, I would greatly appreciate it.
05-13-2008, 09:01 AM
I got to this # of Betaine HCL pills by tial.
Read this article
05-13-2008, 10:43 AM
From what you have posted I see just one blood test.
Rather sketchy and incomplete blood test.
From that test you are trying to divine all your answers.
If you have done any other testing, post it here.
Post all tests that you did, group them by dates.
Post name, number, units, range.
You took invalid Estrodial test that shows you almost within range and used Liquidex, killed the little of any hormones that you have.
To rebuld your previous estrodial level may take more than 2 months.
Now you are taking insignificant dose of HCG and hoping that it will work miracles for you.
You did not do anything about your thyroid except taking Armour (blindly), you do not know if you need it or not.
All this took you 10 month or more to accomplish.
This is using up you will power and causing more problems.
You are also complaining about money, that must be toughest part.
No wonder, someone feeling like a s*t have a hard time to hustle for $$'s.
With out good testing it is going to be tough (impossible) to help you.
In post #2 HAN gave you lots of possiblilities, I do not see any reaction to them, that was 10 months ago.
Not sure what you are trying to accomplish with your HCG now.
One possibility is that you may want to do stimulation test and see if your testis are able to produce more testosterone.
That involves larger dose of HCG and timely blood test to check your reaction.
Check my post #79 for better understanding,
Start someplace with your HCG dose and test to see what it gives you.
Watch also your DHT level, if it does not go any higher, you may end up with transdermal T-gel after all.
Do complete thyroid panel.
05-13-2008, 12:33 PM
05-13-2008, 01:07 PM
i suspect HCG is the wrong drug for you. HCG acts like LH, which of course might help you short term, but YOUR problem is at the HPTA, NOT the testes (as evidenced by the LH=nil and T=okay). HCG will actually shut down your HPTA further, because the surge in test will provide even more suppressive feedback to the hypothalamus.
the ONLY really out-of-whack numbers you have are LH&FSH (terrible) and cortisol & prolactin & progesterone (way way too high, even if they are considered "in range")...considering that the feedback loops that drive their release are so intertwined, i have to conclude (barring any other insights or bloodwork) that the two are related.
ever hear of guys getting deca **** or tren dick? well, it's because of the really high suppressive capacity of these progestinic compounds.....you've got deca **** without the deca. we need to find out and fix whatever is jacking up your progesterone and prolactin and the LH/FSH will take care of themselves. look up 'hyperprolactinemia' for causes and start thinking - word is prescription drugs are often the culprit.
i have heard of guys using MJ getting elevated estrogen / low T panels; never Pr, but i wouldnt be surprised.
05-13-2008, 02:20 PM
Hyperprolactinaemia - Wikipedia, the free encyclopedia
Hyperprolactinaemia may be caused by either disinhibition (e.g., compression of the pituitary stalk or reduced dopamine levels)
or excess production from a prolactinoma (a pituitary gland adenoma tumour).
A blood serum prolactin level of 1000–5000 mIU/L could be from either mechanism,
but >5000 mIU/L is likely due to the activity of an adenoma with macroadenomas
(large tumours over 10 mm diameter) whose levels of prolactin are up to 100,000 mIU/L.
Frequent Misdiagnosis and Mismanagement of Hyperprolactinemic Patients before the Introduction of Macroprolactin Screening: Application of a New Strict Laboratory Definition of Macroprolactinemia -- Suliman et al. 49 (9): 1504 -- Clinical Chemistry
(To convert prolactin mIU/L to µg/L, we divide by 36.)
1000–5000 mIU/L --> (28 - 139) µg/L
Prolactin 19.9 ng/ml (2.1 - 17.7)
I would assume that health4life24's prolactin is acceptable and look some place else.
Unless he admits to use of some prescription and/or street use of drugs.
Since he did not used steroids his HPTA is not shut down so there is no reason in going ino HPTA restart route.
Just guessing, please keep comming with ideas.
Well what is left from your previus post is a possibility of dopamine porblems.
I like to check this on a wholesale basis.
I like Genova Diagnostics NutrEval test.
Definitely it would quickly bring to lite many possibilities plus suggestions of how to deal with a problem if any.
Will give a list of supplements and a daily dosing.
05-13-2008, 04:59 PM
how in the world can you "assume" his prolactin is acceptable, when it's clearly out of range? just because a clinical diagnosis of hyperprolactinemia doesnt apply, doesnt mean that a similar scenario isnt present here. he's out of range of prolactin, progesterone and cortisol, three hormones that are strongly related and two of which are KNOWN to seriously suppress LH/FSH, which he has very little of. in my eyes it's all rather obvious.
what about stims? i believe they've been shown to increase prolactin and cortisol (need refs...)
prolactin and cortisol ARE the "stress hormones" and his are elevated. that's the clear starting point IMHO.
05-13-2008, 08:06 PM
05-14-2008, 01:16 AM
Here are some additional labs done in the last 8 months:
TSH - 7.07 (.40 -4.50 miU/L)
T3 Total - 92 (60 - 181 ng/dl)
T4 Total - 5.3 (4.5 - 12.5 mcg/dl)
Thyroid Peeroxide Antibodies - <10 (35 IU/ml)
Triglycerides - 230 (<150 mg/dl)
Cholestorol, Total - 192 (125 - 200 mg/dl)
HDL Cholestorol - 55
LDL Cholestorol - 91
Testosterone, Total - 465 (241 - 827 ng/dl)
TSH 4.79 (0.35 - 5.5)
Free T3 3.1 (2.3 - 4.2)
T4 4.6 (4.5 - 12.0)
Free T4 1.21 (.61 - 1.76)
Antithyroglobulin Ab <20 (0 - 40)
Prolactin 17.1 (2.1 - 17.7)
What do you guys think? I tried Armour Thryoid for about 2 weeks and only felt a difference in energy, but nothing major. Still did nothing for libido. It's like I feel nothing down there at all, as if something is suppressing any 'feeling'. Wondering if it's either too low Total Test (even though free T is good!) & low DHT. If progesterone is having a suppressing affect, could raising DHT counterbalance progesterone, thus lowering it? I have read that DHT can lower both progesterone & E2. Does this sound plausable? What about other progesterone lowering drugs such as Winstrol? Any ideas guys?
05-14-2008, 01:23 AM
Thanks again for the advice! This actually all came about from many years of heavy marijuana abuse. I have heard that marijuana can increase prolactin, but not sure about progesterone. I used to have a raging libido when I was younger, now I feel nothing after the years of smoking pot. I'm wondering if this drastically affected brain chemistry, thus causing some kind of hormonal imbalance. I have tried dostinex, but it didn't do anything for me. I'm wondering what other options I have.
05-14-2008, 01:28 AM
05-14-2008, 01:30 PM
your total and free T are fine enough - you should have some libido if that's all we look at. your SHBG is also low, which of course contributes to that (although the extent is hotly debated)...HOW this is, given your ridiculously low LH and FSH, is frankly beyond me. the DHT gives me concerns, because it is really low....and the more i think about it, it's probably a big cause of your problems. i know that whenever i use finasteride, it absolutely slaughters my libido...even if i use it on a test cycle, i am basically back to baseline libido-wise. treating the DHT issue is tricky, because the reality is that IT is not the root of your problems.
i am trying to sort out how low DHT and high stress hormones interact...i know that progesterone binds to 5AR, possibly more strongly than T does, and it may be "stealing" the conversion and robbing you of DHT...but i could be wrong.
here's an excerpt from a pubmed investigation regarding prolactin response to stress...(it gives a bunch of other refs):
It is clear that prolactin secretion is dramatically affected by "stress." A myriad of stresses have been used to characterize such effects on prolactin secretion. These include, but are not limited to, the following: ether stress (116, 667, 866, 876, 893, 1077, 1105, 1200, 1257, 1296, 1913), restraint stress (416, 590, 598, 883, 923, 944, 1446), thermal stress (1782a), hemorrhage (274, 883), social conflict (817), and even academic stress in humans (1108).
i think all 3 of the hormones you have in excess can be excreted by the adrenal glands, so that might be a clue...
wish i could help more....i'd do some more research if i had time.
05-14-2008, 02:20 PM
Your antibodies are low, ok
Your Free T3 3.1 (2.3 - 4.2)
yes, you can add a little Armour Thyroid, but it is not that bad as is.
So while we are waiting for SOLARUS to come with some idea about Prolactin............
I see possibility in exploring HCG.
For the next 4 weeks do HCG injection, 2x per week.
Injection size 1500iu
On end of 4 week period, 48 hours after the HCG shot, draw blood. You keep doing your HCG shots while you are waiting for test results and any follow up decission.
Do these tests at Quest Diagnostics, blood drawn at Quest.
Estradiol, Ultrasensitive, LC/MS/MS (30289X)
Estradiol, Free, LC/MS/MS (36169X)
Testosterone, Free, Bio/Total (LC/MS/MS)
Dihydrotestosterone, Free, Serum (36168X)
If you cant get tests at Quest, speak up, I will rewrite the request.
Search for a doctor that deal with Genova Diagnostics.
You can call them, give your zip code they will e-mail you a list.
If you have money, I can add few more items to your blood test.
05-14-2008, 03:49 PM
05-14-2008, 03:57 PM
05-14-2008, 04:00 PM
05-14-2008, 05:34 PM
05-15-2008, 03:03 AM
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