Secondary Hypogonadism Protocol

[MarkLA]

Hi,

First post here

I've been reading messages for the last few days and getting educated. I'm 35, my T is 187 (165 on another test day), sex drive non-existent so I know I need help. I have no steriod history, not taking any other meds. I did take propecia for a short time a few years ago, but do not now.

I had blood work done and saw an Endo already. I have LH of 2.3. I had a Pituitary MRI which came back normal, so the diagnosis Idiopathic Secondary Hypogonadism. Idiopathic = it's low but we don't know why.

I see a new doc on Sat and am going to ask him to test Estradiol to make sure that's not involved. I'm annoyed the first doc did not check this. I figure I should be prepared when I go to see the second doc so I can manage the process and tell him what I think the troubleshooting methodology should be/what the treatment should be.

My goal is to get into the normal range -- maybe 600-900 T without screwing up the rest of my system. If this can be done without directly taking T forever, great. If not then I'll take the T.

Here's what I'm thinking:

1. If Estradiol >30 ask for Arimidex 0.25mg E3D. Then should I wait to see if this increases my natural T or should I get T now as well?

2. If Estradiol <30
a. Ask for 10% compounded cream. I have insurance, but they are a PITA getting them to pay for Androgel. I'm ok paying out of pocket and like that there's less volume of the stuff to apply. I'm trying to minimize needles.

b. Check T in 3 weeks. Adjust dosage up or down.

c. Check again in 2 months. If OK, ask for HcG 250iu E3D. (I know this is a needle).

I'd appreciate any suggestions. I know FAR more than I did a week ago from my reading but there's a lot to learn.

Following is my bloodwork:

I should also add that I weight train and eat protein/low carb. For some reason, the docs like to stick me in the office without telling me to fast first. Thus I think the BUN would probably be closer to normal if I were fasting.

I'm putting a ** near anything out of range.

Glucose 86
Sodium 142
Potassium 3.7
Chloride 101
Carbon Dioxide 27
Anion Gap 14
**UREA Nitrogen 35
Creatinine 1.2
Calcium 9.8
Bilirubin, total 0.3
Protein Total 7.0
Albumin 4.7
Alkaline Phosphotase 82
**Aspartate Aminotransfera 47
**Alanine Aminotransferase 54

Cortisol 15.3
FSH 5.6
LH 2.3

Prolactin 10.5

Thyroxine 6.5
T Uptake 31.0
Adjusted T4 6.7
TSH 1.26

**Testosterone Total 165
**Testosterone Free 20.7
**Testosterone Free 1.25%

Somatomedin-C (IGF-1) 239

PSA 0.12

WBC 5.2
RBC 4.86
Hemoglobin 15.4
Hemocrit 47.1
MCV 96.9
MCH 31.7
MCHC 32.8
RBC Distribution Width 13.7
Platelet Count 156000
Mean Platelet Vol 9.4

Diffs Automated

Polys 53
Lymphs 28
Monos 7
Eos 12
Basos 1
ABS Polys 2.7
ABS Lymphs 1.5
ABS Monos 0.4
**ABS EOS 0.6
ABS Basos 0.1
RBC Morphology Normal
Type of Differential Auto

 

[hardasnails1973]

Hi,

First post here

I've been reading messages for the last few days and getting educated. I'm 35, my T is 187 (165 on another test day), sex drive non-existent so I know I need help. I have no steriod history, not taking any other meds. I did take propecia for a short time a few years ago, but do not now.

I had blood work done and saw an Endo already. I have LH of 2.3. I had a Pituitary MRI which came back normal, so the diagnosis Idiopathic Secondary Hypogonadism. Idiopathic = it's low but we don't know why.

I see a new doc on Sat and am going to ask him to test Estradiol to make sure that's not involved. I'm annoyed the first doc did not check this. I figure I should be prepared when I go to see the second doc so I can manage the process and tell him what I think the troubleshooting methodology should be/what the treatment should be.

My goal is to get into the normal range -- maybe 600-900 T without screwing up the rest of my system. If this can be done without directly taking T forever, great. If not then I'll take the T.

Here's what I'm thinking:

1. If Estradiol >30 ask for Arimidex 0.25mg E3D. Then should I wait to see if this increases my natural T or should I get T now as well?

2. If Estradiol <30
a. Ask for 10% compounded cream. I have insurance, but they are a PITA getting them to pay for Androgel. I'm ok paying out of pocket and like that there's less volume of the stuff to apply. I'm trying to minimize needles.

b. Check T in 3 weeks. Adjust dosage up or down.

c. Check again in 2 months. If OK, ask for HcG 250iu E3D. (I know this is a needle).

I'd appreciate any suggestions. I know FAR more than I did a week ago from my reading but there's a lot to learn.

Following is my bloodwork:

I should also add that I weight train and eat protein/low carb. For some reason, the docs like to stick me in the office without telling me to fast first. Thus I think the BUN would probably be closer to normal if I were fasting.

I'm putting a ** near anything out of range.

Glucose 86
Sodium 142
Potassium 3.7
Chloride 101
Carbon Dioxide 27
Anion Gap 14
**UREA Nitrogen 35
Creatinine 1.2
Calcium 9.8
Bilirubin, total 0.3
Protein Total 7.0
Albumin 4.7
Alkaline Phosphotase 82
**Aspartate Aminotransfera 47
**Alanine Aminotransferase 54

Cortisol 15.3
FSH 5.6
LH 2.3

Prolactin 10.5

Thyroxine 6.5
T Uptake 31.0
Adjusted T4 6.7
TSH 1.26

**Testosterone Total 165
**Testosterone Free 20.7
**Testosterone Free 1.25%

Somatomedin-C (IGF-1) 239

PSA 0.12

WBC 5.2
RBC 4.86
Hemoglobin 15.4
Hemocrit 47.1
MCV 96.9
MCH 31.7
MCHC 32.8
RBC Distribution Width 13.7
Platelet Count 156000
Mean Platelet Vol 9.4

Diffs Automated

Polys 53
Lymphs 28
Monos 7
Eos 12
Basos 1
ABS Polys 2.7
ABS Lymphs 1.5
ABS Monos 0.4
**ABS EOS 0.6
ABS Basos 0.1
RBC Morphology Normal
Type of Differential Auto

ranges be nice !!

 

[plymouth city]

**Testosterone Total 165
**Testosterone Free 20.7
**Testosterone Free 1.25%

We need ranges.

Assuming standard ranges of FT, that isn't all that bad as TT.

Estrogen isn't the problem buddy with a TT of that low. There is no way your E2 level can be that high with that little of aromatization going on plus a better FT level compared to TT. Estrogen alone doesn't cause hypogonadism directly, although it can play a part.

 

[plymouth city]

I am also curious to know how your DR arrived at the conclusion of secondary hypogonadism :wtf: with those LH and FSH numbers, given pituitary came back fine.

 

[MarkLA]

**Testosterone Total 165
**Testosterone Free 20.7
**Testosterone Free 1.25%

We need ranges.

Assuming standard ranges of FT, that isn't all that bad as TT.

Estrogen isn't the problem buddy with a TT of that low. There is no way your E2 level can be that high with that little of aromatization going on plus a better FT level compared to TT. Estrogen alone doesn't cause hypogonadism directly, although it can play a part.

Here we go with ranges. I will include the non T ones too..

Testosterone 165 ng/dL (range 250-1100)
Testosterone Free 20.7 pg/mL (range 35-155)
Testosterone Free % 1.25 (range 1.5-2.2)

Somatomedin-C 239 ng/mL (range 106-255)
Cortisol 15.3 MCG/DL (range 6-19 MCG/DL Morning, 3-14 Afternoon. This was afternoon)
FSH 5.6 MIU/ML (Males 1 to 8 MIU/ML)
LH 2.3 MIU/ML (Males 2-12 MIU/ML)
Prolactin 10.5 NG/ML (range 3.0-14.7)
Thyroxine 6.5 MCG/DL (range 4.5-12.5)
T Uptake 31.0% (range 25-35)
Adjusted T4 6.7 MCG/DL (range 4.4-11.4)
TSH 1.26 MCU/ML (range 0.39-4.60)

I appreciate your help.

Mark

 

[MarkLA]

I am also curious to know how your DR arrived at the conclusion of secondary hypogonadism :wtf: with those LH and FSH numbers, given pituitary came back fine.

The logic was:

1. Total T is below the range. I have 165 ng/dL and range is 250-1100. Therefore diagnosis of hypogonadism. Plus I'm 35 not 75, so I'd figure I should be closer to the top of the range than the bottom.

2. Primary or Secondary: The testicles produce T because they get the LH signal from the pituitary. If the problem was in the testicles (Primary hypogonadism) then we'd expect to see a high LH value. i.e. The testicles are getting LH but not doing their job and producing T, so the body sends more and more LH. So if we saw low T and high LH then we'd infer that the testicles are not responding (Primary hypogonadism).

However in my case, the T is low but the LH is also low, so the problem is not in the testicles but in the pituitary end of things. They did a pituitary MRI to rule out a tumor.

So that's the Dr's logic, which made sense to me. What I am missing?

Thanks for the help,
Mark

 

[cpeil2]

The logic was:

1. Total T is below the range. I have 165 ng/dL and range is 250-1100. Therefore diagnosis of hypogonadism. Plus I'm 35 not 75, so I'd figure I should be closer to the top of the range than the bottom.

2. Primary or Secondary: The testicles produce T because they get the LH signal from the pituitary. If the problem was in the testicles (Primary hypogonadism) then we'd expect to see a high LH value. i.e. The testicles are getting LH but not doing their job and producing T, so the body sends more and more LH. So if we saw low T and high LH then we'd infer that the testicles are not responding (Primary hypogonadism).

However in my case, the T is low but the LH is also low, so the problem is not in the testicles but in the pituitary end of things. They did a pituitary MRI to rule out a tumor.

So that's the Dr's logic, which made sense to me. What I am missing?

Thanks for the help,
Mark

Looks like a classic case of secondary hypogonadism.

 

[JanSz]

Here we go with ranges. I will include the non T ones too..

Testosterone 165 ng/dL (range 250-1100)
Testosterone Free 20.7 pg/mL (range 35-155)
Testosterone Free % 1.25 (range 1.5-2.2)

Somatomedin-C 239 ng/mL (range 106-255)
Cortisol 15.3 MCG/DL (range 6-19 MCG/DL Morning, 3-14 Afternoon. This was afternoon)
FSH 5.6 MIU/ML (Males 1 to 8 MIU/ML)
LH 2.3 MIU/ML (Males 2-12 MIU/ML)
Prolactin 10.5 NG/ML (range 3.0-14.7)
Thyroxine 6.5 MCG/DL (range 4.5-12.5)
T Uptake 31.0% (range 25-35)
Adjusted T4 6.7 MCG/DL (range 4.4-11.4)
TSH 1.26 MCU/ML (range 0.39-4.60)

I appreciate your help.

Mark

You be better off if you did blood test as listed on post #44
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

Absent that, if you decide doing nothing else but small part of hormones then if you give me your lattest SHBG then I could calculate for you weekly testosterone dose.

I am discounting your fear of needles since you already decided to do HCG. The Depo_T injection you also should do using the smallest needle (31ga 5/15"long) and SubQ injections around navel.

The T dose that I could calculate or you can do it, since all info is posted in above thread, that dose is preliminary only, good for 2 - 3 months. You have to do blood testing again, (shorter test).

===================================
Dostinex may be in your future, your Prolactin is in teens.
=====================================
FreeT4 is not high enough, what about FreeT3???

 

[MarkLA]

You be better off if you did blood test as listed on post #44
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

Absent that, if you decide doing nothing else but small part of hormones then if you give me your lattest SHBG then I could calculate for you weekly testosterone dose.

I am discounting your fear of needles since you already decided to do HCG. The Depo_T injection you also should do using the smallest needle (31ga 5/15"long) and SubQ injections around navel.

The T dose that I could calculate or you can do it, since all info is posted in above thread, that dose is preliminary only, good for 2 - 3 months. You have to do blood testing again, (shorter test).

===================================
Dostinex may be in your future, your Prolactin is in teens.
=====================================
FreeT4 is not high enough, what about FreeT3???

Thanks much. I checked and I don't have SHBG on any test.

I'm going to see the new doc this Sat and can ask for new tests. Since I don't know him, I'm a tad reluctant to go in too demanding, although I feel funny even writing that, so I guess I will go in with a list. Ideally, I want to get only what I need and not repeat the other tests unnecessarily since they were done within the last 6 weeks.

As far as Thyroid I have the following info from another test. No Free T3, but it does have total T3.

(from another test)
TSH 1.16 mIU/ml (0.35-5.5)
Total T3 0.74 ng/mL (0.6-1.81)
Free T4 1.32 ng/dL (0.72-1.56)

I know what you're saying about the shots and I respect that. I am not fearful enough to avoid doing it but if I can get the same benefit from cream, why not?

In any case, I'm very curious to hear your advice. I can go on Saturday and ask for more tests, also I can ask for more tests and a prescription or two. This doc is a urologist not an endo and I'm told he'll be pretty reasonable to work with..

Thanks again,
Mark

 

[JanSz]

Thanks much. I checked and I don't have SHBG on any test.

I'm going to see the new doc this Sat and can ask for new tests. Since I don't know him, I'm a tad reluctant to go in too demanding, although I feel funny even writing that, so I guess I will go in with a list. Ideally, I want to get only what I need and not repeat the other tests unnecessarily since they were done within the last 6 weeks.

As far as Thyroid I have the following info from another test. No Free T3, but it does have total T3.

(from another test)
TSH 1.16 mIU/ml (0.35-5.5)
Total T3 0.74 ng/mL (0.6-1.81)
Free T4 1.32 ng/dL (0.72-1.56)

I know what you're saying about the shots and I respect that. I am not fearful enough to avoid doing it but if I can get the same benefit from cream, why not?

In any case, I'm very curious to hear your advice. I can go on Saturday and ask for more tests, also I can ask for more tests and a prescription or two. This doc is a urologist not an endo and I'm told he'll be pretty reasonable to work with..

Thanks again,
Mark

So far I am hearing only the words in red.
There is your chance.

It is all up to you,
but without providing information thru testing the rest is hand vaving, useless chatter.

 

[MarkLA]

So far I am hearing only the words in red.
There is your chance.

It is all up to you,
but without providing information thru testing the rest is hand vaving, useless chatter.

JanSz,

You're right.

I'll go on Sat and try to get the other relevant tests. I looked at your list. Following is what I'm going to ask for to add to my current test results.

If the doc is ignorant, I'm going to have to bring him up to speed on why these values are needed, so I'd appreciate any help in filling in the gaps of my understanding.

SHBG - Calculate free T more accurately than lab measured free T

60 Estradiol, Free, LC/MS/MS (36169X) - get baseline value of aromatization before supplementation starts

40 T3 Free
41 T3 uptake
42 T3,Total

Dihydrotestosterone, Free, Serum (36168X)

Mark

 

[plymouth city]

Your right cpeil, forgive me my estrogen dominant brain has gotten primary and secondary mixed up :rofl:

Mark, let us not forget that SHBG itself is often VERY difficult to measure correctly, even with quest's standards.

The most accurate way to measure bio indentical hormones, the gold standard, is urines. Urines, if I remember correctly, do not measure SHBG. There is much invalidity in bloods, even by Quest standards. I think that Urines may very well be the gold standard in hormone measurement.

It is these reasons in itself why we must not use SHBG as a marker on how to treat a HRT program and adjust dosages. Get Bioavailable T and E in line and let things like SHBG fall where it may.

Besides, how do we treat SHBG with consistency? There is really little to do to raise/lower it. Chrysin cream has shown a little promise in lowering it, yet it is inconsistent.

 

[MarkLA]

It is these reasons in itself why we must not use SHBG as a marker on how to treat a HRT program and adjust dosages. Get Bioavailable T and E in line and let things like SHBG fall where it may.

Hi Plymouth,

Thanks for your response. It sounds like your advice is to go get the Estradiol (I already have T) so I have a baseline before taking anything and then just start the TRT with whatever dosage guestimate the doc and I come up with.

Once I have been under treatment for a while I can get more blood work done and then adjust the T up and down, manage Prolactin, etc if needed at that point.

Is that about right?

Thanks,
Mark

 

[plymouth city]

Hi Plymouth,

Thanks for your response. It sounds like your advice is to go get the Estradiol (I already have T) so I have a baseline before taking anything and then just start the TRT with whatever dosage guestimate the doc and I come up with.

Once I have been under treatment for a while I can get more blood work done and then adjust the T up and down, manage Prolactin, etc if needed at that point.

Is that about right?

Thanks,
Mark

Yes!

We absolutely need a baseline E number to go from before we administer TRT therapy. Doing without an E number would be like trying to find your way in the dark without a flashlight.

I suggest you read, re read and study Dr Johns TRT paper until you can recite it verbatem. http://anabolicminds.com/forum/male-anti-aging/47857-trt-recipe-success.html

 

[plymouth city]

"with whatever dosage guestimate the doc and I come up with"

Most seem to need 100mg of T per weekly in shots. Androgel is more person respondent, but we can start with 5g and go from there.

Remember, a person absorbs 70mg from a 100mg shot. Androgel can vary from person to person, but 5g is a good starting dose.

Dr John in his paper - "There simply is no way to predict how a particular patient will respond—not Medical History (i.e. number or severity of symptoms), body weight, baseline hormone levels, even anabolic steroid history. I have had very slight gentlemen barely elevate on 100mg of test cyp per week, and massively muscled former steroid athletes who went to nearly two times the top of “normal” range on the same dosage (they had similar baselines). Likewise, one man may see only a modest increase in DHT on 5gms of Androgel, another may become quite supraphysiological on same.

I start my guys out on either testosterone cream/gel 5mgs QD or testosterone cypionate 100mg per week. The IM test cyp must be administered in weekly injections, as opposed to taking twice the dosage every other week. Some physicians even dose every third or fourth week, producing wide swings in serum androgen levels. This puts the patient on an emotional roller coaster, increases the risk of developing polycythemia, greatly accentuates aromatase activity, and actually leaves them lower than they were when they started for the last half of the cycle. In order to get the serum androgen concentration to a stable level more quickly, I “frontload” 200mg the first injection (unless converting over from a gel/cream)."

 

[JanSz]

JanSz,

You're right.

I'll go on Sat and try to get the other relevant tests. I looked at your list. Following is what I'm going to ask for to add to my current test results.

If the doc is ignorant, I'm going to have to bring him up to speed on why these values are needed, so I'd appreciate any help in filling in the gaps of my understanding.

SHBG - Calculate free T more accurately than lab measured free T

60 Estradiol, Free, LC/MS/MS (36169X) - get baseline value of aromatization before supplementation starts

40 T3 Free
41 T3 uptake
42 T3,Total

Dihydrotestosterone, Free, Serum (36168X)

Mark

It doesnt make much difference, money or accuracy vise, but rather than asking for SHBG directly I would ask for
Testosterone, Free, Bio/Total (LC/MS/MS)

you are getting more information, but more important newest methodology is being used in testing, the (LC/MS/MS), so more accurate results (hopefully).
-------------
The
60 Estradiol, Free, LC/MS/MS (36169X)

is probably good enough, but again, I like also to know

Estrogens, Fractionated, LC/MS/MS (36742X)
Estrogen, Total, Serum (439X)

in ideal world one would also check 2/16 ratio using RheiLabs.

Interesting,
on 2/16 topic
I found in Great Smokies (now Genova Diagnostics) and in reference yesterday posted by hardasnails

DIM is not mentioned at all while adjusting 2/16 ratio.
I3C still there.
I will keep using DualAction from LEF for adjusting 2/16 purpose.

Genova Diagnostics Estrogen Metabolism Index

Estrogen Metabolism Index

Flaxseed (lignans), soy products (isoflavones), cruciferous vegetables (indole-3-carbinol), vigorous exercise, and omega-3 fatty acids are interventions that may reduce the risk of estrogen-dependent disease by favorably modifying the 2:16alpha-OHE1 ratio. Using this assessment, practitioners can monitor the physiological impact of these and other treatments (including hormone replacement therapy), gaining added insight into their clinical safety and effectiveness.
==============================================================================
Speaking of accuracy of tests;
Direct Free Testosterone using RIA methods is useless, unles performed in research llaboratories.
Total lack of accuracy applies only to laboratories commonly accesible to "regular" patients.
That is because laboratories are using cookie cutter test, better explained in one of the links.

Quest Diagnostic FreeT and BAT (when derived via calculation) are not accused of such inaccuracy.
Testosterone, Free, Bio/Total (LC/MS/MS)
is a good acceptable test troughout.
--------------------------
I do not buy into inaccuracies of other tests,

unless proven otherwise using references to relevant studies.

I heard this story about inaccuracies of:

TotalEstrogens
DHT
progesterone
pregnenolone

probably other.

I expect that someone somewhere proved that
accuracy claimed by laboratory is (say) 0.5%
and somebody find out that it is 10X less (say) 5%
If true, I do not think this will make enough difference to abandon the testing completely and go by subjective feelings or some other theory.

 

[MarkLA]

More test results

I went to see the Urologist.

He's not a hormone guy, but I was able to get SOME additional tests. I think I have a lead on a hormone place here to go visit (http://www.hormoneandlongevitycenter.com) so that'll be my next stop.


I'd appreciate any comments on this bloodwork:

**DHT 107 (ng/dL range 25-75)
Estradiol 13 (pg/mL range 13-54)
SHBG 29 (nmol/L range 8-48)

Thanks
Mark


Reposting my old bloodwork for convenience:

Glucose 86 mg/dL (70-110)
Sodium 142 mmol/L (135-145)
Potassium 3.7 mmol/L (3.5-4.5)
Chloride 101 mmol/L (101-111)
Carbon Dioxide 27 mmol/L (23-31)
Anion Gap 14 mmol/L
**UREA Nitrogen 35 MG/DL (range 5-25)
Creatinine 1.2 mg/dL (0.4-1.5)
Calcium 9.8 mg/dL (8.3-10.7)
Bilirubin, total 0.3 mg/dL (0.1-1.2)
Protein Total 7.0 G/DL (6.0-8.5)
Albumin 4.7 G/DL (3.5-5.5)
Alkaline Phosphotase 82 U/L (<125)
**Aspartate Aminotransfera 47 (range < 46 U/L)
**Alanine Aminotransferase 54 (range < 53 U/L)


**Testosterone 165 ng/dL (range 250-1100)
**Testosterone Free 20.7 pg/mL (range 35-155)
**Testosterone Free 1.25% (range 1.5 - 2.2)

Somatomedin-C 239 ng/mL (range 106-255)
**Cortisol 15.3 MCG/DL (range 6-19 MCG/DL Morning, 3-14 Afternoon. This was afternoon)

FSH 5.6 MIU/ML (Males 1 to 8 MIU/ML)
LH 2.3 MIU/ML (Males 2-12 MIU/ML)
Prolactin 10.5 NG/ML (range 3.0-14.7)
Thyroxine 6.5 MCG/DL (range 4.5-12.5)
T Uptake 31.0% (range 25-35)
Adjusted T4 6.7 MCG/DL (range 4.4-11.4)
TSH 1.26 MCU/ML (range 0.39-4.60)

(from another test)
TSH 1.16 mIU/ml (0.35-5.5)
Total T3 0.74 ng/mL (0.6-1.81)
Free T4 1.32 ng/dL (0.72-1.56)


PSA 0.12 ng/ML (0-4)

WBC 5.2 (4-11) 1000/UL
RBC 4.86 (3.97-5.65) MILL/UL
Hemoglobin 15.4 (13-17) G/DL
Hemocrit 47.1 (37.5-49.9) %
MCV 96.9 (80-100) FL
MCH 31.7 (27-33) PG
MCHC 32.8 (32-36) %
RBC Distribution Width 13.7 (11.5-14.5) %
Platelet Count 156000 (150000-450000) /UL
Mean Platelet Vol 9.4 (7.4-10.4) FL

Diffs Automated

Polys 53%
Lymphs 28%
Monos 7%
Eos 12%
Basos 1%
ABS Polys 2.7 (1.8 to 2.8) 1000/UL
ABS Lymphs 1.5 (1.0-4.5) 1000/UL
ABS Monos 0.4 (<0.8) 1000/UL
**ABS EOS 0.6 (<0.4) 1000/UL
ABS Basos 0.1 (<0.2) 1000/UL
RBC Morphology Normal
Type of Differential Auto

Lipid panel/Glucose (FASTING - from another day)
Total Cholesterol 131 mg/dL
Triglycerides 107 mg/dL
Glucose 87 mg/dL
HDL 48 mg/dL
LDL 61 mg/dL
CLD 21 mg/dL
TC/HDL 2.7 md/dL

 

[JanSz]

I went to see the Urologist.

He's not a hormone guy, but I was able to get SOME additional tests. I think I have a lead on a hormone place here to go visit ((Holtorf Medical Group, Inc - Torrance, CA) Hormone Doctor - Hormone and Longevity Medical Center) so that'll be my next stop.


I'd appreciate any comments on this bloodwork:

**DHT 107 (ng/dL range 25-75)
Estradiol 13 (pg/mL range 13-54)
SHBG 29 (nmol/L range 8-48)

Thanks
Mark


Reposting my old bloodwork for convenience:

Glucose 86 mg/dL (70-110)
Sodium 142 mmol/L (135-145)
Potassium 3.7 mmol/L (3.5-4.5)
Chloride 101 mmol/L (101-111)
Carbon Dioxide 27 mmol/L (23-31)
Anion Gap 14 mmol/L
**UREA Nitrogen 35 MG/DL (range 5-25)
Creatinine 1.2 mg/dL (0.4-1.5)
Calcium 9.8 mg/dL (8.3-10.7)
Bilirubin, total 0.3 mg/dL (0.1-1.2)
Protein Total 7.0 G/DL (6.0-8.5)
Albumin 4.7 G/DL (3.5-5.5)
Alkaline Phosphotase 82 U/L (<125)
**Aspartate Aminotransfera 47 (range < 46 U/L)
**Alanine Aminotransferase 54 (range < 53 U/L)


**Testosterone 165 ng/dL (range 250-1100)
**Testosterone Free 20.7 pg/mL (range 35-155)
**Testosterone Free 1.25% (range 1.5 - 2.2)

Somatomedin-C 239 ng/mL (range 106-255)
**Cortisol 15.3 MCG/DL (range 6-19 MCG/DL Morning, 3-14 Afternoon. This was afternoon)

FSH 5.6 MIU/ML (Males 1 to 8 MIU/ML)
LH 2.3 MIU/ML (Males 2-12 MIU/ML)
Prolactin 10.5 NG/ML (range 3.0-14.7)
Thyroxine 6.5 MCG/DL (range 4.5-12.5)
T Uptake 31.0% (range 25-35)
Adjusted T4 6.7 MCG/DL (range 4.4-11.4)
TSH 1.26 MCU/ML (range 0.39-4.60)

(from another test)
TSH 1.16 mIU/ml (0.35-5.5)
Total T3 0.74 ng/mL (0.6-1.81)
Free T4 1.32 ng/dL (0.72-1.56)


PSA 0.12 ng/ML (0-4)

WBC 5.2 (4-11) 1000/UL
RBC 4.86 (3.97-5.65) MILL/UL
Hemoglobin 15.4 (13-17) G/DL
Hemocrit 47.1 (37.5-49.9) %
MCV 96.9 (80-100) FL
MCH 31.7 (27-33) PG
MCHC 32.8 (32-36) %
RBC Distribution Width 13.7 (11.5-14.5) %
Platelet Count 156000 (150000-450000) /UL
Mean Platelet Vol 9.4 (7.4-10.4) FL

Diffs Automated

Polys 53%
Lymphs 28%
Monos 7%
Eos 12%
Basos 1%
ABS Polys 2.7 (1.8 to 2.8) 1000/UL
ABS Lymphs 1.5 (1.0-4.5) 1000/UL
ABS Monos 0.4 (<0.8) 1000/UL
**ABS EOS 0.6 (<0.4) 1000/UL
ABS Basos 0.1 (<0.2) 1000/UL
RBC Morphology Normal
Type of Differential Auto

Lipid panel/Glucose (FASTING - from another day)
Total Cholesterol 131 mg/dL
Triglycerides 107 mg/dL
Glucose 87 mg/dL
HDL 48 mg/dL
LDL 61 mg/dL
CLD 21 mg/dL
TC/HDL 2.7 md/dL

Your DHT is over the range. At this moment I would not do anything about it except note that transdermal testosterone delivery is not for you.

Estradiol and SHBG are in nice location.
When you start on Depo-Testosterone supplementation your E2 may raise and SHBG may fall, just as you wish they would.
Keep Arimidex or better yet Liquidex handy, one newer know for sure.

Whith your FSH and LH levels I think your testis are doing what they could.
If you wish you may want to spend couple months just on HCG to prove to yourself what may happen. I would stay away from any Clomid or Novarel.
If you give hcg try then use
Novarel 250iu E2D every other day.
Retest in two to three monts see where you are.

If you go T+hcg route ether right away or after hcg trial then your preliminary T dose is:

Routine E3D every three days, T&hcg shots on same day.
Two days in between free of shots.
HCG dose=500iu

preliminary T dose:
you want
FreeT~250
to get there you need
TT~975
per chart #41
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html
your weekly dose od 200mg/mL Depo-Testosterone is
135mg=135mg/200mg/mL=0.675mL=0.675cc=67.5 units on syringe
for E3D schedule each T shot is
67.5/7*3=28.9~29units

When disolving Novarel use 5mL of water, so the 500iu would fit into your 3/10cc syringe I am about to recomend.

For both T&hcg shots you may use
BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b
BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b Price: $25.95

or you can use

Colostomy Supplies, Pet Diabetic Supplies
Easy Touch U-100 Insulin Syringe 31 Gauge 3/10cc 5/16 inch Short Needle 100/Box Sale Price: $13.99

SubQ shots around navel.

Retest 2 to 3 monts latter.
Use my list. You may want to expand my list on thyroid and cholesterol area.
No need to repeat CBC panel.
===============================================================
Your cholesterol is low, lot of fish oil

get freeT3

 

[hardasnails1973]

Your DHT is over the range. At this moment I would not do anything about it except note that transdermal testosterone delivery is not for you.

Estradiol and SHBG are in nice location.
When you start on Depo-Testosterone supplementation your E2 may raise and SHBG may fall, just as you wish they would.
Keep Arimidex or better yet Liquidex handy, one newer know for sure.

Whith your FSH and LH levels I think your testis are doing what they could.
If you wish you may want to spend couple months just on HCG to prove to yourself what may happen. I would stay away from any Clomid or Novarel.
If you give hcg try then use
Novarel 250iu E2D every other day.
Retest in two to three monts see where you are.

If you go T+hcg route ether right away or after hcg trial then your preliminary T dose is:

Routine E3D every three days, T&hcg shots on same day.
Two days in between free of shots.
HCG dose=500iu

preliminary T dose:
you want
FreeT~250
to get there you need
TT~975
per chart #41
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html
your weekly dose od 200mg/mL Depo-Testosterone is
135mg=135mg/200mg/mL=0.675mL=0.675cc=67.5 units on syringe
for E3D schedule each T shot is
67.5/7*3=28.9~29units

When disolving Novarel use 5mL of water, so the 500iu would fit into your 3/10cc syringe I am about to recomend.

For both T&hcg shots you may use
BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b
BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b Price: $25.95

or you can use

Colostomy Supplies, Pet Diabetic Supplies
Easy Touch U-100 Insulin Syringe 31 Gauge 3/10cc 5/16 inch Short Needle 100/Box Sale Price: $13.99

SubQ shots around navel.

Retest 2 to 3 monts latter.
Use my list. You may want to expand my list on thyroid and cholesterol area.
No need to repeat CBC panel.
===============================================================
Your cholesterol is low, lot of fish oil

get freeT3

How does fish oil raise cholestrol? Like to know answer to that one..
His t4 tot3 ratio is off due to adrenal imbalances look at the potassium level

 

[JanSz]

How does fish oil raise cholestrol? Like to know answer to that one..His t4 tot3 ratio is off due to adrenal imbalances look at the potassium level

Raising cholesterol is your specialty.

Have at it.

If you have any reference any help on this topic do not hold it, have at it.
====================
IIRC your doc had you thru some specialized analysis in that direction, Fatty Acid Analysis

 

[hardasnails1973]

Raising cholesterol is your specialty.

Have at it.

If you have any reference any help on this topic do not hold it, have at it.
====================
IIRC your doc had you thru some specialized analysis in that direction, Fatty Acid Analysis

Yep and cholesterol tested low. at 135 and now is 126 so when I look a biodeficiemcy of estrodial due to receptor sites being over run by 16 and 4 aOHE is the likely suspect ans probably the main cause for my adrenal fatigue.. If my hypothesis is correct its Estrogen domaince induced by alterations in 16 and 4 aOHE metabolism due to high fat diets as well as iodine deficiency. Since homocysteine is low this would reflect the DNa alterations in methyation due to these estrogen. Another factor is elevated Liporoptein A induced by estrogens, elevated shbg again increased estrogens due to alteration in liver metabolism. We know that estrogen increases cholestrol, triglycerides, ldl all which I have low levels up, as well as low cortisol. Dim was found to almost double free levels of cortisol why by freeing up cortisol receptors bounded by these estrogens. Before all this crap started I was a BIg ALA freak for 2-3 years but i did not ever know about biotin needed to balance it. IF you have biotin defieincy this causes alteration in fatty liver and insulin deficincy resulting in low choleterol. My lowest cholesrtol ever was 88 and dr said that was awesome..Well being on a ketogenic diet due to ALA acted similar to a high fat diet which causes fluctuation in 2 and 16 aOHE ratio. Now couple that with cooking food in plastic 4 times a day you got a serious xeno estrogen and endogenous estrogen over load..If can link ketogenic diets with elevated 16:2 ratio that will be the root cause..If my prostrate was swelled 80% and it was not because of e2 and DHT then it had to be the hydrox estrones !! and my Tits are so sore and e2 is completely in check then what else could it be estrone have same affinity for e2 receptors in many diffrent tissue and i had high serum estrone and low normal e2. I think my point is very well made and backed up!!

 

[MarkLA]

I would stay away from any Clomid or Novarel.
If you give hcg try then use
Novarel 250iu E2D every other day.

You said stay away from Clomid or Novarel, I think you meant Nolvadex, right? That would make sense as E2 is not my problem.

Your cholesterol is low, lot of fish oil

get freeT3

I thought 130 was good cholesterol? I currently eat 4 Carlson's Salmon oil soft gels each morning. That is 4g fat, 720mg EPA, 500 DHA. Should I eat more?

 

[MarkLA]

Yep and cholesterol tested low. at 135 and now is 126 so when I look a biodeficiemcy of estrodial due to receptor sites being over run by 16 and 4 aOHE is the likely suspect ans probably the main cause for my adrenal fatigue..

HAN, I've read your comments (and your own thread) with interest and appreciate your insights. Honestly, much of it is over my head, but I am learning little by little

More than 6 months ago I used to take a bunch of supplements which I thought were making me healthier. Now all I am taking is Calcium-Magnesium-Zinc, Glucosamine, Fish oil, Iron Free Multi (Centrum Silver) and aspirin.

I'm wondering whether one of the other items I used to take may have screwed me up my T level in the first place. I also used to take Finasteride years ago. I STILL eat very clean - low carb/more protein/fats (peanut-almond butter). I don't eat much red meat and what I do eat is very lean.

In a way, perhaps the original cause is irrelevant. Maybe I should just focus on adjusting the levels from where they are. However, since you've been taking so many supplements, I figured it wouldn't hurt to run the list by you and see if anything jumps out. I took this stuff or variations of it for a few years up until probably Feb of this year.


Here's the old list:

Acetyl L-Carnitine
Vitamin E Gamma Tocopherol
Carnosine
Vitamin C
TMG (trimethylglycine)
N-Acytl Cysteine
Ginko Biloba
Coenzyme Q-10
Folic Acid
Alpha Lipoic Acid
Quercetin
Bromelain
Aspirin
Calcium
Magnesium
Zinc
Glucosamine Sulfate
Multi-vitamin & mineral
Salmon Oil
Garlic

P.S. I stopped eating out of microwave & plastic wrap 5 times per day, although my Estradiol looks like it wasn't the problem anyway. I figure it's better to be safe. "Glass: It's the new plastic!"

 

[JanSz]

You said stay away from Clomid or Novarel, I think you meant Nolvadex, right? That would make sense as E2 is not my problem.
Yes, I ment Nolvadex, sorry.

I thought 130 was good cholesterol? I currently eat 4 Carlson's Salmon oil soft gels each morning. That is 4g fat, 720mg EPA, 500 DHA. Should I eat more?

You want cholesterol (180-200)

130 is too low.

I am trying to figure out how one could raise cholesterol, it appears more difficult than getting it down.

 

[plymouth city]

Your DHT is over the range. At this moment I would not do anything about it except note that transdermal testosterone delivery is not for you.

:frustrate

Not true. Pregnenolone cream would fix that DHT up nicely, and the added bonus of an increase in androgens.

 

[plymouth city]

You also want to avoid taking minerals with calcium as calcium will block absorbtion.

 

[cpeil2]

I thought 130 was good cholesterol? I currently eat 4 Carlson's Salmon oil soft gels each morning. That is 4g fat, 720mg EPA, 500 DHA. Should I eat more?

Think butter, steaks.

 

[MarkLA]

Not true. Pregnenolone cream would fix that DHT up nicely, and the added bonus of an increase in androgens.

I know that (goddamn) finasteride which lowers DHT results in a T increase of 15%. Does Pregenolone result in a similar boost? If so, it's sounds helpful but not an answer in itself as my T needs to go 500% higher..

What do you think?

Mark

 

[MarkLA]

Think butter, steaks.

Right, so I understand that cholesterol is the precursor to all hormones.

I want my T level to be fixed, hopefully with the minimal intervention required. I also want to live a nice long life and not keel over of a heart attack. My cholesterol, per the heart doc is good but not aberrently low.

I also know that supplemental T actually lowers cholesterol.

Maybe there's just a tradeoff betwen good hormones and heart health.

So I'm confused.

 

[cpeil2]

Right, so I understand that cholesterol is the precursor to all hormones.

I want my T level to be fixed, hopefully with the minimal intervention required. I also want to live a nice long life and not keel over of a heart attack. My cholesterol, per the heart doc is good but not aberrently low.

I also know that supplemental T actually lowers cholesterol.

Maybe there's just a tradeoff betwen good hormones and heart health.

So I'm confused.

I should have said "butter and steaks, within reason."

Some would disagree with your doc that your cholesterol level is not too low.

But that doesn't mean it should be really high either. A total cholesterol of 160-180 will promote a healthier hormone level without comprising heart health. And don't forget, total cholesterol doesn't tell the whole story. HDL and LDL levels yield a lot more information than total cholesterol does. In fact, some docs, unless a total cholestrol level is extremely low (kind of like yours) or extremely high, disregard it altogether.

Obviously, with your total cholesterol level, you have more room to play around with your saturated fat intake than someone with total cholesterol of 300.

 

[MarkLA]

His t4 tot3 ratio is off due to adrenal imbalances look at the potassium level

HAN, Can you elaborate on these two points? Also, my potassium is within the range 3.7 mmol/L (range 3.5-4.5). What makes this out of whack?

Thanks,
Mark

 

[hardasnails1973]

HAN, Can you elaborate on these two points? Also, my potassium is within the range 3.7 mmol/L (range 3.5-4.5). What makes this out of whack?

Thanks,
Mark

This in the range bull crap is for the birds even.
Your e2 is in the craper compared to your shbg so you are basically suffering e2 deficiency in several areas of your body including your brain which causes serotonin, melatonin, gaba deficiency. Hence common sense says if you increase e2 inuslin will go up insulin controls cholestrol synthesis. Estrogen also is responsbile for lipidase which helps to burn fat as well and it also helps cholesterol to flush outo of the liver. People with low cholesterol is either genetic or thats its being stored in the liver and building up causes an excess. Same why with triglycerides, low tricgyecerides means they are probably being stored and instead in the liver and not released in to the blood stream. most people with low cholestrol have problems with methyation because of they lack bile acids to help them break down fat ..Its like a vicous cycle low cholesrtol = low bile acid and with out bile acids you can not metablise cholesterol.. Add in some oxbile or super digestive enyzme by now to meals and it should help to increase cholesterol levels. low manganese, potassium is also responsible for low choelsterol since potassium helps with cholestrol synthneses..

 

[JanSz]

This in the range bull crap is for the birds even.
Your e2 is in the craper compared to your shbg so you are basically suffering e2 deficiency in several areas of your body including your brain which causes serotonin, melatonin, gaba deficiency. Hence common sense says if you increase e2 inuslin will go up insulin controls cholestrol synthesis. Estrogen also is responsbile for lipidase which helps to burn fat as well and it also helps cholesterol to flush outo of the liver. People with low cholesterol is either genetic or thats its being stored in the liver and building up causes an excess. Same why with triglycerides, low tricgyecerides means they are probably being stored and instead in the liver and not released in to the blood stream. most people with low cholestrol have problems with methyation because of they lack bile acids to help them break down fat ..Its like a vicous cycle low cholesrtol = low bile acid and with out bile acids you can not metablise cholesterol.. Add in some oxbile or super digestive enyzme by now to meals and it should help to increase cholesterol levels. low manganese, potassium is also responsible for low choelsterol since potassium helps with cholestrol synthneses..

I believe that E2 have a similar to Testosterone relationship with (SHBG and Albumin)

Have any one came across a chart (or other funcion) that would describe this relationship?

Something similar to
F(T)=F(SHBG, Albumin)
F(E2)=F(SHBG, Albumin)
as shown on dr Shippen's chart, post #41
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html
==============================================

But in the mean time E2 range is (10-30)
I would say that (my personal guess that I just made up)
it could probably be broken down like this:

SHBG<15 -----> E2~10
SHBG=(20-25) ---->E2~(20-30)
SHBG>30 ----->E2>30

 

[MarkLA]

Update:

I have new medical help.. A hormone/nutrition expert (nurse practioner) who comes well recommended. I already met with her I'll say that I'm happy so far.

We're ordering up Free T3 bloodwork, also urine/saliva tests for neurotransmitters, etc:

DHEA
Cortisol x4
Epinephrine
Norepinephrine
Dopamine
Serotonin
GABA
Glutamate
PEA
Histamine
Creatinine

https://www.neurorelief.com/index.php?option=com_content&task=view&id=64&Itemid=46

Cost is $224. Probably covered by insurance.

She agrees that my low cholesterol is part of the cause of the problem. Apparently cholesterol < 160 in men is correlated with increased suicide risk. I don't have that problem, but I can see how it would follow from diminished hormones throughout the body.

More steaks and egg yolks for me. Also Niacin 725 mg, Zinc, Magnesium, Calcium. New higher quality Multi Vitamin (All One).

I'm also going to look into the Ox Bile recommended by HAN. Hey HAN - how long to see results from Ox Bile?

I'll speak with her in a couple of weeks once we have the test results.

Remember I have Cholesterol 130 and Total Test 165 (250-1100 range). I'm curious any ideas on how quickly I'll be able to raise the Cholesterol number up to 180 or so?

I also wonder whether if I were to get it up to 180 if I'd get a significant lift in Testosterone up to 700 where I should be?

I know I can get TRT, but I'm wondering whether I'll be able to get my T level up without exogenous Testosterone or HCG just by fixing the cholesterol?

Thanks
Mark

 

[JanSz]

Update:

I have new medical help.. A hormone/nutrition expert (nurse practioner) who comes well recommended. I already met with her I'll say that I'm happy so far.

We're ordering up Free T3 bloodwork, also urine/saliva tests for neurotransmitters, etc:

DHEA
Cortisol x4
Epinephrine
Norepinephrine
Dopamine
Serotonin
GABA
Glutamate
PEA
Histamine
Creatinine

https://www.neurorelief.com/index.php?option=com_content&task=view&id=64&Itemid=46

Cost is $224. Probably covered by insurance.

She agrees that my low cholesterol is part of the cause of the problem. Apparently cholesterol < 160 in men is correlated with increased suicide risk. I don't have that problem, but I can see how it would follow from diminished hormones throughout the body.

More steaks and egg yolks for me. Also Niacin 725 mg, Zinc, Magnesium, Calcium. New higher quality Multi Vitamin (All One).

I'm also going to look into the Ox Bile recommended by HAN. Hey HAN - how long to see results from Ox Bile?

I'll speak with her in a couple of weeks once we have the test results.

Remember I have Cholesterol 130 and Total Test 165 (250-1100 range). I'm curious any ideas on how quickly I'll be able to raise the Cholesterol number up to 180 or so?

I also wonder whether if I were to get it up to 180 if I'd get a significant lift in Testosterone up to 700 where I should be?

I know I can get TRT, but I'm wondering whether I'll be able to get my T level up without exogenous Testosterone or HCG just by fixing the cholesterol?

Thanks
Mark

In the mean time you can check if you nuts are able to produce testosterone.
250iu HCG Novarel EOD, every other day.
Blood test your testosterone levels in two monts.
One vial 1000iu will give you 1000/250=40 injections
will last 80 days
Enough time for this experiment.
Do not worry about writting on package that it last 30 days only.
------------------------------------------------------------
What laboratory is going to do urine/saliva tests?

 

[MarkLA]

In the mean time you can check if you nuts are able to produce testosterone.
250iu HCG Novarel EOD, every other day.
------------------------------------------------------------
What laboratory is going to do urine/saliva tests?

My LH level is towards the bottom of the range 2.3 MIU/ML (Range 2-12) . I think if the nuts are not working then we'd see a high LH.

Now, I agree, if I have more LH (or HCG) we don't know whether I would produce 250 T or 700 T. Your idea is a good test for that.

The problem is that if I introduce HCG and it works and produces say 700 T, this will signal the hypothalmus to tell the pituitary to produce even less endogenous LH.

I think I'm better off seeing if I get a big bump in LH and T just by increasing cholesterol, maybe DHEA too (if that's what my medical person advises). If that doesn't work then it's time for HCG and/or T.

What laboratory is going to do urine/saliva tests?

www.neuroscienceinc.com produces the test. The tests are performed by Pharmasan Labs "CLIA 52D0914898, NY Lab PFI#7426"

 

[JanSz]

My LH level is towards the bottom of the range 2.3 MIU/ML (Range 2-12) . I think if the nuts are not working then we'd see a high LH.

Now, I agree, if I have more LH (or HCG) we don't know whether I would produce 250 T or 700 T. Your idea is a good test for that.

The problem is that if I introduce HCG and it works and produces say 700 T, this will signal the hypothalmus to tell the pituitary to produce even less endogenous LH.

I think I'm better off seeing if I get a big bump in LH and T just by increasing cholesterol, maybe DHEA too (if that's what my medical person advises). If that doesn't work then it's time for HCG and/or T.



www.neuroscienceinc.com produces the test. The tests are performed by Pharmasan Labs "CLIA 52D0914898, NY Lab PFI#7426"

So the question is;
does raising cholesterol help increasing LH?
.
.
I do not have opinion on this.

 

[JanSz]

My LH level is towards the bottom of the range 2.3 MIU/ML (Range 2-12) . I think if the nuts are not working then we'd see a high LH.

Now, I agree, if I have more LH (or HCG) we don't know whether I would produce 250 T or 700 T. Your idea is a good test for that.

The problem is that if I introduce HCG and it works and produces say 700 T, this will signal the hypothalmus to tell the pituitary to produce even less endogenous LH.

I think I'm better off seeing if I get a big bump in LH and T just by increasing cholesterol, maybe DHEA too (if that's what my medical person advises). If that doesn't work then it's time for HCG and/or T.



www.neuroscienceinc.com produces the test. The tests are performed by Pharmasan Labs "CLIA 52D0914898, NY Lab PFI#7426"

I always look for these:

Commonly Used ICD-9 Codes for NeuroScience testing
Abnormal Weight gain 783.1
ADD (with out hyperactivity) 314.00
ADHD (with hyperactivity) 314.01
Adrenal disorder 255.8
Adrenal hypofunction 255.5
Allergic rhinitis 477.9
Chronic fatigue syndrome 780.71
Corticoadrenal insufficiency 255.4
Disorder of thyroid 246.9
Dysmenorrhea 625.3
Endocrine disorder 259.9
Fibromyositis/ Myalgia 729.1
GI symptoms 787.9
Headache 784.0
Hyperglycemia 790.6
Hyperlipidemia 272.4
Hyperlipidemia (mixed) 272.2
Hypertension 401.9
Hypertension (Malignant) 401.1
Hypoglycemia 251.2
Hypothyroidism 244.9
Irritable Bowel Syndrome 564.1
Lipoprotein deficiencies 272.5
Macular Degeneration 362.5
Malise and fatigue 780.79
Menopausal disorder 627.9
Menopausal symptoms 627.2
Migraine (classical) 346.0
Migraine (variants) 346.2
Obesity 278.00
Obesity (morbid) 278.01
Osteoarthros- unspecified 715.9
Peri-menopausal 627.0
PMS 625.4
Rheumatism 729.0
Rheumatoid arthritis 714.0
Rhinitis due to pollen 477.0
Sleep intrusion (repetitive) 307.48

 

[JanSz]

Update:

I have new medical help.. A hormone/nutrition expert (nurse practioner) who comes well recommended. I already met with her I'll say that I'm happy so far.

We're ordering up Free T3 bloodwork, also urine/saliva tests for neurotransmitters, etc:

DHEA
Cortisol x4
Epinephrine
Norepinephrine
Dopamine
Serotonin
GABA
Glutamate
PEA
Histamine
Creatinine

https://www.neurorelief.com/index.php?option=com_content&task=view&id=64&Itemid=46

Cost is $224. Probably covered by insurance.

She agrees that my low cholesterol is part of the cause of the problem. Apparently cholesterol < 160 in men is correlated with increased suicide risk. I don't have that problem, but I can see how it would follow from diminished hormones throughout the body.

More steaks and egg yolks for me. Also Niacin 725 mg, Zinc, Magnesium, Calcium. New higher quality Multi Vitamin (All One).

I'm also going to look into the Ox Bile recommended by HAN. Hey HAN - how long to see results from Ox Bile?

I'll speak with her in a couple of weeks once we have the test results.

Remember I have Cholesterol 130 and Total Test 165 (250-1100 range). I'm curious any ideas on how quickly I'll be able to raise the Cholesterol number up to 180 or so?

I also wonder whether if I were to get it up to 180 if I'd get a significant lift in Testosterone up to 700 where I should be?

I know I can get TRT, but I'm wondering whether I'll be able to get my T level up without exogenous Testosterone or HCG just by fixing the cholesterol?

Thanks
Mark

Nice groups of tests for common conditions,
first all listed there, then few that we encounter here
------------------------------------------------------------------------------------------

https://www.neurorelief.com/index.php?option=com_content&task=category&sectionid=12&id=39&Itemid=46
Symptom Specific Panels
https://www.neurorelief.com/index.php?option=com_content&task=category&sectionid=12&id=39&Itemid=46

Attention Issues Profiles
Anxiousness/ Nervousness Profile
Headaches Profile
Low Mood Profile

Sleep Difficulties Profiles
Appetite/ Weight Control Profiles
Fatigue Profiles
Mood Profile

Women's Issues Profiles
Developmental Delay Profile
Stress Profile
Libido Profile
==================
=================
===================================================================
https://www.neurorelief.com/index.php?option=com_content&task=view&id=38&Itemid=46
Libido Profile- 9047
Profile best suited for persons suffering from reduced sexual motivation, low libido or poor sexual performance.

Estradiol
Testosterone
Dihydrotestosterone
Epinephrine
Norepinephrine
Dopamine
Serotonin
Creatinine

Urine and saliva specimens required for this test.
========================================================
https://www.neurorelief.com/index.php?option=com_content&task=view&id=41&Itemid=46
Mood Profile- 9046
Profile best suited for persons suffering from mood swings or hormone imbalances.

Estradiol
Testosterone
Dihydrotestosterone
DHEA
Cortisol
Epinephrine
Norepinephrine
Dopamine
Serotonin
GABA
PEA
Histamine
Creatinine

========================================================

https://www.neurorelief.com/index.php?option=com_content&task=view&id=35&Itemid=46
Low Mood Profiles- 9051- 9037
Profile best suited for persons suffering from moodiness, mood swings or low libido.

Low Mood Profiles

9051 Basic

Cortisol
Epinephrine
Norepinephrine
Dopamine
Serotonin
GABA
Histamine
Creatinine

Urine and saliva specimens required for this test.

9037 Expanded

Testosterone
PEA
Agmatine
=========================================================
https://www.neurorelief.com/index.php?option=com_content&task=view&id=36&Itemid=46
Fatigue Profiles- 9042- 9043
Profiles best suited for persons suffering from low energy or fatigue

Fatigue

9042 Basic

DHEA
Cortisol x4
Epinephrine
Norepinephrine
Serotonin
Creatinine

Urine and saliva specimens required for this test.


9043 Expanded

Dopamine
Histamine
================================================================
https://www.neurorelief.com/index.php?option=com_content&task=view&id=42&Itemid=46
Stress Profile- 9050
Profile best suited for persons suffering from adrenal dysfunction, fatigue, or hormone imbalance

Cortisol x2
Epinephrine
Norepinephrine
Serotonin
Glycine
Glutamate
Aspartic Acid
PEA
Histamine
Creatinine

=======================================================================
https://www.neurorelief.com/index.php?option=com_content&task=view&id=39&Itemid=46
Women's Issues profiles- 9038- 9053
Profiles best suited for persons suffering from mood swings, menstrual symptoms, hormone imbalances, poor temperature tolerance, hot sweats, night sweats, bone loss or increased bone fracture risk.

Women's Issues Profiles

9038 Basic

Estradiol
Progesterone
Testosterone
Epinephrine
Norepinephrine
Dopamine
Serotonin
GABA
Creatinine


Urine and saliva specimens required for this test.
9053 Expanded

Estrone
Estriol
Cortisol x2
===================================================================

 

[plymouth city]

"More steaks and egg yolks for me. Also Niacin 725 mg, Zinc, Magnesium, Calcium. New higher quality Multi Vitamin (All One)."

This is bad.

Calcium blocks mineral absorbtion.

I do not like multi vitamins for a whole host of reasons.

You want ZMA - zinc, magnesium and Vit B6 formulation.

 

[MarkLA]

"More steaks and egg yolks for me. Also Niacin 725 mg, Zinc, Magnesium, Calcium. New higher quality Multi Vitamin (All One)."

This is bad.

Calcium blocks mineral absorbtion.

I do not like multi vitamins for a whole host of reasons.

You want ZMA - zinc, magnesium and Vit B6 formulation.

OK, I will plan to do Calcium at night then and the rest in the morning. Can you elaborate on B6 (dosage and what it does)?



Also, interesting..

I used to drink a TON of green tea which contains EGCG. I found a study that used rats that shows decreased T (-70%), decreased LH, decreased cholesterol. They were injecting the rats, which of course, I was not doing. However I had a lot of tea over a couple of years.

"Green tea polyphenols, especially the catechin, (-)-epigallocatechin gallate (EGCG), have been proposed as a cancer chemopreventative based on a variety of laboratory studies. For clear assessment of the possible physiological effects of green tea consumption, we injected pure green tea catechins ip into rats and studied their acute effects on endocrine systems. We found that EGCG, but not related catechins, significantly reduced food intake; body weight; blood levels of testosterone, estradiol, leptin, insulin, insulin-like growth factor I, LH, glucose, cholesterol, and triglyceride; as well as growth of the prostate, uterus, and ovary. Similar effects were observed in lean and obese male Zucker rats, suggesting that the effect of EGCG was independent of an intact leptin receptor."

Full article http://endo.endojournals.org/cgi/content/full/141/3/980

 

[hardasnails1973]

OK, I will plan to do Calcium at night then and the rest in the morning. Can you elaborate on B6 (dosage and what it does)?



Also, interesting..

I used to drink a TON of green tea which contains EGCG. I found a study that used rats that shows decreased T (-70%), decreased LH, decreased cholesterol. They were injecting the rats, which of course, I was not doing. However I had a lot of tea over a couple of years.

"Green tea polyphenols, especially the catechin, (-)-epigallocatechin gallate (EGCG), have been proposed as a cancer chemopreventative based on a variety of laboratory studies. For clear assessment of the possible physiological effects of green tea consumption, we injected pure green tea catechins ip into rats and studied their acute effects on endocrine systems. We found that EGCG, but not related catechins, significantly reduced food intake; body weight; blood levels of testosterone, estradiol, leptin, insulin, insulin-like growth factor I, LH, glucose, cholesterol, and triglyceride; as well as growth of the prostate, uterus, and ovary. Similar effects were observed in lean and obese male Zucker rats, suggesting that the effect of EGCG was independent of an intact leptin receptor."

Full article http://endo.endojournals.org/cgi/content/full/141/3/980

Green tea also binds with iodine as well because of the fluoride in it so be careful. What the companies never tell you plus the tannins in it bind to other minerals causing decreased minerabl bioavailability. I learned all these lessons the hard way..

 

[plymouth city]

Green tea also binds with iodine as well because of the fluoride in it so be careful. What the companies never tell you plus the tannins in it bind to other minerals causing decreased minerabl bioavailability. I learned all these lessons the hard way..

This may be true but only to a minor extent.

I believe the real reason why Green Tea can lower androgens is actually because of a good process - It is a very potent appetitie suppressant. Anytime one reduces calories one will experience a drop in androgens.

 

[plymouth city]

OK, I will plan to do Calcium at night then and the rest in the morning. Can you elaborate on B6 (dosage and what it does)?

I see no reason why anyone should take supplemental calcium. There was a large study done a year or so ago by the FDA that showed calcium supplements don't absorb well anyways.

Eat yogurt. It is extremely good for you for a whole host of reasons, and you will get your calcium that way.

You get all the Vit B6, magnesium and zinc you need threw Biotest brand ZMA

 

[MarkLA]

More test results

I talk to my doc tomorrow but appreciate any input. I'd really love not to have to go on TRT if I don't have to. I have been trying to raise my cholesterol. I don't have any numbers, but I do feel better I think.

Blood
T3, Free 271 pg/dl (range 230-420) (Quest)

Saliva (NeuroScience/Pharmasan Labs)
DHEA 6:15am 420.8 (Male 250-450)

Cortisol
6:15am 14.0 ng/ml range 7am 7.0-10.0
10:35am 5.4 ng/ml range noon 3.0-6.0
4:10pm 5.6 ng/ml range 5pm 2.0-4.0
9:10pm 3.9 ng/ml range 10pm <1.5

Urine 8:15am
Epinepherine 4.6 ug/gCr (range 8-12)
Norepinepherine 20.4 ug/gCr (range 35-50)
Dopamine 116.8 ug/gCr (range 110-175)
Serotonin 138.3 ug/gCr (range 150-200)
GABA 4.3 umol/gCr (range 1.5-4.0)
Glutamate 11.6 umol/gCr (range 10-35)
PEA 271.8 nmol/gCr (range 175-450)
Histamine 18.6 ug/gCr (range 10-20)
Creatine 116.2 (mg/dL)Y (no range)

Neuroscience conveniently sells supplements to address the issues.

"Travacor contains 5-HTP to support Seotonin, Taurine to enhance GABA and theanine to block glutamate activity.

Excitaplus contains N-acteyltyrosine and Mucuna Pruriens bean extra (50% L-Dopa) to support dopamine, norepinepherine, and epinepherine. Histidine to support histamine, Rhodiola rosea root extract to help decrease the effects of streess and fatigue."


Mark

 

[JanSz]

I talk to my doc tomorrow but appreciate any input. I'd really love not to have to go on TRT if I don't have to. I have been trying to raise my cholesterol. I don't have any numbers, but I do feel better I think.

Blood
T3, Free 271 pg/dl (range 230-420) (Quest)

Saliva (NeuroScience/Pharmasan Labs)
DHEA 6:15am 420.8 (Male 250-450)

Cortisol
6:15am 14.0 ng/ml range 7am 7.0-10.0
10:35am 5.4 ng/ml range noon 3.0-6.0
4:10pm 5.6 ng/ml range 5pm 2.0-4.0
9:10pm 3.9 ng/ml range 10pm <1.5

Urine 8:15am
Epinepherine 4.6 ug/gCr (range 8-12)
Norepinepherine 20.4 ug/gCr (range 35-50)
Dopamine 116.8 ug/gCr (range 110-175)
Serotonin 138.3 ug/gCr (range 150-200)
GABA 4.3 umol/gCr (range 1.5-4.0)
Glutamate 11.6 umol/gCr (range 10-35)
PEA 271.8 nmol/gCr (range 175-450)
Histamine 18.6 ug/gCr (range 10-20)
Creatine 116.2 (mg/dL)Y (no range)

Neuroscience conveniently sells supplements to address the issues.

"Travacor contains 5-HTP to support Seotonin, Taurine to enhance GABA and theanine to block glutamate activity.

Excitaplus contains N-acteyltyrosine and Mucuna Pruriens bean extra (50% L-Dopa) to support dopamine, norepinepherine, and epinepherine. Histidine to support histamine, Rhodiola rosea root extract to help decrease the effects of streess and fatigue."


Mark

PM to HeadDoc
http://anabolicminds.com/forum/962954-post26.html

 

[Headdoc]

PM to HeadDoc
http://anabolicminds.com/forum/962954-post26.html

I am not familiar with the neurotransmitter values given here. I don't know this Neuroscience company. The adrenals look ok. What are the rest of the thyroid values? What are the clinical problems getting attention? What drugs, meds, supplements are being taken? Sorry to post so soon to your visit?

 

[MarkLA]

I am not familiar with the neurotransmitter values given here. I don't know this Neuroscience company. The adrenals look ok. What are the rest of the thyroid values? What are the clinical problems getting attention? What drugs, meds, supplements are being taken? Sorry to post so soon to your visit?

Thanks for your response. It's time for an update generally..

My original symptoms - no sex drive, somewhat apathetic. I was tested and found to have low T (165 ng/dl 250-1100 range). DHT is above range which is a little strange. More details/test values up higher in the thread.

I'm not currently on any T meds. Having been hanging out here for a while, I realize that it's a lifelong commitment. I figure its worth it to try and correct things without drugs first if possible. If I can't be fixed that way, then off to T-Cream, shots, HCG or whatever I will come.

My cholesterol at 130 is low and I know that it is the building block from which hormones are made. I've been eating lots of grass-fed beef, eggs, bacon, little coconut oil, etc. to increase that. I've been taking digestive enzymes with ox bile to assist with absorbing cholesterol.

My hypogonadism seems to be rooted in the hypothalmus. I'm thinking if that's where the cause is, that's where the therapy should be applied, rather than lower down in the system as would be the case with HCG or T.

The neurotransmitter tests found most of my neurotransmitters low. About the only one above range was GABA which has a role in decreasing T. I figure by addressing these, perhaps the hypothalmus will get what it needs to send my body normal hormone levels.

I'm taking multivitamin, Zinc 50mg, Magnesium 200mg, Niacin 500mg , B6 Complex and 5 HTP. B6 and 5HTP are to support Serotonin. Niacin to increase HDL. Also taking L-theanine.

Next week I start a supplement called Excitaplus which supports Dopamine. This is important as it also supports Norepinepherine which is really low for me and is directly involved in LH release.

Excitaplus contains Vitamin C, Niacin, B6, Folate, Pantohenic Acid, Magnesium, Zinc, Manganese and then 1508 mg of L-histidine, N-acetyltyrosine, L-methionine, Rhodiola rosea root extract (16% rosavins), Macina Pruriens bean extract (50% L-dopa)

I'm working with a Nurse Practitioner (they can prescribe) who specializes in hormones/nutrition. She does 90% women and 10% men, but so far I'm happy with her. She listens and is open to input which is great.

After a couple more weeks I will get more tests and see how I'm progressing. I think I'm feeling better. Sex drive has gone from zero to very low, which is improvement.

Mark

 

[hardasnails1973]

Thanks for your response. It's time for an update generally..

My original symptoms - no sex drive, somewhat apathetic. I was tested and found to have low T (165 ng/dl 250-1100 range). DHT is above range which is a little strange. More details/test values up higher in the thread.

I'm not currently on any T meds. Having been hanging out here for a while, I realize that it's a lifelong commitment. I figure its worth it to try and correct things without drugs first if possible. If I can't be fixed that way, then off to T-Cream, shots, HCG or whatever I will come.

My cholesterol at 130 is low and I know that it is the building block from which hormones are made. I've been eating lots of grass-fed beef, eggs, bacon, little coconut oil, etc. to increase that. I've been taking digestive enzymes with ox bile to assist with absorbing cholesterol.

My hypogonadism seems to be rooted in the hypothalmus. I'm thinking if that's where the cause is, that's where the therapy should be applied, rather than lower down in the system as would be the case with HCG or T.

The neurotransmitter tests found most of my neurotransmitters low. About the only one above range was GABA which has a role in decreasing T. I figure by addressing these, perhaps the hypothalmus will get what it needs to send my body normal hormone levels.

I'm taking multivitamin, Zinc 50mg, Magnesium 200mg, Niacin 500mg , B6 Complex and 5 HTP. B6 and 5HTP are to support Serotonin. Niacin to increase HDL. Also taking L-theanine.

Next week I start a supplement called Excitaplus which supports Dopamine. This is important as it also supports Norepinepherine which is really low for me and is directly involved in LH release.

Excitaplus contains Vitamin C, Niacin, B6, Folate, Pantohenic Acid, Magnesium, Zinc, Manganese and then 1508 mg of L-histidine, N-acetyltyrosine, L-methionine, Rhodiola rosea root extract (16% rosavins), Macina Pruriens bean extract (50% L-dopa)

I'm working with a Nurse Practitioner (they can prescribe) who specializes in hormones/nutrition. She does 90% women and 10% men, but so far I'm happy with her. She listens and is open to input which is great.

After a couple more weeks I will get more tests and see how I'm progressing. I think I'm feeling better. Sex drive has gone from zero to very low, which is improvement.

Mark

Tell you right now if you test histamine I bet they are off the charts if they are then you are like me an undermethyator. People with low cholesterol, low dhea tend to be undermethyators of the liver and respond very well to sam-e, folonic acid, methy cobalonmin. if you have low serotnin you 100% a undermethayator and lack gluthione which once you restore proper methyation to the liver things heal them selves miraculouly

 

[MarkLA]

Tell you right now if you test histamine I bet they are off the charts if they are then you are like me an undermethyator. People with low cholesterol, low dhea tend to be undermethyators of the liver and respond very well to sam-e, folonic acid, methy cobalonmin. if you have low serotnin you 100% a undermethayator and lack gluthione which once you restore proper methyation to the liver things heal them selves miraculouly

Thanks HAN. I appreciate your ideas.

The way that Neuroscience's ranges work is they give you an "Optimal Range" -- what they think you should be and an "Observed Range" which is what they see in the population.

DHEA was tested in the saliva test and was 420.8. Optimal range 250-450. Observed range 100-1200. Based upon this, it looks like my DHEA is OK. I'm going to ask to retest with blood tests in 2-3 weeks.

Histamine was tested on my urine test and came up 18.6 ug/gCr.Optimal is 10-20 and observed is 9-60. Based upon this, histamine is also OK. Worthwhile to note that the supplement I start this week does contain histidine to support histamine anyway.

Mark