NEED INPUT - ELEVATED BUN, URINE URIC ACID

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    NEED INPUT - ELEVATED BUN, URINE URIC ACID


    Current stats:
    Age: 52
    Height: 5-7
    Weight: 167lbs - approx. 130lbs fat-free mass
    Bodyfat: 18.4%



    Average Macros:
    Calories: 1400
    Protein: 135g
    Carbs: 40g (<10g of that from fructose, mostly berries)
    Fat: 75g


    I have been eating VLC paleo and doing intermittent fasting for about the last 6 mos. as I am trying to lose bodyfat. My goal is to get to 10% bodyfat first before I can start adding more lean mass. I resistance train 4 x's/week.

    My latest CMP showed elevated BUN (36 - ref range: 6-24), elevated BUN/Creatinine ratio (39 - ref range:9-20), and elevated urinary uric acid (1118.0 - ref range: 250.0-750.0).

    I also showed elevated serum calcium (10.9 - ref range: 8.7-10.2). My serum uric acid (UA), however, is normal (4.6 - ref range: 3.7-8.6) as is my creatinine (0.92 - ref range 0.76-1.27) and eGFR (95 - ref range >59). There is no protein in my urine. I do not have gout. This would indicate there is no incidence of CKD or kidney failure and that my kidneys are able to remove the UA effectively. These levels have gradually increased over the last 6 mos.

    I understand that the elevated levels are a direct result of purines from increased protein metabolism and its waste products. However, 135g of daily protein to maintain lean mass is by no means excessive, especially for someone who trains, so I cannot understand these markers being increasingly elevated. In fact, according to this excerpt from the following link, increased protein intake DOES NOT translate in increased uric acid excretion:

    "The excretion of uric acid bears no relationship to the extent of protein metabolism, for an excessive consumption of nitrogenous food (free from nuclein) does not increase the amount of uric acid excreted, even although the metabolism may be increased. Thus from 18 grams of protein food 433 mgr. uric acid were excreted, whereas from 80 grams of protein food not more than 442 mgr. uric acid were excreted."

    On a side note, I had passed a 3mm calcium oxalate kidney stone back in March. For stone prevention, I am drinking about 12 cups of water daily and taking approx. 5g potassium citrate to alkalinize urine. I urinate 1500-2000cc daily. I also take magnesium citrate. For many years I've had a problem taking pancreatin in that it made my urine very acid and caused mouth sores. Pancreatin is known to increase UA. In addition, my urine pH has always been about 5.0 (acid).

    I realize that red meat is moderately high in purines (which can elevate uric acid), but I love my grass-fed beef and buffalo and would hate to give them up or reduce them!

    The good news is that any excess UA is not being retained and is being excreted in the urine, otherwise my serum UA would be elevated. Still, this is a warning sign of possible gout or other dysfunctions.

    Possible causes/explanations:

    - serum UA seems to have an inverse relationship to urine UA; decrease of serum uric acid levels seems to increase the urinary excretion of uric acid.

    - when you eat more protein, your kidneys will extract more UA acid in your urine to compensate which is why my serum UA acid is normal.

    - imbalance in the ratio of protein to low-protein foods (i.e. fats, vegetables, fruits); not enough low-protein foods to compensate for increase in BUN and UA.

    - fasting increases UA excretion, but the increase in ketones cancels it out.

    - both potassium and magnesium citrate increase rate of UA excretion.

    - exogenous high doses of zinc and iron can elevate UA.

    - breakdown of fats by the liver produces several byproducts, including uric acid. I have NAFLD (fatty liver) and have read that VLC paleo and IF can accelerate the clearance of FFAs, especially when combined with exogenous choline.

    - other supplements causing elevated urinary UA excretion.

    - It also appears that uric acid increases the storage of body fat. Perhaps this is a factor in my inability to burn fat.

    Possible Solutions (since reducing protein intake would be counterproductive to anabolism):

    - To balance out the overload of UA, I would increase veggies and healthy fats. If I increase fruits, then fructose increases which is counterproductive to fat loss and itself increase uric acid.

    - Maintain Vitamin C intake @ 5-7g daily.

    - drop the zinc to 50mg daily; should I drop the iron (I am taking 33mg from supps to raise serum ferritin)?

    Any reason why serum calcium is elevated? My last PTH was normal.

    Before resorting to meds like allopurinol to decrease urinary UA levels, any other pearls you guys can share??

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    As a severe arthritis person I Can say Malic Acid (apple cider vinegar) has the ability to reduce Uric acid. In the beginning you will need to take it every meal. After a balance is achieved maintain with 1 - 2 tbs a day depending on your diet. I am strict hunter gather Paleo and find balance very easy without the dairy, grains and sugars.
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    Quote Originally Posted by Medical420 View Post
    As a severe arthritis person I Can say Malic Acid (apple cider vinegar) has the ability to reduce Uric acid. In the beginning you will need to take it every meal. After a balance is achieved maintain with 1 - 2 tbs a day depending on your diet. I am strict hunter gather Paleo and find balance very easy without the dairy, grains and sugars.
    Thanks, I have been taking ACV for the last couple years now. This is the first time I've tested for urine uric acid, so I have no idea of what my level was before.
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    Interesting, you deff sound like you need to alkalize. I too am Paleo(strict) 70%20%10% for 1.5y, I do not refeed and have not ever, but I will be in October for mass.

    Are you complete Paleo, ie grains, dairy and sugars removed?

    My knowledge is base on digestion and the intestinal tract --> organs. Everything starts and ends from diet. Personally I believe (oen experience) it's organisms out of balance or un welcome to our intestinal tract that throws us out of wack.
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    Quote Originally Posted by Medical420 View Post
    Interesting, you deff sound like you need to alkalize. I too am Paleo(strict) 70%20%10% for 1.5y, I do not refeed and have not ever, but I will be in October for mass.

    Are you complete Paleo, ie grains, dairy and sugars removed?

    My knowledge is base on digestion and the intestinal tract --> organs. Everything starts and ends from diet. Personally I believe (oen experience) it's organisms out of balance or un welcome to our intestinal tract that throws us out of wack.
    Grain-free, sugar-free, no cow's milk dairy (I will occasionally eat raw goat milk cheese or kefir). Take lots of probiotics.
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    Awesome,

    Any other conditions / symptoms you don't mind mentioning if any?
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    Quote Originally Posted by Medical420 View Post
    Awesome,

    Any other conditions / symptoms you don't mind mentioning if any?
    Occasional gas, dull headaches, hypertension.
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    Don't give up on meats yet, but look into the link i sent you, since I can't post them yet.

    Check out the reviews, i have used it with great results i had major kidney and liver damage from the prescriptions. Between diet, my natural meds and products from them have given me a second chance at health.


    I am currently doing the SmartCleanse with paragone and fibre smart. I have done,Candigone, candizyme, lung therapy, total Kidney, Liver cleanse, critical liver and the bowel cleanse. I recommend the 30 day kidney to you first, then maybe do the SmartCleanse for30 after to clean the rest if your organs.


    I swear to you only great results. My wife HAD chronic UTI's, almost monthly. She did this cleanse and went symptom free for 8 months. It happened again she did the cleanse with the Female Flora enzymes and has been clear for 6 months now.

    Also, I take 2 500mg unrefined ACV every meal. This has reduced daily swelling(uric acid) in my remaining joints quiet a bit
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    Just a theory, but does anyone know if intermittent fasting could increase BUN and uric acid because with a shorter feeding window (as opposed to throughout the day), and thus with protein consumption being condensed/concentrated, the kidneys have less time and work harder to process a larger amount of protein which results in elevated BUN and uric acid levels?
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    Quote Originally Posted by mcs5309 View Post
    Current stats:
    Age: 52
    Height: 5-7
    Weight: 167lbs - approx. 130lbs fat-free mass
    Bodyfat: 18.4%



    Average Macros:
    Calories: 1400
    Protein: 135g
    Carbs: 40g (<10g of that from fructose, mostly berries)
    Fat: 75g


    I have been eating VLC paleo and doing intermittent fasting for about the last 6 mos. as I am trying to lose bodyfat. My goal is to get to 10% bodyfat first before I can start adding more lean mass. I resistance train 4 x's/week.

    My latest CMP showed elevated BUN (36 - ref range: 6-24), elevated BUN/Creatinine ratio (39 - ref range:9-20), and elevated urinary uric acid (1118.0 - ref range: 250.0-750.0).

    I also showed elevated serum calcium (10.9 - ref range: 8.7-10.2). My serum uric acid (UA), however, is normal (4.6 - ref range: 3.7-8.6) as is my creatinine (0.92 - ref range 0.76-1.27) and eGFR (95 - ref range >59). There is no protein in my urine. I do not have gout. This would indicate there is no incidence of CKD or kidney failure and that my kidneys are able to remove the UA effectively. These levels have gradually increased over the last 6 mos.

    I understand that the elevated levels are a direct result of purines from increased protein metabolism and its waste products. However, 135g of daily protein to maintain lean mass is by no means excessive, especially for someone who trains, so I cannot understand these markers being increasingly elevated. In fact, according to this excerpt from the following link, increased protein intake DOES NOT translate in increased uric acid excretion:

    "The excretion of uric acid bears no relationship to the extent of protein metabolism, for an excessive consumption of nitrogenous food (free from nuclein) does not increase the amount of uric acid excreted, even although the metabolism may be increased. Thus from 18 grams of protein food 433 mgr. uric acid were excreted, whereas from 80 grams of protein food not more than 442 mgr. uric acid were excreted."

    On a side note, I had passed a 3mm calcium oxalate kidney stone back in March. For stone prevention, I am drinking about 12 cups of water daily and taking approx. 5g potassium citrate to alkalinize urine. I urinate 1500-2000cc daily. I also take magnesium citrate. For many years I've had a problem taking pancreatin in that it made my urine very acid and caused mouth sores. Pancreatin is known to increase UA. In addition, my urine pH has always been about 5.0 (acid).

    I realize that red meat is moderately high in purines (which can elevate uric acid), but I love my grass-fed beef and buffalo and would hate to give them up or reduce them!

    The good news is that any excess UA is not being retained and is being excreted in the urine, otherwise my serum UA would be elevated. Still, this is a warning sign of possible gout or other dysfunctions.

    Possible causes/explanations:

    - serum UA seems to have an inverse relationship to urine UA; decrease of serum uric acid levels seems to increase the urinary excretion of uric acid.

    - when you eat more protein, your kidneys will extract more UA acid in your urine to compensate which is why my serum UA acid is normal.

    - imbalance in the ratio of protein to low-protein foods (i.e. fats, vegetables, fruits); not enough low-protein foods to compensate for increase in BUN and UA.

    - fasting increases UA excretion, but the increase in ketones cancels it out.

    - both potassium and magnesium citrate increase rate of UA excretion.

    - exogenous high doses of zinc and iron can elevate UA.

    - breakdown of fats by the liver produces several byproducts, including uric acid. I have NAFLD (fatty liver) and have read that VLC paleo and IF can accelerate the clearance of FFAs, especially when combined with exogenous choline.

    - other supplements causing elevated urinary UA excretion.

    - It also appears that uric acid increases the storage of body fat. Perhaps this is a factor in my inability to burn fat.

    Possible Solutions (since reducing protein intake would be counterproductive to anabolism):

    - To balance out the overload of UA, I would increase veggies and healthy fats. If I increase fruits, then fructose increases which is counterproductive to fat loss and itself increase uric acid.

    - Maintain Vitamin C intake @ 5-7g daily.

    - drop the zinc to 50mg daily; should I drop the iron (I am taking 33mg from supps to raise serum ferritin)?

    Any reason why serum calcium is elevated? My last PTH was normal.

    Before resorting to meds like allopurinol to decrease urinary UA levels, any other pearls you guys can share??
    Your fat intake is too low for what you trying to do.Your body uses protein for energy.
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    Quote Originally Posted by vassille View Post
    Your fat intake is too low for what you trying to do.Your body uses protein for energy.
    How's this - looking more keto (65% fat, 30% pro, 5% carbs):

    CALS: 1900
    PRO: 143g
    CHO: 24g
    FAT: 137g
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    Quote Originally Posted by mcs5309 View Post
    How's this - looking more keto (65% fat, 30% pro, 5% carbs):

    CALS: 1900
    PRO: 143g
    CHO: 24g
    FAT: 137g
    better and yes you are venturing into keto, but think of it as low carb because you could increase carbs up to 100g if you do enough physical activity. If you dont, then stick with 50g of carbs per day.
    protein should not be higher than 20- 25% of total caloric intake. Dont worry you will not lose lean mass.
    Once a week have a meal with anything you want...and I mean anything! Pizza, ice cream etc
    Sometimes I eat uppwards of 2500cal at that meal so you get the idea
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    Quote Originally Posted by vassille View Post
    better and yes you are venturing into keto, but think of it as low carb because you could increase carbs up to 100g if you do enough physical activity. If you dont, then stick with 50g of carbs per day.
    protein should not be higher than 20- 25% of total caloric intake. Dont worry you will not lose lean mass.
    Once a week have a meal with anything you want...and I mean anything! Pizza, ice cream etc
    Sometimes I eat uppwards of 2500cal at that meal so you get the idea
    what's your bf at now?
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    Quote Originally Posted by vassille View Post
    8-9%
    How do you measure and what was it before your diet?

    For me, it would only make sense to cut since I'm >15%. I just cannot see bulking when I'm 18-19%.
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    Quote Originally Posted by vassille View Post
    better and yes you are venturing into keto, but think of it as low carb because you could increase carbs up to 100g if you do enough physical activity. If you dont, then stick with 50g of carbs per day.
    protein should not be higher than 20- 25% of total caloric intake. Dont worry you will not lose lean mass.
    Once a week have a meal with anything you want...and I mean anything! Pizza, ice cream etc
    Sometimes I eat uppwards of 2500cal at that meal so you get the idea
    I think I will keeps cals same, but add a modified keto carb cycle to my IF and bump carbs this way only on wo days:

    (60% fat, 25% pro, 15% carbs):

    CALS: 1900
    PRO: 119g (25%)
    CHO: 72g (15%)
    FAT: 127g (60%)

    Again, with 18-19% bf, I fear going past 75g carbs may reverse my fat loss goals.
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    Quote Originally Posted by mcs5309 View Post
    I think I will keeps cals same, but add a modified keto carb cycle to my IF and bump carbs this way only on wo days:

    (60% fat, 25% pro, 15% carbs):

    CALS: 1900
    PRO: 119g (25%)
    CHO: 72g (15%)
    FAT: 127g (60%)

    Again, with 18-19% bf, I fear going past 75g carbs may reverse my fat loss goals.
    THis one seems a bit better although cal still seem a bit low but the break down is much better. Try it out and see if it works.
    THe rule is that if you lower carbs increase the fat intake. Dont just cut calories that's a mistake. I would argue that your cal intake should be around 2500. But I need more info to say for sure.
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    No, I wasn't cutting cals at all, just cycling macros depending on physical activity level. I'm not a big guy (see stats on first post) and 2300 is above my low active TEE, and my RMR is 1500. To lose fat, I chose to be 400 below my low active TEE which puts me @ 1900. I was @ 1400 which is probably too low.

    I am going to try and few things outside of diet to speed up lipolysis while adding lean mass:

    Before I train fasted, Alpha-T2/T3 stack, and down the road, I will be looking into peptides like GHRP-2, 6, CJC-1295 and look into bumping my T from the 500s to at least 800. I'm 52, after all.

    Thoughts?
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    Quote Originally Posted by vassille View Post
    THis one seems a bit better although cal still seem a bit low but the break down is much better. Try it out and see if it works.
    THe rule is that if you lower carbs increase the fat intake. Dont just cut calories that's a mistake. I would argue that your cal intake should be around 2500. But I need more info to say for sure.
    No, I wasn't cutting cals at all, just cycling macros depending on physical activity level. I'm not a big guy (see stats on first post) and 2300 is above my low active TEE, and my RMR is 1500. To lose fat, I chose to be 400 below my low active TEE which puts me @ 1900. I was @ 1400 which is probably too low.

    I am going to try and few things outside of diet to speed up lipolysis while adding lean mass:

    Before I train fasted, Alpha-T2/T3 stack, and down the road, I will be looking into peptides like GHRP-2, 6, CJC-1295 and look into bumping my T from the 500s to at least 800. I'm 52, after all.

    Thoughts?
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    Quote Originally Posted by mcs5309 View Post
    How do you measure and what was it before your diet?

    For me, it would only make sense to cut since I'm >15%. I just cannot see bulking when I'm 18-19%.
    Yes you have the right idea to lean out first then try to put on a bit of mass.

    As for body fat I used a caliper. I have abs and I have veins in my lower abdomen and my legs, arms.
    This is not a diet for me, is how I eat all the time. The past years I've stayed stayed lean but when I started to eat like this I was 12-13% around 275lbs.
    Then I decided that it wasnt healthy to be that heavy and I shed some mass and fat to stay under 250 which I feel great for a number of years now. As I got older I preffer being lean than super heavy.
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    Quote Originally Posted by mcs5309 View Post
    No, I wasn't cutting cals at all, just cycling macros depending on physical activity level. I'm not a big guy (see stats on first post) and 2300 is above my low active TEE, and my RMR is 1500. To lose fat, I chose to be 400 below my low active TEE which puts me @ 1900. I was @ 1400 which is probably too low.

    I am going to try and few things outside of diet to speed up lipolysis while adding lean mass:

    Before I train fasted, Alpha-T2/T3 stack, and down the road, I will be looking into peptides like GHRP-2, 6, CJC-1295 and look into bumping my T from the 500s to at least 800. I'm 52, after all.

    Thoughts?
    My point is and sooner or later you will find out from trial and error that when you eat a low carb diet many rules are not the same as eating a low fat diet. First, calories are not the same ...why? Because a well done low carb diet will increase your rest methabolic rate by a lot down the road. A good portion of your fat intake is not used in the same maner as carbs. Burning fat for fuel is totally different from what you are used with carbs.

    If you plan to lose a lot of fat HGH is your best friend and working out fasted is great followed by a protein shake no carbs. That's a good move. If you can lose weight on your own skip the peptides unless you have problems then get real HGH.
    Increasing the T is good too it will help if done correctly.
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    Quote Originally Posted by vassille View Post
    My point is and sooner or later you will find out from trial and error that when you eat a low carb diet many rules are not the same as eating a low fat diet. First, calories are not the same ...why? Because a well done low carb diet will increase your rest methabolic rate by a lot down the road. A good portion of your fat intake is not used in the same maner as carbs. Burning fat for fuel is totally different from what you are used with carbs.

    If you plan to lose a lot of fat HGH is your best friend and working out fasted is great followed by a protein shake no carbs. That's a good move. If you can lose weight on your own skip the peptides unless you have problems then get real HGH.
    Increasing the T is good too it will help if done correctly.
    Good point on the fats as fuel source. I first heard of that when MCTs came out years ago, but didn't apply it to diet. I've eaten clean for decades now, just in the wrong % for what I needed to accomplish. I just started VLC paleo and IF about 6 mos. ago and have at least maintained, but it's wayyy too slow which is why I'm looking at chemical enhancement. Hopefully, adding the keto will help.

    Have you tried any of the peptides? It's the sides of frank GH that have me concerned that don't happen on the peptides because of their action to induce natural induction of GH from the pituitary and can be dosed to mimic the pituitary's pulsatile rhythm of GH release.
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    Quote Originally Posted by mcs5309 View Post
    Good point on the fats as fuel source. I first heard of that when MCTs came out years ago, but didn't apply it to diet. I've eaten clean for decades now, just in the wrong % for what I needed to accomplish. I just started VLC paleo and IF about 6 mos. ago and have at least maintained, but it's wayyy too slow which is why I'm looking at chemical enhancement. Hopefully, adding the keto will help.

    Have you tried any of the peptides? It's the sides of frank GH that have me concerned that don't happen on the peptides because of their action to induce natural induction of GH from the pituitary and can be dosed to mimic the pituitary's pulsatile rhythm of GH release.
    I do have experience with peptides but from my experience there is no substitute for good diet. Peptides will help in conjunction with a good diet not replece it. Keto works to lose fat. Give it a try. If this doesnt really work for whatever reason then ramp up your hormons such as adding test if you wish and look into T3 suplementation. GH I would suggest to get it tested first. If need it then add it. My point is that if you bring your body up to normal high hormonal levels along with keto there is no way not to lose body fat if you have the dedication to make it happen.
    Im not sure I understand you question about peptides in its entirety.
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    Quote Originally Posted by vassille View Post
    I do have experience with peptides but from my experience there is no substitute for good diet. Peptides will help in conjunction with a good diet not replece it. Keto works to lose fat. Give it a try. If this doesnt really work for whatever reason then ramp up your hormons such as adding test if you wish and look into T3 suplementation. GH I would suggest to get it tested first. If need it then add it. My point is that if you bring your body up to normal high hormonal levels along with keto there is no way not to lose body fat if you have the dedication to make it happen.
    Im not sure I understand you question about peptides in its entirety.
    My last IGF-1 was 174, the lowest it's been despite taking 50mg DHEA. Because I'm hypothyroid, I've been taking 75mcg sustained-release T3 for the last 2 years but it has done nothing to help lose bf. The peptides I am referring to are the injectable ones like GHRP-6, etc. I see a lot of guys using them as a safer alternative to GH.
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    Quote Originally Posted by mcs5309 View Post
    My last IGF-1 was 174, the lowest it's been despite taking 50mg DHEA. Because I'm hypothyroid, I've been taking 75mcg sustained-release T3 for the last 2 years but it has done nothing to help lose bf. The peptides I am referring to are the injectable ones like GHRP-6, etc. I see a lot of guys using them as a safer alternative to GH.
    I see. DHEA is hit or miss. More miss imo. One peptide is not safer than another ppl take fragment because real thing is too expensive for some. If you just take HGH to bring your levels higher is safe. When it's abused it startes to have sides. For HRT you dont need more than 1IU a day and that's in extreme cases. Usually less then 1IU a day of HGH is enough to get your IGF levels to normal. Like I said if you get all your hormons in order along with a low carb diet you will lose fat.
    If oyu have a thyroid problem my advice is to get it under control and within range first.
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    Quote Originally Posted by vassille View Post
    I see. DHEA is hit or miss. More miss imo. One peptide is not safer than another ppl take fragment because real thing is too expensive for some. If you just take HGH to bring your levels higher is safe. When it's abused it startes to have sides. For HRT you dont need more than 1IU a day and that's in extreme cases. Usually less then 1IU a day of HGH is enough to get your IGF levels to normal. Like I said if you get all your hormons in order along with a low carb diet you will lose fat.
    If oyu have a thyroid problem my advice is to get it under control and within range first.
    I agree on the unpredictability of DHEA. Same with pregnenolone. I am considering HGH again (took it once before but it was a tiny dose that didn't do anything), but am first thinking giving peptides a shot. It is still a struggle to get my thyroid hormones in line where my doc wants to see them because of so many other complex factors that affect them. It's not quick or easy.
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    Quote Originally Posted by mcs5309 View Post
    I agree on the unpredictability of DHEA. Same with pregnenolone. I am considering HGH again (took it once before but it was a tiny dose that didn't do anything), but am first thinking giving peptides a shot. It is still a struggle to get my thyroid hormones in line where my doc wants to see them because of so many other complex factors that affect them. It's not quick or easy.
    Then try IGF-lr3 if you want. As for thyroid it's complex i agree, some ppl may require a mix of t3/t4 and some may do well on armor. It all depends. What was your free test if you had your test tested?
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    Quote Originally Posted by vassille View Post
    Then try IGF-lr3 if you want. As for thyroid it's complex i agree, some ppl may require a mix of t3/t4 and some may do well on armor. It all depends. What was your free test if you had your test tested?
    Yes, was looking into IGF-lr3 but don't know enough about it. Last labs in June showed TT @ 474 and Free T @ 9.9. E2 was 8. I've been holding off on T4 since it tends to increase rT3.
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    Quote Originally Posted by mcs5309 View Post
    Yes, was looking into IGF-lr3 but don't know enough about it. Last labs in June showed TT @ 474 and Free T @ 9.9. E2 was 8. I've been holding off on T4 since it tends to increase rT3.
    Free t is a bit low but E seems to be very low. At your age you prob right increasing T would help. Do some research on IGF see what you can dig up.
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    Forgot to mention - it was after starting IF (and keeping protein intake the same), my BUN levels shot up.

    Again, when you have to consume all your calories in a condensed feeding window of 4-8 hours (depending on which IF regimen you choose), then wouldn't you have an extra load on your kidneys to process that much protein all at once? Thus, the increased BUN.

    Has anyone noticed this as well?

    Only thing I can think of: more protein for the kidneys to process because it's in a shorter eating window,
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