T Nation

27 Years Old and Feel Like an Old Man

[quote]SHARKinafishbowl wrote:
too low, could it be lowering my total testosterone which is causing my free test to increase?

dhickey - I haven’t checked progesterone recently, but I just checked pregnenolone. It was listed above I believe:

Pregnenolone LC/MS/MS - 43 (12-208 ng/dl)

So is that considered low? Should I check progesterone just the same?

[/quote]

I am far from an expert, but if those were my results I would consider them low. I would personally try supplementing pregnenolone. From what I understand this would support both the DHEA/Test, and the Progesterone/cortisol loops of the HPTA. I’ve ready that supplementing pregnenolone could also stimulate your body to start producing a bit more on it’s own.

I personally wouldn’t bother testing progesterone until I got pregnenolone sorted, but that’s again based on my limited knowledge.

You should probably wait for someone with a bit more experience to comment on the order of possible treatment. I am either not smart enough to do that or have an overwhelming need to prove things to myself via experimentation, so I would probably start with treating pregnenolone to see what happened. I think you’d want micronized or topical if you go this route.

yeah definitive mind and other sites are a gold mine and go into a lot more depth then we cover here.

[quote]PureChance wrote:
yeah definitive mind and other sites are a gold mine and go into a lot more depth then we cover here.[/quote]

Just browsed definitive mind. Lot’s of good info there. Any other sites you’d recommend for HPTA stuff? I’ve been trying to absorb as much as possible while sorting out my issues.

I’ve been looking for similar sites as well, but haven’t found anything that’s stuck out. I think Marianco posts on mesomophosis.com or something like that - I’ve landed on that site a few times through Google and it may have been how I found defmind. You guys have probably heard of that one, it does seem like it’s focused a little bit more specifically on steroids and bodybuilding, with a touch of adrenal/thyroid/HPTA info.

So the good thing is that my MD is willing to do just about any test I tell her I want. The downside is that, while she is open minded, she isn’t as knowledgeable as an Endo might be in terms of interpreting all the more obscure bloodwork values.

Just kind of on the fence about initiating the SSRI again. I don’t want to excacerbate my current state overall (even if there are some symptoms that are improved). I still figure I can concurrently treat other existing problems, but am I shooting myself in the foot and throwing a wrench in things by starting the RX, while still getting more labs? i.e. I can’t seem to figure out what those drugs do to cortisol, for better or worse, I’m seeing a ton of conflicting info out there. Anyone in a similar situation?

Also dhickey or anyone who can drop some knowledge: pregnenolone safety? Willing to try just about anything, but obviously I don’t want to damage the system further… I guess the first step is to my cortisol values, and then I can figure out where to go from there…

I think the biggest issue (and this is relevant to all who frequent these forums) is how to find an endo who can treat and is willing to try various approaches. I’ve heard one way to go to avoid wasting time with endos who don’t want to fully treat you is to google “anti aging doctor (and then your city)”, or “testosterone doctor (city)”. I’m curious if there’s a more efficient way to get this done.

prenenolone is OTC and fairly safe, it clears out of your system quickly you typically have to dose 2-3 times a day. you can use oral or transdermal. everyone reacts differently - for some it is great, but others overreact or overconvert it down one particular path leading to overload in cortisol, or DHEA, or estrogen.

overloaded right now, but will try to read through and provide a better answer tomorrow.

Pregnenolone is created from cholesterol and can be converted to DHEA and/or Progesterone. I have plenty of cholesterol, so if my pregnenolone were low, i’d look at supplementation. From what I’ve read, taking it orally can be a bit of crap shoot. It’s not absorbed very well. Micronized is supposed to be better. Transdermal would be even better. I haven’t looked around for transdermals. I’ll probably end up making my own if it comes to that. There was a popular DHEA and Pregnenolone transdermal, but not sure they make it anymore or if they would be considered a competitor to this fabulous site.

Once I had pregnenolone where I wanted it, I would look at DHEA and Progesterone. These are two different loops if you will and should be treated separately to a point. Since you seem to have some thyroid issues to sort, you might want to start with the progesterone side.

If Progesterone is low, supplement. Transdermals are readily available. If Progesterone looks good, move on to cortisol.
If cortisol is low, move on to thyroid tests. Not sure what the treatment is for low cortisol. it’s high, treat it. I can’t remember where I read this or if I am remembering this correctly, but I don’t believe you want to take any kind of stimulant if cortisol is screwed up. I believe this would include SSRIs. If it’s high or low, you could sniff around and see if increasing dopamine might help.

If pregnenolone, progesterone, and cortisol all look good, you could move on the the DHEA side.

DHEA side -
At some point E2 should be checked and treated as necessary.
If DHEA is low, supplement directly (transdermal better) or try Magnesium Gel. If DHEA is good, move on the SHBG.
If SHBG is high treat. If it looks good, move on to T and recheck E2.

If pregnenolone and DHEA both look good but T is still not that great, your really just left with looking E2, LH, and maybe DHT. Quite frankly, I’m not sure why someone would be concerned with DHT unless they were losing their hair or had prostate issues, but I haven’t gotten that far.

If you can’t tell, I’m just some anonymous joe on a message board. I am not a doctor or in the medical industry at all. I have my own issues and this is just how I would go about things. There are probably short-cuts and/or better routes to take, but I need to simplify things for my own understanding and take them one step at a time. Hopefully some of the more educated members will provide more feedback.


This is reasonable illustration. Not complete, but the important ones are there.


A bit simpler.


with conversion enzymes.

[quote]dhickey wrote:
Pregnenolone is created from cholesterol and can be converted to DHEA and/or Progesterone. I have plenty of cholesterol, so if my pregnenolone were low, i’d look at supplementation. From what I’ve read, taking it orally can be a bit of crap shoot. It’s not absorbed very well. Micronized is supposed to be better. Transdermal would be even better. I haven’t looked around for transdermals. I’ll probably end up making my own if it comes to that. There was a popular DHEA and Pregnenolone transdermal, but not sure they make it anymore or if they would be considered a competitor to this fabulous site.

Once I had pregnenolone where I wanted it, I would look at DHEA and Progesterone. These are two different loops if you will and should be treated separately to a point. Since you seem to have some thyroid issues to sort, you might want to start with the progesterone side.

If Progesterone is low, supplement. Transdermals are readily available. If Progesterone looks good, move on to cortisol.
If cortisol is low, move on to thyroid tests. Not sure what the treatment is for low cortisol. it’s high, treat it. I can’t remember where I read this or if I am remembering this correctly, but I don’t believe you want to take any kind of stimulant if cortisol is screwed up. I believe this would include SSRIs. If it’s high or low, you could sniff around and see if increasing dopamine might help.

If pregnenolone, progesterone, and cortisol all look good, you could move on the the DHEA side.

DHEA side -
At some point E2 should be checked and treated as necessary.
If DHEA is low, supplement directly (transdermal better) or try Magnesium Gel. If DHEA is good, move on the SHBG.
If SHBG is high treat. If it looks good, move on to T and recheck E2.

If pregnenolone and DHEA both look good but T is still not that great, your really just left with looking E2, LH, and maybe DHT. Quite frankly, I’m not sure why someone would be concerned with DHT unless they were losing their hair or had prostate issues, but I haven’t gotten that far.

If you can’t tell, I’m just some anonymous joe on a message board. I am not a doctor or in the medical industry at all. I have my own issues and this is just how I would go about things. There are probably short-cuts and/or better routes to take, but I need to simplify things for my own understanding and take them one step at a time. Hopefully some of the more educated members will provide more feedback.[/quote]

This is terrific. Thank you. I will have to review this and continue to read the stickies/look at other resources online.

[quote]dhickey wrote:
A bit simpler.[/quote]

This is phenomenal - simplifies things quite a bit and crucial for understanding the kind of hierarchy that exists here. I’m gonna review it some more later.

I was snooping around a bit and it seems that dosing with any kind of pregnenolone has it’s drawbacks as well as potential advantages. Upon realizing that it’s a pro-hormone (I don’t know what I assumed it was before brushing up, lol) makes me a bit dodgy on it, but if I can find someone who can guide me with treatment I’d be a hell of a lot more confident. Same with DHEA if that’s the way to go. I gotta start with those cortisol levels I guess and move from there…

To that point, the lab tests are mostly bunk, it seems. Hard to find any labs who use the ideal approach as far as multiple values per day. Should I just buy a home kit (saliva) online? Anybody have a recommendation?

Found out some more info today which has further confounded the question of whether to start an SSRI once again - and I’m not sure how bummed out to be. Had a small fiber biopsy test done about 1.5 weeks ago and the neuro called with the results saying I am positive for small fiber neuropathy (SNF?). She was rather casual about it, didn’t go into specific causes, but said that the treatment is just the same as was recommended by the Rheum for “central sensitization” and involves SSRIs or sometimes Lyrica/Neurontin type drugs, etc. She didn’t comment on prognosis but said she sees it quite often, although not in people as young as me, typically.

This new development has further motivated me to thoroughly research underlying causes/connections to all of this and to think twice about my next move…

I have found some evidence linking hypothyroidism to this condition. Another source mentions treatment with an antibiotic for both the “central sensitization” (fibromyalgia) as well as the SNF. Also found evidence that Alpha lipoic acid can ameliorate symptoms and possibly regenerate neurons.

What risks are associated with trialing a broad spectrum antibiotic for some of these symptoms and/or trying to fix the root problem?

i feel that doctors are 99% useless, but when you get into specifics like this is the 1% of time when you have to rely on them or find the information on your own, because the chances of someone here being familar with SNF is slim to none.

I do believe that so called ‘alternative’ or ‘natural’ treatment options are normally better than drugs, but there are always exceptions.

saliva tests for Cortisol and DHEA are valid. heck insurance covers it and they are done by Quest and LabCorp.

I agree about the doctors. I’m only putting so much faith in them and have learned to take what most say with a grain of salt.

I will be checking out the cortisol tests, and may also do a glucose tolerance test - another one of my own ideas. Apparently, both hypothyroidism and glucose problems can impact/cause SFN. If these are the causes, then the disorder can be resolved rapidly in most cases.

Despite not being diabetic, I am curious if estimated average glucose readings I have had over the past couple of months of 108 and 111 are telling me something. I am back to dosing 300mg ALA with meals, upping my protein, and cutting back on questionable foods, including diet soda.

I am also hoping that maybe there is something wrong with my cortisol and or pregnenolone that I can fix that proves to resolve all of this. I’ll just have to wait and see and am getting a couple more opinions this week.

Am in the process of finding a good endo to get a few more things looked at. A family friend/doctor (my dentist coincidentally enough) injected her opinion when I saw her the other day. She mentioned my parathyroid hormone was low… Here’s the result from above -

Itact PTH - 17 (15-65 pg/ml)

Here’s where it gets interesting: she is theorizing that my PTH being low is what’s driving my Vit D3 down. It went from 65 to 30 (!) in approximately two months. Am I wrong or is that a ridiculous drop in that time period?? FYI my supplementation DID become irregular a few months ago and ceased entirely in the Nov '11. Still…?

So who knows, but I’m trying to figure out a good focal point to present to the endo, and also bring up any other concerns (or angles of attack) that fellas here might suggest that he/she might otherwise fail to mention.

So far it’s pregnenolone, DHEA, cortisol, PTH? that I’m focused on.

I gotta be thorough!

…oh yea, and the RT3

Are you asking if its strange your Vit D lowered after you started supplementing inconsistently them ceased altogether? No that’s pretty standard

[quote]VTBalla34 wrote:
Are you asking if its strange your Vit D lowered after you started supplementing inconsistently them ceased altogether? No that’s pretty standard[/quote]

Yep, that was what I was curious about. Seems like you have to supplement forever to get your levels up, and apparently they can drop like a brick… I think I was taking 5-6k IUs for about a year before the decent reading a couple months ago of 65. I had been at 29 two years ago before ever supplementing - which I know isn’t that unheard of, but it does make me want to explore the PTH/Vit D connection, if there is one.

Yeah, I think there is something more than meets the eye to the Vitamin D thing we are seeing…nearly NOBODY has sufficient levels of this stuff, at least from the guys that post here (admittedly biased sample given the circumstances)…but it really makes you wonder how the ranges include numbers that nobody here even approaches without supplementation…

we need to find someone who tans regularly and see what their D25-OH levels look like.