T Nation

Anxiety for Years, Hormone Results


#1

Hi everyone. I am 19 years old and have been suffering from panic attacks, anxiety, and memory problems since I was 16. I have also been having major mood swings, depression, and episodes of extreme fatigue. I have found it to be near impossible for me to build muscle and I have noticed that I have very little facial hair.

So, I decided to purchase my own male hormone test since all the doctor wanted to do was put me on an antidepressant (which I refused).

Here are my results:

Total Testosterone: 711 ng/dL (188-882 ng/dL)
Free Testosterone: 14.6 pg/mL (50-210 pg/mL)
DHEA Sulfate: 323.5 ug/dL (115.3-459.6 ug/dL)
Estradiol: 36.4 pg/mL (7.6-42.6 pg/mL)
PSA: 0.5 ng/mL (0.0-4.0 ng/mL)

The first thing I noticed is that my free testosterone is extremely low and my estradiol is elevated.
Based on the lab results, I have more estrogen in my body than free, testosterone. I also noticed that my prostate specific antigen is pretty damn low. I don’t know if that has anything to do with it.

I believe this is what has been causing my anxiety problems.

Why is my free T so low?

-Cody


#2

PSA should be low. Normally would never be checked in a young male.

You need these additional labs:
SHBG
AST/ALT
CBC with hematocrit
prolactin !!!
LH/FSH
FT - to confirm the low result
AM cortisol - at 8AM please

Please confirm FT=14.6 is not a typo

With these results, you should be able to get a doc to do the additional labwork.

Do you get cold easily?
Are you using iodized salt?

Please see the 2nd post in this forum’s one sticky and follow these links:

  • advice for new guys — provide more info
  • things that damage your hormones

We do not yet know the cause of high E2. With low FT, E2 should be way lower. Liver may not be clearing E2 properly [AST/ALT]. SHBG lab will confirm suspected high SHBG. Elevated E2 and low FT both contribute to higher SHBG. T binds to SHBG and SHBG+T is not bio-available.

Meanwhile, you could be taking 0.5mg Arimidex/anastrozole per week in EOD divided doses to lower E2.
Low doses of anastrozole are best managed by dissolving 1mg tabs in vodka, 1mg/ml and dispensing by the drop.

Also have your testes physically examined. Testicular cancer is a young man’s disease. If FSH is elevated, that can be from a cancer.

If prolactin is elevated, a MRI can look for a pituitary adinoma. If found, that is easily managed by 0.5mg Dostinex/cabergoline per week.

Please study the suggested reading. Come back with added info and questions.

Print this thread to hand out to doctors.
Your GP can do the additional labs then you may be send with the labs to an endo if your BP is overwhelmed.


#3

I had AST/ALT and CBC with hematocrit tests done in October. Would the results still be helpful considering they are from 3 months ago?

Along with the hormone test, I did a 24 hour urine cortisol test and I am still waiting on the results. Would those results be helpful at all?

I will get the other tests done and post the results when they are available.

Yes I do get cold easily. But I also get hot easily as well. I have hot flashes every night and occasionally throughout the day.

I’m sure some of the food I eat has iodized salt in it. But when I cook, I usually use sea salt.


#4

Most prepared foods and restaurant food are not made with iodized salt.

I think that you are probably iodine deficient.

Thyroid hormones control your metabolic rate and thus your body temperatures.
Please check oral body temperatures:

  • when you first wake up, should be 97.7 -97.8, higher is OK, 97.3 is a problem
  • also check for 98.6 mid-afternoon
  • if body temps are low, stop using sea salt and read the Thyroid Basics Explained thread/topic.

Low thyroid function leads to weight gain, loss of energy, loss of metal clarity and depression.


KSman is Here
#5

KSman, It turns out that I was using the wrong lab range for free testosterone and was trying to convert from pg/mL to ng/dL. Looking at the correct range of 6.6 - 26.5 pg/mL, 14.6 free testosterone on the last test is well within the normal range. However, I still feel that it should be higher for my age.

So here are the results for the new tests that you requested as well as some other tests:

Total Testosterone: 675 ng/dL (188 - 882 ng/dL)

Free Testosterone: 17.7 pg/mL (6.6 - 26.5 pg/mL)

LH: 4.3 mIU/mL (1.7 - 8.6 mIU/mL)

FSH: 2.1 mIU/mL (1.5 - 12.4 mIU/mL)

8:00 am Cortisol: 20.4 ug/dL (6.2 - 19.4 ug/dL)
—> Note: The Cortisol is probably high because while driving to the test location, I got stuck in stop-and-go traffic and the sun was in my eyes the whole way so I passed the exit ramp and got very stressed out.

Prolactin: 8.6 ng/mL (4.0 - 15.2 ng/mL)

SHBG: 41.6 nmol/L (16.5 - 55.9 nmol/L)

TSH (tested in October) : 3.21 mIU/L (0.50 - 4.30 mIU/L)

AST (tested in October) : 35 U/L (12 - 32 U/L)

ALT (tested in October) : 35 U/L (8 - 46 U/L)

White Blood Cell Count (tested in October) : 8.4 thousand/uL (3.8 - 10.8 thousand/ uL)

Red Blood Cell Count (tested in October) : 5.42 million/uL (4.38 - 5.82 million/uL)

Hematocrit (tested in October) : 51.6 % (42.4 - 53.7 %)

FSH seems very low, AST is high, and SHBG seems elevated. Hematocrit seems pretty high.


#6

Thyroid hormones control your metabolic rate and thus your body temperatures.
Please check oral body temperatures:

  • when you first wake up, should be 97.7 -97.8, higher is OK, 97.3 is a problem
  • also check for 98.6 mid-afternoon
  • if body temps are low, stop using sea salt and read the Thyroid Basics Explained thread/topic.

Low thyroid function leads to weight gain, loss of energy, loss of metal clarity and depression.
Reply as linked Topic


#7

I checked my body temp.

After waking up: 97.0

3:30 pm: 97.7

So I guess I have hypothyroidism. My TSH is 3.21 which is elevated. Do you thing that is what is causing my anxiety or could it be the high estrogen or both?

What doesn’t make sense to me is even with a low body temperature, I often have hot flashes.

I heard that high estrogen can cause thyroid problems. Is that correct?


#8

No, thyroid does not increase E2, but can make you fat and that can increase E2.
Low thyroid function can lower T and mess up any/all systems in your body.

Read the Thyroid Basics Explained thread/topic and come back with questions.

You need a plan for iodine replenishment with selenium.
Often works, but sometimes not enough.


KSman is Here
#9

I have read the Thyroid Basics Explained. I will pick up selenium and iodine supplements tomorrow.

I am not fat at all. I am normal weight for my age. I eat constantly but don’t gain any weight. Yet I have high E2, low TSH, etc…(Please look at my latest test results).

I think you got my question flipped around. Can high E2 CAUSE hypothyroidism? I read that this is true and is the reason why women more often have thyroid problems than men. If this is the cause of my hypothyroidism, then taking Arimidex should help???


#10

See if body temps can be corrected with iodine and see what happens.

Identify factors that may be reducing E2 clearance or increase production.
Did you read “things that damage your hormones”?

“- advice for new guys — provide more info

You have not provide much info about you.


#11

Ok, I will provide some more information about me and my symptom history.
I know that you are very busy but, please read all of it and pay attention to every detail!

When I was 8 years old, I started worrying about unrealistic fears. At that time, I also started gaining weight and became pretty chubby. When I was 13, I ran into a horizontal pole, forehead - level, while running on a play ground ( I am mentioning this because head injuries can cause pituitary damage). At 14, the unrealistic fears worsened. I also started to get acne at this age. At 16 years old, I began losing weight, mainly in my upper body, and became normal weight. During this same year, I went to a dermatologist who prescribed me minocycline for my acne. After taking it for 3 months, I had my first panic attack and have had full blown anxiety ever since.
About me now: I am hungry all the time! I can eat a full meal and be hungry one hour later. My upper body is very thin except for some fat around my lower waist. My butt and legs are large in comparison with my upper body. I worry about everything! If there is something to worry about, I sure as hell will be worrying about it. I have many unrealistic fears but most of them are health related and involve my heart. I am very self conscious and have no confidence in my self. I feel unsafe and uncomfortable in any situation or place that I am not familiar with. An example of this is when my friends took me to a party. Everyone at the party was very nice yet I felt intimidated by everyone and felt uncomfortable so i just kept to myself and stayed out of the way. I have severe mood swings and get irritated very easily. I’m afraid of the dark. One time when I was camping with friends in the woods,at night my friends had to leave me by myself in order to get supplies. I felt so scared about something coming out of the forest that I locked myself in my vehicle. I get very emotional as well. If I listen to a sad song, I will literally start crying. One day I will feel happy. Another day I will feel extremely depressed and hopeless. I have the worst memory in the world and can’t remember shit which is starting to affect my productivity at work. Since a few years ago, I sometimes have trouble articulating certain sounds when speaking which makes me feel stupid. I have scalp psoriasis which I notice mostly goes away when I eat a gluten-free diet. I get sick pretty often and my nose always runs, even when I’m not sick. I can’t build muscle no matter what I do. I barely grow any facial hair and what is there is mostly the small clear hairs. Everyone else my age can grow a full beard. It is not just genetics because all my cousins who are my age have beards and everyone in my family has always been able to grow facial hair easily. (Remember, I’m 20 years old.) I have plenty of underarm and pubic hair. I have normal erections and a fairly strong sex drive. I have hot and cold flashes all the time. The hot flashes mostly happen in the middle of the night. My anxiety is always worse at night. I almost always wake up at about 2:00 a.m. with severe nervousness which usually turns into a massive panic attack. When I wake up in the morning, I feel nauseous. If I eat anything, sweet or caffeinated, it makes me feel jittery and nervous and can cause me to have a panic attack. When I have a full stomach after eating, my anxiety gets way worse.
Just to let you know, The anxiety is the main symptom that I’am wanting to get rid of. It is ruining my life. I am desperate, but not desperate enough to start taking mind altering anxiety medication.

That is pretty much all the information I have to offer. Please read it all in detail!


#12

@ksman - not intending to hijack - what did you mean “reply as linked-topic” ?

When I click reply i just see a box pop up, which I am able to type in.


#13


https://en.wikipedia.org/wiki/Depersonalization

Gut bacterial do influence brain function. Antibiotics may have negative effects via that mechanism.

“Reply as linked topic” is a website error.

I wonder if some of your problems involve digestion and gut flora. Have you tried a good antibiotic? Suggest: http://www.renewlife.com/ultimate-flora-probiotics.html

You should try to lower E2. 0.5mg/week anastrozole per week in divided doses would probably work. Need to make a solution, 1mg/ml with vodka and dispense by the drop after counting drops per ml with a dropper and doing the math. You will need an Rx.

Fish oil supports brain structure and function. Antioxidants may be helpful.

Possible your high cortisol is messing with your mental state.

Did you get through these?
Please see the 2nd post in this forum’s one sticky and follow these links:

  • advice for new guys — provide more info
  • things that damage your hormones

#14

Yes, I have read the two posts.

There is nothing I do that should be affecting my hormone levels negatively. I don’t drink or smoke. I try to eat healthy and I avoid soy products like the plague. I am normal weight and I do not take any medications.

Some interesting information I have found is listed below, please follow the links.

Article on the positive correlation between high TSH and high cortisol-
(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520819/)

Article on thyroid hormone and how estrogen blocks conversion of T4 to fT3-
(http://www.royalrife.com/hypothyroid.html)

Forum thread involving a woman with the same exact symptoms that I am having:
From post #2:
"A TSH of over two is high and you are most likely very hypo. Your high cortisol levels are probably from your hypothyroidism and your adrenals are pumping out too much cortisol to try to compensate for your low thyroid hormone levels. Low thyroid and high cortisol can account for all your symptoms and you need to treat the causes instead of going on antidepressants (which every doctor will try to push on us). What are you currently taking for thyroid hormone replacement? Have you had your free T3, free T4 tested?

Read more: http://www.healthboards.com/boards/thyroid-disorders/746357-hypothyroid-cortisol-high-anxiety-dizziness.html#ixzz41bnAFCc3

I have been taking 6-12mg of iodine for a week and noticed a slight improvement at first but nothing since then.

I will try to to get a prescription for Anastrozole (which will probably be very hard to do). If I can’t get a prescription from a doctor, I have found a website that sells Anastrozole without a prescription.


KSman is Here
#15

I understand people driving past the effects of low thyroid function with hype and adrenaline. Adrenal fatigue and elevated rT3 follows that. Conversely, if thyroid problems are resolved/treated, one might then manage without adrenal compensation, if the body can adjust.

Not sure if we can extrapolate the effects of female high estrogen levels to a male context.
You can keep SHBG under control with higher T levels and lower E2 levels.


#16

How can I increase my T levels? I definitely do not want to do TRT.

Also, what do you think about me taking Aromasin instead of anastrozole? I found out that anastrozole can potentially cause blood clots while Aromasin does not. Aromasin is supposed to be weaker and easier on the body.


#17

You are reading things about anastrozole that are related to women taking 1mg/day to attempt to get to E2=zero. Extremely low E can cause cardio vascular problems and lipid profile problems. That all relates to the low E2 and is not a direct effect of anastrozole. You would be using 1mg/week anastrozole to achieve a ‘normal’ E2 near 22pg/ml. That does not pose and cardiovascular risks and is actually less cardiovascular risk than higher E2 levels that entail estrogen dominance.

You need to learn to read things that you find with a bit more wisdom instead of latching onto something and blinding running with it.

You can take 1mg/week anastrozole or take ~70mg aromasin per week. Which is the higher drug load on your liver?


#18

Your sex hormone profile is not bad at all - T, free T, and E2 are pretty normal. I really wouldn’t latch on to E2 as a cause of anxiety or expect too much out of lowering E2 - keep in mind that this kind of fixation can be part of the anxiety-OCD spectrum.

If you don’t think you’ll be able to let go of the E2 possibility, a short trial of an AI should be pretty harmless. The advantage of anastrozole is that if you accidentally drive E2 too low, your E2 will recover within 2-3 days of stopping, whereas with aromasin it will take much longer for E2 to recover.

Keep in mind that serum levels of E2 only show an average over all organs. Serum E2 may seem fine on an AI even while E2 might actually be too low in, say, bone tissue or blood vessel walls. There really are no guarantees regarding the long term safety of any of these drugs in any given individual.

You cannot draw any conclusions regarding different substances’ effect on the liver by comparing milligrams, since a milligram of one substance can be much more toxic than a milligram of another.

Low thyroid is not usually associated with anxiety.


#19

I had my E2 tested in the afternoon so it is probably even higher in the morning.

My FSH is low. My SHBG is elevated. My cortisol is high. My AST is high.

I definitely have hypothyroidism. My TSH is high, my body temp is low, my hands and feet are always cold, and I have low blood pressure. I have nearly passed out after standing up.

Anxiety is just a symptom of something else going on inside of me. So, something has to be causing it.
I am the only male I know that has anxiety. There is a reason why 10 times more women have anxiety and depression than males: estrogen.

Also, anxiety isn’t the only symptom I am having. I can’t build muscle worth a crap no matter how much effort and time I put into it and how well I eat. I can’t grow any facial hair either. I have no confidence and I physically and mentally feel like a kid, yet I am 20. I carry all of my fat in my butt and legs while my upper body is skinny as a rail. I look around at all the guys who are my age and I immediately notice how much bigger and more masculine they are

So, what do you suggest I do then, seekonk?


#20

I wouldn’t get too stressed about your hormonal levels. Most things are in range, if not optimal, so not likely to be causing problems.

Your problem is most likely to be with depression / anxiety, which in turn will bump up cortisol levels in about half of all sufferers.

Oh, and it’s not necessarily down to E2. My levels are low, and I’m a depressive…

It sounds like you’re really struggling with mood, and you sound like you’ve got some sort of body dysmorphic disorder going on.

I’d seriously consider an antidepressant in your situation if the doctor is offering it. It’ll take the edge off your anxiety once it kicks in, but the first week will be rough. If you go that way then look into genetic testing to see what works best.

SSRIs are generally safe, and you can come off them if they’re not working. So it’s not going to be a lifetime commitment. There are risks, in particular those taking them are more likely to attempt suicide, so it’s not something to jump into.

A better solution would be to find a psychologist who can help you work through the issues.