Blood Work Scheduled for This Friday

Pharma / TRT Testosterone Replacement
21

Please review above re rT3, use ^F to search this page. Your higher fT3 and low body temps really point to rT3. See rT3 references in the thyroid basics sticky again.

T4 has dropped, TSH increased. What has been your iodine maintenance dose?
Thyroid looks/feels OK?
There are thyroid auto immune labs.

Cortisol may not be low for that time of day. AM cortisol is done at 8AM, so can’t be done at time of most office visits.

No labs for TT, FT?

Earlier you had high ALT and that may be part of the reason that your liver is not clearing E2 properly. Another cause can be Rx or OTC drugs that compete for the same enzyme pathways that clear E2 in the liver. See other factors in the 'things that damage your hormones" sticky.

22

[quote]KSman wrote:
Please review above re rT3, use ^F to search this page. Your higher fT3 and low body temps really point to rT3. See rT3 references in the thyroid basics sticky again.

T4 has dropped, TSH increased. What has been your iodine maintenance dose?
Thyroid looks/feels OK?
There are thyroid auto immune labs.

Cortisol may not be low for that time of day. AM cortisol is done at 8AM, so can’t be done at time of most office visits.

No labs for TT, FT?

Earlier you had high ALT and that may be part of the reason that your liver is not clearing E2 properly. Another cause can be Rx or OTC drugs that compete for the same enzyme pathways that clear E2 in the liver. See other factors in the 'things that damage your hormones" sticky.

[/quote]

Thanks for your response KSman. I reviewed rt3 as well as how it pertains in the thyroid sticky. I have been under an immense amount of stress for the last approximate 4 years, however there’s very little I can do that I’m not already doing. I have a high stress sales job, a 4 year old, 2 year and a new born daughter.

It sounds like stress can drive up rt3 levels which then make t3 ineffective. Is there anything besides stress reduction that can be done?

My iodine maintenance dose has only been iodized salt. I’ve gone through IR approximately three times, but only the past 2 with selenium.

I believe my thyroid feels normal, however I don’t know what a normal vs abnormal thyroid would feel like. It does not feel large or lumpy.

More labs are coming. These were the first half of the labs from last week that were just released. I anticipate I’ll have TT, FT etc within the next week.

As far as RX lately, I do take a good amount of ibuprofen when training around injuries, sudafed when I have colds and nicorette gum (non-smoker) to help me wake up and stay sharp while working.

Any other ideas/suggestions based on the above? What would you do if you were me?

23

[quote]KSman wrote:
Please review above re rT3, use ^F to search this page. Your higher fT3 and low body temps really point to rT3. See rT3 references in the thyroid basics sticky again.

T4 has dropped, TSH increased. What has been your iodine maintenance dose?
Thyroid looks/feels OK?
There are thyroid auto immune labs.

Cortisol may not be low for that time of day. AM cortisol is done at 8AM, so can’t be done at time of most office visits.

No labs for TT, FT?

Earlier you had high ALT and that may be part of the reason that your liver is not clearing E2 properly. Another cause can be Rx or OTC drugs that compete for the same enzyme pathways that clear E2 in the liver. See other factors in the 'things that damage your hormones" sticky.

[/quote]

Could I start taking natural desiccated thyroid or would that put more stress on my adrenals?

24

Please get Wilson’s book on adrenal fatigue and read it. Look for parts of the book where you feel like it is taking about you.

Ibuprofen and naproxen can cause kidney problems with higher continued doses. Labs can pick that up.

Get rT3 tested.

Treatment with thyroid meds can be counter productive as more T4 means more T4–>rT3
When rT3 is elevated, thyroid meds should be T3 only. Very few doctors have that depth.

No simple answers or easy fixes. You cannot fix adrenal fatigue with a pill. Please do the reading.

Low thyroid function undermines function of many systems in the body. The added effort and drive to blast past these problems creates more stress. Low cortisol levels also require more stressful effort. Fixing thyroid problems would be an improvement and reduce stresses on adrenals. But if adrenals are totally whacked, the outcome might not be positive. However, if you are functional now, it may go OK. You really do need a comprehensive plan that addresses more than one issue at a time. The book may show you the way.

25

Lab work After 2 Months of TRT 50mg test Cyp twice per week:

Cortisol: taken around 11 am - 13.1
Cortisol Reference Ranges
AM Level: 6.7 - 22.6 ug/dL
PM Level: Less than or equal to 10 ug/dL

Estradiol 34
Estradiol Reference Ranges
Adult Males: <20 - 47 pg/mL

T4, Free 0.8
Reference Range 0.6 - 1.4 ng/dL

T3, Free 3.8
Reference range 2.5 - 3.9 pg/mL

TSH (Thyroid Stimulating Hormone) 3.04
Reference Range. 0.34 - 5.60 uIU/mL

Vit D, 25-Hydroxy, Total. 91.6
Reference range 30.0 - 100.0 ng/mL

TT 904
Ref Range 175-781 ng/dL

FT 2.95
Ref Range 0.87-5.47 ng/dL

DHT 72
Reg Range 16-70 ng/dL

Iodine 66
Ref Range 52-109 mcg/L

Vit b12 978
Ref Range 300-900 pg/mL

Zinc 90
Ref Range 60-130 mcg/dL

Selenium 168
Ref Range 63-160 mcg/L

I have some real concerns on the protocol he wants to begin with me. Below is the synopsis:

50 mg test cyp twice per week (no problem here)

Arimidex 1mg every other day (seems crazy)

hCG 250 IU’s every day (seems crazy)

Vit b12 1000 mg injection once per week (my blood work shows b12 is fine/high)

hydrocortisone oral for adrenal function - pharmacy had to order in and I cannot recall dosage or frequency.

Dr. believes that I have low T and adrenal fatigue. Seems to think my thyroid is ok.

Help?

26

TSH too high, fT4 low to mid-range, fT3 above mid range.
What are current body temperatures? <<<<<<<<<<<<<<<<<<<<<<<

Try 1mg anastrozole per week in divided doses.

FT is rather low and TT strong. See my earlier post re liver clearance of E2.

Serum iodine looks good; but I am deeply suspicious that this is another normal curve analysis based on a population that is substantially iodine deficient. I asked about your iodine maintenance dose earlier. Iodized salt might not be adequate for you.

250iu hCG SC EOD gets the job done, saves $$$ too.

Agree that you do not need B12 injections, but if you tried and felt better? You can get hCG compounded with B12.

27

[quote]KSman wrote:
TSH too high, fT4 low to mid-range, fT3 above mid range.
What are current body temperatures? <<<<<<<<<<<<<<<<<<<<<<<

Try 1mg anastrozole per week in divided doses.

FT is rather low and TT strong. See my earlier post re liver clearance of E2.

Serum iodine looks good; but I am deeply suspicious that this is another normal curve analysis based on a population that is substantially iodine deficient. I asked about your iodine maintenance dose earlier. Iodized salt might not be adequate for you.

250iu hCG SC EOD gets the job done, saves $$$ too.

Agree that you do not need B12 injections, but if you tried and felt better? You can get hCG compounded with B12.

[/quote]

Thanks for your response KSman. I’ll begin monitoring my body temps morning and afternoon again. I have felt warmer lately. I forgot to include that the Dr did give me something called tri-iodine, 12.5mg per capsule and told me to take one per day.

Do you believe that the cause of my relatively low free T is due to somewhat elevated e2 levels and possibly due to liver issues?

I’ve begun taking inositol and a liver cleanser to see if I feel any better.

You previously suggested 0.5mg arimidex twice per week on the same day of the test cyp injection?

Any opinions on the hydrocortisone?

Thank you again for your help!

28

AM cortisol over 10 is typically OK. I can’t see the problem, but cortisol during the day may be suffering. You can try it and learn by your response.

12.5mg iodine for how long before those labs?

More anastrozole will change things up, try and report. You should feel changes in one week.

29

[quote]KSman wrote:
AM cortisol over 10 is typically OK. I can’t see the problem, but cortisol during the day may be suffering. You can try it and learn by your response.

12.5mg iodine for how long before those labs?

More anastrozole will change things up, try and report. You should feel changes in one week.[/quote]

Before the labs it was only iodized salt. Dr gave me the 12.5 mg of iodine which I just started using today.

Are you suggesting “more anastrozole” than 1mg per week in divided doses. Sorry, can you clarify that last part?

30

Sorry I misread/misunderstood. 1 mg in a week spread out in doses EOD. Essentially 1/4 mg EOD.

31

Is hcg always prescribed as an injection or can it be prescribed as an oral as well?

Is there a difference in effectiveness if so?

32

All peptide hormones are digested as food if taken orally. Any product represented as oral is a scam.

GH
IGF-1
insulin
hCG
LH
FSH

Ditto for any growth hormones in milk from BST. Bovine somatotropin - Wikipedia

33

[quote]KSman wrote:
All peptide hormones are digested as food if taken orally. Any product represented as oral is a scam.

GH
IGF-1
insulin
hCG
LH
FSH

Ditto for any growth hormones in milk from BST. Bovine somatotropin - Wikipedia
[/quote]

Great. Apparently the two compounding pharmacies in my area can no longer compound hcg as injectable. I’ve emailed my Dr indicating my concerns and asking if he can call in the prescription to a pharmacy capable of compounding it as injectable.

So this is bogus then KSman?

www.hcgtreatments.com/hcg-drops/

34

You’re right again KSman. The literature says that the submucosal mouth membranes can only readily absorb proteins of a size under 300 daltons. HCG is 36,700 daltons (122 times the largest size that can be absorbed). After speaking with me Dr he said he could order in hcg as injectable and was fine with that.

35

[quote]KSman wrote:
TSH too high, fT4 low to mid-range, fT3 above mid range.
What are current body temperatures? <<<<<<<<<<<<<<<<<<<<<<<

Try 1mg anastrozole per week in divided doses.

FT is rather low and TT strong. See my earlier post re liver clearance of E2.

Serum iodine looks good; but I am deeply suspicious that this is another normal curve analysis based on a population that is substantially iodine deficient. I asked about your iodine maintenance dose earlier. Iodized salt might not be adequate for you.

250iu hCG SC EOD gets the job done, saves $$$ too.

Agree that you do not need B12 injections, but if you tried and felt better? You can get hCG compounded with B12.

[/quote]

Once my e2 has been lowered can I expect my FT to rise? You indicated my TT was strong but not my FT. Aside from lowering my e2, is there anything else I can do/look out for in order to increase my FT?

36

So from some quick reading it appears that aside from lowering e2, if shbg is elevated (no idea if mine is or not), that will result in lower FT.

It looks like the best way to reduce shbg is increase T (check), take vit d (check), taking stinging nettle (uncertain if want want go this route since I’ve read it can decrease conversion to dht), taking boron and also magnesium.

Looks like the best options on top of e2 reduction is adding in boron and magnesium, which I just ordered.

Any other thoughts or ideas?

37

Lower estrogens and more T both should lower SHBG. More T may mean bio-T, not aware of other specifics.

SHBG can be increased/decreased by medical conditions, we wikipedia.

38

Another quesion. I picked up my hcg yesterday. I came home and reconstituted the solution and was very careful to not shake but to roll the vial in my hands.

I’ve injected yesterday as well as this morning.

I had another pregnancy test laying around (two came with the pack) and took it a couple of hours after my injection this morning but came back negative.

Should I be concerned?

39

It has a ~36 hour half life. So repeated EOD injections would reach steady state in about a week.
Test later.