I appreciate any thoughts, ideas or help I can get. I value this site and I have learned a lot over the years but, I am still very ignorant and have a lot to learn.
**I apologize for all the info but, i wanted to provide as much color as possible
Narrative: Through adolescence I have always tended to be estrogen dominant. This was obvious due to my gyno during puberty. I also had a fair amount of acne from middle school until the end of high school. Despite my slight inclination to estrogen dominance I was always fairly strong (T follows E?). I have always been pretty healthy until now.
In 2010 I started a Ketogenic diet with a pretty intense fat loss workout. The diet consisted of mostly oils (evoo, macadamia nut, walnut etc) and lean fish/meats. I lost about 40 pounds in 2-3 months time and was very lean. At this point I added a fat burner to burn off the weight I was having trouble losing. After about 6 months I stopped the workout routine but, kept the diet except allowing my self more cheat days. I would say in late 2010 to early 2011 I started noticing problems with my sleep so I cut back in the gym but, that didnÃ??????Ã?????Ã????Ã???Ã??Ã?Â¢??t help. Soon after I noticed issues with my libido and morning wood disappearing, during this time I had seen 3-4 doctors and 1 endo, I was offered, ambien, Prozac and Viagra. So needless to say I stopped going to the doctors and started to do some research. I didnt have insurance at the time so I was not in a good position to get labs done consistently. I started on a fairly generic supplement protocol with vitamin d3 and iodine and other stress relief type supplements (adaptogens, minerals, vitamins etc). After 8 months of trying this approach I had all but, given up and continued with just your regular multi.
Fast forward to 2014 I was tired of suffering and was finally in a better financial situation to do as much as I could do to figure out what was going on. I am weaker and fatter than I have ever been before in my life. I started back at several doctors and requested labs but, they wouldnt give me what I requested so I decided I would do things through LEF.
Body and Facial Hair - Minimal arm and leg hair, very sparse and minimal chest hair except around the areola. Facial hair is not very thick but, enough to notice a 5' oclcok shadow
Where you carry fat and how changed? I carry fat around my hips and chest, as well as the stomach. Within the past 3 years I have had a significant increase in fat storage on my chest. My legs and arms which are traditionally lean have gotten very soft and my legs are carrying more fat.
Health conditions, symptoms - No pre-existing health conditions, as a teenager I had gyno (more than normal fat storage on my chest). Over the course of the past 3 years, I have zero libido, erections arent hard and dont last very long, very little motivation for anything, intensity of orgasm's have plummeted, fat in my chest has gotten worse, anxiety has increased, foggy memory, mixing up words, sleep has been extremely inconsistent with waking up every couple of hours throughout the night (usually wake up 4-6 times a given night), occasional heart palpitations, frequent urination, cold hands and feet (whats bizarre is that my hands and feet get cold around the same time everyday around 10am and 2pm and then again around 7pm and then they warm up after about an hour or so), mild hypertension (140/85), also sebaceous dermatitis returned and this time it was not only in my hair but, on my face around my nose. In addition, I noticed high Iron in my labs and requested a full iron workup and Hemochromatosis genetic testing. I tested positive for Hemochromatosis with more info in my labs regarding specific genes found. I have been on therapeutic phlebotomies for about 6 weeks until my Ferritin, Serum = 50 (currently at 203).
Rx and OTC drugs, any hair loss drugs or prostate drugs ever- Not currently taking Rx or any OTC, current supplement protocol is towards the end of the post.
Describe Diet? My current diet (since July) is more paleo. Organic meats (not eating Red Meat at the moment See Health Conditions, Symptoms = Hemochromatosis), no fish, organic veggies, organic squash/gourds, eggs, coconut oil, red palm oil, evoo, unpasteurized grass fed cheese, grass fed cow butter, plain almonds, natural nut butters.
Describe Training? I took a long break for training because I had zero energy and motivation in the mornings. In July 2014 I started back in the gym doing 40 mins of incline walking and light stationary bike. Starting in September I started to add some weight training, only one major exercise a day with one assistance exercise. Reps and sets usually 4x5-8
Testes ache, ever, with a fever? Never have had these symptoms
How have morning wood and nocturnal erections changed?? Maybe once a month but, basically non-existent.
Hered. Hemochromatosis, DNA AFFECTED (C282Y and C282Y)
Differential Comment Verified by microscopic examination Atypical Lymphocytes
RBC Comment RBC's Normal
Platelet Comment Adequate
MRI Abdominal The liver is normal in size but diffusely decreased in signal intensity compatible with increased iron deposition and hemochromatosis. No focal hepatic lesion is identified. The spleen is borderline enlarged. There is no evidence of ascites. All other organs in the abdomen appear normal in mass/size.
I am now seeing a Doctor who is probably the best Doctor in the area for this type of issue (Dr. Bruce Rind). He requested the labs above that are dated 10/3. However, my new doctor believes that I poisoned myself by doing a NON-Organic ketogenic diet. I brought up over-training coupled with this diet and he said over-training is possible but, the main culprit was a NON-Organic diet. I have been eating non-organic my whole life, and the ketogenic diet I did was probably the cleanest I had eaten (tons of green veggies, clean oils etc.). I will admit he was right about not having enough fat(animal) in my diet at that time but, I still feel that it is important to note over-training as an equal culprit. In addition he did not really think the values of my cortisol saliva test were very important (but, I think it is a huge deal).
My labs significantly changed from July 2014 to October 2014 and I cant exactly understand why. I have been eating better, exercising, supplementing etc. I would have at least thought they would remain stagnant but, now everything seems out of wack.
So my take on the labs
TSH increased due to iodine since July. After July Labs I dosed at 50mg for about two weeks and now I am taking a maintence dose of 12mg EOD (maybe I should switch to taking idone every two weeks?). I havent read a whole lot of info regarding iodine increasing TSH but, from what I have seen its a non-issue and is pretty typical? Morning temps are low and afternoon are low(see temp chart above). Obviously adrenals play into this and the RT3 would be indicative of tissue resistance to FT3. (crap metabolism) Doctor is waiting on LH to determine pituitary function so no direction given for thyroid assistance. Im thinking T3 but, I dont think he is on board.
Calcitriol (1,25 di-OH Vit D) - I dont know if I fully understand this yet, I have done some research and I have a general sense of what may be going on. Because of my low Vitamin D levels which resulted in parathyroid hormone production resulted in the elevated Calcitriol levels. Doctor is still not sure if there is underlying lyme or chronic infection.
SHBG due to my decent TT levels(not great but, at least within range), it appears as though the SHBG is one cause for lower free T due to it binding to Testosterone. I dont quite understand why this would go from being very good in July, to now being high in my October tests? Doctor didnt address this really, he is more concerned about my Total E for some reason.
Total Estrogen I know that E2 is more important and the more active of the estrogens but, would this be evidence of not being able to clear E? Can some of that E be converted back into E2 or could the total estrogen impact SHBG by causing it to be binded even more with estrogens? Not even sure if this test is really that important but, it is high. Doctor wants to start with an AI to bring down my total estrogens which I dont think it will at all, pretty sure AIs dont impact total E.
DHEA looks to be on the low side but, wont supplement unless taking something to keep estrogen in check.
Estradiol Given my low free T and the Estradiol numbers its obvious that I am estrogen dominant. I think Estradiol could be even higher if my Free T was up, this is of concern to me. If any measures are taken to increase free T (HCG?) I will definitely be on a low dose (.5mg) per week of an AI. Doctor doesnt seem to think my Estradiol is high, I tried to tell him that given how low my T is once T goes up Estradiol will shoot up too. I know this is going to happen but, he doesnt think its a problem as long as T is up.
Glucose: Prior to any of the labs, I have either been in a fasting state or ate a very low carb lunch which would consist of meat and veggies only. With glucose over 90 on each test there appears to be some insulin resistance, perhaps this is stemming from the issues with my cortisol and thryoid function (overall metabolism issue). This may also explain the frequent urination.
Metagenics Wellness Essentials Multi-vitamin ED
Vitamin D3 10000iu ED
Flameout 9 pills ED
Curcumin 1 pill ED
Inflammase 1 pill ED
Green Tea Extract 1 pill ED
Wilsons Adrenal Stress Formula 2 pills ED
Dr. Lam Liponano COQ10 1TBL ED
Magnesium Glyciate 400mg ED
Zinc Picolate 30mg ED
Oregacillin 1 pill ED
Probiophage 1 pill ED
Pro em -1 1 tablespoon will increase to 3
Nopal Cactus 5g ED
Ashwagandha 1 pill ED
Herbal sleeping pill (valerian root, passion flower, etc.) 1 pill ED
I-Throid (iodine supp) 12.5 mg EOD
Selenium 200mcg ED
NOW TMG 2 tablets ED
*updated labs on 10/15/2014 to add LH and recent Iron level info
**The OP will be updated with all new labs