T Nation

High T, FSH, SHBG, Low E2 No Libido. My Lab Results (pellets)

#197

Hell of a write up. Keep us posted.

#198

I received the final results to day for Vitamin B6 (also requested by Asian doctor).

As you see, I am between 6-7 times higher than the top of the scale.

My multi vitamin has 30mg B-6, and my Adrenal Support supplement has 10mg. I would not have imagined that I could be so far out of range … I am NOT taking any other Vit B supplements.

From a web site:

If your level is high, however, unless you are taking high doses of B6, then it usually means that you are actually DEFICIENT in Vitamin B6, as you’ll see below. For most people, it’s safe to take as much as 200-500 mg per day, and toxicity almost never occurs at levels lower than 1000 mg per day. Ironically, high B6 levels in blood will decrease and return to NORMAL when sufficient amounts of P5P are taken to remedy the deficiency.

What??? Over 18 months ago, I was taking 50mg of P5P daily (the active ingredient/enzyme of Vit b6 that is easier for the body to process) but stopped as I felt it was doing nothing.

Here comes a doctor’s visit …

#199

Any out-of-whack results make me start reading.

  1. My Estrogen and SHBG levels
    In most people, Estrogen and SHBG rise and fall together. In my case, they did not. My E was very low and my SHBG was very high – which completely confused the doctors.

Is it possible that my body is changing, and my higher E is translating to higher SHBG?

  1. My high DHEA
    I found patient reports that correlated higher than normal DHEA levels “converting” to E2, making E2 also rise higher. And high DHEA levels added to weight gain.

I can’t claim to have any side effects of high DHEA; but the possibility that my weight gain and my increase in E2 might be tied to it, makes me consider dropping the supplement for a while until I perform the next blood tests.

When I look back at my saliva hormone test, my DHEA-S was considered LOW, not high, which adds more confusion.

My urine test showed me 20 times higher than top of scale. Go figure.

  1. HDL C
    If you are bored enough to have been keeping up, you will remember that I had multiple blood tests where my HDL-C was low. Today I found a study where DANAZOL is known to reduce HDL-C.

I thought it might be due to my high Vit D levels (which I believe explained the out of balance Alkaline Phosphatase levels). But further reading tells me this might be a regular result on my tests as long as I take Danazol.

But, as I said in the last post, a doctor’s visit is necessary in hopes of clarifying some of these issues. I intend to stop DHEA for now.

I still feel good … with regular morning wood. I do not have unlimited energy (mental or physical) nor do I have the desire to lift any cars for fun. Compared to a year ago, I’m doing great. Hopefully tweaking the supplements will continue to make me improve.

#200

@traveling man, you may find this interesting:

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Low E2 All Parts of Cycle (Pellets)
#201

I think you are in wrong place chasing down all those numbers and trying to find one magic pill.
You should consider cheking yourself for something much more major like metabolic syndrome, prediabetis/type2 diabetis, and insulin resistance. Its not easy to find out just by cheking fasting bloog glucose.
Hemaglobin a1c, oral glucose tolerance test should be made.

#202

Thank you for your comment. I would love to find ONE pill … but anyone who has read my thread on the supplements I take would know that isn’t the case. LOL

metabolic syndrome
According to the NCEP ATP III definition, metabolic syndrome is present if three or more of the following five criteria are met: waist circumference over 40 inches (men) or 35 inches (women), blood pressure over 130/85 mmHg, fasting triglyceride (TG) level over 150 mg/dl, fasting high-density lipoprotein (HDL) cholesterol level less than 40 mg/dl (men) or 50 mg/dl (women) and fasting blood sugar over 100 mg/dl.
-waist 31
-no increased blood pressure, consistently normal/low (105/68)
-do not have high blood sugar; tested dozens of times
-Triglycerides in normal range
-ONLY HDL went below 40 for 2 blood cycles; which is explainable by supplements; and returned to normal when supplements stopped.

Prediabetes
-glucose has been from 75-90 for the past six years (that I checked).

  • Prediabetes is defined as a fasting blood glucose of 100 mg/dl to 125 mg/dl followed by a blood glucose of 140 mg/dl to 199 mg/dl at two hours, checked on more than one occasion.

Type 2 diabetes
-A1C (aka HbA1C) tested two separate occasions and both normal.
Doctors confirm no risk of diabetes visible.

  • Diabetes is defined as a fasting blood glucose of 126 mg/dl to higher followed by a blood glucose of 200 mg/dl or higher at two hours.

Insulin resistance
-glucose levels always under 100.
I have not taken the sugary drink insulin resistance test, although I did take the intestinal permeability test (lactulose).

#203

Blood Work 1-16-19 …

Prior to this blood work, I increased dim to 2 per day; continued to reduce vitamin d from 4000 to 2000/day; eliminated dhea completely.


Estradiol increased slightly. This is one of the strangest parts of monitoring my hormones. For years during my issues, my Estradiol was SUPER LOW. Now it is higher (borderline HIGH) and I’m feeling better.


Hematocrit rose again! I caught a virus during this time which I am GUESSING is why my RBC was high trying to fight what I had.

I still plan to test HCT in the afternoon - but I want to control the experiment and have it tested in the morning and the afternoon of the same day by the same lab. Coming soon.


I am still surprised that my Alkaline Phosphatase, LDL/HDL are all back to normal after I eliminated the ultra high dose of Vitamin D. I am back in the US now, which means I will need slightly more Vitamin D than when I was in Asia, but I will stay away from the intense dose I was taking.


Testosterone is 1473. My free T percentage is not as high as my goal and that was disappointing – only 2.4%.


SHBG decreased slightly to 37.38. I am on danazol every day but for the past 90 days, I have been on 100mg per day in one capsule. I am back in the USA on my 50mg x 2 per day and am interested to see if there is a difference in test results based on a most constant amount of the steroid in my body. This is NOT the lowest I have been as I went down to 27.3 one time.

I am a sucker for punishment, so I have decided to see how long I can go before my next insertion since I have not interrupted the Danazol in months. The last time I tried this, I was on and off Danazol and I felt like total shit as I hit month four. But my T insertion dose was lower as well.

I would like to see if I could make it at least five months before needing the insertion. I will never know until I try - and the higher starting dose might make it possible … although I am not confident I can make it past the fourth month. I am at the end of my third month right now.

Hematocrit: How High is Life Threatening?
#204

Excellent.

Fill me in on the dropping the bit D dose to affect Alk. phos, LDL/HDL. What is the correlation here?

#205

In my Oct 18 post, I started looking for corollaries between Low Alkaline Phosphatase and ANYTHING that I might be doing to cause this change. I found one reference which tied it to excess vitamin D; but the poster also gave a dozen other possible reasons.

My Asian doctor wanted me off the Vit D. She felt my numbers were too high (borderline toxic), and was likely throwing other numbers out of balance. I took her advice and my results returned to normal.

In December, I found a study linking Danazol to a reduction of HDL-C; For me, it appears at this time that Danazol wasn’t my issue - but increased Vit D (and possibly increased DHEA-S) was. My American doctor also agreed “He was surprised to see HDL go low, but agreed with my research that Testosterone and Steroids can artificially lower this number, when none of the other reasons fit.”

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#206

I mentioned before that I wanted to take a Hematocrit test twice in a day; once in the morning after fasting; and once in the evening. I had those tests yesterday but have not received the results yet.

I also added a “Lactate dehydrogenase (LDH)” test. I had read that this might be a good test to show whether there is any overall “cell damage” (tissue damage) in my system (liver specifically).

Lactate dehydrogenase (LDH) is an enzyme that helps the process of turning sugar into energy for your cells to use. When illness or injury damages your cells, LDH may be released into the bloodstream, causing the level of LDH in your blood to rise. High levels of LDH in the blood point to acute or chronic cell damage.

Low levels of LDH affect how the body breaks down sugar for energy, particularly in muscle cells. It is very uncommon for an individual to have low LDH levels or a lactate dehydrogenase deficiency.

To detect high levels of lactate in the blood , which may be an indication of lack of oxygen (hypoxia) or the presence of other conditions that cause excess production or insufficient clearing of lactate from the blood

BTW, I used “Ulta Wellness” labs this time because they were running a special of $12.95 for a CBC test.

In reading about the results, “119” is considered normal, even though it is at the lower end of the spectrum. Below 80 is where evidence of damage is shown. “Normal” ranges across the internet are from 100-333.

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#207

god I love bargains

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#208

Holy shit there is one in my town!

Edit: Oh I see now…you can order the tests and get it done at Quest. Perfect.
E2 + Total T + Free T = $69 Yes please!

#209

I now have the tests, separated by 8 hours and proved my theory WRONG. I theorized that my HCT was high in the morning because I had not consumed water in 10 hours which fit the theory that others had – that I was dehydrated.

Now with an afternoon test where I was fully hydrated, I know that isn’t the case. Although it eliminates one diagnosis, it creates more concern.

I charted my hematocrit back to Oct 2013 (which is the oldest results I previously scanned). Prior to TRT, my HCT averaged 44.3%, with highs of 47.8 and 49.3. My post TRT average is 51.9%.

My Hemoglobin has also shown a slow rise as well.

I found an interesting study …

Optimum values in an adult male are: Hemoglobin 14–18 gm/dL and hematocrit 40.0% to 54.0% Source and Source

Hematocrit: How High is Life Threatening?
Aspirin Before CBC Test to Affect Hematocrit?
EPO (Erythropoietin) Tests? High Hematocrit
#210

That’s cheap. Discounted labs was about 80 for these three.

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#211

It looks fine maybe with normal T levels that’s where you are supposed to be? If those other hcg tests were done with lower T then it makes sense why there so low.

#212

I posted a huge dump of reading material and current evaluations of the story on HCT/HGB increases for those who are supplementing with Testosterone on a different thread.

I want to post my current HCT history here so that I have it with the records of my journey.

Totally New Here, Need Help
My TRT Journey Starts Now
#213

Three weeks ago, I returned to the USA and began having sleep problems again. It has been months since I have experienced any insomnia before this. I assumed it was because of traveling and began taking melatonin again thinking my circadium rhythm was off.

One week ago I noticed night-time itching of my face and scalp. I don’t know the relationship or whether it is a coincidence or not, but it does make me wonder. Night pruritis (itching) is one of the symptoms of Polycythemia Vera (along with High Hematocrit).

I was already planning an Erythropoietin test to rule out PV, but now I will need to rush that test along. It is frustrating because I am not anemic, and all of my iron levels have been acceptable.

I’m in my 4th month of pellets. Usually by now, I would have had a re-insertion, but am trying to see how far I can go (5months? 6months) now that I have my SHBG under control.

#214

I want to comment about my USA doctor. I approached him in the beginning, brought years of blood work, and told him up-front that I was going to be a problem patient. My hormones were out-of-whack and defied common “rules” for hormones. I asked him if he wanted my case or should I “move on”.

Obviously, he wanted me to stay but admitted that he didn’t have much experience with PROBLEM CASES such as mine. He has worked with me on modifications and medicines (and RESEARCH that I did not pay for) to get me balanced. He provided me with his email address and allowed me to send him labs when I was out of the country. He reviewed and commented via email at no charge. I told him I would pay for email consults; he declined. He is also a pellet user - and has been for years.

Doctors who prescribe pellets aren’t all trying to drain your bank account or convince you to accept a treatment that you are not happy with. I’m sure there are bad pellet doctors; but read any of the threads on this board and you will see a HUGE percentage of TRT doctors that do not know what they are doing.

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My TRT Journey Starts Now
#215

Good bad everywhere.

#216

I was worried that the onset of night itching COMBINED WITH my high HCT might be pointing me toward a different problem (polycythemia vera).

Blood work is back and I can put that worry to rest.

The test that I was concerned with was Erythropoietin. My results came back within range which is what I was hoping for.

My reading material:

Patients with polycythemia vera have extremely elevated hemoglobin or hematocrit and decreased serum erythropoietin level.

Secondary polycythemia is associated with disorders that cause tissue hypoxia such as living at high altitude, chronic obstructive pulmonary disease, cyanotic heart disease, sleep apnea, high affinity hemoglobinopathy, smoking, or localized renal hypoxia. In secondary polycythemia, EPO production is increased in an attempt to increase oxygen delivery to tissues by increasing the number of oxygen carrying red blood cells. Patients with secondary polycythemia have elevated hemoglobin or hematocrit and higher than normal serum EPO level.

I also tested iron and Ferritin to further eliminate any type of anemia (which shouldn’t have been possible with my high Hemoglobin); but also to verify that they were within range.

I found it interesting that my Ferritin was on the low end of the scale; and the Iron was on the high end of the scale.

From my reading:

A lower -than- normal ferritin level can indicate that you have an iron deficiency ; rephrased “low level of ferritin usually indicates a low level of stored iron.”

I also found a study where a doctor indicated that anything below 75 should be considered “iron deficiency” even though that isn’t what the reference ranges show. I find that hard to believe - but as I wrote previously, I have been having sleep issues again … and then I see this: “Low ferritin is known to cause sleep disorders, most notably Restless Leg Syndrome.” Another report also agreed that anything under 50 is considered “borderline” iron deficient. This is something I would have never considered.

And finally, my HCT was 51.3 (down slightly) and HGB was 17.2, also down slightly.

I’m looking at my multi-vitamin to see if I am taking iron supplementation or not.

“You need iron in your body to maintain a healthy red blood cell count and to produce hemoglobin.” … hmmmmm. I got both of those beat.