HRT - Beyond the Basics

Let me update this thread with new lab numbers. I had posted some stuff a while back about thyroid and iodine replenishment on the thyroid basics sticky, but I need to get everything up-to-date here.

I did try IR for about 20 days. Perhaps that was not long enough to see an increase in temps. I have continued taking 4 to 6 kelp capsules daily which contain 360 mcg iodine each. I also now get plenty of iodine in salt. I did buy Wilson’s book, read some, but have not finished it. Admittedly, I need to continue reading. I will have to read up on using progesterone.

My last set of labs in December show a decrease in DHEA sulfate. That was because I discontinued taking DHEA supplement until I knew what the pregnenolone would do. If I understand it correctly, some pregnenolone converts to DHEA and some goes to progesterone. I have since started taking 25 mg DHEA again since my number dropped.

Also, perhaps worth noting is that I am heterozygous for both the MTHFR 677 and 1298 gene. Supposedly, this can cause methylation problems which can interfere with B vitamin absorption and utilization, and optimal neurotransmitter production. Coupled with other genetic variations, it can also cause detox issues I think. I do take extra B vitamins, methylcobolamin and methyl folate. I believe the methyl folate is much better absorbed as folic acid can be problematic. I did also start taking Sam-e, a methyl donor. Not sure that any of these supplements have improved my mood or energy levels. Quality sleep on a regular basis might do more than anything.

Have looked these new posts over. The body temperatures are disappointing for you.

TSH was improved.

Any changes in vitality?
Progesterone is a short step away from cortisol.

Nice diagram! Vitality? Hmmm… I generally feel tired with brain fog. I tend to get a bit lazy in the colder months. Already a bit anxious about dusting off my bike because I know I’m not feeling my best and wondering how I will begin to work off the extra pounds. I don’t feel emotionally or physically strong, but rather unsure of myself and weak. Tired all the time. Not a good feeling.

Not sure if this is the kind of vitality you are asking about or not, but I do tend to achieve morning erections regularly now. This may have become more often after the pregnenolone or possibly when I upped my dosage of t cyp, or both. Wish the morning wood would continue on throughout the day, but that seems to go away rather fast. I do also take 5 mg tadalafil each night as a maintenance dose which may help with this a little.

If I wanted to try the over-the-counter progesterone cream, how would I use it? Morning or night? Once a day? How much? Should I add it to or replace the pregnenolone with it? I thought pregnenolone is reported to have some positive mental affects such as improving memory, possibly even providing some neuro-protection against oxidative stress, etc. I already have a terrible memory - always have. I think my anxiety gets in the way of normal brain function. You can’t remember anything when always under stress I think.

The more I think and read about it, the more I think stress and adrenal problems are the root cause of my problems. Not sure I have mentioned it before, but vision problems have become more and more pronounced for me. When driving at night, I think everyone has their high beams on. I can’t read any fine print anymore without reading glasses. It often feels like my eyelids are twitching constantly. I have got to get serious with more lifestyle changes. Trying to decide whether I would benefit more from increasing my pregnenolone dose or trying the progesterone cream. I want some relief from symptoms while I try to make changes in lifestyle. Overcoming the adrenal issues almost seems insurmountable. How does one overcome a lifetime of stress? It’s just so damn depressing.

tdsg, I really hope you can find the the cause of your problems.

I feel your pain, other than your ability to control E2, I am in exactly the same boat as you.

My anxiety and insomnia has gotten to the point that I am going to ask for some Ativan in the hope that I can at least get some temporary relief.

Hey Rednose! Not sure how old you are, but a lifetime of anxiety and stress apparently adds up. I have had stress all my life. Have been on my share of SSRIs over the years. They have helped in the past, but I keep thinking that messed up hormones are the root problem and if I can ever get those right, all will be good. Trying hard not to fall back into using them now. Kind of stinks paying out money for the T, HCG, anastrozole, labs, consults, etc. and still not feel well. Hope to solve this adrenal problem eventually. I have learned so much on this site. Do you know if your anxiety and insomnia are adrenal related? I usually don’t have much trouble going to sleep, but I can’t ever sleep long enough because I wake up too early and I’m always dead tired. The waking early seems to be at odds with adrenal issues. I have not figured that part out yet, but I still believe what I am going through is adrenal related. Decided I have to quit the coffee. Switching back to green tea tomorrow morning.

My anxiety and insomnia has gotten to the point that I am going to ask
for some Ativan in the hope that I can at least get some temporary
relief.

@Rednose : I had some pretty bad insomnia a few years back. Here’s some things that helped:

Shut out the lights an hour or two before bed.
Install cf.lumen on phone and f.lux on laptop to dim the screens at sunset.
Play music softly when I’m trying to go to sleep to block out my thoughts.

But what really helped was I stopped drinking alcohol. It was really messing with my sleep and the funny thing was that I thought I needed a beer to get to sleep. I had a few rough nights, but after a week, I sleep much better now.

Appreciate the tips. I have been looking at my sleep issues as needing to sleep longer by figuring out how to not wake up so early. Maybe I can try going to bed sooner, I don’t know. Yes, I know alcohol can cause sleep problems. Can’t seem to tolerate much alcohol now. Used to enjoy some beers but damn gluten issues ruined that for me.

If you need something to get you through for a while, melatonin works pretty good and it’s cheap. You might want to get a time-release one if waking early is your issue. Doesn’t make me hung-over the next day either.

edit: BTW, no caffiene past 2pm for me either. I still adhere to that… Not even a soda.

Thanks GTB, yes I have tried small doses of melatonin in the past.I think Sam-e may help your body make melatonin. Think I read that. I have to stop all the coffee. If I really do have stressed out adrenals, I guess the caffeine is not good at all.

I’m 47. I suspect adrenal problems are at least part of the problem. Went to Dr Wilsons site and took the quiz’s, the results were eye opening. Ordered his book.

I drink coffee like a fish drinks water, its a vicious cycle, I’ll be switching to decafe.

I also rarely have problems getting to sleep, in bed by 8:30 lucky if I make it to 2:30.

My thinking is that if TRT, Iodine replacement(some positive effect) and SSRI"s cant completely resolve this issue, then Dr Wilsons suggestions may be the finale key, certainly cant hurt to try.

The 18 - 24 month recovery period for adrenal fatigue seems daunting.

I’ll be following this thread closely and will contribute when I feel I have something relevant.

@Rednose

8:30 to 2:30 is 6 hours sleep. At your age 7 hours a night is pretty reasonable which puts you at 3:30am wakeup. Why are you in bed by 8:30?

Thanks brother, I don’t want to hijack tdsg"s thread to badly, but I have tried everything from amitriptyline to Xanax. Xanax brings the devil in me out, lol.

This June will be 14 years, without alcohol.

I have to wear earplugs to sleep and have for at least twenty years, the slightest noise and sleep is shot. Same with light.

Thanks for the suggestions.