Journey Towards a Better Me

So I need more T4 in my life?

I don’t think I was taking my temps after eating/drinking/etc. How long should one wait after a drink of water to take one’s temp? I’m going to take my temps for the next week for the endo. I’m going to take my temps upon waking up (usually around 11am), and then 3:00pm and 5:30pm just because the later time seemed to always have a higher reading for me.

I’ve stopped taking iodoral a while back, but have added in kelp flakes to season everything. Hoping the iodine in that will be good for iodine upkeep.

This actually brings up a good point. I’ve seen people talk about dhea-s but I’ve yet to figure out the diff between DHEA and DHEA-s. Will try to make sure the endo tests for it.

I decided to try DHEA in case I’m in the situation of high levels of cortisol, low levels of DHEA, where my body cannot make enough DHEA to balance cortisol. Obviously it would be better to test this first but I was getting impatient. I only took DHEA for like a week then realized I was being rash and should wait to get tested first. Will also make sure to get the D25 tested.

I have read the damage hormones sticky. I see stress being the main cause of my issues. I don’t think I’ve had head trauma, though I have suffered numerous injuries.

Regarding the injuries, to date I’ve been diagnosed with torn labrums in my hips and left shoulder, a torn trap, damaged ligaments where my first rib and clavicle meet the sternum, damaged subclavius, damage to pretty much all the muscles in my left back (QL, Levator, erectors, serratus, multifidus, supraspinatus, etc), torn right pectineus, some damage to the right rectus femoris. Thereâ??s also some damage to the tendon that starts out with the right adductor magnus and then connects with the abdominal rectus. â?¦Basically all of this happened from working out for years with undiagnosed injuries suffered during a practice session in high school wrestling. In addition to all that my right peroneus longus is acts up because I tore three ligaments in that ankle playing soccer. So yeah, kind of a mess. Thankfully I have successfully treated most of these with PRP, so it’s just really the torn trap, adductor/ab tendon, and ankle that’s left. Of course, that doc wants to wait until I get my test levels up before he treats me again.

All these injuries also makes me wonder if I’m a good candidate for hgh? I imagine raised test levels with raise GH levels but if hgh makes these PRP injections more effective then sign me up. Unless, of course, taking hgh would negatively affect my thyroid. I’m talking about legal use of hgh with a script I don’t want to even try to mess with the black market. I’ll try to get them to test my gh levels, if for no other reason then to satisfy my curiosity.

I’m very hopeful with this endo because his specialty is thyroid issues, followed by low testosterone. On paper seems like exactly what I need.

You keep coming up with statements that baffle me; about how what affects something else.

[quote]KSman wrote:
You keep coming up with statements that baffle me; about how what affects something else.[/quote]

Aw man I’m sorry, that’s really not my intent here. Expressing ideas through text has never been my strong point, so I really do apologize for being baffling. You’re referring to the multitude of injuries? My doc think it’s a symptom of having low t and working out. But they are injuries, and that is something that can cause thyroid problems.

So I figured I should mention that here. I’m just trying to mention anything and everything that could be a factor with my hormones. Does that make sense? They all seem related to me.

“The difference between DHEA and DHEAS is that DHEA has an extra sulfate molecule attached to it. DHEAS is a steroid androgen present in both men and women. Your body can convert DHEAS into DHEA with an enzyme called steroid sulfatase. Your body can also reverse this process and change DHEA back into DHEAS. Your body makes DHEA in the ovaries, testes and the adrenal glands.”

Hey KSman if you’re talking about my explanation for why I took DHEA my reference is Adrenal Gland - the gear box of the car (DHEA and cortisol) – underactive - DoctorMyhill

It talks about a stage of adrenal fatigue: “High levels of cortisol, low levels of DHEA. The body cannot make enough DHEA to balance cortisol. This is the first sign of adrenal exhaustion.”

At the time I figured that if this is what happened to be going on with me then perhaps some DHEA could help out. Didn’t think there was much of a downside. But like I said, I recognized I was acting rashly so I stopped.

…Never hesitate to ask how I came to a conclusion, always willing to show my work. Although showing my work was always a problem for me in my EE/Math Classes :confused:

[quote]Davinci.v2 wrote:
“The difference between DHEA and DHEAS is that DHEA has an extra sulfate molecule attached to it. DHEAS is a steroid androgen present in both men and women. Your body can convert DHEAS into DHEA with an enzyme called steroid sulfatase. Your body can also reverse this process and change DHEA back into DHEAS. Your body makes DHEA in the ovaries, testes and the adrenal glands.”[/quote]

Interesting. Why would you want to test for one over the other if they are practically interchangeable in the body? I assume the perform different roles in the body.

" But they are injuries, and that is something that can cause thyroid problems. "
I can’t respond to things like this because it sounds like nonsense, so I ignore.

DHEA levels are pulsatile and any one lab result does not mean much. DHEA-S levels are much more steady and more status representative than DHEA.

Well saw the endo, at first we had a bit of a rough exchange but at the end of the appointment I think we have a mutual respect. He was impressed with the thoroughness of my GP’s lab testing, with him testing my prolactin and whatnot eye roll. If only he knew how much arm twisting it took me to get my GP to order those tests.

When going over He didn’t believe me when I told him that I have never taken roids. It was a little frustrating. As a white male, I think this was the first time I’ve been negatively judged based on my looks. Kind of funny in that it was a compliment in some ways Flex, but super bothersome in that he didn’t trust me.

He says it’s odd that my LH/FSH levels are in the mid-low range when my test is also in the mid-low range (His definition of low range is anything under 200). So, like me, he wants to try to fix whatever’s going on with the HPTA axis that is causing the low LH and FSH. He does recognize that someone my age should have higher test levels, he just defines low range as being 100 below the bottom of the range, for whatever reason.

He is more interested in seeing how the pituitary is functioning than the thyroid, since it’s not sending out the LH and FSH hormones as expected. Been looking up stuff on hypopituitarism and based off of the symptoms it is a possibility. So the endo wanted to see stuff like my ACTH, GH, GF-1 levels and a couple of other things in addition to a couple of other hormones I’ve already had tested. Can’t remember all of the hormones, but will post the results when I get them. Based on these tests (and perhaps others) the next step may be to get an MRI, though he seemed to think that would be a remote possibility.

In Dr. Walsh’s article on here about adrenal fatigue he mentions that High cortisol can suppress pituitary function, so this in combination with the elevated rT3 points to cortisol at least being a factor*. I wasn’t able to convince this doc to test for cortisol by saliva test since he “doesn’t believe in unnecessary testing” but instead he wanted to test my cortisol via blood. Not happy about it but one step at a time. I’m hoping to build up some trust with this guy and then perhaps he will oblige me with some tests if we can’t figure it out doing it his way.

I told him that I want to start trying to have kids soon so I don’t want to be on trt. He said it’s very possible we won’t find out why there is low t and there’s really not much one can after that except get shots of test. When I asked about novadex or HCG he was like “time out” and was essentially like “look you need to be straight with me so I’m going to be straight with you. I’ve had a lot of big, bulky guys walk through that door looking to get drugs from me and that’s not how I work. You’re a big, bulky guy so I’m weary of your intentions here.” I pointed out that what I wanted most was to figure this out and fix my test levels without drugs, and that I was simply asking him a question about those treatments, not asking for those treatments. He still seemed unconvinced. I told him about how in law school they drill into us about when the client is untruthful it hurts both parties, so I understand where he’s coming from and am being absolutely truthful. That seemed to click with him so he nodded and was like “ok, good.”

Blood was drawn yesterday so hopefully I will have results to post soon.

*elevated Rt3 indicating either high or low cortisol comes from Reverse T3 (also called Reverse Triiodothyronine) - Stop The Thyroid Madness

[quote]KSman wrote:
" But they are injuries, and that is something that can cause thyroid problems. "
I can’t respond to things like this because it sounds like nonsense, so I ignore.

DHEA levels are pulsatile and any one lab result does not mean much. DHEA-S levels are much more steady and more status representative than DHEA.[/quote]

Huh. My turn to be baffled. On the Thyroid Basics sticky it is pointed out that injuries can raise rT3 levels. I thought elevated rT3 levels was a thyroid issue. Am I missing something? Is it a liver issue instead? This goes back to my question of if it is known weather once the injuries heal (for example, any torn trap gets fixed) does the rt3 level go back down to normal level, or do they stay elevated because it can’t self-correct?

The basis for the assertion that I have raised rT3 levels is that I have less than 20 times free T3 than rT3, and my free T3 score is in the higher side of the range. So the ratio isn’t off because I’m low in free T3, thus it must be because my rt3 is high. The 20:1 ratio guideline comes from that stop the thyroid madness website i linked to earlier. I apologize in advance if I’m not still not making sense. Trying to be as clear as I can be.

Cool to learn about the diff in DHEA and DHEA-S. Thank you, as always, for your work in this forum KSman.

See thyroid basics and ^F search for rT3, fatigue, Wilson

Stress causes increased T4–>rT3 which blocks fT3 and that slows down many things. So its more like the thyroid is a hit and run victim here.

Stress:
normal stress
injuries
surgeries
illnesses, acute or chronic
chronic inflammation
lack of sleep and overwork
crisis, job loss, death close to you, divorce, conflict
stimulants, ephedra, major caffeine use
starvation diets
over training
combining the above
blasting through things with sheer will power that would stop others like thyroid/adrenal problems

Have yet to meet the Endo about this, but my lab results are online now, so I thought to post them here:

Here’s the normal stuff, didn’t get really very much of what I wanted tested done, but hopefully as I build a rapport with this doc he will be open to doing more tests. I’m pleasantly surprised to see my free T is almost in the middle of the range. The total test is barely in range, and I worry the Endo will point to this and say “you’re fine, go away”, but we will see.

FSH 2.2 (1.6-8.0) mIU/mL IG
LH 2.0 (1.5-9.3) mIU/mL IG
T3, TOTAL 87 (76-181) ng/dL IG
T4, FREE 1.2 (0.8-1.8) ng/dL IG
TSH 0.80 (0.40-4.50) mIU/L IG
TESTOSTERONE, TOTAL, LC/MS/MS 257 (250-1100) ng/dL
FREE TESTOSTERONE 59.7 (35.0-155.0) pg/mL
IGF I, LC/MS 162 (53-331) ng/mL E

Here’s the metabolic panel, I’m really not too sure what to make of this, although the blood cortisol is within range. …I don’t know if I will be able to get a saliva test from this guy, may have to go to a diff doc to see, if that really becomes important.

metabolic panel:
GLUCOSE 84 (65-99) mg/dL
UREA NITROGEN (BUN) 18 (7-25) mg/dL
CREATININE 1.08 (0.60-1.35) mg/dL
eGFR NON-AFR. AMERICAN 88 (> OR = 60) mL/min/1.73m2
SODIUM 139 (135-146) mmol/L
POTASSIUM 4.1 (3.5-5.3) mmol/L
CHLORIDE 105 (98-110) mmol/L
CARBON DIOXIDE 22 (19-30) mmol/L
CALCIUM 9.4 (8.6-10.3) mg/dL
PROTEIN, TOTAL 7.0 (6.1-8.1) g/dL
ALBUMIN 4.5 (3.6-5.1) g/dL
GLOBULIN 2.5 (1.9-3.7) g/dL (calc)
ALBUMIN/GLOBULIN RATIO 1.8 (1.0-2.5) (calc)
BILIRUBIN, TOTAL 0.6 (0.2-1.2) mg/dL
ALKALINE PHOSPHATASE 68 (40-115) U/L
AST 25 (10-40) U/L
ALT 17 (9-46) U/L
CORTISOL, TOTAL 8.3 (3-22) mcg/dL

I seem to remember seeing the Endo checking the box to see how my ATCH levels are, part of his concern about my pituitary not working correctly. I don’t see that here in the results. Perhaps the results come online piecemeal? This new lab is Quest Diagnostics. I see the Endo next week.

well just met with the endo and the gist of what he told me was that everything seems pretty good, and that he can’t give me trt until I finish having kids since test shots will render me sterile. I asked about novadex and he said he doesn’t do that.

So I just called a guy that is recommended on here to make my first appointment. Because of the friends recommendation I thought the endo would be a good call but it seems to have been just a waste of time. On to the next one.

Get your full labs for the next doc!

tT3 is well below mid-range. Needed fT3

With natural guys, TT is normally the indicator. FT can be if consistently low.
Because FT is released in pulses, a single lab can catch a peak and be misleading.
So your “normal” FT is not definitive
This can be a difficult read if SHBG is very low.

CORTISOL, TOTAL 8.3 (3-22) mcg/dL
Was this done at 8AM? If so, that is way too low.
If not, try again.

[quote]KSman wrote:
Get your full labs for the next doc![/quote]

Believe me, I will try my hardest. Again. I feel like there should be a sticky on how to convince your doctor to get a full work up of labs. However, I am hoping this guy will work with me. I have hope because of the positive reviews of him on this forum. The only thing that makes me have some doubt is that all the reviews were for situations for full on trt with HCG and an AI. Still, from what I can tell this guy will be well worth the 45 min drive. I see him on Tuesday and am excited.

I will make sure to ask for this. …Does it matter at all that for the last test my fT3 was 3.6 for range [2.3-4.2]? Because it seems that’s on the higher end of the range. This is with a different lab, so I have no idea if one can compare the two, or if it’s helpful to compare two different labs.

[quote]With natural guys, TT is normally the indicator. FT can be if consistently low.
Because FT is released in pulses, a single lab can catch a peak and be misleading.
So your “normal” FT is not definitive
This can be a difficult read if SHBG is very low.[/quote]

Good to know. Ok so I guess we can ignore the FT since 1) I’m natty and 2) the two times SHBG was tested it was 23; 19 for range [17-66], near the bottom of the range. …I assume near the bottom of the range qualifies as “very low”.

[quote]CORTISOL, TOTAL 8.3 (3-22) mcg/dL
Was this done at 8AM? If so, that is way too low.
If not, try again.[/quote]

This was done at 9AM, I believe, maybe 9:30AM. Would an hour/90 minutes make much of a difference? I pointed this out to the endo, and also commented how this is bound and unbound cortisol, so shouldn’t it be a concern? Endo just rolled his eyes and said it’s fine. …He doesn’t like that I’m one of those “internet guys” (his words). Well doesn’t matter since I’m moving on.

Have to leave this post at that, but later I am going to try to post a summary of what we do know, what we need to know, and possible reasons for the low T. I want to go into this next dr’s office with everything written out, positing hypotheticals and everything.

Alright so here’s basically what I would like to present to the doctor. At risk of alienating him, I’d like to present my concerns and theories, but I’d like to run this by y’all first. Obviously KSman this is more pointed towards you but if anyone else wants to chime in feel free. Pretty much everything one here is based off of what I’ve read at http://www.stopthethyroidmadness.com/ I bought Wilson’s book but have since moved and have been unable to find it over the past couple of months.

I believe my cortisol levels/adrenals are the issue: elevated rT3 can be the result of cortisol problems, rT3 is high because it’s more than 1/20th of fT3. Also, the cortisol tested on 9/25 is pretty low, especially for 9AM. Think this has me thinking I’m subclinical hypothyroid (I believe this is the correct term). Other things that point to hypothyroid: My T4 is lower than midpoint and I also have low total T3.

Possible causes of messed up cortisol levels:

Took Adderall and provigil for like 5 years ending about 10 years ago (was used to treat Weinberg syndrome, have been able to cope without meds for about 10 years now.)
Stress of being in charge of money in family, also working out pushing through a plethora of until recently undiagnosed injuries.

So with the ongoing stress, my adrenals eventually started producing less cortisol (ask “adrenal fatigue” or “adrenal insufficiency”), dropping from high cortisol to a mix of high and low, then to all low. Not making enough cortisol led to thyroid hormones pooling a lot in my blood. So my body responded to this by converting the T4 to excess RT3.

This stress/meds affected my cortisol levels, which affected the thyroid, which then threw off my HPTA axis, which then lowered my test levels. This is because cortisol plays an important role for the thyroid. Namely, cortisol raises one’s cellular level of glucose which works with the cell receptors, ATP and mitochondria to receive T3 from the blood to the cells.

Additionally, dysfunctional adrenal/hpa axis can result in high amounts of thyroid hormones to build in the blood (which is called pooling), making free T3 labs look high in range with continuing hypo symptoms. This is why I have higher fT3 in the one lab that measured it, but everything else (lower T4, lower total T3) points to hypothyroid symptoms (I think).

Being hypothyroid would lower my test levels. Hypothyroidism affects the response of LH to GnRH. In other words, my hypothalamus is telling my pituitary to make LH to raise test levels, but the pituitary isn’t playing along. This would explain my lowish LH despite the fact that I have low test (if the pituitary is operating correctly it should respond to low test by producing higher levels of LH/FSH).

This is all just conjecture (for example, an iron problem could be an issue here as well), but the only way to really prove this one way or the other is to get the tests done that I’m requesting.

Speaking of tests, here are the hormones I want to get tested:

Total Testosterone
Free Testosterone
LH/FSH
E2
SHBG
prolactin
Cortisol (saliva test)
B-12
Folate
Free T3
Free T4
Reverse T3
TSH
Serum Iron
Ferritin
% Saturation
TIBC
Vitamin D25
DHEA-S
Magnesium
Potassium
Calcium
Sodium
Glusose
Growth Hormone
IGF-1

Testing GH, growth hormone, has little value because its released in pulses, varying by time of day, and with very short half-life in serum. So skip that, IFG-1 is the better measure of GH status.

Cortisol needs to be AM cortisol and you need to get the timing right, which means that its not done at the time of your office visit.

[quote]KSman wrote:
Testing GH, growth hormone, has little value because its released in pulses, varying by time of day, and with very short half-life in serum. So skip that, IFG-1 is the better measure of GH status.

Cortisol needs to be AM cortisol and you need to get the timing right, which means that its not done at the time of your office visit.

[/quote]

Got it, will do.

Just met with this new and third doc. He just glanced at my previous labs and offered trt with HCG. I told him I’d like to start with Novadex and he said he’s more familiar and comfortable with clomid + AI, so that’s what he wrote up. He sent the script directly to the pharmacy so I’m not sure about the dosages, but he did want me to start with clomid ED and then after two weeks I think switch to E2D. I think it was half a tab. I asked if I do present sides could we switch to novadex and he said yes.

This guy was super easy to work with. Even after writing up the script I asked if we could do labs and he said yes. When I presented him with the list he said “Boy you’re one of those type A personalities aren’t you?” and then proceeded to write up the lab order for everything. He didn’t question anything, he just did it. It was amazing. He commented “Man, the lab girl is really not going to like me when she sees this.” So tomorrow morning I’m going to Labcore and get my blood drawn. Plan is to get there at 7:45 so by the time the draw my blood it will be 8am. If there’s a wait or something to slow down the process I will just leave and get it done the next day.

The pharmacy is having issues with filling out the script, so I may end up getting the clomid in a day or two. I’m fine with that because honestly I’d like to see the labs first. I really want to try to figure out what is going on.

Ok here are the complete labs:

CBC/Diff Ambiguous Default
WBC 5.1 x10E3/uL for range 3.4 - 10.8
RBC 4.66 x10E6/uL for range 4.14 - 5.80
Hemoglobin 14.0 g/dL for range 12.6 - 17.7
Hematocrit 41.5 % for range 37.5 - 51.0
MCV 89 fL for range 79 - 97
MCH 30.0 pg for range 26.6 - 33.0
MCHC 33.7 g/dL for range 31.5 - 35.7
RDW 13.1 % for range 12.3 - 15.4
Platelets 220 x10E3/uL for range 150 - 379
Neutrophils 53
Lymphs 38
Monocytes 6
Eos 3
Basos 0
Neutrophils (Absolute) 2.7 x10E3/uL for range 1.4 - 7.0
Lymphs (Absolute) 1.9 x10E3/uL for range 0.7 - 3.1
Monocytes(Absolute) 0.3 x10E3/uL for range 0.1 - 0.9
Eos (Absolute) 0.1 x10E3/uL for range 0.0 - 0.4
Baso (Absolute) 0.0 x10E3/uL for range 0.0 - 0.2
Immature Granulocytes 0
Immature Grans (Abs) 0.0 x10E3/uL for range 0.0 - 0.1

Comp. Metabolic Panel (14)
Glucose, Serum 86 mg/dL for range 65 - 99
BUN 11 mg/dL for range 6 - 20
Creatinine, Serum 0.96 mg/dL for range 0.76 - 1.27
eGFR If NonAfricn Am 102 mL/min/1.73 for range >59
eGFR If Africn Am 118 mL/min/1.73 for range >59
BUN/Creatinine Ratio 11 for range 8 - 19
Sodium, Serum 141 mmol/L for range 134 - 144
Potassium, Serum 4.1 mmol/L for range 3.5 - 5.2
Chloride, Serum 101 mmol/L for range 97 - 108 01
Carbon Dioxide, Total 24 mmol/L for range 18 - 29 01
Calcium, Serum 9.3 mg/dL for range 8.7 - 10.2 01
Protein, Total, Serum 6.9 g/dL for range 6.0 - 8.5 01
Albumin, Serum 4.6 g/dL for range 3.5 - 5.5 01
Globulin, Total 2.3 g/dL for range 1.5 - 4.5
A/G Ratio 2.0 for range 1.1 - 2.5
Bilirubin, Total 0.4 mg/dL for range 0.0 - 1.2
Alkaline Phosphatase, S 74 IU/L for range 39 - 117
AST (SGOT) 25 IU/L for range 0 - 40
ALT (SGPT) 14 IU/L for range 0 - 44

Iron and TIBC
Iron Bind.Cap.(TIBC) 315 ug/dL for range 250 - 450
UIBC 230 ug/dL for range 150 - 375 01
Iron, Serum 85 ug/dL for range 40 - 155 01
Iron Saturation 27 % for range 15 - 55

Testosterone, Serum 303 ng/dL for range 348 - 1197
Free Testosterone(Direct) 6.9 for range pg/mL 8.7 - 25.1

Vitamin B12 428 pg/mL for range 211 - 946
Folate, Serum 8.9 ng/mL for range >3.0

DHEA-Sulfate 120.9 ug/dL for range 102.6 - 416.3
TSH 1.500 uIU/mL for range 0.450 - 4.500
LH 2.3 mIU/mL for range 1.7 - 8.6
FSH 2.3 mIU/mL for range 1.5 - 12.4
Estradiol 46.4 pg/mL for range 7.6 - 42.6 <----Perhaps this is why I cry at weddings?
Roche ECLIA methodology
Insulin-Like Growth Factor I 191 ng/mL for range 88 - 246
Reverse T3, Serum 16.8 ng/dL for range 9.2 - 24.1
Vitamin D, 25-Hydroxy 34.1 ng/mL for range 30.0 - 100.0
Thyroxine (T4) 8.8 ug/dL for range 4.5 - 12.0
Magnesium, Serum 1.9 mg/dL for range 1.6 - 2.6
Ferritin, Serum 82 ng/mL for range 30 - 400
Triiodothyronine,Free,Serum 3.5 pg/mL for range 2.0 - 4.4
SHBG, Serum 18.5 nmol/L for range 16.5 - 55.9

EDIT. Cortisol values:

#1 Salivary Cortisol (8am) 0.416 ug/dL for range [0.025 - 0.600]
#2 Salivary Cortisol (Noon) 0.104 ug/dL for range [<0.010 - 0.330]
#3 Salivary Cortisol (4pm) 0.120 ug/dL for range [0.010 - 0.200]
#4 Salivary Cortisol (11:25pm) 0.054 ug/dL for range [<0.010 - 0.090]

I have no idea if the reference ranges are legit or not. I just got my clomid/adex. KSman would it be wise to hold off on clomid+AI until I figure out what’s going on with my adrenals/thyroid? Is there something wrong with my thyroid or adrenals? I’ve been reading so much online that I’ve talked myself into circles. Need to just calm down and form a plan now that I have a full lab set.

Edit: Over the past week or so my balls have started to ache some. Have no idea what could have changed.

Hematocrit is low. But can be from low T.
Iron, ferritin is marginal. Do you eat red meat?
Alternative explanation could be occult blood loss. - digestive issues?

Total proteins could be better, but explained by low T.

fT3=3.5 is good
TSH=1.5 is a bit high
T4 good, fT4 unknown
rT3 is interesting
What are your body temps doing now?

Cortisol seems OK, nothing low. Maybe lower energy mid-day.

IGF-1 is OK, but would expect higher for a young guy.

T is very low because LH/FSH are low.
High E2 does not make sense at all. But E2 may be shutting you down.
You could lower E2 with low dose anastrozole.
Suspect that liver is not clearing E2.
But AST/ALT do not suggest a problem there.
We then consider if any drugs might be interfering with clearance.
Bad gut flora can recycle metabolites of E2 in liver bile back into active E2 and good probiotic for a month might show some effect if that was the problem. - what digestive issues?

Take 5,000iu vit-D3 per day.
Take 25mg DHEA per day with a meal that has more oils/fats and not high fiber.
Are you taking fish oil? take same way

we covered cholesterol earlier?

If E2 was not high you would be needing TRT.
With high E2 we don’t know if something could be fixed.
In any case, your low T, very low FT and high E2 really is very unusual and is probably a major factor in your condition.

I did not review this thread from top to bottom, so point out things that you thing need to be put in front of me.

Aching balls can be from low LH/FSH.
Did you have a doc examine the boys before?
A hCG trial would show if that makes the ache go away or not.

[quote]KSman wrote:
Iron, ferritin is marginal. Do you eat red meat?[/quote]

Yes. A lot of it , actually. A while back I used to have liver and onions once a week, think I should start doing that again?

[quote]
Alternative explanation could be occult blood loss. - digestive issues?[/quote]

I donâ??t think I have any digestive issues. What do I need to be looking for? It’s possible there are signs and I just haven’t noticed them. Occasionally I will have a loose stool, like once or twice a week maybe? So far have not been able to pin down the source. Should I try and get tested for occult blood loss?

[quote]
fT3=3.5 is good
TSH=1.5 is a bit high
T4 good, fT4 unknown
rT3 is interesting
What are your body temps doing now? [/quote]

Not sure about body temps nowadays, will check and post results

[quote]
T is very low because LH/FSH are low.
High E2 does not make sense at all. But E2 may be shutting you down.
You could lower E2 with low dose anastrozole.
Suspect that liver is not clearing E2.
But AST/ALT do not suggest a problem there.
We then consider if any drugs might be interfering with clearance.
Bad gut flora can recycle metabolites of E2 in liver bile back into active E2 and good probiotic for a month might show some effect if that was the problem. - what digestive issues? [/quote]

I normally have some type of fermented food/drink with lunch or dinner. Like kambucha or sauerkraut. I donâ??t think I have any other digestive issue other than the occasional loose stool.

[quote]
Take 5,000iu vit-D3 per day.
Take 25mg DHEA per day with a meal that has more oils/fats and not high fiber.
Are you taking fish oil? take same way [/quote]

Alright will do. Yeah currently taking 2400 mg of fish oil a day. Also been taking 2000 IU of d3 a day, but perhaps the D3 has gone bad? I imagine it has been stored in some hot places at one point or another during my moves. Will buy a new bottle and try that out. Will start taking the DHEA.

[quote]
we covered cholesterol earlier?[/quote]

No we have not discussed cholesterol. But in September a few months ago this was my lipid panel:
Cholesterol 188 for range < 200
Triglycerides 66 for range <150
HDL 49 for range >39
Calculated LDL 126 for range <100
Risk Ratio LDL/HDL 2.57 for range < 3.55ratio

^Does this shed any additional light as to what is going on?

[quote]
If E2 was not high you would be needing TRT.
With high E2 we don’t know if something could be fixed.
In any case, your low T, very low FT and high E2 really is very unusual and is probably a major factor in your condition.[/quote]

Is it possible that the lapcorpâ??s Roche ECLIA methodology isnâ??t very accurate for men? Like my E2 might not actually be that high? Iâ??ve been reading some threads on here where it is said Labcorp estro tests arenâ??t that accurate, though it seems to be inaccurate in saying estrogen is too low not too high like in my case. Should I try testing again with the sensitive assay? That all being said, I was being honest when I say I cry at weddings. I have to say that all my life I’ve been fairly easy to bring to tears. So yeah, it wouldn’t surprise me if my emotionalness was based on having high estrogen. Perhaps my body is just set up to have high levels of E2? Whatever is the case I’d like to experience having lower levels, see how I respond.

only thing I can think of that may be of importance is my previous free T4 results. Free T4 wasnâ??t tested with this last test, but in prior testing it has been:

2/11/15: 1.17 for range [.73-1.95]
4/8/15: 1.12 for range [.73-1.95]
10/8/15: 1.2 (0.8-1.8) ng/dL <–diff lab than the first two

Three diff docs have examined them, and they feel fine. Have also had an ultrasound and that revealed nothing.

A hCG trial would show if that makes the ache go away or not.

Would it be a good idea to ask my trt doc if I could try doing HCG injections before going on clomid? This would be following your protocol laid out in the HPTA restart thread. Iâ??m pretty sure I could just call the guy and have him write the script over the phone.

So plan of action:

Take supplements that you mentioned
Try HCG before getting on clomid/AI?
Test for occult bleeding?
Get body temps for the week.
Is there anything else to test to see if liver is clearing E2?
Maybe find a good probiotic supplement?

Perhaps I should just try some AI before doing hcg? I have no idea what amount to start at. I imagine a very low dose? Not sure about the math with converting the pill to vodka and drops but I will try. I’ve read the thread where you helped a guy with the math and will try to figure it out. …To be honest sometimes I think my brain fog/lack of focus is the worst symptom I’m experiencing.