T Nation

Low T But Very High DHEA


#1

Just got some bloodwork back from the doctor. Testosterone levels are at 188 ng/dL, but DHEA Sulfate is way high at 622.0 mcg/dL. I am a 24 year old male. Doc said he isnt sure what is going on and will be doing more research. Any ideas?


#2

odd. Could be compensation for low T.

Could be jacked up adrenal output. My DHEA was high when cortisol was really low.

Could be a jammed up pathway. DHEA is converted to Test through androstendione/diol. DHEA to Androstendione via 3b-HSD enzyme and through 17b-HSD for diol. Each used the opposite enzyme to convert to Test. Would be interesting to see what androstendione and androstendiol levels are. You could check liver values to see if there issues there.


#3


show this to your doc. Ask him to look for liver issues. If nothing there might want to test for the other hormones in the chain. I'd also ask for a cortisol test.


#4

Yes, doctor is looking into it. He even admitted he needed to do more research. Funny thing is that I have never felt like I had low T. I never had sexual dysfunction or was a hard gainer (always could get it up and go, never had problems packing on mass). In fact I have a very broad stalky build.

He tested 24 things and with this my iron was very low, my sugar was kind of high and my cortisol was elevated too. If my hemoglobin was abnormal he would have diagnosed me with anemia, but it was fine. So was my thyroid. My blood pressure has been high and I was also diagnosed with skipped beats earlier this year. Ive had debilitating depression and irritability too. I bet it is all related.


#5

Actually, my doc showed me that pic!


#6

Did you ALT and AST testing? Liver issues can be problematic for enzymes in general, I'm not sure about these in particular.

You should take care of the iron, blood sugar and cortisol issues and retest. Chronically elevated cortisol can certainly lower T. I beleive that's how it's supposed to work. Cortisol absolutely effects glucose metabolism as well. Cleaning up your diet and and an adaptogen would be my first step.

http://www.T-Nation.com/free_online_article/sports_body_training_performance_nutrition/the_truth_about_adrenal_fatigue

I post this link all the time because it has some good suggestions for both low and high cortisol.

http://www.lef.org/protocols/?fc=2

This link has a ton of good info on lots of different subjects.


#7

Please read the advice for new guys sticky and also note the first paragraph.


#8

Sorry!
Let me elaborate.

I did not get this blood test with the expectation that I had low testosterone, if anything I thought it would have been high for the following reasons:
*I am an aggressive guy - too aggressive for my comfort
*I am mentally never tired despite how I feel physically. This has made it hard for me to "settle down" before I go to sleep
*Very high libido - when I have a gf I am always "ready to go". Any time, any place. Having sex ?just once? is not enough for me in a sitting. I also shake hands with the broker at least once a day. Been doing that since I was...8. I feel like I need to stop.
*Easy time packing on mass - I have large legs and a really large chest naturally. I can neglect squats or bench for weeks at a time and still have bigger legs (24? now) and chest than your average joe. My arms and shoulders are puny though. My traps are also really well developed for doing jack shit for them.

I was concerned about:
*chronic depression. I am going through quite a bit, will explain more below, but it has been debilitating lately
*chronic fatigue. I always feel physically tired and I never feel like I get a good nights sleep.
*Poor sleep patterns - I never feel like I can sleep a full 8 hours comfortably, but I feel like I can sleep in bursts (4-6 hours 3 times throughout the day) and do better overall. Terrible time waking up in the morning too. On the weekends I sleep 10-12 hours, during the week day I typically get 4-5. I feel like I need to nap when I get home from work. I used to do this, but it only makes things worse. Been trying to meditate instead but some days I am just so damn tired that I crash on my couch.
*gained a metric fuck ton of weight in a really short time, will elaborate below
*stretch marks - I look like a mutant from them. The slightest gain in weight or muscle causes them.
*Cravings - lately for sweet, salty and fatty foods (IE McDonalds)
*short term memory problems - I am a pretty smart guy, but I cant remember a damn thing. My long term memory is sharp, but feel like I am always running at 50% at best.
*poor progress in the weightroom - lately Ive been having so much trouble being organized that I haven?t made much progress since august.
*testicular pain - it subsided when I took an antibiotic.
*very disorganized - I have trouble sticking to routines (cleaning my kitchen or room is harder for me than vector calculus), though I can see the ?big picture? real easily and figure out what needs to be done.
*I repeated disorganized unintentionally...see what I mean?

The backstory:
I graduated from engineering school in May of 2012 and had planned to go to graduate school in the fall. When I got down there though, I was completely dysfunctional. While my problems started months prior, I had no ability to organize my time, I was severely depressed and angry. Quite frankly, I did not give a rats ass about any of the work I was doing. It all felt ?empty? or ?pointless? the depression was debilitating. I passed up a great opportunity to do research on supersonic turbulence and started the journey towards ruining my life.

With that said, I was in great shape - about 190lbs, 32-33? waist at 5?9?, just finished a beginner linear progression program with a deadlift at 315lbs and a squat around 260lbs. This might seem like a high weight, but I have a heavy frame. I had to starve myself to get to 185 (2000kcals a day and weight lifting).

I tried going back again next fall, but still couldn?t focus. I ended up panicking 2 months into the semester. I am not sure what happened, but I couldn?t focus on my work. I took a leave of absence from the program and starting seeing psychiatrists and psychologists. After this point is when I went down hill fast. I will spare you the details, but I was prescribed over the course of 1 year (in various combinations and dosages):

Seroquel (up to 150mg), Lithium (up to 1800mg), Lamictal (up to 200mg - doc tried 400 but I told him to piss off and walked out of his office), Zoloft (up to 25mg), Depakote (dont remember), Saphris (10 mg sublingually, this was potent shit), risperidone (up to 1.5 milligrams), probably missing something

After about 1.5 years, this is a summary of the side effects Ive had at one point in time or another
Gained 60lbs that I never lost

Slept 14 hours a night
Akathisia - this was god damn terrible. I felt like I was going to have a seizure or ?freeze up? until I passed out, literally.
Muscle twitching
?black outs? where my eyes would flutter and I would lose my vision for a fraction of second
Loss of fine motor control
Sensations of stiffness in my tongue and cheeks
Difficulty speaking
Loss of ?sharpness? - this is hard to explain, but I felt like I lost the intelligence that made me ?me?. I had to think harder on my school work. I lost creativity
Histamine sensitivity - if I drank beer, I felt really weird. Not drunk, but I got those feelings in my face and felt like I couldn?t speak and coordinate my tongue. I normally like to dance when I go out. The last time I went (a few months go in the summer) and had a beer I felt like I couldn?t coordinate anything. I was not drunk at all, as I only had two beers, nor did I feel drunk. This sounds funny but it really isn?t.
Heart PVCs - this started developing recently but doctors are concerned. I skip every 10 beats or so, sometimes feel a ?heavy? feeling in my chest or a pounding. Does not bother me when I exercise. It is usually mid-day or at night.
High blood sugar - not diabetic, yet.
High blood pressure - my BP has always been high, but it is at the point now where I need medication for it. I am taking an ACE inhibitor

After one year I decided it was time to ditch the doctors. I went cold turkey of everything at the end of January of 2014.I tapered off that one (Seroquel) for a few months, but stayed on a very low dose of 25mg to help me fall asleep. The messed up part was that none of these medications helped me. While I was not as reactive towards my depression, I did not feel like my quality of life improved. I still would get angry and irritable, I still felt depressed, I still had trouble feeling ?awake?, the only difference was that the drugs made it so I didnt have the capacity to react as strongly to my feelings towards my health. On top of that I TOLD THE DOCTORS I FELT LIKE THE MEDICATIONS WERE NOT HELPING. I explained that I think their diagnosis was incorrect. Their response was MORE MEDICATION COMBINATIONS and that it may take SEVERAL YEARS TO FIND THE CORRECT COMBINATION. That was the line that told me ?get out of here?. I would not have went off cold turkey if I felt like the doctors had my health in their interest.
Not once did any of the doctors suggest to do a blood test to check for physical abnormalities, with the exception of when I was taking lithium to check my thyroid and liver.

Most of these have subsided, except the weight gain, cardiovascular symptoms, tiredness, and the feelings in my face and tongue occasionally (which is usually accompanied by cognitive dysfunction). I took my last dose of anything in early August.

Data:
24 panels were taken, the abnormal results were described in my earlier posts. To reiterate, low iron absorption, very high DHEA-S, very low T, high blood sugar, high cortisol.
Hair - lots of hair below the belt and on my legs. My nickname according to my friends older brother was ?wearwolf?. Not much hair on my chest, but it is still growing in. Moderate amount of hair on my stomach, but not too much. A decent amount on my forearms but none on my upper arms or back. My hair on my head is very thick and healthy -it gets lots of complements. I dont grow a beard but do have a natural gotee. That only came in last year
Body Fat - lots around the waist/gut, chest and upper legs. I noticed more fat everywhere since taking those meds.
Frame - heavy. Broad shoulders, short (5?9?), wide hips, high bone density according to my most recent x-ray)
Have not had morning wood in a long time, but I?m always ready to go at night and take care of my business then (maybe that is why?). I was told by my doc that I am doing it too much.
Training - 5/3/1 and walking about 4 miles a week.
Age - soon to be 25

My doc right now isn't sure what is going on. He said just take a multivitamin with iron in it and extra vitamin D until he can get a better answer for me.


#9

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#10

Please see prior post.

Your agitation may be from too much cortisol and if adrenals are messing up that might explain high DHEA.

Males can typically have higher iron levels that females who have monthly blood loss. When a male has low iron, it can often be from a GI bleed from gut or liver-->bile. You can get an occult blood test that can detect blood in your stool at levels that are not visible to the eye.

It would be better if you posted labs with ranges instead of spoon feeding.


#11

Is it possible to attach a scan? The tests are 4 or more pages long.


#12

Maybe the low testosterone value was a lab error. If I were you, I would ask for a retest before going crazy worrying about it.


#13

I am actually more worried about the low iron. I have read bad things about low iron in men.


#14

There are a few things that need to be addressed first. The low iron and your sleep patterns. Adrenals too, but you'll be spinning your wheels if you don't take care of the first two.

I had terrible insomnia for more years then I can count. I've tried just about everything to get solid sleep. These are things that have worked to some degree for me.

Melatonin is a staple for me. Time release is the only way to go for those that can't stay asleep. Start with a small dose and work up if you need. I take 1mg and might try a bit less going forward.

Trazadone - I take this with melatonin now. Getting really solid sleep with 50mgs. Might help a bit with depression as well. After years of shitty results and side effects from different antidepressants, I was pessimistic with Trazadone. It's been great.

Temazapam - I use this only on occasion with the Melatonin and trazadone. If I'm especially wound up or haven't slept well for a couple days due to travel or social life.

Peptides - GHRP-2 , Mod GRF and DISP seem to help a little. Nothing dramatic, but I'm getting really solid sleep with the Melatonin and Trazadone.

Modafinil - Not a sleep med, but made a difference for me. It's for shift work disorder and I always felt like my circadian rhythm was off. Crashing in the late afternoon and waking up wired at 4am. Seemed like my cortisol peaks and valleys were around 4hrs off.

ZMA - worked for a very short period of time. I used the Biotest version.

Z-12 - worked well for awhile when added to ZMA.

I've been logging sleep patterns with my Jawbone Up band, so I have verifiable results for different sups/meds.

Do yourself a favor and really make an effort to straighten out sleep. After a month or two of solid sleep, there is no way you won't feel better in some way.


#15

Hi there Aero51, I've been reading this thread, have similar results (https://forums.t-nation.com/t/low-t-high-dhea-s/217115)

Have u solved this riddle with high dhea-s -> low T ?


#16

I took a supplement, Prostametto, which really amped up my sex drive to the point where I would start to shake. Some of the ingredients in that supplement are tough on the liver. My sex drive is wishy-washy, but here are a few things that helped me:

1) Avoid Porn
2) Avoid excessive masturbation
3) Get enough sleep
4) Eat veggies
5) Lose Weight

Ive lost about 15-20lbs since when I posted that (I was around 265 then I am about 245-250 now) and that significantly improved my sleep. I no longer need CPAP for sleep apnea, though it still happens if I sleep on my back (which I no longer do). Eating healthier definitely helps, but my sex addiction does sometimes mess up my libido. Im getting that under control slowly, but it is very tough to break. My goal is to lose another 15lbs, then I will get my T reevaluated. I spoke with my GP who agreed that he'd rather see me get in better shape first before going through with any treatment.

I find it strange that the ingredients in Prostametto shot my sex drive through the roof. According to what I read nothing in there actually affects sex drive directly. Is this something I should be concerned about?


#17

Could be placebo..my will breaker are bad lab results x) When I start to measure and analyze things, sex drive disappears.

Have u done FSH and LH? Vitamin D, Cholesterol?


#18

I haven't had the test done in over a year. I am blessed with good cholesterol despite having a diet heavy in fats. Vitamin D is low, I take supplements but infrequently. I also take it because my mom has multiple sclerosis and it is the only thing shown to slow the progression of the disease. I don't have any problems with hair loss, and I don't recall anything being discussed regarding LH.

You might also want to take a drink with turmeric. My inflammatory markers (all of them) were elevated. I felt better mood wise and energy wise once I started having it nightly.

For energy, rather than caffeine, I take L-carnitine. I can carry a 150lb sandbag 100 yards, then flip a tire 100 yards, and still have enough energy to go for a 300 yard sprint when I take that stuff.


#19

Interesting..I have hard inflammation after big lifts.
I'm in process off exploring where is my root cause off low test..primarly hipogondal or secundary, and what could I do to improve my state. It's obviously primarly, beacuse signals are sent to testicles, but Test is low..u can look at my thread if u are intrested


#20

If I were you man Id get off that keto diet. Try simple things first before going balls to the wall with supplements.