T Nation

Low T High DHEA-S

Hi all,
I’ve already posted in this category E2 Swings Hard.
Obviously there never been problem with e2 swinging, but with qualty of lab results (i’m seeking good lowyer for this case).

Let me re-post my basic info:
age - 32
-height 5’ 8’’
-waist 36 inches
-weight 220
-Bf 15-17%
-sensitive with DHT, not bold but weak hair since my 15th
-describe where you carry fat and how changed - hips, stomach, general middle area, always been like this.
-libido - no morning wood, libdo is not to brag with, do the job, much better then few months ago. No erectil disfunction.
-health conditions, symptoms /Always tired, can’t get quality sleep. Having big inflamation after workouts. Just to mention, I do PL for 1 year, and my strenght had improved, even do natural PR’s last month, muscle mass is fine.

I was always sport’s guy, competitive BBer. I have feeling that depression and tiredness were always present, but I never payed atention to much. Depression is gone, now I have lot of obligations and I’m trying to improve me energy and QOL.

Last summer I had big impact on my overall health anxiety, chest pain, blood pressure, in that time I was investigating e2 levels, but that appers to be no problem (bogus results from one lab). Sometime in November I felt a huge relief, no anxiety no chest pain, I just tried to relax and to stress to much.
My testicles gain back volume and strength, libido was better, no erection problems, so I tried not to think to much about results and let it go some time.
In addition to improvements, my energy was still low, without a will. I do not accept such a situation, but I’m willing to do what it takes to improve QOL.

From previous week I’m on Keto diet *high fat 200grams, so some turbulence could be in tests.

I had completly physical examination last week, and all seem to be just fine…except hormonal lab results at 9h AM:

My liver is much better now than in August

And now the problems begin:
E2 80,1 pmol/L (94,8-223)
FSH 6,2 mIU/mL (1,50-12,4)
LH 6,9 mIU/mL (1,7-8,6)
Testosteron 9,22 nmol/L (9,90-27,8)

Then i get my Urologist exam, all looks perfectly fine, no single doubt to problems, but I insisted to check relation to thyroid and adrenal gland. I’ve done lab again 6PM this time.
At ultrasound exam, thyroid looked great with nice shape, symmetric

rT3 was unavailable in my lab.
My temperature after waking up was in range:
97.34 - 97.7
During the day was in:
97.7 - 98
Few time I hit 98.6 but felt worm.
Can not tell if i’m Iodine deficent, I use Iodine salt, but that could not tell if that is enough. I ordered idon to do IR.
Rest of results:
E2 41,5 pmol/L (94,8-223)
FSH 5 mIU/mL (1,50-12,4)
LH 3,1 mIU/mL (1,7-8,6)
Testosteron 7,54 nmol/L (9,90 - 27,8)
Prolactin 209 microIU/mL (86 - 324)
DHEA-S 18,63 nmol/L (4,34 -12,20)
Vit D (total) 55 nmol/L (high risk <25, deficit 25-75, normal 75-250)

If I missed to mention somethnig I will edit this post.

This is gonna be long tome job, so I need to be patient and systematic and analytic (good side of us engineers, but need to learn very complex system).

Ultrasound didn’t show any problem with my andrenal glend, so this is total mess for my.
FSH is in not to low, but Test is, this led me to primary - but why? Total vit D was to low, but DHEA-S is too high (last time I checked, cortisol was high).
If is not a tumor, don’t have a clue whats happening…

Dont realy know where to start, I’m gonna do IR (it can hurt), and put 5000IU of D3 daily. I plan to go to Endo to chech Andreanl glend in total (but have no confident in the, at all).

If there are some one with similar experience, or can help, I’d appreciate it!!!

Above, your E2=80 is nice, but with low T, that leaves you estrogen dominated. With low T, E2 should be lower. So something is not right with how your liver clears E2 or your E2 production is high. In the above labs, it looks like primary hypogonadism.

Have you ever had prolactin tested?

TSH is still too high, should be closer to 1.0. fT3 is well below mid-range and fT3 is also below mid-range. Thyroid is a big issue for you that lowers your energy and mood and makes you fat and more fat can increase E2.

Why did this drop?
E2 41,5 pmol/L (94,8-223)

Have you ever taking high dose SERM [clomid, nolvadex], DECA, hCG?

KSman -
First tests was done early in the morning (fasting), and second one in the afternoon (after entire day in front of lap top). So, have no idea why e2 drop so much (maybe somethnig with Keto diet trigered)

In second lab test, prolaction was included:
Prolactin 209 microIU/mL (86 - 324)

Let me try get some conclusion:

  1. I’m aware that i’m e2 dominant. T/E bad ration, no metter real low levels + Thyroid problems cause my bad energy levels? I’m fertile, and waiting for FT (could be that low T&E, but with better ratio, are design to me…as I mentioned, it looks weird to my friends that I’ve low T…always been Alfa)
  2. As my FSH/LH levels are ok, that meens my testical won’t produce Testosteron. DHEA-S is highly elevated, HDL and LDL are ok, so all precondition are there, except vitamin D

Is to high DHEA-S big problem in this puzzle, or is it just andrenalin glend working hard to produce decent level of T?

My plan:

  1. try IR and 10000IU of D3 (someone told me that it takes time to D3 to make real difference).
  2. If Ir and D3 don’t help, than try hCG/nolva restart
  3. and finaly, if I have irreparable primo hypogondisam, than I’ll do TRT

BTW nevere took SERM, DECA or hCG…saving silver bullet for the end :slight_smile:

I will monitor what I do, and what is happening. I learned a lot (neverending mission) from u guys, so wonna leave small contribution (at least for those with similar problem).

D3 is for general vitality. Not expecting any T benefits.

So go for restart.

Links found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • HPTA restart
  • thyroid basics explained

I found some studies that shows relation with deficiency of vit D and low levels of T, it could be improved (only if one have deficiency), but long term.

I’ve already read all the threads. Thanks for input, I’ll do restart, just one doubt:

Should I do hCG, then nolva+AI, or skip hCG ?

  1. Inject 250iu hCG SC EOD 4 weeks
    then I’ll do labs for TT, FT, E2. If things have not improved, my tests failed, i’m primo, and only option is TRT.
    Labs need to be done day after last shot of hCG?
  2. Take nolva 20mg EOD + anastrazol 0.5mg weekly (EOD) for 6 weeks, and do lab for TT, FT, E2, FSH, LH.
    If that goes well, proceed with AI 2 weeks and taper of nolva (first week 10mg EOD, second 5mg EOD), then stop nolva and taper AI down slowly for 2 weeks, then do labs again

Sounds ok?

1- Test TT, FT while on, not after hCG, do labs after hCG injection
If T levels low, you are primary, restart will not work.
If strongly improved, T levels may increase during (2) as testes are still recovering.

2- good as written
If LH/FSH are not good, restart will not work

Will do!
I’ve started hCG, gonna report after 4 weeks.

2 1/2 weeks later
50mcg Iodine ED
30000IU D3 ED

Something is happening, nut sure what for now. As I’m estrogen dominant, already felt brest itching , e2 is rised (from higher T). I’m aware that T/E ration can mask benefits of higher T.

Planning to run AI after hCG. How are experiences with AI on hCG - in respect to intratesticular conversion TO->E?

2 months later (AI was introduced last 4 weeks 0.5mg per week).

It’s obvious, I’m primary…so, no more games, I’m going on TRT.

There are some improvements with my thiroide after IR.

Thanks for helping guys, expecially KSman.

As I always point out and discuss in the stickies, anastrozole does not work inside the testes and cannot control that. Typically no problems with your dose of hCG, but some are hyper in this regard. Your T levels may be increased and anastrozole can reduce T–>E2 in peripheral tissues.

Do not wait to use AI! What are you thinking?

I was on 0.5mg AI weekly.

I expected that T level will be at high end, but results shown that my testicles were not doing their job.

Do you think that I should try something else then TRT?

high dheas = something is wrong with pituitary or adrenals. I think to exclude this. You should do at once do ACTH,Cortisol,Dheas. Beacuse acth (pituitary) stimulate adrenals to make cortisol and dheas. So if acth will be high and dheas and cotisol as well there is issue in pituitary. If acth is low and dheas and/or cortisol is high there is problems with adrenals.

Were labs done on hCG?
What dosing? 300iu EOD?

So FT was undetectable? If so, FT–>E2 would be very small. So your E2=35.8 ng/L seems very odd and high. That suggests that your are not clearing estrogens effectively. Also opens the possibility that E2 is testicular in origin and AI will not work there.

When I see something like your FT result, I consider that there could be a lab error. But TT also drives the same conclusion.

Now read the protocol for injections sticky.

Yes, labs were done while i was on hCG. First 2 weeks my dosage was 300IU of hCG, and next 6 weeks i was on 250IU.

FT lab is finished, middle of the scale:

Night before labs, i was sleeping just for 3h. Don’t know if that could cause big impact.

If DHEAS is high, there is no reason for my testicles not producing enough while on hCG?

Definitly, my andrenals have been over stimulating, but if i’m primary, low T doesn’t helping at all.

After 8 weeks, your testes should be steady state and no further changes are probable. Your T levels are not adequate. Doubling hCG is costly and may create E2 problems. Cost of doubling hCG probably exceeds injecting testosterone. In any case, you do need more anastrozole. If more anastrozole does not work as expected, the cause can be assumed to be from T–>E2 inside the testes and then injected T with smaller hCG dosing may provide a good outcome. As hCG is providing a partial solution, you might be OK with less that 100mg/wk T and 125iu hCG SC EOD.

I would include proviron as well. For now, I’m going on BB cycle, but after that wont come off.
Thanks guys, I really appreciate your enormous knowledge and experience at first place.

I am aware of TRT protocols and what to aim, and what to check.

After 10 days on T (500mg propionat), my tiredness is fading, and that isn’t placebo :slight_smile: