T Nation

Pregnenolone Deficiency on TRT


#1

Hi All,

I have been on TRT for the last 5 years and found my ideal dose to be 160mg a week of test cypionate (split between two injections) and I will cycle 6 weeks of 250iu HCG 3x a week for 6 weeks on, 6 weeks off. I know the common theories are to stay on year round but this seems to work well for me. I also take 6.25mg aromasin once a week and that low dose keeps my e2 around 25.

I recently started reading about pregenolone and how it can lowered while taking testosterone and how HCG can help raise the levels so I got mine tested and it came back extremely low!!! What is the ideal pregnenolone number for well being? Below are my relevant labs 2 days after injection:

Pregnenolone: 14 (22-237)
Total Testosterone: 887 (250-1100)
Estrodial: 26
DHT: 30 (16-79)
Progesterone: .5 (<1.3)
IGF 230 (63-373)
TSH: 1.65 (.40-4.50)
Aldosterone: 6
t3, free (2.7 (2.3-4.2)
Cortisol: 16 (4-22)
Free T4 (1 (.8-1.8)

I definitely feel like something is off as I can experience get mild anxiety and difficulty concentrating at times but my numbers are all dialed in besides pregnenolone. Should I supplement directly with pregnenolone and if so how much should I start with/what is ideal target range for well being?

Side note: I came off for 2 months a while back to regain fertility (25mg of clomid daily after 2 weeks of 500iu HCG EOD and pregnenolone was extremely low as well.

Next time I will get DHEA tested as well.

Thanks and I would appreciate some feedback!!!


#2

Do you have brain fog? The reason I ask is I was wondering if low pregnenolone levels are the culprit for my brain fog and I have not run those labs ever. I ran HCG for the first time 2 months ago and felt great initially (brain fog lifted within 12 hours) but the clear head wonderful mood did not last more than 2 weeks. Am currently off hcg and trying Pregnenolone pills 100 mg per day with no change. May try the cream next and will test for it next time but was curious to know if brain fog was something you have?


#3

Please explain where you were with your hCG cycle for those labs.

A year ago we were discussing your brain fog and thyroid discussion was dropped. Now your TSH is higher, fT3 and fT4 are both well below mid-range. Your oral body temperatures are probably low and this affects energy, mood, mental clarity, libido and more.

DHEA is made in the adrenals pregnenolone–>DHEA. Labs should be DHEA-S, not DHEA. DHEA-S may be a good indicator of pregnenolone status.

hCG should not be cycled. Would shutting off LH on a 6 week cycle improve the quality of life of young normal males? You are also putting pregnenolone production on a 6 week cycle and need understand how hCG cycle impacted pregnenolone.

A good amount of pregnenolone is made in the testes, cholesterol–>pregnenolone and you can see why very low cholesterol levels would be a problem. Pregnenolone is made by the mitochondria in all of your cells in your body. This requires several inputs. CoQ10 is essential and made in the liver. Mitochondria create ATP, the universal currency of cellular energy and the level of activity is your metabolic rate and determines body temperature. Your body regulates all of this via thyroid hormone fT3 that as part of the body temperature control loop. Now you are wondering where this is going. The point is that your thyroid function has a lot of leverage on ATP and pregnenolone production and your fT3 and fT3 levels are low and low body temperatures are expected.

Low thyroid function can easily be a result of not using iodized salt and/or vitamins listing 150mcg iodine + 150-200mcg selenium.

So two major factor for pregnenolone:

  1. hCG cycles
  2. thyroid function

You need to take these thyroid issues seriously. Discuss your history of using iodized salt. Post oral body temperatures - see below.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#4

I appreciate your response and valuable insight! RE iodized salt: I eat very clean and at at home most of the time and don’t add salt to my meals. A month ago I started adding 1/4 teaspoon of iodized to my breakfast. I am very active so I’m assuming my body probably needs much more, especially living in a very warm climate.

RE my status of the HCG cycles: I was on HCG for 4 weeks at that time. The only reason I haven’t done HCG year round is because it gives me massive amounts of body acne, even when e2 is in control. It gives me the cystic, under the skin type when just testosterone stand alone gives me a little but not too much.

Something to note: In the past, my aldosterone has come back completely depleted. Often at .5. reference range is below 28.

I will get on iodine and selenium supplements, measure my body temp every morning and get follow up labs asap (quest takes two weeks to get results unfortunately).

Thanks so much! It is appreciated more than I can express!


#5

Yes, I get it all of the time. It is very frustrating. Hopefully it is something thyroid related and I can get to the bottom on it.


#6

Following. Interested in the Preg / DHEA topic. I have low DHEA at age 26, considering adding Pregnenolone. I have anxiety and adrenal fatigue symptoms. I bet your RT3 is high also.


#7

Your 500iu hCG dose might cause issues.

A couple of guys seemed to have resolved anxiety issue by dealing with iodine and thyroid issues.


#8

Perhaps a lower dose of hCG steady would work. All hCG needs to do is support the testes. We are not trying to get the testes producing significant amounts of T. We have a few, very few, guys who have some hCG issues.

Some do not care for salt. Some avoid because of perceived health issue with salt. Salt does not cause cardiovascular [CV] problems. If one has high BP, reducing sodium reduces blood volumes providing symptomatic relief. I think that this public health concern with salt is flawed, but it does set people up for more tolerance of high BP if/when that occurs. Jumping to the conclusion that salt is the cause is deeply flawed. Diuretics also reduce BP and blood volumes, but no one then concludes that diuretics case CV problems.

The huge campaign to reduce goiters and other problems starting in 1922 with iodized was a vastly important improvement in public health and the lessons have been forgotten. If someone had a drug to do what iodine can do, they would make a lot of money. No one markets the benefit of iodize salt sitting on the shelf at the supermarket.

Is your wife/GH lacking iodine too?


#9

Thank you for the response and you may have misread. I take 250iu three times a week. Perhaps I will try twice a week or 150-200 3x a week and see if acne is not an issue.

I also have no problem with salt. It seems that the iodine supplement recommended in the stickies is 12.5mg (which is just ordered) when iodized salt only gives about 75mcg. I just figure it would be hard to get enough iodine from salt when 12.5 is 8333% RDA.

KSMan: I have always thought the brain fog might be an estrogen testosterone issue but it always came back clear. Do you think that my thyroid levels could be the big contributor to this since they are on the low end of the spectrum? This has been something that has frustrated me for years!!


#10

This is what I currently have on my list to test (fortunately the doctor gives me 5 blood test forms at a time so I can just fill it in myself).

Aldosterone
Cholesterol
HDL
LDL
DHT
DHEA S
Ferrititin
Progesterone
Pregnenolone
LH
FSH
RT3
T3 free
t4 free
Testosterone (TT and FT)
TSH
Vit B12/Folate, s
Vi D, 25-OH, Total

I understand there isn’t much of a point to test FSH and LH on TRT but I am only 4 weeks back on since I did 2 months of HCG followed by clomid (to conceive a child) so I am curious how fast those levels suppress.

Anything else I should have ordered? I have a high quality thermometer arriving today so I can start tracking body temp multiple times a day.


#11

Your thyroid issues can be expected to impact mental clarity, energy, mood and libido. It is a big deal.

Please do not ignore selenium as increased iodine with a selenium deficiency can lead to damage and thyroid auto-immune disease.


#12

Thanks. Is there a certain ratio I should follow or is 200mcg selenium sufficient?


#13

200mcg is probably more than enough


#14

TRT will kill LH/FSH levels in a day or two.


#15

Thanks.


#16

Ft3 looks low. From what I understand, you want it to be in the upper third and Ft4 in the middle. I have been on pregnenolone 100 mg ED for years and my pregnenolone lab is at the top of the range. It has not helped symptoms of brain fog, fatigue, extreme low energy, or general well-being whatsoever. Started natural dessicated thyroid (1 grain) a few days ago. Will take a while to find optimal dose, but I am hopeful that my new doc has me on the right track. I have years of labs posted on my post, HRT - Beyond the Basics. My July labs show aldosterone bottomed out as well. Doc thinks addressing thyroid issues may improve the aldosterone. You could look for any other similarities to your labs there if you like.


#17

Interesting. I will look forward to hearing about your progress. I ordered a thermometer but am out of town until next Monday. I started taking 2mg of iodine via kelp and 200mcg selenium every day and knock on wood, could be a coincidence, but within 5 days I do feel A LOT better. I have the 12.5mg iodine waiting on my doorstep for when I get home.

I get bloods today so I’ll post an update when the results arrive along with morning, afternoon, and night temps.

Something to note as well: Not sure if you are on TRT but I feel 1000x better on 160mg a week than I did 200 and 180mg. Much more clearheaded, zero anxiety (which higher doses definitely caused), even though I dialed in e2 between 22-28 on each dose.


#18

Don’t know why I ignored the temps so long but KS Man, it seems you are beyond correct about a potential thyroid issue. I never thought this could be the case since I stay very lean year round but I am hoping that is the source of the intermittent brain fog that I get.

It is very strange that my temps are so low, considering that I am always hot and demand to keep the house very cool.

Morning Temp: 96.9
Afternoon Temp: 97.2
Morning Temp: 96.8
Afternoon Temp: 97.7
Morning Temp: 96.9
Afternoon Temp: 97.8 (editing these to post the last three days

I should be getting back my most recent blood work drawn 5 days ago (7 days after starting iodine at 50mg a day) so I am interested to see where everything comes back. I will report an update when the labs come in.


#19

For what it’s worth, low body temp will make you feel hot because you’re judging ‘hot’ and ‘cold’ as relative to your body temp. In other words, a 72 degree room is 26.6 degrees cooler than average 98.6 body temp, but it’s only 25 degrees cooler than your 97 degree body temp, thus you perceive it as warmer. And it actually ends up feeling much warmer than the 1.6 degrees difference in the body temperatures. Don’t know why. I’ve seen this happen to my wife, who has had lower body temp since menopause and is sweating all the time.


#20

Keigwin,

Very interesting. Definitely makes sense but counter intuitive. Thanks for the insight.