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Originally Posted by eeso  I am in Australia, and I'm also hypopituitary (empty sella syndrome), and my labs are much worse than his. To be honest i dont think his labs are that bad at all.
I can attest that reducing stress is critical in regaining better health.
I tried dhea, hydrocortisone, armour etc (i had low thyroid, dhea, and cortisol readings) but in the end those meds did more harm than good to me and I felt terrible on them. What did work was moving to a less stressful environment and focusing on diet and exercise. Granted, I was also on TRT which I'm sure helped rest my adrenals. I've recently just stopped TRT though so we'll see how that goes. I'm not expecting miracles I just had to cease it for a while to get hairloss under control until I decide on a path for reducing DHT conversion.
Sounds like you're on track with the diet, but its the lifestyle which is still a problem with long hours etc.
Has he had blood test for e2 and testosterone? And LH + FSH?
He looks like he has reverse T3 - is it possible to use a wilson protocol and take just T3 until the reverse clears, then come off it? |
Hi Eeso,
All his Labs were in first post. For convenience I'll repeat pertinant onesb
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Androgens 17th September'08
Testosterone..........14.3 nmol/L (9.9-27.8) *20 % of youthful range of (9-35)
SHBG ....................36 nmol/L (14-50) *61% in range
FAI .......................40.........(34-106) *below 50 needs HRT
DHEAS .................2.8 umol/L (1.2-8.98) *10% of youthful range of (2.2-15.2)
Free
Test .............277 pmol/L (204-637) *17% in range
DHT....................4.9 nmol/L (1.2-4.7) *slightly elevated
Testosterone (Free & Total) & DHEAS all very low in range
DHT slightly elevated Hormonal Panel 17th September'08
FSH.......................2 U/L (1-15) *low in range
LH........................2 U/L (1-9) *low in range
E2........................74 pmol/L (40-160)
FSH & LH both very low in range despite very low Testosterone & DHEAS Salivary Cortisol 10th Oct'08
8am..........22 nmol/L (6-42) *44% of range TOO LOW
Midday....11.2 nmol/L (2-15) *71% of range
4pm.......10.6 nmol/L (2-11) *95% of range
8pm....... 5.5 nmol/L (1 - 8) *65% of range
Cortisol Burden...49.3 (11-76) *60% of range
AM Cortisol is far from optimal at only 44% in range ACTH 2nd December’08
9am......6.4 pmol/L (1.6-13.9) *39% in range
ACTH is far from optimal at only 39% in range ALDOSTERONE 2nd December’08
9am (Salt fasting)..............347 pmol/L (100-950) *29% in range
Aldosterone far from optimal at only 29% in range RENIN 2nd December’08
9am Salt Fasting.................21 mU/L (3.3-41) *47% in range
Electrolytes 2nd December’08
Sodium................145 mmol/L (134-146) *good
Potassium.............4.7 mmol/L (3.5-5.4) *pretty good
PROLACTIN
2nd December'08......118 mlU/L (54-380) *20% in range
Very low in range Thyroid Tests 17th September'08
TSH............1.28 mU/L (0-4)
Free
T4..........15 pmol/L (9-24) *40% of range
Free T3.........3.9 pmol/L (2.6-6.6) *33 % of range
TPO Abs... .....25 IU/mL (less than 5.7) *elevated
TG Abs........76.1 IU/mL (less than 4.1) *elevated
Reverse T3....449 pmol/L (170-450) *FT3/RT3 Ratio 0.008
Looks pretty HypoT to me!!!!!
Optimal FT4 is top 25% of range his isonly 40%
Optimal FT3 is top of Range his is only 33%
Hashimotos confirmed by elevated Antibodies BOTH TPO & TG Abs
Reverse T3 Dominance confirmed optimal ratio greater than 0.02
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His very low in range Free Testosterone, DHEAS together with low FSH/LH looks Secondary Hypogonadal to me. His Estradiol looks OK as far as I can tell. You mention you were on
TRT? Did you try
HCG yourself? Is it available in Australia for Hypogonadal treatment? Where in Australia do you live if you dont mind me asking?
Thyroid results show he is pretty Hypothyroid. In any case he has Hashis so needs NTH (Aussie Armour) to fully suppress TSH (and Abs hopefully) & optimise frees. I realise he has RT3 Dominance on these numbers. However we cant afford Tertroxin (Aussie T3 med) for him at present so will be trying NTH first. Hormonal Doc has suggested SR T3 but I have heard little good about it so dont wish to try that on the kids or him. In fact I am on Tertroxin for RT3 dominance but qualify for Authority script (demonstrated
T4 resistence) so is cheaper. His low TSH with low Frees suggest he has Secondary Hypothyroid with Hashis combo.
His Saliva am (Free) Cortisol at only 44% in range shows at least mid range severity AI to me too. Certainly his ACTH at only 39% in range is suboptimal. The low am Cortisol with low ACTH suggests Hypopit as does low Androgens & lowFSH/LH, as does low TSH & Frees. His blood (Total ) Cortisol doesnt look too bad. However thats TOTAL not FREE Cortisol & Saliva Cortisol results are superior. The Lab Range on blood Cortisol is pretty low too.
Prolactin is low too at 20% in range.
Regarding reducing stress the real stressor is due to family illness/conditions (myself, twins & DH himself). That causes both financial, emotional & physical demands on him. We are doing our best to deal & treat those but nothing more can be done to reduce stress there. except for us to get well or at least be well managed health wise.
As far as work stress it is actually much better than it was a couple of years ago. He used to do a LOT of travel (intrastate interstate & overseas). That is now reduced to once every 12 months or so. He changed to this job just over 2 years ago it is much more secure with better benefits (is a government job) & better pay than previous job. We also had a small home business & our own company. DH was working full time in a different more demanding job as well as doing the business. We realised the extra stress & hours involved in that was too much for both of us & let the business go. Thats when he changed jobs too. We refinanced ,quit loans, consolidated debts, downgraded homes to releive as much financial stress as we could as well.
Cant see what else we can do to reduce stress further (except get health DX'ed & treated). He cant afford to lose this job & with the economic downturn he is lucky to have it. Without it as I say we would lose our home & have to give up medical/health insurance & much more too.
Surely its time with his numbers & symptoms to do HRT of some kind. We feel we have done all we can to minimise stress & made many diet changes already. He has some tweaking to do with B12 & Folate to reduce Homocysteine. Also some tweaking to improve blood sugars & perhaps HDL/LDL ratios. But none of this is going to fix his Hypogonadism, Hashis & Hypothyroid, nor his Adrenal Fatigue!!!! Especially if it IS Hypopit in origin?