Test results from hell.. this can't be right..

[Sargovar]

A while ago I ordered a full saliva panel through Canary Club & Diagnos-Tech. I did it and shipped it back.. only problem was that it took longer than expected for the samples to reach the Diagnos-Techs lab. This was not really my fault.. it was said in the instructions that you could do the tests any day of the week, so I chose wednesday. It was also said that you should choose the fastest possible shipping method when mailing out the samples, preferably one that would take no longer than 2 days.
Here I ran into 2 problems. First, the postal office ships the express delivery packages that are guaranteed to arrive within 2 days anywhere in the world every day before noon. I was at the postal office at 1:00 PM, so I missed that timeframe (I didn't even know you'd have to be there before midday to get your package into the fastest shipment).It would have also cost me way too much; 135 euros for shipping, effectively doubling the total cost of the tests, so I wouldn't have been able to afford it anyway. So I went with the second fastest method, which guaranteed shipping within 4 working days. 4 working days meant that the lab didn't receive my samples until the middle of the following week. Also, no ice packs were provided to refridgerate the samples for the duration of the freight trip (and it was said that freezing them was not necessary), so I can only hope it was cold enough in the cargo area of the plane.

Anyway, I got the results today, and I find them very hard to believe. If these results were true to the letter, I would be royally screwed, hormone wise. There are several things here that make me suspect the samples were no longer in good shape by the time they were being analyzed by the lab staff.

Take a look and tell me what you think (now you'll all know my name, but what the hell, I trust you guys enough.. plus, it's a bizarre foreign name, so it will sound alien to you anyway and you probably won't remember it ).

Should I completely disregard these results, or draw some sort of conclusion(s) from them regardless of having missed the optimal sample freshness window? It's odd how they contradict my previous saliva tests & bloodwork. DHEA, for instance, was sky high in my previous saliva tests, which were refridgerated and shipped on time. Here it was on the lowest end of normal. Also.. the E2 looks highly suspect here. I would have much more severe E2 symptoms if this were truly the case, and besides, how can you get a bigger reading for a hormone from a sample that has been sitting around for too long, anyways? If anything, I would have thought that you'd get a smaller reading.

[JanSz]

Originally Posted by Sargovar

A while ago I ordered a full saliva panel through Canary Club & Diagnos-Tech. I did it and shipped it back.. only problem was that it took longer than expected for the samples to reach the Diagnos-Techs lab. This was not really my fault.. it was said in the instructions that you could do the tests any day of the week, so I chose wednesday. It was also said that you should choose the fastest possible shipping method when mailing out the samples, preferably one that would take no longer than 2 days.
Here I ran into 2 problems. First, the postal office ships the express delivery packages that are guaranteed to arrive within 2 days anywhere in the world every day before noon. I was at the postal office at 1:00 PM, so I missed that timeframe (I didn't even know you'd have to be there before midday to get your package into the fastest shipment).It would have also cost me way too much; 135 euros for shipping, effectively doubling the total cost of the tests, so I wouldn't have been able to afford it anyway. So I went with the second fastest method, which guaranteed shipping within 4 working days. 4 working days meant that the lab didn't receive my samples until the middle of the following week. Also, no ice packs were provided to refridgerate the samples for the duration of the freight trip (and it was said that freezing them was not necessary), so I can only hope it was cold enough in the cargo area of the plane.

Anyway, I got the results today, and I find them very hard to believe. If these results were true to the letter, I would be royally screwed, hormone wise. There are several things here that make me suspect the samples were no longer in good shape by the time they were being analyzed by the lab staff.

Take a look and tell me what you think (now you'll all know my name, but what the hell, I trust you guys enough.. plus, it's a bizarre foreign name, so it will sound alien to you anyway and you probably won't remember it ).

Should I completely disregard these results, or draw some sort of conclusion(s) from them regardless of having missed the optimal sample freshness window? It's odd how they contradict my previous saliva tests & bloodwork. DHEA, for instance, was sky high in my previous saliva tests, which were refridgerated and shipped on time. Here it was on the lowest end of normal. Also.. the E2 looks highly suspect here. I would have much more severe E2 symptoms if this were truly the case, and besides, how can you get a bigger reading for a hormone from a sample that has been sitting around for too long, anyways? If anything, I would have thought that you'd get a smaller reading.

E2 Estradiol = 21 Male(20-49 yrs): 1-3 pg/ml Male(50-85 yrs): 1-5 pg/ml
P1 Progesterone= 34 Male ( adult ): 5-95 pg/ml
TTF Free Testosterone= 34 Male (20-30 yrs): 60-110 pg/ml
-----------------------------
fTSH Thyroid stimulating hormone=40 Normal
Borderline Low: 20-25 nIU/ml
Normal: 26-85 nIU/ml
Borderline High: 86-120 nIU/ml

The Time elapsed between collection and receipt of specimen exceeded the
optimal number of days for sample stability which may lead to under estimate of
TSH values unless samples were refrigerated/ frozen in the interim. Physicians
phone the lab for questions. Tel: (425) 251-0596
Specimen Collected: 11/28/2007
Received: 12/05/2007
Completed: 12/07/2007
--------------------------------------------------------
fT4 L-Thyroxine 0.24 Normal Normal: 0.17-0.42 ng/dl
-----------
fT3 0.33 Normal Borderline Low: 0.21-0.27 pg/ml Normal: 0.28-1.10 pg/ml
-----------
TPO Thyroid Microsomal Ab, SIgA Negative Normal: Negative
-------------------------------------------------
TAP Free Cortisol Rhythm
07:00 - 08:00 AM---9 Depressed 13-24 nM
11:00 - Noon-------- 4 Depressed 5-10 nM
04:00 - 05:00 PM-- 3 Normal 3-8 nM
11:00 - Midnight 2 Normal 1-4 nM
Cortisol Burden: 18 23 - 42
DHEA Dehydroepiandrosterone=4 Normal Adults (M/F): 3-10 ng/ml
Patient Result Interpretations
Depressed morning cortisol, < 13 nM, is suggestive of marginal HPA performance.
Normal rhythms exhibit highest cortisol value for the day at 7 - 8 AM.
Morning cortisol augmentation, or 11 Beta HSD inhibitors, as in licorice, worth consideration.
================================================== =========
================================================== =========

#1, as far as I learned on this board, saliva testing at Canary is good for Cortisol only, possibly for DHEA

#2, in their report they complain only about fTSH Thyroid stimulating hormone
being affected

#3, You have a low Cortisol and DHEA, ether do nothing because you are going to repeat this or similar test or get Cortisol 5mg and use them as ether 20mg/day version or 30mg/day version.
7AM take 3 or 4 pills
11AM take 1 or 2 pills
If you are interested, look at attachment to see how I figured out your dose.
Take DHEA complete from LEF, 2 pills/day divided
DHEA Complete
100 mg 7-Keto® DHEA & 25 mg DHEA, 60 capsules
Item Catalog Number: 850
Dhea Complete, 60 Capsules
Look at the description under the link,
they tell you to take many other supplements with those pills.

If testing shows that you are still low on DHEA, get 1pill/day of this:
Dhea (Dehydroepiandrosterone) Free Base, 100 Mg 60 Capsules
You should show about 110% of top range on blood serum testing.

#4, your estradiol =21(1-5) hopefully due to bad sample
your FreeT is low, old news

#5, FreeT3 low, calling for Armour, it is not low, it is like you are missing 90% of it
0.93=(1.1-0.33)/(1.1-0.28)



Without proper testing you are done cookie.
Not even sure if you should start any medications now, probably not, not enough informations.
Wish you luck.

[Scottyo]

Like Janz mentioned, just look at the cortisol DHEA and ignore the rest. Highly inaccurate and with the extended shipping/issues probably even more so.


Still, looks about right that your cortisol is fairly suppressed. means your fairly far along in adrenal fatigue...(join the group, im sure we can get you a card and a cup of coffee..wait, no coffee for us. maybe a nice pretty sticker). Anyways, looks to me like you need to go on HC. and soon. If your exercising, drop that for a few weeks and let your body recover. You might/probably will need armour too but HC comes first anyways.

look up all of phil's extensive literature on adrenal issues....he is a pro and can guide better than me. I would also pick up a decent adrenal extract WITH the HC. could also use electryoltye panel to see if you are salt wasting.

[Sargovar]

As usual, you guys are full of invaluable knowledge and advice. My humble thanks, and also thanks for the invitation to the exclusive Adrenal Fatigued Gentlemen's Club.

I'm still perplexed by the fact that my previous 4 x a day saliva test, done through Genova Diagnostics (another reputable lab), shipped in a cold retaining envelope with ice packs (on time, too), showed a much different situation, at least with regards to DHEA - which was insanely high. I get the feeling their lab range for cortisol was much too lenient, though, as it put my morning cortisol midway up the 'normal' range, and the other readings seemed decent enough, too.

Also, the day I did these newer saliva tests, I felt pretty damn good, unlike usual. Mental & physical well being were both at a comfortably high level.. I was relaxed, had a good workout with high energy, even felt more of a sex drive than usual. And then these results came back and took a shit all over my "well being".

Hmm.. maybe I shouldn't be too hung up on the numbers, then. But be that as it may, hydrocortisone is definitely on the menu. Before I thought I could do without it, but I guess that isn't the case.

I wish I could take a 3 week break from working out... unfortunately I find that the first few days of taking a break I feel ok, but then start to feel progressively worse. Not too long ago I took a 2 week break from lifting, and felt utterly shitty towards the end of the second week. I instantly improved once I get a good workout under my belt. Mind you, I keep volume low and cycle my weights so I'm not working with maximum load all the time. Also, I stick with 6 reps and 1 set per exercise, keeping the workouts at around 30 minutes, 3 x a week. That combined with moderate cardio for 30 minutes, twice a week. Seems to do me more good than harm, really.

I have some ideas as to what kind of treatment regimen I would like to start off with (once I've managed to find a source for everything I need):

1. Hydrocortisone (and possible adrenal extracts and/or licorice root).
2. Nebido (newest testosterone delivery system on the market.. very long lasting, time release injectable that works much like testosterone implants.. only available in Europe at present; met with resounding applause from people who have partaken in its clinical trials)
3. hCG, low dose (maybe 250 IU E3D)
4. Liquidex

Thyroid treatment may not be necessary at present, because I don't feel that I'm suffering terribly from low thyroid symptoms, and even though these saliva tests showed lowish values, my bloodwork showed high FT3 & FT4 past midrange. TSH was on the high side, though (in the blood tests).
I will, of course, treat it if it starts to feel like a necessity. I'll also check aldosterone & ferritin as soon as I have some extra cash at hand.

How does this plan look? Just to get me started on something, and hopefully on a road to feeling better. Naturally I expect quite a lot of tweaking to be necessary, but you gotta start somewhere, right?

[JanSz]

Originally Posted by Sargovar

As usual, you guys are full of invaluable knowledge and advice. My humble thanks, and also thanks for the invitation to the exclusive Adrenal Fatigued Gentlemen's Club.

I'm still perplexed by the fact that my previous 4 x a day saliva test, done through Genova Diagnostics (another reputable lab), shipped in a cold retaining envelope with ice packs (on time, too), showed a much different situation, at least with regards to DHEA - which was insanely high. I get the feeling their lab range for cortisol was much too lenient, though, as it put my morning cortisol midway up the 'normal' range, and the other readings seemed decent enough, too.

Also, the day I did these newer saliva tests, I felt pretty damn good, unlike usual. Mental & physical well being were both at a comfortably high level.. I was relaxed, had a good workout with high energy, even felt more of a sex drive than usual. And then these results came back and took a shit all over my "well being".

Hmm.. maybe I shouldn't be too hung up on the numbers, then. But be that as it may, hydrocortisone is definitely on the menu. Before I thought I could do without it, but I guess that isn't the case.

I wish I could take a 3 week break from working out... unfortunately I find that the first few days of taking a break I feel ok, but then start to feel progressively worse. Not too long ago I took a 2 week break from lifting, and felt utterly shitty towards the end of the second week. I instantly improved once I get a good workout under my belt. Mind you, I keep volume low and cycle my weights so I'm not working with maximum load all the time. Also, I stick with 6 reps and 1 set per exercise, keeping the workouts at around 30 minutes, 3 x a week. That combined with moderate cardio for 30 minutes, twice a week. Seems to do me more good than harm, really.

I have some ideas as to what kind of treatment regimen I would like to start off with (once I've managed to find a source for everything I need):

1. Hydrocortisone (and possible adrenal extracts and/or licorice root).
2. Nebido (newest testosterone delivery system on the market.. very long lasting, time release injectable that works much like testosterone implants.. only available in Europe at present; met with resounding applause from people who have partaken in its clinical trials)
3. hCG, low dose (maybe 250 IU E3D)
4. Liquidex

Thyroid treatment may not be necessary at present, because I don't feel that I'm suffering terribly from low thyroid symptoms, and even though these saliva tests showed lowish values, my bloodwork showed high FT3 & FT4 past midrange. TSH was on the high side, though (in the blood tests).
I will, of course, treat it if it starts to feel like a necessity. I'll also check aldosterone & ferritin as soon as I have some extra cash at hand.

How does this plan look? Just to get me started on something, and hopefully on a road to feeling better. Naturally I expect quite a lot of tweaking to be necessary, but you gotta start somewhere, right?

In one of his speaches Patrick Hanaway, MD from Genova diagnostics mentioned that hormone levels in saliva is changing so often that for their difficult cases they do the sampling for three days in the row and every two hours rather than usual one set 4 samples 7AM-11PM.

Glad to know that Genova tests are available to you.
What was the name of the tes that you did?
Post results.
..

[Sargovar]

Yep, the Genova tests were actually a bit easier to order, they came with a cold retaining envelope & ice packs, and they were handled in a lab in my country (before being shipped out to the States), so there was never a problem with shipping or any doubt over the freshness of the samples.

Here's the test I did. 4 x a day saliva cortisol, + morning DHEA. Note the insanely high DHEA. I did this test at the end of may, which is why I find it hard to believe that my DHEA could have gone from 3 x above the highest end of the 'normal' range to the very lowest end of a different normal range. It wasn't that long ago, and nothing particularily stressful has occured since then that could account for such a dramatic progress in adrenal fatigue and a drastic decline in DHEA levels (nor do I feel that different now, to be honest).

[JanSz]

Originally Posted by Sargovar

Yep, the Genova tests were actually a bit easier to order, they came with a cold retaining envelope & ice packs, and they were handled in a lab in my country (before being shipped out to the States), so there was never a problem with shipping or any doubt over the freshness of the samples.

Here's the test I did. 4 x a day saliva cortisol, + morning DHEA. Note the insanely high DHEA. I did this test at the end of may, which is why I find it hard to believe that my DHEA could have gone from 3 x above the highest end of the 'normal' range to the very lowest end of a different normal range. It wasn't that long ago, and nothing particularily stressful has occured since then that could account for such a dramatic progress in adrenal fatigue and a drastic decline in DHEA levels (nor do I feel that different now, to be honest).

I am always puzzled and amazed by a question on how much information can be had by measuring same hormones in diferent body fluids.
That is assuming that the measurements in themselve are correct.

The NutroEval and EstroEssence tests are build around this concept.

At the moment any DHEA supplementation I would rather base on blood tests.
That probably also apply to Cortef supplementation.
You could do 4x or 6x Cortisol measurements.

See how many ways Quest is testing cortisol
Quest Diagnostics: Test Menu
----------------------------------
or LabCorp

1: Cortisol
2: Adrenocorticotropic Hormone (ACTH), Plasma
3: Cortisol, Urinary Free, HPLC
4: 17-Hydroxycorticosteroids, Urine
5: 17-Hydroxycorticosteroids and Creatinine Ratio, 24-Hour Urine

7: Cortisol, AM PM
8: Cortisol, AM
9: Cortisol, PM
10: 11-Desoxycortisol
11: Salivary Cortisol
12: Cortisol, 7 Specimens
13: Cortisol, 6 Specimens
14: Cortisol, 8 Specimens
15: Cortisol, 2 Specimens
16: Cortisol, 5 Specimens
17: Cortisol, 3 Specimens
18: Cortisol, 4 Specimens

Home

[Sargovar]

I definitely seem to be an extreme case, swinging wildly from one end to the other in various hormones. At least in saliva tests.. my bloodwork has been a little more consistent.

Blood DHEA-s was 8.1 umol/l on a scale of 3 - 12, so I guess that was the most normal reading I've gotten so far (DHEA wise).

While I somewhat doubt the accuracy of this latest saliva test with regards to cortisol, I know I'm not exactly swimming in the stuff (even if I do have a normal circadian rhythm), so I will probably need at least some AM cortisol augmentation when I start injecting T & hCG to keep from going from a situation that is still salvageable to full blown adrenal exhaustion.

I got an appointment for a leading endocrinologist at the private sector, and through some contacts, I'm getting a huge discount for the visit. Probably won't end up having to pay a whole lot out of pocket. Before I see him, I'm going to send him a letter outlining my expectations & desires for treatment, and if he does not meet them, I will not waste my time with him.
I know endos usually mean bad business, but it's worth a shot, seeing as this fellow is well reputed and has (apparently) treated cases such as hypogonadism etc with sucess in the past.

Originally Posted by JanSz

I am always puzzled and amazed by a question on how much information can be had by measuring same hormones in diferent body fluids.
That is assuming that the measurements in themselve are correct.

The NutroEval and EstroEssence tests are build around this concept.

At the moment any DHEA supplementation I would rather base on blood tests.
That probably also apply to Cortef supplementation.
You could do 4x or 6x Cortisol measurements.

See how many ways Quest is testing cortisol
Quest Diagnostics: Test Menu
----------------------------------
or LabCorp

1: Cortisol
2: Adrenocorticotropic Hormone (ACTH), Plasma
3: Cortisol, Urinary Free, HPLC
4: 17-Hydroxycorticosteroids, Urine
5: 17-Hydroxycorticosteroids and Creatinine Ratio, 24-Hour Urine

7: Cortisol, AM PM
8: Cortisol, AM
9: Cortisol, PM
10: 11-Desoxycortisol
11: Salivary Cortisol
12: Cortisol, 7 Specimens
13: Cortisol, 6 Specimens
14: Cortisol, 8 Specimens
15: Cortisol, 2 Specimens
16: Cortisol, 5 Specimens
17: Cortisol, 3 Specimens
18: Cortisol, 4 Specimens

Home