Men's Health Forum: This is a discussion on Labs, Dx and Rx within the Anabolic Steroids forums, part of the extensive steroid information at MESO-Rx; Meant to put this up last week to gather some informed opinions befor seeing the MD on Tuesday. But shit ...
Meant to put this up last week to gather some informed opinions befor seeing the MD on Tuesday. But shit happened.
cortisol 10.4 at 5 PM ( 1-10) in PM
LH 7.65 (1.3-10.1)
Total T 345 (225-972)
estradiol <20 (0-44)
albumin 4.3 (3.6-5.0)
glucose 84 (70-110)
urea nitrogen 27H (8-22)
protein total 6.5 (6.5-8.0)
creatinin 1.5H 0(.5-1.3)
sodium 134H (134-145)
potassium 5.1H (3.5-5.0)
alkaline phosphatase 105 (40-120)
ast 31 (15-46)
ALT 43 ( 13-69)
The electrolyte imbalance i and elevated BUN is due to mild to moderate renal impairment due to renal artery stenosis and of no concern here. What I find striking is the wide difference in LH and T levels. Tis at the20th percentile and LH at the 94th. This wide variation is indicative pf primary hypogonadism isn`t it ? The pituitary is screaming at the balls to put out more T but they just arent listening. The elevated cortisol, > 100 th percentile is probably actually higher than indicated since the ref range is an average of all PM values. The normal cortisol value, I think is closer to 4-5 at 5PM. The cortisol vs. T value indicates that metabolism is shifted toward the catabolic side. This is also evidenced by my body weight (142lb at 5'10") and lack of muscle. This could be caused by the renal insuffiency tho and I will clear point up when meeting with my kidney Dr. Tuesday. I think there is also the possibility of an underlying adrenal insufficiency since one of the three adrenal arteries is a branch of the renal artery. My history is one of extensive arterial placques. I`m not sure what the normal E2 level means. except that the T isnt being overlyconverted to E2.
My RX is hcg IM at the recommended doseage and intervals (got that here somewhere) for a month and then retest. Or I could try the Dermicrine for a month and retest.
Btw my primary care physician doesnt seem to know much about HRT and it would by very helpful if I could convince her I know what I`m talking about so she would Rx the hcg. Although seems I read somewhere that hcg isnt approved in the USA for HRT. In which case I suppose her hands are tied and i`m on my own- hint,hint.
Meant to put this up last week to gather some informed opinions befor seeing the MD on Tuesday. But shit happened.
cortisol 10.4 at 5 PM ( 1-10) in PM
LH 7.65 (1.3-10.1)
Total T 345 (225-972)
estradiol <20 (0-44)
albumin 4.3 (3.6-5.0)
glucose 84 (70-110)
urea nitrogen 27H (8-22)
protein total 6.5 (6.5-8.0)
creatinin 1.5H 0(.5-1.3)
sodium 134H (134-145)
potassium 5.1H (3.5-5.0)
alkaline phosphatase 105 (40-120)
ast 31 (15-46)
ALT 43 ( 13-69)
The electrolyte imbalance i and elevated BUN is due to mild to moderate renal impairment due to renal artery stenosis and of no concern here. What I find striking is the wide difference in LH and T levels. Tis at the20th percentile and LH at the 94th. This wide variation is indicative pf primary hypogonadism isn`t it ? The pituitary is screaming at the balls to put out more T but they just arent listening. The elevated cortisol, > 100 th percentile is probably actually higher than indicated since the ref range is an average of all PM values. The normal cortisol value, I think is closer to 4-5 at 5PM. The cortisol vs. T value indicates that metabolism is shifted toward the catabolic side. This is also evidenced by my body weight (142lb at 5'10") and lack of muscle. This could be caused by the renal insuffiency tho and I will clear point up when meeting with my kidney Dr. Tuesday. I think there is also the possibility of an underlying adrenal insufficiency since one of the three adrenal arteries is a branch of the renal artery. My history is one of extensive arterial placques. I`m not sure what the normal E2 level means. except that the T isnt being overlyconverted to E2.
My RX is hcg IM at the recommended doseage and intervals (got that here somewhere) for a month and then retest. Or I could try the Dermicrine for a month and retest.
Btw my primary care physician doesnt seem to know much about HRT and it would by very helpful if I could convince her I know what I`m talking about so she would Rx the hcg. Although seems I read somewhere that hcg isnt approved in the USA for HRT. In which case I suppose her hands are tied and i`m on my own- hint,hint.
Unless proved otherwise your balls are for decoration only, not the end of the world.
HCG would help to keep them full, but they cannot produce.
I did not say not to use Dermacrine, if other tests prove that you will benefit from its ingredients.
Dermacrine is ment to induce testis to production, curently they do not listen to LH so they will not listen to Dermacrine either.
You are going to need supplemental Testosterone.
On your next blood test monitor BioAvailable Testosterone and E2, among many other.
-------------------------- http://www.lef.org/magazine/mag2006/...ysteine_01.htm
Nutritional Therapies for Managing Homocysteine
Search LEF.org for arterial plaque
My blood long blood test checks for about ten "risk factors".
One of them is homocysteine.
You are probably high on it.
zkt you can't test LH when on HCG from what I have been told. Your cortisol test is usless you need to do a full day saliva test for this. Or a fasting morning blood test at 8am. If your doing HCG to bring up your T levels what dose are you doing. It's not working at the dose your on. Best to try 100 IU's everyday then test in 6 weeks it takes time to get your testis going again. The E2 test is the wrong one you need one like this. http://www.labcorp.com/datasets/labc...o/sr012000.htm
I don't see how your sodium is high 134 is the bottom of your labs range. You might want to have your Alsosterone and Renin tested for hypoaldosteronism.
Here is a link on it. http://www.stopthethyroidmadness.com...opic.php?t=581
To help my problem with this I take 1/2 a tsp full of natural Sea Salt in a glass of water first thing in the morning. I could not believe how much better it made me feel.
__________________
Don't believe anything you hear and only half of what you see.
Phil
You may prefer the Dermacrine over the Androgel that a physician would likely prescribe. The Derma would provide the added benefit of increased DHEA, androstenedione, androstenediol, androstenetriol, ect… while also increasing test. I think there is something to be said for providing hormones “lower on the tree” and allowing the body to convert them on its own.
BTW, this is different than the Dermacrine Sustain which would not provide the exogenous hormonal support. They are two different products for different purposes
First of all thanks. Let me clear up a few misunderstandings.
The sodium is low not high- guess I typed a H instead of an L
I should have said tentative RX. No treatment at this time.
Primordial Performance: right, the Dermacrine, not the Dermacrine Sustain. Its a definite possibility.
pmgamer18: it`s not the insurance its the VA. If my MD prescribes T replacement or hcg ( good to know hcg is approved for TRT in the USA) then all is fine. As I indicated, she apparently doesnt think there is problem since I havent seen any T patches show up in the mail. Convincing, persusading, educating (choose word wisely) is another story. According to my wife, diplomacy is not my strong suit. But what the hell does she know ?
Seriously, just how the hell do you tell a doctor they`re wrong ? Particurarily a VA doctor, Not only are they overworked but... Best not to go there now. I`ll rant on that someother time.
Agree that hypoaldosteronism is a possibility. . Will add Alsosterone and Renin to the test list. This is a good time to elaborate on my history. I think there is something significant there.
Three and a half years ago I suffered a small thalamii/ brainstem stroke. Spent 2 weeks in the hospital. Couldnt make a sound, swallow, or move my face, lips or tongue. PEG tube time. Had to sleep sitting up for a few weeks to avoid drownding in my own spit. The point here is I devoted the next six months relearning to swallow. I was either trying , practicing, visualizing or thinking about swallowing. Had energy to burn. The day after I was released I was out waxing the car. After regaining the ability to eat I devoted the next six months to relearning to talk.
( successfully). Still high energy time. I was , I suspect, literally running on adrenaline and ran out.. After a year had regained a good degree of normalicy and relaxed a bit. Then my optimistic outlook, energy and drive slowly diminished. Unfortunately no hormone tests were done until recently. So I suspect adrenal fatigue or some insuffiency might be going on. Will be very interesting to see what the nephrologist thinks of this.
Jan Sz: I have the utmost respect for your opinions. But fail to see where the 345 ng/dl is coming from if the testes arent responding at least a little to LH. The adrenals dont produce that much. Correct me if Im wrong. The degree to which the testes respond to LH would determine the treatment. Hcg, Dermacrine or T replacement. And yes I am aware of the benefits or TRT on the cardiovascular system, altho apparently my primary doctor isnt.
I intend to have the following labs run.
total T
boiavailable T
SHBG
E2
Fasting am cortisol
prolactin
Alsosterone
Renin
homocysteine
c reactive protein DHT
DHEAS
I dont want to overload this guy with too many tests. But if you strongly believe others are necessary please list them. Or if I overlooked any.
Is Estradiol, Bioavailable different from the previous estradiol test ?
First of all thanks. Let me clear up a few misunderstandings.
The sodium is low not high- guess I typed a H instead of an L
I should have said tentative RX. No treatment at this time.
Primordial Performance: right, the Dermacrine, not the Dermacrine Sustain. Its a definite possibility.
pmgamer18: it`s not the insurance its the VA. If my MD prescribes T replacement or hcg ( good to know hcg is approved for TRT in the USA) then all is fine. As I indicated, she apparently doesnt think there is problem since I havent seen any T patches show up in the mail. Convincing, persusading, educating (choose word wisely) is another story. According to my wife, diplomacy is not my strong suit. But what the hell does she know ?
Seriously, just how the hell do you tell a doctor they`re wrong ? Particurarily a VA doctor, Not only are they overworked but... Best not to go there now. I`ll rant on that someother time.
Agree that hypoaldosteronism is a possibility. . Will add Alsosterone and Renin to the test list. This is a good time to elaborate on my history. I think there is something significant there.
Three and a half years ago I suffered a small thalamii/ brainstem stroke. Spent 2 weeks in the hospital. Couldnt make a sound, swallow, or move my face, lips or tongue. PEG tube time. Had to sleep sitting up for a few weeks to avoid drownding in my own spit. The point here is I devoted the next six months relearning to swallow. I was either trying , practicing, visualizing or thinking about swallowing. Had energy to burn. The day after I was released I was out waxing the car. After regaining the ability to eat I devoted the next six months to relearning to talk.
( successfully). Still high energy time. I was , I suspect, literally running on adrenaline and ran out.. After a year had regained a good degree of normalicy and relaxed a bit. Then my optimistic outlook, energy and drive slowly diminished. Unfortunately no hormone tests were done until recently. So I suspect adrenal fatigue or some insuffiency might be going on. Will be very interesting to see what the nephrologist thinks of this.
Jan Sz: I have the utmost respect for your opinions. But fail to see where the 345 ng/dl is coming from if the testes arent responding at least a little to LH. The adrenals dont produce that much. Correct me if Im wrong. The degree to which the testes respond to LH would determine the treatment. Hcg, Dermacrine or T replacement. And yes I am aware of the benefits or TRT on the cardiovascular system, altho apparently my primary doctor isnt.
I intend to have the following labs run.
total T
boiavailable T
SHBG
E2
Fasting am cortisol
prolactin
Alsosterone
Renin
homocysteine
c reactive protein DHT
DHEAS
I dont want to overload this guy with too many tests. But if you strongly believe others are necessary please list them. Or if I overlooked any.
Is Estradiol, Bioavailable different from the previous estradiol test ?
You are right, lets not write the testicles off.
Use Dermacrine for few months, see what happen.
If you cannot do the whole list of tests do as many as you can.
One more thing and I am only trying to help, you have been through a lot. You need to have your Pituitary checked out have an MRI done. Have you had a blow to the head or a shock from an explosion. It sure sounds lke this can be your problem from the get go some damage to your pituitary.
__________________
Don't believe anything you hear and only half of what you see.
Phil
No ,no head trama. Dont seee how you can think pituitary problems- its cranking out the LH like there no tomorrow, Althought a pituitary tumor might cause that . I`l add ACTH, TSH, FSH and GH to the lst. Still seems to me if a pituitary tumor were responsible for the high LH levels the T would be much higher.
I intend to have the following labs run.
total T
boiavailable T
SHBG
E2
Fasting am cortisol
prolactin
Alsosterone
Renin
homocysteine
c reactive protein DHT
DHEAS
ACTH
TSH
FSH GH
No ,no head trama. Dont seee how you can think pituitary problems- its cranking out the LH like there no tomorrow, Althought a pituitary tumor might cause that . I`l add ACTH, TSH, FSH and GH to the lst. Still seems to me if a pituitary tumor were responsible for the high LH levels the T would be much higher.
I intend to have the following labs run.
total T
boiavailable T
SHBG
E2
Fasting am cortisol
prolactin
Alsosterone
Renin
homocysteine
c reactive protein DHT
DHEAS
ACTH
TSH
FSH GH
Check and make sure none of your meds will mess up this testing
I have been doing a lot of searching and reading on this and it looks like we need to be off HC, DHEA, Steroids and so on before testing this. http://www.answers.com/topic/aldosterone-assay
Primary Hypoaldosteronism
Primary hypoaldosteronism is defined as aldosterone deficiency of adrenal cause. Hypoaldosteronism manifests as an inability to conserve sodium, leading to a negative salt balance in a salt-poor environment. This leads to hypotension, hyperkalemia, dehydration, and volume depletion associated with a mild metabolic acidosis. The disorder can be corrected by a high-salt diet or by replacement of aldosterone with fludrocortisone.
Primary adrenal insufficiency is the most common cause of primary hypoaldosteronism. Diagnosis and treatment are the same as those for adrenal insufficiency (see above). Two rare autosomal recessive disorders, corticosterone methyl oxidase (CMO) deficiency types I and II, can result in markedly reduced adrenal secretion of aldosterone. CMO deficiency type I is recognized by the syndrome of mineralocorticoid deficiency and low aldosterone levels associated with high plasma corticosterone concentration. CMO deficiency type II is similar, except that high levels of 18-hydroxycorticosterone will be associated with low levels of aldosterone. These are primarily diseases of childhood, becoming less severe with age and free access to salt.
Secondary Hypoaldosteronism
The syndrome of hyporeninemic hypoaldosteronism is the most common form of secondary hypoaldosteronism. The disorder is often referred to as renal tubular acidosis type 4. It has been described in almost every disorder of renal function. Chronic renal disease is present in 80% of patients with the disorder. The clinical picture is that of hyperkalemia, hyponatremia, and metabolic acidosis in association with a low plasma renin activity and a low plasma aldosterone level. The most direct and rational therapy for this syndrome is replacement of aldosterone with fludrocortisone at a dosage of 0.1 to 0.2 mg/day.
Pseudohypoaldosteronism (Mineralocorticoid Resistance)
Pseudohypoaldosteronism type I and type II are syndromes of end-organ resistance to the effects of aldosterone. Type I is caused by an inactivating mutation in the mineralocorticoid receptor, and type 2 is ascribed to an ill-defined defect in aldosterone action distal to its binding to the mineralocorticoid receptor. Pseudohypoaldosteronism type 1 is characterized by salt wasting that is resistant to mineralocorticoid replacement. It is best treated with a high-salt diet, 10 to 40 mEq/kg/day. Pseudohypoaldosteronism type II (Gordon syndrome) is a non-salt-wasting disorder that can be associated with hypertension, metabolic acidosis, and hyperkalemia. Plasma renin activity and aldosterone are both low, and administration of mineralocorticoid fails to correct the hyperkalemia and acidosis. The basic defect is thought to be a chloride shunt disorder in the nephron. Treatment is with a potassium-wasting diuretic; hydrochlorothiazide and furosemide are most often used.
Click here to subscribe or purchase the full chapter. Loriaux, D. Lynn, 3 Endocrinology, IV The Adrenal, ACP Medicine Online, Dale DC; Federman DD, Eds. WebMD Inc., New York, 2000. http://www.acpmedicine.com/
Disclaimer
Figures, tables, references and sidebars are available in the subscription edition of ACP Medicine .
D. Lynn Loriaux, M.D., PH.D., Oregon Health Sciences University
I can't help but think my tests were not any good I was on Cortef, DHEA, Testosterone and a Diuretic.
And with all the problems I have I am not stopping these meds to do a test. Where can I get Florinef to try this and see if it helps.
__________________
Don't believe anything you hear and only half of what you see.
Phil
Checked the meds interaction with the aldesterone test. The only possible problems are the (ACE) inhibitors ( lisinopril) and the steroid flunisolide whos plasma half-life of is approximately 1.8 hours. Skipping flunisolide the am of the tests ought to be ok. Of course I`ll check with the MD too. Lisinopril has a long half life - ask the MD
The abstract is VERY interesting and need to print it out and reread till I know it. This is right up the kidney DR,`s alley. I`m sure if I ask intelligent questions he will have a lot to say. If not- on to the endocrinologist.
Sorry to have been negligent in my attention to your problems.. You`ve been a lot of help and I definitely owe you one payback starting next week after I see the MD. Ive got so much dissasociated info running around in my mind I`m afraid if I investigated anything else in depth my head would blow right off my neck. LOL
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