New test results

[Rangeball]

Got these a few days ago. Bold number is previous result:

FSH- 5.6 6 (1.6-8)
LH- 4.8 5.3 (1.5-9.3)
Total Testosterone- 436 763 (250-1100)
Free Test- 47.7 63 (46-224)
Bio-available Test- 119] (110-575)
SHBG- 44 70 (8-46) Insert bad word here
DHT- 59 (25-75)
Estradiol- 20 13 (<29)
Prolactin- 6.1 6.6 (2-18)

Cortisol- 7 13 (4-22) This was taking 40mg daily, and 10mg an hour before the draw.
Progesterone- 6.6 (2-18)
DHEA-S- 257 238 (45-345) I take 25mg daily.
Pregnenolone- 29 (10-200) I take 50mg daily.

B12- 469 607 (200-1100) I take 1 B Trio from OHC daily
Magnesium- 4.7 (4-6.4) I take 250mg of zinc oxide daily
Vit A- 50 (38-98) I take 8000 IU natural daily
Zinc- 9.3 (9-14.7)
Copper- .6 (.53-.77)
Vit D 1,25-Dihydroxy- 47 45 (15-60)
Vit D 25-oh Total- 24 30 (20-100) (Upper edge of insufficiency)
Vit D 25-oh, D3- 24 30 (20-100) (represents both endo and exogenous) I take 4000 IU D3 daily.
Vit D 25-oh D2- <4 <4 (20-100) (represents exogenous sources, food or supplements)

Glucose- 105 99 (65-99)
HGA1c- 5.0 (<6)
Insulin- 21 (<17)

SHBG has me baffled. Looking at the things Marianco said increases SHBG there is no correlaton. I plan to order some avena sativa powder with verified >10% avenacosides A&B. Hopefully that will free up the test I am producing but not using. I assume estradiol is low because free test is so low.

Thoughts?

[zkt]

I agree. Its baffling.,and high SHBG is binding up your T.
Not really sure how to lower SHBG, or if it can be.
More interesting is why is it high ?

[Normandy]

Im more concerned about your Cortisol levels. It looks like you have some nasty suppression going on.

How are you feeling on the 40 mgs?

Did you do a pupil dilation test on urself? If so, have you done one lately?





-- Normandy

[Rangeball]

Originally Posted by zkt

I agree. Its baffling.,and high SHBG is binding up your T.
Not really sure how to lower SHBG, or if it can be.
More interesting is why is it high ?

I have no idea. But avena sativa is supposed to bind to SHBG without causing an upregulation in SHBG production. I took protein factory's "unleashed" for a month and did feel beter on it, and it has avena sativa as the main ingredient.

I am in the process of ordering some avena sativa as I type.

[Rangeball]

Originally Posted by Normandy

Im more concerned about your Cortisol levels. It looks like you have some nasty suppression going on.

How are you feeling on the 40 mgs?

Did you do a pupil dilation test on urself? If so, have you done one lately?





-- Normandy

Normandy, do you mean suppression from the 40mg or just in general?

I definitely have adrenal fatigue. My first test was 7. My script is for 20mg, but I took 40mg for the week prior to the blood test. I suspected 20 mg wasn't enough due to malabsorption, and it appears I was right. I felt much better at 40mg, and am requesting a bump in my script from my doc when we meet Thursday.

I have not done a recent pupil dialation test. As I understand it, mid range am serum cortisol is a good place to be. Do you have other thoughts?

[zkt]

15-20 minutes searching for confirmation that the Medical communnity confirms the validity of this test came up empty. I makes sense tho since the adrenal medulla secretes epinephrine which is involved in the pupil dialation during the fight or response. The smooth muscles of the brinchii also dilate which is of particalar interest to me (asthma). I`ll definitely check this with self and others to see how well the resoponse correlates th the known indicators of adrenl fatigue.

[Normandy]

Originally Posted by Rangeball

Normandy, do you mean suppression from the 40mg or just in general?

Rangeball, originally I meant suppresion from the 40mg of cortisol which is a high amount in any case. But that was because I reversed the order in my mind when I saw the 7. So you had 7 ug/dl of AM cortisol before ever administering HC or any adrenal glandular extracts? If that's the case, of all of your labs, this is the most salient. I would rank everything else secondary to your adrenal problem. What i mean by that is tread slowly when tinkering with other elements of ur hormonal profile always double checking whether it could have any impact on ur adrenals.

Also, shift ur mental gears a bit so to speak and focus your attention on your adrenals until you've learned as much as you can about them. You'd be surprised to know how many things affect the adrenals. Anywhere from benzodiazepine receptor sites in the adrenals (and what effect taking benzos might have on them) to avoiding sudden and extreme temperature changes such as jumping in a refreshing pool after a workout and then coming out of the pool and into the heated jacuzzi to relax. Monitering your basal temperature daily, checking your pupil dilation every once in a while (maybe check it during moments of feelign crappy and then during times you're feeling good to compare the two) etc. And keeping a journal of the those findings. Most of these things aren't supported by the medical community, but Im not willing to wait 20 years before it comes to their attention to do something about it.

Also, see if you can come down from 40mg of cortisol tapering very slowly. At 40mg daily, suppresion of the adrenals is a valid concern. And whether it'll be a temporary or permanent suppresion, is still to be seen. Yes, a few well respected docs do feel that 40mg/day of cortisol won't lead to any permanent adrenal atrophy, but then I also know of well respected docs who feel that 2000 iu's of HCG in one shot won't lead to leydig cell desensitization either. When it comes to things such as atrophy or desensitization, I'd like to side on the side of caution.
Much like the 500 iu/day HCG cutoff that shippen and crisler have advised, i'd stick to a 30mg/day cortisol cutoff based on readings from Jefferies et al.

Once you feel confident that you've devoted as much of your effort to understanding ur adrenals as you can, then move on to figuring out how to optimize T, shbg, etc. Goodluck Rangeball, this will be a long and slow journey. But we are infinitely better off than those who have come before us.



-- Normandy

[Rangeball]

Normandy, thanks for your concern and taking the time to respond.

Originally Posted by Normandy

Rangeball, originally I meant suppresion from the 40mg of cortisol which is a high amount in any case. But that was because I reversed the order in my mind when I saw the 7. So you had 7 ug/dl of AM cortisol before ever administering HC or any adrenal glandular extracts? If that's the case, of all of your labs, this is the most salient. I would rank everything else secondary to your adrenal problem. What i mean by that is tread slowly when tinkering with other elements of ur hormonal profile always double checking whether it could have any impact on ur adrenals.

The 7 was before any treatment. I have no doubt that my adrenal fatigue is caused by my hypothyroidism. I tried isocort for a few months with poor results, and cortef produced a night and day difference. I agree with you on the treading lightly comment. When I first tested my testosterone and found it lowered, my doc agreed to TRT as well as another top doc I consulted, but I declined because I felt confident the suppressed T was from hypothyroid. Looks like I was right, as T bounced back nicely. I just have to deal with the high SHBG, and I've ordered Avena Sativa for that.

Also, shift ur mental gears a bit so to speak and focus your attention on your adrenals until you've learned as much as you can about them. You'd be surprised to know how many things affect the adrenals. Anywhere from benzodiazepine receptor sites in the adrenals (and what effect taking benzos might have on them) to avoiding sudden and extreme temperature changes such as jumping in a refreshing pool after a workout and then coming out of the pool and into the heated jacuzzi to relax. Monitering your basal temperature daily, checking your pupil dilation every once in a while (maybe check it during moments of feelign crappy and then during times you're feeling good to compare the two) etc. And keeping a journal of the those findings. Most of these things aren't supported by the medical community, but Im not willing to wait 20 years before it comes to their attention to do something about it.

I have read extensively on these subjects and participate in a private forum with others with similar concerns. I am lucky, my doc is a family friend and personal client, so I can talk to him about things that most docs wouldn't entertain, cortisol support being one.

Also, see if you can come down from 40mg of cortisol tapering very slowly. At 40mg daily, suppresion of the adrenals is a valid concern. And whether it'll be a temporary or permanent suppresion, is still to be seen. Yes, a few well respected docs do feel that 40mg/day of cortisol won't lead to any permanent adrenal atrophy, but then I also know of well respected docs who feel that 2000 iu's of HCG in one shot won't lead to leydig cell desensitization either. When it comes to things such as atrophy or desensitization, I'd like to side on the side of caution.
Much like the 500 iu/day HCG cutoff that shippen and crisler have advised, i'd stick to a 30mg/day cortisol cutoff based on readings from Jefferies et al.

I too have read the Jeffries book. In normal physiology, I agree a 40mg dose could cause suppression. However again hypothyroidism seems to have an impact, this time on absorption. Jeffries discussed this in the book, but his upper dose seems more conservative than other docs in regards to elevating the dose when poor absorption is in play. I've never had any of the signs of elevated cortisol such as easy bruising, thin skin, euphoria, etc. Even at 40mg my am cortisol was just mid-range. Other things I supplement orally showed only a modest increase in levels, while the things I take sublingually showed a greater increase, pointing to malabsorption. I spent several months at 20mg but feel much better at 40mg, it seems to allow my armour to work better, which makes sense due to it's role in transport of thyroid hormones.

Once you feel confident that you've devoted as much of your effort to understanding ur adrenals as you can, then move on to figuring out how to optimize T, shbg, etc. Goodluck Rangeball, this will be a long and slow journey. But we are infinitely better off than those who have come before us.

-- Normandy

Thanks again Normandy. I feel I am at that point now

[hardasnails1973]

Originally Posted by Rangeball

Normandy, thanks for your concern and taking the time to respond.



The 7 was before any treatment. I have no doubt that my adrenal fatigue is caused by my hypothyroidism. I tried isocort for a few months with poor results, and cortef produced a night and day difference. I agree with you on the treading lightly comment. When I first tested my testosterone and found it lowered, my doc agreed to TRT as well as another top doc I consulted, but I declined because I felt confident the suppressed T was from hypothyroid. Looks like I was right, as T bounced back nicely. I just have to deal with the high SHBG, and I've ordered Avena Sativa for that.



I have read extensively on these subjects and participate in a private forum with others with similar concerns. I am lucky, my doc is a family friend and personal client, so I can talk to him about things that most docs wouldn't entertain, cortisol support being one.



I too have read the Jeffries book. In normal physiology, I agree a 40mg dose could cause suppression. However again hypothyroidism seems to have an impact, this time on absorption. Jeffries discussed this in the book, but his upper dose seems more conservative than other docs in regards to elevating the dose when poor absorption is in play. I've never had any of the signs of elevated cortisol such as easy bruising, thin skin, euphoria, etc. Even at 40mg my am cortisol was just mid-range. Other things I supplement orally showed only a modest increase in levels, while the things I take sublingually showed a greater increase, pointing to malabsorption. I spent several months at 20mg but feel much better at 40mg, it seems to allow my armour to work better, which makes sense due to it's role in transport of thyroid hormones.



Thanks again Normandy. I feel I am at that point now

i found reference that high shbg could be the result of low cortisol levels as well as elevated estrogen or altered estrogen metabolism. Since cortisol is needed to help detoxify the liver as well as to metabolize thyroid hormones.

[Rangeball]

Interesting. Do you remember where you read this?

[hardasnails1973]

Originally Posted by Rangeball

Interesting. Do you remember where you read this?

http://209.85.165.104/search?q=cache...nk&cd=10&gl=us

since cushing diseae has low shbg and every thing in the body has pretty much opposite reactions then addison (low adrenals ) would have elevated ones

Low dhea is where your elevated shbg is coming from ..low dhea = elevated shbg
low inuslin would also raise shbg as indicated on your elevated blood glucose test.

Glucose tolerance test would be next step and if hypoglycemic then look into adrenal fatigue, thyroid and magnesium defieincy
low preg usually indicated thyroid abnormalities as well as sugar imbalances

[Rangeball]

Found a good link on testosterone info from Shippen-

http://www.prostate90.com/Male%20Hor...Aging%20LE.htm

The info on nettle roots affect on SHBG is enlightening. Avena Sativa does this also, but does not inhibit DHT as I understand it.

I plan to use avena, and if a retest shows DHT elevation I'll swap out part of the avena for some nettle root.

[hardasnails1973]

Originally Posted by Rangeball

Found a good link on testosterone info from Shippen-

http://www.prostate90.com/Male%20Hor...Aging%20LE.htm

The info on nettle roots affect on SHBG is enlightening. Avena Sativa does this also, but does not inhibit DHT as I understand it.

I plan to use avena, and if a retest shows DHT elevation I'll swap out part of the avena for some nettle root.

Rasiing dhea with decrease shbg

[Rangeball]

Thanks. I have bumped my pregnenolone to 100mg and DHEA to 50mg daily after these results came in.

I have tabs for both and am chewing them up and swallowing. I plan to order sublingual for both if I can find them.

[Normandy]

Originally Posted by Rangeball

Thanks again Normandy. I feel I am at that point now

It sometimes happens that I assume someone knows their shit and later find out they didn't know squat. With you, it was the other way around. I just saw 7 ug/dl of cortisol at the beginning of this post and thought "why the hell are these guys baffled at SHBG when this guy's about to turn Addisonian on us!"

Good to hear you've got it together. Would be interested in knowing what your overall gameplan is. Are you trying to heal your adrenals and within a year or two try to see if you can sustain them without HC, or have you pretty much figured it will be lifelong supplementation? Same question goes for thyroid.

Also, i asked if you've checked your pupil dialation recently because Im in the same boat with adrenal fatigue, hypothyroidism and low t, and my pupils definitely do the chigly wigly everytime I run the test and also see no improvement in my daily temperature fluctuations. Wondering how many others have seen an improvement with regard to pupil dialation.




-- Normandy