[PIC] Steroidogensis Pathway... why am I bottlenecked?

[krazy]

Ok, last thread on this, I promise. I'm getting treatment in a few weeks but I want to make one last effort before I get chalked up to being idiopathic.

Steroidogensis Pathway (c/o Wikipedia):


Related stats:
Pregnanediol: 500 (32-501) - Progesterone metabolite
DHEA: 3032 (5-1476) (No, I don't supplement DHEA, either)
Androstenedione: 53 (0-50)
Estrone: 2.2 (3-12.0)
Androstanediol: 85 (48-578)
Testosterone: 35 (60-103)
Estradiol: 0.5 (0-7.0)
DHT: 9.4 (0-13)
(This was from a urine test on 08/03)


Interesting numbers from earlier labwork:
04/29: LH: 1.3 (1.5-9.3) - out-of-range low
DHEA-S: 293 (110-510) - now in range??
Estradiol: 31 (<= 29) - now out-of-range high??

03/06: LH 2.4 (1.5-9.3) - now low/mid in-range??
FSH: 4.0 (1.6-8.0)

Other pertinent facts:
-No, I've never done steroids/anabolics.
-My adrenals, though very slightly stressed, aren't in chaos.
-Thyroid looks good, too.
-I'll find out my most recent levels of LH/FSH/Total T next Monday Oct 6th.

WTF is the deal with the bottleneck at Androstenedione? Shit, I'd be happy for a ton of estrogen right now that I could just dial down with some Clomid.

Please provide any input and it is much appreciated.

[pmgamer18]

I don't know why your bottleneck at Androstenedione but I can tell you from your labs you have a pituitary problem your Secondary and need an MRI to rule out a tumor don't panic it is rare to be cancer. If you don't have a tumor your pituitary can be bad from other things mine is bad do to a Head injury.
When you have low T and low LH and FSH with good levels of E2 and you not that high above this range. Then your Secondary and you need to have all the hormones that the pituitary controls checked. Look at this link and run labs you have not had done.
realthyroidhelp.com &bull; View topic - Labs we men need done.
And in this link are some good FAQ's that are full of good info.
realthyroidhelp.com &bull; View topic - «:::F:::» «:::A:::» «:::Q:::» «:::S:::»

[krazy]

Thank you for that.

Regarding a hypopituitary situation... have you accurately tested your hypothalamus to make sure it isnt a hypothalamus failure, instead?

Also, my thyroid checks out fine, I'm short (5' 5" @ 21), so, barring a prolactin secreting tumor, my pituitary should be fine, correct?

I'm beginning to think that I am hypopituitary...

[pmgamer18]

Lucky for me I met Chris here when he was posting about Thyroid probelms. I went to his site and he helped me a lot on tihs.
realthyroidhelp.com &bull; View forum - Hypopituitary
I have done ever test and even looking at my old labs they were screaming a pituitary problem. My Testosterone test my first one I was 120 for Total T and very low on LH and FSH to bad for me the Dr.'s were not up on this and told me I was Primary not even paying att. to the low LH and FSH.

[marianco]

The Steriodogenesis Pathway is a nice reference.

However, in real life, the primary question to ask is where are the hormones being produced and which of the products end up in the bloodstream.

For example, the brain produces a lot of pregnenolone and DHEA for its own use - more than any of the other neurotransmitters in the brain. But, these generally are kept in the brain rather than released as a signal to the rest of the body.

Almost all of the DHEA in the blood is from the adrenal glands. 5 % of testosterone is produced by the adrenal glands. This testosterone is then converted outside the adrenals to DHT and Estradiol. DHEA can be later converted to testosterone then later DHT or Estradiol.

The testes produce 95% of the testosterone measured in the blood. Testosterone is later converted to Estradiol or DHT. Progesterone is the primary precursor to testosterone in the testes - not DHEA.

Thus for the most part, prior to supplementation, DHEA and Testosterone levels are going to be independent of each other. One is made by the adrenals, the other primarily by the testes.

Since each organ pumps out a different mixture of signals, the problem is not so much a blockage, but whether or not that particular organ is being signaled to make its products.

Rarely would a person be missing some enzyme to cause a blockage in production. Thus whether or not there is a blockage is not the correct answer.

Rather, it is a matter of whether or not that particular organ is capable of producing the range of products it is suppose to (e.g. primary hypogonadism) or whether or not it is receiving the appropriate and enough of the signal to product its products (e.g. secondary hypogonadism).

DHEA is a poor test. It varies wildly from one moment to the next. DHEA-sulfate is a much more stable and useful test.

High DHEA-s levels generally occur in response to stress. The younger the person, the higher DHEA can go since the layer making it is thicker in a young person compared to older person. If DHEA is high, then its most frequent metabolite can also be expected to be high. ACTH is produced in response to stress. This triggers output from the adrenal glands in a shotgun manner. Thus Cortisol, Progesterone, Pregnenolone, Testosterone, DHEA-s would be expected to increase in output from the adrenal gland in response to stress.

[krazy]

Originally Posted by marianco

Almost all of the DHEA in the blood is from the adrenal glands. 5 % of testosterone is produced by the adrenal glands. This testosterone is then converted outside the adrenals to DHT and Estradiol. DHEA can be later converted to testosterone then later DHT or Estradiol.

This would make sense why I have at least some DHT and Estradiol to measure (combined with at least some, though very hypo, functioning in the testicles).

Originally Posted by marianco

Rather, it is a matter of whether or not that particular organ is capable of producing the range of products it is suppose to (e.g. primary hypogonadism) or whether or not it is receiving the appropriate and enough of the signal to product its products (e.g. secondary hypogonadism).

Yeah. I placed alot of doubt in the 17BHSD enzyme deficiency after all my research. I guess this puts the nail in the coffin on that avenue in my opinion. I will be getting some pretty recent bloodwork soon. I need to keep an eye out on the LH levels in my bloodwork I got last week.

Thanks for the great insight.

[thenxtgrt1]

Originally Posted by krazy

Ok, last thread on this, I promise. I'm getting treatment in a few weeks but I want to make one last effort before I get chalked up to being idiopathic.

Steroidogensis Pathway (c/o Wikipedia):


Related stats:
Pregnanediol: 500 (32-501) - Progesterone metabolite
DHEA: 3032 (5-1476) (No, I don't supplement DHEA, either)
Androstenedione: 53 (0-50)
Estrone: 2.2 (3-12.0)
Androstanediol: 85 (48-578)
Testosterone: 35 (60-103)
Estradiol: 0.5 (0-7.0)
DHT: 9.4 (0-13)
(This was from a urine test on 08/03)


Interesting numbers from earlier labwork:
04/29: LH: 1.3 (1.5-9.3) - out-of-range low
DHEA-S: 293 (110-510) - now in range??
Estradiol: 31 (<= 29) - now out-of-range high??

03/06: LH 2.4 (1.5-9.3) - now low/mid in-range??
FSH: 4.0 (1.6-8.0)

Other pertinent facts:
-No, I've never done steroids/anabolics.
-My adrenals, though very slightly stressed, aren't in chaos.
-Thyroid looks good, too.
-I'll find out my most recent levels of LH/FSH/Total T next Monday Oct 6th.

WTF is the deal with the bottleneck at Androstenedione? Shit, I'd be happy for a ton of estrogen right now that I could just dial down with some Clomid.

Please provide any input and it is much appreciated.

My numbers are eerily similar to yours. My androstenedione was almost twice the upper limit. Your other results correlate to mine as well. This whole thing has really just confused me even further.

I'm still searching for a clear explanation on how "metabolites" can be in higher range but not T. Marianco's insight and this thread has actually been extremely helpful. I too, was viewing androstenedione as being "bottlenecked". But apparently this is wrong way of looking at it.

What are your symptoms? What initially led you to investigate hrt?

[krazy]

Originally Posted by thenxtgrt1

My numbers are eerily similar to yours. My androstenedione was almost twice the upper limit. Your other results correlate to mine as well. This whole thing has really just confused me even further.

I'm still searching for a clear explanation on how "metabolites" can be in higher range but not T. Marianco's insight and this thread has actually been extremely helpful. I too, was viewing androstenedione as being "bottlenecked". But apparently this is wrong way of looking at it.

What are your symptoms? What initially led you to investigate hrt?

My parents go into the whole 'bioidentical hormone thing' and I didn't believe in it but agreed to an initial workup, anyways. Sure enough, my T was way low. I always had a feeling that something in me wasnt 'right' but I didn't think T and I hoped not.

I maintained a girlfriend and had no problems for 7 months but, right around the test time, come to think of it I did experience some ED.

Additionally, even with a PERFECTLY tuned diet (calories, macronutrients, etc) and the utmost dedication and aggressiveness (the most I could muster) in the gym... I couldn't put on more than 2-3 pounds of muscle above my setpoint. I just figured I was a hardgainer.

Its late so I'm not going to ramble too much further but PM me if you want to talk.

[rrcat]

Dr M or anyone,

Dr M. mentions that the brain produces its own dhea and pregnenolone not for use in the body. Since many of us seem to be low in many things, I assume it is possible for the brain to underproduce adequate levels of dhea and pregnenolone. Would supplementation help if this is the case. Do blood levels give an idea of brain levels or not? Pretty confused here.