What effect does TRT have on cortisol?

Buy Lab Tests Online

Okian

New Member
Your opinion on this one please :

''What effect does testosterone (therapy) have on cortisol? Does it raise or lower cortisol levels?

Unfortunately, the answer to that question is not as easy to find as we might like. There is a study that looked at giving men testosterone enanthate, which is very similar to the testosterone cypionate that most American men on HRT are used to and found that "No obvious changes were found in the levels of C." This was a small study on healthy men but shows the consensus: testosterone therapy seems to have no major effect on cortisol. However, I think that testosterone likely does affect cortisol in some rather key ways that I will mention below.
Again, though, finding larger studies on more varied populations is few and far between. I think we can still come to a fairly definite conclusion based on input from the steroid community as well.
First of all, there are quite a few stories out there of steroid users greatly lowering their cortisol levels during a cycle. However, I doubt that this is normative for men on any kind of reasonable testosterone replacement for a simple reason: if testosterone decreased cortisol, we would be reading about it everywhere. For example, if testosterone realy lowered cortisol, why did we not see at least some small effect in the study above. And, let's face it: it would be huge news if testosterone therapy substantially lowered cortisol levels and there are enough men on HRT now that this would almost for sure be a well-known observation.
All of that said, I believe there are two ways that testosterone therapy, and this would be for men with low or lowish testosteorne, would like see his cortisol parameters improve:

1. Testosterone-to-Cortisol Ratio. Stop and think of the significance of the discussion above: if you go on HRT, you are very likely going to significantly increase your T/C, or testosterone-to-cortisol, ratio. Why? A hypogonadal male that doubles or even triples his testosterone without much change to his cortisol levels has clearly doubled or tripled his T/C ratio

2. Cortisol Reactivity. Cortisol or stress reactivity has a very specific medical meaning and I am not referring to that here. However, what I am trying to point out that is men on HRT who have, in fact, actually improved their testosterone numbers will very likely put out much less cortisol than they normally would have due to the ACTH effect mentioned above. [2] Of course, this assumes normal adrenal function.
So the bottom line is that you are not likely to get a big drop in cortisol from testosterone replacement in my opinion, but that doesn't mean that your body's managment of cortisol will not have greatly improved. ''

http://www.peaktestosterone.com/Testosterone_Cortisol.aspx

My result from this morning :

Serum Cortisol : 942.8 nmol/L (7-10 A.M : 171 - 536 ) nmol/L

That may explain panic attacks, anxiety ..

I am also waiting for ACTH result , which will take few days..

''A higher than normal level may indicate:

-Cushing disease, in which the pituitary gland makes too much ACTH because of excess growth of the pituitary gland or a tumor in the pituitary gland

-Ectopic Cushing syndrome, in which a tumor outside the pituitary or adrenal glands makes too much ACTH

-Tumor of the adrenal gland that is producing too much cortisol '' .
Any advice Nelson , Gene , Chris ..please? Thank you.
 
Last edited by a moderator:
Defy Medical TRT clinic doctor

Okian

New Member
I understand Nelson, salivary test is much better than blood test , I may go for that one as well! Thank you
 

Vettester Chris

Super Moderator
Okian, yes, the 4x saliva kit is the gold standard for this lab. This will provide a 24 hour circadian profile with your cortisol rhythm, total cortisol burden, and in most cases it will provide a cortisol/DHEA correlation report, which is also beneficial in the BIG picture of assessing the different stages of adrenal fatigue. All for the ACTH lab, but for the cortisol go with the 24hour 4x w/DHEA.

Also, issues with cortisol can most definitely mean that there is also issues with the thyroid. That will be something that needs addressed. If issues are evident with the thyroid, the focus should still remain on the adrenals before trying to get the thyroid resolved. Again, just keep that in the back pocket for the moment that it will another subject to cover.
 

Okian

New Member
Thank you Chris ,that makes sense! My concern is that the root of my hormones imbalance may be the adrenal glands!
I have done 3 months ago a test for TSH : 1.05 UI/ml (0.27 - 4.2) . I know I should do the whole thyroid panel test, I will go step by step. Once again , thank you!!
 

Vettester Chris

Super Moderator
Thank you Chris ,that makes sense! My concern is that the root of my hormones imbalance may be the adrenal glands!
I have done 3 months ago a test for TSH : 1.05 UI/ml (0.27 - 4.2) . I know I should do the whole thyroid panel test, I will go step by step. Once again , thank you!!

Agree, very good chance the imbalance does stem to the adrenals. A few steps will be needed to check if it's primary or secondary; will be anxious to see your ACTH results.

Yeah, going off the TSH lab by itself to make any determination on the thyroid is a mistake that many physicians make. Easy example ... A patient might have hypothyroidism, whereas Total T4 and Free T4 are suboptimal of lab reference range, say 20%. However, various conditions with the "adrenals", iron, electrolytes, ..., can effect Free T3 from getting into the system. If FT3 isn't adequately getting into the cells, it will build-up, better known as "pooling". This is where Reverse T3 also comes into the picture ... The TSH lab can be influenced by the buildup of FT3, basically tricking the feedback loop and pituitary to look as if thyroid hormone levels are normal.

That's just one common scenario seen quite a bit in both men and women. I've seen it with women where their TSH is tanked in the 0.30 range, with evident overt hypothyroidism. This can be problematic with estrogen dominance during menopause, which in the absence of progesterone is nothing less than a train wreck from hell on the adrenals!!

When you get a better handle on the adrenals, look into the following labs: TSH, Free T4, Free T3, Reverse T3, TPOab and TgAb on the antibodies. Get both antibodies, as autoimmune disorders can be enzyme or protein specific with the thyroid gland.
 

Okian

New Member
Agree, very good chance the imbalance does stem to the adrenals. A few steps will be needed to check if it's primary or secondary; will be anxious to see your ACTH results.

Yeah, going off the TSH lab by itself to make any determination on the thyroid is a mistake that many physicians make. Easy example ... A patient might have hypothyroidism, whereas Total T4 and Free T4 are suboptimal of lab reference range, say 20%. However, various conditions with the "adrenals", iron, electrolytes, ..., can effect Free T3 from getting into the system. If FT3 isn't adequately getting into the cells, it will build-up, better known as "pooling". This is where Reverse T3 also comes into the picture ... The TSH lab can be influenced by the buildup of FT3, basically tricking the feedback loop and pituitary to look as if thyroid hormone levels are normal.

That's just one common scenario seen quite a bit in both men and women. I've seen it with women where their TSH is tanked in the 0.30 range, with evident overt hypothyroidism. This can be problematic with estrogen dominance during menopause, which in the absence of progesterone is nothing less than a train wreck from hell on the adrenals!!

When you get a better handle on the adrenals, look into the following labs: TSH, Free T4, Free T3, Reverse T3, TPOab and TgAb on the antibodies. Get both antibodies, as autoimmune disorders can be enzyme or protein specific with the thyroid gland.

That's why I love this forum! Proper answer.. I received the ACTH result : 49.48 pg/mL ( 7.2 - 63.3 ) pg/mL

So, what do you think Chris , should I forget about the adrenals and move on with the labs wich you have suggested to me ? TSH,Free T4,Free T3,Reverse T3, TPOab and TgAb on the antibodies.

Thanks a lot for your help!! I appreciate!
 

Okian

New Member
Forgot to mention that my doctor made a thyroid scan 3 months ago and said that nothing`s wrong , but I guess the blood test is more accurate!
 

Vettester Chris

Super Moderator
Forgot to mention that my doctor made a thyroid scan 3 months ago and said that nothing`s wrong , but I guess the blood test is more accurate!

Two most common words from doctors when they get patients thyroid results, "Looks normal".

That's why I love this forum! Proper answer.. I received the ACTH result : 49.48 pg/mL ( 7.2 - 63.3 ) pg/mL

So, what do you think Chris , should I forget about the adrenals and move on with the labs wich you have suggested to me ? TSH,Free T4,Free T3,Reverse T3, TPOab and TgAb on the antibodies.

Thanks a lot for your help!! I appreciate!

IMO, I'd stay on course with the adrenals. Your AM cortisol was over the top. Let's see a 24 hour circadian profile with a DHEA/cortisol correlation analysis. If you have the means to get the thyroid labs listed, great, it would be good to see. However, keep the primary focus on the adrenals for the time being.
 

Okian

New Member
Chris, 3 months ago : DHEA - S : 282.7 ug/dL ( 160 - 449 ) , do you think I should test again ?
 
Last edited:

Neil Olson

New Member
Thank you Chris ,that makes sense! My concern is that the root of my hormones imbalance may be the adrenal glands!
I have done 3 months ago a test for TSH : 1.05 UI/ml (0.27 - 4.2) . I know I should do the whole thyroid panel test, I will go step by step. Once again , thank you!!

My TSH sits at .01UI/ML. My ACTH sits at 18 pg/mL My pituitary hates me.
 

Okian

New Member
Just got my results for 24 hour urine Cortisol : 388.8 nmol/24h ( 100 - 379 )

ACTH : 49.48 pg/mL (7.2- 63.3) -was tested one week before '' 24 h urine Cortisol ''

Now what should I do next?
 

Okian

New Member
Anyone ? Nelson ,Chris, Gene ? What are your thoughts on this one ? It may be something wrong with the adrenal glands ? Should I do a scan as well for the adrenals? I am seeing my doc next week, I was hoping you guys have some info about this . Cheers!
 

Nelson Vergel

Founder, ExcelMale.com
Your 24 hour urinary cortisol is over the range. How are you sleeping? How is your stress level? Any pain? How do you feel when you wake up in the morning?
 

Okian

New Member
Hey Nelson! Since I started TRT no more insomnia, I am sleeping well, the thing is that I am tired all day looong,waking up tired ,going to bed tired!
No stress because I am not working anymore since September last year.
Last time I spoke with my doc he said that we are going to make a scan test on adrenals, but they are always looking for extreme, like Cushing disease, etc. but something must be done with Cortisol if it is high right? And suffering from anxiety as well..
I`m curious about what he will suggest about this..
 

Vettester Chris

Super Moderator
Okian, I don't mean to be the spoiler here, but we need an actual 24 hour saliva test, taken 4x (some are even 6x) over the 24 hour period. I want to see the circadian profile of how your adrenals look upon waking, Noon, 6:00 PM and late PM.

I'm looking at the accumulation (total burden), and saliva DHEA included in the Lab Kit to get a DHEA/Cortisol Correlation profile. This will provide a much more comprehensive picture of how your adrenals are function, if DHEA is keeping pace (stress adapted), or if DHEA is slumping and pushing into a maladaptation phase.

The lab you provided is kind of like a TSH only lab, where there's more needed to see the whole picture. Depending on the situation, sometimes pregnenolone steal will be a factor when stress is evident, the adrenals utilize the bulk of pregnenolone for cortisol production, which causes a deficiency in DHEA (and other hormones). I'm just throwing some thoughts at the wall ... If you get the correct labs it will remove the speculation. Thanks!! :)
 

Okian

New Member
Awesome advice Chris,you told me for the first time as well to go for 24h Saliva Cortisol,but I was following my doc advice,which I don't really trust 100%, I understand now, THANK YOU, that's what I needed.
 

Vettester Chris

Super Moderator
Okian, it's been over a months since we left off ... Just keeping some tabs, I want to see you through on this. DO you have any updates, progress, setbacks, ... anything relevant to what we've been talking about on the thread?

Thanks
 

Okian

New Member
Hey Chris! How are you doing? Thanks for your interest ,sorry I was off for a while!


So, update : I have suggested to my doc what you've been adviced me,and he said first '' let's do a dexamethasone suppresion test - Cortisol ''


8:00 a.m - Serum Cortisol - 830.3 nmol/L ( 7 - 10 a.m : 171 - 536 )
On the same day at 23:00 p.m been taking two tablets (0.5mg each) of dexamethasone.


Next morning at 8:30 a.m - Cortisol serum - 26.2 nmol/L ( 7 - 10 a.m : 171 - 536 )

Conclusion : I don't have to worry about Cushing disease or something extreme..which is very good!

I have also done a scan for adrenal glands and another one for thyroid, and doc said everything looks perfect, no need to worry about any tumor or something like that,left and right kidney looks normal.

After this I have done the followings test labs for thyroid :

FT4 - 20.87 pmol/L (10.6 - 22.7)

FT3 - 5.1 pmol/L ( 3.4 - 6.8 )

TgAb - < 10 UI/mL &#8804; 115

TPO - 15.27 UI/mL < 34

I have changed my endocrinologist , I went to a consultation with one of the best in my country,he is professor of endocrinology with International Clinician Award of the American College of Endocrinology , 50 years of career , etc.


I told him my symptoms : anxiety,panic attacks,depression,fatigue,headaches ,brain fog,etc. and I found out that I do have low testosterone and other hormonal imbalances and started TRT with Testim gel for 4 months ,but still no improve in symptoms.

His answer was : '' panic attacks does not have any connection with testosterone , it's like your ears are hurting you and you are going to dentist to fix you .. and then asked me about my job ,if any stress in my life, so I told him that I had a stressful job and start having insomnia and depression ,anxiety and the other symptoms till I could not work anymore.

He told me to undress myself and started to examine my testicles, analyzing me and he said that I do not look like a sick person with endocrine problems ,said that I am looking good,healthy ,asked me about my nutrition,told him that I do not smoke anymore ,no alcohol , no drugs ,I am taking care of my body.

After he went to read the lab tests , and told me that high Cortisol is the result of depression. Also he said as long as my LH is in range { 4.9 - (1.7 - 8.6) } my body will produce Testosterone as much as needed , then he saw my SHBG - 6.95 nmol/L and Free Testosterone - 0.068 nmol/L (0.015 - 0.145) and explained me that as long as my SHBG is low I don't need that much Free T , so I will be fine and suggested me to STOP TRT ,because this is not my main problem. These hormonal imbalances are consequences of too much stress in someone`s life,and he is sorry but he cannot help me, so he send me to a psychiatrist .

I told him that the LH 4.9 result is before starting TRT , so after almost 4 months on Testim gel ,shouldn't go down and how exactly my body will produce testosterone with LH being low ? ( I haven't tested yet ) .
He said if I will stop TRT now everything will be fine ,because I am young and my body will recover but I must see a psychiatrist..and follow a treatment and all this hormonal imbalances will fall into place.

So I went to a psychiatrist and I am on medication from 1 week : Sertraline , Bromazepam and Magnesium + B6 and to be honest for the first time in the last 8 months I am seeing a small improvement in all this symptoms.
 

Okian

New Member
Forgot to mention that I had meningoencephalitis 7 years ago and in the last years I have this headaches very often and this week I am going to see a neurologist to obtain a prescription for MRI , I want to check everything to make sure it's all good .
 
Buy Lab Tests Online
Defy Medical TRT clinic

Sponsors

enclomiphene
nelson vergel coaching for men
Discounted Labs
TRT in UK Balance my hormones
Testosterone books nelson vergel
Register on ExcelMale.com
Trimix HCG Offer Excelmale
Thumos USA men's mentoring and coaching
Testosterone TRT HRT Doctor Near Me

Online statistics

Members online
6
Guests online
3
Total visitors
9

Latest posts

bodybuilder test discounted labs
Top