Finally got great testosterone levels- but have questions about cortisol, thyroid, IgF, DHEA-S

I'm a 41 year old who went through 4-5 months of HCG monotherapy to little effect, and two months ago switched to 60 mg test cyp 2X/week and 750 IU HCG.

It took almost two months to feel much difference, but my total test zoomed up to 1010 ng/dl and free test went to 2.8 (range= 0.87 to 5.47 according to lab). My estradiol was a bit high at 64.0 (range = 20- 75). I feel a lot better. Not perfect, but a lot better.


Since my symptoms of fatigue have not completely gone away, I wonder what anyone's thoughts are on my slightly older (april- June) cortisol, thyroids, IgF, and DHEA.

My total cortisol, total was 9.8 (range is ?? 5-23 I think)

TSH was 1.8
T3 was 32 (22-35 range)
T4 total 6.8 (4.5- 12.0)
free T4 index (T7) was 2.2 (1.4- 3.8)

My DHEA- S was 184 (70-495 range)
my IGF-1 was 126 (53-328 range)

My doctor seems to think that these are all perfectly normal but I wonder what anyone's thoughts are.

I know very little about these, but I wonder if any of these could be optimized in order to deal with the residual fatigue issues. (Note: i really don't understand thyroid values, and there is a buttload of thyroid dysfunction in my family- hypo and hyper in 5 of my siblings).

thanks

Did your doctor discuss the 4x saliva test for cortisol? It provides a more accurate picture.

TSH, T3 and T4 are valuable measures but if you want a clearer picture it is better to test for free T3 and free T4 since TSH and total thyroid hormones may not be as accurate. Your TSH is low so I do not suspect thyroid issues, though.

How are you sleeping? How is your sex drive?

That estradiol test: Was it done using sensitive assay (LC/MS)? The regular test may overestimate estradiol in men with moderate to high CRP.

Nelson Vergel said:

TSH, T3 and T4 are valuable measures but if you want a clearer picture it is better to test for free T3 and free T4 since TSH and total thyroid hormones may not be as accurate. Your TSH is low so I do not suspect thyroid issues, though.

How are you sleeping? How is your sex drive?

That estradiol test: Was it done using sensitive assay (LC/MS)? The regular test may overestimate estradiol in men with moderate to high CRP.

Click to expand...

I'll take note of the free T3 and free T4 labs for next time...

The estradiol was not the sensitive assay. Doctor is not a fan of AIs and just wants me to watch out for nipple sensitivity. (I guess I could always take DIM/ eat a lot of broccoli too..ha)

Sex drive has been solid and improved - under both HCG monotherapy and test/hcg combo

I think the sleep is a big factor, actually. My sleep has improved over past months. I started taking zinc, MG, B6, , tryptophan, and the occasional 1 mg of melatonin. I don't sleep a lot, but I sleep more deeply and don't feel like garbage in the morning.

What are your thoughts on loading up on amino acids before bedtime to increase growth hormone during sleep. I've heard good things about arginine, ornithine, and lysine in particular.

http://www.vrp.com/amino-acids/amin...s-gh-secretagogues-a-review-of-the-literature

I've toyed with the idea of getting sermorelin through Defy Medical as well. may try the better sleep and aminos for a while first.


lastly, I asked if 50-75 mg of DHEA a day would work. Dr said he's not a big fan, but go ahead.

CoastWatcher said:

Did your doctor discuss the 4x saliva test for cortisol? It provides a more accurate picture.

Click to expand...

No. will keep that in mind

SomeG, going off of what I see, I actually do suspect thyroid issues. Like Nelson stated already, we do need the free serum on both T4 & T3, plus you will want Reverse T3, and anitbodies (TPO & TgAb).

Here's my reasoning  ... Going on your Total T4 & T3, take notice with how far apart each lab is from the other within the respective reference range. Total T4 is at 30.6% of the ref range value, Total T3 is at 76.9% of ref. range value. Normal function would usually have both of these semi-close to each other. I suspect free serum levels will follow similar suit, but would want to know for sure.

Additionally, I suspect possible pooling with T3, meaning T3 isn't getting into the cells, it's just building up. The lab that will counter-check this will be Reverse T3 and the comparative ratio to FT3.

This is one KEY example of why TSH is misleading ... If FT3 is pooling, then the feedback loop is indicating that thyroid hormone levels are up, which in turn directs the pituitary to reduce the demand for further hormone production, which in itself reduces TSH levels.

This can be common with Hashis and other thyroid disorders, and evident when transport agents like cortisol, iron, ferritin, and in some cases electrolytes & D3 play a role with T3 productivity. With "transport agents", I am referring to specific hormones/elements/proteins that play a vital role with T3 getting into the body. Cortisol & Iron/Ferritin are usually the two key components that factor into this.

Your cortisol serum lab basically doesn't elaborate anything. There is so much variance between AM & PM, and the only effective way to really gauge it is with a 24 hour -4x saliva kit, which is the gold standard. The cortisol kit should also include a DHEA saliva lab for the sake of getting the adrenal overview with a DHEA/cortisol correlation analysis. The iron & ferritin should remain drawn with blood serum, and I would also include at least a TIBC with it.

My gut says your physician(s) won't buy into much of this, due to the fact that they are running these useless "index" labs. Those labs tell them virtually NOTHING! And do me a favor, double check that T3 lab. You say "T3 was 32" .. Please confirm that this didn't say T3 Uptake?? If it did, then everything I've been saying at the top with the reference range comparisons was just an exercise. If it it is a T3, meaning "Total T3", then the reference range discussions stands, I would evaluate further ... I throw this out because when doctors start ordering some of these useless "index" thyroid labs, they usually throw that Uptake in as well. Sounds snazzy and important, but it's worthless!

Hey guys.

Thanks again for your input.


I'm around 9 months into TRT (Test + HCG) with a urologist.


Gains in mental, physical, and quality of life in this time frame, but also looked into what seemed to be dysfunction in adrenals and thyroid. Now have an endocrinologist who is both cool with not interfering with the TRT my urologist is managing (an actual fear I had when I first met her), but has helped my thyroid function and is now figuring out my adrenal issues.


I turn 42 this month and other than normal life/work stresses that I manage through exercise, meditation, etc, I feel a whole lot better than I did 1-2 years ago.


As an aside, my girlfriend suggested an Ayurvedic herb "Ashwagandha" for stress. My evidence is totally non scientific, but 2 weeks into using this every night before bedtime has seemed to have helped my overall ability to withstand daily stress.