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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
19 yr old functioning poorly for years
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<blockquote data-quote="Vettester Chris" data-source="post: 64236" data-attributes="member: 696"><p>Anne, thank you for taking the time to post such a detailed post pertaining to your son's situation. I can't imagine how difficult it must be when this should be some of the best, outgoing times of his life!</p><p></p><p>There's probably a myriad of possibilities and talking points to cover everything. I'll comment on a few of the things that standout to me ...</p><p></p><p>His White Cell count is a bit elevated. Has anything been determined on this? Sometimes it's just due to a virus passing through, infection, or something fairly simple (?) Just want to make sure there is an awareness with your medical team? With what you've presented, I would think some additional metabolic labs would be warranted (?)</p><p></p><p>NO, the thyroid part is not normal. Free T4 is hanging on the low end of the reference range, Free T3 is over the top. There's a few things to try and identify ...</p><p></p><p>Possibility 1) The thyroid gland is actually working properly, BUT something is causing the pituitary gland to release excess TSH? This could be the case if some type of adenoma /tumor in the region.?? These can & do happen to anyone, but more times than not they tend to be benign and manageable.</p><p></p><p>Possibility 2) The thyroid gland is NOT working properly, whereas Free T3 is pooling and not getting to the cells, and T4 is converting excessively to Reverse T3, which is keeping the T4/ FT4 level on the lower end of the reference range?? I would think that the the high TSH demand would be triggered if both T4 and "T3" were low, but possibly T4 is doing it by itself in the 20% to 25% of reference range?? There's still an autoimmune possibility to explore, noted below ...</p><p></p><p>So, there's ways to rule certain things in or out, or at least to get one step closer to some solutions ... 1) MRI of the anterior pituitary would take care of that adenoma stuff. 2) More labs needed for the other talking points ... Your physician missed a few labs that could tell us volumes with the thyroid ... <strong>Reverse T3</strong> as mentioned above. With this lab (RT3), a comparison ratio to FT3 can be established and it would provide a good indication if his FT3 is pooling. Also, on the antibodies, he NEEDS a <strong>TgAb</strong> antibody, which will check autoimmune at the protein level. Both <u>TPO & TgAb are of equal importance</u> when looking at autoimmune disorders with the thyroid gland!</p><p></p><p>To conclude for now, I really want to see how his 24 hour cortisol results turnout. His elevated DHEA is one key marker that things are not where they should be in Adrenalville. The thyroid productivity is DIRECTLY tied into the well being of the adrenals. If the adrenals are not working adequately with cortisol production, then T3 won't adequately get to the cells (thus, T3 Pooling occurs)! Unlike testosterone, thyroid hormone is dependent on several things to do its job, e.g., cortisol, iron/ferritin, some of the electrolytes, and even D3 plays a key role.</p><p></p><p>I fully agree that it would be a really good thing to at least have a discussion with Dr. Saya and/or another physician that specializes in hormonal treatment (and not one of those PCP endocrine that still work with T3 index and uptake labs)!!. A4M Certification Doctors are also an avenue to explore.</p></blockquote><p></p>
[QUOTE="Vettester Chris, post: 64236, member: 696"] Anne, thank you for taking the time to post such a detailed post pertaining to your son's situation. I can't imagine how difficult it must be when this should be some of the best, outgoing times of his life! There's probably a myriad of possibilities and talking points to cover everything. I'll comment on a few of the things that standout to me ... His White Cell count is a bit elevated. Has anything been determined on this? Sometimes it's just due to a virus passing through, infection, or something fairly simple (?) Just want to make sure there is an awareness with your medical team? With what you've presented, I would think some additional metabolic labs would be warranted (?) NO, the thyroid part is not normal. Free T4 is hanging on the low end of the reference range, Free T3 is over the top. There's a few things to try and identify ... Possibility 1) The thyroid gland is actually working properly, BUT something is causing the pituitary gland to release excess TSH? This could be the case if some type of adenoma /tumor in the region.?? These can & do happen to anyone, but more times than not they tend to be benign and manageable. Possibility 2) The thyroid gland is NOT working properly, whereas Free T3 is pooling and not getting to the cells, and T4 is converting excessively to Reverse T3, which is keeping the T4/ FT4 level on the lower end of the reference range?? I would think that the the high TSH demand would be triggered if both T4 and "T3" were low, but possibly T4 is doing it by itself in the 20% to 25% of reference range?? There's still an autoimmune possibility to explore, noted below ... So, there's ways to rule certain things in or out, or at least to get one step closer to some solutions ... 1) MRI of the anterior pituitary would take care of that adenoma stuff. 2) More labs needed for the other talking points ... Your physician missed a few labs that could tell us volumes with the thyroid ... [B]Reverse T3[/B] as mentioned above. With this lab (RT3), a comparison ratio to FT3 can be established and it would provide a good indication if his FT3 is pooling. Also, on the antibodies, he NEEDS a [B]TgAb[/B] antibody, which will check autoimmune at the protein level. Both [U]TPO & TgAb are of equal importance[/U] when looking at autoimmune disorders with the thyroid gland! To conclude for now, I really want to see how his 24 hour cortisol results turnout. His elevated DHEA is one key marker that things are not where they should be in Adrenalville. The thyroid productivity is DIRECTLY tied into the well being of the adrenals. If the adrenals are not working adequately with cortisol production, then T3 won't adequately get to the cells (thus, T3 Pooling occurs)! Unlike testosterone, thyroid hormone is dependent on several things to do its job, e.g., cortisol, iron/ferritin, some of the electrolytes, and even D3 plays a key role. I fully agree that it would be a really good thing to at least have a discussion with Dr. Saya and/or another physician that specializes in hormonal treatment (and not one of those PCP endocrine that still work with T3 index and uptake labs)!!. A4M Certification Doctors are also an avenue to explore. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
19 yr old functioning poorly for years
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