Adrenal fatigue or low T causing symptoms?

[Stormer]

Been a while since I last posted but I'm still not doing that well. 21 yr old and still struggling with symptoms of primarily low motivation+feeling depressed. Other symptoms include feeling anxious, easily stressed, lower libido, socially withdrawn but I attribute these to the first 2 of low motivation/depression. If that can be taken care of I think the other stuff will also resolve. If I can return to my normal old self, then I know for a fact I'll be able to handle stresses at school.

I have some blood tests and saliva test done on the same day. Don't have thyroid issues (my Free T3 was like 3.7 near the top of the range when last measured months back).

Testosterone: 440 (348-1197 ng/dL)
Estradiol: 16 (7.6-42.6 pg/mL) wasn't sensitive test though
DHT: 32 (30-85 ng/dL)
SHBG: 27 (165-55.9)
Progesterone: 0.3 (0-0.1 ng/dL) HIGH
Pregnenolone: 98 (<151 ng/dL)
DHEA-S: 554 (164.3-530.5) Blood test

Saliva Cortisol labs:

8 AM: 14.20 (5.1-40.2 optimal:18-35)
12 PM: 4.96 (2.1-15.7 optimal: 6-12)
6 PM: 3.35 (1.8-12 optimal:4-8)
12 AM: 0.4 (0.9-9.2 optimal: 2-6) LOW
DHEA-S: 320 (137-336) Same saliva test

I've been really stressed out at school recently having to do it simultaneously while dealing with this. Felt somewhat better in the summer when there was no stress but things still didn't resolve and since school started its gotten worse. Before these symptoms started I'd say I did pretty well at school and I know I can do well again once my health improves.

The thing is--is it the Testosterone that is causing problems or the somewhat low cortisol. I also noticed my DHEA-S is really high but if DHEA-S is a precursor to Testosterone how come my T levels aren't high? And is AF still possible with high DHEA-S/low cortisol?

I am considering just getting on TRT cause of school and all sort of need relief. Have some pretty important projects in the semester and its hard for me to get work done when I feel down. But not sure how effective it is going to be if I have lower cortisol. I also wonder if the stress of low T at school is what pushed my cortisol down over an extended period of time and if that is what is making my DHEA-S so high.

Also have people ever tried out low dose HC (hydrocortisone) therapy in similar situations with or without TRT? I wonder if I should look into this cause I'm in a situation where I cannot get out of the stress at school to recover naturally. Just being here and feeling down makes me stressed cause I'm constantly thinking about how im going to get through this semester when I don't feel like doing anything.

 

[lcvl]

Total T is pretty low for your age, but you should check your free T as well, before deciding if starting TRT or not.

 

[Vince Carter]

With your age a restart attempt might be the best first course of action. Your DHEA and Pregnenolone tests I wouldn't run to Adrenal fatigue with those numbers but then you have this curiously low Cortisol readings. I don't see you as an HRT candidate, not with your age and you have fair enough numbers. How's diet/exercise for you?

 

[Stormer]

Yea I was wondering what causes high DHEA-S+low cortisol. Theres a lot of stuff on the opposite pattern but I haven't seen too much on this. The few things I have seen do mention that it is possible to have this pattern due to stress. I've also read that it could be that my DHEA-S hasn't been depleted *yet* from stress which is good but that it could go low if the stress isn't addressed. Also, is my lowish DHT potentially an issue? Ive never used any herbal or pharmaceutical 5ARI's. Im trying out sorghum to boost it but haven't seen many results.

Diet includes eggs, chicken, shrimp, brown rice, salads, pizza, etc. Rarely eat beef and the only kind of pork I have is pepperoni or bacon. I eat protein bars in the afternoon for calories since I'm at school. Exercise at school I don't have much time lately due to all the projects but I do swimming for cardio and also some weighifting. I don't overtrain and only recently started earlier this year. Mainly do squats, circuit trainint, and some free weight stuff. Not experienced enough to try other things like bench press or deadlifts.

EDIT: Forgot to mention I take a lot of supps. Vit C, Ashwagandha, Magnesium,Zinc/Copper, P5P, SAM-e (helps with mood). I also cycle Mucuna Pruriens on and off as it seems to helo my libido.

 

[johndoesmith]

I think it may be the lower E2 level causing issues. 16 on a standard test is pretty damn low. Do you feel you're excessively thirsty or urinate a lot?

I'd get tested again and add on LH and FSH.

I don't think your adrenals have issues, DHEA-S being high is a good thing, and cortisol doesn't seem too low, although I don't know very much about adrenals so if others have more information take their advice over mine.

 

[Stormer]

Doc sort of stopped getting LH/FSH tests since we sort of had them done in the past and LH has always been like 2-4 so lowish. So we knew it was secondary.

I actually tried a restart protocol over the summer. Clomid 12.5 mg eod raised my T levels very high to like 850 ish. E2 was like in the low 30s sensitive I felt amazing within 3 weeks for just a few days. And then out of nowhere I crashed into a horrible depression. Libido went low and I felt worse than before. Doc thought maybe highish E2 (but it wasnt that high) so tried Arimidex 0.25 mg but it didnt help at all.

The conclusion was that im like so many others who only get temporary improvement on Clomid before the sides kick in. Also concluded its probably the estrogen agonist isomer part of Clomid. What is also interesting is that on Clomid my cortisol levels came up too which I think explains some benefits as well. Before the crash of course.

Then upon withdrawing Clomid I returned to baseline in cortisol as well as T/E2.

 

[Stormer]

Bump--I also noticed that I feel better at night time every single day. Mood improves at night and in the mornings its the worst. I'd say in general I just feel "bleh" like not that interested in things as I used to be and being in my own head a lot.

I read a bit about high DHEA-S and low cortisol and some things turned up:

Low cortisol, high DHEA, and high levels of stimulated TNF-&#945;, and IL-6 in women with PTSD: http://onlinelibrary.wiley.com/doi/10.1002/jts.20372/full



Another one is here: http://press.endocrine.org/doi/abs/10.1210/jcem.83.9.5081 "Increased Diurnal Plasma Concentrations of Dehydroepiandrosterone in Depressed Patients"


Seems like we know so little about the endocrine system even to this day. Looks as if its related to stress but then again I am sort of stressed since I don't feel that great lol.

 

[johndoesmith]

Bump--I also noticed that I feel better at night time every single day. Mood improves at night and in the mornings its the worst. I'd say in general I just feel "bleh" like not that interested in things as I used to be and being in my own head a lot.

I read a bit about high DHEA-S and low cortisol and some things turned up:

Low cortisol, high DHEA, and high levels of stimulated TNF-&#945;, and IL-6 in women with PTSD: http://onlinelibrary.wiley.com/doi/10.1002/jts.20372/full



Another one is here: http://press.endocrine.org/doi/abs/10.1210/jcem.83.9.5081 "Increased Diurnal Plasma Concentrations of Dehydroepiandrosterone in Depressed Patients"


Seems like we know so little about the endocrine system even to this day. Looks as if its related to stress but then again I am sort of stressed since I don't feel that great lol.

Testosterone is lowest at night especially at 9pm.

It could also be you're happier at night because you're not at work, or you're just not a morning person. I wouldn't over complicate this with theories based on a few research studies.

Look up occam's razor

 

[Stormer]

Well yea some of it could be that but I do think there is some pattern going on with the HPA signals and stuff cause I never felt this way prior to having all of this. And I'm at school so most of my work is all done at night. I'd say I generally looked forward to it and the freedom of college until all his happened. I blame too much partying.

T is lowest at night but I think maybe its the difference that matters between my previous T level before the hormone crash and the current one.

I tried the restart and while it worked to boost T and give me my good mood/old self back somehow it never actually lasted and then Clomid put me into a horrid temporary depression that wasn't related to E2 levels. So we chalked it up to "Clomid PMS" and quit it and T went back down to baseline so I didn't get a "restart".

At that point do you sort of have to resort to HCG mono or T+HCG since Clomid didn't give lasting symptomatic relief? I think I have multiple hormone stuff going on with the lowish cortisol and lowish T both of which Clomid elevated and gave me a temporary recovery until its own side effects kicked in. Im not sure how T/HCG treatment exactly interacts with cortisol and if it could make that worse potentially.

 

[Smith67]

Well yea some of it could be that but I do think there is some pattern going on with the HPA signals and stuff cause I never felt this way prior to having all of this. And I'm at school so most of my work is all done at night. I'd say I generally looked forward to it and the freedom of college until all his happened. I blame too much partying.

T is lowest at night but I think maybe its the difference that matters between my previous T level before the hormone crash and the current one.

I tried the restart and while it worked to boost T and give me my good mood/old self back somehow it never actually lasted and then Clomid put me into a horrid temporary depression that wasn't related to E2 levels. So we chalked it up to "Clomid PMS" and quit it and T went back down to baseline so I didn't get a "restart".

At that point do you sort of have to resort to HCG mono or T+HCG since Clomid didn't give lasting symptomatic relief? I think I have multiple hormone stuff going on with the lowish cortisol and lowish T both of which Clomid elevated and gave me a temporary recovery until its own side effects kicked in. Im not sure how T/HCG treatment exactly interacts with cortisol and if it could make that worse potentially.

Did you ever figure out what was causing your high DHEAS and low Cortisol?