Am I on the right track?

[Mark]

Hi Guys,

Just wondering if I can get some info/feedback on latest labs? Just started Armour in August. Doc has slowly increased to 120mg daily in divided doses. I'm wondering though if I need more Armour, or even add in some HC? I did the Adrenal Saliva test awhile back and it shows morning level low normal and night level high. My Doc is not convinced though about adding HC. I am just having so much trouble getting going in the morning, in fact I don't even feel awake till at least noon.

Any info/feedback would really be appreciated. I have other labs too, just let me know what you need to help me out.

Thanks

 

[Mark]

P.S. I'm also on HRT as well as HCG and Cialis


Mark

 

[Nelson Vergel]

Mark


I will wait for Chris to talk about the TBO but everything else looks great.


What are your total and free testosterone blood levels? What dose of TRT+HCG?

 

[Vettester Chris]

Mark, thanks for posting this up. We are definitely seeing some intriguing posts lately regarding thyroid activity in conjunction with the adrenals.

It's a bit late for me and I'll post for a bit, but can pick up on some of this tomorrow. On your antibodies, specifically the TPO, has your physician addressed this? Have you had any discussion(s) about Hashimoto's and/or autoimmune disorders? Your labs indicate that your thyroid peroxidase enzymes are under attack, basically whereas the body doesn't recognize them and the immune system uses antibodies to fight them off. This can be dealt with, but I'm curious what route your doctor is looking to go?

I agree that your cortisol activity is less than optimal. It's not uncommon to see various signs of adrenal fatigue fall hand-in-hand with Hashis, and to see other imbalances with the thyroid. I know you mentioned your doctor isn't leaning towards any HC treatment, but, like the other labs, what is his interpretation of your cortisol combined with the DHEA-s? I will take a closer look at the profile pattern and burden (or load) tomorrow, and will also compare some of the averages with the DHEA value(s) to help get some additional perspective.

On a good note for the moment, your FT3/RT3 ratio is just over 20, which is a good sign, BUT (there's always that but) your FT4 is very low within the reference range at 10.5%, but FT3 is at 66%. Granted, NDT thyroid ratios are different than the normal levels you would see with a healthy human thyroid, but I would hope to see the T4 reserves higher. If they were higher, the question is would your RT3 also elevate and lower the ratio? Your cortisol situation makes me speculate on that possibility, as does your current FT4 and FT3 readings, and of course the TPO antibodies.

Let me know on the questions, and if you have some other labs like CBC, metabolic and any additional electrolyte labs, and it would also be good to see any iron & ferritin labs. Also, please post your stats, any medications, lifestyle and stress load, exercise & diet summary, and/or family history that might be relevant. Good or bad it doesn't matter, nobody is here to judge or blame. The more you can share will just make better conversation to help get some ideas flowing.

 

[Mark]

Thanks Chris and Nelson for getting back to me, the help is really appreciated. Let's see here, nah not worried about being judged, my problem is that I can't stay focused long enough to get my words down on paper.

I'm 47 yrs old, 5' 6" and weigh 230 lbs. I still do cardio 4 times a week even though it hurts so much afterwards. Diet is good, or I should say not really bad. Been struggling with the same type of symptoms for 20 yrs now. Basically started during Desert Storm/Gulf War. I started getting sick with flu like symptoms, was always told to increase fluids, get more rest, etc. After the war I continued to get sick, even though I was in great shape, weighed 150 lbs and 8% body fat. I loved to exercise, ride dirtbikes, streetbikes. After a couple of years I noticed it was harder and harder to recover from any illness or even exercise. In 1995 it really hit me though, gained a lot of weight, memory and concentration down, flu like symptoms, daily headaches and fatigue. I went to Dr. and they ended up diagnosing me with Depression.


As for the TPO Chris, I was diagnosed in 2004 as Hypothyroid and was started on Levothyroxine. My VA Doc never mentioned if any TPO tests had been done and I wasn't smart enough to even ask any questions about it. It was only recently that I discovered ExcelMale website, STTM, and James Wilson's book Adrenal Fatigue. It's only taken me 10 yrs but I'm figuring it out now that the VA is not going to help me, they are strictly going by the book on these conditions or I just have bad luck in Dr's. They kept me on same dose/med for 10 yrs even though I complained constantly of Hypo symptoms, but since my TSH was "normal", that was that.


Anyways, I went out and got a new civilian Doc, then ordered and paid for Thyroid and TPO tests, but have not talked to Doc about the TPO just yet. He did start me on Armour thyroid though. I kinda thought the Armour meds were addressing the Hashimoto? I will go and read up more on this though. My new Dr. is very open and understanding, so hopefully he will look into the Hashimoto and Autoimmune issues. The new Dr. is the one to put me on HRT and HCG as the VA Endo Dr. would not even see me for an appointment.


As for the HC, Doc says he just wants me to try OTC stuff for now, then go from there. He hasn't mentioned the DHEA-s issue, so I'll bring that up with him on next appointment.


New Dr. has me on current meds:
Adrenals- Life Extension's Adrenal Energy Formula 2 caps daily

InterPlexus Seriphos 1 cap daily

Spring Valley Melatonin 3mg 1 tab daily

Thorne Research Adrenal Cortex 50mg 8 caps daily in 4 divided doses

Pure Encapsulations Adrenal 4 caps daily in 4 divided doses


Thyroid Armour thyroid 120mg daily in 3 divided doses

Test C 160mg/.8ml weekly 2 divided doses Tues and Friday

HCG 300IU every other day

Cialis 7mg daily for ED and Enlarged Prostate

Vitamin B12 Inject 1ml weekly 2 divided doses

Nature Made Vitamin D3 5000IU 1 cap daily

Spring Valley Iron 65mg 1 tab daily


VA Doc has me on current meds:

Duloxetine 60mg for depression 1 cap daily

Hydrocodone 10/325 1 tablet twice daily for Fibromyalgia

HCTZ 25 37.5mg 1 tab daily for Blood Pressure

Atorvastatin 40mg 1/2 tab daily for Cholesterol

Amlodipine Besylate 10mg 1 tab daily for Heart/Blood Pressure


Seems to me that with all the meds I am taking that I should be feeling better, but that is not the case. I do feel that I am on the right track, but there is still something going on, something I'm missing. So that's why I'm here asking for help, because I just don't really know, and I'm hoping some of you guys can help me out here.

Thanks again, and looking forward to any info/feedback,
Mark

 

[Mark]

13 Mar 2014

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4 Aug 2014

Oops, looks like a double post on one of those lab results. It's hard to see the results, but the main one was Ferritin, which was low at 9 and a range of 22-322

 

[Nelson Vergel]

I now see why your liver enzymes are elevated. It is difficult to have normal liver enzymes with your medication pill burden!

You are on two blood pressure meds, a statin, thyroid replacement, TRT+HCG, Cialis, an antidepressant and some supplements. You are what clinicians call a patient with multiple comorbidities or a polypharmacy patient. There are so many factors that can contribute to your not feeling at your best (by the way, I do not think you have specifically said what your quality of life issues are).

Can you remind me your body weight, height, waist size and exercise regimen (if any)?

Your hematocrit is good and your ferritin is low. Did you donate blood?

Your vitamin D dose should be increased by double for you to be above 30 ng/mL. People that take a lot of meds may have impaired Vit D metabolism even when taking moderate doses like yours.

Chris will add more for sure.

 

[Mark]

Hi Nelson,
Tell me about it, yeah I thought when I first started HRT that I would actually be able to stop taking/needing the blood pressure and cholesterol meds, but it seems like I take more pills now than ever.
I'm 47, 5'6" and 230lbs. Size 38/40 waist. All my excess weight is right there in the tummy/waistline. I exercise 4 times a week, at least 40 minutes each time in my target heart rate zone. I do exercise bike, or walk treadmill at steep incline.

Can't donate blood anymore, lived overseas where mad cow disease was going on so I'm disqualified.

Will increase Vit D meds, thanks for the info.

Quality of life, I really don't have a life anymore. Disabled veteran, can't keep a job anymore. I used to be able to exercise, jog, ride dirtbikes, etc, but being physically in pain so much just took the joy of doing anything completely away from me. I have zero energy, it takes me 3 days to mow the lawn, I can only work for 30 minutes or so before I become exhausted. If I try to push through it, I get physically ill, vomiting, really bad headaches. Sex is of course suffering also, I can't go but for maybe 5 minutes and I get exhausted. The desire is there, but can't keep energy up. Concentration is also gone, takes me forever to get things going around the house, projects, etc. Seems like I have chronic flu like symptoms.

Mark

 

[Mark]

Here's latest labs. Don't know why the increase in testosterone, but my doc said not to worry about it for now since I do feel ok, no adverse reaction to it being up kinda high. He gave me Anastrozole for the slight increase in Estradiol, so I will be taking .5mg once weekly. Also looks like I might need to do the Therapeutic phlebotomy. Other than that, any info appreciated guys.
Thanks

24 Oct 2014

 

[Tom Larabee]

Be really careful with the Anastrozole, I am not sure you even need it. Definitely want to schedule up that Therapeutic phlebotomy.

 

[a_crossfitter]

Hi Guys,

Just wondering if I can get some info/feedback on latest labs? Just started Armour in August. Doc has slowly increased to 120mg daily in divided doses. I'm wondering though if I need more Armour, or even add in some HC? I did the Adrenal Saliva test awhile back and it shows morning level low normal and night level high. My Doc is not convinced though about adding HC. I am just having so much trouble getting going in the morning, in fact I don't even feel awake till at least noon.

Any info/feedback would really be appreciated. I have other labs too, just let me know what you need to help me out.

Thanks

View attachment 1091View attachment 1092

My cortisol levels, according to the saliva tests, were just like yours. I felt just like you too. Could hardly get up in the morning and as the day went by I would get progressively better.

I stopped taking my armour 45mg and replaced it with adrenal supplements. Tried many adrenal supplements and settled on Gaia Adrenal supplements. I did not feel any different when I stopped taking armour. Over the next couple of weeks I was able to sleep through the night and just recently am feeling better.

AMazon has the Gaia product.

I hope this helps.

 

[Mark]

Hi guys,

Here's my latest lab results. Any idea why my free t4 is so low while free t3 looks ok? Currently taking 180mgs daily in divided doses. I was hoping to ask my Doc for increase in Armour thyroid meds but not sure if he's going to agree. Just looking for any info I might be able to take to him.

Also, how can I get hemoglobin and hematocrit down without tanking my already low ferritin? Therapeutic phlebotomy and then iron supplements? If I take Iron supplements wouldn't my H&H increase again? Or is low ferritin just something I'm going to have to live with?

Any advice/info would be greatly appreciated,
Mark

p.s. My testosterone is high because I messed up and injected day before labs.

 

[JPB]

I do not think you have worries over your hematocrit or hemoglobin, or iron. All those values look fine.