Female blood work

Amberlin · Mar 24, 2018

The following labs are for a 37 year old female. The tests shown were taken in my follicular phase. I started T therapy 2 weeks ago but I cannot figure out why the high level of progesterone wasn't discussed. We discussed low T, possible low thyroid (I have paperwork to have blood drawn for that Monday), & high level of fasting blood sugar. My current therapy is TC 1mg/ml 2xs per week.

I feel less like crying looking at puppy videos (haha!) but the "happy go lucky" pep has yet to re-emerge. Two main side effects I've noticed from the T are water retention (Defy said take dandelion capsules as they serve to be a diuretic) & sore/itchy nipples. If you've taken/are taking T, have you noticed either side effect & if so, what time frame did you notice them to resolve?

I just ordered 10mg DHEA & will begin that in a couple days. Beyond that, do you notice anything I should be looking at? Could the high progesterone level account for my not feeling 100%?

FeelingLost · Mar 24, 2018

Hi Amberlin,
It takes a while for T to build up in your system and you pretty much started with no T. I did a copy and paste from another thread hopefully it will give you some hope.

People on HRT don't realize that after 5 half lives of any medication, you will have double the amount in your system. Just multiply the half life of a medication by 5, and this will give you how long it will take to reach a "steady state" of a medication a.k.a double the amount of that medication in your system compared to your first dose.

Testosterone Cyp (Half life 8 days) - Steady state in 40 days

Remember, 5 x half life of a medication = Steady state of that medication. I do not know what type of T in in your compounded cream.

HTH

PS- I am just getting up to speed on reading women's blood test since my wife started looking into HRT back in Aug 2017. She has only been on a protocol for 2 months and we are awaiting new bklood test results which will be available this coming Tuesday. I'll ask if I can share her numbers with you and the protocol she is on.

There could be big differences since my wife is 58 and postmenopausal. All her lady numbers were basicly 0.

I believe it took her about 5-6 weeks before she started commenting on how much better she was feeling. Other more personal things improved greatly as well after that.

If you would like some non professional comments on your bloods and symptoms just for the sake of discussion here's mine.
Because you are experiencing water retension and itchy nipples that is a sign you are adsorbing the compounding T cream( many men don't) My guess is you will need 5-6 weeks to reach steady state and then do basic HRT checkup bloods.

Now itchy nipples is a sign of high E2 and possibly prolactin in men maybe its the same for women. Your E2 was already very high before you started using T cream. Now some of that newly adsorbed T converts to E so there is a chance your E2 is now out of range. When my E2 and prolactin were out of range my nipples were on fire. Defy gave me anastrozole to reduce my E2. On my next bloods E2 went from 62 to 29 and prolactin went from 18 to 9 and I have never had water or nipple issues again in 8 months.

Amberlin · Mar 25, 2018

Thanks so much for your input! I am not using compound cream. I tried it once for nearly a month & had a terrible reaction. I'm currently taking injections at the rate of 1mg/ml, 2xs per week. IT seems to be a cleaner deliver system & I have a very sensitive system. I emailed Defy with my current side effect & hope to hear from them soon. Maybe I too can have anastrozole. THANK YOU for sharing your side effects & your solution! At this early stage, I'm just feeling overwhelmed, so I do appreciate your comments

I'm glad to hear your wife has improved symptoms as well. Hearing that time has changed things for you both & for the better, gives me hope. I am peri-menopausal which has made lab work interesting but I find that through tracking phases (moons, if you will), that has helped me nail down the best time for certain tests in order to provide a more accurate picture to the doctors. Thanks again.

FeelingLost · Mar 25, 2018

Amberlin said:
Thanks so much for your input! I am not using compound cream. I tried it once for nearly a month & had a terrible reaction. I'm currently taking injections at the rate of 1mg/ml, 2xs per week. IT seems to be a cleaner deliver system & I have a very sensitive system. I emailed Defy with my current side effect & hope to hear from them soon. Maybe I too can have anastrozole. THANK YOU for sharing your side effects & your solution! At this early stage, I'm just feeling overwhelmed, so I do appreciate your comments
I'm glad to hear your wife has improved symptoms as well. Hearing that time has changed things for you both & for the better, gives me hope. I am peri-menopausal which has made lab work interesting but I find that through tracking phases (moons, if you will), that has helped me nail down the best time for certain tests in order to provide a more accurate picture to the doctors. Thanks again.

Injections wow nice. I don't think I could get my wife to do that if her two creams she puts on daily doesn't give us good numbers. I assume your T is T cypionate and if so you are looking at 40 days to be steady state. Men just starting injections experience a lot of side effects that last for a week or three then they go away on their own. Some take meds but most just take time. I don't know if women experience these when they increase their T.

madman · Mar 25, 2018

Transdermal testosterone reaches steady state in 48-72 hrs.

https://academic.oup.com/jcem/article/85/12/4500/2852336

Amberlin · Mar 25, 2018

The cream gave me 2 major side effects that outweighed their doing good; lady area swelling & a lot of weight put on in an incredibly short amount of time. Plus, I had a "moon face" which my Dr attributed to my newly increased progesterone levels. I'm fairly confident I need them lowered so the cream was no longer an option for me. I searched for a solution all to no avail. My husband searched a different forum which has off topic threads, one of which is "men's health". T levels, among other levels are discussed on a regular basis which is where he was introduced to bio-identical therapy. He mentioned it to me & I started researching. I took the plunge & I'm now taking T-cypionate. Not sure if that alone could be causing my progesterone levels to rise through raising the estradiol levels? Both are raised so I wonder if the T is only exacerbating a pre-existing condition & could easily be treated with anastrozole? All hormones seem to be connected like a spider web so treating one affects others. 40 days seems so far away. I'll hold steady

Thanks again!

madman · Mar 25, 2018

https://www.sciencedirect.com/science/article/pii/S0378512213000121

ratbag · Mar 25, 2018

I'm confused on your dosage of 1mg/ml. This is usually referred to as the strength you use but not the dosage. My testosterone is 100mg/ml, while most Americans use 200mg/ml strength. My wife injects 14mg once weekly. There is lots out that that suggest the max a women can take is 20mg weekly. My wife's MD told my wife that if she gets a deep voice or extra hair growing on her face she just needs to reduce the dosage some.

ratbag · Mar 25, 2018

I'm confused on your dosage of 1mg/ml. This is usually referred to as the strength you use but not the dosage. My testosterone is 100mg/ml, while most Americans use 200mg/ml strength. My wife injects 14mg once weekly. There is lots out there that suggest the max a women can take is 20mg weekly. My wife's MD told my wife that if she gets a deep voice or extra hair growing on her face she just needs to reduce the dosage some. She also takes 50mg DHEA daily. She is postmeno and 60 yrs old.

FeelingLost · Mar 25, 2018

Thanks Madman I read your article aloud to my wife. She and I both enjoyed it.

madman · Mar 26, 2018

My pleasure FL! I am glad you are on here, your sense of humor in your many posts is much needed as so many of us are much too serious (me anyone LOL)!

Amberlin · Mar 26, 2018

Glad to hear your wife has found a dose that works for her. There is also adequate research that says low & slow is the best way to go when beginning any new treatment to avoid side effects such as you've noted. I'm ok not having to undo the effects of being hairy or talking in a deep tone like a man. The strength of my T is 50mg/ml. My dose is 10ml Thanks for asking for clarity. I'm very green here & eager to learn

There is always a possibility that at some point my dose will increase but since I only started 2 weeks ago, this is what the doctors prescribed.

Vettester Chris · Mar 26, 2018

Hi Amberlin, thanks for posting the labs. By chance are you taking BC pills? Any noticeable changes in your cycle over the past few years (more, less, infrequency, issues)? Your E2 is also at the very top for being in the follicular phase, but some of the hormone treatment specialists might want to compare all estrogens with an E1, E2 & E3 panel. It could be a myriad of possibilities, but I would pursue this further for more answers, especially if early peri/post menopausal is inherit within your family(?)

Yes, IMO you did good with 10mg of DHEA. Your DHEA serum levels are low, which could indicate some adrenal imbalance, which in turn can be evident and problematic with other hormonal imbalances, especially estrogen. It can also reflect excess stress and other variables too. Cortisol should be at it's highest in the AM, and sharply dropping off thereafter (80% + decline in the afternoon & PM). Thus, many people (including my wife & myself) find DHEA best at night, as it can counter cortisol and help restore some balance.

You might want to explore a 4x saliva diurnal kit to get a comprehensive circadian profile of your cortisol w/ DHEA correlation. A lot of people will also supplement Pregnenolone in conjunction with this, as that is the primary hormone pulled upstream by the adrenal glands. Continued cortisol demand can sometimes pull higher amounts of pregnenolone, which in many cases can stem to the decline of DHEA and other hormones downstream; sometimes referenced as 'pregnenolone steal'.

In my experiences, and for many others, a HUGE improvement in sleep quality was exhibited with DHEA at night (25mg for me, my wife is at 15mg). However, some don't see that benefit, so it just depends on each individual.

My wife is at 8mg to 10mg per week of cypionate. Serum levels tend to be in the 80ng/dl area. She also takes 5,000iu of D3/day, elemental iron, vitamin C -1,000mg, and selenium.

That leads to the thyroid ... It's crucial to get the correct thyroid labs to see the full picture ... You have TSH, but also need Free T4, Free T3, Reverse T3, and antibodies (TPO &TgAb). If there's cortisol issues then there will ultimately be thyroid problems, as is the same for Iron & Ferritin. For many women, both these categories are at an imbalance, which in turn has created an imbalance with the thryoid, usually pooling of FT3. However, full-on overt hypothyroidism can be evident when the body is in a state of estrogen dominance, which is seen many times in post menopausal ladies.

ratbag · Mar 27, 2018

Amberlin said:
The strength of my T is 50mg/ml. My dose is 10ml

If your taking 10 ml that would translate to 50x10=500mg. I think you meant to say your dose is 10mg ? Also you take this twice a week? for a total weekly dosage of 20mg?

FeelingLost · Mar 27, 2018

Amberlin said:
Glad to hear your wife has found a dose that works for her. There is also adequate research that says low & slow is the best way to go when beginning any new treatment to avoid side effects such as you've noted. I'm ok not having to undo the effects of being hairy or talking in a deep tone like a man. The strength of my T is 50mg/ml. My dose is 10ml Thanks for asking for clarity. I'm very green here & eager to learn There is always a possibility that at some point my dose will increase but since I only started 2 weeks ago, this is what the doctors prescribed.

HaHa I wish. We just got her bloods back from her first protocol she was on it for 2 months. Her T went from 8 to 188 I believe the top of the range is 42. Needless to say until her next consult in 3 weeks she is cutting back to two clicks from 4 per day.

If Madman's post that steady state is 48-72 hours for compounding T cream she has been at that lvl for a while now. Funny thing is she has no extremely high T symptoms other than a little more quick tempered but we were blaming that on Tax time and changing major medical insurance companies requiring gobs of new test to justify her other meds.

Amberlin · Mar 27, 2018

I am still learning so thanks for your patience with me

My current dose is .1ml 2xs per week. Total weekly dose is .2ml

Amberlin · Mar 27, 2018

Thank you for the well thought out post! I am not taking BC pills. Yes, very noticeable cycle changes as in periods of time where it is absent, the last 2 consecutive months twice (one every 2 weeks) & most recently, absent again.

I'm not familiar with pregnenolone but in reading a quick bit on Mercola's web page, I exhibit every single low level symptom. However, I also exhibit many low T, hypothyroid, high estradiol/progest symptoms. All this to ask "which came first? What do I treat first?" Knowing hormones are all connected like a spider web, pulling on which thread will yield the best overall results?

I have a lab slip to test free T3, T4, & antibodies. Will do that Thursday. In looking at your wife's levels, I wonder if my testosterone therapy level is simply too low to be doing much of anything right now? I'm still learning so I think I initially posted my dose wrong. I am taking .1ml 2xs per week Having a very poor reaction to the compound cream my family Dr prescribed, I felt it necessary to start the injections with Defy at a lower level than they might otherwise start another patient. Though the doctor noted we could easily increase the dose if I didn't report negative side effects.

At this point, it is very evident that I have too much estrogen. I spoke with Defy 2 days ago who noted than in taking TC, that should lower the levels that need to come down & raise levels that need to come up. That was the reason for starting with TC. In more research on my part (not sure at this point if this is helpful or harmful) I see that TC aromatizes causing MORE estradiol! I am frustrated, confused, & puffy. My testostorone level must be increasing at least a little though because I'm not crying about it. Hahaha!

FeelingLost · Mar 27, 2018

Amberlin, no need to apologize. We are all here to learn from each other. In the beginning there really isn't any dumb questions.
Since you had such a bad reaction to the compounded cream I can see why they wanted to start your T cyp out with a low dose.

Guys go thru quite a few negative side effect when they first start T.
Water weight can be very bad i put on 10# of water weight my face was as round as a pumpkin.
I got one of those English double chins from the swelling.
Oily skin is another.

Amberlin · Mar 27, 2018

Good grief FeelingLost! PLEASE tell me that subsided? That's pretty much spot on to where I'm at. Thanks for sharing your experience too. I don't have anyone to gain insight from & my family doctor isn't helpful at all. I've already contacted Defy twice so I'm very hesitant to ask them anything until at least my thyroid lab results come back & they call me.

FeelingLost · Mar 27, 2018

Amberlin said:
Good grief FeelingLost! PLEASE tell me that subsided? That's pretty much spot on to where I'm at. Thanks for sharing your experience too. I don't have anyone to gain insight from & my family doctor isn't helpful at all. I've already contacted Defy twice so I'm very hesitant to ask them anything until at least my thyroid lab results come back & they call me.

Yes it all went away for me. It took about 5 weeks and then I started noticing positives like muscle tone and reduction in body fat even on my belly where I have always has trouble.

My brain started working better. Where I first noticed it was in my spelling. When I would proof read before hitting the send or post button I did not need to look up as many words.

Then my skin started looking better I am 64 an was developing old man crepey skin. It is all gone now. My wife can't believe it it's flipping her out. I love it and I think it is giving her hope.

I don't claim to be any kind of expert on this subject but my google-fu is quite powerful and I got a crap load of common sense.
If I can be of any help feel free to ask that is what this forum is all about.
We are all on a journey here to feeling better and the journey is much easier with friend even if they are just virtual.