Latest blood work/high SHBG

[Justin Chile Farrar]

What do you guys think,

Currently on 50mg of test cyp 2x per week, Thursday morning Sunday night. 500iu HCG 2x per week. Labs were taken Monday, next day after shot.

 

[Nelson Vergel]

Justin:

Great hematocrit.

Your estradiol is low. Are you taking anastrozole and/or zinc?

Your free testosterone is under 2 percent of total due to your slightly high sex hormone binding globulin. What is your height, weight and waist size? Alcohol use? Are you taking any vitamin D? Please expand.

Any reason why you had your rheumatoid factor checked? Joint pains?

 

[Justin Chile Farrar]

Thanks Nelson,

.5mg of arimidex eod and 200mg of zinc due to low zinc levels.

My my height is 6'1" I weigh 175lbs last time I checked waist size is 33. I don't drink at all. I take 25,000iu vit d 3x per week.

I think it was just part of the panel I don't really have joint pain.

I've read doing injections once a week is better for high shbg. Should I move to that?

 

[Nelson Vergel]

I would stop the arimidex and let your estradiol come back up. Test it in a month using the ultrasensitive test.

You really do not need more than 50 mg per day of zinc. Make sure you take zinc with copper. Many of the zinc supplements out there come with copper added to them. Zinc can bring copper down. Copper is important for immune function. Some men see dramatic reductions of estradiol with zinc. I was one of them and that is why I no longer take it.

To be honest, there is absolutely no data that shows that injecting twice or once per week has any effect on sex hormone binding globulin. SHBG is really difficult to control.

 

[Justin Chile Farrar]

Yeah i knew that about the zinc and copper. I take a multi with copper in it. Didn't know it could lower estradiol that much that's good to know.

So is there nothing i can do about the shbg then? It's never been that high.

 

[Vettester Chris]

Look into some elemental iron supplementation. Iron serum would be good up in the 130 range, which will also promote thyroid productivity, primarily with getting T3 into the cells. Speaking of .. Lot of missing labs including thyroid.

 

[Justin Chile Farrar]

Look into some elemental iron supplementation. Iron serum would be good up in the 130 range, which will also promote thyroid productivity, primarily with getting T3 into the cells. Speaking of .. Lot of missing labs including thyroid.

Chris,
on my last labs my iron was high... Is it normal to fluctuate like that? I do have thyroid issues. Currently I'm taking 30mcg of t3 and 50mcg of t4. I've been using the circadian t3 method to wean of hydrocortisone. Here are the rest of the

 

[Vettester Chris]

Justin, it definitely could have dropped if you have been donating blood since that previous set of labs. Donating is crucial when helping to control hematocrit, but there's got to be a balance so that you also keep iron and ferritin in a healthy range. This is even a problem on my end, and I have excessive high ferritin from having a positive hemochromatosis gene. For me, I'm backing off my donations to every 3 months, and adding elemental iron.

Your FT4 is at 30% of the reference range, and FT3 is at 63%. IMO, these values are best when they're BOTH in the 50% to 80% area, BUT, permitting FT3 is effectively getting into the cells and not pooling. I suspect in your case there might be some pooling of T3. What we need is a Reverse T3 assay to compare the ratios. While you're at it get the antibody (TPO and TgAb) labs.

The Circadian T3 method can be effective. It just requires discipline to get the correct amount administered real early, everyday. Would be curious to see a 4x saliva cortisol panel at some point, and to especially see how your treatment effects the AM reading.

 

[Nelson Vergel]

Justin

Watch your diet if you can. Your LDL and triglycerides are high. Lower your sugars, white breads, sweets, refined carbs and maximize your protein (eggs, lean beef, chicken), nuts, olive oil, salmon, and vegetable consumption if you can. Also, if you drink try to limit it to no more than 2 drinks per day and only while you have food in your stomach.

Your CK is high. Did you work out hard the night before the test was performed? You are obviously not on statins, so that CK increase is not due to their use. High CK may mean muscle destruction. It can increase with exercise, statin use, muscle wasting diseases, etc. You may want to take the two days before the next blood work off from the gym to see what happens to your CK.

I agree with Chris on thyroid (he is the guru on that subject).

 

[Justin Chile Farrar]

Chris, I hadn't given any blood prior to doing this test. Also the blood work I did a few weeks before this one said high iron so I don't know what's going, I can only guess it's something with my thyroid which would also account for the high triglycerides.


Since these labs ive ive raised my t3 dosage to 30mcg and my t4 dosage to 50mcg. I was afraid of pooling but this is why I was trying to get off hydrocortisone. I was afraid it was making the t3 pool since a saliva test I did a while back suggested I never even needed hydrocortisone in the first place. The reverse t3 is on there... It's at 10 which puts my ratio at 35. Does that mean pooling?


I was planning on doing a saliva test after I got off of the hydrocortisone. I'm still on 5mg and trying to wean it but it's been really hard to dial in my circadian method dose.




Nelson,
i eat really clean. No bread, no sugar Exocet for some fruit. I don't eat sweets at all or refined carbs. My diet is high grass fed protein, veggies, fruits, nuts, and rice. I don't drink. I think my LDL and triglycerides are high due to low thyroid function and not having my dosages right because the blood work I did a few weeks before this showed my LDL and tryglicerides were fine.


And yeah ear I think I worked out the day before these labs were done. I've been lifting really heavy.

 

[Vettester Chris]

Sorry about that, I didn't see the RT3 at the bottom. You are correct, your ratio is 35, and that is good. Not sure what happened on the blood tests with the iron. Possibly a lab mistake on one of them? It's hard to say. Either way, I like the 35 ratio you have and that tells me active FT3 is making into the body. Have you considered going with a NDT treatment program instead of the synthetic T4 & T3?

 

[Justin Chile Farrar]

No worries man, it was kind of hard to see. I have read that you can still be pooling if your ratio is good though since the FT3 can be in the high range making the ratio look good, but a sign of pooling would be FT3 in the very high end of the range or even over it right? Yeah I'm not sure, I think I'm going to supplement with elemental iron at 27mg a day or a few weeks and then have labs run again. Ok, that's good news, this thyroid thing has been so frustrating man. I have tired NDT before and would love to go back, I just started with the synthetics so I could do the CT3M and get myself off of HC. How would I go about making the switch if I'm on 30mcg of cytomel and 50mcg of synthroid?

 

[Vettester Chris]

Justin, how much Cytomel do you take for the CT3M treatment? I know you are taking 30mcg total, but presuming you're adding a small amount on top of that for the CT3M?

One possible way to go about it would be to start with 1 grain (60mg) of NDT, BUT, add a little cytomel for the first week (maybe 10 to 15mcg), as the body gets adjusted to the NDT treatment and additional conversion of T4 to T3. From there you should be able to titrate up and cut out the cytomel. In your case you might see where 1-1/2 grains puts you and see how you feel.

Since NDT ratios are different than what the normal human thyroid produces, "some" will add a little T4 if they feel they need a little more storage hormone to balance out the lab reference range if FT4 is lagging. Like TRT, everyone is different .. conversion and metabolism rates will vary by individual. Selenium and kelp have really helped my program, and for the most part I do pretty good between 1-1/2 to 2 grains of Armour, without any additional T4.

Glad you've been doing your homework with the CT3M and adrenals. Will be really curious how it turns out with a 4x saliva panel. I was on it for a bit, but came across some Isocort, which is ridiculously priced if you can find it!!

 

[Justin Chile Farrar]

Chris,
For the CT3M, I've been taking 17.5mcg of cytomel at 7:00am.

So a typical day of dosing looks like this:
17.5mcg @ 7:00am(CT3M dose)
5mcg @ 11:00-11:30am
5mcg @ 4:00-4:30pm
2.5mcg @ 9:30-10:00pm

I was thinking, I could take 2.5mcg of cytomel off the 7am dose and add a half grain of NDT instead, and then do another half grain at the 4pm time instead of 5mcg of cytomel. Or I could do a half grain at 11am and at 4pm instead of 5mcg of cytomel at those times? I'm not sure what would be best or if that makes sense.

I think i'm one of those people that definitely needs a little T4, however I think the synthroid I'm taking now is messing with my results as I'm not getting a good response anymore and I still feel pretty bad. Maybe the iron also has something to do with that as well.

Yeah I was originally on Isocort before I started with HC but my dr switched me to HC after the isocort stopped working. There's still some suppression with isocort though right? I think it's hard to find right now because they're reformulating it.

 

[Vettester Chris]

Justin,

I guess there's probably several dozen ways you could integrate NDT into the mix. As stated before, it sounds like you have done your homework on a lot of this, so hats off to you for that! My personal suggestion is to try to find the way to make your program effective, BUT keep it simple at the same time. I'd personally keep the CT3M about the same, and start NDT treatment at 2x per day; breaking up 1 grain, 1-1/2 grains, or whatever dosage you establish with your physician ...

If you feel you need a little more cytomel T3 during the first week, then that option can always be there. If you did 1-1/2 grains you would be getting approx. 14mg of T3 (If my thinking is correct), and it won' take too long before additional T3 is converted from T4. I don't think you will need any extra T3 beyond what you are taking with the AM CT3M, and of course what will be administered from NDT, but like I said before, we're all different, so you will just need to pay close attention to how you feel, body temperature, and of course labs.

On Isocort, as far as I know they just stopped producing the stuff. I heard something in the rumor mill about a new formulation like you had mentioned, but nothing in concrete. I requested some input from Bezwecken in OR, but they won't respond on the matter.