Miklu's Labs

[Miklu]

so i finally got Rx for NDT (erfa thyroid), i'm going to start taking it next week and we decided with my doctor to simply stop taking T4 one day and next day start taking NDT ½ grain every morning and in 1-2 weeks increase dose to 1 grain daily splitted to morning and afternoon. by then 4x saliva results should be ready.

Edit: i started training again lightly about month ago (MMA) even though i haven't felt very good ( T4 hasn't helped me at all) and i've noticed last weeks that my symptoms are little worse than before i started training again, by that i mean i have more flu-like symptoms ( stuffy nose), headache, dizziness, shaky hands, lightheadness, clumsiness, cold feeling, fatigue, muscle weakness etc. i know it's useless to speculate without those saliva results but could these symptoms be from low cortisol and my training has made it even worse? i'm still going to continue training lightly until those results come but wanted to know if i'm doing more harm than good to my body.

 

[HarryCat]

Training will put stress on the body and one of the body's normal responses to such stress would be to increase cortisol production. If you are suffering from adrenal fatigue then your adrenal glands won't be able to produce the cortisol your body needs and you'll end up running out of energy much sooner than normal. I doubt that you would be doing any harm as long as you don't push yourself too hard.

Looking back over you thread you seem to have said that you felt a little better when you first started taking the T4, but now you feel there has been no benefit, is that true? If so, that is not unusual and probably indicates a need for a higher dose. The same can be true when taking ERFA, so keep that in mind.

 

[Miklu]

Training will put stress on the body and one of the body's normal responses to such stress would be to increase cortisol production. If you are suffering from adrenal fatigue then your adrenal glands won't be able to produce the cortisol your body needs and you'll end up running out of energy much sooner than normal. I doubt that you would be doing any harm as long as you don't push yourself too hard.

Looking back over you thread you seem to have said that you felt a little better when you first started taking the T4, but now you feel there has been no benefit, is that true? If so, that is not unusual and probably indicates a need for a higher dose. The same can be true when taking ERFA, so keep that in mind.

okey, i've been training 1½ hour, 3 times a week light rolling and technique so i think i haven't push myself too hard.
yes well now that i think back when i started this T4 medication, i'm not anymore sure was it just placebo feeling or did it really gave me little bit more energy, either way i know that it hasn't helped me as much as it should have (atleast that's what i think and i didin't even have huge expectations when is started it.)
anyway, i will keep in mind that symptoms might come back if i don't increase dosage soon enough when is start NDT but if my adrenals ain't working properly, wouldn't it be best to stick lower dose of NDT until they've been fixed?

 

[HarryCat]

anyway, i will keep in mind that symptoms might come back if i don't increase dosage soon enough when is start NDT but if my adrenals ain't working properly, wouldn't it be best to stick lower dose of NDT until they've been fixed?

Yes, that is the preferred way to do it.

 

[Miklu]

Here are the saliva results, they came surprisingly fast. these were taken when i was on 75mcg of T4 if it matters. also, i had very bad migraine whole day but i didin't take any pain meds because i was afraid they would affect results.

 

[Vettester Chris]

Yeah, your Circadian Profile needs addressed. If this trend continues, you risk (IMO) adrenal fatigue and having the adequate cortisol needed to cope with stress and avoid lethargic symptoms, which will additionally just compound with inadequate thyroid function, which also depends on a healthy adrenal function

Curious, has your ACTH lab been ordered +compared pituitary activity against your presented cortisol numbers? Surely stress and other factors are probably the culprit, but if Cushing's (again IMO) should be ruled out, ensuring some type of adenoma isn't present in the pituitary region. I also personally think this would be a good opportunity to test your aldosterone, along with potassium. Again, like other things, there could be correlations in this department of the adrenals, which could directly effect the adrenal production of cortisol.

If everything is checking out as 'normal', then it's a matter of figuring out what things and changes you can take to improve this area. Like so many things, factors like lifestyle changes, including balancing your work and personal life effectively and healthy, avoiding alcohol and substances that can stress the body, sleeping, exercising with a balance of resting and repairing the body, supplementing a ample amount of Vitamin C, D3, Zinc, B12, and supplementing various Adaptogens as you review your options with your physician.

Keep us posted ... Unfortunately, this cortisol subject is very critical with thyroid productivity ... Too high and you will see issues with the conversion of T4 to T3, and possible elevated Reverse T3, thus increasing ATP. Too low of cortisol (which will ultimately prevail with primary or secondary adrenal insufficiency) will effect T3 activity in the cells, causing pooling or stagnancy of T3, which will once again trigger higher conversion rates of T4 to RT3 in the liver when the body isn't getting adequate amounts of T3. In similar contrast to low and high estrogen, cortisol will ultimately present many of the same symptoms with hypothyroidism.

 

[Miklu]

Curious, has your ACTH lab been ordered +compared pituitary activity against your presented cortisol numbers? Surely stress and other factors are probably the culprit, but if Cushing's (again IMO) should be ruled out, ensuring some type of adenoma isn't present in the pituitary region. I also personally think this would be a good opportunity to test your aldosterone, along with potassium. Again, like other things, there could be correlations in this department of the adrenals, which could directly effect the adrenal production of cortisol.

ACTH lab hasn't atleast yet been ordered, i will talk with my doctor about this and if it would be possible to take aldosterone and potassium.

If everything is checking out as 'normal', then it's a matter of figuring out what things and changes you can take to improve this area. Like so many things, factors like lifestyle changes, including balancing your work and personal life effectively and healthy, avoiding alcohol and substances that can stress the body, sleeping, exercising with a balance of resting and repairing the body, supplementing a ample amount of Vitamin C, D3, Zinc, B12, and supplementing various Adaptogens as you review your options with your physician.

i've been trying to do lifestyle changes as much as possible last two years when these problems slowly started, first i started to concentrate my nutrition and these days i eat (IMO) pretty clean: whole grains, beans, legumes,lean protein sources, nuts (nut butters), seeds, olive oil, coconut oil, eggs, fatty fish and veggies as much as possible. also currently i take Now foods Special two multivitamin, Now Foods D3 2000iu(been taking almost 7 months) and quality liquid fish oil.

these days, i don't drink very often, maybe once a month (max) because i know it's bad for me and i feel bad already so that's not a problem. i don't smoke or use any other stressful substances. i have pretty rough background on my personal life but currently i feel it's not affecting that much to me but i try to look into it and see what can i change.

also, i'm going to start taking somekind of B-complex, more Vitamin C, and Zinc. how much i should take zinc and when? i would assume the best time would be when those cortisol levels are highest? currently my multivitamin contains 15mg zinc.

Keep us posted ... Unfortunately, this cortisol subject is very critical with thyroid productivity ... Too high and you will see issues with the conversion of T4 to T3, and possible elevated Reverse T3, thus increasing ATP. Too low of cortisol (which will ultimately prevail with primary or secondary adrenal insufficiency) will effect T3 activity in the cells, causing pooling or stagnancy of T3, which will once again trigger higher conversion rates of T4 to RT3 in the liver when the body isn't getting adequate amounts of T3. In similar contrast to low and high estrogen, cortisol will ultimately present many of the same symptoms with hypothyroidism.

what do you think i should do with NDT? plan was that after 1-2 weeks of being on ½grain, i would start taking 1 grain daily and continue this kind of dosing increases until i hit on 2grain. is this still a valid plan and could it be possible, that after my thyroid has been properly supported, my adrenals don't have to make so much cortisol and they will slowly become optimal by simply getting high enough on NDT?

I'm going to start taking my daily temps starting from this day.

 

[HarryCat]

How is your sleep? What struck me about your result was your 10pm -12am number. With cortisol that low you would expect very restless sleep with a lot of wake ups. Your body needs some cortisol at night to maintain sleep.

 

[Miklu]

How is your sleep? What struck me about your result was your 10pm -12am number. With cortisol that low you would expect very restless sleep with a lot of wake ups. Your body needs some cortisol at night to maintain sleep.

i have no problems to fall asleep but i do wake up almost every single night atleast once.

 

[Miklu]

i've been taking my body temps regularly for a week using Geratherm and my average daily temps have been between 98.2-98.5f, is it normal that i have so high reading when considering that i'm currently only on 1grain? i did take my temps when i was on Thyroxin but these were taken using digital thermometer so i'm not sure how accurate results were. when i was on 50mcg T4 my temps were roughly 97.7f and when 75mcg T4 97.8f.

and i don't really feel any better than when i was on T4, i still feel very very fatigued, sluggish and lethargic, daily headaches and even if i don't have headache i have very heavy head, throbbing in my head all the time, weird vision, dizziness, stuffy nose ( started about six months ago) unintentional weight loss despite eating all the time( currently weighing 127 pounds and couple years back about 140.) and i've noticed that if i don't eat every 3 hours or so, i have even more sluggish and lethargic feeling.

 

[Miklu]

i've been a week now on 1½grain NDT, only positive thing i've noticed is that i have much better bowel movements. otherwise no improvements and for some reason my legs below knee all the way to toes are even colder than usual and couple of times this week felt like blood wouldn't circulate in my feet at all.

also even though ACTH test and aldosterone, renin, natrium and potassium labs haven't been done yet, we decided with my doctor to start HCG monotherapy 500iu/EOD
and do labs after month to see if my testicles work. i did my first injection wednesday and everything went well and another one today. how fast should i feel something? these days i don't really expect much from anything so i'm sure that it's real if i feel something.

 

[Miklu]

so here are the lab results after 5 weeks on HCG 500iu EoD, these were drawn approximately 20 hours after injection.

S-LH 0.15 IU/L (1.5-9.3)

S-Testo 16.4 nmol/l (8.4-28.7)

S-SHBG 60.30 nmol/l (17.0-66.0)

S-E2 110.5 pmol/l MAX 146 (Not Sensitive assay)

S-Prog 3.11 nmol/l MAX 4.11

Pregnenolone results isn't ready yet.

also i'm still currently on HCG and 2grain of NDT and i'm gonna take thyroid labs in couple weeks!

 

[Miklu]

and these are finally ready:

S-RT3 0.25 <0.95 nmol/l

S-D-1,25 250 42-211 pmol/l

when i calculated rt3 ratio it was 25.5 so rt3 problem can be ruled out and i guess these thyroid and vitamin D levels couldn't be better even though i don't feel well.

also sinus x-ray came clean so there isn't anything that would cause my stuffed nostrils.
we talked with my doctor about my situation and after i've done sleep study and if everything is fine in that department we should maybe try out sustanon or nebido because he feels HCG just ain't gonna cut it and i'm going to also lower my NDT dosage to 1½grains daily at least for now. i've still been injecting HCG 500iu EoD even though i'm not sure if it's going to make any difference but i guess it ain't hurting either.

 

[Miklu]

i had appointment with my doctor last week about starting TRT and we came to an agreement to try it and see how it goes over the next six months.

he prescribed me 125mg (0.5ml) Sustanon e5d so that i can manipulate dosage and find perfect protocol for me.
HCG 250iu 2xweek
he also gave me prescription for Aromasin just in case i'm going to need it.

The protocol i'm going to start tomorrow morning will be Sustanon 62,5mg (0,25ml) 2xweek to deltoids/thighs
250iu HCG 2xweek subQ

labs will be taken after being on this protocol 6-8 weeks. i'm still on Erfa 1½grains daily.
And Sleep study didn't show anything abnormal.

 

[Vettester Chris]

Good to hear. Keep us posted on how it turns out.

 

[Miklu]

so it's been a while since my last post and i've now been almost 6 months on TRT protocol 62,5mg Sustanon monday morning, thursday evening along with 250iu HCG injected same time. (changed to Subq Sustanon injections from IM 2 months ago).

i know you wonder why i haven't posted labs after couple of months but telling the truth, my financial situation has been pretty bad and i simply haven't had any money to take labs since they are so expensive here in Finland but i've donated blood twice while on TRT, last time was 2 weeks before this bloodwork to make sure i don't get myself one more problem. anyway here they are, these were taken approximately 12 hours before next shot. (Thursday morning, 9.00 am)

Prolactin 182 (53-360) mIU/l

Alkaline phosphatase 44 (35-105) U/l

Aspartate transaminase 30 (15-45) U/l

Alanine transaminase 19 (10-70) U/l

Bilirubin 10 (2-25) µmol/l

Creatinine 83 (60-100) µmol/l

PSA 0.81 MAX 2.50 µg/l

Non-sensitive E2 137.6 MAX 146 pmol/l ( 37.5 pg/ml)

Total Testosterone 20.6 (8.4-28.7) nmol/l (594 ng/dl)

SHBG 25 (17-66) nmol/l

i calculated free t by using one of those sites in internet and it showed
Free testosterone 14.9 ng/dl 2.52%


Lipids

Total Cholesterol 4.8 MAX 5.0 mmol/l

HDL 1.4 MIN 1.0 mmol/l

LDL 3.1 MAX 3.0 mmol/l i'm little worried about this, i didn't found any previous bloodwork that included lipids so i don't know how long its been this high.

Triglyceride 0.65 MAX 2.0 mmol/l

Blood count

White blood cell 5.1 (3.4-8.2)

Red blood cell 4.61 (4.30-5.70)

Hemoglobin 141 (134-167) g/l

Hematocrit 41.6 (39-50.00)%

MCV 90.2 (82-98) fl

MCH 30.6 (27-33) pg

MCHC 339 (320-355) g/l

Thrombocyte/Blood platelet 288 (150-360)

i hope everything's right since i had to translate everything from finnish but i tried to be precise so i guess they are.

i haven't really noticed much positive effects physically since i started TRT expect my libido is much better and i have to admit that i didn't realize before TRT that i had problems with my sexual function and other that kind of things.

also i'm much calmer and feeling better mentally even though i'm still very tired and weak. i used to have racing heart all the time and anxious feeling and all that is almost completely gone.

also i dropped that small NDT dose i was on right after i started trt since i felt it was best to start from clean table and see what TRT on it's own doesto my thyroid function.


Edit: oh and by the way, the reason for my constantly blocked nostril was found out and it's caused by deviated septum which i got from hits to my face from Kickboxing.

 

[Nelson Vergel]

Miklu

Everything looks pretty good. I would not worry too much about your LDL. A little cardio and a diet with more vegetables and low sugar may just bring it down again.

 

[Miklu]

ok, could it be that i've had low t since birth and that's one reason why my ldl is so high? because i have reason to believe so since my mother was an alcoholic who drank when she was waiting me and my both brothers have mental problems so i wouldn't be suprised if i had all along low t and all these SSRI meds, Accutane and hits to my head made everyting even worse.

well the funny things is, i eat really well and a lot vegetables daily plus i regularly eat eggs, coconut and olive oil, butter, nuts, fish/fish oil, all the good fats and still it's so high. of course i haven't been able to train regularly almost a year expect some light bodyweight exercising and walking so you're right, it might get better when i can start training again and shouldn't it get better even with optimal TRT?

like mentioned above, i've been injecting Sustanon subcutaneously about 2 months, top of the buttocks and around navel and almost always no matter what needle size or injecting angle i use, i get that nodule and after seeing this thread "subcutaneous abscess" on allthingsmale forum and what might happen when injecting propionate http://www.allthingsmale.com/community/threads/subcutaneous-abscess.25030/
i'm really starting to worried what are my options because only other injectable testosterone along with Nebido and Sustanon i can get legally here in Finland is Testoviron WHICH also contains propionate

and i'm not really keen to start injecting IM again because i'm currently 21 and if i have to let's say inject next 10 years to my deltoids and thighs and glutes 2x week, when i turn 31 i'm all about scar tissue and especially since i'm not a big guy (currently 135lbs, 5 ft 10).

Edit: i also took serum DHT but it's so rare test here that it's going to take few weeks till i get results.

 

[Miklu]

Here are my thyroid labs+DHT results from earlier bloodwork.

Serum DHT: 2.40 (1.03-2.92) nmol/l

Potassium 4.4 (3.6-5.0) mmol/l

Calsium 2.41 (2.15-2.51) mmol/l

Serum Cortisol: 488 (138-690) nmol/l These labs were taken 9.30 A.M so i guess this would have been higher if taken more earlier like supposed to right?

Sodium 140 (137-145) mmol/l

Free T3 5.09 (3.5-6.5) pmol/l

Free T4 11.56 (10-21) pmol/l

TSH 2.46 (0.4-4) mIU/l

Reverse T3 ain't ready but i've been taking my average daily temperatures for 6 days and my temps have been everyday between 36,7-36,8C (98.06-98.24 F) so considering that my thyroid should be working pretty well?

i'm still currently on same protocol: SubQ Sustanon 62,5mg x2 week+ 250iu hcg 2xweek until i meet my doctor in a month or so and i request if i could get Testoviron Depot that contains only Enanthate since i definitely can't continue injecting Sustanon subQ more than month or two, propionate in it irritates so much my skin plus i got lumps every time i inject it.

 

[Miklu]

i got reverse t3 result back, now my doctor said that there is 2 different labs here in finland who do these tests and that results when taken same time can be like night and day so i don't know if this this really is right or what.

rT3: 0.02 MAX 0.95 nmol/l can this really be so low??
when calculated from FT3 5.09 (3.5-6.5) pmol/l = RT3 Ratio: 254.5 back when i was on NDT my RT3 ratio was something 25 so is there some kind of lab error or what because i've never heard anyone having that high ratio. i also changed injecting Sustanon from subQ back to IM because i can't anymore take it since i don't have places to inject anymore because of lumps and irritated skin.

we decided with my doctor to try LDN (low dose naltrexone) to see if it would help me any possible way since it feels like nothing we have tried ain't relieving my biggest symptoms: fatigue and general weakness/unability to gain weight, despite eating 3000 calories daily. i'm currently weighting 134 pounds, before trt lowest i weighted was 127 pounds.

so i started LDN 2 weeks ago 1,5mg daily taken before going bed and i upped my dosage 3 days ago to 3mg. only thing i've noticed is vivid dreams and sweating at night ( which are propably most common symptoms when starting). we'll see how it goes but i'm really hoping i find at least some relieve to my symptoms from LDN.