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Thread: Hormone panel and MRI results interpretation

  1. #1
    pepous is offline Associate Member
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    Hormone panel and MRI results interpretation

    Hello,

    I am 22 years old man.

    My sympthoms are: (I suffer from this from the age of 15)
    1. lethargy
    2. non agresivity
    3. inability to concentrate
    4. low self esteem
    5. anemia sympthoms
    6. Cant gain muscles
    7. Often tired
    8. Low libido
    9. Psoriasis on my face
    10. Cold hands

    My blood work results which I did in past few months.

    Blood test 1

    LH 2,5 U/L <1,2 - 8,6>
    THS 3,32 mU/L <0,34 - 5,60>
    Free T4 10,1 pmol/l <7,9 - 16,0>
    Free T3 5,1 pmol/l <3,8 - 6,0 >
    T4 total 90,01 nmol/l <78,00 - 157,00>
    T3 total 1,68 nmol/l <1,34 - 2,73>
    FSH 2,7 U/l <1,3 - 19,3>
    Estradiol 130 pmol/l <0 - 173>
    Prolaktin 408,7 mIU/l <56,0 - 278,0>
    Testosteron 14,1 nmol/l <6,1 - 27,1>
    SHBG 25,0 nmol/l <13,2 - 89,5>
    FAI ( free androgen index ) 56,4 % <22,2 - 110,2>

    Blood test 2

    UREA = 6.7
    KREAJ=92
    EGFRM1=1,42
    BIL = 8.3
    ALT=0.59
    AST=0.38
    CRP=0.7
    PGLU=4.51
    CHOL=4.56
    LDL=2.89
    Prolactin=22.93 (ref. range is up to 15 doc sayed)
    U-GLU=normal
    U-PROT=stopy
    U-BIL=negative
    U-UBG=normall
    U-PH5=5.5
    U-Blood=Negative
    U-NITR=Negative
    U-LEURO=2 (higher than range)

    Blood test 3 - This blood test was done 3 hours after I woke up

    IGF-1 290 <265-410>
    STH 0,03 <0-20>
    SHBG 38.1 <12-75>
    LH 2.26 <1,5-9,3>
    FSH 2.43 <1.4-18.10>
    Prolactin 12.04 <2.1-17.7>
    Estradiol <0.09 <0.04-0.19>
    Korizol 504 <118-618>
    Testosterone 12.5 <5.4-30.4>
    T4 - free 15.9 <11.5-22.7>
    TSH 1.707 <0.5-4.9
    ACTH 28.2 <10-60>

    MRI results

    There was found small 2mm pituitary microadenomas. But becouse of my hormones are in range it is no needed to deal with it.

    Conclusion

    My doctor suspected prolactinomas due to higher prolaction levels. In the second blood test prolactin was re-checked and was increased again. Than doctor did MRI where was found small 2mm microadenomas on pituitary. On the third blood test doctor said I should go on test at least 3 hours after I wake up. On this third blood test prolactin was in range (so prolactin is not my problem - it was increased becouse of morning values which is normall).

    What can I do? What is my problem? I suffer from this from the age of 15 and I really need to find solution!
    Last edited by pepous; 09-30-2014 at 03:01 PM.

  2. #2
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    pepous - For starters, your Doctor doesn't know how to deal with your problem and trust me you have a problem that you will have for the rest of your entire life and which can progress if the tumors grow. Lets look at what you posted...

    Blood test 1
    LH 2,5 U/L <1,2 - 8,6>
    For a man your age LH should be or at the top of the reference range and as you can see it's low...in fact very low for your age. This what you'd expect for a man in his late middle age. There's a reason this is low.

    THS 3,32 mU/L <0,34 - 5,60>
    While we don't like to use this as a measurement for Thyroid health whenever TSH is above 2 it means that we have to loo further at the Thyroid. 3.32 is elevated.

    Free T4 10,1 pmol/l <7,9 - 16,0>
    Free T3 5,1 pmol/l <3,8 - 6,0 >
    This where the rubber meets the road with Thyroid panels. FT4 is a bit low but FT3, which is the bioavailable form of Thyroxine, looks good. So you're coverting T4 to T3 well...which is a good thing.

    T4 total 90,01 nmol/l <78,00 - 157,00>
    T3 total 1,68 nmol/l <1,34 - 2,73>
    This is concerning as both panels are low. What this means that while your Free panels are good the Totals are not and these should be at mid to upper part of the reference range. They are both being suppressed.

    FSH 2,7 U/l <1,3 - 19,3>
    Like LH, while in range it is way to low for a male your age. This should be at or near the top of the reference range.

    Estradiol 130 pmol/l <0 - 173>
    I am going to guess that this was not a "Sensitive" Estradiol panel...in which case it's not very accurate. That being said, it states that you have elevated Estradiol levels which is part and parcel why you feel like you do.

    Prolaktin 408,7 mIU/l <56,0 - 278,0>
    As noted, these are elevated due to the tumors on your pituitary gland...classic to be honest.

    Testosteron 14,1 nmol/l <6,1 - 27,1>
    I assume this is a Total Testosterone panel which is about mid range so it's not too concerning. Your testicles are working just fine.

    SHBG 25,0 nmol/l <13,2 - 89,5>
    Fine.

    FAI ( free androgen index ) 56,4 % <22,2 - 110,2>
    Fine.



    Blood test 2
    UREA = 6.7
    KREAJ=92
    EGFRM1=1,42
    BIL = 8.3
    ALT=0.59
    AST=0.38
    CRP=0.7
    PGLU=4.51
    CHOL=4.56
    LDL=2.89
    Prolactin=22.93 (ref. range is up to 15 doc sayed)
    Again, this is due to the tumors on your Pituitary gland..elevated Prolactin levels are not a good thing.

    U-GLU=normal
    U-PROT=stopy
    U-BIL=negative
    U-UBG=normall
    U-PH5=5.5
    U-Blood=Negative
    U-NITR=Negative
    U-LEURO=2 (higher than range)

    Blood test 3 - This blood test was done 3 hours after I woke up

    IGF-1 290 <265-410>
    For a guy your age this should be at or near the top of the reference range It's suppressed and is probably part of your problem as well.

    STH 0,03 <0-20>
    SHBG 38.1 <12-75>
    Fine.

    LH 2.26 <1,5-9,3>
    FSH 2.43 <1.4-18.10>
    As noted, both, while in range, for a male your age these are low.

    Prolactin 12.04 <2.1-17.7>
    In range, but very odd how your serum levels elevate to above reference range during the course of the day...and your Doc thinks that is normal?

    Estradiol <0.09 <0.04-0.19>
    I don't know the values here but this E2 panel looks like you are mid range. Again, going to guess this was not a Sensitive panel.

    Korizol 504 <118-618>
    Testosterone 12.5 <5.4-30.4>
    Going to guess this is Total Testosterone which again for a male your age these are low...they look like an much older man.

    T4 - free 15.9 <11.5-22.7>
    Ok. Where are the other Thyroid panels???

    TSH 1.707 <0.5-4.9
    Ok, but how funny this is now normalized.

    ACTH 28.2 <10-60>

    There are inconsistencies in your lab work and some that are down right significant.

    You present with symptoms consistent with Hypothyroidism (and your Thyroid should be optimized) and Hypogonadism. You are still missing important labs like Free Testosterone and/or Bioavailable as well.

    What dose your Doctor want to do with you and your symptoms?

    Do you trust him and his care?

    Would you be open to finding another specialist and get a second opinion (which I would recommend).

    I want kel to advise on this as well.

  3. #3
    kelkel's Avatar
    kelkel is offline HRT Specialist ~ AR-Platinum Elite-Hall of Famer ~ No Source Checks
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    My initial thought was a TSH secreting adenoma. It's not common but they occur. I know, it's one not discussed much and most aren't aware they exist. Pepous I'll add that I myself have a 2mm microadenoma (so don't feel alone) that was not a prolactinoma, it only shut down my T production almost completely. Far too many people, docs included, judge them via prolactin only which is incorrect and potentially misleading. Micro/macro adenomas can do a variety of things.

    Op, GD is on target here as always and I'll point out that he is probably the sharpest one we have when it comes to Thryoid issues so a long follow-up is not necessary. Take a look at the below articles. From memory I think one speaks of TSH secreting tumors. Like GD said, I would consider finding not just another doctor, but going to a center than specializes in pituitary adenomas. Lets take the guess work out of this. You're too young to not get properly diagnosed and treated.

    Good luck and let us know what course of action you take please.

    http://jcem.endojournals.org/content/82/11/3625.full

    http://www.ccjm.org/content/75/11/793.full

  4. #4
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    This from kel is worth its weight in gold --> "You're too young to not get properly diagnosed and treated".

    This is what we're all about here...

  5. #5
    pepous is offline Associate Member
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    pepous - For starters, your Doctor doesn't know how to deal with your problem and trust me you have a problem that you will have for the rest of your entire life and which can progress if the tumors grow. Lets look at what you posted...

    Blood test 1
    LH 2,5 U/L <1,2 - 8,6>
    For a man your age LH should be or at the top of the reference range and as you can see it's low...in fact very low for your age. This what you'd expect for a man in his late middle age. There's a reason this is low.

    Prolactin acts this way: When it goes up, it alters the normally pulsatile secretion of GnRH (LHRH) in the hypothalamus, therefore affecting the also-pulsatile secretion of LH and FSH, which will result in low testosterone levels.

    So is it possible that my LH and FSH supressed so much due to prolactin mechanism? Unfortunatelly I WAS abusing steroids in past (becouse of I always believed my problem is testosterone related - younger appearance etc. (I was young and stupid but it is reality) but dont I had problem much sooner than I first abused any steroid so dont believe I caused it by myself

    Should´t I try clomid on my own? On this thread I found some member (dont know nick) who did this and worked for him.

    THS 3,32 mU/L <0,34 - 5,60>
    While we don't like to use this as a measurement for Thyroid health whenever TSH is above 2 it means that we have to loo further at the Thyroid. 3.32 is elevated.

    What should I do for confirming this? Do I need some more tests on this? (RT3,RT4 etc.).

    Free T4 10,1 pmol/l <7,9 - 16,0>
    Free T3 5,1 pmol/l <3,8 - 6,0 >
    This where the rubber meets the road with Thyroid panels. FT4 is a bit low but FT3, which is the bioavailable form of Thyroxine, looks good. So you're coverting T4 to T3 well...which is a good thing.

    T4 total 90,01 nmol/l <78,00 - 157,00>
    T3 total 1,68 nmol/l <1,34 - 2,73>
    This is concerning as both panels are low. What this means that while your Free panels are good the Totals are not and these should be at mid to upper part of the reference range. They are both being suppressed.

    FSH 2,7 U/l <1,3 - 19,3>
    Like LH, while in range it is way to low for a male your age. This should be at or near the top of the reference range.

    Estradiol 130 pmol/l <0 - 173>
    I am going to guess that this was not a "Sensitive" Estradiol panel...in which case it's not very accurate. That being said, it states that you have elevated Estradiol levels which is part and parcel why you feel like you do.

    Sorry, dont know. It was checked in this laboratory: http://www.citylab.cz/cz/lekar/vysetreni.php?id=46 (hovewer it is in czech language only) Method: chemiluminiscence .. ??

    Prolaktin 408,7 mIU/l <56,0 - 278,0>
    As noted, these are elevated due to the tumors on your pituitary gland...classic to be honest.

    Yes, but that test was done in early morning. When I wait 3 hours after I wake up than it is low in range (according to 3rd test). That is why doc thinks it is due to morning stress. What do you think? When to measure prolactin? Is it normall to have elevated it in morning or it is microadenoma connected problem? Please explain me this.

    Testosteron 14,1 nmol/l <6,1 - 27,1>
    I assume this is a Total Testosterone panel which is about mid range so it's not too concerning. Your testicles are working just fine.

    SHBG 25,0 nmol/l <13,2 - 89,5>
    Fine.

    FAI ( free androgen index ) 56,4 % <22,2 - 110,2>
    Fine.



    Blood test 2
    UREA = 6.7
    KREAJ=92
    EGFRM1=1,42
    BIL = 8.3
    ALT=0.59
    AST=0.38
    CRP=0.7
    PGLU=4.51
    CHOL=4.56
    LDL=2.89
    Prolactin=22.93 (ref. range is up to 15 doc sayed)
    Again, this is due to the tumors on your Pituitary gland..elevated Prolactin levels are not a good thing.

    U-GLU=normal
    U-PROT=stopy
    U-BIL=negative
    U-UBG=normall
    U-PH5=5.5
    U-Blood=Negative
    U-NITR=Negative
    U-LEURO=2 (higher than range)

    Blood test 3 - This blood test was done 3 hours after I woke up

    IGF-1 290 <265-410>
    For a guy your age this should be at or near the top of the reference range It's suppressed and is probably part of your problem as well.

    Could it be connected to Microadenoma or it is separated problem?

    STH 0,03 <0-20>
    SHBG 38.1 <12-75>
    Fine.

    LH 2.26 <1,5-9,3>
    FSH 2.43 <1.4-18.10>
    As noted, both, while in range, for a male your age these are low.

    Prolactin 12.04 <2.1-17.7>
    In range, but very odd how your serum levels elevate to above reference range during the course of the day...and your Doc thinks that is normal?

    Estradiol <0.09 <0.04-0.19>
    I don't know the values here but this E2 panel looks like you are mid range. Again, going to guess this was not a Sensitive panel.

    Korizol 504 <118-618>
    Testosterone 12.5 <5.4-30.4>
    Going to guess this is Total Testosterone which again for a male your age these are low...they look like an much older man.

    T4 - free 15.9 <11.5-22.7>
    Ok. Where are the other Thyroid panels???

    TSH 1.707 <0.5-4.9
    Ok, but how funny this is now normalized.

    ACTH 28.2 <10-60>

    There are inconsistencies in your lab work and some that are down right significant.

    You present with symptoms consistent with Hypothyroidism (and your Thyroid should be optimized) and Hypogonadism. You are still missing important labs like Free Testosterone and/or Bioavailable as well. Isnt free testosterone just counted according to Total testosterone / SHBG ratio?

    What dose your Doctor want to do with you and your symptoms? I should retest my hormones in 4-6 months. Also when I asked if that can be low testosterone connected she said yes and will do Urologic examination for possible testosterone treatment.
    Doctor said that becouse of prolactin is not increased (was increased only when I did blood test in morning) microdenoma is not my problem she thinks.

    Do you trust him and his care? Hmm. She is good doctor I think but my problem exists so I will probably try some new doctor/View on this.

    Would you be open to finding another specialist and get a second opinion (which I would recommend).

    PS: Microadenomas have aproximatelly 17% of population so it could be all just coincidence. ????
    Last edited by pepous; 03-06-2013 at 02:55 AM.

  6. #6
    VTX1800 is offline Associate Member
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    Kel, gdevine... U guys are the shit!!! It's awesome to see you guys dedicate your time to helping others. Fn awesome!!

  7. #7
    pepous is offline Associate Member
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    Quote Originally Posted by VTX1800 View Post
    Kel, gdevine... U guys are the shit!!! It's awesome to see you guys dedicate your time to helping others. Fn awesome!!
    Yes I appreciate it as well. Thank you .

  8. #8
    kelkel's Avatar
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    No worries guys! Just stick around and pay it forward!

  9. #9
    pepous is offline Associate Member
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    Quote Originally Posted by kelkel View Post
    No worries guys! Just stick around and pay it forward!
    What do you think about what I written in "red" in post above? Does that even matter if my problem is caused by microadenom or not? I am asking becouse of these small microadenomas are not usually operated.

    I am mainly interested in

    - Is prolactin really my problem if it is normal 3 hours after I wake up and increased when I do it sooner?
    - If my problem is hypogonadism which is NOT caused by prolactin, what are possible way to threat? Clomid or HRT?
    - Is my thyroid problem separated problem or it is connected to the problems written above (prolactin or hypogonadism)? What is possible threatment and is it that big problem which may be causing my symthoms? No one doctor will prescribe this I think becouse of I am 80KG / 180cm and my weight is stable and even more my blood results are normall (I am maybe misleading in this)
    - My IGF problem is probably untreatable

    Why I write this

    - Should I just try something what lowers prolactin for few months and than review that?
    - If it is testosterone , shouln´t I just try clomid or HRT for few months and than review that?
    Last edited by pepous; 03-09-2013 at 03:12 PM.

  10. #10
    pepous is offline Associate Member
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    What do you think?

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    my lh and fsh numbers are similar to yours. my dr who was a complete moron said that is great that they are low.

  12. #12
    Trific's Avatar
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    I WAS abusing steroids in past (becouse of I always believed my problem is testosterone related -
    So, did you feel any better when on steroids ?

    Did any of your symptoms go away when on steroids?

  13. #13
    pepous is offline Associate Member
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    Quote Originally Posted by Trific View Post
    So, did you feel any better when on steroids ?

    Did any of your symptoms go away when on steroids?
    Yes, all was gone. Absolutely diferent person honestly. But everyone feels much better on supra doses of testosterone I think. I was also training and eating very good. Training and eating is half of the succes for my symthoms I believe. I believe hormones are just 50%. The rest is good lifestyle.

  14. #14
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    Quote Originally Posted by pepous View Post
    Yes, all was gone. Absolutely diferent person honestly. But everyone feels much better on supra doses of testosterone I think. I was also training and eating very good. Training and eating is half of the succes for my symthoms I believe. I believe hormones are just 50%. The rest is good lifestyle.
    Hmmm, makes one wonder how you'd be on 50mg test every 3.5 days.

  15. #15
    pepous is offline Associate Member
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    Quote Originally Posted by Trific View Post
    Hmmm, makes one wonder how you'd be on 50mg test every 3.5 days.
    Also I feel press on my neck when I am stressed. May that be connected to Thyroids problem?

  16. #16
    pepous is offline Associate Member
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    Hello again (new update) with new results:

    Na 141 <136-145>
    K 4,1 <3,5-5,1>
    CI 104 <98-107>
    Ca 2,35 <2.15-2.55>
    Mg 0.8 <0.66-1.07>
    Cu 10.9 <12.4-20.6>
    Zn 17.7 <7-23>
    Glukosa 4.63 <3.33-5.59>
    Fe 12 <10.6-28.3>

    It seems I am also bordeline anemic :-).

    PS: What doses of cabergoline should I use to lower my prolactin? I just want to try it.

    Thank you.

  17. #17
    pepous is offline Associate Member
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    Hello,

    next tests are done. What do you think? Do I need HRT?

    Minerals
    Na 142 <137 - 146>
    K 4,3 <3,8 - 5,0>
    CI 100 <97 - 108>
    Ca 2,57 <2,00 - 2,75>
    Fosfor anorg. 1,07 <0,65 -1,61>
    Iron 26,1 <7,2 - 29>
    Copper 15,3 <10,99 - 21,98>
    Zinc 23,3 <9,1 - 13,7>
    Osmolality 292 <275 - 295>
    Ferritin 134,6 <22 - 322>
    Glucose 4,6 < 3,9 - 5,6>

    Urea 5,8 <2,8 - 8>
    Kreatinin 95 <44 - 110>

    Liver function tests
    Bilirubin total 17,6 <2 - 17>
    ALT 0,51 <0,1 - 0,78>
    AST 0,37 <0,1 - 0,72>
    GGT 0,25 <0,14 - 0,84>
    ALP 1,01 <0,66 - 2,2>

    Proteins


    Albumin 50,6 <35 - 53>
    Protein total 79,6 <65 - 85>

    Lipids


    Cholesterol 4,66 <2,9 - 5>
    Triacylglyceroly 0,78 <0,45 - 1,7>
    Cholesterol HDL 1,44 <1 - 2,1>
    Cholesterol LDL 2,87 <1,2 - 3>

    Hormones
    IGF-I 342,9 <265 - 410>
    STH 0,17 <0 - 20>
    LH 1,41 <1,5 - 20>
    FSH 2 <1,5-9,3>
    Prolactin 16,59 <2,1 - 17,7>
    Estradiol < 0,090 <0,04 - 0,19>
    Progesteron 0,8 <0,9 - 3,9>
    Cortizol 594 <118 - 618>
    Testosteron 13,57 <5,4 - 30,4>

    T3 total 1,45 <0,9 - 3>
    T4 total 110,7 <60 - 150>
    T4 Free 16,2 <11,5 - 22,7>
    TSH 2,509 <0,5 - 4,9>
    Anti Tg <15 <0,0 - 60>
    Anti TPO 28 <0 - 60>

    PSA 0,66 <0,0 - 1,4>
    ACTH 40 <10 - 60>

    Leukocyts 6,8 <4,1 - 10,2>
    Erytocyts 5,44 <4,19 - 5,75>
    Hemoglobin 164 <135 - 174>
    Hematokrit 0,469 <0,390 - 0,510>

  18. #18
    pepous is offline Associate Member
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    bump

  19. #19
    pepous is offline Associate Member
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    Hello again. I was after 1 year at my endocrinologist again to recheck my hormone profile. And it seems like this: (test was done about 3 hours after I woke up)

    Blood test from 3.2.2014

    Vitam B12 413 <141-489>
    TSH 1,29 <0,27 - 4,2>
    FT4 Free 16,5 <12 - 22>
    FT3 Free 4,9 <3,1 - 6,8>
    FSH 3,8 < 0 - 12,4>
    LH 4,1 <1,7 - 8,6>
    Estradiol 49,4 <28 -156>
    Prolactin 10,79 <4,04 - 15,2>
    Testosteron Total 15,25 <8,64 - 29>
    Kortizol 292,6 <171 - 536>

    Also in few next weeks I will restest my pituitary on MRI. The sympthoms remain the same. Gym/sport/good food helps me beat it very much.

    What do you think about that? Is it possible that my body is simply setted up on lower level of androgens with no reason? Just genetically?

    My idea is (becouse of my testes are OK) to try very low doses of anastrozole to boost my testosteron levels. What do you think? May it work?

    Thank you for any idea.

  20. #20
    pepous is offline Associate Member
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    Also I would like to ask what do you think about these posibilities:

    HCG therapy
    Clomid low dose therapy
    Arimidex low dose therapy

    What do you think may one of these things works? Is it used? Are example of peoples whom it works? Arent there some long term side effects? What do you recommend?

  21. #21
    kelkel's Avatar
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    Your LH/FSH are low but not totally in the toilet.
    Don't mess with an AI until you get a proper Sensitive Estrogen Assay specific to males.
    Clomid will stimulate production but maintaining it is the issue.
    -*- NO SOURCE CHECKS -*-

  22. #22
    pepous is offline Associate Member
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    Hello,

    I would like to write some updates to this thread.

    At 6.2.2014 (February 6 2014)

    I started using Anastrozole at dosing of 0,20 Mg / twice a week. My goal was to improve the testosterone and estradiol ratio, to boost LH, FSH and Testosterone levels .

    At 17.3.2014 (March 17 2014)

    I did new bloodwork test and results was: (The test was done at the same medical centre as a previsious one at 3.2.2014)

    FT4 17,25 <12-22> +0,75 (compared to bloodwork done at 3.2.2014 - Before starding Anastrozole low dose protocol)
    FT3 4,9 <3,1-6,8> +-0
    FSH 4,5 <1,5-12,4> +0,7
    LH 3,4 <1,7-8,6> -0,7
    Estradiol 27,2 <28-156> -22,2
    Testosterone 18,29 <8,64-29> +3,04


    Subject:

    Until now (from the start of experiment) I noticed some light changes. I had more energy, I was leaner, Little stronger maybe and had better overall feelings of wellbeing.

    In next week I would like to go to recheck my blood levels again. Also I am not sure if it is due to this test but I noticed in last two days slight anxieties.

    I will update thread upon I will know something new.

    Thank you for everyone who reads this thread :-).
    Last edited by pepous; 04-11-2014 at 02:14 PM.

  23. #23
    kelkel's Avatar
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    Keep updating with your progress Pepous.
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  24. #24
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    Wow, one of tne best threads on here. Huge thanks to the senior members, their responses are are In depth and very time consuming, very much appreciated
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  25. #25
    pepous is offline Associate Member
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    Hello,

    in last several days I felt joint pain (I suspect low estradiol). Becouse of that I decreased today dose to 0,05 mg and furthermore I will continue with lowered protocol with dosage at 0,15 mg / twice a week.

    My last 0,2 MG dose was done at 12.4.2014

    Blood work results from 16.4.2014 (today) - Compared to results from 17.3.2014
    LH 1,7 <1,7-8,6> -1,7
    Estradiol 31,1 <28-156> 3,9
    Testosteron 16,61 <8,64-29> -1,68

    According to these numbers it looks my estradiol is higher than in previsious blood test but I dont think so. It is becouse the last blood test was done 2 days after last anastrozole dose and current blood test was done 4 days after last anastrozole dose.

    My original idea was to do blood test at the same day (friday) as the previsious test (for better comparison) but due to joint pain I disrupted this schedule.

    Thank you.

  26. #26
    pepous is offline Associate Member
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    Hello again,

    In friday I was on blood test again becouse I feld something is wrong again (suspected low estradiol). My results were:

    Estradiol 26,6 <28-156>
    Testosteron 16,77 <8,64-29>

    Becouse of this I lowered dosage of adex to 0,1 MG / twice a week and probably will even skip one dosage.

    I will see how thigs go. But it is interesting becouse first 2 months I was dosing 0,2 MG / twice a week and all was OK. Than I lowered to 0,15 Mg and now even to 0,1 Mg and still I feel I am too low.

    Have a nice day.
    Last edited by pepous; 05-06-2014 at 02:45 AM.

  27. #27
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    Quote Originally Posted by pepous View Post
    Hello again,

    In friday I was on blood test again becouse I feld something is wrong again (suspected low estradiol). My results were:

    Estradiol 26,6 <28-156>
    Testosteron 16,77 <8,64-29>

    Becouse of this I lowered dosage of estradiol to 0,1 MG / twice a week and probably will even skip one dosage.

    I will see how thigs go. But it is interesting becouse first 2 months I was dosing 0,2 MG / twice a week and all was OK. Than I lowered to 0,15 Mg and now even to 0,1 Mg and still I feel I am too low.

    Have a nice day.
    Do you mean "lowered your dosage of adex?" If not, refresh my memory please.
    Remember like I said near the beginning of this thread, Estradiol is not the correct panel to pull and tends to run higher than a Sensitive Estrogen Assay does. This in and of itself can cause an unnecessary use of adex which further exacerbates E2 issues. Males sit at the bottom of the bell curve on the standard estradiol test and it's not "sensitive" enough to accurately read.
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  28. #28
    pepous is offline Associate Member
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    Yes I mean lowered dosage of Adex, sorry.

    You are right. I will probably have to either find lab where to check Senstitive Estrogen Assay or to do the job with non accurate results (according what I feel etc.)

    Also I found study of supplemeting Anastrozole in men. The study shows that the estradiol decrease continually for the first three months of usage and than it gets its bottom. So it is probably not surprise that I am low even with lowered dosage.

    Click image for larger version. 

Name:	586804-fig2.jpg 
Views:	311 
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ID:	150288

    Entire study: http://www.medscape.com/viewarticle/586804_3

    Thank you.

  29. #29
    pepous is offline Associate Member
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    Hello again.

    I did bloodwork today again (just becouse I want to know how my body work). My last dosage of AI was at 3.5.2014 (3rd of May). The dose was 0,1 Mg. I lowered dosage due to I didnt felt well. I skipped the dose at wednesday and today the results of estradiol and testosterone are bellow:

    Estradiol 53,3 <28-156>
    Testosteron 12,81 <8,64-29>


    Surprisingly estradiol rised back to initial value very quickly (I didnt expected). There is also obvious the relationship between estradiol and testosterone values (probably not big surprise) ...

    Tomorow I will start new lowered protocol with dosage of 0,1MG / twice a week. I hope it is a good idea. What is unknown for me is if it is long term sustainable to reduce estradiol and to have increased testosteron (long term).

    Thank you.

  30. #30
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    Hello,

    Today I was again on blood testing. Last week I was on pituitary MRI (annual checking) but I dont have results yet. I am still on dosage of 0,1 MG of Anastrozole twice a week from the 9 of May.

    Todays blood test results:

    Estradiol 68,7 <28-156>
    Testosteron 16,57 <8,64-29>

    The results are for me surprising. Even with 0,1MG/2X week of anastrozole my estradiol is higher than 3 weeks ago when I stopped anastrozole for a week. I am not sure if it is due to incorrect measuring or it is reality. Interesting and maybe a little odd is that my testosteron is quite high for me even with that high level of estradiol.

    During these three weeks I felt for about a half of this period a little weird (maybe unmotivated - weird feeling - dont know how to describe). I will stay on this protocol and I will see what happens.

    Thank you.

  31. #31
    pepous is offline Associate Member
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    Hello,

    I would like to just update this thread. At the 14 of June I ended using anastrozole becouse I started having mood swings (I was maybe too low for long period of time or something like that). But I will give it a chance in future becouse it obvisously improved many signs of low test for atleast period of 2 months. Than I experienced as mentioned some swings etc.

    Today it is about 1 month from the end of that protocol so I did blood test to confirm all is OK.

    Results from 11 of July 2014

    Testosteron 18,85 <8,64-29> (higher than on anastrozole??)
    Estradiol 79,2 <28-156>
    LH 2,9 <1,7 - 8,6>
    SHBG 32 <14,5 - 48,4>


    And just for evidence I did bloodwork also at 13 of June


    Estradiol 80,2 <28-156>
    Testosteron 17,83 <8,64-29>


    For me it is a little suprising how high my testosterone now is. Even when I was using anastrozole my testosterone was not that high. Does anyone knows why?

    Also I dont feel like with more testosterone right know. I feel I am "low" but not totally in the toilet. Also can anyone explain why my testosterone levels vary so much? In the past it was somewhere between 12 - 15 now it is almost 19.

    Also I today started supplementining with vitamin D at dose 4000 UIP / day. I will just give it a try.

    Thank you.
    Last edited by pepous; 07-16-2014 at 07:13 AM.

  32. #32
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    Update from 9.8.2014

    I am supplementing low dose of anastrozole to lower estradiol and prolactin and waiting for cabergoline to arrive. I am dosing 0,1 MG / 3 X week.

    My blood work results after 14 days on this protocol:

    Testosteron 20,88 <8,64-29>
    Estradiol 29,2 <28-156>
    Prolactin 8,83 <4,04 - 15,2>

    Test was done late after I woke up. Prolactin has its peak in the morning so I believe my prolactin is even with reduced estradiol slightly elevated. Last few days I dont feel good.

  33. #33
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    Update from 9.8.2014

    I am supplementing low dose of anastrozole to lower estradiol and prolactin and waiting for cabergoline to arrive. I am dosing 0,1 MG / 3 X week.

    My blood work results after 14 days on this protocol:

    Testosteron 20,88 <8,64-29>
    Estradiol 29,2 <28-156>
    Prolactin 8,83 <4,04 - 15,2>

    Test was done late after I woke up. Prolactin has its peak in the morning so I believe my prolactin is even with reduced estradiol slightly elevated. Last few days I dont feel good.

  34. #34
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    Hello,

    Just updating my thread. Three weeks ago a had some cramp in my stomach and temperature. From that moment I have problems with energy levels (while sporting mainly) etc. Hope it is being dying away from my "short illness".

    Due to that I went to check my hormones and results are bellow (8.9.2014)

    TSH 2,1 <0,27 - 4,2>
    FT4 free 14,9 <12 - 22>

    LH 2,6 <1,7 - 8,6>
    Testosteron 11,13 <8,64-29>
    Estradiol 47,6 <28-156>
    Prolactin 8,28 <4,04 - 15,2>

    All my values are supressed. I believe it is partly due to my "illness" and it will go up after I will be fit.

    ADD: I am not on any drug at the moment. I have cabergoline prepared on hand. I am going to test it while I will be completely fit.

    Thank you.
    Last edited by pepous; 09-10-2014 at 02:30 PM.

  35. #35
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    glad to see you are keeping the log going
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  36. #36
    pepous is offline Associate Member
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    Update:

    Early morning Cortisol 568 <171 - 536> (doctor checked as a possible culprit of my fatigue).

    From Sunday I have problem with headache, poor energy, faitness, cold hands and sensitivity to cold. This started after big meal :-( ...
    Last edited by pepous; 09-30-2014 at 08:43 AM.

  37. #37
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    Do you take any corticosteroids (hydrocortisone, prednisone etc.) for any inflammatory condition(s) or use lots of asthma inhalers, creams for skin rashes etc?

    Is the physician ruling out whether the microadenomas could be secreting ACTH?

  38. #38
    pepous is offline Associate Member
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    Quote Originally Posted by thisAngelBites View Post
    Do you take any corticosteroids (hydrocortisone, prednisone etc.) for any inflammatory condition(s) or use lots of asthma inhalers, creams for skin rashes etc?

    Is the physician ruling out whether the microadenomas could be secreting ACTH?
    Thank you for your questions and time at first.

    1. I do not take any drugs
    2. All results I have I post on to this thread. So probably not. According to history my ACTH values were:


    28.2 <10-60> (from 02-27-2013)
    40 <10 - 60> (from 05-23-2013)

    Also doctor few months ago rechecked MRI and my pituitary microadenoma is the same size as one year before.

    Do you recommend to recheck my ACTH values?

    Also I bought on internet on my own drug called Cabergoline and I am planning to give it a try. My prolactin is increased in morning. But when I test the prolactin 3 hours after wake up than my prolactin is normall. So not sure if this is normall or not.

    Thank you ...

    PS: I edited my sympthoms in the first post. I added psoriasis which I have longtermly on my left cheek.
    Last edited by pepous; 09-30-2014 at 03:02 PM.

  39. #39
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    Sorry pepous, I have looked at the thread a couple of times, but of course there is a lot of info and I can't keep it all in my head, and I don't have time to re read it right now. I haven't had much to add as nothing has jumped out at me from what I had read.

    As I understood, originally it was thought the microadenomas could be prolactinomas, then blood work ruled that out. Since your am cortisol is slightly high, I was just wanting to make sure that someone is considering whether they are secreting ACTH. Normally with a slightly high cortisol, there would be recs to take vitamin C, etc, but since the microadenomas are there, I would want to consider whether they might be an issue.

    Cortisol can often be all over the place - generally high in the morning, generally low at midnight, but one blood draw does usually not tell us much (you might be worried about the needle stick or the test result, etc,. and get a result that is slightly affected), even if you had an adenoma secreting ACTH. I am in no way an expert about microadenomas, I am just trying to help you by making sure someone is considering this possibility and ruling it out. I would imagine a midnight cortisol test, if elevated, would make this more likely. Have you had a look at the symptoms of Cushing's to see if they sound like they fit you? Maybe I am barking up the wrong tree.

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