Plateau and labwork - T3?

[Giggle]

Thanks Angel. I do take it, but I'd appreciate knowing what dose he recommends.
The kit is supposed to come tomorrow, and I'll do it on Wednesday. Whew - long process, but thanks so much for your help!

[thisAngelBites]

My levels were at the bottom of the reference range, so he had me taking 100,000 iu a day. I was pretty surprised it was such a high dose. I'm due to do blood work, so it will be interesting to see where I am now.

[Giggle]

Let us know.
Thanks

[Giggle]

Finally got the results - and I'd appreciate any thoughts...all this is from the saliva test with 4 samples -
Estradiol 8.1 (1.3-1.7)
Progesterone 38 (12-100)
Pg/E2 ratio 5 (Optimal 100-500 when E2 is 1.3 -3.3
Testosterone 346 (16-55)
DHEAS 59.0 (2-23)
Cortisol 1 4.6 (3.7-9.5) morning
Cortisol 2 2.3 (1.2-3.0) noon
Cortisol 3 1.2 (0.6-1.9) evening
Cortisol 4 0.8 (0.4-1.0 night

Taking the test and DHEA pellets into account, that explains those high levels.
The cortisol looks to be on the low side - but better than I expected.
I am not sure about the Estradiol and Progesterone though.
Any thoughts?

I have been reading a LOT about the adrenals and trying to reduce stress (during the holidays lol). I've also tried to take better care of myself in general, take more Vitamin A and more B's, and drink lots of water.
Thanks for anything you can think of to help me!

[thisAngelBites]

Hi Giggle,

Your cortisol production is still following the natural rhythm of starting higher in the morning, and decreasing during the day, but if you examine the results, your highest reading, in the morning, is in the lowest quintile of the reference range. As nighttime approaches, your cortisol moves higher into the reference range. The midnight cortisol is much closer to the top of the range (the fourth quintile). I think anyone who agrees that adrenal fatigue is a useful concept (some people don't, and they would say you are absolutely fine until your cortisol output drops enough that your adrenals produce almost nothing during a stimulation test, and until you are there, you are fine. You will have to make up your own mind about this controversy) would say your adrenals are not performing optimally. Typically someone with this low-in-range to later high-in-range pattern is considered to have adrenal glands which are not able to make morning levels as high as they should be, and keep trying to make cortisol when normally production would slow down, which results in the late, normal-high cortisol, which can make sleep and evening winding down more difficult. Sometimes this problem perpetuates itself, because not resting well or sleeping soundly through the night makes it harder for the body to cope overall.

Your estradiol is obviously elevated in comparison to the reference range. I imagine this is largely due to you having a large excess of testosterone in your body. It's the same conversion process from T to E2 that you see the guys talking about in the other forums - having gyno. It makes you estrogen dominant (that's why they give you a progesterone/estrogen ratio), and there are risks of having so much E2 and not enough progesterone to balance the estrogen. Too much estrogen without sufficient progesterone puts you at higher risk of breast cancer (it's significant, you do need to pay attention to this problem), and without enough progesterone, your brain is less likely to produce sufficient amounts of a neurotransmitter called GABA, which helps you sleep well and relax/counter anxiety (which as you say can be difficult issues near the holidays).

Additionally, high levels of estrogen can inhibit the release of cortisol from the adrenals, and it can increase the amount of transcortin, which is a binding globulin for cortisol - all this means that having too much estrogen can lower your cortisol, and bind up what you do have so there is less available for your tissues to use.

It could be the case that the T pellets have caused all of this. I don't know. T increases E2, inhibits cortisol, increases transcortin. It also could cause the low HDL that you posted earlier on. That could be the underlying cause of it all, and perhaps you were just slightly low T, slightly low DHEAs, as we all get with time, and you needed more subtle dosing to get it all in line. On the other hand, maybe your cortisol levels were not so great to begin with - strenuous exercise is something that can also stress the adrenals. If you don't have bloods from before, it's all just guessing.

In the end, I have to say I would not put too much value in a physician who will implant these pellets in you without checking your hormone levels before and after. That's kind a surprise from a legal standpoint, not even considering the quality of healthcare. Supplementing a hormone is never an isolated incident - it always has other effects, and physicians who know their stuff are always planning for the undesired consequences of adding a hormone to shore up levels. I'll bet that having that much testosterone helps to mask symptoms because typically it makes you feel good, but I think if you want to keep those elevated T levels, you need help from someone very knowledgeable who makes sure you are not raising risks for other problems by balancing things like estrogens with progesterone and factors in your adrenal hormones. Otherwise you could reduce the T dose so that the level is not so high, in order to minimise the impact on other hormones.

I'll let you know if I think of anything else...

[Lunk1]

Very good coverage TAB. I would add that T levels this high are bound to result in viralization. I was wondering what your results would be after you had the implants.

Curious where you were during your monthly cycle when this test was taken?

[Giggle]

Hi Angel -
Thank you so very much!
This is giving me a lot to think about and I'm working through it. Trying to compare your notes with the couple of books I've gotten.
I have also had an appointment with an HRT specialist in the area. Didn't have the results yet, but did all the preliminary questions. He is expensive, to say the least. So, I'd like to see what I can do myself in the meantime.

The T pellets should be wearing down in the next 2 months, so that may help in one way, and make things worse in another.
About the first physician, I entirely agree. She should never have done anything without pre labs and I didn't know enough then to insist or question it. Well I do know now thanks to you all!
I'll keep working on it and keep you all updated.
Some things that were keeping me up at night have settled down anyway - so I do feel better.
Thanks again - so much.

Hi Giggle,

Your cortisol production is still following the natural rhythm of starting higher in the morning, and decreasing during the day, but if you examine the results, your highest reading, in the morning, is in the lowest quintile of the reference range. As nighttime approaches, your cortisol moves higher into the reference range. The midnight cortisol is much closer to the top of the range (the fourth quintile). I think anyone who agrees that adrenal fatigue is a useful concept (some people don't, and they would say you are absolutely fine until your cortisol output drops enough that your adrenals produce almost nothing during a stimulation test, and until you are there, you are fine. You will have to make up your own mind about this controversy) would say your adrenals are not performing optimally. Typically someone with this low-in-range to later high-in-range pattern is considered to have adrenal glands which are not able to make morning levels as high as they should be, and keep trying to make cortisol when normally production would slow down, which results in the late, normal-high cortisol, which can make sleep and evening winding down more difficult. Sometimes this problem perpetuates itself, because not resting well or sleeping soundly through the night makes it harder for the body to cope overall.

Your estradiol is obviously elevated in comparison to the reference range. I imagine this is largely due to you having a large excess of testosterone in your body. It's the same conversion process from T to E2 that you see the guys talking about in the other forums - having gyno. It makes you estrogen dominant (that's why they give you a progesterone/estrogen ratio), and there are risks of having so much E2 and not enough progesterone to balance the estrogen. Too much estrogen without sufficient progesterone puts you at higher risk of breast cancer (it's significant, you do need to pay attention to this problem), and without enough progesterone, your brain is less likely to produce sufficient amounts of a neurotransmitter called GABA, which helps you sleep well and relax/counter anxiety (which as you say can be difficult issues near the holidays).

Additionally, high levels of estrogen can inhibit the release of cortisol from the adrenals, and it can increase the amount of transcortin, which is a binding globulin for cortisol - all this means that having too much estrogen can lower your cortisol, and bind up what you do have so there is less available for your tissues to use.

It could be the case that the T pellets have caused all of this. I don't know. T increases E2, inhibits cortisol, increases transcortin. It also could cause the low HDL that you posted earlier on. That could be the underlying cause of it all, and perhaps you were just slightly low T, slightly low DHEAs, as we all get with time, and you needed more subtle dosing to get it all in line. On the other hand, maybe your cortisol levels were not so great to begin with - strenuous exercise is something that can also stress the adrenals. If you don't have bloods from before, it's all just guessing.

In the end, I have to say I would not put too much value in a physician who will implant these pellets in you without checking your hormone levels before and after. That's kind a surprise from a legal standpoint, not even considering the quality of healthcare. Supplementing a hormone is never an isolated incident - it always has other effects, and physicians who know their stuff are always planning for the undesired consequences of adding a hormone to shore up levels. I'll bet that having that much testosterone helps to mask symptoms because typically it makes you feel good, but I think if you want to keep those elevated T levels, you need help from someone very knowledgeable who makes sure you are not raising risks for other problems by balancing things like estrogens with progesterone and factors in your adrenal hormones. Otherwise you could reduce the T dose so that the level is not so high, in order to minimise the impact on other hormones.

I'll let you know if I think of anything else...

[Giggle]

Hi Lunk...
Thanks for answering. No virilization that I can tell. I am post-menopausal - no cycle.
That IS high for a female, right? I thought so.
Thank you!

Very good coverage TAB. I would add that T levels this high are bound to result in viralization. I was wondering what your results would be after you had the implants.

Curious where you were during your monthly cycle when this test was taken?

[Lunk1]

The estrogen isnt alarmingly high but that is a pretty high T level. I'm not familiar enough with the implants to understand how they work but if they are creating a spike in your and then gradually drop down, that just simply goes against all HRT logic.

Curious, have you experienced any noticeable sides from the higher T levels? Libido, energy, aggresion?

[Giggle]

Oh yes definitely.
Strength, libido, feel more energy. Almost all of this is positive, with one exception. I wouldn't call it aggression, but I do get irritable more quickly. I'm usually pretty "Type A", but now I'm even worse!

The estrogen isnt alarmingly high but that is a pretty high T level. I'm not familiar enough with the implants to understand how they work but if they are creating a spike in your and then gradually drop down, that just simply goes against all HRT logic.

Curious, have you experienced any noticeable sides from the higher T levels? Libido, energy, aggresion?