Input on Thyroid and Free T in latest BW

[TMan96]

Hi all, would like to get input on my latest BW.

RBC 5.78 (Range 4.00 – 6.2)
Hemo 16.1 (Range 11.0-17)
Hemat 49.0 (Range 35.0 – 55.0)

TSH 1.05 (.27 – 4.2)
T4 5.23 (4-10.4)
T3 1.01 (.8-2.1)
T3 uptake 1.01 (.8-1.3)
Free Thyroxine Index 5.2 (4.4-11.4)
Triiodothyronie, Free 3.3 (2.0-4.4)

Testosterone , Serum 882 (348-1197)
Free T, 38.9 (5.0 – 21.0)
Estradiol, 29.1 (7.6-42.6)

My T shot is on Saturday and Tuesday. This blood was drown of Friday (day before next normal shot)

Current protocol is as follows:
Cypionate – 40 mg a twice a week
Anastrozole - .25mg a week. (once a week on Sunday after my Saturday shot)
HCG – (Not currently taking)
Armour Thyroid - 90mg daily

Current stats:
172lbs 5'6

My Observations:

1. Doc didn't say anything about my Free T? Should I be concerned? It seems to keep going up, even though everything else seems in check. I have read that twice a week injections can cause this to rise... should I drop back to once a week? From what I remember, it was near the top or the FT range, but not over, when I was doing once a week injections a year ago.

2.Thoughts on Thyroid at this dose of Armour? Everything look optimal? T3 and T4 high enough? Think would be any different with Synthyroid? Just looking for input.

Thanks!

[Brohim]

#'s look good - how do you feel?

Take temps during day as we'll to monitor thyroid

[TMan96]

I am feeling fine other than coming off of a sinus injection I have had for 2 weeks (finally went to see my doc and got some antibodies)

Also realized that you should always READ your prescription bottles. I couldn't remember what dose of Armour I was for the above protocol so I checked the bottle. Turns out that two weeks ago when I had my script filled they must have been out of the 90mg, so they filled with 60mg. It said to take 1 1/2 on the bottle but I didn't see it until just now and they don't look different enough for me to realize until now...lol

I was on the 90mg when my bw was drawn. Now getting back on the correct dose.

[jomamma007]

dam that's a hell of a free test at your dosage. Definitely because of the anastrozole and possibly a low SHBG. Have you ever had that tested?
You feel good which is the most important part, although I think you should get an estradiol sensitive panel. With a 29 on the standard panel you could be quite low, which isn't optimal for long term health.
Are you supplementing with DHEA and Pregnenolone? Something to look into since your foregoing HCG.
Be sure to keep an eye on that HEMO and HEMA and RBC. With your free T I wouldn't be surprised if you had to donate every 2 months... Might even want to start now
any reason for not having a free T4?
I believe it's recommended to have free t3 at least half way through the range, and a free T4 in the upper 1/3.

Lastly I'd even consider dropping your dosage to 70mgs per week, maybe even 60-65. If you really do have a low SHBG (reason your free T is so high), you can probably end up dropping your anastrozole altogether. We try to avoid ai's and only use them as a last resort. With a Free T double the range, yuo can afford to lower your dose. Don't get caught up if your total T drops down to 700, as long as your free T is good. This will also keep your blood count down and avoid the need for donating, as well as keep your lipids optimal from ceasing the anastrozole. Something to look into...

[TMan96]

dam that's a hell of a free test at your dosage. Definitely because of the anastrozole and possibly a low SHBG. Have you ever had that tested?
You feel good which is the most important part, although I think you should get an estradiol sensitive panel. With a 29 on the standard panel you could be quite low, which isn't optimal for long term health.
Are you supplementing with DHEA and Pregnenolone? Something to look into since your foregoing HCG.
Be sure to keep an eye on that HEMO and HEMA and RBC. With your free T I wouldn't be surprised if you had to donate every 2 months... Might even want to start now
any reason for not having a free T4?
I believe it's recommended to have free t3 at least half way through the range, and a free T4 in the upper 1/3.

Lastly I'd even consider dropping your dosage to 70mgs per week, maybe even 60-65. If you really do have a low SHBG (reason your free T is so high), you can probably end up dropping your anastrozole altogether. We try to avoid ai's and only use them as a last resort. With a Free T double the range, yuo can afford to lower your dose. Don't get caught up if your total T drops down to 700, as long as your free T is good. This will also keep your blood count down and avoid the need for donating, as well as keep your lipids optimal from ceasing the anastrozole. Something to look into...

Yeah, you would think with FT that high I would be putting on muscle like crazy and be Horney as heck all the time. Far from the truth. I struggle to gain any weight and hardly any muscle gain. My libido is okay, but I am far from having the urges of a teenager. (it was actually stronger when I 1st started TRT a year or so ago) If anybody has input on this, it is welcome.

You think the anastrozole would raise my FT that high? I am not sure about SHBG. I will try to get that checked next time. I am definitely going to try to go back to once a week and see if that makes a difference.

I already donate blood every 2ish months. When I had this BW, I was due, so I am sure H&H is lower now. That is one of the reason I am concerned about my FT. Think if I do get it down, my H&H want raise as fast.

As far as my Thyroid, any recommendations for getting T4 an T3 up a little higher?

[TMan96]

Bump one time for any more input?

[Vettester]

As noted, your free T is up there (4.3%), and the obvious culprit would be an insufficient amount of SHBG (low single digits). IMO, I think it goes a little deeper than just adjusting your injection frequency. Is that level were to sustain, you could realistically get your serum level down to the 500-to 600 range, which in turn could probably cut out your AI all together. Not saying to change it up, but just putting the whole free test thing in perspective ...

As I said, it probably goes a little deeper, and the obvious road to that truth is more labs (just what you wanted, I know). My situation is somewhat similar, and one of my primary issues 'was' significant elevated ferritin. Some of this ties in with the thyroid as well, so be patient with it. With that said, have you tested ferritin and iron (TIBC), hopefully in a time prior to donating blood. My ferritin is under control with donating blood, but for many years when I didn't donate, my levels were >1,400! The ferritin and iron are under control, but I have some damage done with all the years of excess iron.

On the thyroid results, that's somewhat of what I might have expected with knowing that you're on Armour. If there's a downside with Armour it might be that it's T4/T3 ratio is 4:1, whereas a normal healthy thyroid will naturally produce T4/T3 at approx. 20:1. So, what I'm seeing is that your FT4 is converting nicely, although it might not hurt if your FT3 went up just a tad, however it's not in a bad place either. The T3 uptake is useless, they can throw it out door LOL. "Some" people do a little combo-therapy of T4 and Armour, just for that purpose to get a little more thyroxine in the system, thus ultimately getting a little more T3 in the picture after conversion. Some doctors will do this, some advise against it, so it's just kind of a call between you and your physician.

All and all (as Brohim asked), how do you feel overall? I'm actually interested in some other labs to see a bigger picture. As I mentioned, iron and ferritin should be checked, and both are also pertinent for making sure the thyroid functions well. One marker that could tell us more would be your Reverse T3 level and the ratio it has with FT3. Being that you donate blood, there's the other scenario where serum levels get too low, and that will have a litany of other related issues, including issues with the deiodinase and the peroxidase enzymes, which are vital for thyroid hormone production and conversion.

So, in respect to labs ... If you could go carte blanch ...
Ferritin, TIBC,
Cortisol (4x saliva), DHEA, and ACTH
Magnesium
D3
B12
Just to confirm, run your SHBG
RT3
Presume you've done antibodies in the past?
prolactin
Lipids, CBC's, metabolic panel

If anyone sees something I overlooked, just add it on. Lastly, can you list your supplements?

[TMan96]

As noted, your free T is up there (4.3%), and the obvious culprit would be an insufficient amount of SHBG (low single digits). IMO, I think it goes a little deeper than just adjusting your injection frequency. Is that level were to sustain, you could realistically get your serum level down to the 500-to 600 range, which in turn could probably cut out your AI all together. Not saying to change it up, but just putting the whole free test thing in perspective ...

As I said, it probably goes a little deeper, and the obvious road to that truth is more labs (just what you wanted, I know). My situation is somewhat similar, and one of my primary issues 'was' significant elevated ferritin. Some of this ties in with the thyroid as well, so be patient with it. With that said, have you tested ferritin and iron (TIBC), hopefully in a time prior to donating blood. My ferritin is under control with donating blood, but for many years when I didn't donate, my levels were >1,400! The ferritin and iron are under control, but I have some damage done with all the years of excess iron.

On the thyroid results, that's somewhat of what I might have expected with knowing that you're on Armour. If there's a downside with Armour it might be that it's T4/T3 ratio is 4:1, whereas a normal healthy thyroid will naturally produce T4/T3 at approx. 20:1. So, what I'm seeing is that your FT4 is converting nicely, although it might not hurt if your FT3 went up just a tad, however it's not in a bad place either. The T3 uptake is useless, they can throw it out door LOL. "Some" people do a little combo-therapy of T4 and Armour, just for that purpose to get a little more thyroxine in the system, thus ultimately getting a little more T3 in the picture after conversion. Some doctors will do this, some advise against it, so it's just kind of a call between you and your physician.

All and all (as Brohim asked), how do you feel overall? I'm actually interested in some other labs to see a bigger picture. As I mentioned, iron and ferritin should be checked, and both are also pertinent for making sure the thyroid functions well. One marker that could tell us more would be your Reverse T3 level and the ratio it has with FT3. Being that you donate blood, there's the other scenario where serum levels get too low, and that will have a litany of other related issues, including issues with the deiodinase and the peroxidase enzymes, which are vital for thyroid hormone production and conversion.

So, in respect to labs ... If you could go carte blanch ...
Ferritin, TIBC,
Cortisol (4x saliva), DHEA, and ACTH
Magnesium
D3
B12
Just to confirm, run your SHBG
RT3
Presume you've done antibodies in the past?
prolactin
Lipids, CBC's, metabolic panel

If anyone sees something I overlooked, just add it on. Lastly, can you list your supplements?

Vettester,

Thanks so much for the input! Well as luck would have it, I did a fairly comprehensive panel back in early August. Please review and let me know what other test that are left that you would recommend I have given these results.

DHEA-Sulfate 63.0 (44.3-331.0)
Insulin-Like Growth Factor I 180 (59-201)
Ferritin, Serum 58 (30 – 400)
Iron Bind. Cap (TIBC) 399 (250-450)
UIBC 366 (150-375)
Iron 131 (50-212)
Prolactin 7.1 (4 -15.2)
Magnesium, Serum 2.0 (1.6-2.6)
SHBG, Serum 21.9 (15.5-55.9)
Cortisol, blood AM 5.5 (6.2-19.9)
Vit D 25 Hydroxy 53.8 (>30.0)
Progesterone .6 (.2-1.4)

As far as supplements, I use to take a lot more. But I really never could tell any difference so this is what I currently have:

Zocor (Simvastatin) 5mg – not supplement, but wanted to mention this is the other script I have.
CoQ10 200 mg
Flaxseed oil 1300mg
LD aspirin
Fishoil 1200mg w/ D3 2000iu
Zinc 50mg

Also, ThisAngelBites, asked me in an IM:
Can I ask when you took your Armour relative to when the bloods were drawn for this test?
BLOOD DRAW WAS FRIDAY IN AM. LAST DOSE OF ARMOUR WAS THURSDAY IN THE AM
Secondly, are you having a lot of the sinus infections that you mentioned?
NO, I USE TO A FEW YEARS AGO, BUT HAVEN'T BEEN GETTING MANY IN A WHILE... MAYBE 1 EVERYOTHER YEAR NOW.
Thirdly, I don't remember ever seeing pre-Armour bloods. Were you converting well from T4 to T3 (was T3 a lot lower than T4)?
SEE BELOW, THIS WAS THE ONLY ONES I COULD FIND. THIS WAS THE BW THAT CAUSED DOC TO START ME ON ARMOUR.Lastly, are you just trying to get yourself settled on doses for T and Armour, or are you having some symptoms?
ONLY ISSUES ARE, I SEEM TO BE PUTTING ON MIDSECTION FAT SINCE I STARTED ON THE ARMOUR. I DON'T REALLY FEEL ANY DIFFERENT ON THE ARMOUR. OVERALL, ON THE TEST AND ARMOUR I AM NOT GAINING ANY MUSCLE AT ALL. ANY WEIGHT I HAVE GAINED, MAYBE 3LBS APPEARS TO ALL BE IN MY WAIST. NEVER REALLY HAD THIS PROBLEM BEFORE.

Prior to Armor:
TSH 5.44 (.45 – 4.5)
T4 6.4 (4.5-12.0)
T3 100 (71-180)
T3 uptake 39 (24-39)
Free Thyroxine Index 2.5 (1.2-4.9)

[dreadnok89]

Vettester,

Thanks so much for the input! Well as luck would have it, I did a fairly comprehensive panel back in early August. Please review and let me know what other test that are left that you would recommend I have given these results.

DHEA-Sulfate 63.0 (44.3-331.0)
Insulin-Like Growth Factor I 180 (59-201)
Ferritin, Serum 58 (30 – 400)
Iron Bind. Cap (TIBC) 399 (250-450)
UIBC 366 (150-375)
Iron 131 (50-212)
Prolactin 7.1 (4 -15.2)
Magnesium, Serum 2.0 (1.6-2.6)
SHBG, Serum 21.9 (15.5-55.9)
Cortisol, blood AM 5.5 (6.2-19.9)
Vit D 25 Hydroxy 53.8 (>30.0)
Progesterone .6 (.2-1.4)

As far as supplements, I use to take a lot more. But I really never could tell any difference so this is what I currently have:

Zocor (Simvastatin) 5mg – not supplement, but wanted to mention this is the other script I have.
CoQ10 200 mg
Flaxseed oil 1300mg
LD aspirin
Fishoil 1200mg w/ D3 2000iu
Zinc 50mg

Also, ThisAngelBites, asked me in an IM:
Can I ask when you took your Armour relative to when the bloods were drawn for this test?
BLOOD DRAW WAS FRIDAY IN AM. LAST DOSE OF ARMOUR WAS THURSDAY IN THE AM
Secondly, are you having a lot of the sinus infections that you mentioned?
NO, I USE TO A FEW YEARS AGO, BUT HAVEN'T BEEN GETTING MANY IN A WHILE... MAYBE 1 EVERYOTHER YEAR NOW.
Thirdly, I don't remember ever seeing pre-Armour bloods. Were you converting well from T4 to T3 (was T3 a lot lower than T4)?
SEE BELOW, THIS WAS THE ONLY ONES I COULD FIND. THIS WAS THE BW THAT CAUSED DOC TO START ME ON ARMOUR.Lastly, are you just trying to get yourself settled on doses for T and Armour, or are you having some symptoms?
ONLY ISSUES ARE, I SEEM TO BE PUTTING ON MIDSECTION FAT SINCE I STARTED ON THE ARMOUR. I DON'T REALLY FEEL ANY DIFFERENT ON THE ARMOUR. OVERALL, ON THE TEST AND ARMOUR I AM NOT GAINING ANY MUSCLE AT ALL. ANY WEIGHT I HAVE GAINED, MAYBE 3LBS APPEARS TO ALL BE IN MY WAIST. NEVER REALLY HAD THIS PROBLEM BEFORE.

Prior to Armor:
TSH 5.44 (.45 – 4.5)
T4 6.4 (4.5-12.0)
T3 100 (71-180)
T3 uptake 39 (24-39)
Free Thyroxine Index 2.5 (1.2-4.9)

Your taking all this stuff to just put muscle on? And why do you take the thyroid stuff? Does it help you lose weight? Your test levels are only normal your not gonna get gigantic. The thyroid stuff can burn muscle too right?

[thisAngelBites]

I agree with Vettster that your thyroid results look pretty good and I'm not sure I have much to add. It's a bit difficult discussing optimal levels because optimals are just hypothetically optimal, and of course are going to vary from person to person. Often times the only way to find an optimal place for yourself is to experiment with dosages. If you only started Armour, that would be easier to do, but since you have two variables (T and thyroid) it is a bit harder.

I would say that if it was me, and there was some concern about T levels and binding globulin, I would try to address that before thyroid.

Once that is sorted, if you are still not happy, you could try adding a small amt of synthroid as Vettester mentioned, or increasing your Armour, very slowly (by about 1/4 of a grain at a time for a couple of weeks), watching carefully for any signs of hyperthyroidism, and backing down right away if you see any. But don't change more than one thing at once.

Somehow I doubt it's your thyroid levels, but that is just intuition. The only other thing that occurs to me is that your morning cortisol is pretty low, and the DHEA is lower than what I would say is "optimal". It's hard for me to say, because I am not sure of the units, but the reference range to me looks like a woman's ref range, and not a man's but maybe we are just in different countries using different units. DHEA is made by the adrenal glands, and sometimes, can be (not definitively) imparting some info about the adrenals, and when taken together with what doesn't look like a good morning cortisol, I would say it warrants additional investigation. It's pretty common for people to medicate an under-performing thyroid and then to start to have signs of adrenal problems.

Typically what is recommended to assess is a salivary cortisol profile in which you submit saliva samples at 8am, noon, 4pm and midnight (Vettester also mentioned this) in order to see if your adrenals are producing a proper amount of cortisol in the diurnal rhythm as is typical. Sometimes the people who test for salivary cortisol also test for DHEA-s in your saliva.

Adrenal hormones are also implicated in fat around the midsection, so I would say this is something you definitely want more info about. I hope that helps a bit.

[Vettester]

TMan, Angel is reading my mind on the post she just made. I'll make a comment on the cortisol thing shortly. Here's what's puzzling me, you posted your SHBG to be 21.9nmol/L. If we take that and calculate it with your recent total serum number (882ng), your free test is calculated at 25.2ng/dl, or call it 2.86%. This is based on albumin being 4.3, so +/- a small amount if albumin is a little higher/lower. Albumin accounts for only a small fraction of test being weakly bound, SHBG being the primary protein responsible. Something is telling me that there might be a mistake with your free test assay. If possible, please see if you can't get it retaken. There's no possible way that you could yield a >4% free test result with SHBG at 21.9nmol/L. If your SHBG sustains at/near that level on your next lab, and your free test is in that 2.8% zone, then IMO you're about damn near perfect in that area. BTW, here's the free test calculator link if anyone doesn't already have it ... Free & Bioavailable Testosterone calculator

On to Cortisol ... Angel hit it spot-on. Going by that AM Serum test, plus your DHEA being VERY low, the suspicion is adrenal fatigue. DHEA and cortisol should be counterbalancing each other, working synergistically together. IMO, you need to also recheck this area with the 4x saliva panel, described so eloquently by Angel (she's a smart cookie that one), and I would ask that you make sure the ACTH assay is included to get data on how the pituitary is responding in the feedback loop. Also, IMO, a good, healthy DHEA level would be in the 250sh ug/dl range for most men +/- depending on how you feel and other variables. The only time this wouldn't be the case is if you supplement with Keto7, which wouldn't have an impact on the serum result. I suspect your pregnenolone is also suffering, so as time goes on do some research on both of these hormones, the benefits they provide, and backfilling as part of a total HRT regiment.

Lastly, for now ... If there is indeed cortisol concerns, then that plays a major role in the functioning of the thyroid. I won't get overly deep into this, but sufficient cortisol is needed to ensure that T3 is being received to the cells from your blood throughout your body. So, without making sure the adrenals are functioning properly, you could increase your T3 all you want, but you would ultimately just be increasing the T3 level in bloodstream, which is better known as "pooling". As I noted in my prior post, include a Reverse T3, which can help shine some light. Almost forgot, your original pre-Armour labs (as anticipated) definitely lean the hypo diagnosis ... I had asked in the prior post about antibodies, has anyone checked you for Hashis?

[TMan96]

Thanks so much for the responses on this... Let me digest this and I will respond back... Thanks again!

[TMan96]

I agree with Vettster that your thyroid results look pretty good and I'm not sure I have much to add. It's a bit difficult discussing optimal levels because optimals are just hypothetically optimal, and of course are going to vary from person to person. Often times the only way to find an optimal place for yourself is to experiment with dosages. If you only started Armour, that would be easier to do, but since you have two variables (T and thyroid) it is a bit harder.

I would say that if it was me, and there was some concern about T levels and binding globulin, I would try to address that before thyroid.

Once that is sorted, if you are still not happy, you could try adding a small amt of synthroid as Vettester mentioned, or increasing your Armour, very slowly (by about 1/4 of a grain at a time for a couple of weeks), watching carefully for any signs of hyperthyroidism, and backing down right away if you see any. But don't change more than one thing at once.

Somehow I doubt it's your thyroid levels, but that is just intuition. The only other thing that occurs to me is that your morning cortisol is pretty low, and the DHEA is lower than what I would say is "optimal". It's hard for me to say, because I am not sure of the units, but the reference range to me looks like a woman's ref range, and not a man's but maybe we are just in different countries using different units. DHEA is made by the adrenal glands, and sometimes, can be (not definitively) imparting some info about the adrenals, and when taken together with what doesn't look like a good morning cortisol, I would say it warrants additional investigation. It's pretty common for people to medicate an under-performing thyroid and then to start to have signs of adrenal problems.

Typically what is recommended to assess is a salivary cortisol profile in which you submit saliva samples at 8am, noon, 4pm and midnight (Vettester also mentioned this) in order to see if your adrenals are producing a proper amount of cortisol in the diurnal rhythm as is typical. Sometimes the people who test for salivary cortisol also test for DHEA-s in your saliva.

Adrenal hormones are also implicated in fat around the midsection, so I would say this is something you definitely want more info about. I hope that helps a bit.

Thanks Angel! This definitely gives me a place to start. Definitely agree with addressing one thing at a time.

As far as the T levels and binding globulin. Is there anyway to address that other than with trying different T dosing?

Also interested in checking saliva cortisol and DHEA. If there are issues with low cortisol, is there anything that can be done about that?

[TMan96]

TMan, Angel is reading my mind on the post she just made. I'll make a comment on the cortisol thing shortly. Here's what's puzzling me, you posted your SHBG to be 21.9nmol/L. If we take that and calculate it with your recent total serum number (882ng), your free test is calculated at 25.2ng/dl, or call it 2.86%. This is based on albumin being 4.3, so +/- a small amount if albumin is a little higher/lower. Albumin accounts for only a small fraction of test being weakly bound, SHBG being the primary protein responsible. Something is telling me that there might be a mistake with your free test assay. If possible, please see if you can't get it retaken. There's no possible way that you could yield a >4% free test result with SHBG at 21.9nmol/L. If your SHBG sustains at/near that level on your next lab, and your free test is in that 2.8% zone, then IMO you're about damn near perfect in that area. BTW, here's the free test calculator link if anyone doesn't already have it ... Free & Bioavailable Testosterone calculator

On to Cortisol ... Angel hit it spot-on. Going by that AM Serum test, plus your DHEA being VERY low, the suspicion is adrenal fatigue. DHEA and cortisol should be counterbalancing each other, working synergistically together. IMO, you need to also recheck this area with the 4x saliva panel, described so eloquently by Angel (she's a smart cookie that one), and I would ask that you make sure the ACTH assay is included to get data on how the pituitary is responding in the feedback loop. Also, IMO, a good, healthy DHEA level would be in the 250sh ug/dl range for most men +/- depending on how you feel and other variables. The only time this wouldn't be the case is if you supplement with Keto7, which wouldn't have an impact on the serum result. I suspect your pregnenolone is also suffering, so as time goes on do some research on both of these hormones, the benefits they provide, and backfilling as part of a total HRT regiment.

Lastly, for now ... If there is indeed cortisol concerns, then that plays a major role in the functioning of the thyroid. I won't get overly deep into this, but sufficient cortisol is needed to ensure that T3 is being received to the cells from your blood throughout your body. So, without making sure the adrenals are functioning properly, you could increase your T3 all you want, but you would ultimately just be increasing the T3 level in bloodstream, which is better known as "pooling". As I noted in my prior post, include a Reverse T3, which can help shine some light. Almost forgot, your original pre-Armour labs (as anticipated) definitely lean the hypo diagnosis ... I had asked in the prior post about antibodies, has anyone checked you for Hashis?

Thanks Vettester for your input! You had asked about Antibodies. I went back and looked and in one of my BWs, my doctor had ordered Antibodies. This goes back to February, I was on Armour at that point.... 1grain.
TPO 7.1 (0-34)
TG 25.4 (0-115)

Same question as I had to angel, As far as the T levels and binding globulin. Is there anyway to address that other than with trying different T dosing? I will look to get a redo of the SHBG in a couple of weeks.

Will also look at the saliva panel this week, because I am interested to see how that turns out and your thoughts about adrenal fatigue. If there are issues with low cortisol, is there anything that can be done about that? I think I read one time that drinking coffee can raise your cortisol? I already drink coffee.

Thanks again for your expert input!!

[2Sox]

Thanks Vettester for your input! You had asked about Antibodies. I went back and looked and in one of my BWs, my doctor had ordered Antibodies. This goes back to February, I was on Armour at that point.... 1grain.
TPO 7.1 (0-34)
TG 25.4 (0-115)

Same question as I had to angel, As far as the T levels and binding globulin. Is there anyway to address that other than with trying different T dosing? I will look to get a redo of the SHBG in a couple of weeks.

Will also look at the saliva panel this week, because I am interested to see how that turns out and your thoughts about adrenal fatigue. If there are issues with low cortisol, is there anything that can be done about that? I think I read one time that drinking coffee can raise your cortisol? I already drink coffee.

Thanks again for your expert input!!

This is great reading and makes me aware of how much I have to learn about endocrinology.

Vette, Angel, can you recommend some books or material I can pick up as a primer so that I can begin to understand the information in your posts and in other member's posts? Thanks.

[thisAngelBites]

Tman,

Coffee does indeed push the adrenals to make more cortisol. In the context of adrenal problems, however, most people would tell you to NOT drink coffee (and also to stop any other significant source of caffeine), because it's just placing more demand on the adrenals, which are (for whatever reason) not making enough hormone as it is. The thinking is that more demand just puts the glands under further stress.

As for why the adrenals are not performing as we would expect - there is a lot of speculation about that and no one is sure. To begin with, some physicians think that adrenals are absolutely fine until such time they are making so little hormone that one qualifies for a diagnosis of Addison's Disease. On that view, it doesn't matter that levels are low compared to healthy people of the same age, and it doesn't even matter that an individual's level are in constant slow decline. I don't subscribe to that view, but you should look around and have a read and make up your own mind about it.

The people who think adrenals hormones in decline is of clinical significance before an Addison's diagnosis is reached disagree about what the causes of decline might be. Some people think that in today's higher stress world some people are constantly evoking what is colloquially called "the fight or flight response" where they experience even minor issues as quite threatening, and that over time the adrenals can no longer cope with the incessant demand for hormones, and at some point cannot even manage to make the cortisol needed for the day to day needs.

People who think that seem to think it's helpful to do a short duration relaxation practices (10-15 minutes a day) and think that is important for adrenal health. I heard a seminar this weekend in which Dave Asprey (he's a biohacker, and founded the company Bulletproof Executive) mentioned he used to take every small slight, such as inconsiderate driver, as a serious threat, akin to an attacking tiger, and finally ended up using biofeedback in order to train himself to not respond in that typical racing-heart style way.

Jack Kruse, who is a neurosurgeon (he is in Kentucky or Tennessee, I think, Living an Optimized Life -, iirc), also does relaxation stuff, but he also thinks that the high rates of declining cortisol levels he sees in his practice are due in part to our decreasing exposures to natural light. He thinks blue light in sunlight is a strong signal to our adrenals. He's a bit of a crazy guy, but extremely intelligent (and I happen to think that crazy people sometimes say quite fascinating, out-of-the-box things that are well worth considering) - I've been experimenting with his light thesis lately, and I am finding v interesting results. So maybe that is part of the issue for some people.

Other people have other theories, or just respond to the fact that the adrenals are not making enough hormone by supplementing it directly. I see a very well known endocrinologist from Belgium and he just has me on a small dose of a synthetic corticosteroid for my low adrenal levels. We didn't speak about it last time, but I think he presumes I will just stay on this med indefinitely.

Sorry, I don't understand the relation between testosterone levels and SHBG (altho I do between thryoid and SHBG), so I will leave Vettester to take that up with you, if he can help. I am always meaning to read more about male hormones, but somehow I don't get through enough that I feel comfortable commenting. But there is lots of knowledge from V and the others here, so I trust someone more qualified than me will help.

[thisAngelBites]

This is great reading and makes me aware of how much I have to learn about endocrinology.

Vette, Angel, can you recommend some books or material I can pick up as a primer so that I can begin to understand the information in your posts and in other member's posts? Thanks.

2Sox, I learned a lot of my endocrinology from a book I bought when I did a little work at the med school when I was at uni (I am not a physcian and the classes I took at med school I did as electives, btw), which means it is seriously out of date, and it also weighs about 30 pounds, and there are better ways to get a general idea of endocrinology without having to memorise all the hormone cascades, etc. I've read a lot online as well, and I will see if I can put together some useful links for you.