Doc prescribed A LOT, what to do....?

Went to an anti-aging doc and had bloods drawn below is what was prescribed after two draws;

current meds 15.25mg Valium 7.5mg Remeron at night and 25mg Trazodone at night


////Blood work on 12.11.14////

Whats was drawn: Level: Range:

PSA 0.4 0.0-4.0
TSH 2.81 0.46-4.68
DHEA 267 280-640
Free T3 3.1 2.4-4.2
Triiodothyronine Reverse 15.2 9.0-27
Free T 144 47-244
% Free T 1.7 1.6-2.9
Prolactin 7.4 2.1-17.7
SHBG 44 11-80
Total T 824 300-1080
Estradiol 52 ?
Igf 368 155-432

//////Blood Draw on 12.30.14//////

TSH 3.40 0.46-4.68
Free T3 2.9 2.4-4.2
Triiodothyronine Reverse 19.4 9.0-27
IGF 306 155-432
Estradiol 79 ?
SHBG 35 11-80
Total T 708 300-1080
Free T 137 47-244
% Free 1.9 1.6-2.9


What the doc sent me home with...
I just feel like this is a lot...
Any help would be greatly appreciated....

Adreno Balance - 2 pills am, 1 in pm
Adreno Revive - 2 pills am, 2 pills pm
IGF 1 powder - take one scoop at bedtime (Amino Blend Powder)
Arimidex - 1mg 2 x week
WP Thyroid 1/2 grain 1 in am
Hydrocortisone 5mg 1 pill am, 1 pill afternoon w/adreno supps
7 Keto DHEA - 1 capsule 2xday

Just seems like a ton of stuff...

Any input?

Other than the arimidex, it looks like a good protocol. He's trying to get your thyroid functioning better with the adrenal stuff. Its hard for your thyroid to work properly unless your adrenals are functioning optimally.

Make sure to take the amino blend on an empty stomach. If there is any insulin spike when you take it then it won't trigger the gh release.

Were you following a protocol before this?

I'd be taking dhea if I were you. . But that's all. (Based on the labs you provided)

Sounds like cash register to me

2mg of dex per week is high non-cycle dose, but you didn't post your ranges, and was that E2?

It looks like the doc is thinking that your adrenal function is not what it might be, and is giving you some hydrocortisone to supplement, and although I don't know what Adreno balance and revive are, I would be they are some supplements with adaptogenic herbs that help to support adrenal function. There is no blood work that supports this, strictly speaking, but the physician examined you, and took a proper medical history, so there may be findings there that would support this treatment. Perhaps part of the indication is that you seem to not be sleeping well (trazadone) and are perhaps struggling with stress of some sort (hence the valium) - I am just guessing.

Then he's given you some thyroid replacement, which is a natural dessicated thyroid product - that's due to your T3 levels being suboptimal, and your TSH being high, meaning your pituitary is signaling your thyroid to make more hormone, but your levels are still not where you would want them.

The IGF - 1 powder is probably some amino acids and supplements that are supposed to support growth hormone production - not sure if there is anything in there that will help because I don't know the ingredients. That would probably be a general anti-aging and well-being type supplement.

The 7 keto DHEA is to support your low DHEA levels - and is also anti aging (low DHEA levels are associated with all sorts of problems - just google around to do some reading). I don't know why he recommended 7 keto instead of regular DHEA, but it should be fine.

The arimidex is to lower your estrogen, which seems like it might be high, but I am not super knowledgeable about that, so perhaps someone else will chime in.

thisAngelBites knows her stuff!

I would add that that arimidex dosing will probably crash your E2.

Quote:

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Originally Posted by BallSak

Other than the arimidex, it looks like a good protocol. He's trying to get your thyroid functioning better with the adrenal stuff. Its hard for your thyroid to work properly unless your adrenals are functioning optimally.

Make sure to take the amino blend on an empty stomach. If there is any insulin spike when you take it then it won't trigger the gh release.

Were you following a protocol before this?

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The doc is concerned with my Adrenal Functions, believes I'm suffering from Adrenal Fatigue and Sub-Clinical Hypothyroidism...

How would I know if the IGF -1 powder is spiking insulin? I take one scoop at night 1 hr before bed. She said it will help with GH release....

No protocol before this... just tappering off the Valium very, very slowly....

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Originally Posted by hawk14dl

I'd be taking dhea if I were you. . But that's all. (Based on the labs you provided)

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The 7 Keto DHEA is the only DHEA I was given. It's to be taken 1 capsule 2x day... AM and Afternoon? 12-1pm?

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Originally Posted by GSXRvi6

Sounds like cash register to me

2mg of dex per week is high non-cycle dose, but you didn't post your ranges, and was that E2?

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Unfortunately, the ranges weren't given in the labs, which i find kinda weird... is there a range that I can find online somewhere?

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Originally Posted by Keep_It_Moving

Unfortunately, the ranges weren't given in the labs, which i find kinda weird... is there a range that I can find online somewhere?

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It can vary with lab/test

Quote:

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Originally Posted by thisAngelBites

It looks like the doc is thinking that your adrenal function is not what it might be, and is giving you some hydrocortisone to supplement, and although I don't know what Adreno balance and revive are, I would be they are some supplements with adaptogenic herbs that help to support adrenal function. There is no blood work that supports this, strictly speaking, but the physician examined you, and took a proper medical history, so there may be findings there that would support this treatment. Perhaps part of the indication is that you seem to not be sleeping well (trazadone) and are perhaps struggling with stress of some sort (hence the valium) - I am just guessing.

Then he's given you some thyroid replacement, which is a natural dessicated thyroid product - that's due to your T3 levels being suboptimal, and your TSH being high, meaning your pituitary is signaling your thyroid to make more hormone, but your levels are still not where you would want them.

The IGF - 1 powder is probably some amino acids and supplements that are supposed to support growth hormone production - not sure if there is anything in there that will help because I don't know the ingredients. That would probably be a general anti-aging and well-being type supplement.

The 7 keto DHEA is to support your low DHEA levels - and is also anti aging (low DHEA levels are associated with all sorts of problems - just google around to do some reading). I don't know why he recommended 7 keto instead of regular DHEA, but it should be fine.

The arimidex is to lower your estrogen, which seems like it might be high, but I am not super knowledgeable about that, so perhaps someone else will chime in.

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The doc is looking at my thyroid and adrenals as not operating at an optimal functional level. She believes i'm suffering from adrenal fatigue...

I do sleep slightly poorly... hence the remeron and trazodone which could be causing the adrenal insufficiency or the other way around... who knows....

the adreno balance and revive are supplements with a bunch of vitamins in them...
the IGF 1 powder contains the following;
L-Arginine HCL 2.7 g
L-Glycine 1.3g
L-Carnitine Fumarate .9g
L-Tyrosine .9g
L-Lysine HCL .9g
L-Ornithine HCL .9g

per serving - 1 scoop, 1 hr before bed.

The doc said the 7 Keto DHEA is far superior as other DHEA converts to estrogen and this form doesn't. After reading wiki, 7 Keto DHEA is banned in sports and considered doping? I could be wrong....

The adex sounds wayyy toooo high to me and I'm worried about that. Was thinking of taking just .25mg 2x week and see how that makes me feel.

I was truly hoping for HGH or serm/ghrp2/6 but she said that would be dangerous as my igf1 levels are high....
Said she would have no problem prescribing it but I don't need it.

I'm worried about the hydrocortisone though... This makes me feel a bit uneasy....

Quote:

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Originally Posted by Keep_It_Moving

The adex sounds wayyy toooo high to me and I'm worried about that. Was thinking of taking just .25mg 2x week and see how that makes me feel.

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It is way to high and you will crash your E and have more problems at that point. 2mg's per week is more than most cycle dosages.

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Originally Posted by kelkel

It is way to high and you will crash your E and have more problems at that point. 2mg's per week is more than most cycle dosages.

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Kel -

I was hoping you would chime in....

I believe it would crash it as well.. I was thinking of doing .25mg 2/week, possibly Mon morning and Thursday morning?

How do you feel about the other stuff?

I'm worried about the hydrocortisone pills.. that kinda scares me...

Also, the thyroid medication? From what I'm reading this is one of the best? has the natural t3 and t4 with only 2 inactive ingredients....

Why are u worried about hydrocortisone? Dr Crisler says you can take something like 40-60mg a day without suppressing your own cortisol. It gives your adrenals a chance to recover.

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Originally Posted by BallSak

Why are u worried about hydrocortisone? Dr Crisler says you can take something like 40-60mg a day without suppressing your own cortisol. It gives your adrenals a chance to recover.

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She didn't really explain when she gave it to me... That's the reason why...
What is it's purpose? Hopefully someone can chime in and let me know....

Do you have a reference handy? I was also prescribed cortisone and have not taken it due to concerns about supressing natural cortisone.

I agree the arimidex is too much. But your estradiol is high. Try 1mg a week (split into quarters) for a couple weeks and then if you start feeling better try less.

I'd be watching Oprah and crying with an estradiol that high!

Quote:

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Originally Posted by Keep_It_Moving

Kel -

I was hoping you would chime in....

I believe it would crash it as well.. I was thinking of doing .25mg 2/week, possibly Mon morning and Thursday morning?

How do you feel about the other stuff?

I'm worried about the hydrocortisone pills.. that kinda scares me...

Also, the thyroid medication? From what I'm reading this is one of the best? has the natural t3 and t4 with only 2 inactive ingredients....

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Trust in everything ThisAngelBites said. She's very squared away on thyroid. I think he's on target for all but the adex. Remember though that standard estradiol reads higher then E2, which leads to doc's over prescribing adex. Use a minimum dosage and retest in a month if possible.

Quote:

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Originally Posted by Keep_It_Moving

She didn't really explain when she gave it to me... That's the reason why...
What is it's purpose? Hopefully someone can chime in and let me know....

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Anyone can Google meds and find out what they do, but really it's a good idea to discuss the treatment plan with your doctor so you can understand exactly what they're trying to accomplish.

Quote:

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Originally Posted by OingoBoingo

Anyone can Google meds and find out what they do, but really it's a good idea to discuss the treatment plan with your doctor so you can understand exactly what they're trying to accomplish.

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So true. Being on the same page is a great benefit...

Suppose I should touch base with the doctor on Monday, felt a little rushed and overwhelmed with the protocol. Thanks for all the advice on the forum. I appreciate it!

Was so hoping for gh or serm/ghrp treatment, but oh well...

Quote:

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Originally Posted by kelkel

So true. Being on the same page is a great benefit...

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Can anyone suggest a proper Adex protocol... 8 1mg pills cost me 40bux, insurance doesn't cover...

Was thinking .25mg on Monday morning and .25mg on Thursday evening (if sleep problems happen, will switch to Thursday morning) ?

Does that sound reasonable and have a retest of bloods in 2 months she said with my follow up appt.

That sounds about right...depending how sensitive you are to it. Look into getting your arimidex from Costco online pharmacy. 26 pills costs me like $14 cash for generic.

Quote:

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Originally Posted by BallSak

That sounds about right...depending how sensitive you are to it. Look into getting your arimidex from Costco online pharmacy. 26 pills costs me like $14 cash for generic.

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I'll give them a call and find out what the costs are. I typically use CVS but it was something like $44 for 8 1mg pills...
Ridiculous!

If you're not using exogenous testosterone and your LH is still in the game, Adex actually might not crash the E2. Correct me if I'm wrong, but all the studies I'm able to find of Anastrozole in males, are done on a normal males with elevated E2. Doses have been 0,5mg or 1mg daily. In those studies it seem to decrease E2 around 50% regardless of the dose. So it significantly lowered their E2, but didn't crash. Unlike it does when on gear. I'm not sure if I'm able to post any links, but the studies are quite easy to find. Anyway, just something to think of.

Quote:

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Originally Posted by FakeLove

If you're not using exogenous testosterone and your LH is still in the game, Adex actually might not crash the E2. Correct me if I'm wrong, but all the studies I'm able to find of Anastrozole in males, are done on a normal males with elevated E2. Doses have been 0,5mg or 1mg daily. In those studies it seem to decrease E2 around 50% regardless of the dose. So it significantly lowered their E2, but didn't crash. Unlike it does when on gear. I'm not sure if I'm able to post any links, but the studies are quite easy to find. Anyway, just something to think of.

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Once I go on the AI, gotta stay on it correct and play the balancing game....?

Deleted post.

Irrelevance

Quote:

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Originally Posted by FakeLove

If you're not using exogenous testosterone and your LH is still in the game, Adex actually might not crash the E2. Correct me if I'm wrong, but all the studies I'm able to find of Anastrozole in males, are done on a normal males with elevated E2. Doses have been 0,5mg or 1mg daily. In those studies it seem to decrease E2 around 50% regardless of the dose. So it significantly lowered their E2, but didn't crash. Unlike it does when on gear. I'm not sure if I'm able to post any links, but the studies are quite easy to find. Anyway, just something to think of.

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There's a lot we don't understand yet, but we are learning more every year.

I read something last night about a large dose of Anastrozole causing a double spike of Testosterone in normal men; one upon taking, and another four days later. One doctor opined that this is a common response when we over-regulate our system.

In my case, I didn't take Anastrozole before TRT, but on TRT I know that taking Anastrozole more often than I have symptoms will crush E2.

There is a lot of bro-science around from reading package inserts that were written perhaps 60 years ago, that 100mg of Testosterone is the proper starting dose for TRT. Yet 2014 saw Dr. Crisler lowering his starting dose to 70mg per week, and Dr. Gordon lowering his starting dose to 60mg per week. There's gotta be a reason for that!

Quote:

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Originally Posted by Keep_It_Moving

Once I go on the AI, gotta stay on it correct and play the balancing game....?

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Not necessarily. In six months I've gone from taking Anastrozole every 6 days, to every 8 days. It could be that as our body gets used to having Testosterone again, the need for an AI might go away.

But I'm also thinking that we as a group are taking more Testosterone than we really need to.

Just want to clarify so everyone is aware...

I do not take exogenous T, as a matter of fact, I don't take anything except the following; which I believe are causing my elevated levels...

I've always tested within the 400-600 range in T until I started taking 7.5mg of Remeron at night (started on 10.8.14) and taking approx. 25mg Trazodone at night (started around the same time).

I'm currently at 15.25mg Valium... doing a micro taper of .25mg every 14 days (I came across some study that Valium increases T levels by 20 or 30% but can't seem to find it now).

Hope this helps with clarification.

The main reason is; benzo withdrawal is pure hell... Don't think anyone on here knows about it but, it makes coming off heroin a walk in the park...

and I suffer from insomnia, possibly due to tolerance withdrawal from the benzo since I've been on them for approx 6 yrs.

Don't mean to overwhelm ppl, but just want to paint a better picture.

My main reason for seeking treatment was for growth hormone treatment initially. I was truly hoping to be prescribed anti-aging hgh to benefits from the smoother skin, better mood, better sleep, etc...I always knew I had sub-clinical hypothyroidism and never treated it due to most endo's not treating with desiccated meds and only prescribing t4's... The adrenal fatigue is a hit or miss, I believe it to be true but most of the medical community laughs at the idea.

Hope this helps....

Quote:

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Originally Posted by Keep_It_Moving

Just want to clarify so everyone is aware...

I do not take exogenous T, as a matter of fact, I don't take anything except the following; which I believe are causing my elevated levels...

I've always tested within the 400-600 range in T until I started taking 7.5mg of Remeron at night (started on 10.8.14) and taking approx. 25mg Trazodone at night (started around the same time).

I'm currently at 15.25mg Valium... doing a micro taper of .25mg every 14 days (I came across some study that Valium increases T levels by 20 or 30% but can't seem to find it now).

Hope this helps with clarification.

The main reason is; benzo withdrawal is pure hell... Don't think anyone on here knows about it but, it makes coming off heroin a walk in the park...

and I suffer from insomnia, possibly due to tolerance withdrawal from the benzo since I've been on them for approx 6 yrs.

Don't mean to overwhelm ppl, but just want to paint a better picture.

My main reason for seeking treatment was for growth hormone treatment initially. I was truly hoping to be prescribed anti-aging hgh to benefits from the smoother skin, better mood, better sleep, etc...I always knew I had sub-clinical hypothyroidism and never treated it due to most endo's not treating with desiccated meds and only prescribing t4's... The adrenal fatigue is a hit or miss, I believe it to be true but most of the medical community laughs at the idea.

Hope this helps....

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Sorry, my bad. I assumed you were on TRT.

If it were me, I'd want to find out why my E2 was so high. You don't want to live with high E2.

Quote:

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Originally Posted by OingoBoingo

Sorry, my bad. I assumed you were on TRT.

If it were me, I'd want to find out why my E2 was so high. You don't want to live with high E2.

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The problem is, it wasn't the e2 ultra sensitive, it was just adult estradiol... regular...

I called the lab (which is a hospital that has a laboratory and they said they send it out to ARU Labs) and didn't have the ranges...

bunch of idiots... oh well...

I believe that for most the ultra sensitive is over rated. It's not available where I live, and am doing okay without it.

And LEF recommends the standard test.

Quote:

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Originally Posted by OingoBoingo

I believe that for most the ultra sensitive is over rated. It's not available where I live, and am doing okay without it.

And LEF recommends the standard test.

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I've had both, only about ten points if memory serves. I'm ok with the standard.

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Originally Posted by Beethoven

I've had both, only about ten points if memory serves. I'm ok with the standard.

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so what do u guys suggest is the normal range for the estradiol, adult in pg/mL?
all of my research points to 27-122
does that mean im still far off?

Quote:

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Originally Posted by OingoBoingo

Sorry, my bad. I assumed you were on TRT.

If it were me, I'd want to find out why my E2 was so high. You don't want to live with high E2.

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What are some of the consequences of living with high e2? or slightly high... I do have relatively high natty t levels... but i presume these are due to my other meds..
vaium, remeron and traz...

if looking at ratio 52 e with t at 823 and 79 e with 708 t

Quote:

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Originally Posted by Keep_It_Moving

so what do u guys suggest is the normal range for the estradiol, adult in pg/mL?
all of my research points to 27-122
does that mean im still far off?

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At my lab, which most likely won't be the same as yours, the normal range of Estradiol (E2) for men is 11 - 44 pg/mL.

LEF recommends mid-range, so I shoot for 27.

For me, the range where I feel good is pretty tight, so I deal with it at the first signs of symptoms.

Quote:

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Originally Posted by Keep_It_Moving

What are some of the consequences of living with high e2? or slightly high... I do have relatively high natty t levels... but i presume these are due to my other meds..
vaium, remeron and traz...

if looking at ratio 52 e with t at 823 and 79 e with 708 t

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According to LEF:

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... excess estrogen contributes to the development of atherosclerosis.

Men with even slightly elevated estrogen levels doubled their risk of stroke and had far higher incidences of coronary artery disease.

Our early observations also revealed that men presenting with benign prostate enlargement or prostate cancer had higher blood estrogen levels (and often low free testosterone blood levels).

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Also from LEF:

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A study published in the Journal of the American Medical Association (JAMA) measured blood estradiol (a dominant estrogen) in 501 men with chronic heart failure. Compared to men in the balanced estrogen quintile,... men in the highest estradiol quintile were 133% more likely to die.

The men in the balanced quintile—with the fewest deaths—had serum estradiol levels between 21.80 and 30.11 pg/mL. This is virtually the ideal range that Life Extension® has long recommended male members strive for.

The men in the highest quintile who suffered 133% increased death rates had serum estradiol levels of 37.40 pg/mL or above.

The dramatic increase in mortality in men with unbalanced estrogen (i.e., estradiol levels either too high or too low) is nothing short of astounding.

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Awesome info
Thank you...

:)