Hormone results in need advice!

[Rjay]

I took a saliva sample exactly 1 month after I had switch to creams from cypionate(50mg e3d). I was applying 75mg daily half scrotally and half on my inner thigh as per my doctors suggestion. In this time my energy improved roughly 50% but still needs some work, same with sexual function, roughly 50% improvement but still could use some improvements. My gains in the gym have stayed very similiar no strength or size gains but lots of motivation to hit it hard and frequently. My well being has been much more stable though, my frequent depressive thoughts have vanished and I actually live in the moment which has been awesome for me.

(I had plans to do full bloodwork with the doc in a month Im just not covered by insurane so Im saving the funds and did a saliva test in the meantime)

Anyways I got the results back and my T is at 3021pg/ml (150-350 scale) and E2 is only 2.08 (<2.5 scale) WTF!!!

On cypionate my T was 200pg/ml and e2 was roughly 3.5pg/ml


Now my questions:
-why is my T SO much higher yet I only feel roughly 2x as good but still not fully 'fixed'
-Why is my e2 LOWER when my T is %1500 percent higher?? I hadn't taken any AI within 5 days of the sample...

[OingoBoingo]

I don't believe saliva testing is accurate for Testosterone.

If you like to read, Dr. Chen who also believes saliva testing does not accurately measure Testosterone has compiled a list of 26 studies that include discussions on saliva vs blood tests:

1. American Association of Clinical Endocrinologists (AACE). Medical guidelines for clinical practice for management of menopause. Endocrine Pract. 1999;5:355-366.

2. Hodgson SF, Watts NB, Bilezikian JP, et al. .American Association of Clinical Endocrinologists medical guidelines for clinical practice for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003. Endocr Pract. 2003;9(6):544-564.

3. AACE Thyroid Task Force. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002;8(6):457-469.

4. Huppert FA, Van Niekerk JK. Dehydroepiandrosterone (DHEA) supplementation for cognitive function. Cochrane Database Syst Rev. 20062):CD000304.

5. Grimley Evans J, Malouf R, Huppert F, van Niekerk JK. Dehydroepiandrosterone (DHEA) supplementation for cognitive function in healthy elderly people. Cochrane Database Syst Rev. 2006;(4):CD006221.

6. Herbert V, Kava R. The miracle of melatonin? Priorities (American Council on Science and Health). 1995;7(4).

7. No authors listed. Melatonin: Interesting, but not miraculous. Prescrire Int. 1998;7(38):180-187.

8. Contreras LN, Arregger AL, Persi GG, et al. A new less-invasive and more informative low-dose ACTH test: Salivary steroids in response to intramuscular corticotrophin. Clin Endocrinol (Oxf). 2004;61(6):675-682.

9. No authors listed. Chronic hypoadrenalism. GPNotebook. General Practitioner Notebook. Warwickshire, UK: Oxbridge Solutions, Ltd.; 2005.

10. Odeke S, Nagelberg SB. Addison disease. eMedicine Endocrinology Topic 42.

11. Rubin GJ, Hotopf M, Papadopoulos A, Cleare A. Salivary cortisol as a predictor of postoperative fatigue. Psychosom Med. 2005;67(3):441-447.

12. American College of Obstetricians and Gynecologists (ACOG) Committee on Gynecologic Practice. ACOG Committee Opinion #322: Compounded bioidentical hormones. Obstet Gynecol. 2005;106(5 Pt 1):1139-1140.

13. National Institutes of Health (NIH). NIH State-of-the-Science Conference Statement on Management of Menopause-Related Symptoms. NIH Consensus and State-of-the-Science Statements. Bethesda, MD: NIH: March 21-23; 22(1).

14. Institute for Clinical Systems Improvement (ICSI). Menopause and hormone therapy (HT): Collaborative decision-making and management. Bloomington, MN: ICSI; October 2006.

15. The North American Menopause Society. The role of testosterone therapy in postmenopausal women: Position statement of The North American Menopause Society. Menopause. 2005;12(5):497-511.

16. Carroll T, Raff H, Findling JW. Late-night salivary cortisol measurement in the diagnosis of Cushing's syndrome. Nat Clin Pract Endocrinol Metab. 2008;4(6):344-350.

17. Elamin MB, Murad MH, Mullan R, et al. Accuracy of diagnostic tests for Cushing's syndrome: A systematic review and metaanalyses. J Clin Endocrinol Metab. 2008;93(5):1553-1562.

18. Doi M, Sekizawa N, Tani Y, et al. Late-night salivary cortisol as a screening test for the diagnosis of Cushing's syndrome in Japan. Endocr J. 2008;55(1):121-126.

19. Nieman LK, Biller BM, Findling JW, et al. The diagnosis of Cushing's syndrome: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008;93(5):1526-1540.

20. Klebanoff MA, Meis PJ, Dombrowski MP, et al; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Salivary progesterone and estriol among pregnant women treated with 17-alpha-hydroxyprogesterone caproate or placebo. Am J Obstet Gynecol. 2008;199(5):506.e1-e7.

21. Gröschl M. Current status of salivary hormone analysis. Clin Chem. 2008;54(11):1759-1769.

22. Carroll T, Raff H, Findling JW. Late-night salivary cortisol for the diagnosis of Cushing syndrome: A meta-analysis. Endocr Pract. 2009;15(4):335-342.

23. Raff H. Utility of salivary cortisol measurements in Cushing's syndrome and adrenal insufficiency. J Clin Endocrinol Metab. 2009;94(10):3647-3655.

24. Flyckt RL, Liu J, Frasure H, Wekselman K, et al. Comparison of salivary versus serum testosterone levels in postmenopausal women receiving transdermal testosterone supplementation versus placebo. Menopause. 2009;16(4):680-688.

25. Alexandraki KI, Grossman AB. Novel insights in the diagnosis of Cushing's syndrome. Neuroendocrinology. 2010;92 Suppl 1:35-43.

26. Sereg M, Toke J, Patócs A, et al. Diagnostic performance of salivary cortisol and serum osteocalcin measurements in patients with overt and subclinical Cushing's syndrome. Steroids. 2011;76(1-2):38-42.

[kelkel]

I took a saliva sample exactly 1 month after I had switch to creams from cypionate(50mg e3d). I was applying 75mg daily half scrotally and half on my inner thigh as per my doctors suggestion. In this time my energy improved roughly 50% but still needs some work, same with sexual function, roughly 50% improvement but still could use some improvements. My gains in the gym have stayed very similiar no strength or size gains but lots of motivation to hit it hard and frequently. My well being has been much more stable though, my frequent depressive thoughts have vanished and I actually live in the moment which has been awesome for me.

(I had plans to do full bloodwork with the doc in a month Im just not covered by insurane so Im saving the funds and did a saliva test in the meantime)

Anyways I got the results back and my T is at 3021pg/ml (150-350 scale) and E2 is only 2.08 (<2.5 scale) WTF!!!

On cypionate my T was 200pg/ml and e2 was roughly 3.5pg/ml


Now my questions:
-why is my T SO much higher yet I only feel roughly 2x as good but still not fully 'fixed'
-Why is my e2 LOWER when my T is %1500 percent higher?? I hadn't taken any AI within 5 days of the sample...

Somethings wrong. 3021 pg/ml converts to 302.1 NG/Dl.
And on an every 3 day injection protocol for test it converts to 20 Ng/Dl.

[Rjay]

Thats what it says for units on the results, thats all I know. Ya I definately will need to get bloodwork pulled for more accurate reading although everytime I got it pulled via injections it seemed consistent, I guess the cream works in a different mechanism with saliva?

[Rjay]

I think I found the answer to my own question..

"On the other hand, saliva testing has repeatedly been found to indicate significantly higher than physiological levels of hormones assayed in samples from patients using transdermal creams to deliver bio-identical hormone replacement therapy. This gives a false impression of overdosing.6 A possible explanation may be that red blood cells passing through capillaries rapidly uptake steroid hormones, which are lipophilic, and quickly transport them to salivary glands and other tissues. This results in elevated hormone concentrations in saliva, while serum and urine levels remain low."

That would explain a lot. Ill be getting bloodwork done asap because until I do I have no clue where to adjust my protocol any further :/

[Chauffeur]

I'm thinking that you might have your units of measurement mixed up. As Kel mentioned, your total T when converted is still very low. And there's no way that your total T was 20ng/dl on injections.

[kelkel]

I think I found the answer to my own question..

"On the other hand, saliva testing has repeatedly been found to indicate significantly higher than physiological levels of hormones assayed in samples from patients using transdermal creams to deliver bio-identical hormone replacement therapy. This gives a false impression of overdosing.6 A possible explanation may be that red blood cells passing through capillaries rapidly uptake steroid hormones, which are lipophilic, and quickly transport them to salivary glands and other tissues. This results in elevated hormone concentrations in saliva, while serum and urine levels remain low."

That would explain a lot. Ill be getting bloodwork done asap because until I do I have no clue where to adjust my protocol any further :/

Take a look at the second set of BW in the Finding A Doc Sticky thread.

[Rjay]

I should have said that it was bioA testosterone since its a saliva test. I will ask my doc to set me up with those labs when I see her on monday