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Got Some More Labs - Frustrated With My Doctor

Discussion in 'Optimal Labs' started by fireforlunch, Jul 17, 2013.

  1. fireforlunch

    fireforlunch New Member

    Went to a new Dr. last week. She agreed to all the tests I requested but the ASI.

    She said she didn't think it was necessary.

    I refuted but she wouldn't budge.

    Here are the results:

    Bold are my results with normals to the right

    Sex Hormone Bind Globulin 34 nmol/L 10-57

    Pregnenolone 72 ng/dL 33-248


    Testosterone, Free 10 ng/dL 9-30

    Testosterone, Total 336 ng/dL 240-950

    Thyroid Peroxidase Ab 13 U/mL <=34

    DHEA Sulfate 282 ug/dL 120-520

    T4 (THYROXINE) TOTAL 5.6 ug/dL 4.9-11.7
    T3 UPTAKE 32.2 % 22.0-35.0
    TSH 3.96 uIU/mL 0.35-4.94

    PSA, TOTAL 0.33 ng/mL <4.00

    ESTRADIOL <10 pg/mL 11-44


    My TSH came down from 4.89 to 3.96 and even though I still feel like crap she says it's within normal range.

    She even says the Testosterone numbers are normal even though they are on the low end.

    She wasn't concerned about my Estradiol even though it's less than 10.

    Since everything is "normal" in her mind she won't give me anything but offered to refer me to an Endo (for thyroid) and a Urologist for the Testosterone.

    I'm so discouraged.

    The numbers are clearly out of wack yet she says there is no need for action.

    Considering the numbers above what Dr would you recommending seeing first - Endo or Urologist?

    Thanks for your input
     
  2. fitness@home

    fitness@home Silver

    I actually have found most endos to be useless. Many don't look beyond the TSH. I finally stopped seeing one.

    Earlier today I was reading an older blog post and there was a lot included in it about thyroid and other hormones as well:

    http://www.jackkruse.com/your-vap-brain-love-not-war/

    Make sure you read the comments...
     
    Last edited: Jul 17, 2013
  3. fireforlunch

    fireforlunch New Member

    Thank you, having a look now

     
  4. Dextery

    Dextery New Member

    You need to find another doctor that is at the very least a low carb, high fat doctor. There are so many people out there that say the same thing..."the doc says my thyroid numbers are within range, but I still feel like crap."

    This is a database of paleo type doctors to search for one in your area.
    http://paleophysiciansnetwork.com/
    http://lowcarbdoctors.blogspot.com/
    http://primaldocs.com/

    I would also encourage you to read the iodine thread. Iodine plays a huge role in proper thyroid function.

    Iodine video that has been posted before: It is estimated that 90-95% of the population is Iodine deficient. And the chlorine, bromine & fluorine has replaced what iodine you did have in the thyroid gland....thus not functioning well. Grizz is the Iodine expert on Dr. Brownstein's protocol for thyroid.

    [video=youtube;uc4Q3kzBSc4]http://www.youtube.com/watch?feature=player_embedded&v=uc4Q3kzBSc4[/video]


    And this 5 part video by Dr Tennant. "An Understanding of How the Body Works" After this one plays, find Part 2 2/5, then Part 2 3/5 on out to Part 2 5/5.
    2/5 starts him talking about Iodine
    http://www.youtube.com/watch?v=QBbYU7Tp0co

    If your thyroid ain't functioning well, you will feel like crap.
     
    Last edited: Jul 17, 2013
  5. Jack Kruse

    Jack Kruse Administrator

    Those labs are not close to optimal.......lots can be done.
     
  6. fireforlunch

    fireforlunch New Member

    Thank you for your input

    I am following the iodine protocol

    I will definitely use those links to find a doc

     
  7. fireforlunch

    fireforlunch New Member

    Thank you for your input.

    In addition to a natural thyroid like armour can you give me some suggestions about what can be done that I can talk to my doc about?

    I kind of feel like if I give her some concrete ideas that she might give the ideas a shot.

     
  8. JanSz

    JanSz Gold

    Consider someone who have a prescription pad and will use it when you ask.
    That is per-requisite #1.
    That is the hardest part.
    All other questions come latter.

    Forget MD or 99.99% of them

    Try your luck with osteopaths and other specialties when able to write scripts.
    That varies from state to state.

    There is lots of medical advisers (who can't write scripts) engaged in hormonal manipulations.
    They work by feel, guess, magic wand and saliva tests.
    I would stay away from those.

    But you Mom or Grandma may have doc that she knows for the last 45 years, he may be willing to bail you out.
    ///////

    You already know lots of bad stuff about you.
    Some of it is easy to correct using otc pills.

    I would suggest that you do not exercise or do strenuous work until you come with better numbers.


    //////

    You may find this post interesting and couple further down.

    http://jackkruse.com/forum/showthread.php?6427-PG-E2-ratio&p=81508#post81508

    \


    //

    Next time instead of ASI ask for

    Cortisol AM/PM
    Cortisol (7:30AM)(noon)(2:30PM)

    Saliva is to exotic for most, but LabCorp have it.

    =============================
    LabCorp
    Salivary Cortisol, MS
    Test Number: 500179 CPT Code: 82533
    eight (8) serial samples
    Salivette tubes (item # 51.1532) and
    specialized patient collection kits
    (item # 38330G)
    255.3 Other corticoadrenal overactivity
    255.8 Other specified disorders of adrenal glands
    255.4 Corticoadrenal insufficiency


    ==================================
     
    Last edited: Jul 17, 2013
  9. fireforlunch

    fireforlunch New Member

    Thank you for posting

    Yes that would be fantastic to get a doc like that and I can see that's the hardest part.

    I found an Osteopath like you recommended before but then my mom told me she thought for sure her doc (the lady I who ran these tests) would be mindful of my requests.

    I stopped the football at work last week so I'm doing nothing now.

    I do have two questions for you.

    1) What OTC items are you referring to that could help?

    2) I know my cortisol is messed up - what can be done about that besides trying to fix my sleep?

    I will say that I am trying to do as much CT as possible as well as looking at the sun as many mornings as possible and doing the Iodine protocol


     
  10. JanSz

    JanSz Gold

    ad#1)
    Pregnenolone-MLM
    DHEA-MLM
    HCG or Ovidrel(rHCG)
    Injectable Testosterone (by script)
    Arimidex (by script)

    ad#2)
    Sleep is just one item, dr Kruse provided numerous aspects and ways to work on Circadian Rhythm.
    Good Circadian Rhythm is the very first pre-requisite to good health.

    Optimizing Steroid Hormone Panel(LabCorp blood tests required to provide guidance)
    Optimizing Micronutrients (Spectracell blood test required to provide guidance)
    Optimizing Fatty Acids (Mayo Clinic or Genova Diagnostic blood test required to provide guidance)

    Tests are listed under link in my previous post.

    ...................
     
    Last edited: Jul 18, 2013
  11. MsYo

    MsYo Silver

    Consider finding an anti-aging doctor for your requests. I was fortunate to find a physician that specializes in weightloss and anti-aging (before I found this forum). I started slowly with detailed discussions on how I felt. He was the first to stress the importance of sleep to me when all other doctors did not. When I ask for labs he doesn't resist. I believe he has learned that I am an educated patient and my requests can be substantiated. Not all doctors work this way but keep searching to find one that will work with you. Also, you could pay for the ASI out of pocket. I prepay for the test even though I have insurance.

    I have low morning cortisol too. I just followed JanZ suggestion on pregnenolone and it has helped me in the last week. I have my scripts for updated ASI, thyroid, spectracell that I will be doing in the next week.
     
  12. fireforlunch

    fireforlunch New Member

    I have been following the adrenal fatigue RX for the circadian Rhythm issues.

    Ovidrel?

    I looked that up on Google and the only thing I could find about it is that it helps with women who have infertility issues

    I will look into the additional tests.

    Are you willing to make dosing recommendations for the Pregnenolone-MLM and DHEA-MLM


     
  13. fireforlunch

    fireforlunch New Member

    That's a great idea, I will have a look around my city

     
  14. JanSz

    JanSz Gold

    I am glad that you are posting your results.

    While using pregnenolone-MLM you will need to monitor your progesterone and likely wean out of any direct progesterone supplementation, specially in first half of menstrual cycle.

    At this time I (I am a man) only monitor my preg and prog levels and my
    pregnenolone-MLM dose (rather tightly) correlate with
    Cortisol,serum(7:AM)
    results.
    I aim at:
    Cortisol,serum(7:AM)=20ug/dL(6.2-19.4)


    .............
     
  15. JanSz

    JanSz Gold


    It would help to know your
    prolactin
    LH
    FSH
    to figure out why your testosterone is low.

    If LH and FSH were low
    I would want to check your pituitary (pituitary MRI).
    I would also ask if you were hit in the head, specially forehead, specially top of nose where eye glasses rest, because that could cause pituitary problems (sometimes).

    Think about above, see what you can do.
    Pituitary problems may impact other pituitary hormones.






    Most docs would use short course of Clomiprene (25-50)mg/day for few months and check if that raises testosterone.
    I am not a doctor.
    I think that it would be a waste of time (and possibly impair vision).
    I suggest
    HCG-shot=250iu/EOD
    then check TotalTestosterone(TT) within a month.
    If TT raised significantly but less than desirable,
    increase to 500iu/EOD
    see what happens.
    If you good with TT, stay on that HCG dose indefinitely
    If you are missing on TT,
    go back to HCG-shot=250iu/EOD
    and
    introduce
    Testosterone Cypionate or Enanthate 200mg/mL
    T-shot=20units/EOD=40mg/EOD=140mg/week average
    (With time you will figure out more precise size of test dose, for now that is good ballpark for SHBG=34
    actually, (doctor permitting/cooperating) you can go right away to T-shot=30units/EOD

    Use this for T & HCG injections.
    Inject anywhere you want, (but no eyes, bone, veins, tendons), with one hand only, the other hand is not touching you, preferably put it in your pocket.





    You really are looking for a testosterone dose that would push down your SHBG to =20
    but not lower than 15.

    Raising testosterone lowers SHBG
    Raising testosterone raise Estradiol
    Raising Estrogens raise SHBG
    Balancing act.
    You need to raise TT and estrogens.

    At this time, (with currently low E2 levels), make sure that you are not using any Aromatase inhibitors or promoters to metabolize estrogens.
    Anastrozole=Arimidex, I3C, DIM, cruciferous vegetables (cabbage, Brussels sprouts, cauliflower are out at this time, that may change rapidly)




    You must monitor hemoglobin Hgb level.
    Raising testosterone (in some people) raises Hgb excessively.

    Hgb=15 ok, but you do not want less (eat lots of liver)
    Hgb=16 ideal
    Hgb=17 still ok but you do not want more than that
    Hgb>17 use phlebotomy to control, gingerly when discussing this with doctors, they may spoil your day and ban testosterone supplementation because they worry about their behind (instead of dealing with additional variable).


    ---------------------
    Pregnenolone 72 ng/dL 33-248
    DHEA Sulfate 282 ug/dL 120-520

    Use enough DHEA-MLM to get DHEAs=490
    Start with 100mg/day divided, wakeup time and noon

    You are missing
    progesterone
    Cortisol,serum(7:30AM, noon and 2:30PM)
    keep getting them latter

    Start with 300mg/day preg-MLM divided, wakeup time and noon

    monitor
    preg
    prog
    Cortisol,serum(7:30AM, noon and 2:30PM)

    Some people are getting spacey at some point when using preg-MLM, that will be stopping and reevaluation point.
    Otherwise,
    just monitor preg and prog
    but try to get preg-MLM dose that gives you:
    Cortisol,serum(7:30AM)=20

    At first you may need higher and higher dose (I got to 900mg/day, some others got to 1200mg/day) but after a year I was getting too much cortisol,
    gradually lowered dose.
    My current preg-MLM dose =300mg/day


    ................
    In the mean time you may be getting progesterone that is higher than maximum usual lab ranges of
    prog(1.4ng/ml)

    actually progesterone is protective hormone that balances estrogen activities.

    Good Estradiol=20pg/mL

    At this time I think that you should be in good shape when your
    progesterone=(1.4-5)ng/mL

    at prog=5ng/mL
    and E2=20pg/mL
    your
    P/E2 ratio would be about 200
    far cry from 500 recomended by dr Kruse (for women)


    I am not a doctor.
    ////////


    Keep this

    thyroid-s.com/
    alldaychemist.com
    reliablerxpharmacy.com

    Look there for thyroid hormone from pigs
    Cialis
    HCG

    We will talk latter about Ovidrel=rHCG


    /////////////////////
     
    Last edited: Jul 18, 2013
  16. fireforlunch

    fireforlunch New Member

    Are these the correct meanings of the abbreviations you posted?
    LH - luteinizing hormone
    FSH - follicle-stimulating hormone


    That's interesting, I normally eat a decent amount of those vegies - but I will stop that.

    cruciferous includes broccoli as well right?


    I simply cannot afford this amount of Preg and DHEA if I am going to go with the MLM but I can do at least half.

    I assume that would be better than nothing but correct me if I'm wrong

    I understand you are not a Dr, thank you for your input

    I have had a concussion - 12 yrs ago I was in a mountain biking accident.

    I don't know exactly where I hit my head (I was alone) but there was a bruise directly above my eyebrows as if whatever I hit went right between my eyebrows and my helmet.

    I don't remember anything from the whole day but my friends who took me to the hospital said that I kept asking the same questions over and over again for hours.

    I remember waking up at my mom's house the next day.


     
    Last edited: Jul 18, 2013
  17. Martin

    Martin Gold

    Interesting subject, those pituitary labs. I looked into them not long ago and here they are for review/opinion/comparison:


    DHEA-S 154.0 ug/dl 38-313

    Testosterone, Free 5.5 7.2- 24.0

    ACTH 43 7.2-63.3pg/ml

    renin and aldosterone .82ng/ml/hr

    Aldosterone 2.4 ng/dl 0-30

    DHT 30 30-85

    GNRH <10 pg/ml <25

    Prolactin 3.6 ng/ml 4-15.2

    IGF-1 142 ng/ml 81-225

    aMSH <8 35-81

    TSH 2.68 uIU/ml

    T4 7.7 ug/dl 4.5-12

    FT4 2.3 1.2-4.9

    T3 92 ng/dl 71-180

    Estradiol 20.6 pg/ml 1-47

    As you can see, many are in the crapper. Standouts for me are: a-MSH below 8, IGF-1-low, Free T-dismal, DHEA-S-sad, Prolactin-ugh, etc. Doc says there are still some hormones in there working, but overall a andropause sorta feel to the whole thing. NO fun, lemme tell ya.

    Just had these labs drawn:
    Total T 645 152-669 ng/dl
    T, Free 7.94 3.2-12.2 ng/dl
    T, Bioavailable 165 76-289 ng/dl
    T, % Free 1.2 1.4-2.9
    SHGB 77 12-59 nmol/L

    JanZ, my astute forum-mate, what's your take on these?
     
    Last edited: Jul 19, 2013
  18. Jack Kruse

    Jack Kruse Administrator

    Jansz is giving some great advice here.........
     
  19. Jack Kruse

    Jack Kruse Administrator

    Martin SHBG still too high.......that is when you look at thyroid and adrenal (ASI) closely.........my bet is your pregnenolone is still low because you are not converting LDL to pregnenolone for some reason......inflammation vs EMF. If your Ca/ Mg and BUN/creat are up you need to look closely at environmental EMF.
     
  20. JanSz

    JanSz Gold




    SHGB =77
    you have dr Kruse in your neighborhood
    beg him for (even more detailed) help,
    shear it with the rest of us.

    ideal SHBG=20
    acceptable 15<SHBG<25

    If you rebuild the whole Ferrari, there is a good chance that SHBG will go down.

    My understanding is that you are fighting mold, possibly Lime
    and you follow dr Jack Kruse advice.
    Keep doing that.

    Additionally, buy this book:

    http://www.bodybio.com/storeproduct304.aspx

    $34.65
    Do not buy it from Amazon (may be cheaper but old revision).

    Either ask them for name of local to you professional that they recommend
    or
    try DIY job.
    Phone below, red lined.

    For DIY
    http://www.allthingsmale.com/forum/showthread.php?20061-Dr.-Patricia-Kane

    [​IMG]


    Generally speaking you want:

    get rid of bad fatty acids (long, rigid, distorting cell and mitochondrial membranes)
    get good fatty acids profile
    get lots of different phospholipids

    test via
    visual contrast test
    and
    Red Blood Cell Fatty Acid test from Kennedy Krieger Laboratory
    (this is only known laboratory that tests not only
    even carbons fatty acids (normal)
    but also
    odd carbons fatty acids (toxic)

    In paralel you want

    supplement with selenium, iodine/iode
    and
    about 40 micronutrients optimization with help of Spectracell Micronutrient testing

    also

    Steroid Hormone Panel optimization
    and latter
    Thyroid Hormone panel.

    Also monitor the numerous inflammation markers.

    ======================

    Consider looking at this post and mine posts below it:

    http://jackkruse.com/forum/showthread.php?6427-PG-E2-ratio&p=81508#post81508



    ===========================

    aMSH <8 35-81

    clarify units, what was tested, where?

    Dr Hertoghe Hormone Handbook 2nd ed

    page 396
    aMSH=20pg/mL (10-45)

    page 83
    Melanotan II (0.1-2)mg/day (value high)(injections)

    Melanotan II=MT2

    PT141 =Bremelanotide (do not use it)

    I use MT2 second year for ease of tanning
    0.5mg/ every 2-3 weeks

    The sexual help from MT2 is highly overrated in my case, but for the first two 3 injections it helps to have ready girlfriend neraby on high alert.




    //

    Prolactin 3.6 ng/ml 4-15.2

    People are eating Cycloset at dr K advice (to lower prolactin.

    You have an opportunity to ask dr Kruse what is so special about Cycloset.

    I am guessing that he wants quick morning suppression of Prolactin,
    but latter on he does not mind when Prolactin raises.

    Cycloset suppresses Prolactin rappidly and then (the Cycloset) is gone.
    Other varieties of Bromocriptine Mesylate are relatively slow and continuously acting.

    ////////////////////////////////////////////////////////////


    DHEA-S 154.0 ug/dl 38-313


    Use DHEA-MLM from Allergy Research
    use enough of it to aim at

    DHEAs(350-490)



    ///////
     
    Last edited: Jul 19, 2013

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