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Secondary Hypogonadism - Help me get to the root cause

Discussion in 'Optimal Labs' started by kris90, Jul 22, 2016.

  1. kris90

    kris90 New Member

    Thanks guys! The timing was perfect for us.


    I usually have a bowl of ice cream with some honey for dessert after dinner. Not right before bed, but usually around 6:00 PM. About an hour or 2 before bed, I will have a big glass of orange juice with collagen powder, and a little bit of cottage cheese (for the casein protein).

    Blood sugar has been very stable. My morning levels went from about 4.0-4.5 mmol/l (from keto) to around 5.0 mmol/l very consistently (I actually see that as a good thing personally). Also, I feel like my insulin sensitivity improved since eating more carbs. Last weekend, we went to a sugar bush and had their all-you-can eat breakfast. I ate: 4 sausages, 3 eggs, 3 slices of French toast, 3 pancakes, and 3 Belgian waffles smothered in butter and real maple syrup. I was thinking I should've been diabetic after that meal, but within 3 hours post meal, my blood sugar was at 4.5 mmol/l lol! I felt a sugar high for sure, but no crash afterwards, just sustainable energy and elevated mood all day!

    As for snacking, no. I fast for about 16 hours or so, sometimes more, sometimes less. I'll usually break my fast around 11 or 12 PM with just an apple or orange. The fructose replenishes liver glycogen without stimulating insulin. Then I'll eat a big lunch around 1 PM. Usually rice, veggies and some shrimp, mussels, or eggs with chocolates for dessert. Easily 100g+ carbs. Then I eat a big dinner about 4-5 hours later, about the same size, maybe a little more with my ice cream dessert lol. And then my bed time snack (orange juice + cottage cheese) around 7:30-8:00 PM.
     
  2. kris90

    kris90 New Member

    So I randomly conducted a very cool experiment yesterday, and discovered that you can be in ketosis and still eat lots of carbs!

    On Monday evening, my last meal was a glass of OJ with collagen, and some cottage cheese around 7:30 PM. Fast forward to yesterday morning when I broke the fast with a large orange around 11:30 AM (so a total of 16 hours). After consuming the orange, I checked my blood glucose around noon (so within 30 mins of eating) and was around 6.0 mmol/l (not surprised as the fructose goes straight to the liver). I had 1 ketone strip left, so decided to check for the fun of it, and my blood ketone level came in at 0.6 mmol/l! Nutritional ketosis is considered to be between 0.5 and 3.0 mmol/l, so I was just within that range, even after eating an orange and eating probably 250g-300g of carbs the day before.

    Very cool! It's nice to be a fat burner in a FED state. My body is so used to being in starvation mode whenever I go into ketosis (via carb restriction).
     
    Last edited: Mar 15, 2017
  3. MSH

    MSH New Member

    I am glad you are having success with this protocol. I think I may have done too much too soon. For the first few days I felt MUCH better adding in the milk, OJ, and ice cream. But then I started having panic attacks and my BP went up to 195/95 with a pulse of close to a hundred! I'm wondering if this happened because my liver wasn't able to process all that sugar? My sleep has suffered as well.
     
    Last edited: Mar 16, 2017
  4. kris90

    kris90 New Member

    Sounds like quite the reaction. Maybe your T3 receptors were suprasensitized from doing typical low carb/high fat diet, and then the influx of sugar caused a swing toward hyperthyroidism? Definitely could've been liver related as well.

    I'm not sure what my pulse was prior to switching to Peatatarian diet, but it's still on the low side now around 60 BPM or slightly below at rest, but my temps are pretty consistent at 37 C and I feel warmer especially in the fed state. Still a little cold when fasting.
     
  5. kris90

    kris90 New Member

    So after 4 weeks of pounding back carbs, getting lots of rest, and eating a ton of calories, here are my results:

    LH: 3.0 IU/L (ref: 1.0-9.0)
    FSH: 3.0 IU/L (ref: 1.0-19.0)
    Estradiol: 60 pmol/L (ref: 40-160)
    Prolactin: 8 ug/L (ref: < 18)
    Total Testosterone: 21.0 nmol/L (ref: 6.1-27.1)
    Free Testosterone: 300 pmol/L (ref: 110-660)
    Bioavailable Testosterone: 7.0 nmol/L (ref: 2.8-15.5)
    SHBG: 61 nmol/L (ref: 12-60)

    So obviously a HUGE improvement in Total and Free T (increases of over 3-fold), and a major improvement in SHBG (from 84 to 61). My SHBG is still high which is affecting my Free T, and my LH, FSH and Estradiol are still on the low side, so obviously I know my body is capable of producing a lot more T, but I know this recovery will take some time. Insulin seems to lower SHBG, so as long as I keep eating carbs, I think I'll get to where I need to be.

    As far as I'm feeling, much better! Back in the home gym lifting, much more energy, better moods, improved libido, etc. So I'll keep doing what I'm doing and I'm sure in the next couple of months I will top the charts NATURALLY! Finally! :)
     
    Last edited: Mar 29, 2017
  6. JanSz

    JanSz Gold

    Testosterone suppresses SHBG
    Estrogens increase SHBG
    You want to know
    E1 (if too high reduce DHEAs)
    E2 (estradiol sensitive done at LabCorp)
    Total Estrogens (if too hig--->Calcium-D-glutarare)
    DHEAs
    progesterone
    Cortisol,serum(AM/PM)(7;30, noon)

    to possibly assess how to lower SHBG and re-adjust other hormones.
    ------------------
    http://unitslab.com/node/113
    Estradiol: 60 pmol/L=16.3pg/mL good number, test may be questionable

    ------------------

    possible scenario:
    Say, if you take too much DHEA pills............
    Your high SHBG may be due to high E1
    high E1 may be due to too large DHEAs

    you may also have higher progesterone and good cortisol(AM)

    Next time you do blood test, add those tests, so we have more info.

    ....
     
    Last edited: Mar 29, 2017
  7. kris90

    kris90 New Member

    Interesting JanSz. I don't take DHEA, so honestly not sure why my SHBG is so high when E2 levels are on the low end.

    My assumption is that chronic starvation/low carb diet caused my SHBG to go as high as 84 nmol/L and after 1 month of refeeding, I'm already down to 61 nmol/L, which is a great improvement, but still too high. I think if I keep going, it will continue to fall. I'll monitor every 4-8 weeks and we'll see where I'm at next time. I know insulin lowers SHBG, and my chronic keto-ing kept insulin low. Now I'm eating lots of carbs.
     
  8. JanSz

    JanSz Gold

    If you do more testing next time around, we may find something.
    Not everything is working as it should, you are taking Clomid.
    There may be something else.

    If you find spare $400, consider this test:
    https://dutchtest.com/shop/
    DUTCH Complete

    $399.00
     
    Last edited: Mar 30, 2017
    kris90 likes this.
  9. JanSz

    JanSz Gold

  10. kris90

    kris90 New Member

    Unfortunately my levels dropped:

    LH: 2.0 IU/L (ref: 2.0-9.0)
    FSH: 2.0 IU/L (ref: 2.0-12.0)
    Total T: 13.2 nmol/L (ref: 7.6-31.4)
    Estradiol: <60 pmol/L (ref: 40-160)
    Prolactin: 8 ug/L (ref: <18)

    Waiting for my Free T results, and Vit D levels, but last time Vit D was at 138 nmol/L (ref: 70-250). Also, waiting for a CBC, but got the following done as well:

    Glucose: 5.3 mmol/L (ref: 3.6-7.0)
    Creatinine: 114 umol/L (ref: 60-110) HIGH
    Sodium: 142 mmol/L (ref: 136-146)
    Potassium: 4.4 mmol/L (ref: 3.7-5.4)
    Vitamin B12: 557 pmol/L (ref: >220)
    Ferritin: 294 ug/L (ref: 22-334)

    Blood glucose (which was fasted) is higher than normal. I'm usually around 4.5 mmol/L, but I have been experimenting with diet a little. Should I be concerned with Ferritin? 294 seems a little high. I believe my last test I was around 110. I know hemachromatosis is linked to secondary hypogonadism (low LH/FSH/T) although I'm not sure 294 is quite high enough for hemachromatosis to be considered.

    Anyways, back to the drawing board... I'm off all meds and have been for about 5 weeks. It's tempting to go back on HCG, but I really want a natural fix. Any ideas for someone who follows all the principles taught here, has very low stress levels, very healthy lifestyle, and a good environment? Will post remaining labs when they are in.
     
  11. JanSz

    JanSz Gold

    When you learn how to readjust your body's natural set-point to higher LH level, your problem will be solved.
    I do not know this answer, but seen others trying.
    The promising trials are worst then living with low LH.
    In the mean time enjoy you HCG shots.
    Be happy that they work for you, there is only few guys that are able to make it work.
    And do not even think of Mad Cows some of the HCG donors may allegedly carry.
    --------------
    Hopefully you will solve my two other questions better than I did yours.

    1-How to raise body's set temperature to 37C in the mouth?
    2-How to increase (naturally) aldosterone set up point, to adjust/improve hydration?


    ------
    Ferritin: 294 ug/L (ref: 22-334)
    Iron?
    Iron saturation?
    Hgb?
    HCT?

    Good idea to have them all.
    Overall, it seems as you could drop 1 pint blood every so often (6-12 months)
    and then do not worry when enjoying liver with onions or steak.

    After you done above set of test few times, consider thinking of trend and correlations.
    Eventually you want to look at your Hgb and be able to tell if you want give blood.
    Hgb is easier to test (in seconds)(at blood donation places).

    ...............................................

    Vitamin B12: 557 pmol/L (ref: >220)

    Good idea to test homocysteine when testing this area.
    ----------------------------------------------------------------
    Creatinine: 114 umol/L (ref: 60-110) HIGH
    ----------
    The kidneys maintain the blood creatinine in a normal range. Creatinine has been found to be a fairly reliable indicator of kidney function. Elevated creatinine level signifies impaired kidney function.
    -----------
    There is a twist to above statement.
    You have very high muscle mass.
    Possibly also consuming higher proteins.
    Still
    I would watch
    eGFR

    I would welcome @Jack Kruse
    opinion on how to evaluate kidney function of person like you.

    -----------------------

    The kidneys maintain the blood creatinine in a normal range. Creatinine has been found to be a fairly reliable indicator of kidney function. Elevated creatinine level signifies impaired kidney function or kidney disease.

    As the kidneys become impaired for any reason, the creatinine level in the blood will rise due to poor clearance of creatinine by the kidneys. Abnormally high levels of creatinine thus warn of possible malfunction or failure of the kidneys. It is for this reason that standard blood tests routinely check the amount of creatinine in the blood.

    A more precise measure of the kidney function can be estimated by calculating how much creatinine is cleared from the body by the kidneys. This is referred to as creatinine clearance and it estimates the rate of filtration by kidneys (glomerular filtration rate, or GFR). The creatinine clearance can be measured in two ways. It can be calculated (estimated) by a formula using serum (blood) creatinine level, patient's weight, and age. The formula is 140 minus the patient's age in years times their weight in kilograms (times 0.85 for women), divided by 72 times the serum creatinine level in mg/dL. Creatinine clearance can also be more directly measured by collecting a 24-hour urine sample and then drawing a blood sample. The creatinine levels in both urine and blood are determined and compared. Normal creatinine clearance for healthy women is 88-128 mL/min. and 97 to 137 mL/min. in males (normal levels may vary slightly between labs).

    Blood urea nitrogen (BUN) level is another indicator of kidney function. Urea is also a metabolic byproduct which can build up if kidney function is impaired. The BUN-to-creatinine ratio generally provides more precise information about kidney function and its possible underlying cause compared with creatinine level alone. BUN also increases with dehydration.
    ===================

    As you see, dehydration (or lowish aldosterone) would be nice problem to have handle on.

    .....
     
    Last edited: May 6, 2017
  12. kris90

    kris90 New Member

    @JanSz you are right, life is too short. I've tried everything. With that said, just shot 500 IU of HCG into my abdomen. Feels good man!

    I'll get more iron work done soon to further investigate. I've had high Ferritin before (300+) but usually I'm at 70-110.

    As for creatinine, it's always been high. Lowest for me was 93, highest was around 120. I do have more muscle mass than the average person, and doctor's always told me this. I don't consume very much protein. Maybe 80-120g per day on average. Forgot to mention my eGFR is 76 and it should be >=60. Is that ok, or do you suspect issues with my kidneys?

    As for your questions, I'm not entirely sure how to increase temps. I feel like I'm not doing anything in particular to keep them up, but I woke this morning with a temp of 36.9 C. I took my temp later in the day and I was around 36.7 C. I seem to be between 36.5 and 37, but I'm not really focusing on it. I just eat a diet of mostly fuel: carbs and fat, with very minimal protein. I think low protein diet is good, as it allows the body to learn to recycle proteins.

    For aldosterone, I don't know much about it. I think I remember reading about how insulin positively affects aldosterone levels, so maybe you need to consume more carbs?
     
  13. JanSz

    JanSz Gold

    I suspect that your eGFR=76 is ok, considering your muscles and exercising.
    But e in eGFR stand for estimated.

    When opportunity arises you may want to double check it, with urine+blood combination as described above.

    ..
     
  14. JanSz

    JanSz Gold

    I mention about body set points for temperatures, aldosterone or LH not because I expect you to know about it,
    but,
    sometimes,
    breadcrumb may arrive,
    and I want everybody to know that I am looking for it.

    ...
     
  15. JanSz

    JanSz Gold

    Good to know about how insulin affect aldosterone, thank you. That is new to me.
    But,
    I am not ready for more carbs,
    if or when I get my body temperature higher, may be a different story.
    As it is now, more carbs would just raise my fasting insulin and bring even more visceral and belly fat.
    '
    .
     
  16. kris90

    kris90 New Member

    Good stuff @JanSz. It's fun having conversations with you. Can I ask whereabouts you live, and a bit about your environment? Are you practicing intermittent fasting?

    If no carbs, I wonder if increasing the amount of MCTs (i.e. coconut oil) might help raise your body temp? I assume you supplement with iodine also? I have stopped personally now that I drink non-fluoridated well water from my home, but however, I will take it on an as-needed basis. For example, yesterday I swam in a chlorinated pool, so when I got home, I showered thoroughly, and took about 1000mcg of iodine from kelp. This morning, I rolled out of bed, and my oral temp was 37 C.
     
  17. kris90

    kris90 New Member

    Got the results from my CBC:

    HEMOGLOBIN: 145.0 g/L (ref: 110-169)
    HEMATOCRIT: 0.42 L/L (ref: 0.31-0.51)
    RBC: 4.7 x 10*12/L (ref: 3.7 - 6)
    MCV: 90.0 fL (ref: 75 - 103)
    MCH 31.0 pg (ref: 23 - 33)
    MEAN CELL HEMOGLOBIN CONCENTRATION: 342.0 g/L (ref: 308-340) HIGH
    RBC DISTRIBUTION WIDTH: 12.9% (ref: 12.4-18.8)
    WBC: 4.8 x 10*9/L (ref: 3.5-11.8)
    PLATELET COUNT: 203 x 10*9/L (ref: 136-400)
    MEAN PLATELET VOLUME: 7.4 fL (ref: 7.5-11.7) LOW
    WBC NEUTROPHILS: 2.1 x 10*9/L (ref: 1.7-8.3)
    WBC LYMPHOCYTES: 1.8 x 10*9/L (ref: 0.8-3.4)
    WBC MONOCYTES: 0.3 x 10*9/L (ref: 0.2-1)
    WBC EOSINOPHILS: 0.5 x 10*9/L (ref: 0-0.6)
    WBC BASOPHILS: 0.05 x 10*9/L (ref: 0-0.11)
     
  18. JanSz

    JanSz Gold

    I think my biggest problem is the missing 0.5C in my under tongue temperature.

    ZIP 07054
    About 50% time I eat 1x/day, the other 2x/day
    2x/day is within about 4 hours.
    height 5'8" weight 155# lately closer to 160#
    wear 32" pants but they are getting real tight.
    And I would love to talk about 28" waist.
    My fatty acids are withing laboratory ranges but many are low per my %Status
    %Status=0% when at mid laboratory range
    laboratory range=100%
    when %Status =+50% that is upper laboratory range
    when %Status =-50% that is lower laboratory range

    I eat coconut oil and nutmeg (and hemp oil), but as you see below, they do not want to stick.
    At least large part of the problem is how to make it stick.
    When I was on seafood bandwagon, my fatty acids were even worse.
    I mostly do not eat seafood now.


    upload_2017-5-7_9-39-11.png



    upload_2017-5-7_9-39-41.png



    upload_2017-5-7_9-26-36.png
     
    Last edited: May 7, 2017
  19. JanSz

    JanSz Gold

    In another post, you were concerned with high-ish ferritin.
    Most people go by HCT, yours is far from being excessive.

    When thinking of phlebotomy, I think that you should go by
    ferritin, %iron saturation, iron.

    ..
     
  20. JanSz

    JanSz Gold

    upload_2017-5-7_10-43-17.png

    -------------------------------------------------------
    MCHC---MEAN CELL HEMOGLOBIN CONCENTRATION: 342.0 g/L (ref: 308-340) ----HIGH
    MPV---MEAN PLATELET VOLUME: 7.4 fL (ref: 7.5-11.7) -----LOW
    -----

    A high MCHC level can also be caused by having too little B12 or folic acid
    https://en.wikipedia.org/wiki/Mean_platelet_volume
    ---------------------------------------------------------------------------------
    Overall,
    you may be toying with some kind of (marginal) anemia.
    If you are looking for something to study,
    I would look first at this metabolic chart;
    first the blue part.
    [​IMG]


    [​IMG]
     

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