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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

    @JanSz perhaps the mild anemia is caused by my low T levels, because when I am on HCG, and my T levels are optimal, the Ferritin is where it should be, and my RBC, Hemoglobin and Hematocrit are all at the high end of the range.
     
  2. JanSz

    JanSz Gold

    You do have some problem, somewhere.
    You are not able to raise your LH sufficiently.
    When you do that using HCG you may want to consider doing it daily or EOD injections.
    Yes, higher TT may raise your Hgb.
    I have seen opinions that ideal Hgb=16


    ...
     
  3. kris90

    kris90 New Member

    @JanSz here was my bloodwork when I was dialed in on HCG:

    Estradiol: 144 pmol/L (ref: 40-160)
    Total Testosterone: 29.2 nmol/L (ref: 6.1-27.1) HIGH
    Free Testosterone: 738 pmol/L (ref: 110-660) HIGH
    Bioavailable Testosterone: 17.3 nmol/L (ref: 2.8-15.5) HIGH
    SHBG: 28 nmol/L (ref: 13-89)

    Glucose: 4.8 mmol/L (ref: 3.6-6.00)
    Creatinine: 117 umol/L (ref: 60-110) HIGH
    eGFR: 74 mL/min/1.73m* (ref: >=60)
    Calcium: 2.36 mmol/L (ref: 2.20-2.65)
    Magnesium: 0.81 mmol/L (ref: 0.65-1.05)
    Albumin: 47 g/L (ref: 35-52)
    Vitamin B12: 429 pmol/L (ref: > 220)
    Ferritin: 108 ug/L (ref: 22-334)
    Sodium: 140 mmol/L (ref: 136-146)
    Potassium: 4.4 mmol/L (ref: 3.7-5.4)
    Alkaline Phosphatase: 48 U/L (ref: 40-129)
    AST: 29 U/L (ref: <=36.99)
    ALT: 19 U/L (ref: <=45.99)
    TSH: 4.10 mIU/L (ref: 0.35-5.00)
    Hemoglobin A1c: 0.052% (ref: <=0.0649%)

    Hemoglobin: 168 g/L (ref: 135-170)
    Hematocrit: 0.51 L/L (ref: 0.38-0.49) HIGH
    RBC: 5.80 x 10*12/L (ref: 4.2-5.7) HIGH

    That was the best I've ever felt probably in my life. I was taking 325 IU of HCG/EOD. Normally, when I've been off HCG for a while and go back on, I will start at 500 IU/EOD for the first month or so until I feel it kick in, then slowly lower it back down to find my "sweet spot". I think I could get away with 250 IU/EOD.
     
  4. kris90

    kris90 New Member

    Free Testosterone: 154 pmol/L (ref: 196-636) LOW
    25 Hydroxy Vitamin D: 132 nmol/L (ref: 76-250)

    With a Total T of 13.2 and Free T 154, it looks like my SHBG is high (above 70). My liver must not be healthy. Maybe high Ferritin = high iron?

    http://www.lifeextension.com/protocols/metabolic-health/hemochromatosis/page-04
     
    Last edited: May 9, 2017
  5. JanSz

    JanSz Gold

    [qu ote="kris90, post: 213658, member: 19157"]@JanSz here was my bloodwork when I was dialed in on HCG:

    Estradiol: 144 pmol/L (ref: 40-160)
    Total Testosterone: 29.2 nmol/L (ref: 6.1-27.1) HIGH
    Free Testosterone: 738 pmol/L (ref: 110-660) HIGH
    Bioavailable Testosterone: 17.3 nmol/L (ref: 2.8-15.5) HIGH
    SHBG: 28 nmol/L (ref: 13-89)

    Glucose: 4.8 mmol/L (ref: 3.6-6.00)
    Creatinine: 117 umol/L (ref: 60-110) HIGH
    eGFR: 74 mL/min/1.73m* (ref: >=60)
    Calcium: 2.36 mmol/L (ref: 2.20-2.65)
    Magnesium: 0.81 mmol/L (ref: 0.65-1.05)
    Albumin: 47 g/L (ref: 35-52)
    Vitamin B12: 429 pmol/L (ref: > 220)
    Ferritin: 108 ug/L (ref: 22-334)
    Sodium: 140 mmol/L (ref: 136-146)
    Potassium: 4.4 mmol/L (ref: 3.7-5.4)
    Alkaline Phosphatase: 48 U/L (ref: 40-129)
    AST: 29 U/L (ref: <=36.99)
    ALT: 19 U/L (ref: <=45.99)
    TSH: 4.10 mIU/L (ref: 0.35-5.00)
    Hemoglobin A1c: 0.052% (ref: <=0.0649%)

    Hemoglobin: 168 g/L (ref: 135-170)
    Hematocrit: 0.51 L/L (ref: 0.38-0.49) HIGH
    RBC: 5.80 x 10*12/L (ref: 4.2-5.7) HIGH

    That was the best I've ever felt probably in my life. I was taking 325 IU of HCG/EOD. Normally, when I've been off HCG for a while and go back on, I will start at 500 IU/EOD for the first month or so until I feel it kick in, then slowly lower it back down to find my "sweet spot". I think I could get away with 250 IU/EOD.[/quote]
    -------------------------------------------------

    [qu ote="kris90, post: 213728, member: 19157"]Free Testosterone: 154 pmol/L (ref: 196-636) LOW
    25 Hydroxy Vitamin D: 132 nmol/L (ref: 76-250)

    With a Total T of 13.2 and Free T 154, it looks like my SHBG is high (above 70). My liver must not be healthy. Maybe high Ferritin = high iron?



    http://www.lifeextension.com/protocols/metabolic-health/hemochromatosis/page-04[/quote]
    ///////////////////////////////////////////////////////////////////////////////////////////
    Assuming that your estradiol test was good (which is questionable)
    Estradiol: 144 pmol/L (ref: 40-160)
    If you could, get from LabCorp
    Estradiol, Sensitive Test Number: 140244 CPT Code: 82670
    anyhow
    good estradiol is 10-20-30pg/mL
    10-20 likely better
    Yours is at least twice as high.
    Lower E2 would cause you drop in SHBG, and possibly raise TT (but for sure would raise freeT). Good SHBG (15-20)
    so
    you could do your job using less HCG.

    250iu/EOD=250*7/2=875iu/week
    That is normal level. Just right. I have seen people reporting up to 1500iu/week but that usually requires adding Anastrozole=arimidex.
    Some say that using excessive amounts of HCG raises their E2.
    So if you are in that category, you may get away with just reducing HCG.
    upload_2017-5-9_8-10-19.png
    If you would have to use Anastrozole, it comes in 1mg pills.
    Some give them to compounding pharmacies and they break it to 0.1 or 0.2 mg
    Overall 1-2mg/week is seen often.

    Eventually, best way of assessing personal level of sweet E2 spot is using woodometer.
    Nocturnal erections.

    -------------------------------------------------------------------
    It looks to me that you should donate pint of blood and be done with.
    And do it from time to time. (once a year??)
    Then you could enjoy liver and onions in large amounts.
     
    Last edited: May 9, 2017
  6. JanSz

    JanSz Gold

    Creatinine: 117 umol/L (ref: 60-110) HIGH
    eGFR: 74 mL/min/1.73m* (ref: >=60)

    Likely your kidneys are ok, the results are just a price of lots of muscles.
    But some day get that urine/serum test I was posting about in other post.

    ....
     
  7. kris90

    kris90 New Member

    Actually, I had no symptoms of high E2 @ 144 pmol/L. In fact, my libido was great at that level, and I was very strong in the gym. I think my E2 needs to be a bit higher than the average man to feel my best. When it is lower (i.e. in the 70s) I don't feel as good.

    Right now, I have low T and E2. I'm very suspicious about some sort of underlying condition due to my high-ish Ferritin, and very high SHBG. My liver is definitely involved somehow. I've started HCG, but in the meantime, I think I would like to further investigate these bizarre markers.
     
  8. JanSz

    JanSz Gold

    Highish ferritin and HCT and HGB
    you can toss it up and down
    then the only solution that I know about it
    is to let the blood out.

    -------
    SHBG is tightly correlated to E2, your is high
    the may be other reasons
    -------

    before you look into liver
    check kidneys/creatinine with more accurate test:
    https://forum.jackkruse.com/index.p...et-to-the-root-cause.18202/page-4#post-213522
    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).

    --------------------
     

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