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Latest observations from 'experimenting' with HRT for Adrenal Fatigue

Discussion in 'Adrenal Dysfunction' started by drob31, Jan 21, 2016.

  1. drob31

    drob31 Senior Member

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    My free testosterone was low, although my total testosterone was normal. (free: 9.1 ref :11 -25. total: 685 ref: 390-1100) This is due to high SHBG. Because the SHBG stays high, my doctor suggested trying testosterone replacement. Knowing my adrenals were burdened by **SOMETHING** I knew that the subsequent up regulation in metabolism might be hard on the adrenals.

    I was correct. After trying 40 mg testosterone cypionate, after an initial pleasant feeling and energy (a few hours), I became very tired for the next few days. The further away I got from the shot, the less tired I became. It was not a "tired but wired feeling," either.

    Rewinding to last year, I tried slow release t3 and cytomel. Both seemed to raise my cortisol through the roof and made symptoms worse. In comparison, the testosterone just made me tired, almost like a need to sleep and heal, and I plan to do more experimentation.

    However, it dawned on me my that HCG may be the way to go. HCG mimics LH, and besides causing your testes to produce testosterone (if male), it also causes them and your adrenals to produce pregnenolone. At one point supplementing with pregnenolone was very helpful, but the dose and bioavailablity were questionable.

    I was also prescribed hydrocortisone, 20 mg/day to try. I have tried a single dose of hydrocortisone here or there, but I didn't feel anything in particular. Does it need to be used for a long period of time?
     
    Theodore likes this.
  2. Thinktank

    Thinktank Senior Member

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    Interesting, when do you plan on starting HCG?

    I have pretty much the same problem as you except that i'm high in total testosterone.

    Borderline low free testosterone
    High total testosterone
    Very High SHBG
    Very Low pregnenolone (almost non-existent)
    Low cortisol

    I think the high SHBG and high albumin are binding to all the testosteron thus the high total testosteron but low free testosterone.

    But why does this occur? I believe i have a problem in methylating/excreting certain estrogens, they were all low in morning urine but normal in blood.
     
  3. drob31

    drob31 Senior Member

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    What are your symptoms?

    Mine most closely resemble hypothyroidism, but free t3 is normal, but I realize there is way more factors than that.

    "High t3" pooling in the blood would elevate SHBG. Low insulin would elevate SHBG, and high estrogen or other hormones could elevate it as well. My estrogen is low normal, my insulin is low normal. However i have switched from low carb paleo to higher carb paleo, and giving bigger insulin spikes (with low GI controlled carbs) seems to lower SHBG.

    Your LH must be high to have high testosterone, and it almost sounds like you are deficient in 3 beta hydroxy or 21 hydroylase enzymes, as it appears pregnenolone is used up rapidly and sent down the DHEA pathway. How do your DHEA levels look?
     
  4. Thinktank

    Thinktank Senior Member

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    Many hypothyroid symptoms, i've ordered a natural desiccated thyroid product to see if it makes a difference.

    These are my results.
    Some 17-ketosteroids and 17-hydroxyketosteroids have been tested but not the ones you mentioned. dit: Here's my urinary profile: Undetectable pregnenolone - hormones messed up
    hormones.jpg
     
  5. drob31

    drob31 Senior Member

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    I'm sure how accurate urine testing is for most hormones, although the numbers do seem to correlate (low free t, high SHBG). Have you done any blood testing? Thyroid, iron, b12, vitamin D, etc?
     
  6. Thinktank

    Thinktank Senior Member

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    All the results you see on the picture are blood drawn. The results displayed in the other thread are all from morning urine.

    TSH = 2.78 (reference range 0.35 - 4.94), although i believe any TSH above 2.5 should be investigated
    FT3 = 2.7 (reference range 1.71 - 3.71)
    FT4 = 1.16 (reference range 0.7 - 1.48)

    B12 = >2000, higher than measurable because i inject hydroxyb12 10mg twice weekly.

    Vitamin D3 (25 OH-) = 33,5
    Vitamin D3 (1,25 Di-OH) = 73,2
    Vit D that was measured approx. 5 months ago and the last 3 months i've not supplemented with it.

    I've not tested iron, ferritine etc. over 2 years so thanks for the reminder, gotta have that checked out again. I have no anemia though, no real sign of low iron.

    It's really frustrating, i've been having some serious hormonal symptoms for so many years and i've never been able to figure it out! Conventional doctors told me nothing is wrong and functional/holistic/etc. doctors tell me the hormal problems will disappear when you treat the underlying issues. Guess what, the hormonal problems are still there. :)

    Have you ever tried desiccated thyroid?
    Sorry if i hijacked your thread!
     
  7. drob31

    drob31 Senior Member

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    I honestly felt way more normal when my TSH was 4.5, it's now 1.8. From what I understand hormones fluctuate fairly rapidly, especially TSH, so one measurement may not represent what's actually going on.

    In many cases, I think everything goes back to the adrenal glands, and the screwed up signaling from the HPA-axis. I think the reason this is the case is because they produce so many hormones and at the same time are instrinctly linked to the autonomic nervous system and the stress response. Whatever causes the alteration is a trigger, but what causes it to continue to malfunction must be something else like a pathogen, damage to the PVN (caused by low glutathione?--if so methylation would help?), or autoimmune response.

    I have tried dessicated thyroid (armor), and also cytomel, and slow release t3. They made me much worse because, ironically they drove my cortisol too high. When ever I tried to boost my thyroid, it seemed to crash my adrenal glands. Even TRT testosterone pushed the adrenals too hard. I did have luck at times with pregnenolone, dessicated adrenal gland, and 7 keto (to lower cortisol when it was high).

    Your free testosterone actually looks ok, even though SHBG is high. The issue is that even if your testosterone is ok, the high levels of SHBG bind with other hormones. I've read anecdotally that TRT patients experience low cortisol when their testosterone is too high. Using a low dose of TRT would theoretically lower the T.

    One thing I seem to be having luck with, although it's too early to know, is D-ribose. I've been trying really large doses and it seems to be helping produce ATP, and also eletrolytes, like sodium, and magnesium. It turns out allot of autonomic issues could be caused by low aldosterone and increasing sodium intake can help raise it. Also, low magnesium can cause CFS like symptoms. Not to mention potassium can as well...
     
    Last edited: Jan 26, 2016
    Thinktank likes this.
  8. Thinktank

    Thinktank Senior Member

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    I think you have a point with the adrenal glands, but probably it starts even higher up at the hypothalamus.

    Interesting that it drove your cortisol high, was that a feeling you had or did it actually test high in blood or saliva?
    I have hypo symptoms and my labtest from yesterday shows a cortisol deficiency in blood serum. I can't cope with stress anymore, every little trigger sends me up the wall so maybe adding a small amount of NDT might help with that.
    My 24hr saliva sample is still on the way to the lab but i'm sure that will score pretty bad as well.
    I have tried a small amount of prednisolone but it makes me feel very jittery, i can handle 1.25 mg not more than that.

    Yes, i'm pretty sure most of the T gets bound up by SHBG and albumin which is also high. I can use something to lower SHBG but then estrogen will skyrocket. I believe i have a problem with estrogen clearance/detoxification thus high SHBG.

    D-ribose makes me jittery.
    I believe my aldosterone is low but i need to get that tested. How about yours?
    Sodium is always kinda low (138) and TCO2 high (33) in electrolytes blood serum, i've noticed that when sodium is > 141 and TCO2 is <28 i feel a lot better, much less dysautonomia symptoms. But for the last 6 months i've not been able to get sodium up, no matter how much i supplement.

    It's all so complex, when you try to correct it the body has a redundant ways to do whatever it likes anyway.
     
  9. drob31

    drob31 Senior Member

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    I don't think measuring blood electrolyte levels is an accurate representation of what's going on at the cellular level. I think these levels are tightly regulated and don't represent the levels in the rest of the body. That's probably why you can't affect the sodium measured in blood.

    In regards to raising sodium, flourinef would theoretically help if the issue was low aldosterone. I know that my pee smells very salty, and always seems to be clear, and I slightly retain water I think because I'm so dehydrated in the morning. I think I'm losing salt and that makes me dehydrated, especially in the morning when I have dry mouth and feel fatigue, but drinking 32-40 ounces of water with breakfast helps, as does increasing carbs. Carbs give the body glucose which allows it to not use gluconeogensis which requires cortisol. This less of a reliance on cortisol theoretically will help maintain steadier levels of the hormone.

    D-ribose I think is continuing to help, but I'm doing 30 grams a day.
     
    actup likes this.
  10. outdamnspot

    outdamnspot Senior Member

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    Hi, just wondering if either of you found a way to tolerate thyroid treatment? My symptoms look like hypothyroidism as well, but TRT, NDT and DHEA have made me worse. Still trying the NDT, but even at 1/2 grain it crashes me.
     
  11. drob31

    drob31 Senior Member

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    Thyroid treatment never worked for me because of HPA-axis dysfunction. Infact, it will never work until HPA-axis issue are resolved, and that's not just cortisol, but the rest of the adrenal hormones as well.

    High cortisol and HPA-axis dysfunction cause me to go hypothyroid sporadically. This is caused when I do exersize like weight lifting, and occurs 24-48 hours later and lasts a few days, but in general has been going on for 2 years.

    It's basically Post Exertional Hypothyroidism caused by high cortisol which desensitizes cellular thyroid receptors, and you essentially have to figure out whats causing it and avoid it, while modulating the HPA-axis with supplements.
     
  12. Rlman

    Rlman Senior Member

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    d-ribose also make me jittery. I wonder why. I also have low cortisol on saliva test. but blood is normal. Also sugary foods make me jittery right after eating them.
     
  13. Mikee5

    Mikee5

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    What type of supplements could 'modulate' the HPA axis? I also react poorly to thyroid medication and cortisol therapy, and I have confirmed secondary hypothyroidism and adrenal fatigue.
     
  14. Rlman

    Rlman Senior Member

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    hey @drob31 how was your libido with these blood levels of testosterone? normal or low libido? and was LH at lower end of normal range?
     
    Last edited: Jul 29, 2016
  15. Rlman

    Rlman Senior Member

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    hey @Thinktank how was your libido with the testosterone levels you posted in the above chart. normal or low libido?
     
  16. Thinktank

    Thinktank Senior Member

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  17. Rlman

    Rlman Senior Member

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    well that's a good sign i guess, so free t should be adequate, unless shbg can cause increased libido
     
  18. Rlman

    Rlman Senior Member

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    @Thinktank i just saw in your other thread that u said the blood tests were done at 14:00. some hormone tests are better done in the morning, since levels are higher then for some hormones
     
  19. drob31

    drob31 Senior Member

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    Lower than normal.

    I haven't measured it lately, but I just had mono 2 months ago.

    Now, after battling it and starting to use antivirals (lysine/olive leaf/ astragalus) and a little creatine, my libido is very high, so I'm not sure what's going on.
     
    Rlman likes this.

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