Aussie Male Labs Comments Please

[Lethal Lee]

Hi All,

I would appreciate any comments advice re my husbands Labs below. I had been talking with Phil on RTH Mens Forum but he is unavailable due to his operation as you know. Phil & Chris had mentioned this Forum & Dr Marianco very favourably hence my post here.

DH has a appointment with Hormone Doc on 13th Jan when we expect an order for an ACTH Stim to be approved (this Doc has done this for me & our kids too).

It appears DH is Hypopit (subject to ACTH Stim result of course) as per Saliva & blood results. He looks Secondary AI, Secondary Hypothyroid (with Hashis) and Secondary Hypogonadal as well.

He has high Ferritin but tests negative for Hemochromatosis. His Homocysteine is slightly elevated & he has started Methycobalamin & Folinic Acid since it was tested hoping to bring this down.

Note we are in Australia so you may not be familiar with the measures/ranges.

Phil had suggested HCG & Tesosterone/DHEA HRT but I am unsure if HCG is available here except for Fertility/IVF purposes. We are located in Perth WA. Testosterone & DHEA Cream/Troches are avilable by RX.

Also Extra Sensitive E2 & BAT is not available here so no results for them.



==============================================================
Supplements

ALA (Thiocid by Thorne Research) - 100mg
COQ10 (Ubiquinol CoQH-CF by Now) - 50 mg
Fish Oil - (Nordic Naturals Pro EPA) 1000mg containing 850mg EPA + 200mg DHA + 180mg other Omega 3's
Folinic Acid - (Folocal by Thorne Research) 800mcg Calcium Folinate started 9th December'08
Garlic Tabs (by Golden Glow) - 2000mg Extract containing Alliin 3.71mg x 2
Milk Thistle Extract - (Mega Silymarin by Life Extension) - Silmarin 720mg + Silibinin 270mg + Isosilybin B 40.5mg
Multi-B- (B-Complex #5 by Thorne Research) started 12th Dec'08
Olive Leaf Extract (Olimmune by Naturamedics) - 6250mg Extract containing Oleuropein 150mg
Probiotics - (Inner Health Plus Dairy Free by Ethical Nutrients) - 12.5 billion Lacto Acidophilus + 12.5 billion Bifidobacterium Lactis
Vit A - (Natures Own) 5000 IU
Vit D3 - (Ostelin by Reckitt Benckiser) - 1000 IU
Vit E - (Unique E by AC Grace) - 400 IU
VitB12 - (Methylcobalamin by Jarrow) 5000mcg sublingual started 9th Dec'08

=============================================================
Relevant History

DH is 52 years old is not overweight but certainly has lost tone.
He does no regular exercise
Vasectomy Nov 1995
Kidney Stones Sept 1999
Tends to constipation sometimes severe
Severe Constipation required ER visit Feb 2005
Psoriasis Right Shin Sept 2006
Recurrent bouts of Tonsilitus - requiring antibiotics
Chronic Headaches - uses lot of Nurofen
Fatigued & has little stamina
Brain Fog & difficulty focusing
Recurrent back strain/muscular pain/ Neck pain/ Right Elbow pain
Recurrent Fungal (Tinea) infections
Constant Sinus congestion (has always snored)
Very low Libido & erection quality is poor
Enlarged breasts
Sometimes difficulty sleeping & is light sleeper
Low level depression & anxiety
Very dry skin looks thin alligator like
Feet - skin peeling all over including toes & badly cracked heels

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Tests Wanted

ACTH Stim & Serum ACTH
GH, IGF-1 & IGFBP-3
Vit B6 (never tested)
Vit E (never tested) - has been supping 400 IU for a few months now
Vit A (never tested)

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TEST RESULTS
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Salivary Cortisol

10th Oct'08
8am..........22 nmol/L (6-42) *44% of range TOO LOW
Midday....11.2 nmol/L (2-15) *71% of range
4pm.......10.6 nmol/L (2-11) *95% of range
8pm....... 5.5 nmol/L (1 - 8) *65% of range

Cortisol Burden...49.3 (11-76) *60% of range

====================================================
Salivary DHEAS
10th Oct'08
8am.......22.4 nmol/L (5-30) *70% of range
DHEAS/Cortisol am ....1.02 (0.20-0.60) *ratio elevated

=====================================================
CORTISOL
2nd December’08 9am......505 nmol/L (171-536) *92% in range

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ACTH
2nd December’08 9am......6.4 pmol/L (1.6-13.9) *39% in range

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ADRENAL ANTIBODIES

Adrenal Cortex Abs
2nd December’08...............Negative (less than 1:10)
21-OH Adrenal Abs
2nd December’08...............results pending

====================================================
ALDOSTERONE
2nd December’08
9am (Salt fasting)..............347 pmol/L (100-950) *29% in range

RENIN
2nd December’08
9am Salt Fasting.................21 mU/L (3.3-41) *47% in range

ALDO/RENIN RATIO
2nd December’08..............17 (less than 70)

=====================================================
Thyroid Tests

17th September'08
TSH............1.28 mU/L (0-4)
Free T4..........15 pmol/L (9-24) *40% of range
Free T3.........3.9 pmol/L (2.6-6.6) *33 % of range
TPO Abs... .....25 IU/mL (less than 5.7) *elevated
TG Abs........76.1 IU/mL (less than 4.1) *elevated
Reverse T3....449 pmol/L (170-450) *FT3/RT3 Ratio 0.008

Optimal FT4 is top 25% of range
Optimal FT3 is top of Range
Hashimotos confirmed by elevated Antibodies
Reverse T3 Dominance confirmed optimal ratio greater than 0.02

===================================================
Blood Sugars

Fasting Glucose
8th Dec ’94..........5.3 mmol/L (3.5-6)
28th April’03........5.4 mmol/L (3-5.4) *top of range
16th November'04..5.0 mmol/L (3-5.4)
6th July'05...........5.3 mmol/L (3-5.4) *near top of range
29th April'06.........5.3 mmol/L (3-5.4) *near top of range
17th September'08
Insulin (fasting)..........14 mU/L (less than 20) *good
Glucose(fasting) .......5.2 mmol/L (3.5-5.4) *good
Ratio.................... 6.7 (Insulin Resistance less than 4.5/Normal greater than 10/Borderline 4.6-10)

Borderline Insulin Resistant Result

===================================================
Hormones

17th September'08
FSH.......................2 U/L (1-15) *low in range
LH........................2 U/L (1-9) *low in range
E2........................74 pmol/L (40-160)

==================================================
Androgens

ANDROGEN PANEL
Desirable FAI greater than 70
DHEAS & Testosterone top 25% of YOUTHFUL Range
SALIVARY TESTOSTERONE
27th July’02.............0.2 nmol/L (0.3-.08)
2nd Oct’02..............7.1 nmol/L (0.3-.08)
20th Nov’02...........27.1 nmol/L (0.3-.08)
6th July’02
Testosterone......15.4 nmol/L .(8-56) *15% in range
SHBG ..............34.3 nmol/L .(10-70) .*41% in range
FAI .................4.9 ...........(30-150) .*12% in range
2nd Oct’02
Testosterone.......19.9 nmol/L (9-35) *42% in range
SHBG .................42 nmol/L (10-50) *80% in range
FAI .................47.4 .........(22-100) *33% in range
20th Nov’02
Testosterone.....18.5 nmol/L (9-35) *35% in range
SHBG ...............33 nmol/L .(10-50) *58% in range
FAI ...............56.1 ..........(22-100) *44% in range
DHEAS ............2.7 umol/L (2.2-15.2) *4% in range
1st Feb’03
Testosterone.......5.1 nmol/L (9-35) ...*DEFICIENT
SHBG ................30 nmol/L (10-50) ...*50% in range
FAI ...................17 .........(22-100) ...*DEFICIENT
DHEAS ............11.2 umol/L (2.2-15.2) .*69% in range
6th Dec’03 *on DHEA supplementation
Testosterone........15.4 nmol/L (9-35) ...*25% in range Suboptimal
SHBG ...................29 nmol/L (10-50) ...*48% in range
FAI ...................53.1 .........(22-100) ...*40% in range
DHEAS ...............19.1 umol/L (2.2-15.2) .*elevated
12th September’05
Testosterone..........9.9 nmol/L (10-35) .*DEFICIENT
SHBG ...................39 nmol/L (10-50) ...*48% in range
FAI ....................25.4 ........(22-100) ... *4% in range
DHEAS .................2.7 umol/L (2.6-14) . *bottom of range
Free Test..............170 pmol/L (225-725) *DEFICIENT
17th September'08
Testosterone..........14.3 nmol/L (9.9-27.8) *20 % of youthful range of (9-35)
SHBG ....................36 nmol/L (14-50) *61% in range
FAI .......................40.........(34-106) *below 50 needs HRT
DHEAS .................2.8 umol/L (1.2-8.98) *10% of youthful range of (2.2-15.2)
Free Test .............277 pmol/L (204-637) *17% in range
DHT....................4.9 nmol/L (1.2-4.7) *slightly elevated
Testosterone (Free & Total) & DHEAS all very low in range
DHT slightly elevated
==================================================
Prostate Specific Antigen

27th July ’02.........0.8 ug/L (less than 2.3)
28th April’03........0.7 ug/L (0.2-5)
6th Dec’03............0.8 ug/L (less than 2.3)
6th July’05............0.8 ug/L (0-3.5)
29th April’06........0.8 ug/L (0-3.5)
17th Sept'08.........1.1 ug/L (0-3.5) *excellent

==================================================
Lipids
Goal LEF ideal range 4.66 to 5.18 mmol/L
Total Cholesterol has varied between 4.1- 6.1
Dr Sandra Cabot suggests minimum Total Cholesterol 4.6

26th Oct’99
Total Chol ....6.1 mmol/L (less than 5.5) .... *elevated
Tri's ............0.8 mmol/L (less than 2) ......
HDL ............1.4 mmol/L (greater than 1) ... *far from ideal need higher
LDL ............4.3 mmol/L (less than 3.5) *elevated
HDL/LDL.....0.23
Risk ratio......4.3 .............(less than 5)
13th May’00
Total Chol ....5.2 mmol/L (less than 5.5)
Tri's ............0.8 mmol/L (less than 2)
HDL ............1.3 mmol/L (greater than 1) *far from ideal need higher
LDL ............ 3.6 mmol/L (less than 3.5) elevated
HDL/LDL.....0.36
Risk ratio......4.0 .............(less than 5)
27th Jan’01
Total Chol .....5.9 mmol/L (less than 5.5) *elevated
Tri's ............1.3 mmol/L (less than 2)
HDL ............1.1 mmol/L (greater than 1) *far from ideal need higher
LDL ............4.2 mmol/L (less than 3.5) *elevated
HDL/LDL.....0.32
Risk ratio.....5.4 .............(less than 5) *elevated
22nd Aug’01
Total Chol .....4.1 mmol/L (less than 5.5) *far too low
Tri's ............2.0 mmol/L (less than 2)
HDL ............1.1 mmol/L (greater than 1) ... *far from ideal need higher
LDL ............ 2.1 mmol/L (less than 3.5)
HDL/LDL......0.52
Risk ratio......3.7 .............(less than 5)
10th April’02
Total Chol .....5.3 mmol/L (less than 5.5)
Tri's ............0.8 mmol/L (less than 2)
HDL ............1.2 mmol/L (greater than 1) *far from ideal need higher
LDL ............ 3.7 mmol/L (less than 3.5) *elevated
HDL/LDL.....0.32
Risk ratio......4.4 .............(less than 5)
6th July’02
Total Chol .....5.7 mmol/L (less than 5.5) ....*elevated
Tri's ............1.0 mmol/L (less than 2) .....
HDL ............0.9 mmol/L (greater than 1) *DEFICIENT
LDL ............ 4.3 mmol/L (less than 3.5) *elevated
HDL/LDL......0.21
Risk ratio......6.3 ..........(less than 5) *elevated
28th April’03
Total Chol .....4.8 mmol/L (less than 5.5) .....*OK
Tri's ............0.9 mmol/L (less than 2)
HDL ............1.0 mmol/L (greater than 1) *far from ideal need higher
LDL ............ 3.4 mmol/L (less than 3.5)
HDL/LDL.....0.29
Risk ratio......4.8............ (less than 5)
5th Nov’03
Total Chol ....4.7 mmol/L (less than 5.5) ..... *OK
Tri's ............0.8 mmol/L (less than 2) .....
HDL ............1.0 mmol/L (greater than 1) *far from ideal need higher
LDL ............ 3.3 mmol/L (less than 3.5)
HDL/LDL......0.30
Risk ratio.......4.7 ............ (less than 5)
10th June’04
Total Chol ....4.1 mmol/L (less than 5.5) ..... *far too low
Tri's ............0.9 mmol/L (less than 2) .....
HDL ............0.9 mmol/L (greater than 1) *far from ideal need higher
LDL ............ 2.8 mmol/L (less than 3.5)
HDL/LDL......0.32
Risk ratio......4.6 ........... .(less than 5)
16th Nov'04
Total Chol .......4.2 mmol/L (less than 5.5) *far too low
Tri's ..............1.1 mmol/L (less than 2)
HDL ..............0.8 mmol/L (greater than 1) *deficient
LDL ..............2.9 mmol/L (less than 3.5)
HDL/LDL.........28
Risk ratio.......5.3 ........... .(less than 5) *elevated
6th July'05
Total Chol .......4.7 mmol/L (less than 5.5) *far too low
Tri's ..............1.0 mmol/L (less than 2)
HDL ..............1.2 mmol/L (greater than 1) *far from ideal need higher
LDL ..............3.0 mmol/L (less than 3.5)
HDL/LDL.......0.40
Risk ratio........3.9 ..........(less than 5) *elevated
29th April'06
Total Chol .............3.7 mmol/L (less than 5.5) *far too low
Tri's ....................1.2 mmol/L (less than 2)
HDL ....................0.8 mmol/L (greater than 1) *far from ideal need higher
LDL ....................2.4 mmol/L (less than 3.5)
HDL/LDL.............0.33
Risk ratio..............4.6 ...........(less than 5) *elevated
17th September'08
Total Chol ..............5.8 mmol/L (less than 5.5) *slightly elevated
Tri's .....................1.4 mmol/L (less than 1.8) *fine
HDL .....................1.2 mmol/L (greater than 1) *far from ideal need higher
LDL ............ .........4.0 mmol/L (less than 3.5) *little high
HDL/LDL...............0.30
Risk ratio...............4.8 ...........(less than 3) *elevated

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Haematology

8th Dec’94
Haemaglobin ......1..5.4 g/dL. (12.5-17)
Haematocrit (PCV).... 48.5% (39-55)
MCV .....................88.5 fL ..(79-98)
RCC.....................xxxx (4.5-6)
RDW ...................xxxx (10-15)
MCH .................28.1 pg ... (26-32)
MCHC ..............31.8 g/dL (31-35)
WCC .............6.7x10`9/L (4-11)
Neutrophils ...51% 3.42x10`9/L (2-7.5)
Lymphocytes..32% 2.14x10`9/L (1.5-4)
Monocytes .....13% 0.87x10`9/L (0.1-0.8) *elevated
Eosinophils.....4% 0.27x10`9/L (0.04-0.45)
Basophils........0% 0x10’9/L.....(0-0.2)
Platelets........220x10`9/L (140-400)
ESR ..................3 mm/h ..(0-10)
26th October’99
Haemaglobin .........163 g/L (130-180)
Haematocrit (PCV) 0.48 (0.40-0.54)
MCV .......................89 fL ..(82-98)
RCC.............. 5.4x10’2/L (4.5-6)
RDW ...................xxxx (10-15)
MCH ...................30 pg ... (27-32)
MCHC ...............340 g/L (310-350)
WCC .............5.7x10`9/L (4-11)
Neutrophils ....3.4x10`9/L (2-7.5)
Lymphocytes..1.5x10`9/L (1.5-4)
Monocytes .....0.5x10`9/L (0.2-1.2)
Eosinophils.....0.2x10`9/L (0-0.4)
Basophils.............0.1 n/L ..(0-0.1)
Platelets........207x10`9/L (150-400)
ESR ......................9 mm/h ..(0-10) *high in range
27th July’02
Haemaglobin .........158 g/L (130-180)
Haematocrit (PCV) 0.47 (0.40-0.54)..
MCV .......................90 fL ..(80-100) ..
RCC.............. 5.3x10’2/L (4.5-6.5) .
RDW ...................11.6 (10-15)..
MCH ...................30 pg ... (27-32)...
MCHC .................34% (31-36)
WCC .............5.9x10`9/L (4-11)
Neutrophils ....3.4x10`9/L (2-7.5)
Lymphocytes..1.8x10`9/L (1.2-4)
Monocytes .....0.5x10`9/L (0.2-0.8)
Eosinophils.....0.2x10`9/L (0-0.5)
Basophils...less than 1 n/L ..(0-0.1)
Platelets........237x10`9/L (150-400)
ESR ......................1 mm/h ..(0-15)
20th Nov’02
Haemaglobin .........152 g/L (130-180)
Haematocrit (PCV) 0.45 (0.40-0.54)..
MCV .......................88 fL ..(80-100) ..
RCC.............. 5.1x10’2/L (4.5-6.5) .
RDW ...................11.4 (10-15)..
MCH ...................30 pg ... (27-32)...
MCHC .................34% (31-36)
WCC .............5.9x10`9/L (4-11)
Neutrophils ....3.4x10`9/L (2-7.5)
Lymphocytes..1.8x10`9/L (1.2-4)
Monocytes .....0.5x10`9/L (0.2-0.8)
Eosinophils.....0.1x10`9/L (0-0.5)
Basophils...less than 1 n/L ..(0-0.1)
Platelets........189x10`9/L (150-400)
ESR ......................1 mm/h ..(0-15)
20th Nov’02
Haemaglobin .........152 g/L (130-180)
Haematocrit (PCV) 0.45 (0.40-0.54)..
MCV .......................88 fL ..(80-100) ..
RCC.............. 5.1x10’2/L (4.5-6.5) .
RDW ...................11.4 (10-15)..
MCH ...................30 pg ... (27-32)...
MCHC .................34% (31-36)
WCC .............5.9x10`9/L (4-11)
Neutrophils ....3.4x10`9/L (2-7.5)
Lymphocytes..1.8x10`9/L (1.2-4)
Monocytes .....0.5x10`9/L (0.2-0.8)
Eosinophils.....0.1x10`9/L (0-0.5)
Basophils...less than 1 n/L ..(0-0.1)
Platelets........189x10`9/L (150-400)
ESR ......................1 mm/h ..(0-15)
6th Dec’03
Haemaglobin .........161 g/L (130-180)
Haematocrit (PCV) 0.48 (0.40-0.54)..
MCV .......................89 fL ..(80-100) ..
RCC.............. 5.4x10’2/L (4.5-6.5) .
RDW ...................12.2 (10-15)..
MCH ...................30 pg ... (27-32)...
MCHC .................33% (320-360)
WCC .............5.9x10`9/L (4-11)
Neutrophils ....3.4x10`9/L (2-7.5)
Lymphocytes..1.8x10`9/L (1.2-4)
Monocytes .....0.6x10`9/L (0.1-1.2)
Eosinophils.....0.2x10`9/L (0-0.5)
Basophils
Platelets........210x10`9/L (150-400)
ESR ......................1 mm/h ..(0-15)
17th September'08
Haemoglobin .........150 g/L (130-180)
RCC.............. 5.2x10`12/L (4.5-6.5)
Hematocrit ...............0.45 (0.4-0.54)
MCV .......................88 fL (80-100)
MCH.......................29 pg (27-32)
MCHC ...................331g/L (310-360)
RDW .........................13 (10-15)
Platelets .........199 x10`9/L (150-400)
WCC ..............6.3 x10`9/L (4-11)
Neutrophils ......3.1 x10`9/L (2-7.5)
Lymphocytes.... 2.1 x10`9/L (1.2-4)
Monocytes .......0.8 x10`9/L (0.2-1)
Eosinophils.......0.3 x10`9/L (0-0.5)
Basophils ........0.1 x10`9/L (0-0.1)
ESR.....................3 mm/h (0-15)
2nd December'08
Haemoglobin .........161 g/L (130-180)
RCC.............. 5.4x10`12/L (4.5-6.5)
Hematocrit ...............0.49 (0.4-0.54)
MCV .......................90 fL (80-100)
MCH.......................30 pg (27-32)
MCHC ...................330g/L (310-360)
RDW .........................13 (10-15)
Platelets .........214 x10`9/L (150-400) *is this a bit on low side?
WCC ..............5.1 x10`9/L (4-11)
Neutrophils ......3.0 x10`9/L (2-7.5)
Lymphocytes.... 1.4 x10`9/L (1.2-4)
Monocytes .......0.5 x10`9/L (0.2-1)
Eosinophils.......0.2 x10`9/L (0-0.5)
Basophils ........0.0 x10`9/L (0-0.1)
ESR.....................1 mm/h (0-15) *good

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Iron Studies

27th July’02
Ferritin................143 ug/L (30-450) *too high optimal ~90
17th September'08
Ferritin optimal ~80-100
Total Iron...............14 umol/L (8.1-28.6)
Transferrin ............28 umol/L (25-45.4)
TFN Satn ..............25% ........(10-45%)
Ferritin ...............419 ug/L... (30-450) *FAR too high test

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HFE Gene Mutation
2nd December'08........ negative for C282Y & H63D mutations

====================================================
PROLACTIN
27th July’02.............80 mIU/L (less than 300) *27% in range
2nd December'08......118 mlU/L (54-380) *20% in range

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VITAMIN B12

27th July’02........462 ng/L (greater than 250)
converts to
27th July'02.........341 pmol/L (139-651) *39% of range far too low
2nd December'08...324 pmol/L (139-651) *36% of range far too low
====================================================
VITAMIN D (25-OHD)
2nd December’08.......77 nmol/L (50-150)

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FOLATE RED BLOOD CELL
27th July’02.........472 ug/L (greater than 280) *27% in range far too low
2nd December'08...569 ug/L (267-1023) *40% in range far too low

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MTHFR Gene Mutation testing
2nd December'08......negative

=====================================================
LIVER FUNCTION TESTS

8th Dec’94
AST................22 U/L.......(0-40)
ALT ...............37 U/L.......(0-50)
ALP ...............51 U/L.......(35-135)
GGT ..............30 U/L ......(0-65)
Total Bilirubin....8 umol/L...(less than 20)
Protein ..........71 g/L .......(63-83)
Albumin ........43 g/L .......(35-50)
26th Oct’99
AST................25 U/L.......(0-40)
ALT ...............40 U/L.......(0-40)
ALP ...............55 U/L.......(0-135)
GGT ..............38 U/L ......(0-65)
Total Bilirubin..12 umol/L...(0-20)
Protein ..........75 g/L .......(63-80)
Albumin ........39 g/L .......(35-50)
Globulin.........36 g/L .......(20-35) *elevated
10th April’02
AST................14 U/L......(less than 45)
ALT ...............46 U/L......(less than 40) *elevated
ALP ...............52 U/L......(0-135)
GGT ..............44 U/L .....(0-65)
Total Bilirubin...14 umol/L..(less than 20)
Protein ..........71 g/L ......(63-80)
Albumin ........42 g/L .......(35-50)
Globulin.........32 g/L........(20-35)
27th July’02
AST................19 U/L.......(less than 45)
ALT ...............45 U/L.......(less than 40) *elevated
ALP ...............60 U/L.......(30-140)
GGT ..............35 U/L ......(less than 50)
Total Bilirubin.10 umol/L...(less than 20)
Protein ..........72 g/L .......(63-83)
Albumin ........41 g/L .......(35-50)
Globulin.........31 g/L........(20-40)
2nd Oct’02
AST................27 U/L.......(less than 45)
ALT ...............48 U/L.......(less than 40) *elevated
ALP ...............58 U/L.......(30-140)
GGT ..............41 U/L ......(less than 50)
Total Bilirubin....8 umol/L...(less than 20)
Protein ..........71 g/L .......(63-83)
Albumin ........42 g/L .......(35-50)
Globulin.........29 g/L........(20-40)
6th Dec’03
AST................27 U/L.......(less than 45)
ALT ...............54 U/L.......(less than 40) *elevated
ALP ...............48 U/L.......(30-140)
GGT ..............45 U/L ......(less than 50)
Bilirubin..........11 umol/L.. (less than 20)
Protein ..........72 g/L .......(63-83)
Albumin .........42 g/L .......(35-50)
Globulin.........30 g/L........(20-40)
1st Feb’03
AST................24 U/L.......(less than 45)
ALT ...............37 U/L.......(less than 40)
ALP ...............55 U/L.......(30-140)
GGT ..............34 U/L ......(less than 50)
Bilirubin...........7 umol/L.. (less than 20)
Protein ..........73 g/L .......(63-83)
Albumin ........42 g/L .......(35-50)
Globulin.........31 g/L........(20-40)
2nd December’08
AST................19 U/L.......(10-40)
ALT ...............24 U/L.......(5-40)
ALP ...............51 U/L.......(30-110)
GGT ..............27 U/L ......(5-50)
Bilirubin...........9 umol/L..(4-120)
Protein ..........74 g/L .......(63-80)
Albumin .........42 g/L .......(36-47)
Globulin..........32 g/L........(23-39)

====================================================
KIDNEY FUNCTION TEST
2nd December'08
Urea...................6.4 mmol/L (2.5-8)
Creatinine............105 umol/L (62-115)
Sodium................145 mmol/L (134-146)
Potassium.............4.7 mmol/L (3.5-5.4)
Chloride...............110 mmol/L (95-108) **slightly elevated
Bicarbonate............26 mmol/L (21-32)
eGFR...................68 ((greater than 60) *60-89 mild Kidney damage
Anion Gap...........13.7 (8-16)
BUN.................17.93 (8-20)
===================================================
AUTOANTIBODY INVESTIGATION
17th September ‘08
Antinuclear Antibodies (ANA)..........Positive Speckled Pattern (Titre 1.40)

====================================================
INFLAMMATORY MARKERS

Homocysteine
2nd December’08............12.3 umol/L (5-12) *elevated
hsCRP
2nd December’08.............2.25 mg/L (less than 5) *1-3 is average risk

================================================================
COAGULATION STUDIES

Fibrinogen
2nd December’08................2.9 g/L (2-4.5) *good
=====================================================
EBV

13th August'02
IgG.............................positive test *consistent with previous exposure
======================================================
Hepatitis
13th August'02
Hep A, B C Abs...............all negative

=====================================================
HIV 1 & 2 Abs
tested twice 1993 & 1999 both negative

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

 

[eeso]

For at least 6 months, put all the time he and you would have spent on researching meds and going to doctors into exercising and eating healthily. Exercising must include both walking->running and weight sessions.

 

[hardasnails1973]

AMen,
Those words are music to my ear.
First of all clean up his eating, and then have him run glucose and insulin tolerance tests 3 hours
Your lipids are screaming it backed by several elevated readings.
Who ever told fasting insulin of 14 is good you better run and run far because that is a red flag for severe insulin resistance !!
Run the glucose insulin test I bet his insulin pushes 150 plus in the first hour !!
I do not look at past labs because I am only interests in the present readings. As you can see there was a rapid decline in dhea from years back. So again low dhea can be imparied by elevated cortisol and also this leads into insulin resistance and diabetes. With proper testing which I have been stressing pretty every client to look for nutrient imbalances could be a simple solution to insulin resistance as it has been the case in over 80% of my clients. Just from one test i can pretty much predict how insulin sensitive or resistant a person is. That measiliy dosage of fish oils is not doing crap to help his lipids. My proper balancing out the cellular membrane peoples lipids profiles have improved 100-200 % in less then 4 months. If lipids are high eat more soluable fiber. Again it goes back to a perosn eating patterns. 90% of people lipid profile can be siimple altered by increaseing fiber and lower fat intake (getting in the right ratio and by passing metabolic blocks) that most prediabetics (including your DH)..If he is over weight then by losing 7% of your body weight will reduce your chances of heart disease by a large percentage. First thing I would do is detox his systems work on correcting his nutritoinal balance, and practice stress reduction ...

 

[Lethal Lee]

AMen,
Those words are music to my ear.
First of all clean up his eating, and then have him run glucose and insulin tolerance tests 3 hours
Your lipids are screaming it backed by several elevated readings.
Who ever told fasting insulin of 14 is good you better run and run far because that is a red flag for severe insulin resistance !!
Run the glucose insulin test I bet his insulin pushes 150 plus in the first hour !!
I do not look at past labs because I am only interests in the present readings. As you can see there was a rapid decline in dhea from years back. So again low dhea can be imparied by elevated cortisol and also this leads into insulin resistance and diabetes. With proper testing which I have been stressing pretty every client to look for nutrient imbalances could be a simple solution to insulin resistance as it has been the case in over 80% of my clients. Just from one test i can pretty much predict how insulin sensitive or resistant a person is. That measiliy dosage of fish oils is not doing crap to help his lipids. My proper balancing out the cellular membrane peoples lipids profiles have improved 100-200 % in less then 4 months. If lipids are high eat more soluable fiber. Again it goes back to a personal eating patterns. 90% of people lipid profile can be siimple altered by increasing fiber and lower fat intake (getting in the right ratio and by passing metabolic blocks) that most prediabetics (including your DH)..If he is over weight then by losing 7% of your body weight will reduce your chances of heart disease by a large percentage. First thing I would do is detox his systems work on correcting his nutritoinal balance, and practice stress reduction ...

Hi & Thanks Eeso & HAN,

Weight & Exercise

DH is not overweight he has been the same weight for well over a decade. However Fat/muscle ratio has certainly changed & likely a result of his abysmal Androgens. He is the only breadwinner in the family as I havent been able to work for over a decade. I have similar problems to him but was/am a lot more symptomatic. Both our 16yo twin sons are Hypopit with Hashis, AI & ADD too. They are about to start Thyroid & Adrenal meds this week (have had ALL the testing). So he is under a lot of emotional/financial pressure thats for sure. W cant afford for him to stop working wouldnt be able to afford any medicine supps or Docs at all & would lose the house as well.

DH used to do swimming as his regular exercise. This has dropped by the wayside due to lack of time (as he was promoted required longer hours & evening work). Also as my own health demands increased & those of the twins he has had to takeover main responsibility for cooking, household cleaning & maintenance. I have been able to restart some chores in a minor way only recently. Now its not just time its a matter of NO energy/stamina as well.

It is all he can do to keep working it is a responsible well paid job but he does work fairly long hours. No way he has energy or time for formal exercise or weight training. In fact with his numbers I think it would be detrimental to his health & make matters worse. We are both trying to do some walking though & will try to gradually increase as long as Adrenals dont get more stressed by that. I hope Adrenal meds will increase his ability to exercise & they will be started once ACTH Stim is done & if they support blood & Saliva results indicating low ACTH & low Cortisol.

FishOil

Whats wrong with the amount of Fish Oil DHA/EPA he is on?

We are all using Nordic Naturals ProEPA as it is the HIGHEST amount of DHA/EPA that I have been able to find. It is also extremely expensive. The recommended dose is 2 caps a day but as 4 of us have to be on it we simple cant afford that so take 1 cap daily.

We actually dont eat fish or seafood at home either due to my Mercury Toxicity. DH has 2 Amalgams as well. I am trying to persuade him to get them removed (with appropriate precautions).

Cholesterol

I dont think his total Cholesterol is too bad at all. I dont buy into the keep Cholesterol very low propaganda!!! Interestingly myself & both our sons have OPPOSITE problem of low Cholesterol. I do agree he need to up his HDL & reduce LDL & Tri's. We already eat good amount of Fibre so dont think thats an issue. I thought Lipid issues tie into HypoThyroid & improve once Thyroid is treated? Certainly many say their numbers improved.

Note DH used to be on Zocor but hasnt been for about 4 years or so. He was never told about COQ10 being depleted by the Statins either!!! I have had him on COQ!) for the past 2 years.

Cleaning Up Diet

We HAVE all made many changes to diet & cleaned that up years ago when my health problems first started. He rarely drinks, we only have occassional takeaways, use Coconut Oil for all cooking, use organic butter, eat organic free range eggs, have lean red meat 3-4 times a week., we rarely have sweets or confectionary. We do have a little Ginger Beer on occassion but far less Soda than we used to. We are all eating much better with fruit & veges than we were but there is certainly some room for further improvement there. We cant afford organic meat & veges it is way too expensive.

In fact DH is the one that does all grocery shopping & most of the cooking due to my ill health.

DH does tend to rely on Coffee a bit for energy but I'm sure with Adrenal meds he will be able to greatly reduce that. Interestingly Coffee does block Iron uptake. Imagine how high his Ferritin would be IF he didnt have 3-4 (weak) cups a day?

Nutritional Deficiencies & Detox

We ARE working on nutritional deficiencies that we are aware of. Folinic Acid, B12, Magnesium, Multi-B's all being supped. I will add Chromium Picolinate.

He IS being detoxed with Vit D, ALA, Vit E, Milk Thistle, Garlic tabs, Olive Leaf Extract & has been on these for some time. I waited to test Ferritin before considering Vit C & with his Ferritin at over 400 will NOT be using Vit C at all. His most recent LIver numbers look good. My only concern is with his constipation issues despite being on good Probiotics as well. I think I'll try him on Thornes BPP (HCl & Pancreatin) digestive enzymes & see if that helps.

Blood Sugars

There is also no way that the Doc will agree to GTT or ITT testing with those Blood Sugar numbers. As I indicated above he is classed as borderline IR. It is the first time Insulin was tested although Glucose was tested several times & seems to remain pretty much the same.

I may be able to persuade Doc to do A1c do you think thats worth doing? I will also start him on Chromium Picolinate it certainly helped my Insulin levels which were a LOT worse than his. Do you need to do Fasting Insulin & Glucose at same time as A1c? I asssume its best done early am fasting too? I thought Blood Sugar issues are tied into HypoAdrenal issues too? Wont treating the low Andogens & Cortisol help blood Sugar regulation too?

Hypopit/Hypoadrenal/Hypothyroid

I thought DH's results indicate Hypopit?
Certainly they indicate Hypogonadal, Secondary AI, Secondary Hypothyroid and Hashimotos too.

How is diet & exercise ALONE going to help those?

Doesnt he need HRT for all those? Hypopit cant be 'cured' by lifestyle changes!!!!! In any case we HAVE made many lifestyle changes including diet already. I think his numbers are pretty well the best we are gonna get without HRT.

Ferritin

What about his very high Ferritin? Any idea what could be causing that?

Would he benefit from donating blood to get that down? The only indication of inflammation was slightly elevated Homocysteine. I plan to ask for a repeat Iron Studies to recheck the Ferritin levels. Blood donations can only be done every 3 months (4 times a year) here unless you have Hemochromatosis DX (which I do by the way). It will take a lot more than 4 phlebs to bring down Ferritin from current >400 to around 100 which is considered optimal (assuming not increased by infection/underlying inflammatory conditions).

Final Comments

I was hoping to get advice & suggestions regarding his Androgens & other Sex Hormones in particular from this Forum. Have you got any comments on those? Do you agree his Androgens need HRT? He will be doing ACTH Stim in January & I was thinking as he is likely Hypopit correct order of treatment would be Adrenals, Androgen HRT, then Thyroid .

Phil thought his E2 was fine & not an issue?

I notice some get Progesterone tested though Phil didnt suggest it. Should we get that tested too?

What about the DHT is the slight elevation there a concern.

Phil suggested he would benefit from HCG but I am not sure IF it is avalable here yet. Do you agree he would benefit? What about DHEA & Testosterone? I know I can get him HRT for those note BOTH are RX only in Australia.

What are the consequences of doing HRT without HCG? I know about fertility & 'ball shrinkage' side effects. However he is 52 & has had a Vasectomy so fertility is NOT an issue. Ball shrinkage then is only a cosmetic concern then isnt it? I have read that HCG in combination with Androgen HRT does work a lot better for Secondarys is that right? Assuming I can source the HCG & I can convince DH to do injections that is.

Further Testing
Note ACTH Stim expected to be done in January
Will try & get A1c testing & repeat Blood Sugars
Repeat Iron Studies.
Will be getting Hair Analysis done in Januray.

Note there is no Rheins Urine testing, Spectracell or EFA type testing available in Australia that I am aware of (we live in Perth Western Australia).

 

[eeso]

I am in Australia, and I'm also hypopituitary (empty sella syndrome), and my labs are much worse than his. To be honest i dont think his labs are that bad at all.

I can attest that reducing stress is critical in regaining better health.

I tried dhea, hydrocortisone, armour etc (i had low thyroid, dhea, and cortisol readings) but in the end those meds did more harm than good to me and I felt terrible on them. What did work was moving to a less stressful environment and focusing on diet and exercise. Granted, I was also on TRT which I'm sure helped rest my adrenals. I've recently just stopped TRt though so we'll see how that goes. I'm not expecting miracles I just had to cease it for a while to get hairloss under control until I decide on a path for reducing DHT conversion.

Sounds like you're on track with the diet, but its the lifestyle which is still a problem with long hours etc.

Has he had blood test for e2 and testosterone? And LH + FSH?

He looks like he has reverse T3 - is it possible to use a wilson protocol and take just T3 until the reverse clears, then come off it?

 

[Lethal Lee]

I am in Australia, and I'm also hypopituitary (empty sella syndrome), and my labs are much worse than his. To be honest i dont think his labs are that bad at all.

I can attest that reducing stress is critical in regaining better health.

I tried dhea, hydrocortisone, armour etc (i had low thyroid, dhea, and cortisol readings) but in the end those meds did more harm than good to me and I felt terrible on them. What did work was moving to a less stressful environment and focusing on diet and exercise. Granted, I was also on TRT which I'm sure helped rest my adrenals. I've recently just stopped TRT though so we'll see how that goes. I'm not expecting miracles I just had to cease it for a while to get hairloss under control until I decide on a path for reducing DHT conversion.

Sounds like you're on track with the diet, but its the lifestyle which is still a problem with long hours etc.

Has he had blood test for e2 and testosterone? And LH + FSH?

He looks like he has reverse T3 - is it possible to use a wilson protocol and take just T3 until the reverse clears, then come off it?

Hi Eeso,

All his Labs were in first post. For convenience I'll repeat pertinant onesb
======================================================
Androgens
17th September'08
Testosterone..........14.3 nmol/L (9.9-27.8) *20 % of youthful range of (9-35)
SHBG ....................36 nmol/L (14-50) *61% in range
FAI .......................40.........(34-106) *below 50 needs HRT
DHEAS .................2.8 umol/L (1.2-8.98) *10% of youthful range of (2.2-15.2)
Free Test .............277 pmol/L (204-637) *17% in range
DHT....................4.9 nmol/L (1.2-4.7) *slightly elevated
Testosterone (Free & Total) & DHEAS all very low in range
DHT slightly elevated

Hormonal Panel
17th September'08
FSH.......................2 U/L (1-15) *low in range
LH........................2 U/L (1-9) *low in range
E2........................74 pmol/L (40-160)
FSH & LH both very low in range despite very low Testosterone & DHEAS

Salivary Cortisol
10th Oct'08
8am..........22 nmol/L (6-42) *44% of range TOO LOW
Midday....11.2 nmol/L (2-15) *71% of range
4pm.......10.6 nmol/L (2-11) *95% of range
8pm....... 5.5 nmol/L (1 - 8) *65% of range
Cortisol Burden...49.3 (11-76) *60% of range
AM Cortisol is far from optimal at only 44% in range

ACTH
2nd December08
9am......6.4 pmol/L (1.6-13.9) *39% in range
ACTH is far from optimal at only 39% in range

ALDOSTERONE
2nd December08
9am (Salt fasting)..............347 pmol/L (100-950) *29% in range
Aldosterone far from optimal at only 29% in range

RENIN
2nd December08
9am Salt Fasting.................21 mU/L (3.3-41) *47% in range

Electrolytes
2nd December08
Sodium................145 mmol/L (134-146) *good
Potassium.............4.7 mmol/L (3.5-5.4) *pretty good

PROLACTIN
2nd December'08......118 mlU/L (54-380) *20% in range
Very low in range

Thyroid Tests
17th September'08
TSH............1.28 mU/L (0-4)
Free T4..........15 pmol/L (9-24) *40% of range
Free T3.........3.9 pmol/L (2.6-6.6) *33 % of range
TPO Abs... .....25 IU/mL (less than 5.7) *elevated
TG Abs........76.1 IU/mL (less than 4.1) *elevated
Reverse T3....449 pmol/L (170-450) *FT3/RT3 Ratio 0.008
Looks pretty HypoT to me!!!!!
Optimal FT4 is top 25% of range his isonly 40%
Optimal FT3 is top of Range his is only 33%
Hashimotos confirmed by elevated Antibodies BOTH TPO & TG Abs
Reverse T3 Dominance confirmed optimal ratio greater than 0.02
=======================================================

His very low in range Free Testosterone, DHEAS together with low FSH/LH looks Secondary Hypogonadal to me. His Estradiol looks OK as far as I can tell. You mention you were on TRT? Did you try HCG yourself? Is it available in Australia for Hypogonadal treatment? Where in Australia do you live if you dont mind me asking?

Thyroid results show he is pretty Hypothyroid. In any case he has Hashis so needs NTH (Aussie Armour) to fully suppress TSH (and Abs hopefully) & optimise frees. I realise he has RT3 Dominance on these numbers. However we cant afford Tertroxin (Aussie T3 med) for him at present so will be trying NTH first. Hormonal Doc has suggested SR T3 but I have heard little good about it so dont wish to try that on the kids or him. In fact I am on Tertroxin for RT3 dominance but qualify for Authority script (demonstrated T4 resistence) so is cheaper. His low TSH with low Frees suggest he has Secondary Hypothyroid with Hashis combo.

His Saliva am (Free) Cortisol at only 44% in range shows at least mid range severity AI to me too. Certainly his ACTH at only 39% in range is suboptimal. The low am Cortisol with low ACTH suggests Hypopit as does low Androgens & lowFSH/LH, as does low TSH & Frees. His blood (Total ) Cortisol doesnt look too bad. However thats TOTAL not FREE Cortisol & Saliva Cortisol results are superior. The Lab Range on blood Cortisol is pretty low too.

Prolactin is low too at 20% in range.

Regarding reducing stress the real stressor is due to family illness/conditions (myself, twins & DH himself). That causes both financial, emotional & physical demands on him. We are doing our best to deal & treat those but nothing more can be done to reduce stress there. except for us to get well or at least be well managed health wise.

As far as work stress it is actually much better than it was a couple of years ago. He used to do a LOT of travel (intrastate interstate & overseas). That is now reduced to once every 12 months or so. He changed to this job just over 2 years ago it is much more secure with better benefits (is a government job) & better pay than previous job. We also had a small home business & our own company. DH was working full time in a different more demanding job as well as doing the business. We realised the extra stress & hours involved in that was too much for both of us & let the business go. Thats when he changed jobs too. We refinanced ,quit loans, consolidated debts, downgraded homes to releive as much financial stress as we could as well.

Cant see what else we can do to reduce stress further (except get health DX'ed & treated). He cant afford to lose this job & with the economic downturn he is lucky to have it. Without it as I say we would lose our home & have to give up medical/health insurance & much more too.

Surely its time with his numbers & symptoms to do HRT of some kind. We feel we have done all we can to minimise stress & made many diet changes already. He has some tweaking to do with B12 & Folate to reduce Homocysteine. Also some tweaking to improve blood sugars & perhaps HDL/LDL ratios. But none of this is going to fix his Hypogonadism, Hashis & Hypothyroid, nor his Adrenal Fatigue!!!! Especially if it IS Hypopit in origin?

 

[hardasnails1973]

To answer your question is he a candidate for TRT
Second TRT may help the adrenals rest but will also deplete DHEA even lower, and if you are low cortisol it will lower it even further. Dr give TRT to people that have low adrenals is asking for diaster. Treating the adrenals and thyroid first then sex hormones is the proper order.
So supplementing DHEA with TRT keeping check on E:T ratio keeping it >1:20 , but also be more focused on bioavailable..

I have people come to me tuned up on TRT, but there adrenals or thyroid are imbalanced causing the TRT not be be effective at the tissue level. Treating the TRT should help the insulin resistance over time as cellular changes take place. As always I put emphasis on Stress reduction, sleep quality, and lifestyle changes in conjucntion with HRT. Him being 52 his test will most likely not return to health levels with out TRT. If he is low on folinic acid then this could be an indicator that he is b-12 defieincy or b-12 biounavailable to impaired methylation possible due to TOxins..his vitamin D levels are probably about 30-40 if that if he is lucky. due to your wonderful gov't scaring people about skin cancer..80% of australia is not vitamin D defieint.

 

[eeso]

Yes you can get HCG in Australia from any GP who's willing to prescribe it. You can't get HMG though except from fertility programs.