What tests should I ask my doctor for?

[JackBauer]

I'm going to see my PCP on Monday. He knows I've been seeing a specialist and is open - yes, open to me doing so. He wants to be engaged. He even thought that hCG treatment was not an unreasonable thing to try. (Like an endo I saw who said it was only used for fertility issues)

Anyway - I'm currently on 100mg DepoT 1x a week, 300IU hCG two times a week, and I'm trying to decide what tests to ask him for as things aren't working right for me yet. (See a description of my recent injections / results below)

I agree with Jan - that I should get:

Estradiol, Free, LC/MS/MS (36169X)
Testosterone, Free, Bio/Total (LC/MS/MS)

I'm also thinking it woiuld be good to get:
SHBG (been 1.25 years since my last test)
LH (since hCG alone didn't seem to do anything I'm curious if my LH levels really are dropping now that I am on exogenous T - my one remaining testicle has not atrophied since starting topical T over 6 months ago, and doesn't seem to have in the last 6 weeks since starting injections)

Any other tests that I have strong evidence of needing? I don't know how "test weary" my PCP is - I don't think he'll test something without a reason.

I'm half tempted to go to Michigan to see Dr. John just for his comprehensive testing.

So - what other tests should I push? If you read below you'll see that a 90mg injection of DepoT did have a nice result a few days after injection - I'm waiting for the 100mg lab results to see whats happened since.

I greatly appreciate the help - I"ve been working at this for like 2 years now and I saw a glimmer of hope a couple weeks ago, but none since. I wish I could wait until Monday to post my TT / E2 numbers from last week, but that isn't enough time for me to get feedback before seeing my PCP.

Thanks again.





I tried everything before moving to Testosterone Cypionate about a month ago. Doctor put me on 70mg 1x a week, with 300IU hCG on days 6 and 7.

I did this for 3 weeks, didn't notice any substantial improvement in EQ, maybe a little. I tested at 645 Total Testosterone, and 33 E2. My highest T number ever in my labs. I was relieved that something finally got my T up, and I thought maybe there was some improvement in how I was feeling.

Week 4 I went to 90mg, and then on days 2 and 3 after that injection, I finally had the best erectile function in years. Days 5,6, 7 I still had problems. Again I was thinking still - progress... And using roidcalc, and my previous weeks injections, I determined to get to the right level of active T-Cyp in my system on day 7, as days 2/3 on my 90mg injection, that I'd have to go up to 120mg per week...

And after 3 weeks, day 7 would be where I was on day 2/3 with 90mg injected.

However since I don't want to go too high - I want to be careful about losing my hair... I decided that on week 5 of my T-Cyp treatment, I would go to 100mg, and hopefully I'd have good EQ out to day 4, confirming progress... And slowly working up to whatever was required to get me through to day 7. (Confirming my roidcalc slowly, not just jumping in)

The problem is that after my 100mg injection, I did not see great results in terms of EQ on days 2/3. I didn't really see any substanital improvement at all really. Maybe a few more morning erections.

[JackBauer]

Anyone?

I go to my primary care physician tomorrow...

[JanSz]

Anyone?

I go to my primary care physician tomorrow...

I see that you already know my advice, so here I will only clarify for you:

these tests that you listed on previous post have the following as result:


58 Estradiol, Free, LC/MS/MS (36169X) http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=41772N&SITE=4&SearchString=ESTR&tmradio=title
59 /------------------------------------ Estradiol, Free (Males (Adult): < or = 0.45 pg/mL )
60 /------------------------------------ Estradiol (Males (Adult): < or = 29 pg/mL)





66 Testosterone, Free, Bio/Total (LC/MS/MS) http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=14966X&SITE=4&SearchString=BIOAVAIL&tmradio=title
67 /------------------------------------ Testosterone Total (included in T panel)
68 /------------------------------------ Testosterone Free(included in T panel)
69 /------------------------------------ Testosterone Bioavailable(included in T panel)
70 /------------------------------------ SHBG(included in T panel)
71 /------------------------------------ Albumin, serum(included in T panel)

[JackBauer]

Thanks Jan - I had no idea that SHBG and Albumin were included in the Quest Total/Free/Bioavailable T test.

[Dr. John Crisler]

I see that you already know my advice, so here I will only clarify for you:

these tests that you listed on previous post have the following as result:


58 Estradiol, Free, LC/MS/MS (36169X) http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=41772N&SITE=4&SearchString=ESTR&tmradio=title
59 /------------------------------------ Estradiol, Free (Males (Adult): < or = 0.45 pg/mL )
60 /------------------------------------ Estradiol (Males (Adult): < or = 29 pg/mL)




66 Testosterone, Free, Bio/Total (LC/MS/MS) http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=14966X&SITE=4&SearchString=BIOAVAIL&tmradio=title
67 /------------------------------------ Testosterone Total (included in T panel)
68 /------------------------------------ Testosterone Free(included in T panel)
69 /------------------------------------ Testosterone Bioavailable(included in T panel)
70 /------------------------------------ SHBG(included in T panel)
71 /------------------------------------ Albumin, serum(included in T panel)

The bolded assays are not ultrasensitive, and so are not valid for adult males. Treating based upon them can lead to disaster.

[pmgamer18]

Thank you Dr. John I have been telling him this for some time now.

The bolded assays are not ultrasensitive, and so are not valid for adult males. Treating based upon them can lead to disaster.

[Dr. John Crisler]

Thank you Dr. John I have been telling him this for some time now.

Our good friend is actually hurting people by doing this. Not what he's into, so this really surprises me.

[Dr. John Crisler]

PLAIN RED TOP TUBE FOR TESTOSTERONES and ESTROGEN—NO SST’s


Bioavailable Testosterone #14966X
Total Testosterone
Sex Hormone Binding Globulin (SHBG)
DHEA-S
Cortisol
Prolactin
Progesterone
LH
FSH
Lipid Panel
PSA
CBC
Comprehensive Metabolic Panel
TSH
Free T4
Free T3
reverseT3
IGF-1
Homocysteine
Fasting Insulin
s-CRP
Estradiol (“ultrasensitive” assay only) #30289X
Estrogens, Fractionated, LC/MS/MS #36742X
Ferritin
25(OH)D

[hardasnails1973]

PLAIN RED TOP TUBE FOR TESTOSTERONES and ESTROGEN—NO SST’s


Bioavailable Testosterone #14966X Total Testosterone
Dihydrotesterone (DHT) Sex Hormone Binding Globulin (SHBG)
DHEA-S Cortisol
Prolactin Progesterone
LH FSH
Lipid Panel PSA
CBC Comprehensive Metabolic Panel
TSH Free T4
Free T3 reverseT3
IGF-1 Homocysteine
Fasting Insulin s-CRP
Estradiol (“ultrasensitive” assay only) #30289X
Estrogens, Fractionated, LC/MS/MS #36742X
Ferritin 25(OH)D

What is the purpose of these if really the estrodial we are most concerned with?


How do standard e2 test (13-54) vs ultrasensitve results (<29) compare to one another and what are the optimal ranges a male should look for with this new testing

[JanSz]

Our good friend is actually hurting people by doing this. Not what he's into, so this really surprises me.

Please provide a link to the test that you like.

Other Quest laboratories may still use the other Ultrasensitive E2,
with top and bottom ranges.

------------------------------------------------------------------------------------
Assuming that when done at

Quest Diagnostics Nichols Institute
33608 Ortega Highway
San Juan Capistrano, CA 92690-6130

it is cuttiting edge of Quest;

CA - San Juan Capistrano 33608 Ortega Hwy (800)642-4657 (SJC)

http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=30289N&SITE=4&SearchString=ESTR&tmradio=title

Code: 30289N Estradiol, Ultrasensitive, LC/MS/MS (30289X)
Males: < or = 29 pg/mL
================================================== ===============

http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=41772N&SITE=4&SearchString=ESTR&tmradio=title

Estradiol, Free, LC/MS/MS (36169X)

Males (Adult): < or = 29 pg/mL

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

I just ask for a version of test that additionally calculates
FreeE2

please check the link provided.

You may want to take a look at thise opinion of Nichols Institute,
quoted from above link:

Clinical Significance:
Much of Estradiol is bound to proteins. The unbound
portion and Estradiol bound to proteins with low affinity
reflect the Free concentration. The Free Estradiol may
better correlate with medical conditions than the Total
Estradiol concentrations.

[Dr. John Crisler]

What is the purpose of these if really the estrodial we are most concerned with?


How do standard e2 test (13-54) vs ultrasensitve results (<29) compare to one another and what are the optimal ranges a male should look for with this new testing

I have been running the second estrogen mini-panel of late. It actually includes the ultrasensitive E2. I'm just looking to see how it goes.

Of note, the u.s. E2 in the fractionated E's is not matching the straight u.e. E2. I have no idea why, but the u.s. E2 in the panel has come back surprisingly and innappropriately low, not matching clinical symptoms.

Standard E2 and u.s. E2 often do not correlate whatsoever. If you give Arimidex based upon elevated standard E2, and in reality u.s. E2 would show it low normal, you will cause the patient great harm. It happens all the time in my field, and worries me to no end.

The ideal range for E's are patient specific, depending upon total amount, SHBG level, and the distribution of individual components. For instance, I'll allow Total Estrogens to get to the top of range, on 24 hours urines, if the E3 component is a lot of it (with no elevated E symptoms).

[hardasnails1973]

that is really interesting so you just use the U.S e2 by itself to to help idenify e2 problems but when taken fro the fractional estrogen it is really not of any use. If a person is high on 16 hydroxy estrone low on E3 look towards iodine defieincy. It going to be interesting to see if using the iodine actiually increase T receptor sensitivity. 6 months prior my free T was at low normal. I ran iodoral and DIM retesting showed a double highed on free t and free T% and increase by mid line bioavailable to top end. i found these to be rather amazing despite no change in TRT at all. So the results for DIm and iodine look promiseing. Tommorrow I am doing the iodine loading test and estrogen metabolite test to check up on status of things, Results should be interesting to see how tjhe DIM and iodoral change the ratios 2/16.4 plus sam-e with TMG with them methyated metabolites.

[pmgamer18]

This is why I use the wood meter if your wood stops your to high or to low. This morning wood was so strong I could not void had the wait for it to go down. I take my Arimidex tomorrow with my Testosterone shot. If your like me you need to get in touch with how you feel when your to high or to low. You just can not take arimidex the same amout week after week and keep it in the zone. I some times stop taking it for a week to let my levels go back up. I feel the arimdex builds up and one of the guy at the H2 group does this about every 8 weeks and it helps for dosing. Labs are helpfull to me but my body tells the real story.

[hardasnails1973]

THis would drive me nuts and I am sure it does you. Since you have a pituitary problem your e2 might fluctuate alot more then normal. I try to keep all the variables the same and asses with each badge of tests. I feel for a guy in e2 of 50- 60 range .25 m,w,f bring them down to proper range.

Here is my question
If one has a result on 20 on standard e2 and there is a huge deviation between the ultrasentive e2 ran at same time. Which one would you go with?

[JanSz]

This is why I use the wood meter if your wood stops your to high or to low. This morning wood was so strong I could not void had the wait for it to go down. I take my Arimidex tomorrow with my Testosterone shot. If your like me you need to get in touch with how you feel when your to high or to low. You just can take arimidex the same amout week after week and keep it in the zone. I some times stop taking it for a week to let my levels go back up. I feel the arimdex builds up and one of the guy at the H2 group does this about every 8 weeks and it helps for dosing. Labs are helpfull to me but my body tells the real story.

You are right, smal amount of difference in pills make big difference in results.

If you eat broken Arimidex pills, you are newer taking known equal dose.
At least I am not able to cut them evenly.
That is why I am on a liquid type.
Ability of being able to take planned dose.

[JanSz]

I have been running the second estrogen mini-panel of late. It actually includes the ultrasensitive E2. I'm just looking to see how it goes.

Of note, the u.s. E2 in the fractionated E's is not matching the straight u.e. E2. I have no idea why, but the u.s. E2 in the panel has come back surprisingly and innappropriately low, not matching clinical symptoms.

Standard E2 and u.s. E2 often do not correlate whatsoever. If you give Arimidex based upon elevated standard E2, and in reality u.s. E2 would show it low normal, you will cause the patient great harm. It happens all the time in my field, and worries me to no end.

The ideal range for E's are patient specific, depending upon total amount, SHBG level, and the distribution of individual components. For instance, I'll allow Total Estrogens to get to the top of range, on 24 hours urines, if the E3 component is a lot of it (with no elevated E symptoms).

Same experience here,
my blood draw Aug 30/07
I decided to use FreeE2 for my Liquidex dose adjustment.

60 Estradiol, Free, LC/MS/MS (36169X)
61 /------------------------------------Estradiol, Free 0.75 (< or = 0.45) pg/mL
/------------------------------------Estradiol, Free &#37; 2.59 (1.25-1.85) %
62 /------------------------------------Estradiol, ultrasensitive 29 (< or =29) pg/mL
63 Estrogens, Fractionated, LC/MS/MS (36742X)
64 /------------------------------------Estrone, serum 24 (< or =68) pg/mL
65 /------------------------------------Estradiol, serum 61 (<or=29) pg/mL
66 /------------------------------------Estriol <0.10 (0.2 or less) ng/mL

[JanSz]

PLAIN RED TOP TUBE FOR TESTOSTERONES and ESTROGEN—NO SST’s


Bioavailable Testosterone #14966X
Total Testosterone
Sex Hormone Binding Globulin (SHBG)
consider changing to
Testosterone, Free, Bio/Total (LC/MS/MS) http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=14966X&SITE=4&SearchString=BIOAVAIL&tmradio=title

DHEA-S
Cortisol
Prolactin
Progesterone
LH
FSH
Lipid Panel
PSA
CBC
Comprehensive Metabolic Panel
TSH
Free T4
Free T3
reverseT3
IGF-1
Homocysteine
Fasting Insulin
s-CRP
Estradiol (“ultrasensitive” assay only) #30289X
consider changing to
Estradiol, Free, LC/MS/MS (36169X) http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=41772N&SITE=4&SearchString=ESTR&tmradio=title

Estrogens, Fractionated, LC/MS/MS #36742X
Ferritin
25(OH)D

------------------------------------------------
Looking at attachment;
Is there a way to manage estrodial in such a way that just enough of it comes in and is metabolized in Phase I

How to measure/manage what is comming?

At least a thought if not real possibility.

[brandO]

Estradiol (Males (Adult): < or = 29 pg/mL) ULTASENSITIVE

this is the test Shippen has me do every 1 month.

[wondering]

I'm so baffled and must give Adrenals and Thyroid a shot....

subset of Rhein panel (100mg Test Cyp 1x week)

E2 3.7 (0 - 7.0) seems ok
E3 12 (1-16) based on Dr. J below.. looks ok
Total E 27 (4-22) ok based on below comment?
Test. 91 (45-85)
DHT 18 (0-13)
DHEA 5022 (5-1476)
Androstenedione 107 (0-50)

BW drawn same day (day prior to injection)
SHBG 14 (11-80)
Test 657 (241-827)

Based on Low SHBG, I assumed late week anxiety was caused by rapid destruction of hormones as I have heard marianco state.

So as T level seemed a bit high.. dropped T to 90mg 1x per week and still had a bit of same feeling.

Tried splitting dose of 90mg to 45mg 2x week to balance out

I AM NOT an expert, but only thing i can imagine would result from split dose is slightly higher SHBG, less conversion to DHT and Estrogens.

libido was worse.. imagine elevated DHT spoiled me. but cant imagine split dose didnt give a decent amount. we shall see.

read somewhere high DHEA coupled with high Andostenedione is indicative of Adrenal tumor. Any thoughts ?

This was run in July... I had BW run that was very comprehensive a couple weeks ago.. I will get from my dr and see.


oh well... I spend too much time on here.. you're all so patient. I should just go to bed.

take care.



I have been running the second estrogen mini-panel of late. It actually includes the ultrasensitive E2. I'm just looking to see how it goes.

Of note, the u.s. E2 in the fractionated E's is not matching the straight u.e. E2. I have no idea why, but the u.s. E2 in the panel has come back surprisingly and innappropriately low, not matching clinical symptoms.

Standard E2 and u.s. E2 often do not correlate whatsoever. If you give Arimidex based upon elevated standard E2, and in reality u.s. E2 would show it low normal, you will cause the patient great harm. It happens all the time in my field, and worries me to no end.

The ideal range for E's are patient specific, depending upon total amount, SHBG level, and the distribution of individual components. For instance, I'll allow Total Estrogens to get to the top of range, on 24 hours urines, if the E3 component is a lot of it (with no elevated E symptoms).

[JanSz]

I'm so baffled and must give Adrenals and Thyroid a shot....

subset of Rhein panel (100mg Test Cyp 1x week)

E2 3.7 (0 - 7.0) seems ok
E3 12 (1-16) based on Dr. J below.. looks ok
Total E 27 (4-22) ok based on below comment?
Test. 91 (45-85)
DHT 18 (0-13)
DHEA 5022 (5-1476)
Androstenedione 107 (0-50)

BW drawn same day (day prior to injection)
SHBG 14 (11-80)
Test 657 (241-827)

Based on Low SHBG, I assumed late week anxiety was caused by rapid destruction of hormones as I have heard marianco state.

So as T level seemed a bit high.. dropped T to 90mg 1x per week and still had a bit of same feeling.

Tried splitting dose of 90mg to 45mg 2x week to balance out
I AM NOT an expert, but only thing i can imagine would result from split dose is slightly higher SHBG, less conversion to DHT and Estrogens.

libido was worse.. imagine elevated DHT spoiled me. but cant imagine split dose didnt give a decent amount. we shall see.

read somewhere high DHEA coupled with high Andostenedione is indicative of Adrenal tumor. Any thoughts ?

This was run in July... I had BW run that was very comprehensive a couple weeks ago.. I will get from my dr and see.


oh well... I spend too much time on here.. you're all so patient. I should just go to bed.

take care.

Looking at my table, post #40
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html

120 889 xx13 300 xx23 250
125 917 xx15 300 xx25 250

to achieve desired BioAvailable Testosterone level
you need about 120-125 mg/week
it is good that you are splitting it twice weekly, I do E2D

I suggest that you use these two blood tests when making adjustment of your T and AI dosing.

When making T adjustments, pay careful attention to resulting BioAvailableT,
do not get side tracked by observing other numbers within that test.
----------------------------------
Estradiol, Free, LC/MS/MS (36169X)

http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=41772N&SITE=4&SearchString=ESTR&tmradio=title

Testosterone, Free, Bio/Total (LC/MS/MS)
http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=14966X&SITE=4&SearchString=BIOAVAIL&tmradio=title
-----------------------------------

Each of the above tests have multi number output.

For testosterone, I use only BAT
my goal is being on top of range, BAT~575

For Estrodial I use
Estradiol, Free (Males (Adult): < or = 0.45 pg/mL )
but I extended the range to (0.45 - 0.6)

Within that test, you will also have the more commonly used
Estradiol (Males (Adult): < or = 29 pg/mL)
that have the same range as
Estradiol, Ultrasensitive, LC/MS/MS (30289X)
http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=30289N&SITE=4&SearchString=ESTR&tmradio=title
Males: < or = 29 pg/mL

that Dr John recomends

For myself I am using FreeE2 because I think it is more accurate.
Quest Diagnostics Nichols Institute have this to say describing FreeE2:

Clinical Significance:
Much of Estradiol is bound to proteins. The unbound
portion and Estradiol bound to proteins with low affinity
reflect the Free concentration. The Free Estradiol may
better correlate with medical conditions than the Total
Estradiol concentrations
==================================================
One reason, among many, for your anxiety, you are dealing with low SHBG,
your test and E's levels may fluctuate more than someone's with much higher SHBG.
You may benefit from more frequent schedule, say E2D.
Examine your supplements, do not take anything that is known to lower SHBG.
==================================================
All my suggestions are, obviously, just that,
you will listen to your doctors orders.

[hardasnails1973]

Looks to me like you have some major insulin resistance going on here could explain why high dhea levels, Low shbg . Elevated dhea on urine could also be a sign of defieincy as well (DR JOHN PLEAE COMMENT). Estrogens look perfect. I would examine insulin imbalnces next as probably cause through dietary life styles and stress. Elevated dhea could also be response to an infection or bacteria too causing immune system to be over active.

[JanSz]

Estradiol (Males (Adult): < or = 29 pg/mL) ULTASENSITIVE

this is the test Shippen has me do every 1 month.

By now, how many times have you done this test?
What is the goal for your E2 number?

When you are not at the desired level,
describe process of changing a dose of Arimidex.

I am alway concerned with unequal splitting of these small pills and resulting unintentional change of dose.

[pmgamer18]

I am talking to a guy at the H2 group he is 55 on TRT and not doing good he read one of my posts about checking E2.
His level came back 199 Holy Cow Bat Man I was at 90 in living in hell.

THis would drive me nuts and I am sure it does you. Since you have a pituitary problem your e2 might fluctuate alot more then normal. I try to keep all the variables the same and asses with each badge of tests. I feel for a guy in e2 of 50- 60 range .25 m,w,f bring them down to proper range.

Here is my question
If one has a result on 20 on standard e2 and there is a huge deviation between the ultrasentive e2 ran at same time. Which one would you go with?

[pmgamer18]

Ok when your test comes back and it just says < or = 29 how in the hell do you know how low your are. Quest did this to me trying to put this test on me. And thats all it said my Dr. called the lab and talked to a friend of his and was told this is a womens test that they put a rang on for men. It is worthless for us men. My Dr. had the test redone my level was at 7 I was taking to much Arimidex it he had not done this I could still be to low.

Estradiol (Males (Adult): < or = 29 pg/mL) ULTASENSITIVE

this is the test Shippen has me do every 1 month.

[pmgamer18]

Sorry for the error in this post I fixed it I ment to say. " You just can not take arimidex the same amount week after week and keep it in the zone. "

This is why I use the wood meter if your wood stops your to high or to low. This morning wood was so strong I could not void had the wait for it to go down. I take my Arimidex tomorrow with my Testosterone shot. If your like me you need to get in touch with how you feel when your to high or to low. You just can not take arimidex the same amout week after week and keep it in the zone. I some times stop taking it for a week to let my levels go back up. I feel the arimdex builds up and one of the guy at the H2 group does this about every 8 weeks and it helps for dosing. Labs are helpfull to me but my body tells the real story.

[wondering]

Actually, I am borderline Hypoglycemic and 2 hr Glucose showed I'm def sensitive to Insulin.

High DHEA has been repeated on BW on several occasions.

I am inclined to subscribe to the chart Phil shared on my "adrenal function" thread showing high DHEA in conjunction w/ low Cortisol can be indicative of later stage Adrenal issues and the body is trying to overcompensate.

I have considered a theory of infection of some sort.. this idea came about after reading your composite of Marianco posts where he was brought a patient hat noone could fine the answer for. Suffered from anxiety and he discovered an infected nasal bone that became infected thru a bad tooth. The bone was removed and after a run of antibiotics the Anxiety was gone. Curious as I have never had my wisdon teeth pulled and they bother me sometimes.... Maybe I'm searching too deep.

thanks again.



Looks to me like you have some major insulin resistance going on here could explain why high dhea levels, Low shbg . Elevated dhea on urine could also be a sign of defieincy as well (DR JOHN PLEAE COMMENT). Estrogens look perfect. I would examine insulin imbalnces next as probably cause through dietary life styles and stress. Elevated dhea could also be response to an infection or bacteria too causing immune system to be over active.

[pmgamer18]

At WebMD the Uro forum a guy posted to the Dr. that he had a Vac. can't spell it he was cliped so he could not get his wife pregnant. And after the surgey later his Testosteone levels went down.

The Dr. told him some times you get a low grade infection that is only seen with a special test. And if he has this it talkes a special med. He did the test and this was his problem the guy was a mess. He posted back later thanking the Dr. he was now fine.

[wondering]

Goes to show... we will never completely figure out this thing that carries us thru life - our body.

I will look into this as well. Quite possible that it's a bit of everything and some treatments only treat symptoms instead of the problem.. perhaps infection has caused a series of events... low sex drive leads to relationship issues/irritability... leads to stress.. leads to Adrenal disorder.. and round and round we go.

Need to stop putting a bucket under the leaking ceiling and find the hole in the roof.



At WebMD the Uro forum a guy posted to the Dr. that he had a Vac. can't spell it he was cliped so he could not get his wife pregnant. And after the surgey later his Testosteone levels went down.

The Dr. told him some times you get a low grade infection that is only seen with a special test. And if he has this it talkes a special med. He did the test and this was his problem the guy was a mess. He posted back later thanking the Dr. he was now fine.

[hardasnails1973]

Goes to show... we will never completely figure out this thing that carries us thru life - our body.

I will look into this as well. Quite possible that it's a bit of everything and some treatments only treat symptoms instead of the problem.. perhaps infection has caused a series of events... low sex drive leads to relationship issues/irritability... leads to stress.. leads to Adrenal disorder.. and round and round we go.

Need to stop putting a bucket under the leaking ceiling and find the hole in the roof.

Thats what i have been preaching from the start !! Take care of the crap of crap at the top of the cascade before first before it gets down stream. Thats like trying to fix a car thats does not start by fixing the engine with out seeing the gas tank is empty in the first place

Something just dawned on me about elevated insulin levels. If you have high insulin senitivity you may be a risk of a choline defieincy as well as arachondonic acid. Let me explain. Over time high insulin levels cause an elevation of PLA2 which is an enzyme that breaks open the cell membrane and releases fatty acid from the cell membrane. This depleting of cell membrane despire normal diet may require higher omega 3 to omega 6 to offset this. One theory I have been exploring is that most type 2 diabetics are low on AA and have low testosterone because the fact that high insulin levels. The high insulin levels with elevated PLA2 rip open the membrane deplete AA. This chain reaction causes the bodies ability to uptake zinc is imparied. If zinc is depleted then Lh is reduced and there for as well as testosterone and also reverse t3 are increased. Oh yes that notorious rt3 I also had and did not lower untill I got my testosterone levels back in line as well as bringing up my arachonsdonic acid up to par. SO I beleive one that has elevated rt3 despite good eating could be a result of elevated inuslin lower the arachondonic acid and zinc absorption.

[wondering]

Phil - do you know the approx date of that thread and perhaps aany idea on thread title.

thanks.



At WebMD the Uro forum a guy posted to the Dr. that he had a Vac. can't spell it he was cliped so he could not get his wife pregnant. And after the surgey later his Testosteone levels went down.

The Dr. told him some times you get a low grade infection that is only seen with a special test. And if he has this it talkes a special med. He did the test and this was his problem the guy was a mess. He posted back later thanking the Dr. he was now fine.

[pmgamer18]

It was a good 6 yrs ago but you can ask the Dr. here is a link.
http://boards.webmd.com/webx?14@488.O4zka6MTdIA.0@.5987f442

[JanSz]

Ok when your test comes back and it just says < or = 29 how in the hell do you know how low your are. Quest did this to me trying to put this test on me. And thats all it said my Dr. called the lab and talked to a friend of his and was told this is a womens test that they put a rang on for men. It is worthless for us men. My Dr. had the test redone my level was at 7 I was taking to much Arimidex it he had not done this I could still be to low.

Phil,
thake a breather,
I think you may be confused.
Lets start from scratch:

on this post, 22 hours ago:
http://74.54.133.233/forum/showpost.php?p=672&postcount=8

Dr John is saying that he is using:
Estradiol (“ultrasensitive” assay only) #30289X

take the number in red and follow it:
to right here:

http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=30289N&SITE=4&SearchString=ESTR&tmradio=title
what you got is this:
Estradiol, Ultrasensitive, LC/MS/MS (30289X)
for the range you have got something that you do not like:
Males: < or = 29 pg/mL
=================================================
I will stop here, but better test is this particular one,
plus FreeE2

Quest do have such a test.
That test even comes with explanation of why FreeE2 is better that
"plain ultrasensitive E2".
================================================== =============
There is similar story with Bioavailable testosterone that Dr John posted.
The top three lines of his list should be replaced with one line that contains all,
and is really the same test that he wants.
-----------
Bioavailable Testosterone #14966X
Total Testosterone
Sex Hormone Binding Globulin (SHBG)
------------
Testosterone, Free, Bioavailable, and Total, LC/MS/MS (Code: 14966X)http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=14966X&SITE=4&SearchString=BIOA&tmradio=title
---------------------------------------------------------------

[Bill-NJ]

PLAIN RED TOP TUBE FOR TESTOSTERONES and ESTROGEN—NO SST’s


Bioavailable Testosterone #14966X
Total Testosterone
Sex Hormone Binding Globulin (SHBG)
DHEA-S
Cortisol
Prolactin
Progesterone
LH
FSH
Lipid Panel
PSA
CBC
Comprehensive Metabolic Panel
TSH
Free T4
Free T3
reverseT3
IGF-1
Homocysteine
Fasting Insulin
s-CRP
Estradiol (“ultrasensitive” assay only) #30289X
Estrogens, Fractionated, LC/MS/MS #36742X
Ferritin
25(OH)D


This post by the Dr should be a stand alone locked sticky

[pmgamer18]

Jan it may well be that Quest labs are pulling one over on us but my Dr. told them not to do my tests that way. I get a range 13 to 54 pg/ml with the result down to zero my last test was 8. I don't have a number on my labs results. But you can't tell me use what your doing will tell me I am at 8 to dam low.

[JanSz]

Jan it may well be that Quest labs are pulling one over on us but my Dr. told them not to do my tests that way. I get a range 13 to 54 pg/ml with the result down to zero my last test was 8. I don't have a number on my labs results. But you can't tell me use what your doing will tell me I am at 8 to dam low.

Phil;

all I am trying to clarify is that;

I am using exactly the same tests as currently used/posted by dr John.
--------------------------------
I believe in benefit of using FreeE2
but that is a story for another day.