Blood work

I received my blood work protocol from Dr. Shippen’s office yesterday. Tests ordered(to be drawn after taking 25mg of clomiphene for 7 nights at bedtime): TSH, FT3, FT4, RT3(Reverse T3), FSH/LH, SHBG, Cortisol, Total T, Estradiol, DHT, Progesterone, Prolactin, Total Vitamin D, and IGF-1. That’s alot of blood. I Will post my results when i get them back, probably in about 3 weeks.

any updates?

Back from Dr. Shippen with my lab numbers after clomid stimulation and his initial plan for me. Here goes:

TSH 1.5 (.40-4.5 mIU/L)
FT3 2.7 (2.3-4.2 pg/mL)
FT4 1.8 (.8-1.8 ng/dL)
RT3 57 (11-32 ng/dL)
FSH 8.6 1.6-8.0mIU/mL)
LH 8.7 (1.5-9.3 mIU/mL)
SHBG 58 (8-48 nmol/L)
Cortisol 31.5 (4-22 mcg/dL)
Total T 929 (241-827 ng/dL)
Estradiol 53 (13-54 pg/mL)
DHT 65 (25-75 ng/dL)
Progesterone 1.6 (<1.4 ng/mL)
Prolactin 6.0 (2-18 ng mL)
Total Vitamin D 34 (30-100 ng/mL)
IGF-1 Did not do (Dr.'s office said they were having problems with the way some labs were measuring it.

Here’s the initial plan. At this point I am just trying to stop the muscle wastage and feminization of my body. I hope it helps because right now I feel like an 80 year old transvestite.

Low dose T3 to bring down RT3. Start at 5mcg, after 2 weeks go to 10, after another 2 weeks go to 15
Phosphatidyl Serine 100 to bring down Cortisol.
Vitamin D 5000 IU daily
Clomiphene 10 mcg and Anastiagde?(hard to read his writing and did not receive yet) 3 times a week to boost T and lower E2. Did not feel anything from clomiphene during stimulation test, but I was not taking an aramotose inhibitor at the time.
Trazadone for sleep. Start at 50 mg(can go up to 150). Phase out Ativan and Restoril which I have been taking. After a month can add Gabatril 4mg if I feel I need it.
L-dopa/carbidoya?(again hard to read and did not receive yet) 25 mg and L-tyrosine( unsure of dosage) 2 times a week. Should receive from his pharmacy in about 7-10 days.

Thoughts??

Very nice response to clomiphene, especially FSH which does not respond in some.

It would be worthwhile finding the online calculator and use your T and SHBG levels to calculate free testosterone.

Find my prior post on phosphatidylserine, you want a good grade of DHA conjugated form, and take 300 to 500 mgs every morning. It is not an inexpensive therapy, 100 mg a day probably won’t make a dent. Did you have an intense workout the day before the test?

I doubt he had an intense workout if he has severe muscle wastage.

wtf, I have similar symptoms to you. Interesting that your thyroid and adrenals are off, at least that gives you something to work at other than increasing androgens which seems to do little for most of us unfortunately. May help with fog, fatigue, sleep and more.

I hope someone cracks how to solve muscle wastage as I consider it possibly the worst side.

These were while i was taking Anistrozole/Clomid .1/10mg

Testosterone 866 (241-827ng/dL)
Progesterone .7 (<1.4ng/dL)
Estradiol 34 (13-54pg/mL)
Cortisol 25.5 (4-22mcg/dL)
Reverse T3 33(11-32ng/dL)
TSH .83 (.4-4,5mIU/L)
SHBG 45 8-48 nmol/L)
Vitamin D 42 (30-100ng/mL)

To me it’s obvious that there is some serious androgen resistance at play here. All my secondary sexual characteristics are still fading. My body hair is still lightening, my voice is cracking, my beard growth is pathetic. What’s left of my muscle(very little) is stiff and inelastic. It’s like I’ve going through puberty in reverse and I’m going to be back to my prepubescent body state. My bones hurt, my sleep is awful (even with Trazadone). Sex drive is hovering at zero, although in my physical condition, i wouldn’t be able to do anything with it anyway. Mentally I still feel completely numb. I’ve just about given up all hope.

Next up is TRT injections with hcg. T starting at .5cc 2x a week. Hcg at .25 cc 2x a week. Can progress T by .1cc every 2 weeks up to a maximum of 1cc 2x a week trying to “wake up” my androgen receptors. New bloods after 3 weeks. I hope it atleast allows me to put some of the muscle I’ve lost back on. Also, upped Liothyronine from 15 to 20 mcg a day.

At this point I really don’t think anything can help, but i have nothing to lose.

Hi

Your symptoms and timeline are very similar to mine. The padding on my feet has wasted away to the point that its painful to stand and have a shower. I do sometimes wonder if i might actually die because of this.

I hate to push my theory: viewtopic.php?f=27&t=4695&p=34053#p34053 but i have in fact discovered a novel way that androgens can stop working which could create a state of androgen resistance after stopping. Please ask Dr Shippen if it makes any sense - it also only takes a simple blood test to determine if this is what has happened!

Thanks

Most often, high RT3 is caused by low cortisol. The fact that you tested high in serum cortisol is just noise, because it provides only a snapshot of cortisol levels. If you took a saliva test throughout the day, the level would probably be low at some point. This is pretty much guaranteed given your symptoms (and your RT3). Insomnia is often times caused by too high cortisol overnight which is usually caused by too low cortisol during the day. Brain fog is likely caused by low pregnenolone, which is a precursor of cortisol. The low cortisol would be definitely confirmed if you had fatigue and sleepiness during the day (please confirm this).

On the other hand, I see that Shippen is treating you for high cortisol, and I bet he feels pretty sure about it. Can you please ask him what is the mechanism for which high cortisol causes high RT3?

wtfhasthisshitdone,

Please keep posting and updating. Much of your bloodwork looks very much like mine.

I’m interested to see if you have any response to the TRT and HCG.

Your RT3 is Very high and your Free T3 is on the extreme low end. Did Shippen discuss this with you at all?

If your not supplementing with D3 why not? My bones hurt too, until I started on D3 which increase my Vit D levels quite a bit.

My latest numbers

TSH .46 (.4-4.5mIU/L)
T4 1.1 (.8-1.8 ng/dL)
T3 3.8 (2.3-4.2 pg/mL)
T3 Reverse 37H (11-32ng/dL)

Cortisol 17.2 (4-22 mcg/dL)

Total T 1366 H (241-827ng/dL) Pretty funny it says verified by repeat analysis as if they didn’t believe the number
Estradiol 44 (13-54pg/mL)

Reverse T3 still high even after increasing my T3 supplementation. First time cortisol came down to within range, i guess that’s good.
Testosterone way out of range high and estradiol in the upper third of range. I’m feeling only slightly better. This was drawn after 3 weeks of twice weekly testosterone (.5cc) and hcg (.25cc) injections. I’m feeling only slightly better. I can’t really work out because my joints and lower back are giviing me problems. Don’t think i’m going to continue the injections too much longer. The T number doesn’t mean a damn thing if I’m not feeling it. I’ll probably talk to the doctor about tapering them down. I think i’m just going to go back to clomid and arimidex and stay on it long term to keep me going until more is known about this dreaded condition.

I did the 24 hour saliva test. Top of the rage in morning, and out of range high in afternoon and evening. Still got a out of range Rt3. So Rt3 is caused by low cortisol only is not true. It could be high or low - thyroid-rt3.com/whatare1.htm

Hope you dont mind answering a few quick ones

Have you experienced insomnia or sleep problems?

If so, have any of your new medications helped with that?

Thanks!

Any update? I hope things are better