Hi all,
I am writing this post to give my impressions about Dr. Crisler, what he is able to help right now and what he is not. Also, to pass on his opinions about our symptoms and how to treat some of them. We talked for about two hours, he checked all the hormone tests i had done before and we discussed theories and what to do. Unfortunately, there are so many issues, that time was short to talk about everything and i feel there is much more to be discussed with him. Please understand that i can’t remember his actual words when aswering these questions, plus english is my second language.
About Androstenadiol Glucoronide, 3 Adiol G:
(My lab result 2.44 ng/dl, range 3.5 - 22.00 ng/d)l. He is aware of this problem on some propecia sufferers, although he doesn’t know a way to treat it yet.
I asked him: “Isn’t this result a proof that our 5arII is not working properly since it is a subproduct of Dht conversion by 5ar II?”
Dr. Crisler: “But i have tested some guys in order to check for 5ar activity in cell and the result is normal”
Me: “Are you able to differenciate 5arI and 5arII in these results? Because propecia only inhibits type II.”
Dr. Crisler: “No, but i have seen results of guys who took Dutasteride, and after they quit, 5ar activity on these patients appear normal on these results. I think what you have could be related to the hormone receptor, it might not be working properly, we don’t know. It could be some type of androgen insensitivity”
He was open to the 5arII deficiency theory though. The 3 adiol G result is worth further investigation.
About Adrenal Fatigue
He asked me to create a thread here on the forum about adrenal fatigue. He is positive that all of us have adrenal issues. These issues could go from overworking adrenals (and thus some Cushing-like symptoms) or slow acting adrenals (with some addison-like symptoms).
In some of these cases he believes Hydrocortisone, daily, can be helpful. On the first case, to let the Adrenals “rest” for some time and recover. On the second case, the cortisone should supply the hormones the adrenals are not producing. Anyway, he points out that 5 ar has a big role on adrenal hormones (i don’t remember his explanation) and this could explain why our adrenals are affected.
About my Adrenals
There is a twist about my case. You need to divide it before June 2009 and after June 2009. In June 09 i had a lung inflammation caused by food allergies (never had this before). So i had to go on Prednisone (cortisone) for 5 days.
My symptoms before June 2009 (related to adrenals):
Agressiviness, insomnia, depression, difficult to focus, bloating, overall excessive inflammation reaction, allergies.
After June 2009:
Skin inflammation (rosacea, dermatitis), allergies.
He explained to me that Prednisone “shuts down” temporalily the adrenals, and that is why i improved from the other symptoms (depression, agressiviness, insomnia). I feel that in my case it shut down my addrenals too much and i am having syptoms like addisons disease. He explained to me that Prednisone is 4 times stronger than hydrocortisone and you can shut down the adrenals completely in 14 days with only 5 mg a day of prednisone. On the other hand, he assured me that i was right in taking prednisone (it was with a doctor), because lung inflammation is very dangerous and sometimes fatal. He wants me to take 10 mg a day of hydrocortisone to relief my new food allergies (it is a symptom that adrenals are not producing enough hormones, as i didn t have this before) and to mild the inflammation reaction. It also could help with the skin problems i have been facing lately (also related to inflammation). On the other hand, i am afraid of long run use of cortisone as it can lead to diabetes, and i am already experiencing insulin resistance like effects.
Adrenals, blood pressure, and vasopressin:
He asked me if I get light headed when standing up too fast, if I am craving salt, and if I urinate a lot. My answer was yes to all questions. He said it is all related to the adrenals, and I am probably having a tendency to have a drop in blood pressure, even though my blood pressure shows normal. The body craves for salt because I am probably having a hard time mantaining sodium levels and this explains my vasopressin elevated level. Even though he thinks the result is probably a mistake from the lab, he believes my vasopressin level is elevated. It is an attempt of the body to maintain sodium levels and blood pressure.
About Thyroid hormones:
Even though my results are normal, he said i could be suffering from hypothyroidism, as cortisol has a role on making thyroid hormones reach cells. So if our adrenals are affected, it is possible that the Thyroid hormone level could be normal in blood, but not in cells. He needs to see my 24hr cortisol test result before he can say more about this.
About Growth hormone:
He saw my blood tests and immediately said my Gh level is low for my age. IGFBP-3 is elevated and capable of carrying more IGF-1 according to him. My Igf-1 is 180 in a range that goes up to 327. I asked him if he has any propecia sufferer on HGH and he said no. He agreed that some of my symptoms could improve with HGH increase. So he offered that I take GHRP-6. Growth hormone releasing peptide. It will raise my Gh level and it costs only U$ 30,00 a month. It is an injection before bedtime. I am going to take 100 mcgs/ night, a low, conservative dosage. He has right now 200 patients on this drug (not propecia sufferers). I asked about possible side effects and he states he has not seen any in his patients, only an increase in hunger, because this peptide is similar to Ghrelin, the hormone produced in the stomach and pancreas that induce hunger. When he said that, I remebered that I don’t ever feel as hungry now as I did before propecia. Maybe my ghrelin level has not been the same after finasteride. Anyways, I am going to do my own research, and if I decide to take it, I will observe very closely for possible side effects and quit if any. So far on my research, it seems like a good idea, as GHRP-6 acts in the CNS in a way similar to DHT.
About Tamoxifen:
I asked him if I could benefit from using Tamoxifen but he was cautious about it, apparently my Estradiol levels are not that high as I thought, and my T levels (even if low for my age, he agrees) sufficient for a good sex life and overall health according to him.
About my hormones:
Overall he said nothing stands out, other than IGF1 level and Cholesterol. About the last, he said we should not worry if it is under 240 and if we are having a healthy diet.
About diet:
I told him that I started feeling better after I quit sugar, caffeine, gluten, pasta, wheat and processed foods. He said it makes sense to him, as I gave relief to my adrenals, and this points again to adrenal fatigue.
Vitamins and supplements:
Multivitamin/mineral (non- iron)
1000mg of vitamin C (in divided doses)
400IU of vitamin E
3 gms of Omega 3 fatty acids (from fish oil)
50mg zinc/2mg copper
Melatonin may make adrenal fatigue worse
One gallon of water a day.
Blood tests and other tests:
He gave me a Rhine urine test, 24 hr cortisol
And in five weeks I will have blood tests done.