Extensive Lab Reports- Dubya_B


#1

Long story short: I crashed, spent over a decade living with the same problems suffered by most on this message board (ED, emotional blunting, blunted sexual sensations, depression, lethargy), made many attempts to find out what happened to me, then around October 2010 found out I took accutane or a similar drug within a year of my crash.

My story: http://www.propeciahelp.com/forum/viewtopic.php?f=3&t=5004

“Most” bloodwork came back well within normal ranges (Sex hormones, Thyroid function, Vitamin and mineral levels).

FSH has been at or near hypogonadal ranges on every test.

Testosterone has been normal range, but a little low for my age (500s) on most tests when I was not taking something to stimulate production.

Various adrenal hormones have been high on several tests.

Rhein Labs 24hr urinary steroid profile showed insane high amounts of many sex and adrenal hormones.

Doctor commented that my vitamin D3 was a little low.

Semen analysis came back with nearly every parameter at rock bottom of normal range.

My labwork:


10/01/2010

8:30 AM

tests performed by Quest

DHEA Sulfate - 736 range: 110-510 (H)

IGF-1, ECL - 333 range: 88-374

Cortisol - 20.3 range: 4.0-22.0


8/30/2010

Labs 3 weeks into treatment with Tamoxifen 10mg SR daily.

9:06 AM

tests performed by Quest

Testosterone - 640 range: 250-1100

% Free T - 2.59 range: 1.50-2.20 (H)

Free T - 165.8   range:  35.0-155.0  (H)

     SHBG - 21   range: 7-49

 Estradiol - 35  range: 13-54

       DHT - 53  range:  25-75

Cortisol - 26.1  range: 4.0-22.0  (H)

7/22/2010

Labs for Clomiphene Stimulation Test (Took 25mg Clomiphene daily for one week before blood draw)

10:20 AM

tests performed by Quest Diagnostics

Testosterone - 855 range: 241-827 (H)

Estradiol - 50   range:  13-54
      
      DHT - 33   range:  25-75

Vitamin D - 43   range:  30-100

Prolactin - 8.2 range: 2-18

     FSH - 2.2   range:  1.6-8.0
      
      LH - 6.4   range:  1.5-9.3

6/18/2003

2:30 PM

tests performed by quest

(I do not have ref ranges for these tests)

Testosterone - 535 ng/dl

% Free T - 2.39

  Free T - 128.0

m

Had pituitary MRI (sequential slice method) to look for possible adenoma as cause for low FSH levels. No abnormalities were found.


#2

The remaining labwork:

Urine Catecholamine Battery 12/14/2010


24hr urinary steroid profile 11/13/2010


basic metabolic panel 6/22/2010


Semen analysis 5/15/2010


Ultrasound of testes 4/5/2010


1st set Bloodwork Feb-Mar 2010


2nd set Bloodwork Feb-Mar 2010



#3

The rest:

Bloodwork 10/31/2002 1st set


Bloodwork 10/31/2002 2nd set


Bloodwork 10/31/2002 3rd set


Bloodwork 11/29/2001



#4

Dubya, thanks for posting such a large amount of data. I will only comment on two items:

1.) Had heard accutane caused problems similar to post finasteride. The hypogonadal FSH is one factor we have in common.

2.) The second major factor in common are your urinary metabolite ratios. Did’t have the time to calculate all your 24 hour urinary steroid metabolites, but I did calc 5a-THF/THF, the most sensitive ratio, at 0.42. According to the ratios in the paper "Diagnosing 5alpha reductase 2 Deficiency: A Local Experience referenced in the link below, a male > 17 years old should be 0.48 to 2.35. You are clearly below range. And 24 hour urinary steroid profiling is the gold standard for endocrinology - it’s why they use it generally (not the ratios) to check up on Olympic and other athletes to detect doping. Find a treatment to raise this ratio and it should lead to symptom reduction, in my opinion.
viewtopic.php?f=4&t=4674


#5

Blood test results from draw on 7/22/2011 at 8:40 am.
I have not taken any drugs or supplements that have any hormonal effects for over 6 months.
DHT, T, and E2 look perfect. Free T is high out of range. DHEAS is high out of range. FSH is low out of range (as usual).

Inhibin-A was tested instead of Inhibin-B. Dumbasses :angry:

So, the best test results I’ve had in ten years and I am feeling worse than ever (particularly bad on the day the test was performed)

ACTH: 31 (7-50)pg/ml

Prolactin: 14.1 (2.8-29.9)ng/ml

LH: 2.8 (2.0-9.0)mIU/ml

FSH: 0.7 (0.9-15.0)mIU/ml L

Inhibin-A: 1 (<21)pg/ml

Cortisol: 20.4 (9-25)ug/dl

DHEAS: 523 (110-370)ug/dl H

17 OH-Progesterone: 90 (32-307)ng/dl

IGF-1: 207 (53-331)ng/ml Z-score = 0.7 (-2.0 to +2.0) (not sure what z-score is)

Total T: 729 (250-1100)ng/dl

Free T: 168.4 (35-155)pg/ml H

DHT: 63 (25-75)ng/dl

E2: 17 (6-54)pg/ml

Adiol-G: still pending. Does anyone know how long it normally takes quest to return some numbers for Adiol-G? Its been over 2 weeks now.


#6

Great that you had such comprehensive labs done. Is it “normal” sometimes to detect NO progesterone?

My 3 alpha diol G took 4 or 5 weeks. Yea, it takes forever.

Your sperm count is rock bottom, like others.


#7

Ya, AFAIK progesterone itself doesn’t normally get excreted in urine, only progesterone metabolites.
Adiol-G should be posted by mid week.
There’s definitely something up with my sperm count/FSH/Inhibin-B. Probably gonna go for bloods for just Inhibin-B and FSH in the near future.
When I look at most people’s bloodwork, FSH and LH seem to parallel each other. My FSH is always around 1/5 of LH.


#8

You write this alot but in reality 2.2 FSH on the low side but can be a healthy reading and is definately not “hypogondal” by any stretch…


#9

The 2.2 FSH was taken after a clomiphene stimulation test. My latest reading was 0.7 -> out of range. Its been out of range low 4 out of about 8 times it was tested. It should not be as low as it is with the miserable sperm count that I have. Something is wrong…


#10

You haven’t tested thyroid hormones (decent levels increase androgen expression). Furthermore, you should test your cortisol with a saliva test (which measures free cortisol), not with a blood test (which measures total cortisol). The fact that your progesterone is low may indicate low cortisol, despite the high serum cortisol and the high ACTH (too pulsatile to be reliable).

Also, what are your non-sexual symptoms?


#11

Also should get

free t3
reverse t3

interested in what your 3a-diol-g is. overall your labs look great. fsh is always low though.


#12

TSH has tested normal several times, tested a little higher than optimal once and a few other thyroid hormone tests (T3 uptake, T7, Thyroxine) have come back normal. That was long ago, but I had the same symptoms then as I do now.

Urinalysis showed 24 hr cortisol in upper quarter of range. Blood tests consistently show high or high-normal cortisol. My ACTH looked to be in the middle of the range given. I don’t mean any sarcasm but is that considered to be higher than it ideally should be? AFIAK 17-OH progesterone doesn’t necessarily reflect true progesterone levels. That test was only done by my doctors recommendation to rule out adrenal hyperplasia (I have had high blood pressure since crashing + high cortisol levels). Urinary Pregnanediol supposedly does reflect true progesterone levels and it was elevated on my test from Rhein labs. Salivary testing for free cortisol is still considered “experimental” but I may have it tested someday if it appears to be of value.

Blunted emotions, depression, some anxiety, lethargy, hypertension (sometimes severe).
Decrease in scalp oil, body oil, and earwax production. Decrease of acne. Mild popping of joints. Almost complete loss of body odor. Mild muscle and joint pains. Lowered body temperature (that has actually made me suspicious of a thyroid issue). That’s pretty much it besides the sexual symptoms. Some of these symptoms may be coincidental though and I may have missed a few, but I definitely experienced rapid physical and mental changes which happened simultaneously.

Read my labwork again and my member story and all of your questions should be answered.

@moonman1: I have no insurance and have to pay a good bit out of pocket towards any doctor visits or blood work. As much as I would like to have FT3 and RT3 checked out just for the sake of knowing, I haven’t seen enough evidence to warrant getting those tests done. If they do someday appear to be a fairly common factor in people suffering symptoms like ours, I will likely get them tested. I’m pretty anxious to see what my Adiol-G level is too even though it will probably be of little consequence besides being another possible link between PFS and post accutane syndrome.


#13

rT3 is elevated in probably 80% of PFS guys that have tested it, if not more. The only explanation for lowered body temperature that you explain is a) low T3 or b) high Reverse T3.

if you would like to get it tested for $40, without needing a doctor visit…then go to PrivateMDLabs.com . You pay for it, print out the lab req… go to a PA Labs, and they email you the results in a few days…


#14

Thanks for adding these details. I also took a look at your previous hormones. In particular, I noticed that on the 11/13/10 urine test, you have:
-high cortisol
-undetectable progesterone
-low DHEA (interesting that you have high DHEA-s)

The fact that you experience depression suggests low pregnenolone. Assuming that this is true, you would have low pregnenolone, low progesterone, and high cortisol. That is exactly my situation at the end of 2010, i.e., your body gives high priority to producing cortisol, at the expense of the intermediate hormones pregnenolone, progesterone, and, possibly, DHEA. This behavior is rare. Most people with high cortisol also have high pregnenolone and high progesterone.

What I did, under my dr’s supervision, was to supplement with TD pregnenolone and TD DHEA. The former cured the depression and anxiety, while the second helped tremendously with joint pain, back pain, and recovery from sport. You may want to talk to your dr about taking these supplements.

As a final note, I would like to add that a lot of us have high RT3, as reported here viewtopic.php?f=4&t=3866. It’s probably not your case though, because you have high cortisol. But, as moonman1 noted above, you may have low FT3.


#15

@moonman: The price for both tests will only be about $130 and the nearest labcorp lab is only 15 min away from me. Pretty reasonable. Thanks

@m_81:

The info included in the urinalysis test results states “P (progesterone) is normally not detectable in urine (<<1 ug/24hrs). The level of its major metabolite, pregnanediol, reflects progesterone homeostasis.”
My Pregnanediol level came back high at 790 ug/24hrs on a scale of 32-501 which indicates an abnormally high progesterone level.

I appreciate the advice but I’m very leery about supplementing DHEA with such high DHEA-S especially since DHEA wasn’t even near out of range low on the urinary panel, just a little on the lower side. I’ve also read that over supplementation of DHEA can lead to excessive conversion to E2 and possibly inhibit testosterone production as well as affecting the adrenal glands. I tried TRT even though my bloodwork showed it wasn’t necessary and ended up feeling like shit for months because of it. Not going to make that mistake again.


#16

make sure you use the save 10% code you can find on the right side of the page


#17

Finally.

Androstanediol Gluccoronide: 315 (260-1500)ng/dl

with

Total T: 729 (250-1100)ng/dl

Free T: 168.4 (35-155)pg/ml H

DHT: 63 (25-75)ng/dl

taken the same day.


#18

You said you have low body temp. Could you give us a bit of a log. If your body temp is not normal you will have problems…

Please measure before getting out of bed + 3hrs + 3hrs and +3hrs. If your body temp is low you really do need to fully test FT3 FT4 RT4 and silivary cortisol ( 4 times a day). Body temp should be easy to fix once you know these values.