Markus' Blood tests

Member Stories Lab Tests
#1

Age: 37
Took Propecia for 7 years (stopped a few times for a few months in the last 3 years)

Quit Propecia: Oct 2006 - BUT there is 1 complication, I took 1 pill at the end of June 2007 because I had no idea my depression could be linked to Propecia at the time. After that pill I felt very panicky and depressed. This all led me to this website.

Side effects noticed: For the 7 years I was on it I had a low mood and some brainfog from time to time but nothing that made me think there was anything wrong with me. No physical or sexual side effects.

Side effects started in January 2007 – 2.5 months after quiting: Anxiety (constant and unrelenting), panic, major depression, brainfog, and loss of interest in just about everything. No sexual side effects though.

Blood test Sept 26, 2007

Testosterone: 19.0 (7.3 – 23.5) nmol/L
Free T: 45 (31-94) PMOL/L
DHEA-S: 7.7 (3.3 – 14.0) umol/L
FSH: 1 (2 – 8) IU/L
LH: 2 (2 – 6) IU/L
Prolactin: 7 (2 – 18) UG/L

I also had a blood test done around July 1st 2007, right after my 1 pill of propecia since October last year, but do not have the results. My doctor tested Cortisol (free), PSA, and Progesterone and said all were well within in range with no problems. He gave me the following numbers as well:

Blood test July 1, 2007

Testosterone: 18.5
Free T: 38.7
Prolactin: 6

Free T and Prolactin have both increased.

Could someone (like Mew or Hypo perhaps) please help me interpret these results? I would like to get more tests done on DHT, Estrogens, SHBG, etc but my doctor said there was nothing from these tests that showed an urgent need to do other tests. I see him in 2 weeks and need to be ready with an argument for getting each of the other tests done, that is, if it needs to be done. If someone could recommend what else I should test and reasons for each I will take it in with me and try to persuade my doctor.

#2

Overall, from the test results you listed, things look ok. Interestingly you don’t have sexual side effects, probably because you have a high Total Testosterone level.

Your Free T level is mid-range, however in conjunction with the lack of sexual side effects, I doubt it is of much concern – but if you could get SHBG done, you’d be able to see if SHBG was in fact binding it and thus reducing your Free T level.

Apparently, Dr Shippen likes to keep Prolactin between 3-5 in men… and you are at 7. I don’t think this is cause for concern yet but you may want to keep an eye on it.

However, you DO need to get your DHT and Estrogen levels checked (Estradiol in particular, sensitive assay method… and Estrone, Estriol, and Total Estrogens if possible as well). The various mental/anxiety/depression symptoms you describe can be a sign of elevated Estrogen levels in a man.

Convincing the doc about testing for DHT should be a no-brainer: you just took a drug that inhibits it. If they can’t understand why you’d want DHT tested after taking Finasteride, I’d get another doctor. In terms of convincing your doc about testing for Estrogens, the drug is KNOWN to increase estrogen levels in some men – hence the warning about gynocemastia and breast tenderness on the drug!

The following are a result of Finasteride use, due to increased Estrogen levels resulting from the drug’s method of action (blocking DHT, increasing T, extra T aromatizes to E2 since it can’t convert to DHT anymore). Suggest printing out and highlighting the relevant passages.

propecia.com/finasteride/pro … safety.jsp
— Clinical studies showed men treated with PROPECIA had increased mean testosterone and estradiol levels (approximately 15%), but these levels were within normal physiologic range.

propecia.com/finasteride/pro … drogen.jsp
"Physicians should instruct their patients to promptly report any changes in their breasts such as lumps, pain, or nipple discharge. Breast changes including breast enlargement, tenderness, and neoplasm have been reported. "

merckfrosst.ca/assets/en/pdf … 2_06-E.pdf
PAGE 3:
Four patients in MTOPS reported the adverse experience breast cancer. Three of these patients were on finasteride only and one was on the combination therapy… The relationship between the long-term use of finasteride and male breast cancer is currently unknown.

Cytologic Atypia in a 53-Year-Old Man With Finasteride-Induced Gynecomastia
arpa.allenpress.com/arpaonline/? … -9985(2000124%3C0625:CAIAYO%3E2.0.CO%3B2

Case report: finasteride-induced gynecomastia in a 62-year-old man.
propeciahelp.com/forum/viewtopic.php?t=185

jcem.endojournals.org/cgi/reprint/89/12/6359
"In this study, chronic inhibition of 5-reductase was associated not only with sexual dysfunction and gynecomastia, but also with a worrisome increased risk of high-grade prostate cancer. Keeping in mind a higher incidence of breast cancer reported by the other group (3), it seems reasonable to believe that long-term treatment with finasteride may disturb androgen-estrogen balance to the extent that may result in carcinogenesis.

Many epidemiological and experimental studies have shown that prostate hyperplasia and cancer develop more frequently in a hormonal milieu where estrogens predominate over androgens, as it happens in aging males. The inhibition of 5-reductase further shifts the hormonal imbalance associated with aging by decreasing 5-dihydrotestosterone and increasing testosterone, which in turn may be locally aromatized to estrogens. The aberrant up-regulation of aromatase expression in benign prostate hypertrophy and prostate cancer (4) makes this scenario even more probable. "

#3

Thanks a million Mew!

Is amazing that you helped me out with the analysis, links, and quotes! I’ll make good use of them. It’s been a long uphill battle with getting these tests. I live in Canada so although we get free blood tests, they have to be ordered by our GPs first. I know my GP is short on knowledge when it comes to this drug so by bringing this stuff in he won’t be able to refuse doing the tests.

#4

I also live in Canada and feel your pain.

However, if you offer to pay for the tests instead of having them billed to MSP, they should have no objections. That’s what I had to do on my last round.

Also FYI: DHT apparently cannot be tested in Canada. They can draw the blood here, but need to courier it to a lab in the US. Also, serum blood tests for DHT are not entirely accurate – 24/hr urine panel is… again, likely only available via the US.

#5

I wouldn’t call his Free T mid-range. Its quite low, with respect to the reference range. Also, I wouldn’t say it is of little concern either… Testosterone plays a big role in mental function, energy levels, attention, and personal strength, as well as sexual functions we are all aware of.
This seems to be your problem as well.

I would definately get the SHBG and Estrogen tested as Mew has suggested.

#6

Yes, my bad… his Free T is still somewhat on the low side and could certainly stand to be higher. Mid-range would be more like 60 or so.

Yes, Testosterone is crucial – with Free T being more crucial than Total T, as Free T is the actual unbound T available to the body.

See if you can get that SHBG tested, Markus.

#7

Mew, I spoke to a different doctor today and she agreed to get SHBG, and S. Estradiol done. I asked about Estrone, Estriol, and Total E and she didn’t know if labs here do these tests or not. Do you know if these tests are available in Canada? Does it depend on the Lab company? She said if they are available she would OK them. BTW, what part of Canada are you from?

#8

And…

I got her to add on DHT which I called the Lab about and they said they can do it but it will be a taken from plasma because the 24 hour urine is not available. It also costs $67. Should I go ahead and order it? Are the results really that inaccurate?

She also put on Cortisol and was wondering if there was just 1 test for Cortisol or is there also a Free Cortisol (fasting AM) test? Which one should I do?

#9

I don’t think they are, but could be wrong. They are available in the US though. Might depend on the lab company. The tests they couldn’t do for me in Canada were done at ARUP Labs in Utah – aruplab.com/

Yes you should go ahead and order it, it may not be AS accurate as Urine but it obviously is somewhat accurate enough to give you an idea of if its high or low.

There is actually 2 Cortisol tests – AM and PM Cortisol. So if you can, get both. But if you can only do one, get AM at the same time as all your others.

Sounds like you have a good doc who’s willing to work with you.

#10

Mew, I spoke with MDS Labs and Canadian Medical Labs and both do all the Estrogens listed. MDS Labs also does DHT (blood) testing as well. You might want to check them out before going through the States again. BTW, I’m from London, Ont.

Here’s the MDS Labs website:

mdsdx.com/MDS_Diagnostic_Services/

#11

Markus, I went through MDS.

They shipped the DHT down to Arup because they don’t do it in Canada.

That’s what I was told, anyway.

#12

I had 2 more blood tests done recently. Both taken at about 8:15am.

On about October 15th:

E2: 45 pg/ml

On November 26th:

Testosterone: 24.1 (7.3 – 23.5) nmol/L (converts to about 688 in US units)
Free Testosterone: 48.1 (31-94) PMOL/L (converts to ???)

So… in 2 months I’ve had a huge jump in T but very little improvement in Free T. Any ideas why this has happened? The only thing I’ve done differently in the past 2 months is I’ve been hitting the gym about 5 times a week doing both cardio and weights. E2 is quite high so I got my doc to approve a SHBG test for this monday. If it ends up on the high end I’ll start to take DIM along with some other supplements.

#13

Blood test results as of Jan 21, 2008:

Total T: 21 (7.3 – 23.5) nmol/L
Free T: 42.5 (31-94) PMOL/L
Estradiol: 45 pg/ml
SHBG: 33 (10-70)
Progesterone: 1.6 (upper limit around 2.5 if I’m not mistaken)

This time my doc wouldn’t give me a copy of the results so I can’t post the exact ranges for progesterone but I do know that it is well under the upper limit and lower than it was 9 months ago.

So my E has not changed in the past 3 months and my Total T and Free T have declined in the past 2. The only reasons I can think of is that I had been taking some protein supplements everyday for about 2 weeks when I noticed I felt worse. I checked the ingredients and it contains whey AND soy protein so I stopped taking it and about 4 days later I started feeling much better. I stopped about 2 weeks before I too this blood test. I read that people with estrogen dominance should avoid soy as much as possible, so this could have influenced these values. Another reason could be due to a problem with 5AR causing the testosterone that should have been converted into DHT to be converted into E.

I’m sure if I can reduce E my free T will increase but getting that down has been impossible. I’ve been to an Endo who was no help at all, my GP who doesn’t have the time to spend on me, and really beyond monitoring my hormones doctors can’t do jack. I am going to a different Endo sometime this year (whenever they can take me) who supposedly has some experience with Propecia related problems. Other than that I am thinking about going to see Dr. Crisler (and spend a ton of money in the process).

Any comments are welcome.

#14

If your local doctor is cool, and willing to work with another doctor and work with you based on that, Dr. Crisler will treat you from where you are now, via telephone.
He has told me that, and I have talked to my young, and very cool, open-minded doctor (general practitioner), and we are going to start speaking with Crisler from Boston.

Tell me what you end up doing.

Good luck!

PS. I actually think my problems are E as well. I have high T, but low Free T as well.
Although by SHBG is very high, but I would like to get all E’s tested for because I am also suspecting that this may also be the source of my problems.