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Messages - PeakT

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1
Happy to see that my patient population is well represented here in the success stories! Great idea, BTW, to survey with such thoughtful and relevant questions.

Well, I'm not surprised of course!  Yeah, I am seeing some other parallels there and want to ask the guys a couple more questions.

2
This article provides a great summary of some of the research out there with regard to GSE as an aromatase inhibitor, and this site from Cohen's selfhacked.com site offers a great summary of the man benefits of this powerful supplement.

What I'm wondering is if anyone here has noticed any drop in their estradiol or a reduction in symptoms related to excess estrogen by taking GSE.

I don't think it has much of an effect.  And an important comment:  a lot of guys will take large amounts of CDG, DIM, I3C, etc.  GSE is quite bioactive:  it's kind of like a pycnogenol.  So you don't want to overdo it imo (since it has powerful antioxidant(s), i.e. there is likely a max dosage that is good for long term health.

3

Very well said on your part as well.

I recently had a very good discussion with Dr Richard Walker, whom I know you're very familiar with, but for others will suffice to say he is the GH secretagogue/IGF-1 guru and (IMO) authority on same topics. He has invested much of his life studying aging and he is of the mindset that a significant component of aging is dyssynchrony within the body and biological processes. Dyssynchrony all the way from a hormonal level, cellular/metabolic level, circadian rhythm, etc.

So, I assume by "dyssynchrony," he is essentially saying that physiological implies more than than just matching up simplistic plasma levels, i.e. we need to better match the actual "wave/step forms" and AUC, right?

4
Did you have access to the full text? That result for total testosterone is fairly small and somewhat contradicts other studies, but the DHT result is in line with the older research.

DHEA really ramps up DHT?  I didn't remember that?

6
Nutritional issues from GI problems could lead to muscle wasting. 

Dr. Crisler or Saya can better comment, but I believe undiagnosed hyperthyroidism could do the same thing.

Of course, always give any medications the eagle eye.
hyperthyroidism is almost always Graves Disease.

Being an automimmune disease, and since there are TSH receptors all over your body, it may come as no surprise even when the thyroid gland is removed, and Thyroid Replacement Therapy administered, the patient is still at increased risk for premature morbidity.

Unlike LH receptors, similarly all over the body, peripheral TSH receptors are not good to stimulate.

This is the first time I have typed the above statement. Realized it the other night, while sitting in the MSU Breslin Center, watching MSU (barely) beat Rutgers. LOL

TSH would be driven from low to normal if you removed a Graves Diseased thyroid and restored thyroid hormones, right?

8
LOL. Well thanks ;)  [edited by moderator] Maybe I can convince him to see me -- or ask his guidance on the phone...

Yeah, I have also heard he will retire soon.  Of course, I have been hearing that for a few years, so who knows when.

9
I am taking quite a few supplements mainly at the direction of my integrative medicine MD.  He is a big supporter of supplementation (at reasonable levels) mainly because he believes as we age our bodies do not process the vitamins obtained in food as efficiently.  In some cases I am taking more than the FDA, but not by that much.  (The exception is B vitamins.  I am MTHFR positive so those are taken like a prescription drug in higher doses).  I also take food based supplements:  Garlic, Citrulline.  I have had great results from my current protocol (along with TRT of course)

So did you feel better when you took those extra B vitamins?  Did it pull down homocysteine or any other markers you were targeting?

10
Look at Table 1 here:

https://www.sciencedirect.com/science/article/pii/S0735109705004705

CRP really spikes four hours afterward.  However, the baseline CRP is quite low for these guys.

11
I started on pellets and quickly realized how cost ineffective they are vs injections. Especially if you need larger doses (which I did). Testopel pellets are $1/mg. The compounded pellets I got were $0.37/mg. Injections cost me $0.06/mg. In addition, you'll pay at least $200 to have them inserted. I would've needed them inserted at least every 3 months. I had 1500 mg inserted. One month later, my total testosterone level was only 550. Another month and I probably would've been back to where I started. At 3 months, my levels would've probably been lower. I'm on 160mg/week. To get that equivalent with pellets, I'd be spending $237/month (for compounded pellets) or $640/month (for testopel). Plus, $230 every 2-3 months to have them inserted. Only to end up with inferior results to injections (high levels in the beginning and low levels at the end). No thanks.

Yeah, my theory has always been that it's the doctors mostly pushing pellets, because they get an extra reimbursement from it.  The guys enjoying pellets have been few and far between also.

12

So I assume like the great majority of us, secondary?  If so, then usually you can move that testosterone (total) significantly enough to make a difference.  Now DHEA may raise your free testosterone a little and there is research that correcting hypothyroidism can raise your testosterone about 30%.  Check this out:

http://www.peaktestosterone.com/testosterone_thyroid.aspx

But you probably won't feel good if your free T is up after all of that by 40% (assuming that even happens).  But you may want to try it and see - it's possible.  Considering your age, it might not be a bad idea?  Discuss with Defy if you have any hesitations - it's an important decision.

Now one practical comment:

When you were low testosterone, what was your E2?  Some guys can have such low testosterone that they are probably experiencing bone loss.  In that case, there is not much choice except to treat.  (It is also possible to be anemic when testosterone is low.)

Yes, I am secondary. DHEA was 191 (Dr. said it should be low 500s) & my free T3 has been consistently low w/ good FT4 & <2 TSH consistently. My E2 w/ low T was 23 & with clomid it went up to 26 (so not a big increase which is surprising). Clomid works for me, but its not 100% consistent & I can't tell if im having eye issues that I didn't have before. I wake up every morning with wood. I don't have any crazy brain fog or anything but my main symptoms were sexual & body composition wise(+ the pain but that might more thyroid related as well). Dr. Calkins basically said if I wanted to take the conservative route i could try it for a month or two. 

I also have elevated liver enzymes & hear clomid is harsh on the liver.

From that thyroid study & page it looks like it brought T from like 300 to 400 or so.

Got it.  Yeah, the DHEA could be an issue. 

Hey, I accidently wrote that you can change your testosterone if you are secondary.  I didn't mean that - the exact opposite in fact.  Very few guys on here budge their testosterone no matter what they try.  Now, if you are zinc deficient or have a lot of weight to lose, then that may be something different.

13


I am not an SHBG expert but I am using on the latter end of you, within 1-3 points off the base min and when that happens, I usually do not feel well.  Perhaps someone on the forum can touch base with you on that because I lack understanding in how SHBG plays a role, but based on what I read, it really does and is related to things which are relatively complicated and harder to balance.

Your Thyroid looks normal.

One thing you didn't check for is prolactin.  It is important to rule out prolactinomas, they are a common cause of hypogonadism in young people; an MRI would show that, a blood test showing severely elevated prolactin levels would typically indicate that.

Yeah, a lot of the higher SHBG guys do not feel well.  Of course, a guy with higher SHBG can just take more testosterone and, therefore, get more estradiol and DHT.  However, why they often do not feel that great even after that I am not sure.  I think the consensus on here is that more SHBG is much better than less - look at the thread stickied at the top of the forum to see why that probably is:

http://www.peaktestosterone.com/forum/index.php?topic=14226.0

14


As I said, I definitely understand what you're saying and is why I didn't jump right into therapy and instead chose to look into diet and lifestyle improvements over the last year and a half.  I am just investigating clomid to see if I can do more to elevate my natural production. 

I remember reading about a variant of clomid. .. . I think it was clomid minus one of the estrogenic isomers, but can't remember what it is called?  My main hesitation with clomid are estrogenic sides and the *possibility* of this effecting mood.

At any rate, I appreciate the feedback.

Enclomiphene which got killed by the FDA in its infinite wisdom.

15
Well today I saw my dr. She wants me of off my arimidex for 6 weeks and see what the levels are then since the sensitive came back at 5. She also went up on my t cream from 150 to 200 and asked that I apply this time on the flanks since it was 465 or so when applied on my thigh.  We'll see!

Yeah, you have to really watch that.  She knows about the bone loss issue, right?

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