Very Low Androgens after Cortisol replacement?

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Hi Val,

DeborahSu & Oz of RTH have suggested a couple of times that

I should post here & benefit from your experience & wisdom.What I am

VERY concerned at present are my Androgens.

-------------------I HAVE AN FAI OF ZERO!!!!!------------------------

I had been on Prednisolone for just over a month, and started

Florinef 5 days before most recent tests done.

So what effect do Corticosteroids(HC Prednisolone) have on Androgens

& (Sex)Hormones? Check out my Androgens results below! Pretty dire

especially considering I ALREADY take 20mg DHEA daily (note except

for 3 days prior to these tests)!!!! Progesterone & E2 also pretty

low too (on HRT over a year for both of those too).

I am a 50 year old Female who thought she was Postmenopausal UNTIL

had a period in Feb'08.

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Links to my Member Logs on RTH

Lethal's Labs Part One

http://forums.realthyroidhelp.com/viewtopic.php?t=2468

Lethal's Labs Part Two

http://forums.realthyroidhelp.com/viewtopic.php?t=4645

Lethal's Meds & Supps

http://forums.realthyroidhelp.com/viewtopic.php?t=2418

Lethal's Personal/Family/Medical History & Background

http://forums.realthyroidhelp.com/viewtopic.php?t=2419

Lethals Temp & BP's,Pupil Response,Cardiology,Hair Analysis

http://forums.realthyroidhelp.com/viewtopic.php?t=2417

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Meds & Supps

CHROMIUM PICOLINATE

Started 403mcg daily in Oct'07

increased to 806mg daily 14th Jan'08

VITAMIN D

1000 IU daily started 14th Dec'07

increased to 2000 IU daily since 30th Jan'08

BIEST

Natural HRT Biest (E2/E3) 1gm x 0.1% Cream from 4th Dec'06

PROGESTERONE

Profeme (Progesterone) 32mg daily from 4th Dec'06

Increased to 64mg daily from 1st Dec'07.

DHEA

DHEA supplements 15mg daily since 2004

increased to 20mg daily since Oct'07

NATURAL THYROID HORMONE

Natural Thyroid Hormone increased by 15mg late Jan'08

Now on 90mg total NTH

FLORINEF

Currently still flunk the BP & Pupil tests.

Started 24th Feb'08 0.025mg (1/4 Tab)

increased to 0.050 (1/2 tab) 29th Feb'08.

Increased to 0.075mg (3/4 tab) 5th March'08

In another 5 days will increase to 0.100mg (1 tab)

All being well will remain on 1 tab thereafter.

Note: I am still supping Salt & Potassium.

Recent Sodium result was good (at top of range)

Potassium had improved a bit.

SOLONE (PREDNISOLONE)

Started 26th Jan'08 on 20mg tapered DOWN. Tried HC didn't suit me

(metabolised too quick & had to stress dose too much & often) &

couldn't reduce Solone down further than 7.5mg daily.

From 13th Feb'08 onwards on the following schedule-

Morning 2 1/2 mg (1/2 Tab) Solone

7-8 Hours Later 2 1/2mg (1/2 Tab) Solone

7-8 Hours Later 2 1/2mg (1/2 Tab) Solone

Total 30mg HC daily equiv as 'normal daily dose'

nb.haven't needed to stress dose for two weeks now. Actually not sure

if 7.5mg is equiv to 30 or 37.5mg HC (1mg Prednisolone = 4 OR 5mg HC?)

NOTE: I stopped the Dhea caps, Folic Acid tabs, Prog & Estrogen

Creams 3 full days before 29th Feb tests. Thyroid & Adrenal meds were

NOT stopped but took morning meds AFTER tests done. Back on all of

them now.

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RECENT LABS

ANDROGENS

24th Nov'07

Testosterone........ 2.2 nmol/L (0.02-2.9) *76% of Ref GOOD result

SHBG ...................70 nmol/L (26-110)

FAI ........................3..............(0.51-6.5)

DHEAS ...............7.2 umol/L (0.9-11.7) *58% good improvement BUT

still too low

Androstenedione...4.6 nmol/L (1-11.5)

Free Test ..............24 pmol/L (4-39)

29th Feb'08

Testosterone........ 0.1 nmol/L (0.02-2.9) *BELOW RANGE DEFICIENCY

SHBG ...................44 nmol/L (26-110)

FAI ........................0............(0.51-6.5) *ZERO????????

DHEAS ................0.6 umol/L (0.9-11.7) *BELOW RANGE DEFICIENCY

Androstenedione...1.0 nmol/L (1-11.5) *BOTTOM OF RANGE

Free Test .............1.6 pmol/L (4-39) *BELOW RANGE DEFICIENCY

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HORMONES

24th Nov'07 *Peri-Menopausal Result

No HRT for 7 days prior & day of test

FSH..................24 U/L

*AFTER 1 year HRT improved still Postmenopausal

LH ...................24 U/L

*AFTER 1 year HRT improved still Postmenopausal

E2..................245 pmol/L

*AFTER 1 year HRT doubled pre-HRT levels

Prog................0.4 nmol/L *AFTER 1 year HRT 80% LESS

LH/FSH Ratio.......1

29th Feb'08 *Menopausal Result

No HRT for 3 days prior & day of test

FSH..................30 U/L

LH ...................17 U/L

E2....................89 pmol/L *dropped 60% since last test

Prog................2.5 nmol/L *has increased back to preHRT levels

LH/FSH Ratio....0.57

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THYROID PANEL

24th Nov'07

TSH.....................0.57 mU/L (0.4-4.0) *3 months on 75mg NTH

FT4.......................11 pmol/L (9-19) *low end ref range!

FT3......................3.8 pmol/L (2.6-5.7) *only slightly better

than before NTH!

TPOAb............less than 1 IU/mL (less than 5.6)

TGAb.. ..................1.6 IU/mL (less than 4.1)*first +ve Abs

since 2001

Reverse T3...............329 pmol/L (170-450) *57% of ref range

Ratio FT3/RT3 (3.8/329)..0.0115501 *<0.20 RT3 Dominance

29th Feb'08

TSH.....................0.13 U/L (0.4-4.0) *1 month on 90mg NTH

FT4.......................11 pmol/L (9-19) *no change far too low!

FT3........................4 pmol/L (2.6-5.7) *only slightly better!

TPOAb............less than 1 IU/mL (less than 5.6)

TGAb.......................1 IU/mL (less than 4.1)

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KIDNEY FUNCTION TEST

24th Nov'07

Urea ...........3.9 mmol/L (2.5-8)

Creatinine.......66 umol/L (53-97)

BUN ..........10.93 .......(8-20) *good

eGFR ..........87.5 .......(90-120) *Just below Range

Sodium..........145 mmol/L.(134-146)*best result ever

Potassium.......3.8 mmol/L.(3.5-5.4)*low worst result since supps

Chloride........105 mmol/L.(95-108)

Bicarbonate......28 mmol/L.(21-32)

Anion Gap......15.8 .......(8-16) *Improved now just in Range

20th Feb'08

Urea ...........5.1 mmol/L.(2.5-8)

Creatinine.......69 umol/L (53-97)

BUN ...........14.2 .......(8-20) *Getting too high again

eGFR ..........83.1 .......(90-120) *Lower again below Range

Sodium..........145 mmol/L.(134-146) *GOOD

Potassium.......4.3 mmol/L.(3.5-5.4) *improved

Chloride....... 106 mmol/L.(95-108)

Bicarbonate.... 29 mmol/L..(21-32)

Anion Gap.....14.3 ........(8-16) *Further improvement still high-

normal

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LIVER FUNCTION TEST

24th Nov'07

AST ................31 U/L ...(less than 37)

ALT ................56 U/L ...(less than 40) *elevated again

ALP ................78 U/L ...(30-140)

GGT ................23 U/L ...(less than 32)

Total Bilirubin.....10 umol/L (less than 20)*Starting to creep up

Protein ............73 g/L ...(63-83)

Albumin.............43 g/L ...(35-50)

Globulin ...........30 g/L....(20-40)

Alb/Glob Ratio....1.43........(1-2 ~1.7 Ideal)

29th Feb'08

AST ...............14 U/L ....(less than 37) *ARE THESE LOW LEVELS

GOOD OR BAD???

ALT ...............25 U/L ....(less than 40)

ALP ...............75 U/L ....(30-140)

GGT ...............25 U/L ....(less than 32)

Total Bilirubin.....6 umol/L (less than 20)

Protein ...........72 g/L ....(63-83)

Albumin............41 g/L ....(35-50)

Globulin ..........31 g/L.....(20-40)

Alb/Glob Ratio...1.32.........(1-2 ~1.7 Ideal)

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VITAMIN D ideal 70-90

24th Nov'07 25-Hyroxyvit D....16 nmol/L (35-150) *DEFICIENT

20th Feb'08 25-Hyroxyvit D....67 nmol/L (35-150) *Now 74% of optimal

PARATHYROID HORMONE (PTH) peaks at 2am apparently

24th Nov'07 PTH.....8 pmol/L (1.3-7) *Secondary HyperParathyroid

20th Feb'08 PTH.....7.4 pmol/L (1.3-7) *still elevated WHY?

CALCIUM STUDIES

24th Nov'07

Calcium.................2.26 mmol/L

Albumin...................41 g/L(35-50)

Corrected Calcium.......2.32 mmol/L (2.15-2.55)

Ionised Calcium.........1.22 mmol/L (1.12-1.32)

20th Feb'08

Calcium.................2.24 mmol/L

Albumin...................38 g/L....(35-50)

Corrected Calcium.......2.37 mmol/L (2.15-2.55)

Ionised Calcium.........not tested

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FERRITIN goal maintain ~50 (have Hemochromatosis)

24th Nov'07

Total Iron..............10 umol/L (5.4-28.6)*OK for HH

Transferrin ............30 umol/L (25-45.4)

TFN Satn ...............17% ......(18-30%) *good for HH

Ferritin ...............84 ug/L...(20-180) *STILL too high for HH

29th Feb'08

Ferritin................54 ug/L...(30-270)

*marked reduction since Nov IDEAL for HH

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BLOOD SUGARS

24th Nov'07

Glucose Fasting ..........4.6 mmol/L (3.5-5.4)

Insulin Fasting ...........11 mU/L (<20)*75% lower than June

Glucose/Insulin Ratio.....7.5 *Borderline Insulin Resistant Result

20th Feb'08 *effectively back in 'Insulin Resistant' category

Glucose Fasting ..........4.1 mmol/L (3.5-5.4)

Insulin Fasting ...........16 mU/L (<20)*45% higher than Nov BUT

still 60% less than June

Glucose/Insulin Ratio.....4.6

*Top of Borderline/Bottom Insulin Resistance Ref

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LIPIDS

24th Nov'07

Total Chol..... 3.5 mmol/L..(less than 5.5) *TOO LOW

Tri's ..........0.5 mmol/L..(less than 1.8) *good 60% decrease

HDL.............1.1 mmol/L..(1.1-3.5) *far from ideal needs to be

higher

Risk Ratio .....3.2.........(less than 3.5)

LDL ............2.2 mmol/L..(less than 3.5)

HDL/LDL........0.50

29th Feb'08

Total Chol..... 4.2 mmol/L..(less than 5.5) *still suboptimal

Tri's ..........0.7 mmol/L..(less than 1.8). *good

HDL.............1.5 mmol/L..(1.1-3.5) *still suboptimal

Risk Ratio......2.8.........(less than 3.5)

LDL ............2.4 mmol/L..(less than 3.5)

HDL/LDL........0.63

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Comments

KFT & LFT

I also had these done which seem pretty OK?

VIT D

has come up well (had bad deficiency), Calcium is fine however my PTH

is still elevated. I'm not sure why? Hopefully once Vit D fully

optimised the PTH will go down. Will retest all again in 2 months

time. I'm still supping Vit D.

VIT B6

is top of range

FERRITIN

has reduced (needed to was too high for HH)

although I did want this to go down NOT AT ALL SURE WHY IT HAS????

I now eat much MORE red meat than I was before - lots of steak due to

frequent protien needs. I have not donated blood BUT levels reduced

from 84 to 54 in 3 months???

CHOLESTEROL

has increased (needed to was too low)

BLOOD SUGARS

show fasting Glucose lower & Insulin higher. Hopefully once the

Florinef & Pred sorted blood sugar regulation will improve.

THYROID

TSH is pretty well suppressed (which is fine)

FT3 & FT4 still too low (Hypothyroid) but to be expected as NTH is

NOT optimised as yet. Once Florinef & Solone is sorted (Adrenals

fully supported) I will be starting to Raise NTH (as per recommended

schedule).

VIT B12

I'm still supping B12 (was almost 50% of range last November)

FOLATE/FOLIC ACID

also still supping Folic Acid (Folate was 40% of range last

November).

HORMONES

We thought Progesterone was being used for Cortisol before I started

Cortisol replacement. Progesterone is now testing higher which makes

sense as with the Solone I'm now on prog NOT needed for Cortisol?

Also Prog HRT was doubled in Nov.

NOTE- I had a period 15th Feb to 22nd Feb FOR THE FIRST TIME IN 9

MONTHS!!!!

Despite this Estrogen is way down compared to Nov tests- I don't know

why. There has been no change to my Estrogen HRT dose.

ANDROGENS

The strange thing about the Testosterone & DHEA is that my Libido has

IMPROVED since starting the Adrenal meds. Could being off DHEA for

just 3 days have such a devastating effect on my levels??? I think I

did read that steriods may lower DHEA. Well " Holey, toledo Batman! " -

in MY case its seems to have STOPPED it completely!!!!!

STILL PENDING

Red Cell Magnesium, Red Cell Zinc & Red Cell Folate were all tested

but results are pending.

What do I do about it? Obviously is was a VERY bad idea for me to

stop my DHEA (AND Progesterone & Estrogen)!!!

Maybe I need to INCREASE them all in view of the above????

So Val any idea what do you think is going on with my DHEA &

Testosterone???

Lethal Lee