Endocrinologist clueless any ideas?

[Cbreeze]

Hi guys, recently found out about Ray Peat(rediscovered rather)and think the dude was fricken amazing. I was a trained osteopath and resonate with his philosophy very much. These results were from a visit to an endocrinologist, she was a bit clueless on why I presented with these findings "presented with low libido and absence of morning erections, in the context of normal erectile function. His total testosterone levels had been normal to high, therefore freetestosterone and SHBG were not done. It is likely that he has non-testosterone related libidoissues, for example stress, external +/- relationship factors. No issues with sexual intercourse" I would love to hear everybodies thoughts on what might be going on. The symptoms I experience have been going on since maybe early 20s. I am currently 29, no change.

She asked if I was on steroids haha to which the answer is definitely not.

Medication:Magnesium/ZInc supplementHerbal - Tongkat Ali / Boron

No known allergies.

Examination Findings, Looks well BP 128/84, pulse 115 (on arrival - I had actually been running as I almost missed my appointment.. normal pulse around 60.)
Weight 81.2kg, height 182cm, BMI 23.5
No goitre
Normal facial hair volume and distribution
No gynaecomastia
Genitalia not examined

Total testosterone (T) 32.3 nmol/L (8.7-29.0) - was 20.2 on 22/09/17Negative ANA, dsDNA, coeliac screenNormal Hb (142), LFT, HbA1c (33), Na (1420, K(4.4), creatinine 117 (eGFR 74), CRP<1

26/03/19 8am
Total T - 34.1 nmol/L (8.7-29.0) = normal/highFree T,
SHBG - not done by Lapplus as total T was >15FSH 10.3 (2-11),
LH 5.4 (2-11),
prolactin 222 (ref<240),
estradiol 122 pmol/L (ref<161)
DHEAS 4.7 umol/L (4.0-13.9)
17OH progesterone 2.8 nmol/L (<6.0)
Growth hormone 0.22 ug/L (0-24); IGF- 1 229 ng/ml (125-371) = normal
Cortisol 461nmol/L (normal),
ACTH 8 pmol/L (2-11)T4 17,
TSH 2.3 (normal TFT);
Thyroperoxidase antibody 29U/mL (<60)
PSA 0.5 (normal),
ferritin 105 ug/L (normal),
renal function - normal,
HbA1c 34 mmol/mo


More recently I've been diagnosed with CRS(chronic rhinosinusitis), severe polyps, consistently elevated eosinophils (0.8) for over a year since getting the vaccine (potentially just a coincidence though).
Thank you very much

 

[Jessie]

Your TSH, though considered normal, is still elevated beyond what's considered optimal. Getting it below 2.0 mu/L would be best for metabolism. I don't think, however, that would be enough to consider the source of your libido problem.

What's your diet look like? Do you eat seafood occasionally for trace minerals like zinc and selenium? Trying increasing your red meat and oyster consumption, also throw in some low dose pregnenolone (25-50mgs).

 

[Mister]

You taking finasteride or other things?

 

[stoic]

I don't know what that reference value is based on, but your prolactin seems high.

Given its direct anti-libido effects, I think it's a hormone that should be looked into.

 

[Hans]

Hi guys, recently found out about Ray Peat(rediscovered rather)and think the dude was fricken amazing. I was a trained osteopath and resonate with his philosophy very much. These results were from a visit to an endocrinologist, she was a bit clueless on why I presented with these findings "presented with low libido and absence of morning erections, in the context of normal erectile function. His total testosterone levels had been normal to high, therefore freetestosterone and SHBG were not done. It is likely that he has non-testosterone related libidoissues, for example stress, external +/- relationship factors. No issues with sexual intercourse" I would love to hear everybodies thoughts on what might be going on. The symptoms I experience have been going on since maybe early 20s. I am currently 29, no change.

She asked if I was on steroids haha to which the answer is definitely not.

Medication:Magnesium/ZInc supplementHerbal - Tongkat Ali / Boron

No known allergies.

Examination Findings, Looks well BP 128/84, pulse 115 (on arrival - I had actually been running as I almost missed my appointment.. normal pulse around 60.)
Weight 81.2kg, height 182cm, BMI 23.5
No goitre
Normal facial hair volume and distribution
No gynaecomastia
Genitalia not examined

Total testosterone (T) 32.3 nmol/L (8.7-29.0) - was 20.2 on 22/09/17Negative ANA, dsDNA, coeliac screenNormal Hb (142), LFT, HbA1c (33), Na (1420, K(4.4), creatinine 117 (eGFR 74), CRP<1

26/03/19 8am
Total T - 34.1 nmol/L (8.7-29.0) = normal/highFree T,
SHBG - not done by Lapplus as total T was >15FSH 10.3 (2-11),
LH 5.4 (2-11),
prolactin 222 (ref<240),
estradiol 122 pmol/L (ref<161)
DHEAS 4.7 umol/L (4.0-13.9)
17OH progesterone 2.8 nmol/L (<6.0)
Growth hormone 0.22 ug/L (0-24); IGF- 1 229 ng/ml (125-371) = normal
Cortisol 461nmol/L (normal),
ACTH 8 pmol/L (2-11)T4 17,
TSH 2.3 (normal TFT);
Thyroperoxidase antibody 29U/mL (<60)
PSA 0.5 (normal),
ferritin 105 ug/L (normal),
renal function - normal,
HbA1c 34 mmol/mo


More recently I've been diagnosed with CRS(chronic rhinosinusitis), severe polyps, consistently elevated eosinophils (0.8) for over a year since getting the vaccine (potentially just a coincidence though).
Thank you very much

Prolactin too high and DHEA-S too low. Prolactin is anti-libido as already mentioned and DHEA-S and downstream hormones (e.g. androsterone and DHT) are very important for libido and sexual function.

E2 is also a big high and elevated E2 has been shown to be an independent risk factor for lack of morning wood.

TSH can be a bit lower, which makes me think that T3 is a bit low. T3 will help to optimize the testosterone to estradiol ratio as well as the DHT to testosterone ratio.

Make sure to eat a nutrient dense diet high in dairy (if you tolerate it), oysters, eggs, red meat and organ meat. That will give you all the nutrients (e.g. B6, zinc, etc.) you need to lower TSH, prolactin and estradiol.

As a side note, FSH is high at a 10 which can indicate some sort of Sertoli cell dysfunction.

 

[Normal Human]

Hi guys, recently found out about Ray Peat(rediscovered rather)and think the dude was fricken amazing. I was a trained osteopath and resonate with his philosophy very much. These results were from a visit to an endocrinologist, she was a bit clueless on why I presented with these findings "presented with low libido and absence of morning erections, in the context of normal erectile function. His total testosterone levels had been normal to high, therefore freetestosterone and SHBG were not done. It is likely that he has non-testosterone related libidoissues, for example stress, external +/- relationship factors. No issues with sexual intercourse" I would love to hear everybodies thoughts on what might be going on. The symptoms I experience have been going on since maybe early 20s. I am currently 29, no change.

She asked if I was on steroids haha to which the answer is definitely not.

Medication:Magnesium/ZInc supplementHerbal - Tongkat Ali / Boron

No known allergies.

Examination Findings, Looks well BP 128/84, pulse 115 (on arrival - I had actually been running as I almost missed my appointment.. normal pulse around 60.)
Weight 81.2kg, height 182cm, BMI 23.5
No goitre
Normal facial hair volume and distribution
No gynaecomastia
Genitalia not examined

Total testosterone (T) 32.3 nmol/L (8.7-29.0) - was 20.2 on 22/09/17Negative ANA, dsDNA, coeliac screenNormal Hb (142), LFT, HbA1c (33), Na (1420, K(4.4), creatinine 117 (eGFR 74), CRP<1

26/03/19 8am
Total T - 34.1 nmol/L (8.7-29.0) = normal/highFree T,
SHBG - not done by Lapplus as total T was >15FSH 10.3 (2-11),
LH 5.4 (2-11),
prolactin 222 (ref<240),
estradiol 122 pmol/L (ref<161)
DHEAS 4.7 umol/L (4.0-13.9)
17OH progesterone 2.8 nmol/L (<6.0)
Growth hormone 0.22 ug/L (0-24); IGF- 1 229 ng/ml (125-371) = normal
Cortisol 461nmol/L (normal),
ACTH 8 pmol/L (2-11)T4 17,
TSH 2.3 (normal TFT);
Thyroperoxidase antibody 29U/mL (<60)
PSA 0.5 (normal),
ferritin 105 ug/L (normal),
renal function - normal,
HbA1c 34 mmol/mo


More recently I've been diagnosed with CRS(chronic rhinosinusitis), severe polyps, consistently elevated eosinophils (0.8) for over a year since getting the vaccine (potentially just a coincidence though).
Thank you very much

Seconding what others have said here. What is your waking temperature? Have you read Broda Barnes' book "Hypothyroidism the Unsuspected Illness"? It's got to be one of the best books on clinical, empirical medicine ever written and the cases he presents are mind-blowing. Waking temperature is the best metric of thyroid function since it is an end organ test.

Do you know your Vitamin D?

Lastly, what you mention in the last paragraph sounds very similar to the symptoms of Aspirin-Induced Asthma. I don't necessarily think it's related to the libido, but probably something good for you to look into yourself if you haven't already.

 

[ThazMYchocolate]

yeah i agree with others, TSH is a little high (which means thyroid is not working--it's asking the thyroid to pump out more). High prolactin could be because of not enough thyroid hormone

 

[ThazMYchocolate]

to put it in perspective my TSH was only ever as high as 1.5 when I was very hypothyroid, so I was never treated for it until I had thyroid nodules the size of walnuts. My labs were always "good" to the docs (but in retrospect my Total T4 was actually low and that should have tipped off my endo)

 

[Cbreeze]

Hey guys apologies for the late response, I really appreciate all the replies. I figured my prolactin was the biggest issue there. It's interesting about the thyroid. I'm not sure of my temperature readings being very new to Peat ideas. I've always found heat difficult to handle though. I mention of E2 surprises me with my testosterone being so high, unfortunately SHBG was not tested as the lab technicians thought they knew better then the endo (lol). I've always eaten eggs, high protein(ish). Have recently cut out gluten, including orange juice, fruit for carbs (no more rice/potato/etc). Have an immunologist apt in a few days due to what feels like OA in my fingers (i'm 29 :/ ) so will be able to see if anything autoimmune is going on as well.

One finding I forgot to mention is it seems I have chronic neutropenia as well, which, appears to be related to copper deficiency. I did for a few years take 45-50mg zinc for awhile everyday without copper so possibly that is the issue. Have recently started liver around 40-50grams a week thus far. In week 1 :)