High DHEA, low T, 20s male; Help with blood work interpretation.

[EnergeticLeo]

I'm a bit confused as to whether I would benefit from a progesterone + DHEA supplement. Maybe 20-50 mg progesterone + 2-5 mg DHEA (inspired by Structural Requirements For An Optimal Anti-Catabolic Steroid). I'm thinking such a supplement, especially progesterone, could take the stress of the adrenals, while the DHEA could mitigate any anti-androgenic effects of the progesterone.

My DHEA sulphate was really high, so I'm wary that taking extra DHEA may simply convert to estrogen. On the other hand I'm almost certainly low on androgens, and so am looking for ways to boost them, as a way to improve metabolism (inspired by The Thyromimetic Mechanism Of Androsterone (and Other Androgens)).

Am male, low 20s.

Suffering from numerous hypo-metabolic symptoms such as poor sleep, frequent fatigue and headaches, poor skin, slow beard growth, easy fat gain etc...

My most recent bloods (not fasted) are:

Item	Value	Range
DHEA Sulphate	15.7	6.5 - 14.6 umol/L
Cortisol	310	nmol/L
FSH	1.9	1.5 - 12.4 mIU/ml
LH	3.3	1.7 - 8.6 U/L
Estradiol	95	41.4 - 159 pmol/L
Prolactin	274	86 - 324 mU/L
Testosterone	17.24 [497 ng/dL]	8.6 - 29 nmol/L
SHBG	27.3	8.3 - 54.1 nmol/L
Free Androgen Index	63.15	35 - 92.6 %

A recent cortisol saliva test x 4 showed high cortisol in the evening.

Thanks!

 

[Jessie]

Your T is actually in the reference range. It could technically be a little higher, but don't fix what isn't broken. Have you tried thyroid supplementation? Taking a little extra calcium (eggshell powder) will push that prolactin down some more.

 

[EnergeticLeo]

yep, on about 37.5 T3, and 75 T4. Have been on thyroid for a few months.
Yes I love eggshell calcium! Between eggshell calcium, and calcium from cheese I very consistently get 2.5-3g daily. Have recently upped my Vit D too to push prolactin down more.

 

[Vanset]

Do you have bloods with trigs, fasting insulin, liver enzymes, total cholesterol, ldl?
What do you eat? Calories, macros, individual foods and in what quantity.

 

[Hans]

I'm a bit confused as to whether I would benefit from a progesterone + DHEA supplement. Maybe 20-50 mg progesterone + 2-5 mg DHEA (inspired by Structural Requirements For An Optimal Anti-Catabolic Steroid). I'm thinking such a supplement, especially progesterone, could take the stress of the adrenals, while the DHEA could mitigate any anti-androgenic effects of the progesterone.

My DHEA sulphate was really high, so I'm wary that taking extra DHEA may simply convert to estrogen. On the other hand I'm almost certainly low on androgens, and so am looking for ways to boost them, as a way to improve metabolism (inspired by The Thyromimetic Mechanism Of Androsterone (and Other Androgens)).

Am male, low 20s.

Suffering from numerous hypo-metabolic symptoms such as poor sleep, frequent fatigue and headaches, poor skin, slow beard growth, easy fat gain etc...

My most recent bloods (not fasted) are:

Item	Value	Range
DHEA Sulphate	15.7	6.5 - 14.6 umol/L
Cortisol	310	nmol/L
FSH	1.9	1.5 - 12.4 mIU/ml
LH	3.3	1.7 - 8.6 U/L
Estradiol	95	41.4 - 159 pmol/L
Prolactin	274	86 - 324 mU/L
Testosterone	17.24 [497 ng/dL]	8.6 - 29 nmol/L
SHBG	27.3	8.3 - 54.1 nmol/L
Free Androgen Index	63.15	35 - 92.6 %

A recent cortisol saliva test x 4 showed high cortisol in the evening.

Thanks!

Have you checked your TSH, free and total T3?
Hypothyroidism is a common cause of high prolactin.

Stress will promote both the release of DHEA and cortisol. You likely don't need extra DHEA as you mentioned. You can try some prog to see if it helps with the stress, which it should. Maybe other adaptogens such as magnesium, taurine, theanine, etc, can also help to calm the stress.
As stress drops, DHEA-S will also drop a bit.

 

[EnergeticLeo]

Do you have bloods with trigs, fasting insulin, liver enzymes, total cholesterol, ldl?
What do you eat? Calories, macros, individual foods and in what quantity.

A very typical day of eating for me looks like

These bloods are recent too:

Item	Value	Range
Cholesterol	5.7 mmol/L [220 mg/dL]
LDL	3.9 mmol/L
HDL	1.22 mmol/L	1.01 - 5 mmol/L
Triglycerides	1.3 mmol/L	0 - 1.7 mmol/L
Cholesterol/HDL ratio	4.7
Liver ALT	146 u/L	0 - 41 u/L
Transferrin saturation index	57 %	20 - 50 %
Ferritin	650 ug/L	30 - 400 ug/L

 

[EnergeticLeo]

Have you checked your TSH, free and total T3?
Hypothyroidism is a common cause of high prolactin.

Stress will promote both the release of DHEA and cortisol. You likely don't need extra DHEA as you mentioned. You can try some prog to see if it helps with the stress, which it should. Maybe other adaptogens such as magnesium, taurine, theanine, etc, can also help to calm the stress.
As stress drops, DHEA-S will also drop a bit.

Recent TSH: 0.42 mIU/L (range: 0.27 - 4.2 mIU/L).

They don't test FT3, FT4 if TSH is within range, which is annoying, but I'll try to get them tested somehow soon.

Thanks, will give the prog a try.

Do you think androsterone could be of use? Or would the high DHEA provide plenty of precursor for androsterone, DHT etc...?

 

[Hans]

A very typical day of eating for me looks like
View attachment 46005

These bloods are recent too:

Item	Value	Range
Cholesterol	5.7 mmol/L [220 mg/dL]
LDL	3.9 mmol/L
HDL	1.22 mmol/L	1.01 - 5 mmol/L
Triglycerides	1.3 mmol/L	0 - 1.7 mmol/L
Cholesterol/HDL ratio	4.7
Liver ALT	146 u/L	0 - 41 u/L
Transferrin saturation index	57 %	20 - 50 %
Ferritin	650 ug/L	30 - 400 ug/L

I think you can benefit from higher dose thyroid to bring cholesterol down and HDL up.
Perhaps also donate blood to bring your ferritin and saturation down.

 

[EnergeticLeo]

I think you can benefit from higher dose thyroid to bring cholesterol down and HDL up.
Perhaps also donate blood to bring your ferritin and saturation down.

Ok sounds good, didn't know about the HDL-thyroid link.

 

[EnergeticLeo]

Have you checked your TSH, free and total T3?
Hypothyroidism is a common cause of high prolactin.

Stress will promote both the release of DHEA and cortisol. You likely don't need extra DHEA as you mentioned. You can try some prog to see if it helps with the stress, which it should. Maybe other adaptogens such as magnesium, taurine, theanine, etc, can also help to calm the stress.
As stress drops, DHEA-S will also drop a bit.

And what do you think about the potential anti-androgenic effect from prog-only?

 

[Vanset]

Trig are alright. DHEA-S is only slightly elevated. If it dropped to the upper range I wouldn't personally pay much attention to it. You're already on thyroid and your SHBG and total t are quite low. ALT through the roof and so is ferritin... you should try blood donations first tbh

 

[EnergeticLeo]

Trig are alright. DHEA-S is only slightly elevated. If it dropped to the upper range I wouldn't personally pay much attention to it. You're already on thyroid and your SHBG and total t are quite low. ALT through the roof and so is ferritin... you should try blood donations first tbh

Ok, thanks!

 

[Ned Nederlander]

I’ll add that while your T is in the reference range, it’s pretty low for your age. I’d try a few natural actions to raise it.

Lift weights three times a week. (Most effective thing you can do to raise test, in my opinion)
Trim down if you’re overweight.
Eat more saturated fat and egg yolks.
Stop watching porn and masturbating if you do.
If you smoke weed or do other recreational drugs, drop them.
Limit alcohol to a few drinks once a week.

 

[youngsinatra]

Do you possibly have genetic hemochromatosis?

I am asking because your ferritin is dangerously high and your liver enzymes and iron saturation levels are significantly elevated too.

 

[EnergeticLeo]

Do you possibly have genetic hemochromatosis?

I am asking because your ferritin is dangerously high and your liver enzymes and iron saturation levels are significantly elevated too.

You're right - it's worryingly high, especially the ferritin and iron.

My ALT was 24 (range 0 - 41), and ferritin was 380 (range 30 - 400) just before I started Peating, about 8 months ago. Could this too be consistent with hemachromatosis?

Ferritin was 270, ALT was 26 in 2021.

 

[Vanset]

you could probably also try replacing some of the juices or white sugar with more eggs. Do you really need almost 4L of various juices and granulated sugar? Do you tolerate eggs well? Try having like 6 softboiled eggs daily instead of the granulated sugar for example

 

[EnergeticLeo]

you could probably also try replacing some of the juices or white sugar with more eggs. Do you really need almost 4L of various juices and granulated sugar? Do you tolerate eggs well? Try having like 6 softboiled eggs daily instead of the granulated sugar for example

I have considered that, but when I go by appetite I gravitate towards those amounts consistently. The sugar is just to sweeten the coffee.
I'm also wary of the strong blood sugar lowering effect of the eggs, and having more protein than my body needs, but it's certainly something to experiment with.

What would you suggest the benefit of doing so may be?

 

[Vanset]

What would you suggest the benefit of doing so may be?

some people don't do well with high quantity of sucrose and it can manifest as liver issues

 

[aniciete]

How much vitamin a do you take? Do you really eat liver daily? If you are already having liver issues that amount of retinol isn’t doing you any favors.

 

[Vanset]

How much vitamin a do you take? Do you really eat liver daily? If you are already having liver issues that amount of retinol isn’t doing you any favors.

good thinking, i didn't even notice the supplement and the liver.