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

[youngsinatra]

I had similar liver enzymes after one year of Peating.

The liver is so central to overall health. It regulates so many things.

I‘d try to lift the burden from your liver so that your liver enzymes can come down.

That means actively lowering the intake of things that need to be processed (and excreted) by the liver/biliary system— fructose, retinol, copper, iron, manganese, exogenous hormones, dietary fats and demethylating agents like high dose niacinamide.

Increasing starchy carbohydrates, lean animal protein sources, a few portions of fruits and adding in methylation support (B12/B9/betaine..)

All while lowering your iron footprint via blood donation every 2 months, rechecking ferritin after 3 blood donations.

That would be my game plan. :)

 

[EnergeticLeo]

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

Ah I see, thanks. Will definitely investigate. Would you know the mechanism?
These liver issues seem to have started when I started Peating. I also suspect it might endotoxin overburdening the liver. On carnivore there were zero gut issues.

 

[EnergeticLeo]

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.

Yep beef liver daily - averaging about 180g / wk; and 2500IU supplemental retinol, so around 10-12.5k IU daily total.

What amount would you suggest daily instead?

 

[EnergeticLeo]

I had similar liver enzymes after one year of Peating.

The liver is so central to overall health. It regulates so many things.

I‘d try to lift the burden from your liver so that your liver enzymes can come down.

That means actively lowering the intake of things that need to be processed (and excreted) by the liver/biliary system— fructose, retinol, copper, iron, manganese, exogenous hormones, dietary fats and demethylating agents like high dose niacinamide.

Increasing starchy carbohydrates, lean animal protein sources, a few portions of fruits and adding in methylation support (B12/B9/betaine..)

All while lowering your iron footprint via blood donation every 2 months, rechecking ferritin after 3 blood donations.

That would be my game plan. :)

cool, thank you :)

 

[Risingfire]

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!

I experienced this in my late 20's. You're entering hypogonadism and your adrenals are picking up the slack for your testes. Any idea why it may be so low?

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.

Terrible logic. The bottom of the reference range was at 400 a few years ago. He has very low T for his age

 

[EnergeticLeo]

I experienced this in my late 20's. You're entering hypogonadism and your adrenals are picking up the slack for your testes. Any idea why it may be so low?



Terrible logic. The bottom of the reference range was at 400 a few years ago. He has very low T for his age

Yes this makes sense to me; I think the main causes were extreme work stress, intense exercise (weight lifting, lots of cardio) for years, combined with all the classic "healthy" habits that were popular at the time e.g. lots of vegetables, no sugar, intermittent fasting / caloric restriction etc. etc..


How did you approach your own hypogonadism?

 

[Risingfire]

Yes this makes sense to me; I think the main causes were extreme work stress, intense exercise (weight lifting, lots of cardio) for years, combined with all the classic "healthy" habits that were popular at the time e.g. lots of vegetables, no sugar, intermittent fasting / caloric restriction etc. etc..


How did you approach your own hypogonadism?

I started taking thyroid around 30. It definitely helped. In the last few years, I sporadically take DHT. Thought I wouldn't recommend it for someone who's endocrine system hasn't fully matured. You may want to try to low doses of dhea/prog.

Do you check your temp and pulse?

 

[Ned Nederlander]

Your T levels aren’t totally destroyed, but terrible for your age.

For a comparison, I’m less than a year from 40 and my natural TT level just came back at 911.

 

[EnergeticLeo]

I started taking thyroid around 30. It definitely helped. In the last few years, I sporadically take DHT. Thought I wouldn't recommend it for someone who's endocrine system hasn't fully matured. You may want to try to low doses of dhea/prog.

Do you check your temp and pulse?

Ok cool; am actively looking into dhea/prog, as well as increasing thyroid further as others have suggested above.

At what age do you think DHT would be safer?

Waking pulse is anywhere from 68-78, and waking underarm temp is anywhere from 35.9 - 36.3°C, so really low.

 

[EnergeticLeo]

Your T levels aren’t totally destroyed, but terrible for your age.

For a comparison, I’m less than a year from 40 and my natural TT level just came back at 911.

Haha yep pretty terrible. I suspect a lot of people my age have similar levels unfortunately.

 

[Risingfire]

Ok cool; am actively looking into dhea/prog, as well as increasing thyroid further as others have suggested above.

At what age do you think DHT would be safer?

Waking pulse is anywhere from 68-78, and waking underarm temp is anywhere from 35.9 - 36.3°C, so really low.

I would do everything in your power to get your thyroid up before you even consider dhea/prog much less DHT.

I only take DHT because of propecia usage in the past. I would wait until at least 27.

Your temps are pretty low. Does your body warm up after eating breakfast?

 

[EnergeticLeo]

I would do everything in your power to get your thyroid up before you even consider dhea/prog much less DHT.

I only take DHT because of propecia usage in the past. I would wait until at least 27.

Your temps are pretty low. Does your body warm up after eating breakfast?

OK.

I think so, but it's hard to say, since I immediately put on multiple layers and turn the heater on after waking, so I'm not sure if breakfast is increasing my temps. My temps only noticeably rise in the second half of the day. I usually feel my best right before bed.

 

[redsun]

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!

You got a lot of solid advice from many in this thread. Your liver is likely overburdened with iron, too much daily copper intake (zinc to copper ratio is also terrible), too much retinol from liver and the supplement, very high fructose intake. Iron overload can eventually lead to diabetes, hypogonadism, liver problems (looks like your already there), and other issues. So first thing you really should do is donate asap and keep doing it for a little while to bring iron down.

Excess copper intake as well as iron overload can also contribute to sleep problems. You need to keep copper intake to 1-2mg a day. Its enough in someone who is not deficient to maintain levels and you need to make your diet much more zinc dominant and get a little more niacin to help your skin and hormonal health and health in general. Zinc may have benefit for liver function as well.

Excess retinol can also dry the skin and thus reduce skin quality overtime. You really should not eat any liver or take that vitamin A if you want to improve your skin. Eating liver will ironically make your own liver worse probably with all that retinol besides the fact that your copper intake is so high just from daily liver alone.

As someone said it would be good to eat some starches to replace some of that sugar you are eating. Less fructose to not tax the liver so much and get more protein from red meat/dark chicken meat to increase zinc and niacin intake which will help your liver.

All that liquid alone can make you cold, and especially if the liquids are cold. That would be my first guess why you feel cold. This is why its not good to drink so many of your calories. Otherwise you overhydrate and expose yourself to too much cold liquid. Too much copper can make some people feel cold.

You really do not need any exogenous hormones at all when the root of your problems is very obvious. All these issues (copper, fructose, and retinol excess, iron overload, excessive liquid, poor zinc to copper ratio) are to blame for any kind of apparent hormonal imbalance and your symptoms. If you adjust your diet as others have already advised and donate blood regularly to reduce your iron burden, your hormones should balance out on their own.

 

[youngsinatra]

I would definitely speak with an MD and ask to screen for hemochromatosis. Those levels of ferritin are very high, even if one eats a significant amount of heme iron a day.

Do you eat a lot of red meat?

If they screen you for it and it comes back positive, then you can get therapeutic phlebotomy (every 2-4 weeks instead of every 6 weeks as a regular male blood donor) which lowers your iron footprint much faster.

 

[EnergeticLeo]

You got a lot of solid advice from many in this thread. Your liver is likely overburdened with iron, too much daily copper intake (zinc to copper ratio is also terrible), too much retinol from liver and the supplement, very high fructose intake. Iron overload can eventually lead to diabetes, hypogonadism, liver problems (looks like your already there), and other issues. So first thing you really should do is donate asap and keep doing it for a little while to bring iron down.

Excess copper intake as well as iron overload can also contribute to sleep problems. You need to keep copper intake to 1-2mg a day. Its enough in someone who is not deficient to maintain levels and you need to make your diet much more zinc dominant and get a little more niacin to help your skin and hormonal health and health in general. Zinc may have benefit for liver function as well.

Excess retinol can also dry the skin and thus reduce skin quality overtime. You really should not eat any liver or take that vitamin A if you want to improve your skin. Eating liver will ironically make your own liver worse probably with all that retinol besides the fact that your copper intake is so high just from daily liver alone.

As someone said it would be good to eat some starches to replace some of that sugar you are eating. Less fructose to not tax the liver so much and get more protein from red meat/dark chicken meat to increase zinc and niacin intake which will help your liver.

All that liquid alone can make you cold, and especially if the liquids are cold. That would be my first guess why you feel cold. This is why its not good to drink so many of your calories. Otherwise you overhydrate and expose yourself to too much cold liquid. Too much copper can make some people feel cold.

You really do not need any exogenous hormones at all when the root of your problems is very obvious. All these issues (copper, fructose, and retinol excess, iron overload, excessive liquid, poor zinc to copper ratio) are to blame for any kind of apparent hormonal imbalance and your symptoms. If you adjust your diet as others have already advised and donate blood regularly to reduce your iron burden, your hormones should balance out on their own.

OK thanks for you detailed response. I'll certainly consider all of this moving forward.

What I don't understand is why high fructose taxes the liver - I was of the impression that fructose best increases liver glycogen which is needed for good liver function?
And also how does retinol tax the liver? I've been sticking to Peat's conservative figure of around 10K IU / day.
Finally, what would an appropriate zinc:copper ratio be in your opinion?

I've also been thinking about the fluid intake issue a lot and for a while experimented with Matt Stone's "eat for heat" guidelines with the aim of increasing blood osmolarity, but then I remembered haidut and Peat talking about how for every 1000 calories burnt you evaporate around 1L of water, suggesting that drinking sugary liquids should not lead to overhydration as would happen with drinking water.

You raise a good point about the cold liquids lowering my own temperatures, though.

Thanks again!!

Here are my minerals from a typical day of eating:

 

[EnergeticLeo]

I would definitely speak with an MD and ask to screen for hemochromatosis. Those levels of ferritin are very high, even if one eats a significant amount of heme iron a day.

Do you eat a lot of red meat?

If they screen you for it and it comes back positive, then you can get therapeutic phlebotomy (every 2-4 weeks instead of every 6 weeks as a regular male blood donor) which lowers your iron footprint much faster.

OK very interesting - I did not know therapeutic phlebotomy was an option - will definitely look into this, especially due to the high iron saturation.

I don't eat much red meat; I was on a carnivore diet for nearly 1.5 years before finding Peat in March this year. But I was iron deficient at the end of the carnivore diet. I have been more strict on eating liver and oysters since finding Peat, so that may have pushed up the iron. Peat has also said that high estrogen "exponentially" increases iron absorption.

My understanding, however, was that ferritin is not a marker of iron stores, but an "acute phase reactant" and a marker of cell death (when cells die in a "non-altruistic" way they spill their contents, including iron, into the blood, and the ferritin is needed to clean up that iron)?

 

[youngsinatra]

OK very interesting - I did not know therapeutic phlebotomy was an option - will definitely look into this, especially due to the high iron saturation.

I don't eat much red meat; I was on a carnivore diet for nearly 1.5 years before finding Peat in March this year. But I was iron deficient at the end of the carnivore diet. I have been more strict on eating liver and oysters since finding Peat, so that may have pushed up the iron. Peat has also said that high estrogen "exponentially" increases iron absorption.

My understanding, however, was that ferritin is not a marker of iron stores, but an "acute phase reactant" and a marker of cell death (when cells die in a "non-altruistic" way they spill their contents, including iron, into the blood, and the ferritin is needed to clean up that iron)

I know multiple people that got iron overload by eating a red meat centered carnivorous diet (1-3 lbs of beef a day), some of which showed up with anemia or „low iron“ in the blood.

Most of them ate a muscle meat based diet with plenty of iron and zinc, but insufficient intakes of copper and riboflavin, which are both needed to release iron from the liver and metabolize it in the RES.

You probably repleted yourself in copper and riboflavin with regular liver and oyster consumption. By that, your body was finally able to release the stored iron from your tissues into mobilization.

True iron deficiency on a carnivore diet is almost 99% impossible in my opinion, except if you have very severe digestive or bleeding disorders.

 

[EnergeticLeo]

I know multiple people that got iron overload by eating a red meat centered carnivorous diet (1-3 lbs of beef a day), some of which showed up with anemia or „low iron“ in the blood.

Most of them ate a muscle meat based diet with plenty of iron and zinc, but insufficient intakes of copper and riboflavin, which are both needed to release iron from the liver and metabolize it in the RES.

You probably repleted yourself in copper and riboflavin with regular liver and oyster consumption. By that, your body was finally able to release the stored iron from your tissues into mobilization.

True iron deficiency on a carnivore diet is almost 99% impossible in my opinion, except if you have very severe digestive or bleeding disorders.

I see! That's one of the most interesting things I've heard lately.

I was very surprised when I was told I was iron deficient after carnivore - your explanation seems to fit the facts.

 

[Jessie]

I experienced this in my late 20's. You're entering hypogonadism and your adrenals are picking up the slack for your testes. Any idea why it may be so low?



Terrible logic. The bottom of the reference range was at 400 a few years ago. He has very low T for his age

"Could be higher" is not the same thing as low. Most men feel their best between 650-700 ng/dl. If you're willing to crash your own production with TRT just to raise it 100-150 points have at it.....doc. But the better solution is to optimize thryoid and get prolactin at the lower end of the reference range, then reassesses the numbers.

 

[Ned Nederlander]

"Could be higher" is not the same thing as low. Most men feel their best between 650-700 ng/dl. If you're willing to crash your own production with TRT just to raise it 100-150 points have at it.....doc. But the better solution is to optimize thryoid and get prolactin at the lower end of the reference range, then reassesses the numbers.

No one here told the OP to get on TRT.

You said his T levels aren’t broken because they are in the reference range. The reference range for TT is a joke. Twenty something’s should not have TT levels in the 400’s. I don’t care who you are, you will not have the same level of vigor, confidence, strength, etc with levels like this.

His levels are abysmal for someone in their 20’s, and I’m pretty confident he would feel much better if he bumped them up (naturally) above 700 at least.

As the others have said, possibly if he corrects his other health issues, his TT level will trend upward.

I firmly believe health issues are the cause of the testosterone decline in aging males, not the act of aging itself. So many 20 and 30 year old males are presenting with levels below 500, which speaks pretty negatively to their overall health IMO.

After those health issues and other concerning lab results are corrected, things like lifting weights, losing fat/building muscle, eating more egg yolks/saturated fat, eliminating seed oil consumption, etc can go a long way in bumping up T for most.