HPA Dysfunction ( Low Dhea-s) Former Anabolics User ( Bloodwork Included)

vibnad1991

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Jan 8, 2021
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Hi All,

I am 29 year old male who came off anabolics after 9 years straight use in March 2020 ( last two were trt levels only). Got my bloodwork last month Feb 21. Everything seems to be back in range. I dont think i am fully recovered yet, it may require another 6 months to a year.
Symptoms:

-Still have erectile dysfunction ( able to get an erection at about 50-60% strength). No morning erections in about 3 years
- waking up in the night to pee 1 to 3 times
-havent had a deep consistent good night sleep in years. still dreaming but being broken by waking to pee
-sometimes hard to fall asleep
-bones clicking sometimes

I have had chronically low dhea-s since beginning ped's. I dont know what my levels where prior unfortunately. When i had my last morning erection it was three years ago and this was also the first time i supplemented with Dhea ( 50 mg/daily) - unfortunately i was not able to maintain it for more than three days. Maybe estrogen got too high. My question is do i have adrenal fatigue or high cortisol and does it take longer for the HPA to recover from steroids than HPG. How can i resolve this?



1613723467495.png


Dhea-s levels since Jan 17. ( Came off testosterone in Mar 20)

The spikes up in Dhea-s are concurrent with exogenous supplementation of DHEA in supplement form. However it caused my estrogen to skyrocket
1613723976385.png
 

Kozak

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I'd do pregnenolone first thing in the morning (start at 50 mg oral) and redo the test in 4-6 weeks.
 

James b

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Would be interesting if anyone has anything from Ray with recommendations for those who have disrupted the endogenous hormones/HPA axis. I experimented with anabolics at a young naive age and now my blood work is skewed. Other than large doses of pregnenolone does anyone have any recommendations to try to restore endogenous hormone production?
 

theantagonist

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Jan 11, 2021
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I would check prolactin. You could have high estrogen tissue levels, while blood levels of estrogen are 'oke'.
If your doctor allows it, also check E1S, estrone sulfate, it's the long term form of estrogen.

If DHEA is that low i would presume steroid synthesis could use a boost. I would check cholesterol levels and thyroid panel or your pulse + temperature. If thyroid is low, you won't properly convert cholesterol to pregenenolone.

I would definitely try, the pregnenolone option above, but add in some DHEA. Max 5 mg per dose, no more than 15 mg per day.

It can't hurt to check vitamin D levels as well.
 

Hans

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Hi All,

I am 29 year old male who came off anabolics after 9 years straight use in March 2020 ( last two were trt levels only). Got my bloodwork last month Feb 21. Everything seems to be back in range. I dont think i am fully recovered yet, it may require another 6 months to a year.
Symptoms:

-Still have erectile dysfunction ( able to get an erection at about 50-60% strength). No morning erections in about 3 years
- waking up in the night to pee 1 to 3 times
-havent had a deep consistent good night sleep in years. still dreaming but being broken by waking to pee
-sometimes hard to fall asleep
-bones clicking sometimes

I have had chronically low dhea-s since beginning ped's. I dont know what my levels where prior unfortunately. When i had my last morning erection it was three years ago and this was also the first time i supplemented with Dhea ( 50 mg/daily) - unfortunately i was not able to maintain it for more than three days. Maybe estrogen got too high. My question is do i have adrenal fatigue or high cortisol and does it take longer for the HPA to recover from steroids than HPG. How can i resolve this?



View attachment 21788


Dhea-s levels since Jan 17. ( Came off testosterone in Mar 20)

The spikes up in Dhea-s are concurrent with exogenous supplementation of DHEA in supplement form. However it caused my estrogen to skyrocket
View attachment 21789
In the short term stress increases both cortisol and DHEA and then in the long term, the part that creates DHEA shrinks and DHEA production drops while cortisol remains high. Did you check cortisol as well?
There is a study on the forum that shows that estrogen can lower DHEAS, so checking prolactin and estrone-S can be helpful.

If both cortisol and DHEA is low, then you'll have to focus on restoring adrenal function, but if only DHEA is low, then you'll have to look into the other things as well.
 

vibnad1991

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In the short term stress increases both cortisol and DHEA and then in the long term, the part that creates DHEA shrinks and DHEA production drops while cortisol remains high. Did you check cortisol as well?
There is a study on the forum that shows that estrogen can lower DHEAS, so checking prolactin and estrone-S can be helpful.

If both cortisol and DHEA is low, then you'll have to focus on restoring adrenal function, but if only DHEA is low, then you'll have to look into the other things as well.
Hi @Hans thanks for the reply. I havent checked it in a while but last time i checked it was 179 ...i think. I will try pull out the results. Do you think I should get another test. I cant find an estrone sulfate test in the UK, does anyone have any suggestions. I am genuinely at a loss as to how to resolve this dhea-s issue. I expected that now my LH and FSH levels are back up ,that my adrenals would start producing DHEA again but still no luck.
 

Hans

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Hi @Hans thanks for the reply. I havent checked it in a while but last time i checked it was 179 ...i think. I will try pull out the results. Do you think I should get another test. I cant find an estrone sulfate test in the UK, does anyone have any suggestions. I am genuinely at a loss as to how to resolve this dhea-s issue. I expected that now my LH and FSH levels are back up ,that my adrenals would start producing DHEA again but still no luck.
As in nmol/L? The reference range for cortisol is 19 – 618 nmol/L, so if yours is 179 in the morning, that's too low. Did you check your T3?
 

vibnad1991

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As in nmol/L? The reference range for cortisol is 19 – 618 nmol/L, so if yours is 179 in the morning, that's too low. Did you check your T3?
@Hans - Found my blood test result - April 2019

Please note that i was still on exogenous testosterone at this point.

Cortisol (8-10 am) - 441.0 nmol/L ( 166-507)
Progesterone - 0.6 nmol/L
Dhea-S - 3.63 umol/L
Testosterone - 7.38 nmol/L
LH - <0.3
FSH - <0.3


TSH - 1.96 mIU/L
Free T4 - 16.50 pmol/L
Free T3 - 4.51 pmol/L


Vitamin D - 35 nmol/L (Low)
Vitamin B12 - 625 pmol/L (Very High - know idea why)
Ferritin - 455 ug/L (High)
TIBC - 44.63 umol/L (Low- no idea what this is)
Urea - 11.4 nmol/l (High)
Creatinine - 104 umol/L ( right on the cusp of the upper range)
CK - 444 iu/L (High)
ALT - 96 iU/L (High)
 

Hans

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@Hans - Found my blood test result - April 2019

Please note that i was still on exogenous testosterone at this point.

Cortisol (8-10 am) - 441.0 nmol/L ( 166-507)
Progesterone - 0.6 nmol/L
Dhea-S - 3.63 umol/L
Testosterone - 7.38 nmol/L
LH - <0.3
FSH - <0.3


TSH - 1.96 mIU/L
Free T4 - 16.50 pmol/L
Free T3 - 4.51 pmol/L


Vitamin D - 35 nmol/L (Low)
Vitamin B12 - 625 pmol/L (Very High - know idea why)
Ferritin - 455 ug/L (High)
TIBC - 44.63 umol/L (Low- no idea what this is)
Urea - 11.4 nmol/l (High)
Creatinine - 104 umol/L ( right on the cusp of the upper range)
CK - 444 iu/L (High)
ALT - 96 iU/L (High)
Although more recent results will be helpful, the excess ferritin could be elevated due to inflammation, or just the over absorption/retention of iron (promoted by estrogen). The iron in turn can promote tissue inflammation and increase your CK and ALT. Did you get CRP tested? If inflammation was high, then it would have greatly increase aromatase, and estrogen is known to lower DHEA-S.
High ferritin could also be high because of low copper and low copper can also lower DHEA-S.
Urea correlated inversely with thyroid function. Your free T3 is at a good place, but if there is elevated reverse T3, then it could cause hypothyroid symptoms.
B12 isn't very high since the reference range is 118 to 701pmol/L. If your B12 intake was low, then excess B12 can be a sign of SIBO.
 

vibnad1991

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Although more recent results will be helpful, the excess ferritin could be elevated due to inflammation, or just the over absorption/retention of iron (promoted by estrogen). The iron in turn can promote tissue inflammation and increase your CK and ALT. Did you get CRP tested? If inflammation was high, then it would have greatly increase aromatase, and estrogen is known to lower DHEA-S.
High ferritin could also be high because of low copper and low copper can also lower DHEA-S.
Urea correlated inversely with thyroid function. Your free T3 is at a good place, but if there is elevated reverse T3, then it could cause hypothyroid symptoms.
B12 isn't very high since the reference range is 118 to 701pmol/L. If your B12 intake was low, then excess B12 can be a sign of SIBO.
@Hans CRP was 0.45 - so not elevated. I think i need to get another full bloodwork done. What should i prioritse when testing? What is the likelihood of me having a copper deficiency - my diet primarily consists of carrots,chicken breast and white rice, chicken wings and chocolate.
 

Hans

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@Hans CRP was 0.45 - so not elevated. I think i need to get another full bloodwork done. What should i prioritse when testing? What is the likelihood of me having a copper deficiency - my diet primarily consists of carrots,chicken breast and white rice, chicken wings and chocolate.
Seems like very low copper in your diet. You can benefit from beef liver. Except that your iron is very high. I'd recommend getting an iron panel done, checking ferritin, transferrin saturation, serum iron and ceruloplasmin. You can also look at cholesterol, T3, T4 and rT3.
Also estradiol, estrone-S, prolactin, testosterone and DHT.
 

IVILA

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Does DHEA-S production have anything to do with the function of the liver? Or is it pure adrenal and pregnenolone output? @Hans
 

Hans

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Does DHEA-S production have anything to do with the function of the liver? Or is it pure adrenal and pregnenolone output? @Hans
The adrenals pump out DHEA and if the body isn't in too much of a stressed state, some of that DHEA will convert to the sulfate form. The liver doesn't produce DHEA, but it does metabolize it, usually for excretion.
 

IVILA

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I think that the excess iron is causing heavy metal toxicity. This in turn lowers DHEA-s levels as well as doesn't allow DHEA to convert properly to testosterone. Therefore you get an excess of estrogen/estrone in the body. You probably have a liver issue as well as excess iron and prolonged stress. I would suggest eating a copper rich diet, avoiding iron-enriched foods, chelating iron as well as working on the liver as a start. What do you think about this? @Hans
 

vibnad1991

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@Hans @IVILA
Okay Guys a Quick Hormone Update.

Just a quick overview once again: Last injection 27 th March 2020 ( after 9 years straight of anabolics use - mainly testosterone, and orals like anavar and superdrol)

Feb 21 ( was taking 6.25 mg clomid eod)
1618910008581.png




April 7th 2021 ( Off Everything)

1618909968150.png


Interestingly DHEA-s has come up slightly for the first time in years. I think it may be due to the fact that my LH levels are restoring.

LH halved from last bloodwork as i stopped clomid. But hopefully once LH levels start to rise again, my test levels will come back up.

Very interesting point around heavy metals. This is something that concerns me considering the fact that i used these UGL with god knows what in them. I made so many mistakes. Also used orals for extensive periods of time so i am sure i have a fatty liver. I am trying o get as lean as possible to resolve the issue without becoming micro nutrient deficent.


Sleep is still not the best, wake up at around 230 and 430 to pee. few nights i couldnt get back to sleep. Maybe my cortisol is all over place.


I still think its early days, considering, i was on for so long and my last enanthate injection was end of march. So the ester would not have even fully cleared until end of april or may.
 

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vibnad1991

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erections still really bad. penis has lack of blood flow, sensitivity and almost numb at times
 

Hans

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@Hans @IVILA
Okay Guys a Quick Hormone Update.

Just a quick overview once again: Last injection 27 th March 2020 ( after 9 years straight of anabolics use - mainly testosterone, and orals like anavar and superdrol)

Feb 21 ( was taking 6.25 mg clomid eod)
View attachment 22856




April 7th 2021 ( Off Everything)

View attachment 22855


Interestingly DHEA-s has come up slightly for the first time in years. I think it may be due to the fact that my LH levels are restoring.

LH halved from last bloodwork as i stopped clomid. But hopefully once LH levels start to rise again, my test levels will come back up.

Very interesting point around heavy metals. This is something that concerns me considering the fact that i used these UGL with god knows what in them. I made so many mistakes. Also used orals for extensive periods of time so i am sure i have a fatty liver. I am trying o get as lean as possible to resolve the issue without becoming micro nutrient deficent.


Sleep is still not the best, wake up at around 230 and 430 to pee. few nights i couldnt get back to sleep. Maybe my cortisol is all over place.


I still think its early days, considering, i was on for so long and my last enanthate injection was end of march. So the ester would not have even fully cleared until end of april or may.
Recovery can be a slow process, at least you're making progress even after using steroids for so long.
I'd personally focus on thyroid, preg and prog. Thyroid for natural steroidogenesis. Preg for providing the precursors and prog for minimizing stress and replenishing neurosteroids in the brain that has been reduced by long-term TRT use. I talked about it in this vid.
 
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