Labs/A Mysterious Problem

[Gone Peating]

I took accutane for 2 rounds 10yrs apart, right now eating a very low to zero vitamin A diet is helping immensely. I am close to 5 months VA free, but hoping to make a real judgement at 1 year whether I fully endorse this. Going low A is very simple, and easy to test, and doesn't appear to be detrimental, lots of anecdotal reports are starting to come around, its a relatively new theory. What are your post accutane symptoms?

I'm not aware that accutane did anything, hard to say for sure since I was on it about 8 years ago. While on it I had joint pains when working out and a little decrease in libido.

I did some labs a few months ago and my Testosterone was at the low end of the range and my TSH was at a 5, while my total t3 and t4 were within range. My cholesterol was at 160 and 40 for the ldl

I feel like the joint pains might be from low estrogen, any time I take the fat solubles which are supposed AIs my joints get achier

 

[Douglas Ek]

I'm not aware that accutane did anything, hard to say for sure since I was on it about 8 years ago. While on it I had joint pains when working out and a little decrease in libido.

I did some labs a few months ago and my Testosterone was at the low end of the range and my TSH was at a 5, while my total t3 and t4 were within range. My cholesterol was at 160 and 40 for the ldl

I feel like the joint pains might be from low estrogen, any time I take the fat solubles which are supposed AIs my joints get achier

Low testosterone equalls low estrogen. That’s why low T and low E tends to have same symptoms. You make estrogen out of testosterone and decreased libido from low T is probably even due to low E. Have you tested you estrogen? This was at least the case for me. I first had low T all symptoms you have. Then I raised my T to 900 and my estrogen went up slightly over reference range just like my T was. Then I used exemestane/aromasin an AI which should lower E and raise T levels. And even with high T i got the same symptoms as low T. Estrogen more important than you think for well being. T is mostly good for anabolism. It’s not that androgenic even only anabolic building muscles. DHT effect is androgenic and the mental effects of that is mood stability and calmness. Low anxiety. Low estrogen is more low libido, aches and pains plus depression.

 

[Gone Peating]

Low testosterone equalls low estrogen. That’s why low T and low E tends to have same symptoms. You make estrogen out of testosterone and decreased libido from low T is probably even due to low E. Have you tested you estrogen? This was at least the case for me. I first had low T all symptoms you have. Then I raised my T to 900 and my estrogen went up slightly over reference range just like my T was. Then I used exemestane/aromasin an AI which should lower E and raise T levels. And even with high T i got the same symptoms as low T. Estrogen more important than you think for well being. T is mostly good for anabolism. It’s not that androgenic even only anabolic building muscles. DHT effect is androgenic and the mental effects of that is mood stability and calmness. Low anxiety. Low estrogen is more low libido, aches and pains plus depression.

How did you boost your T so dramatically? I've been eating a Peat styled diet for almost a year now

 

[meatbag]

yes, both regularly. but I am stopping the mushroom consumption due to its copper content.

what's your weekly diet look like?

 

[Kyle Bigman]

pretty much wake up drink some o.j. and a couple coffees with sugar, then have some basic lunch near my work (like some grilled meat and bread), then typically come home and eat some fruit and chocolate or a carrot, and dinner is usually some starch like potato or rice and either ground beef, chicken breast, or eggs, with mushrooms and well-cooked broccoli. If I'm still hungry I will have oatmeal with yogurt and honey or something similar. I also supplement with some vitamin e (tocovit) and b-vitamins, gelatin, and magnesium. Started zinc recently to experiment.

For protein, its usually beef, chicken, eggs, cheeses, and yogurt/milks.

 

[meatbag]

pretty much wake up drink some o.j. and a couple coffees with sugar, then have some basic lunch near my work (like some grilled meat and bread), then typically come home and eat some fruit and chocolate or a carrot, and dinner is usually some starch like potato or rice and either ground beef, chicken breast, or eggs, with mushrooms and well-cooked broccoli. If I'm still hungry I will have oatmeal with yogurt and honey or something similar. I also supplement with some vitamin e (tocovit) and b-vitamins, gelatin, and magnesium. Started zinc recently to experiment.

For protein, its usually beef, chicken, eggs, cheeses, and yogurt/milks.

Yeah that seems like a pretty good diet. Is the b-vitamins energin or just generic? There are some posts about vitamin b-6 in relation to things like dandruff, etc. Do you ever eat liver?

When I started to reduce pufa intake and I was exercising a lot I got really bad dandruff and dry skin. In the PUFA depletion studies this are alleviated by supplementing b-6. You could try increasing SFA intake with ice cream, fuller fat milk, etc if you're fairly lean. Also adding cream to the coffee to slow the absorption of the caffeine. When I feel off increasing fat intake can be helpful

 

[Kyle Bigman]

I do eat liver occasionally but stopped because I thought it was giving me symptoms. I use energin but also some "bulk supplements" niacinamide powder.

 

[meatbag]

I do eat liver occasionally but stopped because I thought it was giving me symptoms. I use energin but also some "bulk supplements" niacinamide powder.

I try eating the liver with more fat. I have trouble digesting the liver unless I eat it with a lot of fat; ex cooked in butter and eat ice cream afterwards. You could try Danny Roddy's pate recipe too

Peat often recommends that stopping all supplements can be helpful to figure out what's going on. You could just use the b-vitamins mixed with vodka and vit. e topically

 

[Kyle Bigman]

I am thinking of stopping all supplements, yeah. Still waiting for the 24 hour urine copper test results but I don't see how they can be "normal" if my free serum copper remains high and ceruloplasmin low. If the free unbound copper is high then it would necessarily be excreted, and therefore my urine sample would test high for copper as well, right? I may be missing something but I have a feeling I will have to see a specialist for Wilson's. Otherwise I am at a loss for an explanation because my other labs returned normal [I got CBC, some kidney function, urine test, and abdominal ultrasound]. Last thyroid panel (few months ago) was also normal.

 

[meatbag]

Hi all, I was wondering if you could help me, because no doctors have so far been successful.

My abnormal labs are 1) persistently elevated bilirubin – pretty much slightly elevated in every single test I take, 2) low ceruloplasmin (0.19 g/L/), normal: 0.20-0.50 g/ L); and 3) a positive ANA test (1:80, so borderline), which read as fine densely speckled pattern.

My GP diagnosed me with Gilbert's syndrome because of the bilirubin elevations.

My symptoms: Since joining the Peat forum I have been trying to discover what is causing a host of mysterious symptoms. I have a lot of autoimmune type symptoms, from acne, joint pain, and mouth ulcers when stressed, but I also have had other symptoms like extreme sensitivity to cold, fatigue and depression, and a recurring pain and bloatedness in my upper right abdominal quadrant area that typically worsens upon stress. I also have yellowish skin, eczema, and dandruff and hair loss. I experienced some bad twitching issues upon stress last year, along with weird symptoms that seemed neurological in nature. I was taking finasteride so I blamed that.

At first I thought this was due to a liver/gallbladder issue but no doctor has found anything wrong with those organs yet. Then, I thought it was autoimmune of some kind, or perhaps related to vitamin A toxicity. Now, I am wondering whether I have some kind of copper metabolism malfunction. But basically I think all of this is a liver problem. Just not sure how to go about addressing it.

Thanks for the help and all the advice you have given me through the forum, it is much appreciated.

did they test serum albumin and vitamin d?

what's your exercise look like?

 

[Kyle Bigman]

last time albumin was checked (a couple months ago) it was normal. Vitamin D was low at some point but lately in the normal range. I walk a lot and try to do strength training 3x per week, kinobody inspired style lifting (reverse pyramid, heavy compound lifts).

Also, just an update: my urine 24 hour copper labs came back "normal" at 8 ug/l (reference: <60) I questioned this with the lab technician because I read an article on pubmed where a doctor was questioning the results of an earlier study on the basis that he hadn't seen a Wilson's disease patients result under 10ug/l in 30+ years unless lab error or that person was copper deficient. In that original study the lab results were not converted properly, and were given in mols rather than ug. But, my lab technician tried to assure me that they were legitimate.

I only produced 1,100 ml of urine. The lab tech was surprised and said that was quite low. He actually advised I test for adrenal function, and said that my never being thirsty could be a sign of a pituitary or hypothalamus problem as well, which concerned me a lot because it sent me researching pituitary tumors...

So, at the moment I am wondering whether I am actually copper deficient or whether I have some kind of adrenal insufficiency, and if so, where that stems from. Not sure if you guys have any input on this. I appreciate the help!!

 

[meatbag]

last time albumin was checked (a couple months ago) it was normal. Vitamin D was low at some point but lately in the normal range. I walk a lot and try to do strength training 3x per week, kinobody inspired style lifting (reverse pyramid, heavy compound lifts).

Also, just an update: my urine 24 hour copper labs came back "normal" at 8 ug/l (reference: <60) I questioned this with the lab technician because I read an article on pubmed where a doctor was questioning the results of an earlier study on the basis that he hadn't seen a Wilson's disease patients result under 10ug/l in 30+ years unless lab error or that person was copper deficient. In that original study the lab results were not converted properly, and were given in mols rather than ug. But, my lab technician tried to assure me that they were legitimate.

I only produced 1,100 ml of urine. The lab tech was surprised and said that was quite low. He actually advised I test for adrenal function, and said that my never being thirsty could be a sign of a pituitary or hypothalamus problem as well, which concerned me a lot because it sent me researching pituitary tumors...

So, at the moment I am wondering whether I am actually copper deficient or whether I have some kind of adrenal insufficiency, and if so, where that stems from. Not sure if you guys have any input on this. I appreciate the help!!

I noticed my joints felt a lot better when I increased gelatin intake and tried to get a better Ca:P ratio and it seems like you consume a lot of muscle protein but you do need a good amount of protein for liver and weightlifting.

I'm not sure where in your diet you would be getting excessive amounts of copper. It is possible to have a contaminated water supply though so you could check your local facilities water tests.

There was thread about how you can get an idea of your liver health by doing a test with how much caffeine you can ingest.

 

[Kyle Bigman]

I will try to cut back on the muscle meat, especially as I have run out of gelatin here. A common problem for me on a ray peat inspired diet is how to get adequate protein without eating too much muscle meat, because I tend to overdo dairy consumption to compensate, and that makes me feel worse.

 

[meatbag]

I will try to cut back on the muscle meat, especially as I have run out of gelatin here. A common problem for me on a ray peat inspired diet is how to get adequate protein without eating too much muscle meat, because I tend to overdo dairy consumption to compensate, and that makes me feel worse.

I think 1.8 g Protein /kg was the recommended amount if your active, the liver needs protein for proper functioning. Have you tried eggshell for calcium, I usually just buy the gelatin powder from the store and pour it over meat when its cooking - pretty lazy but it works

This looks like an interesting interview about the possible relation between carbon monoxide and bilirubin
Carbon Monoxide, Kmud, 2013

 

[meatbag]

last time albumin was checked (a couple months ago) it was normal. Vitamin D was low at some point but lately in the normal range. I walk a lot and try to do strength training 3x per week, kinobody inspired style lifting (reverse pyramid, heavy compound lifts).

Also, just an update: my urine 24 hour copper labs came back "normal" at 8 ug/l (reference: <60) I questioned this with the lab technician because I read an article on pubmed where a doctor was questioning the results of an earlier study on the basis that he hadn't seen a Wilson's disease patients result under 10ug/l in 30+ years unless lab error or that person was copper deficient. In that original study the lab results were not converted properly, and were given in mols rather than ug. But, my lab technician tried to assure me that they were legitimate.

I only produced 1,100 ml of urine. The lab tech was surprised and said that was quite low. He actually advised I test for adrenal function, and said that my never being thirsty could be a sign of a pituitary or hypothalamus problem as well, which concerned me a lot because it sent me researching pituitary tumors...

So, at the moment I am wondering whether I am actually copper deficient or whether I have some kind of adrenal insufficiency, and if so, where that stems from. Not sure if you guys have any input on this. I appreciate the help!!

did they test serum copper or just urine?

see this post by haidut: "Serum copper and ceruloplasmin. You want serum copper to be normal and ceruloplasmin to be close to the upper range. High serum copper and low ceruloplasmin means copper toxicity, normal serum copper and low ceruloplasmin means functional copper deficiency (and iron toxicity) and low serum copper needs no explanation.
I would always test copper, iron, zinc and manganese together as they affect each other and one test does not mean much. Iron should always have ferritin, transferrin, and saturation and copper should always have ceruloplasmin as well. High ceruloplasmin means low iron in tissues. Ceruloplasmin and ferritin are usually inversely correlated."
-High PUFA Diet Is Pro-aging, Diabetogenic, And Increases Cortisol

 

[Kyle Bigman]

I had normal (89 ug/dl) total serum copper. The reference range being 70-140. My Ceruloplasmin was just lower than the bottom reference. So, according to @haidut I have iron toxicity and functional copper deficiency.

What is strange though, is that my ferritin is not too high it seems (70ng/ML), reference being 30-400. My iron blood content was very normal, and so was the total iron binding. So this is very confusing. I'd appreciate Haidut's opinion.

 

[haidut]

I had normal (89 ug/dl) total serum copper. The reference range being 70-140. My Ceruloplasmin was just lower than the bottom reference. So, according to @haidut I have iron toxicity and functional copper deficiency.

What is strange though, is that my ferritin is not too high it seems (70ng/ML), reference being 30-400. My iron blood content was very normal, and so was the total iron binding. So this is very confusing. I'd appreciate Haidut's opinion.

Where did I say that low ceruloplasmin means iron toxicity?