Low test, low SHBG, High DHEA - Fatigued and unwell for years, what to do?

[Callmestar]

Sorry to keep pestering you guys with my bloody health problems but I'm unsure what to do currently and can't seem to find any improvement in my health. If anything it's getting worse and I'm getting desperate.

I posted a thread here a few months ago about my symptoms of being dehydrated/depleted/frequent urination/thirst/fatigue and have had some great responses but unfortunately have not gotten any better. More recent blood tests are showing my test is getting lower and lower and I don't want my health to deteriorate further so I'm wondering if my best option is to go on TRT? I had the dehydration problem long before any testosterone problems but I'm guessing my test and other hormones coming down is likely due to the constant stress and dehydration I seem to be experiencing. I've also developed prostatitis in the last few months which is likely related somehow.

Since posting here around 5 months ago I've tried various forms of thyroid to no avail, many supplements and a peat style diet which at times briefly felt as though it helped for the odd few hours here and there, maybe due to extra calories and sugar, but overall I feel I've gotten worse. I've also gotten fat around the belly and chest which has never really been an issue for me previously. I've currently just gone Keto under the suspicion I may have sort of insulin resistance or similar as despite testing negative for diabetes I seem to be completely dependent on sugar to hydrate even to a small degree. I know Keto is not exactly something that would go along with Peat ideas but for now I feel slightly better on it and have to give it a try to see if it can in anyway rebalance what seems to be dependence on sugar.

My main question is should I be considering TRT with these blood results? Why is my DHEA always high on bloods (I don't take DHEA)? I will attach a recent blood test below. This test shows testosterone of 10 but a more recent test it was 8. It's dropped from about 20 to 8 in a year. Any advice would be greatly appreciated.

 

[Callmestar]

Just to add, and also as a way of bumping. My sex drive doesn't seem to have massively decreased with the lowering of testosterone. I wouldn't say it's really high anyway for the past 4 years or so but there's been no noticeable decrease with the decrease in test blood results.
I also don't seem to have lost muscle and maintain a decent amount of muscle despite not being able to workout due to lack of energy and dehydration.
Outside of that, I have gained some fat as mentioned before and general feel crap with no energy.

Also I forgot to mention, please don't pay too much attention to the high triglycerides on the blood test. I wasn't advised it was supposed to be a fasted blood test so had eaten no long before. I had triglycerides tested a week later fasted and they were in normal range.

 

[Kaur Singh]

That high CK is pointing towards muscle tissue damage/destruction.
Do you experience muscle pain anywhere in your body,
or episodes of stiffness/rigidity/spasms?

have you asked yer doctors about the high progesterone levels?
in conjunction with the high DHEA?

has it been followed up with and ACTH stimulation test and a bigger panel of all your hormones/steroids at baseline
- including 17-OH progesterone ?
what's your aldosterone and renin?

 

[Callmestar]

That high CK is pointing towards muscle tissue damage/destruction.
Do you experience muscle pain anywhere in your body,
or episodes of stiffness/rigidity/spasms?

have you asked yer doctors about the high progesterone levels?
in conjunction with the high DHEA?

has it been followed up with and ACTH stimulation test and a bigger panel of all your hormones/steroids at baseline
- including 17-OH progesterone ?
what's your aldosterone and renin?

Thank you for responding.

No muscle pain and no stiffness/rigidity/spasms that I can recall. My creatinine is often also slightly high, I don't know if that could be linked but I suspect that's down to the dehydration.

Yes I've asked multiple doctors about the high progesterone levels as well as the high DHEA. They literally say they don't know why they are high and don't see it as relevant.

I've not had an ACTH stimulation test but my steroid baselines are generally normal/high. My morning cortisol is usually around 600 nmol/L. I had a couple of Aldosterone and Renin tests a few weeks apart, the results were:

Supine:
Renin Reference Range 5.4 - 30.0 mU/L
Aldosterone Reference range 100 - 450 pmol/L
Plasma aldosterone level 408 pmol/L [100.0 - 800.0]
Plasma renin level 16.3 mu/L [5.4 - 60.0]
Plasma aldosterone:renin activity ratio 25 [< 80.0]

Standing/sitting:
Renin Reference Range 5.4 - 30.0 mU/L
Aldosterone Reference range 100 - 450 pmol/L
Plasma aldosterone level 388 pmol/L [100.0 - 800.0]
Plasma renin level 42.6 mu/L [5.4 - 60.0]
Plasma aldosterone:renin activity ratio 9 [< 80.0]

I've not had 17-OH progesterone tested. They certainly won't do it for males on the health service here but I could look privately if you think it might be relevant?

 

[Kaur Singh]

On your other thread, other test results in January 2021 - your progesterone was actually low?
do you have other test results, from diff times?
have you supplemented any hormones before this latest test?

Where you upright for two hours for the upright aldosterone/renin test?

 

[Callmestar]

On your other thread, other test results in January 2021 - your progesterone was actually low?
do you have other test results, from diff times?
have you supplemented any hormones before this latest test?

Where you upright for two hours for the upright aldosterone/renin test?

The two progesterone results you've seen are the only times I've had that tested. Again it's another one they don't test for males on the NHS. I tried progest e in between those test, maybe for 4 or 5 days, months before the more recent test and stopped as I felt absolutely nothing from it.

In regards to the aldosterone/renin test, in the UK they go by the laying down test results. Laying flat for 30 mins before the test. For the standing one, I would have likely only been standing for 10 minutes and then sat for the test. (Unorganised mess I know). Why, what are your suspicions around aldosterone renin? Don't they look middle of the road results?

 

[Kaur Singh]

The two progesterone results you've seen are the only times I've had that tested. Again it's another one they don't test for males on the NHS. I tried progest e in between those test, maybe for 4 or 5 days, months before the more recent test and stopped as I felt absolutely nothing from it.

In regards to the aldosterone/renin test, in the UK they go by the laying down test results. Laying flat for 30 mins before the test. For the standing one, I would have likely only been standing for 10 minutes and then sat for the test. (Unorganised mess I know). Why, what are your suspicions around aldosterone renin? Don't they look middle of the road results?

I wonder if it could be possible that something you are taking is rising (or lowering) your progesterone.
-- Are you taking any medications supps when you do tests?
Biotin for example, it interferes with your TSH falsely lowered. They say three days to stop the biotin, to be safe, I go for a week. B6 is something like two months to clear from the blood stream, etc.

I would wait a bit and test progesterone again and see where that is at before ore specific testing.

The test I am familiar for upright aldosterone/renin, you have to be upright for two hours (at least) after waking up.
So before you get to the lab, you need to be upright
I don't know how laying down for 30 minutes jives with that...
Maybe they were going by diff. procedures

I know little about the workings of renin/aldosterone.
I know that a lower ratio can indicate salt wasting (in a specific hormonal condition)
How low is low? That one would have to look it up

Have you ever done 24 hour urine collection for all the minerals?
Just curious

 

[Callmestar]

I wonder if it could be possible that something you are taking is rising (or lowering) your progesterone.
-- Are you taking any medications supps when you do tests?
Biotin for example, it interferes with your TSH falsely lowered. They say three days to stop the biotin, to be safe, I go for a week. B6 is something like two months to clear from the blood stream, etc.

I would wait a bit and test progesterone again and see where that is at before testing 17-OHP

The test I am familiar for upright aldosterone/renin, you have to be upright for two hours (at least) after waking up.
So before you get to the lab, you need to be upright
I don't know how laying down for 30 minutes jives with that...
Maybe they were going by diff. procedures

I know little about the workings of renin/aldosterone.
I know that a lower ratio can indicate salt wasting (in a specific hormonal condition)
How low is low? That one would have to look it up

Have you ever done 24 hour urine collection for all the minerals?
Just curious

I've slowed down on the supplements and stop taking any I am taking in the lead up to bloods so I don't think that would be impacting it.

Yes some labs want you upright, some want you laying down. I don't have salt wasting or low aldosterone which was a suspicion at one point and even tried Fludrocortisone at one point which mimics aldosterone but saw no improvement.

What exactly are we trying to find with testing 17-OHP? What's the point? If it's high or low what does it tell us? If we assume my pregesterone is high, currently still no on seems to know why that or DHEA is high.

No I haven't done 24 hour urine collection for minerals, I've asked but again doctors here don't see it as relevant. Its a ******* nightmare.

 

[Callmestar]

So TRT not something should be looking at with these numbers?

 

[rockarolla]

Higher than normal calcium often means VDR over activation. Your ferritin and uric acid are also kinda high suggesting chronic inflammation which depletes you out of glucose = energy. Your vitamin D is very high though and could be the reason of higher calcium, since the number of VDRs grows with the background level of D25.

 

[Callmestar]

Higher than normal calcium often means VDR over activation. Your ferritin and uric acid are also kinda high suggesting chronic inflammation which depletes you out of glucose = energy. Your vitamin D is very high though and could be the reason of higher calcium, since the number of VDRs grows with the background level of D25.

Thanks. Yes Uric acid creatinine seem to be consistently high, along with DHEA. My corrected calcium was normal and I've had it tested a number of times and has been normal since this test.

Lost as to know what to do.

 

[gaze]

a TSH above 3 can cause those problems. you have to find a way to get it down one way or another, there are a million different theories on how to do it, but I would focus on that before trying TRT or anything. you said you tried thyroid hormones and failed, but I would double down and keep trying different things or taking a different approach. your vitamin D is also on the lower end, since it's in nmol/L. try to get it to 125 or above.

 

[ChopSuey]

This is the problem taking advise from people on the internet, receiving terrible advise from a few users above.

Regarding vitamin d - they probably didn't realize the test unit is done in nmol/l , converted to ng/ml which is what most people are probably use to seeing your vitamin D level is only 48.6 - so not high at all, in fact could be bumped up a bit.

Progesterone - it isn't high - the lab refference range was resently change for some reason and pretty much every man is testing "high" now when the level is perfectly normal. There was a few videos about this posted on the trt websites as every client was calling and asking why progesterone was high when it wasn't.

 

[Callmestar]

This is the problem taking advise from people on the internet, receiving terrible advise from a few users above.

Regarding vitamin d - they probably didn't realize the test unit is done in nmol/l , converted to ng/ml which is what most people are probably use to seeing your vitamin D level is only 48.6 - so not high at all, in fact could be bumped up a bit.

Progesterone - it isn't high - the lab refference range was resently change for some reason and pretty much every man is testing "high" now when the level is perfectly normal. There was a few videos about this posted on the trt websites as every client was calling and asking why progesterone was high when it wasn't.

Thanks. I will bump up the vit d.

Any thoughts on the high DHEA because that's one that certainly is high no matter where I get it tested on multiple occasions. Along with the declining test?

For those above, I appreciate my TSH is a little high and I will again try and get it down but just to add I had all of these symptoms for the past few years when my TSH has often been down around 2.0. seems whatevers going on is just impacting negatively multiple symptoms now.

 

[Kaur Singh]

Thyroid: Therapies, Confusion, and Fraud

Ray Peat

raypeat.com

Amazon.com: Hypothyroidism: 9780690010299: Barnes, Broda: Books

Amazon.com: Hypothyroidism: 9780690010299: Barnes, Broda: Books

www.amazon.com

 

[Kaur Singh]

When women go low/zero carb, they often develop amenorrhea.
- that's healthy women, and this is well known/has been observed outside Peat circles.
Eating sufficient carbs again restores it.

Anything that disrupts your energy production will have an effect on everything in how your body organizes itself.
This includes hormones and steroids - in all sexes and ages.
If you read up on biology and biochemistry, you'll understand why.

I like the little video on the plants here:

https://www.bbc.co.uk/bitesize/guides/zg2xxnb/revision/1

Them million dollar question is why it shows up differently in each one:
why is cancer in some, mental issues in others, etc
The way your cells and systems are organizing themselves may be particular to you
and it means that how you go on about recovering your health has to apply and work for you
at the particular moment in time.

I couldn't do salt for the life of me.
Even just a few grains would create havoc - for days.
I knew I needed it, because I had very little of it in my diet, multiple testing and symptoms showed deficiency.
I went on about addressing other things, which also took its time and tinkering
and at some point, I craved the salt.
I can consume with no problems now.

If thyroid hormone supplementation is not quite working yet
- ask why.

Microdosing is one option.
In general, if you try too many things at once, it will be harder to track their effect.
Low and slow, titrate as needed seems to be the name of the game for most, including dietary changes.

The beauty of Peat's work is that it is comprehensive and looks at the big picture
and how different systems interact.

Go back to basics:
what are temps + HR + BP throughout the day, before/after meals
track glucose
When you are feeling like ***t - take measurements
Glucometers are excellent investments. Pretty affordable now days.
Urinalysis sticks, the 14 parameters ones, might prove useful too.

As to why do these things - the answer you will begin to find in the links provided (here and the other thread)
Be curious!

 

[peateats1]

Sorry to keep pestering you guys with my bloody health problems but I'm unsure what to do currently and can't seem to find any improvement in my health. If anything it's getting worse and I'm getting desperate.

I posted a thread here a few months ago about my symptoms of being dehydrated/depleted/frequent urination/thirst/fatigue and have had some great responses but unfortunately have not gotten any better. More recent blood tests are showing my test is getting lower and lower and I don't want my health to deteriorate further so I'm wondering if my best option is to go on TRT? I had the dehydration problem long before any testosterone problems but I'm guessing my test and other hormones coming down is likely due to the constant stress and dehydration I seem to be experiencing. I've also developed prostatitis in the last few months which is likely related somehow.

Since posting here around 5 months ago I've tried various forms of thyroid to no avail, many supplements and a peat style diet which at times briefly felt as though it helped for the odd few hours here and there, maybe due to extra calories and sugar, but overall I feel I've gotten worse. I've also gotten fat around the belly and chest which has never really been an issue for me previously. I've currently just gone Keto under the suspicion I may have sort of insulin resistance or similar as despite testing negative for diabetes I seem to be completely dependent on sugar to hydrate even to a small degree. I know Keto is not exactly something that would go along with Peat ideas but for now I feel slightly better on it and have to give it a try to see if it can in anyway rebalance what seems to be dependence on sugar.

My main question is should I be considering TRT with these blood results? Why is my DHEA always high on bloods (I don't take DHEA)? I will attach a recent blood test below. This test shows testosterone of 10 but a more recent test it was 8. It's dropped from about 20 to 8 in a year. Any advice would be greatly appreciated.

View attachment 28250View attachment 28251View attachment 28252

I had high creatine kinase and taking thyroid and getting my tsh down brought the ck within normal levels.

 

[rockarolla]

Lost as to know what to do.

Check out for chronic viral infections constantly stimulating immune system(inflammation) leading for fatigue. At least for EBV/CMV.

Then several options exist: Ray Peat diet(recovering from hypo aka chronic glucose depleted state aka immune system exhaustion -> hopefully taking chronic viral load under control), Marshall Protocol(normalizing vitamin D + olmesartan + specific antibiotics(minocycline, azithormycin, clindamycin)/antivirals(ivermectin) microdosing), Grant Protocol(normalizing vitamin A).

 

[Callmestar]

I had high creatine kinase and taking thyroid and getting my tsh down brought the ck within normal levels.

Thanks. I haven't had creatine kinase tested since but I've had creatinine tested again and it's even higher along with my TSH being higher so maybe there's a link. Although I think it's mainly down to the dehydration and recent keto eating that's caused the increase in creatinine. I have started thyroid meds again though just after getting that blood test so let's see what happens.

 

[Callmestar]

Thought I'd post this here as well for anyone interested.

I just has some blood tests back from the doctor, taken after 3 weeks of keto which I tried on the idea I possibly had some problem with sugar causing the thirst/dehydration.(I've stopped keto now).

Testosterone has gone for 8 to 15 which is the only positive. TSH continuing to rise. This was a period without taking any Thyroid meds. I will be taking some from now.
Creatinine high which is a common theme and probably because I'm dehydrated. (There's never any idea from doctors about what can be done about this)
Cholesterol higher.
All in all looks like more confirmation of the tanked metabolism and thyroid?

Results:
Full blood count
Haemoglobin concentration 168 g/L [130.0 - 180.0]
Total white blood count 5.2 10*9/L [3.6 - 11.0]
Platelet count - observation 279 10*9/L [140.0 - 400.0]
Red blood cell count 5.52 10*12/L [4.5 - 6.5]
Haematocrit 0.493 1/1 [0.4 - 0.54]
Mean cell volume 89.3 fL [80.0 - 100.0]
Mean cell haemoglobin level 30.4 pg [27.0 - 32.0]

Thyroid function test
Serum TSH level 4.1 mu/L [0.2 - 5.5]

Serum testosterone level 15.2 nmol/L [8.0 - 31.0

Bone profile
Serum total protein level 79 g/L [60.0 - 80.0]
Serum albumin level 49 g/L [35.0 - 50.0]
Serum globulin level 30 g/L
Serum calcium level 2.58 mmol/L [2.2 - 2.63]
Serum adjusted calcium concentration 2.46 mmol/L [2.2 - 2.63]
Serum alkaline phosphatase level 54 u/L [30.0 - 130.0]

Serum lipid levels
Serum cholesterol level 8.1 mmol/L
Serum HDL cholesterol level 1.1 mmol/L
Serum cholesterol/HDL ratio 7.4
Serum non high density lipoprotein cholesterol level 7.0 mmol/L
Serum LDL cholesterol level 6.3 mmol/L
Serum triglyceride levels 1.6 mmol/L [0.6 - 1.9]

Urea and electrolytes
Serum sodium level 142 mmol/L [133.0 - 146.0]
Serum potassium level 4.4 mmol/L [3.5 - 5.3]
Serum creatinine level 115 umol/L [59.0 - 104.0]

Liver function tests
Serum total protein level 79 g/L [60.0 - 80.0]
Serum albumin level 49 g/L [35.0 - 50.0]
Serum globulin level 30 g/L
Serum alkaline phosphatase level 54 u/L [30.0 - 130.0]
Serum alanine aminotransferase level 20 u/L [< 50.0]
Serum total bilirubin level 10 umol/L [< 21.0]