Strange hormonal profile

Igorevich

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Mar 23, 2021
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Hi. I recently posted my story here, but I want to be more precise in asking for advice.

I'm 27 years old male. My main problems right now are the following:
1) Most of the time I'm fatigued, having malaise, uneasiness, pure concentration, low-grade akathisia, brain fog.
but every little stress is able to kick me into a different state:
2) Overwhelmed excitation, extreme brain fog, extreme thirst, polyuria,
and when it happens it continues for hours. And nothing helps until it subsided with time.

I feel like it is related to cholesterol metabolism. Because I have a strange hormonal profile right now:
1) Very high DHEA-S (over the reference)
2) Low progesterone (in the reference)
3) Low morning cortisol (in the reference)
4) Very high 17-oh-progesterone (over the reference)
5) High free T (in the reference, but some years ago it was 2-fold lower)
6) My T3 and T4 are in the reference (T3 is closer to the lower range, while T4 is closer to the higher)
7) My LH/FSH is 2/1
8) A little over the top cholesterol

Here is my half-handcrafted cholesterol metabolism diagram, and I think my hormones are going in the wrong way (marked with red arrows):
1617711541232.png
(I hope you are able to open the full image)

So I wonder if it is a cause of my current problems? Why could such a shift have happened? What do you think I should try to supplement (progesterone, dhea, pregnenolone)?
I have tried topical progesterone up to the dosages of 10 mg and nothing happened. I am afraid to increase the dosage, I don't want to rise my testosterone even more.

Thanks!
 

PxD

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Your symptoms combined with the low morning cortisol lab result make me think you have weak or stressed adrenals, and an overstimulated fight-or-flight response.

are you getting enough dietary salt and sugar?

You might want to investigate adrenal fatigue or adrenal insufficiency further, see if that sheds any more light on your issues.
 
OP
Igorevich

Igorevich

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Your symptoms combined with the low morning cortisol lab result make me think you have weak or stressed adrenals, and an overstimulated fight-or-flight response.

are you getting enough dietary salt and sugar?

You might want to investigate adrenal fatigue or adrenal insufficiency further, see if that sheds any more light on your issues.
Yes, thanks. Some time ago I realized I was undereating, so I probably can have any nutrient deficiency right now.
But after changing the diet nothing changed at all. I also tried carb-loading during these overwhelmed states. Nope.
Also, my blood sodium is a little over the top and I drink a lot of mineral water.

I read about adrenal fatigue a bit and found that stimulation with pregnenolone/progesterone/DHEA is a pretty solid approach. But I really don't know if it is applicable to my hormonal profile. For example, supplementing DHEA while high on DHEA isn't sound right.
 

Korven

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Could you post the lab numbers perhaps and it would be easier to decipher your situation? Did you check TSH? Also what's your diet like?

T3 in lower range and higher cholesterol suggests hypothyroidism and/or inflammatory condition (likely gut related) exacerbating low thyroid function. High DHEA and low morning cortisol sounds like a stress coping mechanism/adrenal insufficiency. These sound like classic hypothyroidism symptoms: "fatigued, having malaise, uneasiness, pure concentration, low-grade akathisia, brain fog.".

Have you ever tried supplementing thyroid? That could help shift your body in a positive direction and will support your adrenal glands. When temps and pulse are optimal (98.6 F and 85 BPM) your body should produce a good balance of testosterone, pregnenolone and DHEA etc without the need for supplementation. Though small amounts can be helpful when recovering.
 
OP
Igorevich

Igorevich

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Thank you for the answer. You can see my numbers here:

2014 (20 years old, feel pretty well):
T4 - 16.8 pmol/l (ref 9.0 - 22.0)
TSH - 3.38 mIU/l (0.4 - 4.0)
Testosterone - 17.95 nmol/l (5.76 - 30.43)

2021 (27 years old, feeling awful most of the time):
All my other bloodwork always came clean, I will include only discovered abnormalities
T3 - 1.86 nmol/l (0.98 - 2.33)
T4 - 134 nmol/l (62 - 150)
TSH - 1.97 mIU/l (0.4 - 4.0)
Testosterone - 29.67 nmol/l (8 - 42)
DHT - 597 pg/ml (250 - 990)
Cortisol - 165 nmol/l (100 - 500)
DHEA-S - 17.2 mcmol/l (4.6 - 16.1)
Prolactin - 108 mIU/l (73 - 407)
Androstendion - 8.8 nmol/l (1.8 - 11.8)
Progesterone - 0.5 nmol/l (0.3 - 2.2)
17-OH-Progesterone - 7 nmol/l (1.52 - 6.36)

Estradiol - 77 pcmol/l (40 - 161)
IgE total - 912 MIU/ml (<100)

I just didn't want to overburden the initial post.

I didn't try thyroid supplementations because my numbers are in the range and I am not sure it will not cause more mess.

Also, something about temps and pulse. My pulse is pretty much always over 85 bpm, also my temp is 98.24F most of the time and raise to 98.78F almost every evening. And NSAIDs don't lower it!
 
OP
Igorevich

Igorevich

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About my diet. I was eating poorly in terms of quantity for the last ten years. The dominant part of the ration contained sausages, white bread, apple juice, chocolate cookies. Also, I was on keto for several months.

Now I am trying to reach more calories and also food diversity. So it's buckwheat, rice, sugar, butter, cheese, kefir, eggs, fruits, green vegetables, beef, and chicken. I'm trying to switch towards saturated fats. Yes, I eat starch, but I found it convenient to handle my blood sugar. Also, I have avoided gluten for the past week, and nothing changed so far, unfortunately.
 

IVILA

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Thank you for the answer. You can see my numbers here:

2014 (20 years old, feel pretty well):
T4 - 16.8 pmol/l (ref 9.0 - 22.0)
TSH - 3.38 mIU/l (0.4 - 4.0)
Testosterone - 17.95 nmol/l (5.76 - 30.43)

2021 (27 years old, feeling awful most of the time):
All my other bloodwork always came clean, I will include only discovered abnormalities
T3 - 1.86 nmol/l (0.98 - 2.33)
T4 - 134 nmol/l (62 - 150)
TSH - 1.97 mIU/l (0.4 - 4.0)
Testosterone - 29.67 nmol/l (8 - 42)
DHT - 597 pg/ml (250 - 990)
Cortisol - 165 nmol/l (100 - 500)
DHEA-S - 17.2 mcmol/l (4.6 - 16.1)
Prolactin - 108 mIU/l (73 - 407)
Androstendion - 8.8 nmol/l (1.8 - 11.8)
Progesterone - 0.5 nmol/l (0.3 - 2.2)
17-OH-Progesterone - 7 nmol/l (1.52 - 6.36)

Estradiol - 77 pcmol/l (40 - 161)
IgE total - 912 MIU/ml (<100)

I just didn't want to overburden the initial post.

I didn't try thyroid supplementations because my numbers are in the range and I am not sure it will not cause more mess.

Also, something about temps and pulse. My pulse is pretty much always over 85 bpm, also my temp is 98.24F most of the time and raise to 98.78F almost every evening. And NSAIDs don't lower it!
Your labs are very good in my opinion... What're you complaining about? I don't think you need any hormones to supplement with, you can do it fairly naturally. To increase cortisol levels you can use some sort of adaptogen like ashwagandha or rhodiola. Just have an active lifestyle with a very peaty diet and proper amount of sleep. You should be good. Maybe check your magnesium levels as well. You might benefit from a tiny bit of pregnenolone too.
 

Gustav3Y

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Very high 17-oh-progesterone, low cortisol and high testosterone could be Congenital adrenal hyperplasia, there more types of CAH but that is one of them, I wont go into tons of details.
17α-Hydroxyprogesterone (17-oh-progesterone) is a an antagonist for mineralcoticosteroids and partial for glucorticosteroids, when that is very high cortisol goes very low, and androgens can be high or very high.
 

Gustav3Y

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I only now see the "spoiler", I do not think the Testosterone is that super high really rather normal-high, neither 17α-Hydroxyprogesterone.
 

IVILA

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You're feeling awful probably because of the cortisol. It's too low. Maybe early stage addison's disease? I'm not too sure.
 

Gustav3Y

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I am really curious why did you test for 17α-Hydroxyprogesterone?
You had to have a reason, because no one tests for this hormone around here.
 

IVILA

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I am really curious why did you test for 17α-Hydroxyprogesterone?
You had to have a reason, because no one tests for this hormone around here.
no people do... but I think it isn't that necessary.
 
OP
Igorevich

Igorevich

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I want to thank all for engaging in the discussion.

I only now see the "spoiler", I do not think the Testosterone is that super high really rather normal-high, neither 17α-Hydroxyprogesterone.
So do you think it is not the root cause? I do not think it is a catastrophic hormonal profile, but it's strange and it is very similar to women with PCOS. I believe they have shifted steroid metabolism in this direction too.

You're feeling awful probably because of the cortisol. It's too low. Maybe early stage addison's disease? I'm not too sure.
I read yesterday about it. But I don't have any other signs of it.

I am really curious why did you test for 17α-Hydroxyprogesterone?
You had to have a reason, because no one tests for this hormone around here.
I just read a lot about steroid metabolism. After I got high testosterone, I wanted to have all the available info about what happened. These kinds of tests are cheap where I live. They have tested 17-OH-progesterone twice because it is a very strange result for man.
 

Gustav3Y

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I just read a lot about steroid metabolism. After I got high testosterone, I wanted to have all the available info about what happened. These kinds of tests are cheap where I live. They have tested 17-OH-progesterone twice because it is a very strange result for man.
I know a couple of people in real life that tested for it once kept seeing low cortisol.
Never actually saw the numbers but they said his testosterone is high and 17α hydroxyprogeterone is high, cortisol is very low.
Problem is many doctors and people consider that is test is 850 is something bad going on being at the top end of natural levels according to labs.
Now, these tests were not done because too much free time on their hands, they actually feel bad, so I understand why you are concerned, you are not feeling good and having issues.

You could try to test some other of the 17-OH-progesterone related issues, not only cortisol, like aldosterone, blood sodium, etc.
But if you read around this hormone you will see sometimes there are no issues with aldosterone or sodium even if 17-OH-progesterone is high.
Maybe even test for hydroxypregnenolone and see if that is why DHEA is high..

Even cortisol can sometimes be very little and and sometimes normal, thinking about a relative that did some random testing.

Now considering that 17α hydroxyprogeterone is partially antagonizing glucorticosteroids (like cortisol) I am not that surprised Crotisol is low.
In theory hydroxyprogeterone should be more potent at antagonizing mineralocorticoids (see aldosterone, see sodium implications)

They have tested 17-OH-progesterone twice because it is a very strange result for man.
Look at the implications in women, if it is very high for women it will cause certain issues, like virilization (prenatal or adolescence) and the possible other issues with cortisol, etc.
 

youngsinatra

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Your body runs on enzymes and those enzymes run on minerals and vitamins.
From my experience, the body has innate intuition what to do to heal - just give it the right resources to produce energy and to run enzymes. — most importantly magnesium, K2 and copper.

Also your low cortisol seems to indicate exhausted adrenals, so an „adrenal cocktail“ might help - OJ, collagen, salt + maybe some magnesiumglycinate or -malat.

Sometimes it‘s just as simple as fixing a vitamin D, calcium, magnesium, sodium or copper deficiency/insufficiency.
Or clearing the burden of endotoxins.

But sometimes of course it isn‘t that easy.
And often even that is easier said than done.

Stay well man!
 

Gustav3Y

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How is cortisol going to go up with magnesium, glycine and collagen, these inhibit it.
As long the 17-OHP is high Cortisol will be low.
 

Korven

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About my diet. I was eating poorly in terms of quantity for the last ten years. The dominant part of the ration contained sausages, white bread, apple juice, chocolate cookies. Also, I was on keto for several months.

Now I am trying to reach more calories and also food diversity. So it's buckwheat, rice, sugar, butter, cheese, kefir, eggs, fruits, green vegetables, beef, and chicken. I'm trying to switch towards saturated fats. Yes, I eat starch, but I found it convenient to handle my blood sugar. Also, I have avoided gluten for the past week, and nothing changed so far, unfortunately.

Ten years of eating poorly can take some time to fix. It could just be that you need to give your body time to heal with low PUFA quality foods, and carbs + salt + magnesium + vitamin C for adrenals. Self experimentation is necessary and you'll need to find nutritious foods that work well for you.

If diet (+ maybe small amounts of preg, DHEA, prog, testosterone) isn't enough I still think thyroid can be worth trying for a few months to ignite oxidative metabolism. High temp and pulse can be driven by adrenaline/serotonin. Your TSH is 2 which should be under 1.
 
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Igorevich

Igorevich

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Many thanks for all the replies! I really appreciate it.

You could try to test some other of the 17-OH-progesterone related issues, not only cortisol, like aldosterone, blood sodium, etc.
But if you read around this hormone you will see sometimes there are no issues with aldosterone or sodium even if 17-OH-progesterone is high.
Maybe even test for hydroxypregnenolone and see if that is why DHEA is high..
My aldosterone is normal-low I think - 56 pg/ml (17.6 - 230.2)
Blood sodium is high - 147 nmol/l (136 - 145), but I am not sure if this reliable. Because I think I experienced dehydration due to bad digestion.
There is no test for hydroxypregnenolone here, but I suppose this pathway is the most solid explanation of high 17-OHP and DHEA.
I read papers about such shifts during the menstrual cycle in women. There is a difference between microsomal and mitochondrial metabolism of pregnenolone. 3B-HSD vs 17a-hydroxylase. Luteinizing hormone is able to control such a shift:

Your body runs on enzymes and those enzymes run on minerals and vitamins.
From my experience, the body has innate intuition what to do to heal - just give it the right resources to produce energy and to run enzymes. — most importantly magnesium, K2 and copper.
Yes, I think so. All these changes are just consequences of energy depletion and nutrient deficiency. I suspect such a shift in steroidogenesis could be associated with body attempts to energy saving. Maybe it is a less consuming way to produce androgens and estrogens. For example, PCOS women often have glucose metabolism abnormalities. I do not know if this is a root cause of violation of steroidogenesis, but at least I can address this way.

Ten years of eating poorly can take some time to fix. It could just be that you need to give your body time to heal with low PUFA quality foods, and carbs + salt + magnesium + vitamin C for adrenals. Self experimentation is necessary and you'll need to find nutritious foods that work well for you.

If diet (+ maybe small amounts of preg, DHEA, prog, testosterone) isn't enough I still think thyroid can be worth trying for a few months to ignite oxidative metabolism. High temp and pulse can be driven by adrenaline/serotonin. Your TSH is 2 which should be under 1.
Yes, I have a plan to eliminate all nutrient deficiencies right now, and then I think I will experiment with fuel (cholesterol, pregnenolone) and ignition (thyroid).
 

Daniil

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there is such a thing as "bound cortisol". it can be caused by iron overload, inflammation, and excess estrogen.

Regarding hypothyroidism - level 2 is not so high and is unlikely to cause so many problems.
 
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