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Anomalies in my blood tests report – can you explain?

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 Posted 5/13/2014 8:30:15 AM
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Thank you JimC for your post, which I also just see (btw, I noticed the Forums were inaccessible for several days).

My E2 seems quite OK at 15.8 pg/mL (range 7.6-42.6) and actually trend was lowering. DHT has indeed increased to 51 ng/dL (range 25-99). For the time being I leave it as such. I need to retest all next month incl. my PSA. As I had a TURP surgery in Jan 2013, the inner side of the prostate was partly removed. I just wonder what I should expect now for E2 and DHT and freeT after the surgery. PSA has lowered of course (at 0.8 post TURP). I tend to agree with you regarding DHEA.


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 Posted 5/14/2014 5:01:50 AM
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Hi Albedo,

The ideal E2 range is 21-30 pg/ml with total testosterone 700+ ng/ml depending on lifestyle, mass activity etc. 

Please note that the lab's ref range for hormones are nothing more than a statistical analysis of the lab's reference group. Typically this is taken from their patients and represents 2 standard deviations from the mean (95% confidence interval). Since the healthiest of our population typically don't get tested, the reference range is skewed toward the ill and elderly or those suspected of illness. The point is that the reference range does not indicate health status.  2.5% of the lab's reference group will have results that are lower than the reference range. 

Free testosterone is a poor diagnostic indicator because it fluctuates significantly.   Imagine you wanted to know how fast your daughter was traveling on a trip from SF to LA. You could check one time with no other information than instantaneous speed. If you happened to check when she was passing a slow truck or stuck in traffic or slowing for a signal, then you have a misleading number. Its far better to use:

Total Testosterone 
SHBG





Better yet
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 Posted 5/15/2014 3:47:44 AM
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Thank you JimC, that is interesting.

I fully agree with you on the problems related to the reference range but always wondered how you determine the optimal or ideal and how to determine it for you, personally. Someone might say that you just need to use the values of your youth but I remain confused on the relationship between "hormonal values of your youth" and health status. It is intuitive but is it true? It might be true in general (do we have studies?) but is it true for the individual? Also here we need personalized medicine!

I always thought free-T is more indicative than total but have been monitoring both of them and also SHBG fairly constant at least along my past 10 year as per the link I provided.


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 Posted 5/15/2014 6:29:11 AM
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Hi Albedo,

If this were 100 years ago it would be safe to correct to levels of our youth - unless hormonal pathology was present.  Today our hormone levels are affected by environmental factors such as, diet, high stress life lifestyle as well as chemicals such as phalates, xenoestrogens etc.

So, what's optimal?  The minimum level that ameliorates all physical and psychological symptoms of hormone deficiencies or excesses.  When you are evaluated by a competent doc, they know what your hormone status is before lab testing.  The lab work is really only to catch gross excesses and deficiencies and confirm a clinical diagnosis.

For example, if your doc notices that the outer 1/3 of your eyebrows are thinning, you have slowed Achilles Tendon reflexes, your bp is elevated and narrowed, you have kyphosis and hyperlordosis, sub-orbital edema, always cold (especially the extremities), facial edema (not moon face - that's excess cortisol), thinning coarse hair etc - they know you are hypothyroid. Of course there are just as many psychological, hormone specific complaints.

Here is the typical scenario that occurs with the low information/ignorant physician:

Patient:  Doctor, here all my complaints.  I seem to have 90% of the physical and psychological symptoms associated with this particular deficiency.  It's really affecting my quality of life.

Doctor:  Yes I do agree that you have these symptoms.  Let's run lab testing.

2 weeks later...

Doctor: Your lab values are low normal.  Everything is fine.  Get more rest, improve your diet and get more exercise. 

There are thousands of patients that have ignorant docs treating a lab (that's not based on health status - rather statistics) rather than the patient.  I hear of a friend or acquaintance at least one a month that is really struggling and experiencing this situation. 

Free Testosterone:

The other problem with using free T is that the reference range is unusually low and will mislead the uninformed doc.
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 Posted 5/16/2014 12:31:48 PM
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JimC, I very much agree with you and your point on clinical relevance/health status and symptoms. I am lucky enough to have had local doctors (in particular an anti-aging) and also a doctor at LEF whom I consulted a couple of times with the right approach.
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 Posted 7/14/2014 6:58:52 AM
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Transpower (5/6/2014)
Albedo, I still strongly suggest you get entirely off of soy.  Rather than just looking at papers, look at the posts of real people all over the Web who've discovered that soy is toxic.


Hi Transpower!

I just return on this. I respectfully disagree with you. We only have science to rely on and we must be very cautious to adopt behaviors based on anecdotic experience of course including my very one here!  

Please understand: you might be right but so far I do not find conclusive science. Even critic reports on known toxicity (e.g. the following one on genistein on thyroid) mentions:

".. The failure to find hypothyroidism caused by genistein in rats, despite extensive inactivation of TPO (35), or by mixed isoflavone consumption (47) points to additional risk factor(s) necessary to induce hypothyroidism. In particular, iodine deficiency is necessary for soy to cause antithyroid effects in rats. Although the mechanism of this iodide effect is unknown, a significant literature supports this concept (10,14,46,47)..."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241182/pdf/ehp110s-000349.pdf

I feel it is all a matter of balance.

If I put on the balance, I mean my balance, weighting all with my condition (prostate), the amount of benefit of including soy in my diet vs the risk of toxicity, the balance looks tilting in favor of the former.

Based in part by your remarks and concerns which I fully share, I have been reducing soy intake, probably not more than 1-2 servings per day, removing soy milk and checking iodine status.

In my last works, my TSH is back to typical levels (free T3 and free T4 where already normal while TSH increased but yet in the range) and iodine, using an extremely moderate supplementation, is in range toward the high end.

So overall I feel I might be grasping some of the benefits without the damage.

I know this is controversial but so far it is the best I have found.

Thank you for keeping writing in this Forum and sharing your experience.


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