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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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 Posted 8/8/2014 2:45:01 AM
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I run a second set of blood (and urine) tests and compared with last year. Overall, they are not bad but neither excellent. Please feel free to comment and criticize! Again thank you to everyone here bothering to look at this as last year!

link to my June 2014 blood tests results


Positive
  • Finally I could get DHEA-S in range. I think I could accomplish this with an extremely low supplementation (2x25mg per week) but I am sure the most important factor has been an increase in my strength training shown to increase this hormone.
  • IGF-1 has been slightly lowering which is an objective for cancer growth control.
  • Testosterone and free-T have been increasing while doing ok on DHT (and E2, to less extent)
  • DHT has been lowering which is an objective for by prostate condition, trying not to fuel its growth in size (due to my BPH, had to go - successfully to TURP). Maybe a protective effect of my prostate protection formula (LEF) and pumpkin seeds and oil extract.
  • E2 has been increasing but still in the norm and aligned with values I had over almost 10 years. I am not taking any pharmaceutical aromatase inhibitor beside probably the gently acting stinging nettle contained in my prostate protection formula and moderate I3C/DIM.
  • TSH was and still in the norm. However it went down from a worrying 4 to 2.9. I reduced soy foods intake but did not stop it to grasp some benefits of its genistein content. I checked my iodine.
  • For the slightly high calcium level I went and checked my PTH for first time which is in the norm. I did not cut out dairy but will further reduce.
- Ferritin went unfortunately up from a wonderful 98 to 115 (despite my IP6 supplementation) but still not that high as I had in my past (was up to 450!)

- I look to do better on my FFA panel as my palmitic acid (saturated FFA) has normalized. I need to address the GLA and DGLA though (see below).

- For the second time in 10 years, A1C went below 5, possibly due to the green coffee extract supplementation (chlorogenic acid) which however might have been negatively impacting homocysteine (see below).

- The objective of lowering chronic inflammation as much as I can is achieved with a consistently low hr-CRP.

Negative

- GLA (and DGLA) is consistently very low (which also brings to low Arachidonic Acid, a good thing for inflammation but not too much as it is important for cognition). I am considering a moderate supplementation of GLA.

- Total cholesterol and LDL went up, despite supplementation with red yeast rice (1200mg)! Unfortunately I relaxed on my diet (dairy in particular), which was particularly stupid maybe relying on some supplement protection! Not good for my prostate too!! I will control my diet more strictly but still continue to supplement. My doctor was not that worried by the values and also recommended this approach.

- Homocysteine went up to very high values (16.1) despite supplementation of B-complex and TMG. I am pretty sure my niacin supplementation (despite only 400-500 mg) affected this as well as some green coffee extract (chlorogenic acid) to control post prandial glucose spikes. Both are confounding! I also may not well absorbing folate and considering giving another try to methylfolate 1000mcg. My 23andMe results also look quite good on the methylation pattern. Please challenge this! I do not want to use high folate for too long not to fuel cancer!

- Fasting glucose is still worrying (despite very good A1C though). Doctor was not that worried at this (when looking at A1C) and recommended to watch what I was eating prior to the test. I am still confused on the labs: they also did a serum measurement which turned to be 68.5 (ref 72-108) and calculated insulin sensitivity (HOMA) based on that value at 0.79  (the calculation is: Glucose is mg/dl * Insulin in mIU/l / 405).

- RBC magnesium was also a negative surprise despite some supplementation (160mg). I upped the dose and got prescribed a special formula/dose (Diasporal/300mg) which was more effective in the past. This is a possible additional explication of my high homocysteine level (Mg is needed in the conversion of homocysteine to SAMe, via methionine).

- Calcium is again on the high side. I checked PTH which is normal though. I did not cut out dairy but will further reduce. Please challenge this!

- I did not report, for simplicity, my spot urine tests but maybe you can help understanding (so far absolutely no clue or preoccupation from doctors) the urine low creatinite value (5.8 mmol/l with ref range 8.8-16) and urea 188 mmol/l which gives a urea/creatinine ratio of 32.4 which is 10x higher than the ref range (2.54-2.82). This is now so for the 4th year in a row and I still do not understand it. Can you explain?

Lesson (re)learned

I am still studying all this and try to understand/find fixes. GP docs are often lost at much of this stuff and of course cannot come up with sensible replies when only given 10-15 mins max. to tell you all!  It's good to have Forum like this one and people as you to discuss! Supplementation can help but if you relax on diet and exercise it turns to be almost useless and might unbalance markers. You need to keep fixing big things first. Still reduce animal fats, dairy, increase whole plant foods and … be happy <img style=">

Thank you for your criticisms!!
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 Posted 8/8/2014 5:55:58 AM
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I still think you should get rid of all soy....
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 Posted 8/8/2014 6:04:49 AM
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albedo,

I saw your current test results as posted in my other topic.

Your testosterone numbers look good, and seem to be improving.  Are you supplementing for that or taking HRT?  Hopefully you can tell me you regime.

My highly sensitive CRP test results is very low. <0.1 is considered low.  Mine this year is very low at 0.019.  Last year it was base low at 0.1.  The improvement this year I think may be due to the very potent AKBA boswellic acid supplement that I've been taking (recommended dose of 3 caps per day). This appears to be the best one available. You might want to give it a try this year and see if the numbers improve next year.

http://store.truebotanica.com/store/product/SRW0244P/AKBAPlus.aspx

-Tom


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 Posted 8/8/2014 7:24:51 AM
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Tom

No I am not supplementing neither on HRT. I hope I can go on like this. If ever I will need doing something I will first try the supplementation regime (and find back some of your post for that if I recollect well) and maybe re-try HRT. While I am not happy of few things in my 2014 panel, I do am happy of my hormone panel. I assume fixing a bit DHEA did contribute.

Your hs-CRP is fantastic! Do you think this can help my wife with OA in her hands (she has <0.1 for hs-CRP)? I know you do a lot of research: is there anything we should be careful with that formula? Thank you for sharing it!


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