chipdouglas
Member
- Joined
- Sep 24, 2016
- Messages
- 19
Hi,
Gender : male
Age : 47
Height : 5’7’’
Weight : 200 lbs
Rx : none
Supplements : Stinging nettle root
Blood pressure : ~117/ 70
Health professionals I’ve consulted with : endocrinologist (1), General Practitioners (many), neuropsychologist (1), psychiatrist (2).
Psychiatric diagnoses : GAD, ADHD, dysthymia
Psychological diagnoses : ADHD + giftedness
Medical diagnoses : liver steatosis, Gilbert’s syndrome, Mononucleosis (15 years ago). Severe cystic acne (from age 14 to 25).
I’ve been looking for the root causes of below symptom picture. For those of you that’ve been through a similar journey, you know that you’re unlikely to find real answers within psychiatry. Psychiatric diagnoses are highly subjective ; you’d see three individual psychiatrists and chances are you’d also get three different diagnoses or opinions. Plus, psychiatric diagnoses are merely descriptive. They do nothing to inform one about issues underlying one’s symptom picture.
Core symptomatology for the last 20 years : poor motivation, low mood, non-existent libido.
An ER doc with an anti-aging medical practice on the side, has diagnosed me with a mild case of adrenal insufficiency (i.e. cortisol insufficiency). He thinks all of my issues stem from insufficient cortisol. He prescribed : Cortef (hydrocortisone) 10 mg at 8 am and between 5-10 mg at ~ 3 pm. I refused to take it, lest a shutdown would result from this. Since ACTH also drives the production of other adrenal hormones, losing the CRH/ACTH signals would further compound the issue.
Clearly, I don’t have Addison’s disease. The symptoms of an adrenal crisis wouldn’t have gone unnoticed.
Congenital Adrenal Hyperplasia (aka 21-hydroxylase deficiency) ? I don’t think I have this, especially not the salt-wasting type. Again, symptoms are so severe that It’d have been detected soon after my birth.
If anything, what I might have is : NCAH or Nonclassic Congenital Adrenal Hyperplasia, which is a mild form of CAH. In this type, the 21-hydroxylase deficiency is less severe.
The above mentioned ER doc didn’t run a Cortrosyn test, which is the test whether there’s enough backed-up 17-Hydroxyprogesterone to meet the diagnostic threshold for NCAH.
In NCAH, there’s basically low cortisol production due to a partially functional 21-hydroxylase enzyme, along with high androgens.
From what I can understand, the negative feedback loop (through cortisol) is never really interrupted, which results in high androgens but not cortisol, since however hard ACTH is shouting to the adrenals to make more cortisol, there’s a primary adrenal issue preventing enough cortisol to be made.
I’ve done an ASI (i.e. salivary) : it shows normal 4-point cortisol, but off-the-chart high DHEA. IIRC, saliva cortisol is free cortisol and DHEA is the sulfated form. Correct me if mistaken.
Other than that, serum DHT was done twice. The first time, it came back in the upper part of range. The second time around, it was off-the-chart high.
Progesterone has also been done twice : both tests were above upper limit.
Total Testosterone has been done a number of times. Most of the time, it was somewhere in mid-range.
E2 has also been done a few times. It never seemed truly high enough to be clinically significant.
UFC was done once and came back as low normal (87 out of a ref. range of 55 – 300 nmol/d).
As to prolactin, I’ve seen it about mid range and another time it was in the upper part of range.
DHEA-S (serum) was tested twice. Both time, it was in the upper part of range – near the upper limit.
What puzzles me is that my serum cortisol is in the upper part of range. So there must be something that the MD who made that diagnosis knows that I don’t relative to the difference between UFC and serum cortisol. What I know, is that some MDs think of serum cortisol as being inaccurate relative to salivary cortisol. However, tbh I’ve also seen docs who don’t trust salivary assays.
I once took 50 mg DHEA (it was prescribed by Dr. Eric Braverman in NYC). I experienced severe anxiety as a result. It clearly didn’t benefit libido.
Positives about my situation, is I’m strong as an ox. Strength goes up rather easily. However, I’m not lean.
Stinging nettle root markedly increases subjective well-being and spontaneous erections and libido. At first I thought it might have something to do freeing up Free Testosterone, but then I found this : http://www.ijcrar.com/vol-2-7/Farzad Najafipour, et al.pdf
I find interesting that some posters on RPF have seen their libido wiped out as a result of taking exogenous DHEA. One such poster wrote that he’s naturally high DHEA-S.
In order to avoid clutter, I’ll post blood works below as separate msgs.
What do you think ? Don’t hesitate should you have any questions.
Best regards & thanks !
Gender : male
Age : 47
Height : 5’7’’
Weight : 200 lbs
Rx : none
Supplements : Stinging nettle root
Blood pressure : ~117/ 70
Health professionals I’ve consulted with : endocrinologist (1), General Practitioners (many), neuropsychologist (1), psychiatrist (2).
Psychiatric diagnoses : GAD, ADHD, dysthymia
Psychological diagnoses : ADHD + giftedness
Medical diagnoses : liver steatosis, Gilbert’s syndrome, Mononucleosis (15 years ago). Severe cystic acne (from age 14 to 25).
I’ve been looking for the root causes of below symptom picture. For those of you that’ve been through a similar journey, you know that you’re unlikely to find real answers within psychiatry. Psychiatric diagnoses are highly subjective ; you’d see three individual psychiatrists and chances are you’d also get three different diagnoses or opinions. Plus, psychiatric diagnoses are merely descriptive. They do nothing to inform one about issues underlying one’s symptom picture.
Core symptomatology for the last 20 years : poor motivation, low mood, non-existent libido.
An ER doc with an anti-aging medical practice on the side, has diagnosed me with a mild case of adrenal insufficiency (i.e. cortisol insufficiency). He thinks all of my issues stem from insufficient cortisol. He prescribed : Cortef (hydrocortisone) 10 mg at 8 am and between 5-10 mg at ~ 3 pm. I refused to take it, lest a shutdown would result from this. Since ACTH also drives the production of other adrenal hormones, losing the CRH/ACTH signals would further compound the issue.
Clearly, I don’t have Addison’s disease. The symptoms of an adrenal crisis wouldn’t have gone unnoticed.
Congenital Adrenal Hyperplasia (aka 21-hydroxylase deficiency) ? I don’t think I have this, especially not the salt-wasting type. Again, symptoms are so severe that It’d have been detected soon after my birth.
If anything, what I might have is : NCAH or Nonclassic Congenital Adrenal Hyperplasia, which is a mild form of CAH. In this type, the 21-hydroxylase deficiency is less severe.
The above mentioned ER doc didn’t run a Cortrosyn test, which is the test whether there’s enough backed-up 17-Hydroxyprogesterone to meet the diagnostic threshold for NCAH.
In NCAH, there’s basically low cortisol production due to a partially functional 21-hydroxylase enzyme, along with high androgens.
From what I can understand, the negative feedback loop (through cortisol) is never really interrupted, which results in high androgens but not cortisol, since however hard ACTH is shouting to the adrenals to make more cortisol, there’s a primary adrenal issue preventing enough cortisol to be made.
I’ve done an ASI (i.e. salivary) : it shows normal 4-point cortisol, but off-the-chart high DHEA. IIRC, saliva cortisol is free cortisol and DHEA is the sulfated form. Correct me if mistaken.
Other than that, serum DHT was done twice. The first time, it came back in the upper part of range. The second time around, it was off-the-chart high.
Progesterone has also been done twice : both tests were above upper limit.
Total Testosterone has been done a number of times. Most of the time, it was somewhere in mid-range.
E2 has also been done a few times. It never seemed truly high enough to be clinically significant.
UFC was done once and came back as low normal (87 out of a ref. range of 55 – 300 nmol/d).
As to prolactin, I’ve seen it about mid range and another time it was in the upper part of range.
DHEA-S (serum) was tested twice. Both time, it was in the upper part of range – near the upper limit.
What puzzles me is that my serum cortisol is in the upper part of range. So there must be something that the MD who made that diagnosis knows that I don’t relative to the difference between UFC and serum cortisol. What I know, is that some MDs think of serum cortisol as being inaccurate relative to salivary cortisol. However, tbh I’ve also seen docs who don’t trust salivary assays.
I once took 50 mg DHEA (it was prescribed by Dr. Eric Braverman in NYC). I experienced severe anxiety as a result. It clearly didn’t benefit libido.
Positives about my situation, is I’m strong as an ox. Strength goes up rather easily. However, I’m not lean.
Stinging nettle root markedly increases subjective well-being and spontaneous erections and libido. At first I thought it might have something to do freeing up Free Testosterone, but then I found this : http://www.ijcrar.com/vol-2-7/Farzad Najafipour, et al.pdf
I find interesting that some posters on RPF have seen their libido wiped out as a result of taking exogenous DHEA. One such poster wrote that he’s naturally high DHEA-S.
In order to avoid clutter, I’ll post blood works below as separate msgs.
What do you think ? Don’t hesitate should you have any questions.
Best regards & thanks !