[urano75]

As we are speaking about testo values, you've seen my total testo is top range, while my free testo is about mid-range.
I've seen in past labs sometimes a slight lower (but good) total testo, and sometimes higher (up to 32) free testo, so clearly binding is a big variable.
I'd like to ideally keep my free testo higher.
My latest (and only test) of SHBG is on the low side, so I can't say that high SHBG is responsible for excessive binding. Albumin is also normal.

I have the following questions:

1- What's the difference, meaning and importance of total and free testo values? Some say that free testo is most important being the active form, others state that total testo is important as well. So what should we mainly be looking at?
2- Most of the usually given suggestions will aim to increase total testosterone, but not necessarily free testo. Do you know of any ways to decrease testo binding to transport proteins? I only know about nettle root extract, which is supposed to work on decreasing SHBG. I tried at consistent doses for a period and the effect was an increased libido, but not less POIS symptoms.
3- Are there other factors besides SHBG and albumin levels to control testo binding? Are there other transport proteins involved? Is it possible that, if transport proteins  are normal if not lowish (as in my case), other factors determine excessive binding?
4- Are there factors influencing (free) testosterone function at cellular level? E.g. I know that insulin resistance is sometimes correlated to testosterone resistance at cellular level, hence the importance of insuline/sugar control.  Are there other hormones which can potentiate or hinder testosterone activity at cellular level? E.g. do other steroid/thyroid hormones, or vit D, or omega3 play some important role in that?
5- Would testosterone replacement therapy be of any use if total testo level is already adequate but free testo not so?

Maybe I'm asking trivial questions for some, but I think that if an instructive discussion about testo has to be done then at least all these points need being considered.

[urano75]

You might find this free/bioavalaible testo calculator interesting:

http://www.issam.ch/freetesto.htm

In my case, input values:

Total Testosterone           8.80 ng/ml
SHBG                             36.6 nmol/l
Albumin                          4.36g/dl

Output:

Free Testosterone          0.194 ng/mL  =  2.2 % (slightly smaller than my labs, after the due unit conversions)
Bioavailable Testo          4.61 ng/mL  =  52.4 %

These values don't look a problem to me, but let me know your values and your ranges.

[gondal4]

What is normal.  Give me numbers.  It should be in  upper range.   The range for testosterone  is for  15-80 years old.  So if you are in  low  quarter of the range, that means you are 60.)))

506 ng/dL    range 166 - 877

[Gbolduev]

Urano,

I look at your numbers,  if you could   send me or post here the tests that I asked for It would be easier for me to help you ..  Since you told me that you were supplementing zinc and copper for 2 years, and B5. And you are complaining about weak adrenals at the tissue levels,  what do you mean by that/  Low sodium? because  adrenals dont produce enough aldosterone.  This way  you dont retain copper, and  during stress you miss that. 
In this case I would assume that you  might miss manganese,   which is also needed for acetylcholine  synthesis.

You  guys are  right that everyone is different and POIS symptoms are different/  When I had POIS and I was   changing my  body chemistry I  would get different POISes all the time.   In one  chemistry I would get  stuffy noses,  itchy eyes,   in another chemistry  I would get   pressure in my head.  SO it changed.   
Testosterone plays the part in inflammation, and  most POIS sufferers are  low on it.  Also border anemic  situation is  what plays huge part also.     Balance  adrenals and thyroid against  each other, which will balance  sodium pottasium in your cell.  That is the answer .

Look at   horse owners,  how do they  balance their horses?    Take a guess,     iron  zinc copper manganese  balance.   

[Gbolduev]

Urano,

it is also not about  supplementing something for 2 years, it is about  the ratio  you  supplement especially for your body chemistry.   If you can tell me what you are supplementing now, that would be helpful also. and  what  POIS symptoms   you are getting.     And what are you doing for  test levels, obviously  they are  corrected by you.

[urano75]

Gbolduev,

my history: http://www.thenakedscientists.com/forum/index.php?topic=6576.18418

my regimen: http://www.thenakedscientists.com/forum/index.php?topic=6576.18442

with some little recent changes (methylfolate 3x1g, methylcobalamine 3x1g).

When I say I can't properly convert/use thyroid hormones at tissue level, I mean that my thyroid produces adequate amounts of T4 now (not 2 years ago), but too much of it gets converted to rT3 instead of T3, and eventually the FT3/rT3 ratio is too low, which creates thyroid hormone resistance at cellular level.

This is a thyroid panel before starting T3:

FT3= 5.45 p mol/l         [2.3-6.3]
FT4= 17.60 p mol/l         [10.6-19.4]
TSH= 1.81         [0.40-4.0]
rT3= 36.00 ng/dl = 360 pg/ml   *[20-50]   
FT3/rT3=9.86         *[>20]

rT3 overconversion (or T3 "pooling", or T3 resistance) is said to be caused by different factors, the most common of which are adrenal issues (low cortisol, high cortisol, mix of low-high cortisol) and iron deficiency. Folic/B12 and blood sugar issues are also said to affect thyroid hormone function.

Low temps point to underactive thyroid, unstable temps to adrenal dysfunction. Before starting T3 I had both low and unstable temps. Now I only have fluctuating temps (PM peaks 36.7C-37.2C).

My adrenal fatigue has much improved  with 2 years of adrenal support and 5 months of T3, but adrenals not totally fixed yet.
Insufficient sleep, overexercise, excessive sun exposure, sex are still triggers for adrenal downs (fatigue, muscular/joints weakness/pains).
It's very likely I get viral infections after sex. I've been told one of the problems is recurring CMV infections.
Fluctuating average body temperatures from day by day still point to adrenal weakness. The circadian T3 method I'm following is a relatively new methods supposed to help adrenals recovery their activity, without suppressing them with HC/Isocort/DHEA. And to balance the rT3 dominance out.
I'm also taking zeolite to help chelating metals.

I've been now abstaining for 3 weeks and feel better (no infections), but I still have some adrenal lows (temp drops, fatigue) e.g. after a late night.

Unfortunately my adrenals have been under stress for several reasons for 20-30 years, so even if I'm doing the right things now I'm afraid it takes time to recover.

All supplements are kinesiologically tested by my doctor. I'm currently on 100mg zinc and 5mg copper per day. zinc dose is higher than average but, he says, I always tested low when I took 50mg, so I doubled. He says I don't test low in manganese/copper. My iron is mainly OK. It's likely that I have had and possibly still have absorption issues. I use digestive enzymes, betaine HCL and ACV to help with that. I'm underweight (58Kg vs 1.81m). Actually I've been losing weight after a surgery last summer (bone tumor), months before starting T3.

Not sure what labs you want to see exactly, last ones are 3 months ago, that was 2 month after starting T3. Sodium/potassium were OK, aldosterone was mid-range, so probably suboptimal. I suffer of postural hypotension, but now it's improved.

Cortisol                                195ng/ml                            [40-225]
DHEA-S                                192mcg/ml         [125-483] for men of age 30-39
Aldosterone (sitting)     172pg/ml                            [35-300]
Renin (sitting)                   71,50pg/ml          (I couldn't find reliable range values for orthostatic renin)
Sodium                       147 [135-155]
Potassium                    4.1 [3.5-5.0]

SHGB      36.6nmol/l   [15-100]
Progesterone   1.23ng/ml   [0.11-1]*
Testosterone   8.80ng/ml   [3.0-10.6]
Testosterone Free   23.00pg/ml   [5.5-42]
17-beta-estradiol   32.35      [<62]
Prolactin      11,47      [<25]

Serum Iron      120   [50-175]
TIBC         326   [250-500]
Transferrin Saturation %   37%   [20-50]
Ferritin         240   [25-380]

Sugar      91   [70-105]
Insulin      3.4   [2-25]
Hgb AC1      5.0%   [4.3-6.3]

No point in showing thyroid labs while on T3.

Currently having an issue of hypercalcemia, I need to determine if that depends on T3 (eg calcitonin suppression) or excess vit D. I've decreased D to understand it next labs:

Parathormone   3,3pg/ml      *[12-72]
Calcium      10,80      *[8.6-10.7]
Phosphorus   4.70      [2.5-5.0]
Vit D3      85      [50-100]

Salivar tests:

Cortisol:
wake-up        at 8:30AM, as everyday
9AM...                 18.6nM        [12-22nM]    a bit low    should be top range:22nM
12:30PM...        6.5nM        [5-9nM]            a bit low    should be upper quarter: 8-9nM
5PM...                 3.8nM        [3-7nM]          a bit low    should be mid range: about 5nM
11:30PM...        0.9nM        [1-3nM]             OK   should be bottom range: about 1nM

DHEA AM: 0.22nM [0.40-1.47] low
DHEA PM: 0.19nM [0.40-1.47] low

But I was supplememting some DHEA few weeks before, that might have been a suppression effect.

I hope you have some information to get an overall picture.
I'm happy with docs following me (although impatient to solve long-term issues), but don't mind to get new ideas, if reasonably explained and documented.

Thanks!

[Gbolduev]

Urano,

I read  your case, and looked thru your results.   Also I look at what you are taking.   Looking at the latest ones, it looks like you are doing too much  т3.  But that is not the main  issue of my concern.  You are taking so much  crap it is not even funny.   Main goal for  supplementing stuff is to  have perfect  sodium pottasium  ratio in the  cell.  I am not sure that is the case with you at  all.   I  dont know how you will be able to keep balance with  all this stuff.

I think the best  thing to do  for you  would be to  figure out your metabolism right now.  Get tested for it, and  then you  can cut out a lof  of stuff that you are taking.   It is hard for me to tell , what is the pull in your case, since you are  taking so much stuff.  Also  I would   be careful  ommiting manganese  out of all this,  since it is needed for dopamine and acetylcholine.

I was the one who mentioned  RT3 on this forum and that it could be a problem for people,  but then   we did many tests and it looks  like RT3 is proactive not stable. So that  went off my table.

I think you should  do the hairtest.  All this blood work is just guessing in your case/

 You can  e-mail me if you want , I might  suggest you where to get it done, if you did not do it yet.
Gbolduev@mail.ru

[Gbolduev]

Urano,

I am 100% sure you need manganese.  Your adrenals wont  get stable without it.  Yes you are supporting them with Bs C   B5 and other stuff, but manganese  is vital for them and for pancreas

[Gbolduev]

Plus if you overshoot with T3 lets say ,  then your  pottasium will be  higher then sodium  in the cell  meaning  cortisol will be  higher on the  immune response  than  aldosterone. /  Your immune system will get screwed.   Both high  sodium potassium and  low sodium  potassium will lead to loss of energy.

[urano75]

Gbolduev,
thanks for taking your time for looking at my case.

I have few questions for you, if you don't mind:

1- How do you see from my blood work that I'm taking too much T3?
2- Is the serum sodium/potassium OK as I think to be, and does it somehow reflect the sodium/potassium in the cells?
3- How can one understand if intracellular sodium/potassium is optimal, are there direct (unlikely) or indirect (likely) lab tests for that?
4- How should I "test my metabolism" exactly, apart from taking temps, heart rate and blood pressure measurements multiple times a day as I'm doing since I'm on T3 for dose tuning?
5- Can you explain a bit more why you think that rT3 is not "stable" or meaningful? Isn't it tru that rt£ make T3 receptors unavailable at cellular level? Is it OK to have consistently low FT3/rT3 ratios in labs?
6- Do you think that my cortisol/aldosterone ratio is too high? Does that apparently high renin level say anything to you? Most say that blood cortisol is not a very meaningful test, and a salivar cortisol profile is far more accurate, do you agree?
7- I will include some manganese, how much do you suggest to take with 100mg zinc and 5mg copper?

I know I'm taking lots of stuff (not sure about "crap") and probably more than necessary, however all this work in the last 2 years has helped me recover so far, and I'm far better than I have been for decades. Understanding what's needed and what's not isn't an easy process. And you're right, it's not easy to manage it all. But for every thing that I take there's a history or a reason behind, so before giving up things I must have a good reason too.

Never done a hair test before, never looked for it here in Italy. I could do it sooner or later.

Thanks again.

[urano75]

4- Are there factors influencing (free) testosterone function at cellular level? E.g. I know that insulin resistance is sometimes correlated to testosterone resistance at cellular level, hence the importance of insuline/sugar control.  Are there other hormones which can potentiate or hinder testosterone activity at cellular level? E.g. do other steroid/thyroid hormones, or vit D, or omega3 play some important role in that?

As I said a lot of times, the sugar controle play a major role in my Pois. I often supposed high glycemic food may increase inflammation reaction supposed in semen allergy theory.
 But there is something else :

There is scientific and evident link between insuline and dopamine (eng or fr ) . Some guys here have taken ritaline, dopaminergic med.

What do you mean exactly: are you insulin resistant,  insulin deficient or hypoglycemic? In other words, did you have impaired glucose tolerance (prediabetes diabetes type-II), diabetes type-I, or reactive hypoglycemia (possibly related to insufficient cortisol)? Did you manage that from a dietary perspective with good results? Do you relate it to testosterone activity specifically?

The article you quote points to neurotransmission problems with insufficient insulin (type-I), but it's likely that problems occur when insulin resistance is present (type-II) and it can't be properly effective at cellular level. Insulin/leptin resistance is said to be one of the main causes of inflammation. As well the excessive consumption of fructose, industrial omega-6 PUFAs, and possibly gluten.

Personally, I pay attention to keep blood sugar under control after a meal, eat moderate amount of complex carbs and limit high-glycemic/simple sugars. On the other hand, I've been thru month of strictly carbs-restricted diet, no starches and grain, with no particular benefit and some frustration. I had some mild reactive hypoglycemia related to low cortisol, and it showed up more evident after sex.

Sorry, I joined the group just a couple of months ago, tied to catch up with recent topics but miss years of discussions :-)

[Gbolduev]

Urano,

1.  Your progesterone is high , meaning high cortisol, meaning high  pottasium in the cell.  Your ferritin  is  highish , meaning  copper could be deficient relatively.  Renin is high.  Caclium problem.  I did not see the  tests pre T3,  but  it looks like too much T3 to me for the reasons I mentioned.
2. Your sodium is high ,  normal is 140,  and definetly  not  147 or 155,  But serum is not  that reliable,  147 sodium is telling me that you are stressed,  4.1  pottasium is of  no use, since  pottasium is inside of the cell,   high progesterone  is telling me that  you have  high  pottasium in the cell and  probably high thyroid effect at the moment.

3.The most  precise way to see soidum pottasium is  in hair.   Write me an e-mail, I will hook you up,    hair testing in italy wont do,  I am in Cyprus and I send mine to  the US.
4. I use NES machine to test my  metabolism weekly.  You might look into that, and  if you have any questions on how to  use it I will  gladly answer those. I use temperature  charts also and blood pressure.
5.  RT3 is reactive and to me  it changes with the other changes.   I found that when cortisol falls  , it changes,  It changes with  adrenals and  bioavailability of iron.  It is ok to use it to  look at Thyroid on cellular level , if you dont have hair test. which is   precise.
6.I think  now your cortisol./aldosterone is high  might be  because of T3.  To me the only  correct way to  test  is hair test  Saliva might be ok. 
7. Well  to me it looks like  your sodium potassium  ratio is low and you are  retaining zinc  right now,   So  RDA for manganese is  2 , but I would take 4 at least.  Also  note , that  if you have weak adrenals   overshooting on  thyroid supplements  makes then  weaker.     If adrenals are weaker than  thyroid,  the proper  ratio is    maganese 30   mg a day , zinc 50 copper 3
So you see if you  use the minerals in  a different ratios let say , it would do completely different things, and it does not matter if you are taking them or not.  They are not balanced togethter and worthless.

Trust me, do the hair test ASAP, and you will see exactly where you are and what you need to take .  And actually if you are  taking  these supplements routinely  , that  would be great for you to see  how they afffect you  so you  can   easily  correct the dosages or the ratios and  put your metabolism right in the middle where the energy is maximum and  the body can start  healing itself.


Good luck/
Herman

[urano75]

Herman,

thanks for your thoughtful response.

Progesterone is high while on T3, unfortunately I never tested it before. As I didn't test aldosterone/renin before.
It's not very obvious that cortisol is high though. It seems that salivar and blood test don't give the same indications.

Salivar cortisol taken last September (before starting T3) was:

wake-up at 8AM
8AM.. 6.45 ng/ml = 17.8nM
Noon... 3.99 ng/ml = 11.0nM
4PM... 1.93 ng/ml = 5.3nM
10PM... 1.08 ng/ml = 3.0nM

If you compare it to the latest labs taken on T3 (see previous post), you don't see a tremendous difference, there is even a decrease of total cortisol during the day. And in both cases you see cortisol not high enough for most reference ranges (typically top range is 22-26nM).

Blood tests before T3:

Cortisol      135ng/ml      [40-225]
DHEA-S       91mcg/ml   [125-483]* for men of age 30-39

Blood tests after T3:

Cortisol      195ng/ml      [40-225]
DHEA-S      192mcg/ml   [125-483] for men of age 30-39

Salivar DHEA low, as previously written.

Here you see cortisol had improved, as well as DHEA (which was very low before). So what to believe, salivar or blood? I've often been told that salivar is more reliable than blood for what concerns cortisol/DHEA at tissue level. If so, I couldn't say my cortisol is high at all. Does low DHEA say anything to you? Consider that I didn't feel much difference when I supplemented up to 50mg of 7-Keto-DHEA.

On a side note, progesterone may be high because I take my first T3 dose 4AM to support adrenal activity 4 hours before waking up (which is the main point of circadian method), but it's unclear that big progesterone is converted to enough cortisol (for the reasons discussed above), and very likely not to enough aldosterone, which is far from top range. How is it possible to have high progesterone and not adequate cortisol/aldosterone?

Another point, my aldosterone is likely not enough, as confirmed by postural hypotension and positive pupil test. Why should sodium be slightly high with a slightly low aldosterone? My blood pressure is typically 100/60, so on the lowish side.

I acknowledge that high renin might be related to high calcium. By the way, do you really think that vit. D levels are optimal around 80 as many say? Because I just suspect it's too much for me. I didn't have hypercalcemia and PTH suppression when my D was 25 (low). I just can't go above 30-35 with D with regular intensive sun exposure, my body just can't make it: is it a safety mechanism to keep calcium normal? Am I forcing this mechanism supplementing D? I've stopped taking calcium supplements, reduce D intake and kept magnesium high since I've been observing this.

Iron: I was supplemting it because I've had low serum/ferritin for awhile. Keeping the same dosage (100mg), before T3:

Serum Iron      61   [50-175]
Ferritin         80   [25-380]
Transferrin      242   [200-400]

After 2 months of T3:

Serum Iron      120   [50-175]
TIBC         326   [250-500]
Transferrin Saturation %   37%   [20-50]
Ferritin         240   [25-380]

so clearly my iron absorption had dramatically improved on T3. I eventually stopped iron supplementation. Mainly I was struck by the ferritin surge. That may indicate excessive storage, inflammation or, I learn from you, copper deficiency. I'll have to take iron labs again soon to check the situation.

Certainly rT3 continuously changes while cortisol, iron and other factors affecting thyroid hormones utilization change. While on T3, is TSH fluctuates during the day, it changes even much. In fact I use temp charts to asses my adrenal status. When exhausted or tired temps fall, no matter the amount of T3 I'm using. I think it's because thre is not enough cortisol to use thyroid hormones. That would point again to insufficient, or at least unstable cortisol production.
I tend to believe in the rT3 model because, after few weeks taking T3 at the appropriate dosage, I feel an increase of effectiveness and tend to switch to the hyper side, which can be explained by T4 clearing off and eventually rT3 decreasing. I have to decrease a bit T3 dosage when that happens.

Considering that I'm already taking zinc 100mg and copper 5mg, I'd have to take at least 50mg of manganese for weak adrenals. Maybe it's a bit too much to start with? I could start with 10-20mg and gradually increase, what do you think? You see from iron example how absorption can be an issue, and how needed doses may vary...

I once got in touch with a NES practitioner and had few sessions. Now I'm mainly remotely followed by a doctor in US using Applied Kinesiology, Biomagnetism, NeuroModulationTechnique and various energetic medicine techniques. That's how I get most conditions and remedies tested.

Does anyone in Europe do hair test, or you have to necessarily refer to US labs? I am always reluctant to have samples/good travelling from and to outside Europe because they are invariable blocked by Italian customs, which is very annoying.

Thanks,
Andrea

[urano75]

Herman,
actually just surfing on the internet I've found at least three laboratories in Rome (where I live) doing hair tests.
Are there specific standards to be respected for hair tests, for which I shuld prefer a US lab rather than a local one?

[Gbolduev]

Urano

 We are taking about    perfect metabolism here.  YOu see after т3 your cortisol is   on the upper range 195,  which is high  just  as I said.  I think you are definetely  overdoing on т3  100%. 
Hair tests should  be done only in  1 lab that I know of,  which is  ARL,  which is number 1 lab in the US.who I tested very very acurate. All other labs I have no idea how good they  are.   I overnight  my hair   for 40 euros from  Cyprus and it is  done in 3-4 days,  e-mail me, I will  give you the  address and phone  number.
Also  I dont understand why you  are worried about calcium. At this point, I think you need caclium .  Ionized calcium  is different from  the bound with albumin.  It is the bioavailable calcium that you  dont have.  I think if you add calcium  your situation may  now  be balanced

[Gbolduev]

Andrea,

Also I look at  aldosterone cortisol as stress response,   and  I doubt it cant be tested  even within one day  . It really should be tested  within 1 month, or even 2 months periods as average.   Since the stress response is what important to me at least. Manganese  try to  take  10-20  and 30 , dont go over 30 I think for now.
Thyroid and  iron  is a sure thing,  your absorbtion went up huge   since T3 increased acid  in stomach and also  dont forget it increases progesterone which  favors  zinc metabolism , so you are losing copper with cortisol going higher.
Be careful with Iron , 250 ferritin  is  high already. Need to keep it tight,  you are right about the inflammation,   it  is caused by iron easily. I  like to  keep  ferritin below 150 and above 100,  this way I monitor my  zinc copper ratio.   

What I do , is  I try to   put my metabolism  in lock and keep it in the middle all the  time.  For that you need  breaks and  speed up stuff,   breaks are  mainly   magnesium and calcium,  it is not about  if I need them or not, I always  take them. Speed up stuff is the complex of vitamins,  like you are taking.  So basically    to raise sodium and potassium in the cell, I use a core complex with  ACEBs iodine and so for   for both glands at the same time so that complex is set to raise potassium and sodium at the same time., to  put breaks on that I use  magnesium and calcium,  and  to regulate  the  sodium pottasium ratio I use  manganese raises sodium,  copper raises  sodium , zinc raises pottasium.   I use NES machine to  trace this.
here is the approximate system/    First week, you take only  breaks and  core complex/  then go to NES see what is going on , NES will tell you   your sodium and potassium and  calcium magnesium level,   vitamin Bs missing that way you know  do you  have enought  speed up  stuff , or  do you need to breaks  to slow down metabolism.  Plus  NES will tell you how you stand on   manganese zinc and copper,  that will tell you  which side , sodium or potassium  you need to supplement. Let say if you supplement sodium side, you  move the manganese zinc copper complex  to the manganese side, if you  supplement potassium side , then  zinc side.   If you can find  NES machine near you , I can  help you to do it. 

If you  keep  sodium potassium balanced, most of the  bodily  functions will be  perfect including neurotransmitters and   aminos and everything else.   That is why I  think supplementing with quercetin not nessasary at all for instance.   I tied it out , it works pretty good, this kind of approach  at least for me.   

I hope this  helps
Herman

[urano75]

Herman,

let me be sure I understand well your points.

You state that cortisol is high because of the blood value. But it's not high at all looking at salivar values, which is considered as the golden standard by many. Also you say that cortisol pattern may vary from day to day depending on stress, and I agree with that, but this should be true both for blood and for salivar values. So, as one can't take blood/saliva cortisol tests everyday, do you mean these tests are completely worthless? And if they have some value, would not the salivar profile be more accurate and informative than a blood test?

Calcium: I don't like to have excess serum calcium and suppressed PTH with a situation of osteopenia and a history of bone tumor, that's why I'm concerned. Also, soft tissues calcification is not an appealing perpective. I didn't take a test of ionized calcium, how can you be confident that I need calcium supplementation, and that I don't have enough bioavailable calcium? I though it was not a good idea to further load calcium in the body with hypercalcemia, and that taking it from food would have been enough (plus magnesium supplementation). Am I wrong?

T3: when I did my tests on January I was on 25mcg@4AM+15mcg@11AM+10mcg@6PM, total=50mcg a day
I took my labs and was very surprised to see the following:

FT3= 5.14 p mol/l (=3,35 pg/ml)   [2.3-6.3]
FT4= 18.10 p mol/l (=1,41 ng/dl)   [10.6-19.4]
TSH= 0.01         [0.40-4.0]
rT3= 59.00 ng/dl          *[20-50]   
FT3/rT3=3,70         *[>20]
Anti-TPO=11,1 UI/ml      [<35]
Anti-TG<20UI/ml         [<20]

The most interesting bit was that FT4 was completely there, and upper range, after 2.5 months of T3. On an adequate dose, it should have been suppressed, if not cleared out. As a consequence, rT3 was very high (T4 went all to rT3 because of early morning T3 dose and TSH suppression). Being TSH suppression there, the most likely possibility was: insufficient T3 dosing, especially daytime doses (possibly caused by absorption issues). That's why I increased to 35mcg@4AM+20mcg@11AM+20mcg@6PM. Next thyroid panel will show the outcome.
If I keep my temps, HR and blood pressure in range, how can I say I'm overdoing T3? Shouldn't I have hyperthyroid symptoms? The purpose for me to take T3 in this way (CT3M) was exactly to raise cortisol and all steroid hormones, which I saw from salivar and blood labs were in need for it, and above all from symtpoms/signs of adrenal weakness. Do you disagree with this approach?

I understand you rely on NES for tuning. I don't have a NES practitioner at hand anymore, if I'll need your help I'll send you a message. I can't thread on too many different paths at the same time. By now, I'll introduce manganese gradually and see how it goes. I'll send you a message about hair test analysis too, then I'll decide when and where to take it.

Thanks,
Andrea

[Gbolduev]

Andrea,

I understand that the  idea was to  raise cortisol and  thus raise pottasium in the cell, so your thyroid can work  better and get rid of that biounavailable calcium build up on the membranes. (ionized is still needed you dont have that).  What I am saying is that if you raise  your  potassium too much,  as you did  according to your  progesterone levels and cortisol,  that  can create an inversion,  where aldosterone  is lower than cortisol, which was  not the case before t3.  Inversion is much worse, since it  is the case of catabolism ,  and immune system  gets  supressed.  The  idea is balance.    not too much and not too little.
Adosterone over  cortisol is bad ,  so is cortisol over aldosterone.  We need to keep it  balanced. 

[Gbolduev]

Andrea,

I found that  most of  cortisol testing is bs by the way . I helped more than 300 people within 3-4 months  this year,  and also many last year while balancing myself  also..So I saw  quite a few tests and  hair tests  and NES tests.  They did extensive testing like you , and  most of them  were suprised to find out that the problem was complete opposite  of what they were thinking/   Saliva and  blood, I dont think it is accurate at all,  we need   to see  your stress response  not for 1 day,  we need it for 1-2 months average.   I mean  those tests can give you the idea of what is going on  I  must admit/  That is why I just  dont look at cortisol in blood  at all, I try to look at  many factors in blood trying to read metabolism, and when I  know metabolism, I know  how  body will react to stress  in this particular metabolism.  Stress theory is what  many good nutritionists base their stuff  on,  since all  replacement  strategies dont work at all.

[urano75]

Herman,

I understand you might use an intuitive approach based on your direct experience and knowledge, but I still don't catch:

1- How can you say that I don't have enough ionized calcium, if I have excessive total serum calcium and normal albumin, to which I understand calcium is bound in blood, and I have never taken a test of ionized calcium (should I take it by the way?)

2- How can you say that cortisol/aldosterone ratio was smaller before T3, if I didn't take any aldosterone labs before T3? If progesterone has increased after T3, which is a reasonable assumption (I didn't take a progesterone test before T3 either), being progesterone roughly a precursor both of cortisol and of aldosterone (am I wrong in stating this?), why should have cortisol increased more than aldosterone?

Excessive catabolism is very likely, given the ongoing weight loss (which started before T3 though...).
Immune suppression: I don't know, immune system has never been good, I've been coping with infections since I can remember. Now it's a bit better then before, especially if I abstain from sex. Also seasonal allergies improve if I abstain.

I agree that replacement strategies can give short term relief but are not likely to solve the underlying causes alone (whatever they are). That's why I tried CT3M after two years of different kinds of adrenal support, to have a perspective of going somewhere, hopefully in the right direction. Actually I feel somewhat better on T3, but what the side effects on the long term, and how will it go when I'll stop it?

I see for you metabolism tuning is the main point, as reflected by the intracellular sodium/potassium ratio. How would you check metabolism if you don't have access to NES tests? Would hair analysis alone be enough to have a snapshot of current status?

Thanks for your patience.