# STEROIDS FORUM > HORMONE REPLACEMENT THERAPY- Low T, Anti-Aging > HORMONE REPLACEMENT FOR *WOMEN* >  Plateau and labwork - T3?

## Giggle

Especially for Vett -
I have been following austenite's fat loss protocol for a few months now and leaning out slowly. Lately it feels like a plateau, and wondered about adding in T3. 
Had some recent labs:

TSH 0.321 (0.465-4.827)
T3 Total 0.88 (0.85-1.65)
T4 total 6.30 (5.53-11.00)
T4 Free 0.82 (0.78 - 2.19)
LH 14.4 (13.1-86.5)
FSH 27.1 (21.5-131)
Cortisol 4.12 (4.46 - 22.7)
Thyroglobulin AB <20 (<116)

So, essentially, the low end of normal for most of them.

Thanks for any thoughts!
Giggle

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## bass

yes you are border line T3 and T4, I think you'll do well with T3 cycle. TSH is fine even though its below the range, the new labs I believe are 0.3-3.5

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## Brett N

Giggle, would you be taking anything else to help eliminate any muscle loss with it? My wife is considering starting a round of T3 later in the winter but she is concerned for muscle loss. She isn't very big but it has taken time to build the strength she has and she doesn't want to lose the progress.

I was just curios on your plans with it.  :Smilie:

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## Giggle

Hi All -
Just to fill in some of the holes, I'm 56, 5'5", and 148#. I'm not good with body fat - but a little less than 20% I'm guessing. Because of bodybuilding and powerlifting, I have a reasonable amount of lean mass.
I take no prescription meds, and am very healthy.

Brett - I did get test and DHEA implants this fall. I also lift heavy and try to stick pretty tight to diet. 

I am supposed to get lipids and some other bw tomorrow - so I'll post that up soon.
Thank you all for your thoughts!

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## Giggle

I don't usually post my pic, but I changed my avatar for a bit so you can see bf%.

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## bass

nice skin tome for 56! yes looks like you have some muscles on but I think you are higher with BF% judging from the avatar, but with a better pic we can guestimade better. if you didn't mention your age I would have guessed early 40s. whatever you been doing keep doing it!

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## Giggle

I always feel fat! Thanks, though Bass.

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## bass

we all do! LOL

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## Vettester

> Especially for Vett -
> I have been following austenite's fat loss protocol for a few months now and leaning out slowly. Lately it feels like a plateau, and wondered about adding in T3. 
> Had some recent labs:
> 
> TSH 0.321 (0.465-4.827)
> T3 Total 0.88 (0.85-1.65)
> T4 total 6.30 (5.53-11.00)
> T4 Free 0.82 (0.78 - 2.19)
> LH 14.4 (13.1-86.5)
> ...


Giggle, thanks for posting. I must say, it's been the week of thyroid at this place! Well, those are some low numbers being posted. I wish it was as simple as saying add some T4/T3, or some desiccated thyroid medication, but unfortunately it's much more complex. 

You are exhibiting classic signs of adrenal fatigue, probably resulted from estrogen dominance. This can be quite common and quite problematic with women in peri and post menopausal stages. I'm presuming that you are going through, or have gone through this phase? The imbalance of progesterone during this process can easily lead to estrogen dominance, which in turn will wreck havoc on the adrenals and cortisol production. Your cortisol lab is low, I'm presuming it's an AM serum assay? I know I'm sounding like a broken record to many members lately, but the gold standard to go by is a saliva test, preferably the 4x test kit. This will tell the story of what's going on throughout a 24 hour day. Additionally, have you taken (or can you get) a ACTH lab to see how the pituitary is working with all of this?

Getting back to the T4/T3 supplementation ... Here's the deal, cortisol is highly needed to work with getting the T3 in your body to the receptor sites of your cells. The same goes with iron, as it is needed in the transport process of T3. If you're sitting where I think you are on this, then you will just end up getting an elevated T3 level not making it to the cells. This is what they call "Pooling". The last thing you will want is ample T3 level that end up stagnant. Having a low T4 and T3 score is one thing when other variables are normal, and TSH is elevated. However, you're low across the board (TSH, FT4 & FT3), which presents evident adrenal issues.

Did you physician address any of this when prescribing treatment for testosterone and DHEA? DHEA counteracts with the adrenals, so I'm kind of curious with doctor's position on this? Although it's a long shot, any discussion of Addisons or any autoimmune? Do you by chance know your test and free test scores, and/or SHBG value (current and baseline)? As I mentioned above, iron (plus ferritin) is also crucial in this, and I would seriously suspect your levels are low due to everything else taking place. All of this compounds upstream and downstream, starting with pregnenolone and going down from there ... It's just fun and games with the endocrine system. 

To wrap up for now, any thought of supplementing T4/T3 or any desiccated thyroid medication should be thoroughly reviewed with a qualified physician before going forward. I would personally avoid any thyroid supplementation until you know for sure you have a handle on things. There's a multitude of variables associated with all of this, so let's keep the discussion open. Also, lookup Dr. Uzzi Reiss and the books he has to offer. I follow a lot of his stuff, and he is as good as they come for female hormonal support.

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## Vettester

> yes you are border line T3 and T4, I think you'll do well with T3 cycle. TSH is fine even though its below the range, the new labs I believe are 0.3-3.5


Bass, that's just not good advise, and your assessment on her T3 and T4 is incorrect. Both FT3 and FT4 are less than 3% of their respective value ranges. 

Giggle, as discussed, please review this much deeper before proceeding.

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## thisAngelBites

Hi Giggle, I have a couple of questions. Was that cortisol blood level taken from blood drawn early in the morning? And secondly, was it taken before or after your pellets were implanted?

Like Vette, I am concerned about why your T3 and T4 levels are so low, but your pituitary doesn't seem bothered, and I am also concerned about the state of your adrenals. It may be that your T and DHEAs were low, along with your cortisol, and your physician was trying to increase your cortisol by providing your body with some of your lower level hormones in order to keep your body from shunting away pregnenolone from your cortisol production in order to make more T and DHEAs, in order to concentrate more on cortisol, if you see what I mean.

I would hold off on T3 and T4 until someone can help you figure out what is going on.

In the meanwhile, I know it's a pain, but could you please post all the bloodwork your doc did pre-pellets, and then any bloodwork taken after the pellets? And then I will have another look, as I am sure Vette will, and let you know what else we see. I think Vette knows a lot more than I do about the mechanism of estrogen dominance, so I don't have anything to add there, but it sounds like your doc may have done a complete hormonal workup before the pellets, and that would be good to see.

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## bass

> Bass, that's just not good advise, and your assessment on her T3 and T4 is incorrect. Both FT3 and FT4 are less than 3% of their respective value ranges. 
> 
> Giggle, as discussed, please review this much deeper before proceeding.


hmmm, i'll have to read a little more. but how is a T3 cycle a bad thing?

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## Vettester

> hmmm, i'll have to read a little more. but how is a T3 cycle a bad thing?


Basically, in order for T3 to work at the cellular level and with ATP, you need cortisol function to be adequate. Additionally, iron levels need to semi-sufficient for the transport of T3, and her chances of being iron deficient are very high, this being based on just what we've learned from her. So, to answer you, if she starts adding T3, but doesn't have the transport agents, or the glucose support for mitochondria and the cells to receive T3, then the T3 will work against her by pooling. The ADP ratio to ATP will increase, and she will start having a whole host of new issues.

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## bass

> Basically, in order for T3 to work at the cellular level and with ATP, you need cortisol function to be adequate. Additionally, iron levels need to semi-sufficient for the transport of T3, and her chances of being iron deficient are very high, this being based on just what we've learned from her. So, to answer you, if she starts adding T3, but doesn't have the transport agents, or the glucose support for mitochondria and the cells to receive T3, then the T3 will work against her by pooling. The ADP ratio to ATP will increase, and she will start having a whole host of new issues.


thanks for the clarification Vette.

Giggle, my suggestion was based on what I have learned from reading about T3 cycles, many people do it and they come out fine. but to play it save follow Vette's advice, I would.

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## Giggle

Hi All -
Well this is a bit overwhelming since I thought it was a simple decision - boy was I wrong!
I will try to answer all the questions in one post to make it easier on you all.
Yes, I'm post menopausal.
No, no history of autoimmune (or ANY illnesses)
The GYN didn't do any labs pre-pellets which confused me (how can it be "bio-identical" if we don't know where we are starting, but that's another question)
I will try to figure out the exact timing of labs the Endocrinologist did, and the pellets.
I will also start to read up on this, and Dr. Uzzi Reiss.

For now, I did get some more labs done today:
TSH ultrasensitive 0.318 (0.465-4.827)
Alk phos 86 (

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## Giggle

Crud...I hit enter!

Alk phos 86 (38-126)
SGOT 72 ((12-46)
SGPT 67 (13-69)
Bili Total 0.5 (0.0-1.1)
Bili direct 0.1 (0.0-0.4)

Chol 223
Trigly 75
HDL 20
LDL 188
HemeA1C 5.5

(My lipids are never this bad - usually perfect) 

Thanks so much for helping me here - I'm clearly over my head. I had no idea!

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## thisAngelBites

Vette,

I wonder if something is going on with the synephrine in the fat loss protocol, with possible additive or potentiating effects of clenbuterol .

I know ephedrine hastens the deiodinase from T4 to T3 and I am sure synephrine is just a synthetic that also acts on adrenergic receptors. I am wondering if taking this, the T4 was converting quickly, causing pituitary to lower TSH, then being depleted by what I imagine must be a high reverse T3. And T4 is left depleted as well.

Clen is a beta 2 adrenergic agonist and may be making it worse.

I am bothered by the idea that Giggle, who is so healthy, has so many possible underlying problems and yet no symptoms - it just is too counterintuitive, although it is possible.

Do you know anything about these drugs or can you have a look for us? Please add what you can, if you have time, as I am off to bed with as much medication as I can muster to try and fight this head cold. If not I will do some reading in the morning and see if it all ties together or now.

Giggle, if something like this is going on, it would also explain your messed up lipids - throwing off what might be usually good thyroid values would cause that.

Goodnight.

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## Giggle

Thank you Angel. Sure hope you feel better!

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## bass

> Vette,
> 
> I wonder if something is going on with the synephrine in the fat loss protocol, with possible additive or potentiating effects of clenbuterol .
> 
> I know ephedrine hastens the deiodinase from T4 to T3 and I am sure synephrine is just a synthetic that also acts on adrenergic receptors. I am wondering if taking this, the T4 was converting quickly, causing pituitary to lower TSH, then being depleted by what I imagine must be a high reverse T3. And T4 is left depleted as well.
> 
> Clen is a beta 2 adrenergic agonist and may be making it worse.
> 
> I am bothered by the idea that Giggle, who is so healthy, has so many possible underlying problems and yet no symptoms - it just is too counterintuitive, although it is possible.
> ...


I was on Austinite's fat loss stack for 4 weeks, did BW and both lipids and thyroid were same as always. Not saying it's not effecting Giggle but thought I'd mention it. Good observation though.

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## Vettester

> Vette,
> 
> I wonder if something is going on with the synephrine in the fat loss protocol, with possible additive or potentiating effects of clenbuterol .
> 
> I know ephedrine hastens the deiodinase from T4 to T3 and I am sure synephrine is just a synthetic that also acts on adrenergic receptors. I am wondering if taking this, the T4 was converting quickly, causing pituitary to lower TSH, then being depleted by what I imagine must be a high reverse T3. And T4 is left depleted as well.
> 
> Clen is a beta 2 adrenergic agonist and may be making it worse.
> 
> I am bothered by the idea that Giggle, who is so healthy, has so many possible underlying problems and yet no symptoms - it just is too counterintuitive, although it is possible.
> ...


Angel (and Giggle of course),

IMO, I think it stems a bit deeper than the compounds associated with that protocol. I agree though that Clen anything else is just probably compounding to the issue(s) at hand. On top of everything else, the liver enzyme readings are elevated, indicating additional problems. Giggle, has your doctor reviewed this with you? Do you know how these labs compare with previous labs? Usually this will happen when drinking a fair amount of alcohol, or taking medications that can be hepatotoxic. Even Niacin and various oral supplements can cause enzymes to increase (I know, it happened to me on Niacin).

Anyhow, regarding the thyroid, I would bet this has been an ongoing ordeal for a long time, probably starting during the final years of peri-menopause, and continuing thereafter. IMO, I suspect the entire thyroid function is tanked. I don't think T4 is evident, thus no synthesis of T3, and think the pituitary is suppressed (TSH specific) and gave up along time ago with trying to get feedback. I doubt pooling is an issue, as there's no excess T3 being suppressed in the cells. As stated earlier, this IMO is leaning towards adrenal fatigue being the culprit; possibly resulted from the absence of progesterone in the stage of menopause. Progesterone counterbalances estrogen, and when it's depleted the effects of estrogen dominance can present a litany of issues. Again, for any doctors or medical professionals reading this, I am just speculating here and this by no means a diagnosis. 

Giggle, the best possible advise I can give at this point is to align yourself with a top notch physician, A4M certified if possible, and one that has some special training with female endocrine support. Dr. Uzzi Reiss is in So Cal. He is the caliber of doctor that you need. I know you initiated this thread with hoping to get some quick T3 advise, get over this plateau, and get on the fast track. I'm sorry that we took what was potentially a simple thread, then turned and made it quite complicated at best. However, it is what it is, and I would be doing some real injustice if I sat here and tried to tell you how to self treat this. I think you are a prime candidate for a complete BHRT program, addressing your situation top to bottom. There are just too many variables, ranging from the adrenals, thyroid, pregnenolone, GABA, GH, test/free test, SHBG, etc..., and of course the estrogen status and progesterone. I know you're not looking to reinstate a menstrual cycle, but you should really seek some opinions from experts in this field, who can provide various options to get you on the fast track again. 

You have the support of the forum, so feel free to ask ANY question. If we don't know, we don't know, you will get honesty, and a lot of discussion coming from different perspectives and experiences. If you have time, get Dr. Reiss' book, The Natural Superwoman. I have read it, and I assure you it will make a lot of sense with all of this discussion of female hormonal health. Another good source for information is Dr. Bruce Rind in D.C, and you will find all sorts of good information pertaining to endocrine support, and in particular with the thyroid. Stop the thyroid madness has a crazy amount of information, and a very good book for around $20. Just some ideas in case you're intrigued to want to research this stuff. 

Let's keep an open discussion going, but please give some thought into getting the big picture looked at. I do believe you can not only overcome your plateau, but you can probably reach some amazing heights that you never dreamed possible. Hell, just look at Suzanne Sommers!! 

To quote a good friend, "Goodnight"  :Smilie:

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## thisAngelBites

After I sent that post, and went to bed, I thought to myself "but the things she is taking don't account for the low cortisol."  :Smilie: 

I'm not saying it's the fat loss protocol on its own, synephrine is pretty safe. But I am still wondering about the fat loss protocol, plus clen , plus a possible subclinical thyroid problem. I can't quickly lay my hands on how synephrine affects the thyroid, but I do see a number of places say it is contraindicated in people with thyroid problems, although I wonder if they mean hyperthyroidism, specifically. For that reason alone I wouldn't personally add T3 to what you are already doing, Giggle.

I've looked quickly at the ephedrine and synephrine molecules, and they differ in two different locations, and based on that, I am not sure I can say for sure what the effect on the thyroid hormones is by the synephrine. And I just don't have the capacity at this moment to search it all out. 

Vette, on first glance I assumed the AST/SGOT was elevated due to protein breakdown from the heavy lifting Giggle does, as AST is not specific to liver, but I think, taken in the context of all of the rest of this, it's impossible to say.

I'm sure it's disappointing Giggle, but if it were me, I would stop everything for a month, and then get all the necessary blood work re-done to see where you are without taking anything. Thanks for the kind health wishes. I'm sadly not feeling better today and I'm off to try and stop the sinus pain.

I'd be very interested in anyone else's input, or seeing more bloodwork, Giggle. Have a good day, everybody.

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## austinite

Sorry about your concerns, Giggle. Hope it gets figured out. This thread however, turned into a gem of information. ThisAngelBites and Vette, thank you so much for the interaction in here. Learned a few things myself. 

angel, yes, Synephrine is often compared to ephedrine, but it's quite a different animal, different pathways and targets.

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## Giggle

Vette and Angel -
I don't even know how to say thank you! My health is one of the most important things to me, and it blows me away to think there's odd things going on - and I didn't even know it. Thanks for all of your thoughts and writing, AND on this holiday!

I absolutely will stop all the fat loss supps for right now. I'll do fine I think with just a good nutrition plan and a tad more cardio and I can handle the holidays.
I also will get both of the books you recommended. I'm somewhat of a researcher in my "real" life, and I love to delve into new topics. But honestly - this is really confusing. Since the Endocrinologist I saw thought everything was fine in the first labs, I do think I'll need to find an expert. He doesn't have the labs from yesterday of course, but you all seem to be far more knowledgeable than him.

I'll keep you posted, but in the meantime - I'm your biggest fan! You all are wonderful.

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## austinite

Good call, Giggle. Looking forward to updates from you!

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## Giggle

Thanks Austinite - it's a little bit worrisome, but I'll figure it out.

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## Giggle

I tried to read about adrenal fatigue today, and I really don't have many of the symptoms. I always have plenty of energy, wake up early, no cloudy thinking, etc. The only thing I can really relate to is I have to eat often or I get hypoglycemic.

One thing that I was hoping to clarify - adrenal fatigue comes about from chronic stress...is that right? In thinking it over, in the last 6 years I've been under some additional stress - 10 bodybuilding shows, 4 powerlifting meets, full-time work, and got a doctorate degree. I'm NOT whining, you know!! I'm just asking if maybe I've contributed to the problem. And every time I dieted down for a show, it became harder and harder to stay lean. Maybe this is ALL part of the problem.

Dr. Reiss' book should be here soon so I'll get reading on that. I hope it makes sense.

Could you all help me make a list of any more labs that I should ask to be done? 
It sounds like the saliva x4 cortisol, estrogen, progesterone, test/free test, GABA, and what else??

Thanks a bunch

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## Vettester

Giggle, here's a copy of the _Ultimate Female Anti Aging_ package at Private Lab MD. 

The Female Ultimate Anti-Aging Panel w/F&T Testosterone contains the following tests: 
-Lipid Profile
-Complete Blood Count w/ Differential
-Estradiol
-Hemoglobin A1c
-Cardiac C-Reactive Protein Test, High Sensitivity
-Insulin Growth Factor (IGF-1)
-Thyroid-Stimulating Hormone (TSH)
-Gamma Glutamyl Transpeptidase (GGT)
-Insulin, Fasting
-Comprehensive Metabolic Panel
-Luteinizing Hormone(LH)
-Testosterone, Free (Direct) With Total Testosterone, LC/MS-MS 
-Sex Hormone binding Globulin, Serum
-Urinalysis, Routine
-Follicle-Stimulating Hormone (FSH)
-Magnesium, Serum
-Thyroxine (T4) Free, Direct
-Iron, Serum w/ TIBC
-Progesterone
-Cancer Antigen (CA) 125
-Dehydroepiandrosterone Sulfate (DHEA-S

** Add D3, B12, Ferritin, Manesium ... If I think of others I'll edit and add them.

You can order the 4x Saliva Kit from The Canary Club if you don't have a place to get it, and it sounds like you know all of the thyroid labs needed on future labs. 

Yes, considering all you have been through, I'm surprised your adrenals didn't fall out!! In all seriousness, it's not just the stress and fatigue that can contribute to it. In peri and post menopausal stages your body goes on a rampage of hormonal imbalances. Progesterone is primarily produced in the ovaries, and it is also produced in the adrenals. When the ovaries cease production, the adrenals go into overdrive trying to make more progesterone to compensate what the ovaries are not doing. This is where estrogen dominance comes into the picture. As explained earlier, the adrenals will effect the thyroid. So in essence, the depletion of progesterone was probably the culprit, but it's all speculation at this stage. 

BTW, congrats on all the accomplishments! Should we call your Dr. Giggle?  :Thumps Up:

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## Giggle

Oh WOW - thanks!!
I guess it is sounding right, because all of this was during my peri- and post-menopausal period.
Right now I know I just never seem to get (and stay) as lean as I did when I was younger.
I DO want to figure it out, and I'll keep in touch. Trying to get the tests done, and finding someone to interpret them and treat me sounds like it will take a while - but you know I'll be working on it.

THANK YOU!!

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## Vettester

When you get Dr. Reiss' book(s), a lot of this process will make more sense after reading. The body has always been in a state of homeostasis with the progesterone counterbalance to estrogen. Despite diet and doing everything right, your body didn't stand a chance when the progesterone went away. The adrenals could handle the overload and they gave up. At least that is the theory at hand that I am presenting. 

You will do fine, and just knock when labs arrive or something comes up.

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## Giggle

Just an update - I'm reading as fast as I can in Dr. Reiss' book but boy there's a lot of information. I've ordered the x4 cortisol test.
I'm trying to look at some of the symptoms as an outsider - and although I didn't recognize it ever, there were plenty of days that I did feel oh so tired. That I couldn't get up in the morning for cardio, that I didn't sleep much, or that I crashed at my desk after lunch.

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## ElectraMaddox

> Just an update - I'm reading as fast as I can in Dr. Reiss' book but boy there's a lot of information. I've ordered the x4 cortisol test.
> I'm trying to look at some of the symptoms as an outsider - and although I didn't recognize it ever, there were plenty of days that I did feel oh so tired. That I couldn't get up in the morning for cardio, that I didn't sleep much, or that I crashed at my desk after lunch.


Were you taking T3, fatburners or other stimulants?

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## Giggle

Not T3, but yes to clen and the fat-burning stack. I'd been doing them for a few months - either one or the other. I took a few weeks off, but not that much.
mostly I think this has been going on for a long time now.



> Were you taking T3, fatburners or other stimulants?

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## ElectraMaddox

> Not T3, but yes to clen and the fat-burning stack. I'd been doing them for a few months - either one or the other. I took a few weeks off, but not that much.
> mostly I think this has been going on for a long time now.


In my experience, long term use of clen fifties up your beta receptors. That's a possibility. 

Also fat burning stacks usually have heavy amounts of caffeine which raises your cortisol numbers dramatically. High cortisol through out the day makes weight loss harder. Stimulant usage caused my cortisol levels to double out of the normal range. That's certainly a possibility. I just got a cortisol stimulation test and it's not fun. Your fasted and get pricked with needles for close to two hours. By the time your done you look like a drug addict and feel like a chemo patient. I also did two 24 hour urine tests and 2 cortisol blood test. Basically the final result is that my adrenal glands were taxed and that would inhibit weight loss.

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## ElectraMaddox

> Vette,
> 
> I wonder if something is going on with the synephrine in the fat loss protocol, with possible additive or potentiating effects of clenbuterol .
> 
> I know ephedrine hastens the deiodinase from T4 to T3 and I am sure synephrine is just a synthetic that also acts on adrenergic receptors. I am wondering if taking this, the T4 was converting quickly, causing pituitary to lower TSH, then being depleted by what I imagine must be a high reverse T3. And T4 is left depleted as well.
> 
> Clen is a beta 2 adrenergic agonist and may be making it worse.
> 
> I am bothered by the idea that Giggle, who is so healthy, has so many possible underlying problems and yet no symptoms - it just is too counterintuitive, although it is possible.
> ...


I went through the same exact thing until I came off of everything that's when it hit me. I was going on my third week off everything where I felt like shit. I couldn't concentrate, everything was blurry, I was so fatigued yet had anxiety. It was a mess. My question for Giggle is how are you feeling off of everything?

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## ElectraMaddox

> Especially for Vett -
> I have been following austenite's fat loss protocol for a few months now and leaning out slowly. Lately it feels like a plateau, and wondered about adding in T3. 
> Had some recent labs:
> 
> TSH 0.321 (0.465-4.827)
> T3 Total 0.88 (0.85-1.65)
> T4 total 6.30 (5.53-11.00)
> T4 Free 0.82 (0.78 - 2.19)
> LH 14.4 (13.1-86.5)
> ...


Did you get your blood taken at 8am fasted? My Dr made me do that because that's when you get the mist accurate number for cortisol . I believe it should be around 17 at 8 am. 

Being that your TSH us slightly surpressed and not your t3 or t4, he didn't order an MRI to see if your pituitary gland is enlarged or there's a tumor? The pituitary makes TSH. 

Were you off all your supplements when you got this done and for how long? If a supplement was surpressing the TSH then it would self regulate in about three weeks.

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## Giggle

Hey EM - So - what did you do to treat the adrenal problems?
I should have my x4 cortisol saliva kit in a few days, and then I'll maybe form a plan of attack.




> In my experience, long term use of clen fifties up your beta receptors. That's a possibility. 
> 
> Also fat burning stacks usually have heavy amounts of caffeine which raises your cortisol numbers dramatically. High cortisol through out the day makes weight loss harder. Stimulant usage caused my cortisol levels to double out of the normal range. That's certainly a possibility. I just got a cortisol stimulation test and it's not fun. Your fasted and get pricked with needles for close to two hours. By the time your done you look like a drug addict and feel like a chemo patient. I also did two 24 hour urine tests and 2 cortisol blood test. Basically the final result is that my adrenal glands were taxed and that would inhibit weight loss.

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## Giggle

To answer - I did not know to get it done at 8AM, and it was middle of the afternoon - so that really screws it up. I'm hoping the salivary test will begin to shed some light on what is really going on.
Everything just takes so much time and I'm probably not the most patient person.

No MRI order. 
I'm not on any fat burners or clen now, and I feel about like you described. I don't know if it's a placebo effect or what, but I'm just feeling more tired and a little fuzzy. 
Also going thru some hard times with the family, so I'm really not sure if this is mental or not, but I occasionally have some fast heart rate and nervousness - which is NOT normal for me in the least. Can't eat, cant sleep blah blah blah!

What I know is that this will all get better and there's ups and downs in life.
Thanks so much for the support though - it means a lot. And I hope you feel better as well! 


> Did you get your blood taken at 8am fasted? My Dr made me do that because that's when you get the mist accurate number for cortisol . I believe it should be around 17 at 8 am. 
> 
> Being that your TSH us slightly surpressed and not your t3 or t4, he didn't order an MRI to see if your pituitary gland is enlarged or there's a tumor? The pituitary makes TSH. 
> 
> Were you off all your supplements when you got this done and for how long? If a supplement was surpressing the TSH then it would self regulate in about three weeks.

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## ElectraMaddox

> To answer - I did not know to get it done at 8AM, and it was middle of the afternoon - so that really screws it up. I'm hoping the salivary test will begin to shed some light on what is really going on.
> Everything just takes so much time and I'm probably not the most patient person.
> 
> No MRI order. 
> I'm not on any fat burners or clen now, and I feel about like you described. I don't know if it's a placebo effect or what, but I'm just feeling more tired and a little fuzzy. 
> Also going thru some hard times with the family, so I'm really not sure if this is mental or not, but I occasionally have some fast heart rate and nervousness - which is NOT normal for me in the least. Can't eat, cant sleep blah blah blah!
> 
> What I know is that this will all get better and there's ups and downs in life.
> Thanks so much for the support though - it means a lot. And I hope you feel better as well!


Sorry to hear about that. Basically in my own experience similar to yours I think it's a host of events. Lets say in adrenal failure youre going to have to see an endo for a corticosteroid. Anxiety and fuzziness comes from adrenal fatigue and hypothyroidism. Also elevated liver enzymes play a huge role in fatigue. If its chirrossis which is scarring that is going to need to be treated it depends the severity of the damage. What happens when scarring occurs is the live doesn't provide the necessary bile to flush out the toxins. Basically a dirty filter. I myself went through and had almost identical labs to you so I think you're going to have to go on an entire HrT regimen. 

In the mean time drink a lot of water to help with your filter system.
Coffee stimulates which stresses the adrenals but DHEA supplements help a little bit with adrenal fatigue. 

Progesterone is necessary to feel somewhat decent. I'm on 1mg a day. 

Hypothyroidism might correct itself or your adrenals are hindering the process from them working optimally as in my case.

Given the nature of everything if there's no tumor in the pituitary or adrenals then your body is just taxed and needs hormone replacement. I think things are so out of balance and that's why not matter what you are doing your still tired you have more than one item contributing to your fatigue

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## Giggle

Thanks EM - I'm drinking a lot of water, and have cut back to only one small cup of coffee in the mornings. I've also started taking B5 and a B complex. Other than trying to be more chill and being careful with my meals, I don't know a lot of proactive steps to take yet.
I'm still lifting heavy, which is not recommended - but I'm not ready in the least to make that change. I'll see what the cortisol levels are first and go from there.

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## thisAngelBites

Giggle,

my doc, who treats my adrenals, always emphasises the important of sufficient vitamin A levels for people with adrenal problems - I thought I would mention it in case you hadn't done bloodwork yet. Since it's a fat soluble vitamin it's not a good idea to just dose yourself up on it, but if you're low or low normal it might be worth upping levels.

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## Giggle

Thanks Angel. I do take it, but I'd appreciate knowing what dose he recommends.
The kit is supposed to come tomorrow, and I'll do it on Wednesday. Whew - long process, but thanks so much for your help!

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## thisAngelBites

My levels were at the bottom of the reference range, so he had me taking 100,000 iu a day. I was pretty surprised it was such a high dose. I'm due to do blood work, so it will be interesting to see where I am now.

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## Giggle

Let us know.
Thanks

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## Giggle

Finally got the results - and I'd appreciate any thoughts...all this is from the saliva test with 4 samples -
Estradiol 8.1 (1.3-1.7)
Progesterone 38 (12-100)
Pg/E2 ratio 5 (Optimal 100-500 when E2 is 1.3 -3.3
Testosterone 346 (16-55)
DHEAS 59.0 (2-23)
Cortisol 1 4.6 (3.7-9.5) morning
Cortisol 2 2.3 (1.2-3.0) noon
Cortisol 3 1.2 (0.6-1.9) evening
Cortisol 4 0.8 (0.4-1.0 night

Taking the test and DHEA pellets into account, that explains those high levels.
The cortisol looks to be on the low side - but better than I expected.
I am not sure about the Estradiol and Progesterone though.
Any thoughts?

I have been reading a LOT about the adrenals and trying to reduce stress (during the holidays lol). I've also tried to take better care of myself in general, take more Vitamin A and more B's, and drink lots of water.
Thanks for anything you can think of to help me!

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## thisAngelBites

Hi Giggle,

Your cortisol production is still following the natural rhythm of starting higher in the morning, and decreasing during the day, but if you examine the results, your highest reading, in the morning, is in the lowest quintile of the reference range. As nighttime approaches, your cortisol moves higher into the reference range. The midnight cortisol is much closer to the top of the range (the fourth quintile). I think anyone who agrees that adrenal fatigue is a useful concept (some people don't, and they would say you are absolutely fine until your cortisol output drops enough that your adrenals produce almost nothing during a stimulation test, and until you are there, you are fine. You will have to make up your own mind about this controversy) would say your adrenals are not performing optimally. Typically someone with this low-in-range to later high-in-range pattern is considered to have adrenal glands which are not able to make morning levels as high as they should be, and keep trying to make cortisol when normally production would slow down, which results in the late, normal-high cortisol, which can make sleep and evening winding down more difficult. Sometimes this problem perpetuates itself, because not resting well or sleeping soundly through the night makes it harder for the body to cope overall.

Your estradiol is obviously elevated in comparison to the reference range. I imagine this is largely due to you having a large excess of testosterone in your body. It's the same conversion process from T to E2 that you see the guys talking about in the other forums - having gyno. It makes you estrogen dominant (that's why they give you a progesterone/estrogen ratio), and there are risks of having so much E2 and not enough progesterone to balance the estrogen. Too much estrogen without sufficient progesterone puts you at higher risk of breast cancer (it's significant, you do need to pay attention to this problem), and without enough progesterone, your brain is less likely to produce sufficient amounts of a neurotransmitter called GABA, which helps you sleep well and relax/counter anxiety (which as you say can be difficult issues near the holidays). 

Additionally, high levels of estrogen can inhibit the release of cortisol from the adrenals, and it can increase the amount of transcortin, which is a binding globulin for cortisol - all this means that having too much estrogen can lower your cortisol, and bind up what you do have so there is less available for your tissues to use.

It could be the case that the T pellets have caused all of this. I don't know. T increases E2, inhibits cortisol, increases transcortin. It also could cause the low HDL that you posted earlier on. That could be the underlying cause of it all, and perhaps you were just slightly low T, slightly low DHEAs, as we all get with time, and you needed more subtle dosing to get it all in line. On the other hand, maybe your cortisol levels were not so great to begin with - strenuous exercise is something that can also stress the adrenals. If you don't have bloods from before, it's all just guessing.

In the end, I have to say I would not put too much value in a physician who will implant these pellets in you without checking your hormone levels before and after. That's kind a surprise from a legal standpoint, not even considering the quality of healthcare. Supplementing a hormone is never an isolated incident - it always has other effects, and physicians who know their stuff are always planning for the undesired consequences of adding a hormone to shore up levels. I'll bet that having that much testosterone helps to mask symptoms because typically it makes you feel good, but I think if you want to keep those elevated T levels, you need help from someone very knowledgeable who makes sure you are not raising risks for other problems by balancing things like estrogens with progesterone and factors in your adrenal hormones. Otherwise you could reduce the T dose so that the level is not so high, in order to minimise the impact on other hormones. 

I'll let you know if I think of anything else...

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## Lunk1

Very good coverage TAB. I would add that T levels this high are bound to result in viralization. I was wondering what your results would be after you had the implants. 

Curious where you were during your monthly cycle when this test was taken?

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## Giggle

Hi Angel -
Thank you so very much!
This is giving me a lot to think about and I'm working through it. Trying to compare your notes with the couple of books I've gotten.
I have also had an appointment with an HRT specialist in the area. Didn't have the results yet, but did all the preliminary questions. He is expensive, to say the least. So, I'd like to see what I can do myself in the meantime.

The T pellets should be wearing down in the next 2 months, so that may help in one way, and make things worse in another.
About the first physician, I entirely agree. She should never have done anything without pre labs and I didn't know enough then to insist or question it. Well I do know now thanks to you all!
I'll keep working on it and keep you all updated.
Some things that were keeping me up at night have settled down anyway - so I do feel better.
Thanks again - so much.




> Hi Giggle,
> 
> Your cortisol production is still following the natural rhythm of starting higher in the morning, and decreasing during the day, but if you examine the results, your highest reading, in the morning, is in the lowest quintile of the reference range. As nighttime approaches, your cortisol moves higher into the reference range. The midnight cortisol is much closer to the top of the range (the fourth quintile). I think anyone who agrees that adrenal fatigue is a useful concept (some people don't, and they would say you are absolutely fine until your cortisol output drops enough that your adrenals produce almost nothing during a stimulation test, and until you are there, you are fine. You will have to make up your own mind about this controversy) would say your adrenals are not performing optimally. Typically someone with this low-in-range to later high-in-range pattern is considered to have adrenal glands which are not able to make morning levels as high as they should be, and keep trying to make cortisol when normally production would slow down, which results in the late, normal-high cortisol, which can make sleep and evening winding down more difficult. Sometimes this problem perpetuates itself, because not resting well or sleeping soundly through the night makes it harder for the body to cope overall.
> 
> Your estradiol is obviously elevated in comparison to the reference range. I imagine this is largely due to you having a large excess of testosterone in your body. It's the same conversion process from T to E2 that you see the guys talking about in the other forums - having gyno. It makes you estrogen dominant (that's why they give you a progesterone/estrogen ratio), and there are risks of having so much E2 and not enough progesterone to balance the estrogen. Too much estrogen without sufficient progesterone puts you at higher risk of breast cancer (it's significant, you do need to pay attention to this problem), and without enough progesterone, your brain is less likely to produce sufficient amounts of a neurotransmitter called GABA, which helps you sleep well and relax/counter anxiety (which as you say can be difficult issues near the holidays). 
> 
> Additionally, high levels of estrogen can inhibit the release of cortisol from the adrenals, and it can increase the amount of transcortin, which is a binding globulin for cortisol - all this means that having too much estrogen can lower your cortisol, and bind up what you do have so there is less available for your tissues to use.
> 
> It could be the case that the T pellets have caused all of this. I don't know. T increases E2, inhibits cortisol, increases transcortin. It also could cause the low HDL that you posted earlier on. That could be the underlying cause of it all, and perhaps you were just slightly low T, slightly low DHEAs, as we all get with time, and you needed more subtle dosing to get it all in line. On the other hand, maybe your cortisol levels were not so great to begin with - strenuous exercise is something that can also stress the adrenals. If you don't have bloods from before, it's all just guessing.
> ...

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## Giggle

Hi Lunk...
Thanks for answering. No virilization that I can tell. I am post-menopausal - no cycle.
That IS high for a female, right? I thought so.
Thank you!



> Very good coverage TAB. I would add that T levels this high are bound to result in viralization. I was wondering what your results would be after you had the implants. 
> 
> Curious where you were during your monthly cycle when this test was taken?

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## Lunk1

The estrogen isnt alarmingly high but that is a pretty high T level. I'm not familiar enough with the implants to understand how they work but if they are creating a spike in your and then gradually drop down, that just simply goes against all HRT logic. 

Curious, have you experienced any noticeable sides from the higher T levels? Libido, energy, aggresion?

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## Giggle

Oh yes definitely.
Strength, libido, feel more energy. Almost all of this is positive, with one exception. I wouldn't call it aggression, but I do get irritable more quickly. I'm usually pretty "Type A", but now I'm even worse!



> The estrogen isnt alarmingly high but that is a pretty high T level. I'm not familiar enough with the implants to understand how they work but if they are creating a spike in your and then gradually drop down, that just simply goes against all HRT logic. 
> 
> Curious, have you experienced any noticeable sides from the higher T levels? Libido, energy, aggresion?

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