So, a lower lh is indicative of secondary hypogonadism (pituitary or hypothalamus) The igf-1 being lower like that would indicate a possible gh deficiency but you would need a glucagon or ITT stim to find out. Besides the full iron panel, if it were me, I would want a reverse t3 checked as well as am cortisol, acth serum, and a mri. I cannot remember if dhea-s , or any thing else was tested . Other things like serum sodium/potasium and chloride serum would give you some more ideas as to your condition. Obviously the tsh elevated is a issue, however I would be getting both antibodies tested for Hashimoto's if it were me. Free t3, (the active thyroid hormone) the average healthy person really does have a free t3 in the upper portion of the range (3.5 to 3.8) range of 2 to 4.2-so not anything in the range is all good as they test healthy and sick people in the hospital to get that range like that-just some thing to consider. Sorry to write so much
Water Retention and Rapid Weight Gain Caused by Testosterone
- Thread starter ryn996
- Start date
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- Tags
- protocol water retention
Labs on 3/7 are pre-TRT.
Labs on 5/7 - last injection was 5/4 in the morning. Next injection was 5/7 in the evening.
3/7/19 5/7/19 Range
Hemtocrit 46.7 48 (37.5-51)
Test., total 316 >1500 (264-916)
Test., free 2.9 35 (8.7-25.1)
DHEA-Sulfate 185.5 198 (102.6-416.3)
TSH 4.05 3.43 (0.450-4.500)
Free T3 N/A 3.2 (2.0-4.4)
Free T4 N/A 0.63 (0.82 - 1.77)
LH 3.4 N/A (1.7-8.6)
IGF-1 136 N/A (83-233)
Estradiol, Sens 10.4 60.5 (8-35)
SHBG 76.1 55.4 (16.5-55.9)
Blood draw 10:20am 9:28am
Not sure why LH and IGF-1 weren't tested on the 5/7 labs. I have a phone consultation on Monday to discuss the results.
* I spaced it out to make it more readable, but once it's posted it gets squished...
Labs on 5/7 - last injection was 5/4 in the morning. Next injection was 5/7 in the evening.
3/7/19 5/7/19 Range
Hemtocrit 46.7 48 (37.5-51)
Test., total 316 >1500 (264-916)
Test., free 2.9 35 (8.7-25.1)
DHEA-Sulfate 185.5 198 (102.6-416.3)
TSH 4.05 3.43 (0.450-4.500)
Free T3 N/A 3.2 (2.0-4.4)
Free T4 N/A 0.63 (0.82 - 1.77)
LH 3.4 N/A (1.7-8.6)
IGF-1 136 N/A (83-233)
Estradiol, Sens 10.4 60.5 (8-35)
SHBG 76.1 55.4 (16.5-55.9)
Blood draw 10:20am 9:28am
Not sure why LH and IGF-1 weren't tested on the 5/7 labs. I have a phone consultation on Monday to discuss the results.
* I spaced it out to make it more readable, but once it's posted it gets squished...
Lh originally when it was tested it was low, indicated secondary (pituitary or hypothalamus) hypogonadism , so that is why he didn't retest it. Also testosterone will lower that further anyway. The igf-1-the doctor probably thinks that is fine. The problem here having secondary hypogonadism is that usually growth hormone is the first to go and to test that you need a glucagon stim test or insulin tolerance test to see what that is. IgF-1 is not growth hormone and is often normal with growth hormone deficiency. Your shbg may keep coming down and may have been high because of the low testosterone. SHBG increases the half life of testosterone, so that is still why your total testosterone is elevated now. That free testosterone level is just a direct measurement I am assuming but I do not know. It is not very accurate at all. It should be done with equilibrium Dialysis.Total should be done using LC-Ms/MS to be more accurate. The average male is around 30 shbg. If your shbg is coming down then that total testosterone will come down as well. My total testosterone was 1200 at 65 shbg now it is 700 at 44 shbg.
Thanks for the info. Are you in the medical field? Self-taught?
I’ll bring up growth hormone when I have my consultation on Monday.
Why aren’t the more accurate tests used? Cost?
The free t4 is low and free t3 is a shade low too. Since most of your thyroid made is t4 it is obvious you have a production is. Now, If it were me I would get antibodies tested for Hashimoto's antibodies like TPO (thyroid peroxidase antibodies) to detect autoimmune thyroid disease. The 4 t's is the most important What You Need to Know About Thyroid Testing | Holtorf Medical Group
Mine is a long boring story. As far as cost I think the Glucagon Stim would be the cheapest. Now, some of that depends upon your insurance and what they require. Now, even if your insurance covers nothing of gh, each company has their own programs you may get gh not too expensive or even free. Diagnosing Growth Hormone Deficiency in Adults
I ordered
Antithyroglubulin AB (Thyroid Ab)
Thyroid Peroxidase Antibody (TPO)
and
Ferritin
Iron
TIBC
% Saturation
Nelson Vergel
Founder, ExcelMale.com
Swelling is one of TRT's most troublesome and hard to manage side effects. It occurs (in my estimate) to about 20 percent of users. The potential causes could be cortisol build up, increase sodium retention, in rare cases high estradiol, or cardiovascular issues. I am enclosing several posts on these issues.
Most cases of lower extremity (peripheral) edema has nothing to do with estradiol and a lot to do with cardiovascular issues. My number one suggestion if edema does not get better after a month on TRT is to get a full cardio work up by a cardiologist.
Some men report decreased edema after a short cycle of a diuretic like HTZ, so that is something to explore. Low sodium intake and plenty of water plus cardio may also help. Cardio exercise and sweating in a sauna have also been reported to help. But these are speculations that should not replace a good cardiovascular work up.
Pulmonary hypertension caused by sleep apnea has also been reported as a cause.
Obstructive Sleep Apnea Associated with Leg Edema
"A common but under-recognized cause of edema is pulmonary hypertension, which is often associated with sleep apnea. Venous insufficiency is treated with leg elevation, compressive stockings, and sometimes diuretics. The initial treatment of idiopathic edema is spironolactone. Patients who have findings consistent with sleep apnea, such as daytime somnolence, load snoring, or neck circumference >17 inches, should be evaluated for pulmonary hypertension with an echocardiogram."
edema[swelling] what is the cause
Ankle swelling after starting testosterone injections
How many of you are on Diuretics for water retention onTRT?
Here are excerpts from an interesting paper:
"This is the first controlled study demonstrating that testosterone increases extracellular water ECW. Previous data concerning the effects of testosterone on plasma volume (19, 20) and urinary sodium excretion (18, 21) are limited and conflicting. The underlying mechanism is unknown, but several possibilities exist. Testosterone could act directly on the kidney, because androgen receptors are expressed in renal tubules (31). There is evidence that androgens stimulate the expression of the angiotensinogen gene in the kidney (32, 33). Therefore, androgens could activate the local renal RAAS to stimulate sodium and water retention through an autocrine or paracrine mechanism (34). The epithelial sodium channel plays an important role in the sodium balance, as demonstrated by genetic abnormalities in its activity, such as in Liddle's syndrome (35). It has recently been reported that androgens increase mRNA expression of the α-subunit of the epithelial sodium channel in a human renal cell line (36), providing a potential mechanism of sodium and water retention by testosterone.
Plasma aldosterone Aldo levels fell significantly during testosterone treatment, whereas a modest fall, which failed to reach significance, occurred during GH treatment. During combined treatments, a significant fall in Aldo was also observed. The uniform trend toward a fall in Aldo levels observed with single and combined treatments suggests an adaptive response to ECW expansion. The observation that the fall in Aldo was greater in the presence of testosterone suggests that additional androgen-mediated mechanisms are probably involved. Androgen receptors have been identified in human adrenocortical cells and appear to exert an inhibitory influence. In vitro studies have demonstrated that testosterone reduced the proliferation of human adrenal adenoma and adrenocortical cancer cell lines (38). It is possible that testosterone directly suppresses Aldo biosynthesis or secretion, but this remains to be demonstrated.
More on aldosterone
The effects of testosterone on the volume and distribution of ECW could theoretically occur secondary to aromatization to estrogen in peripheral tissues. Estrogen may cause fluid retention through reduction of the plasma antidiuretic hormone (arginine vasopressin)-plasma osmolality set point (39, 40) or stimulating the synthesis of hepatic angiotensinogen (41), enhancing the overall activity of RAAS and leading to sodium retention. However, this postulate is not supported by the observation that urinary sodium excretion is increased during oral contraceptive use (42) or that the plasma renin concentration is reduced in women receiving estrogen treatment (43). Moreover, estrogen reduces the plasma renin concentration, the activity of angiotensin-converting enzyme, and the Aldo response to angiotensin II (44, 45). These actions of estrogen putatively generated from aromatization of androgens could explain the slight reduction in plasma Aldo levels in response to testosterone in our study." Source
I notice that I hold more water when I eat higher sodium foods, drink alcohol, and skip the gym for more than 3 days. Higher simple carb intake also worsens water retention. I weigh myself every morning. If I am not careful, I can gain 3-4 pounds of water in 1 or 2 days. Not drinking enough water also makes the body retain water. My kidney function (eGFR) is good (80).
I think decreasing sodium and sweets intake, increasing water consumption, and doing some cardio are ways to control water weight. If it gets bad, the use of a diuretic only once can stabilize this issue during days where I go off the wagon at my family's parties.
Most cases of lower extremity (peripheral) edema has nothing to do with estradiol and a lot to do with cardiovascular issues. My number one suggestion if edema does not get better after a month on TRT is to get a full cardio work up by a cardiologist.
Some men report decreased edema after a short cycle of a diuretic like HTZ, so that is something to explore. Low sodium intake and plenty of water plus cardio may also help. Cardio exercise and sweating in a sauna have also been reported to help. But these are speculations that should not replace a good cardiovascular work up.
Pulmonary hypertension caused by sleep apnea has also been reported as a cause.
Obstructive Sleep Apnea Associated with Leg Edema
"A common but under-recognized cause of edema is pulmonary hypertension, which is often associated with sleep apnea. Venous insufficiency is treated with leg elevation, compressive stockings, and sometimes diuretics. The initial treatment of idiopathic edema is spironolactone. Patients who have findings consistent with sleep apnea, such as daytime somnolence, load snoring, or neck circumference >17 inches, should be evaluated for pulmonary hypertension with an echocardiogram."
edema[swelling] what is the cause
Ankle swelling after starting testosterone injections
How many of you are on Diuretics for water retention onTRT?
Here are excerpts from an interesting paper:
"This is the first controlled study demonstrating that testosterone increases extracellular water ECW. Previous data concerning the effects of testosterone on plasma volume (19, 20) and urinary sodium excretion (18, 21) are limited and conflicting. The underlying mechanism is unknown, but several possibilities exist. Testosterone could act directly on the kidney, because androgen receptors are expressed in renal tubules (31). There is evidence that androgens stimulate the expression of the angiotensinogen gene in the kidney (32, 33). Therefore, androgens could activate the local renal RAAS to stimulate sodium and water retention through an autocrine or paracrine mechanism (34). The epithelial sodium channel plays an important role in the sodium balance, as demonstrated by genetic abnormalities in its activity, such as in Liddle's syndrome (35). It has recently been reported that androgens increase mRNA expression of the α-subunit of the epithelial sodium channel in a human renal cell line (36), providing a potential mechanism of sodium and water retention by testosterone.
Plasma aldosterone Aldo levels fell significantly during testosterone treatment, whereas a modest fall, which failed to reach significance, occurred during GH treatment. During combined treatments, a significant fall in Aldo was also observed. The uniform trend toward a fall in Aldo levels observed with single and combined treatments suggests an adaptive response to ECW expansion. The observation that the fall in Aldo was greater in the presence of testosterone suggests that additional androgen-mediated mechanisms are probably involved. Androgen receptors have been identified in human adrenocortical cells and appear to exert an inhibitory influence. In vitro studies have demonstrated that testosterone reduced the proliferation of human adrenal adenoma and adrenocortical cancer cell lines (38). It is possible that testosterone directly suppresses Aldo biosynthesis or secretion, but this remains to be demonstrated.
More on aldosterone
The effects of testosterone on the volume and distribution of ECW could theoretically occur secondary to aromatization to estrogen in peripheral tissues. Estrogen may cause fluid retention through reduction of the plasma antidiuretic hormone (arginine vasopressin)-plasma osmolality set point (39, 40) or stimulating the synthesis of hepatic angiotensinogen (41), enhancing the overall activity of RAAS and leading to sodium retention. However, this postulate is not supported by the observation that urinary sodium excretion is increased during oral contraceptive use (42) or that the plasma renin concentration is reduced in women receiving estrogen treatment (43). Moreover, estrogen reduces the plasma renin concentration, the activity of angiotensin-converting enzyme, and the Aldo response to angiotensin II (44, 45). These actions of estrogen putatively generated from aromatization of androgens could explain the slight reduction in plasma Aldo levels in response to testosterone in our study." Source
I notice that I hold more water when I eat higher sodium foods, drink alcohol, and skip the gym for more than 3 days. Higher simple carb intake also worsens water retention. I weigh myself every morning. If I am not careful, I can gain 3-4 pounds of water in 1 or 2 days. Not drinking enough water also makes the body retain water. My kidney function (eGFR) is good (80).
I think decreasing sodium and sweets intake, increasing water consumption, and doing some cardio are ways to control water weight. If it gets bad, the use of a diuretic only once can stabilize this issue during days where I go off the wagon at my family's parties.
This is a good video by Nelson explaining the hormonal cascade, and the consequent shut down from TRT.
Hey bro....the HCG is the issue. Some men can't tolerate it. If you are not having kids, lose the HCG. HCG is a wildcard and ruined TRT for me for a long time. It spins my E2 up, causing water gain, sweating, moodiness and night sweats.
I would suggest you dump the HCG. I did and things have been fine.
Thanks for the info. If I wanted to test that theory how long would I need to be off the HCG to start noticing any differences?
The % saturation and ferritin are very low. Those need to come up for deiodinasis to properly occur. Saturation should be 35 to 45% and ferritin should be at least over 50. With levels like that a person would actually have low thyroid at a cellular level. Deiodinases - National Academy of Hypothyroidism
I’ve been taking 150 mg of Iron daily, half in the AM, half in the PM. I plan to get my levels checked again in a few months.
When you do check iron it you need to be off all iron for at least 3 days, some say 5 days. Another thing to look into is the patch md iron patch . Many have very good luck with that
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