Hormones 101 by chilln a mod at Dr. 's forum.

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Hormones 101 by the Mod. Chillin at Dr. 's forum.

For those who need a concise intro to hormone modulation therapy - here it is.

__________________

Warning:

A) Slow excreters have pooly functioning livers. They must monitor hormone

levels very carefully, to ensure their dosages are low enough to prevent

accumulation of hormones to the point where levels become excessive, or even

toxic, after several days or weeks of supplementation.

Fast excreters have excessive liver enzyme activity. These people require

relatively high and frequent doses of hormones, and the cost of hormone

supplementation, for these people, is relatively high.

What exactly is causing my hormones to go too low ?

We all need to understand the fundamental effects of genetic aging which

definitely affect us all.

Genetic aging results in the following 6 main effects on everyone once they get

past the age of 20:

a) gradual downregulation of LH and FSH -> which reduces our pregnenolone,

progesterone, DHEA and T but our body likes to maintain E2 [see " d) " below]

gradual downregulation of ACTH -> which reduces our pregnenolone,

progesterone and aldosterone and cortisol, and which starves our thyroid hormone

metabolism (which depends on cortisol), and which drives our LDL cholesterol

higher since less cholesterol is being converted into pregnenolone

c) gradual downregulation of GH (growth hormone)

d) gradual downregulation of D1 enzyme activity -> which reduces our thyroid

hormone T3

e) gradual downregulation of our genetic setpoint for optimum T -> which further

reduces our T, but raises our E2 and our DHT since our testicles keep making T,

but our body detects too much T metabolism, so our body takes evasive action and

dumps T into E2 and DHT.

f) gradual loss of leydig cells in the testes -> fewer cells to make T

One of the combined effects of these downregulations is that pregnenolone takes

a hammering, which guarantees the starvation of all of our downstream hormones.

###

The obvious theoretical best solution which addresses the root cause, would be

use a non-existent genetic engineering solution to reverse out the genetic

aging.

Since we don't yet have a safe version of the theoretical best solution,

therefore we cannot address the root cause.

###

Therefore we are left with workaround solutions.

The obvious best workaround solution is the multiple hormone modulation therapy

solution we advocate on this forum:

a) put back ACTH to boost preg, prog, aldosterone and cortisol -> much cheaper

to put back pregnenolone

put back LH and FSH to boost preg, prog, DHEA and T -> freekin' expensive, so

we use HCG, which mimics the activity of both LH and FSH

c) But since our leydig cells are reducing over time, then we must gradually

swap out our HCG for exogenous testosterone and more pregnenolone

d) boost thyroid hormone T3 via either iodone, selenium, vit D3 and / or direct

supplementation with hormones T4 and / or T3.

e) take some arimidex to suppress the amount of T which converts into E2

f) take some GH boosters or some recombinant GH to put back enough of the GH to

trigger the repairs which testosterone doesn't trigger.

We don't recommend taking finasteride to reduce DHT because there is a small

percentage of people who suffer an extreme hormone crisis from finasteride.

We recommend starting with just pregnenolone, HCG and some T (as either

transdermal or injected). And then only add in the T4/T3, or arimidex, or GH /

GH booster peptides after doing your level best to optimize with just

pregnenolone, HCG and some T.

###

This may be more complex than you believe you need, but yif you believe you can

avoid this level of complexity, then you'll discover that as you start to

modulate cortisol, your T will most likely be downregulated (that's what

cortisol does) and as soon as you start to consider boosting T, you'll have to

consider HCG, T and possibly some arimidex too.

And finally, when you discover you can't get your body fat into the single

digits, no matter how much cortisol and T you have, then you'll work out that

only a thyroid homone T3 boost will burn stubborn fat.

There's no free lunch when it comes to optimizing your health and your hormones.

###

Long before commencing supplementation with testosterone and / or pregnenolone -

read chilln's hormone primers

The following hormones all feedback very strongly on each other:

Testosterone, estradiol, thyroid hormones T4 and T3, growth hormone, cortisol,

insulin (as insulin sensitivity).

There are many root causes for hormones being too low, a few of them can be

reversed without having to supplement with any prescription booster supps, and

these should be investigated first, and these require some serious

investigation.

The optimum hormone modulation therapy options are all discussed in the

following 3 critical hormone discussions:

1) Testosterone: http://musclechatroom.com/forum/show...5 & postcount=12

2) Cortisol: http://musclechatroom.com/forum/show...36 & postcount=2

3) Thyroid: http://musclechatroom.com/forum/show...6 & postcount=12

Learning about hormones is too hard, so I'll just ask questions on the forum and

implement the " most appropriate " response

In hormone modulation therapy, what happens to others has only a very low

likelihood of happening to you.

This is because while the individual molecular reactions are exactly the same in

all of our bodies, there are three other critical factors at play which dictate

our reponse to a variation on a single hormone:

1) variations in our diets result in variations in the supply of bulk materials

(which may be limited or excessive)

2) variations in our genes result in variations in the production of enzymes

which convert the bulk materials we ingest, or apply topically, into raw

molecules (eg: hormones),

3) variations in our genes result in variations in the regulation of the

feedback loops between molecules (including hormones) which do not chemically

react with each other.

Most people and most doctors too, completely miss number 3).

If you want to understand hormones well enough to treat yourself, then that

takes years and years and years of dedication to studying and it takes a LOT of

money spent on labs to learn thier stregths and weaknesses. You will not learn

enough about hormone modulation therapy to reliably suggest what to change next,

simply by asking a few pointed questions over the space of a few months.

chilln's recommended hormone labs:

Here are the labs your medical professional adviser will need to issue you with,

by way of a lab requisition, to get an overview of what your hormones are doing.

I'm assuming your medical professional adviser knows enough to monitor blood

cell counts and fats/oils/lipids, as I see the majority of new members posting

those, but without adequate hormone metrics, hence I'm only going to focus on

the hormone metrics.

serum total T

serum bioavailable T (not free T)

serum SHBG

serum sensitive E2 (the sensitive is critical)

Don't waste your time, or our time, with standard E2 testing, which only

provides accurate metrics for females with high E2 levels, not males with low E2

levels. This is discussed here:

http://musclechatroom.com/forum/show...9 & postcount=10

thyroid suite (all serum)

a) thyroid hormone antibodies, ie: thyroid peroxidase antibodies, and either TSH

or thyroglobulin antibodies (all would be nice, but not critical)

total T3 <--- not critical, but still useful

c) free T3

d) total T4 <--- not critical, but still useful

e) free T4

f) reverse T3 <--- critical

g) TSH.

cortisol, as either

a) urinary cortisol: http://musclechatroom.com/forum/show...99 & postcount=6

salivary cortsol: http://musclechatroom.com/forum/show...8 & postcount=38

....but morning fasting cortisol is only helpful when it confirms your morning

cortisol is very low.

serum DHEAS

serum progesterone

a glucose tolerance test to monitor insulin sensitivity, or home monitoring of

glucose via a home-test-kit.

Assessments of insulin sensitivity via dietary assessments are usually tainted

to pander to the patient's view of carbohydrate management, so these are usually

unreliable.

serum IGF-1 (not optimum) or urinary GH (optimum) eg: www.rheinlabs.com) to

assess growth hormone status

Why do I need labs at all ?

Successful and reliable hormone modulation therapy must not target absolute

metrics but must use the combination of four inputs:

a) labs

symptoms

c) results of previous therapeutic trials (dosage-response trials)

d) knowledge of the various competing hormone feedback loops

.....to gradually adjust the list of supps / drugs, their dosages, and when to

take them, in order to balance the minimum set of hormones which improves a

person's health (long term stable homeostasis).

The way we use labs, in the above methodology, is as follows:

1) We apply our knowledge of the hormone feedback loops, and the currrent set of

lab metrics, to predict the outcome of our next therapeutic trial.

2) We conduct the therapeutic trial, and we measure the results via labs and

symptoms.

3) We then compare the actual outcome to the predicted outcome, and then we

determine which of the competing hormone feedback loops are dominant, versus

those which are more subtle, and thus we are better able to model our body's

behavior on the next therapeutic trial.

4) After a few iterations (1 -> 2 -> 3 -> 1 -> 2 -> 3 -> etc..) , and provided

we know most of the important hormone feedback loops, then we only need a few

iterations to get a very accurate model of our body's optimum setpoints for each

of our main hormones, and by that time we'll have actually achieved close to

those optimums !

Along with good labs, you should commit to seeking out a doctor with skills in

hormone modulation therapy

The most experienced medical professional advisers iterate through the loop a

minimum number of times, no matter how many hormones are initially

dysfunctional. Ie: 1) -> 2) -> 3) -> 1) -> 2) -> 3) -> STABLE.

The group of medical professional advisers in this category is small, eg: Dr

Crisler, Dr Mark L Gordon, Dr Dach, Dr. Eugene Shippen, and a few

others.

This is the fastest possible route to getting tuned, ie: almost no mistakes

along the way. These core medical professional advisers don't accept insurance,

and each visit is much more expensive that a visit to your local doc, and

usually includes a lot of travel.

The intermediate experienced medical professional advisers iterate through the

loop many times , ie: 1) -> 2) -> 3) -> 1) -> 2) -> 3) -> 1) -> 2) -> 3) -> 1)

-> 2) -> 3) -> STABLE.

Most members elect a partial approach whereby they team up with a local, but

more expensive medical professional adviser than their local doc, and they learn

the info that their medical professional adviser doesn't understand, and

together they get tuned faster, but not via the fastest possible route.

###

The least experienced medical professional advisers are effectively using

" trial-and-error " instead of 3). They never restore a patient to anywhere near

optimum health.

To find a more skilled medical professional adviser, try googling the terms

" testosterone " and " bioidentical " and your local town name(s), and identify a

medical professional adviser in your area whose websites are at least heading in

the same direction as the website of some of Dr Crisler's buddies, eg:

Dr Mark L Gordon: http://www.millenniumhealthcenters.com/

Dr Ron Rothenberg: http://www.ehealthspan.com

Dr Bartnof: http://www.drbartnof.com//bio_hormones.html

Dr Dach: http://www.drdach.com

I accept these medical professional advisers are the elite, but at least you

need to get closer to these, than where you are now.

Then follow-up and make an appointment with your newly chosen medical

professional adviser.

This is more complex than I thought. What's the fastest and lowest cost route to

hormone optimization ?

My recommendation is that your hormone modulation therapy will be fast-tracked

if you visit a medical professional adviser such as Dr Crisler, and get a quick

tune up, and then simply repeat his therapy under the care of your local medical

professional adviser.

My recommendation is that if you want to " drive " your existing doctor from the

back seat, by asking questions on this forum, or any other forum, and then

suggest to your doctor what he must do next, then expect to take years to

recover your optimum health. You will get there, we'll help make sure that

happens, but you will take years to get there.

Quote:

Originally Posted by phife

what would putting back ACTH involve?

Unfortunately it requires a visit to an endocrinologist, because

doctors-who-are-not-endocrinologists will not work with ACTH.

Doctors-who-are-not-endocrinologists will not work with ACTH because of the high

availability and low cost of pregnenolone.

Endocrinologists will only modulate a person's hormones such that the person

improves from a near-death state, to an operational-but-degraded state.

Our members all want to get to a good-and-healthy state (even if it's not

optimized), in other words, they definitely want to do better than get to an

operational-but-degraded state.

So we never recommend endocrinologists as an appropriate choice for a medical

professional adviser.

So we don't want to get access to ACTH therapy via endocrinologists, and we

don't want access to expensive ACTH therapy when there is a much lower cost

option available (pregnenolone supplementation).

Quote:

Originally Posted by phife

also, why do we not measure serum pregnenolone?

Primarily because the overwhelming majority of forum responders can't afford to

fund a lot of tests and are always asking for the bare minimum of tests which

they can obtain which we can then use to:

a) reverse engineer their hormone dysfunctions at baseline (without hormone

modulation)

reverse engineer their hormone responses to therapeutic trials

(dosage-response trials).

For that we rarely need both pregnenolone and progesterone, we only need one or

the other.

Since the progesterone serum test is lower cost and more widely available than

the pregnenolone serum test, therefore I have only included the progesterone

serum test.

Obviously there are people with less usual genetic optimums for pregnenolone and

progesterone, where their pregnenolone is low even when their progesterone is

average. But we can usually reverse engineer this from poor sleep symtoms

(inadeqaute neurotransmitters due to inadequate pregnenolone).

..

__________________

Warning:

A) Slow excreters have pooly functioning livers. They must monitor hormone

levels very carefully, to ensure their dosages are low enough to prevent

accumulation of hormones to the point where levels become excessive, or even

toxic, after several days or weeks of supplementation.

Fast excreters have excessive liver enzyme activity. These people require

relatively high and frequent doses of hormones, and the cost of hormone

supplementation, for these people, is relatively high.

Quote:

Originally Posted by phife

what would putting back ACTH involve?

Unfortunately it requires a visit to an endocrinologist, because

doctors-who-are-not-endocrinologists will not work with ACTH.

Doctors-who-are-not-endocrinologists will not work with ACTH because of the high

availability and low cost of pregnenolone.

Endocrinologists will only modulate a person's hormones such that the person

improves from a near-death state, to an operational-but-degraded state.

Our members all want to get to a good-and-healthy state (even if it's not

optimized), in other words, they definitely want to do better than get to an

operational-but-degraded state.

So we never recommend endocrinologists as an appropriate choice for a medical

professional adviser.

So we don't want to get access to ACTH therapy via endocrinologists, and we

don't want access to expensive ACTH therapy when there is a much lower cost

option available (pregnenolone supplementation).

Quote:

Originally Posted by phife

also, why do we not measure serum pregnenolone?

Primarily because the overwhelming majority of forum responders can't afford to

fund a lot of tests and are always asking for the bare minimum of tests which

they can obtain which we can then use to:

a) reverse engineer their hormone dysfunctions at baseline (without hormone

modulation)

reverse engineer their hormone responses to therapeutic trials

(dosage-response trials).

For that we rarely need both pregnenolone and progesterone, we only need one or

the other.

Since the progesterone serum test is lower cost and more widely available than

the pregnenolone serum test, therefore I have only included the progesterone

serum test.

Obviously there are people with less usual genetic optimums for pregnenolone and

progesterone, where their pregnenolone is low even when their progesterone is

average. But we can usually reverse engineer this from poor sleep symtoms

(inadeqaute neurotransmitters due to inadequate pregnenolone).

..

__________________

Warning:

A) Slow excreters have pooly functioning livers. They must monitor hormone

levels very carefully, to ensure their dosages are low enough to prevent

accumulation of hormones to the point where levels become excessive, or even

toxic, after several days or weeks of supplementation.

Fast excreters have excessive liver enzyme activity. These people require

relatively high and frequent doses of hormones, and the cost of hormone

supplementation, for these people, is relatively high.