Case Study #3 Age: 45 Sex: Male
Thanks for signing up. Here is the questionnaire to get us started. For all but the first question please answer only with simple lists, as explanations make it difficult to take in the data..
1) What are your current symptoms and how would you like to improve? What are your health challenges?
2) Please list everything you might eat in a day.
3) List everything you might eat in a week.
4) Times of day you eat.
5) All supplements you are currently taking.
6) All medications you are currently taking as well as those you've taken in the past, including drugs and alcohol.
7) Times and frequency of physical activity, if any.
Looking forward to it, Nathan :)
1.) Some hair loss the last year or so in the front, along with getting more gray hairs. I have varying energy levels throughout the day, and generally lack motivation, drive and passion for things these days. Some of this can probably be resolved through a Personal Inventory, so I plan to book that after this coaching (he’s referring to the therapy in chapter 31 of my book) - but I have spent the last 10 years on self-development ranging from classical techniques such as NLP, EFT and CBT all the way to Soulspring Masterclass which is a very spiritual approach. I used to be a powerlifter and then a bodybuilder, but my strength is about half of what it used to be. I have poor connective tissue health and have had 2 shoulder surgeries on the left side, and have a torn supraspinatus on the right side and lots of clicking noises. Hips have osteoarthritic symptoms, most likely inherited from my mom. I have had high LDL cholesterol for a while now, most likely cause both by my diet but also subclinical hypothyroidism. My thyroid health has improved tremendously these last 2-3 months since I started implementing more milk, fruits, honey etc. My daily oral temp is now 97.8-98.3F. I struggle to get and stay lean unless I calorie restrict and use the stress-based model, I reached single digit bf% but needed to go down to 2200kcals which isn’t a lot of food for a guy weighing 220lbs at 6´1." Most symptoms likely related to being on a low-carb diet for a couple of years now, in the most extreme case eating meat-only in various ratios of fat vs. lean (all the way into the PKD ratios of ***************** when I worked with them). I have been on TRT (topical gel) for 25 years. I have tried twice to restart my HPTA with medical interventions but I have given that up and will rely on it for life.
2.) 3 out of 4 meals is usually a combination of various fruits (apples, pears, strawberries, blueberries, banana, melon, cherries etc etc), honey, cottage cheese, milk and cream, butter (organic, low-pasteurized, non-homogenized), coconut oil, hydrolysed collagen, eggs (in the breakfast meal). Dark chocolate for snacks if still hungry. 20g or so of milk protein isolate per day mixed with the cottage cheese and cream or milk. Sometimes ice cream for the evening snack. Coffee with cream and honey 1-2 cups/day. 1 out of 4 meals is ground beef or fish, some type of veggie (asparagus, cucumber, tomato), cheese, butter, and once in a while potato but most often just more fruit.
3.) Variations of the above. Saturdays we have pizza with ground beef and sausage, crust made with spelt flour.
4.) 7-8am, noon, 3-4pm, 7-8pm.
5.) Hydrolysed collagen. Milk protein isolate. Used liver capsules but stopped that fearing too much iron (after reading your book). Pregnenolone 20mg in the morning. Sodium Acetate morning and evening. 250ml can of Monster Energy Drink (with Vitamin B, Taurine, Caffeine). On the way, after reading your book: Boron. Natural Vitamin C. Chelated Molybdenum. Niacinamide. Brewers Yeast. Jarrosil activated Silicon (unsure about this, though). Iodine. Taurine
6.) Testavan - topical testosterone gel + recently testosterone enanthate injection subcutaneous 2x/week. Ephedrine for workout energy boost, or fat loss - 10mg. Nicotine gum 2mg 2-3x/day - but have stopped this the last couple of weeks. Very moderate alcohol consumption (my dad was an alcoholic), 2 units per week at the most (beer), but I went from New Years to May without drinking anything. I have tried cocaine, amphetamine and Attentin (methylamphetamine) reacreationally, but I tend to get rebound depression and low energy so don’t really like it. I don’t tend to addiction at all, I would have friends that would be binge drinking, smoking and doing drugs - I could take it or leave it at any time…perhaps except for when I was going through some depressive episodes, but then again the effects wouldn’t last so it wouldn’t be worth it to me.
7.) Weight training 3x/week or so, 30min workouts. Some easy walking here and there, have a ******* year old boy so walk him in the stroller with my gf. :)
Let me know if anything is unclear.
Thanks for your answers, and thanks again for signing up.
So I know you've read my book, and some of the symptoms you've brought up are discussed in specific chapters. Energy overall is complicated, such as you can have motivation but not have much energy to actually do anything. Motivation specifically is stimulated by sex hormones as discussed in the chapters on erectile dysfunction and depression. It is possible to get your motivation back but not also have a ton of energy, because motivation can be pretty easy to restore but energy not so much. That being said, it is possible to improve everything you've listed as symptoms, though they are unlikely to return 100% the way they were when you were younger, they will certain reach a level that will make you feel better and enjoy life again.
Specifically for "motivation" you will need to focus on restoring robust testosterone production as discussed in the chapter on erectile dysfunction. Because this is pretty straight forward I will just refer you to that chapter, although I'm not sure which version of the book you have so I am attaching the latest eBook file, which also includes some updated information that is going to be released in the upcoming book update, although since it's not an official release please still get that copy when it comes out as there may still be other additions forthcoming.
I'm really glad to hear you've already started making changes and seen improvements. It's amazing what simply having fruit every day can do to the body. Berries for instance are potent erectile support, almost more than anything else I've ever tried (next to sunlight [and nectarines]).
It is often impossible to both get lean and be healthy after a person has already begun exhibiting metabolic problems, especially because this reflects changes in the gut microbiome in response to stress which can be difficult to reverse. That being said, zinc is one of the best supports for both managing the gut microbiome and promoting a lean figure (as well as many other things including hair restoration and a healthy libido). But most people are not aware that zinc is incredibly difficult to absorb, and if you have metabolic issues you are likely not producing sufficient gastric acid to properly digest and absorb dietary zinc or many of the supplement forms, such as those chelated to amino acids. Zinc sulfate is one of the best and doesn't require gastric acid for absorption, so I would recommend getting on it right away. There aren't many products available. Right now I am using ********** zinc sulfate. You will want to use this [just about] every day for the rest of your life. You could start with two or three capsules a day for a week, then cut back to just one a day thereafter. Zinc is slow to absorb as a natural mechanism to prevent overdose in our bodies, so it takes 1-2 weeks to start seeing real benefits of using it.
So, your TRT medicine is actually one of the bigger contributors to a lot of your problems. Two things happen when you supplement testosterone in a biological male (or anyone really). The first is that our own production of testosterone drops, because it is a self regulating system, and since you're adding extra the body turns down its own production. Second is that more aromatization of testosterone occurs. This is a process which converts testosterone into estrogen, and this is also the mechanism by which our own T is downregulated, because the body knows that elevated estrogen means excess aromatization so it slows the production of testosterone to prevent excess estrogen. Because you're using supplemental testosterone, the body can't control how much is produced and thus how much is aromatized (a process which is also increased during metabolic insufficiency), and you are in essence pumping your body full of estrogen, not testosterone, and this is in turn causing your joints and connective tissue to stiffen, your morale to drop, hair to fall out, and promotes hypothyroidism, etc. You will also need to stop taking the ephedrine and nicotine (good job on stopping) in order to get your body to regenerate. The body does not take well to forceful stimulants, which instead cause stress hormone release and in a metabolically compromised person these stress hormones, which are normally meant to only bridge gaps during acute deficiencies, instead catabolize your organs and increase your symptoms. In order to see improvements you will need to completely stop TRT. Not to worry, you can turn your own production on pretty quickly specifically by following the instructions in the chapter on erectile dysfunction—specifically promoting mitochondrial respiration by liberating it from the influence of nitric oxide through the use of sunlight, dietary thiols, and foods high in anthocyanins (don't forget zinc and dietary carotenes, though). Instead of TRT you can safely use a supplement of pregnenolone instead. You will mostly likely lose all libido functions in the week or two after stopping TRT, but normal function should return shortly after, depending on your age. If you are a bit older it might take more effort in raising the metabolic rate as well, which we will discuss below.
Your diet isn't awful but it's also not yet great. Good job getting in fruit and using spelt flour. I want to make sure you are avoiding all normal wheat, because even one serving a week can be enough to cause systemic inflammation and stop healing. One thing you are desperately missing are foods high in vitamin K. Without vitamin K our healthy gut microbes cannot remain in the gut, and they require it even more than we do. For this reason you need to have foods high in vitamin K every day for a while, then afterward at least every two or three days (dark lettuce, spinach, collard greens, etc.) The less difficult ones can be had raw, like lettuce, or baby spinach, and a lunchtime salad with carrots, cucumber, onions, cheese, berries or raisins, etc, and homemade vinaigrette (to avoid harmful, cheap, store bought brands) is a great way to do this. Because they have enough of the worst types of PUFA, eggs unfortunately can interfere with recovery [in those with metabolic illnesses] if having them every day. For this reason I would relegate them to the weekends as a treat. You can have them a little more often if you are eating pastured eggs, or if they are included in some dish where they are buffered by other good sources of fat (such as a fried egg on a salad which has coconut oil dressing). Don't have them every day though. For protein use cheese, milk, nuts, or protein supplement [nuts contain some PUFA but they also have lots of vitamin E which protects the PUFA from oxidation]. Remember the key to cutting out bad foods is [not to focus on cutting them out but ] to replace them [with options that you enjoy just as much]. Otherwise you will just end up craving them and give in eventually.
Collagen can sometimes cause problems like headaches or contribute to gastrointestinal bloat. I'd recommend using normal gelatin or getting a glycine supplement (or both). Yes, don't use liver capsules. Increase pregnenolone to 100 mg in the morning—this will decrease the burden of stress on your body during the day. It may contribute to failure of libido but this will subside after you get your metabolic rate up and fix the nitric oxide balance in your testicles as described in the chapter on erectile dysfunction. You do not have to give up caffeine right now, but I would have you read the chapter on GABA to understand how blood volume affects metabolic recovery and erectile quality. Caffeine can often be necessary to get a robust metabolic rate going, and that should be first priority, but keep in mind that as you improve you might want to spend some time without caffeine, to increase the influence of potassium on regeneration, and thus achieve more improvements if you ever feel like you hit a wall or can't get some things to get better. This information on increasing blood volume can help increase the rate of healing as well as improve emotions and energy as it helps to increase the flow of blood and nutrients to the rest of the body, especially if using the methods to balance nitric oxide expression as discussed in the chapter on erectile dysfunction (also in the chapter on hair restoration, and another I forget at the moment).
Yes that ******** [silicic acid] product just may work. There are two ways you can tell—with about 30 minutes of taking it you should feel an increase in relaxation, every time. If it's not working you will instead feel more irritated or no effect, and after several days of use you might start to exhibit symptoms of eczema as the silica irritates skin tissue. If that happens stop taking it. I'd love to hear how it goes for you so I can have another product to recommend. Again, also get a supplement of zinc sulfate too. I don't think any of your other drug or alcohol use is getting in the way since you say you don't use them often, and none of those have serious long term effects (for instance if you had taken finasteride).
I think your physical activity should be fine, except that you will have a noticeably reduced capacity for exercise without your stimulants. This is really important though because if you continue to use stimulants to promote your workouts you will only make your problems worse. You will feel better in the future and be able to have good workouts without resorting to stimulants (coffee is fine, as long as you are not avoiding caffeine for reasons discussed earlier), but right now you need to take care of yourself, and going to the gym isn't really doing that. Mentally it might help, but physically you are hurting your body. The good news is that when your body is able to retain more amounts of minerals you actually get more more conductivity to the cells, your muscles get harder and more responsive to contraction, and so workouts will be more fun and productive in the future even without stimulants. If you also want a practice which is holistic, safe, and even more productive than the gym I would highly recommend getting the book "Muscle Control" my Maxick and giving that a go. It's really nothing short of amazing, and is a good routine to do while taking it easy.
The most important thing you need to be doing right now, though, is the temperature and pulse diagnostic as discussed in the chapter on self therapy. These are numbers at rest so if you've exercised during the day you will have to interpret those results through the knowledge that exercise, through the elicitation of stress hormones, will raise the metabolic rate but not in a way that is regenerative. It is only through diet and nutrients at rest that an increase in metabolic rate is regenerative, and it is important that you do this diagnostic because it will help me further understand exactly what is going on with your endocrine system and how better to address your health. It will also give you the tools to directly measure your progress. Most people simply hope and observe their waistline and this is not a reliable method of analysis, and leads to demoralization and distraction. Please share with me the first four days of data after you have them.
This is a great place to start, looking forward to your data.
First, I completely understand about restoring testosterone function as a primary intervention. I reread the erectile dysfunction chapter (thanks for providing the updated e-book, I will reread it), and I think I have everything covered. It also refers to the GABA chapter, the gut health chapter, the thyroid chapter and the niacin therapy chapter - so I’m assuming that everything is important when it comes to this important hormone. As for restoring natural T production, that would be amazing…but I have tried it before without any success. The last time was in 2015-2016 and I spent a full year consulting with both Dr ************ who is one of the world’s most prominent experts on hormone restoration, as well as a specialist for getting regular labs and the prescription drugs to do it. I was diagnosed with low T levels as a teenager (6-8nmol/L with reference range 8-35), and I had high estradiol levels back then (0.20-30nmol/L with reference range below 0.18 for men), but the ********* medical system didn’t allow use of anti-aromatase for men back then.
I started self-treatment with an anti-aromatase in 2000 when I worked in the US (returned back home to ******** a few weeks before 9/11…), and I also got prescribed testosterone injections. I was finally able to build some muscle mass (was skinny as a teenager) and it lifted my depressive symptoms and brain fog I had experienced for some years. I tried to come off everything for a few months a couple of times through the years, but with no success. Then in 2015 I decided to make a proper attempt working tightly with specialists, since I had started entertaining the thought of becoming a father. My testosterone progressively got worse, and so did Estradiol. There was also very little sperm activity. I tried coming off all TRT (so no SERMs or HCG for another 6 months, and retested my testosterone levels: The result was 4 (range 8-35). FSH and LH undetectable. I lost a lot of muscle mass, gained fat, and had really low energy and was prone to depression - just like in my teens. I also think my diet was on point at the time - carb-based, not too far from how I eat today, just with rice being about half of my carb intake. Still - my girlfriend and I were able to conceive a month after I restarted TRT with Testogel - so that was an unexpected happy side effect of this story…most likely due to residual FSH activity of the HCG treatment and it just took some time to produce that one “soldier” lol. My son ****** was born ********* 2017. So to conclude - you can probably understand that I don’t have much faith in my ability to restore endogenous T production after so many failed attempts and 20 years on TRT (I turned 45 in June). I shudder at the thought of having to go several months with low T, libido and having to experience muscle loss and depressive thoughts again. If you have any convincing case studies, I am obviously willing to give it a try - as I really WANT to, I just don’t have any evidence that I CAN. Finally - my interpretation of the way of eating is to just go by hunger and intuition from the recommended foods, and measure pulse and temperature in the morning and then after every meal (so 4 times per day) and send you this data? Thanks again, I was overwhelmed and pleasantly surprised at such an extensive reply!
There is every chance that something in your childhood caused a permanent inability to produce Testosterone, but the body is capable of remarkable healing and generally the organs which are involved in hormone production can regenerate pretty rapidly. No, you will not have to persist for months and months in those conditions, nor should you. That's not how any of this works. You should only have to spend about 2-4 weeks in a deficient metabolic state, more likely only 2-3, before you start seeing improvements in your pulse and temperature readings. When your pulse and temperature start to rise, which can occur in as little as a week of beginning this process, you will also start to experience improvements in your symptoms. Sometimes it can take as much as six months for people to get their pulse and temperature up to the ideal levels, but that is also usually due to noncompliance in measuring and promoting those numbers (eating common wheat, for instance). So it depends on how much you align to the recommendations along with some troubleshooting here and there. Generally you should see a steady and consistent increase in your resting numbers, and your resting numbers reflect the body's ability to sustain the metabolic rate without the assistance of stress hormones (or not), and when the body can sustain the metabolic rate without the assistance of stress hormones that is when metabolic regeneration occurs. Doctors don't know about this connection of the metabolic rate and regeneration, so none of them would have been able to help you permanently heal those conditions you've been suffering. This process does that (within reason). So if you get much worse after four weeks I would recommend going back on the hormones, but in my experience you will most likely find some improvement by then which will justify abstaining indefinitely.
I would advise you not to use any new products or anything that I have not recommended—the reason being that those things are not part of the natural body. They may have effects, good or bad, but they will not directly address the metabolic pathways which naturally support human health. The foundations of human health are based on vitamins, minerals, and environmental stimuli like sunshine exposure. Healthy people don't need geopeptides to function properly, and neither do you. Of course, we encounter things like glyphosate, and you may very well have been exposed to something in your youth which caused all these health problems, but the persistence of the condition is not caused by that exposure but instead other factors which inhibited healing and regeneration.
Only use one aspirin a day, or one every other day. You're not ill enough to use it in those amounts and overuse can cause depletion of glycine and vitamin K. Of course, take one whenever you feel poorly though.
Also, try using the brewer's yeast in the morning and 30 minutes before any sun exposure. There are proteins which use riboflavin to sense sunlight and regulate circadian rhythms and this process will benefit from that.
Looks great. Looking forward to getting your temp and pulse readings.
Ok, so the general idea is that restoring metabolic health and thyroid function will increase regenerative capabilities and thus improve the chances of recovering the HPTA function?Previous use of testosterone and its derivatives have a pretty horrible recovery statistic depending on length of use: [provided links to stats of hormone recovery] A lot of these being athletes, is the assumption that the combination of stress from training and diet deficiencies is the reason why they are still not fully recovered after 6-12 months after stopping all exogenous hormones? I have done a handful of “cycles” of AAS in my 20s and 30s when I competed, 10-20 weeks in duration, and then “normal” levels with TRT in between just to provide context.
Ok, so based on these last two days it seems like the metabolic issues isn’t all that bad? Yesterday - morning temp 97.4F, pulse 75 - the next 3 measurements had me at 98.6F and pulse 78-82. Today - morning temp 97.7F, pulse 82 - the next 3 measurements had me at 98.8F and pulse 88, 92, 80 - and the last (just going to bed now) - 99F and pulse 80. All pulse readings are strong. I will provide pulse and temp in another 2 days.
I have gained 10lbs of weight the last 3-4 weeks. I sometimes eat before I’m hungry and sometimes eat beyond fullness (I finish my plate instead of leaving leftovers for later), as I’m intent on restoring metabolic health moreso than staying lean - but I guess I could listen more to my hunger cues and go a little easier on the butter, cream and coconut oil unless you think this is all important for my recovery. I still tend to analyze and concern myself with food choices and macros for each meal, but mostly I’m able to just eat according to instinct.
When everything I ordered from iHerb and eBay has arrived I will give your advice about stopping TRT an honest try, do a blood test in 4 weeks and determine what to do based on that.
The reason those states exist [low sex hormones] is because the same factors which caused the condition in the first place don't get addressed (exposure to glyphosate or endocrine disrupting chemicals, lack of sunlight and calories, consumption of common wheat, etc.) so the person stays in a state of perpetual inhibition, and doesn't really have anything to do with the medication.
No, those aren't terrible numbers but they're not great either. Also, they need to be taken into context, it's great that you hit 99 but did you do any physical activity today? How did you get to that number, was it just through food or did you also use anything like aspirin, coffee, or exercise? Are you still on any of your meds/stimulants or are they still circulating in your body? The problem is that if your temps were elevated through the elicitation of cortisol or adrenaline as a result of exercise or stimulants it doesn't [really] help, because stress hormones have a catabolic effect on the body which stimulates the rise in numbers, and this catabolism tears down your organs or promotes calcification, etc,—to your thyroid, your thymus, testicles, pituitary, etc. The numbers have to be from the rested state, which means no [manual] elicitation of stress hormones and only facilitated through food and nutrition.
Yes good fats like butter and coconut oil are important for recovery, but there are also bacteria which feed on our bile which is expressed during the presence of these fats, and those bacteria are some of the strongest stimulators of weight gain. This is a protective mechanism from the body to prevent malnutrition caused by these microbes, so the solution is to get rid of them rather than avoid fat—you do that through the use of apple pectin, iodine, and restoring proper vitamin D function in the body as discussed in the chapter on gut health.
Yeah don't worry at all about macros or count calories. Just eat to prevent hunger and whatever you enjoy, as long as its from the safe choices of food.
Sounds good. We should probably wait to do the numbers until you are completely off all the meds, as that will be artificially skewing the data—or you can still take numbers until then and they should actually drop after you go off the meds, it would be good for you to see so you can correlate those results with the state of your health. It's a great tool for managing your own health in the future.
Oh I just had another thought, you could also probably benefit from a lithium supplement. I'd add that to your list too, and take every day. The effect of lithium is a little hard to pinpoint, but generally results in improvements in mood, cognitive function, sleep, and it [strongly] benefits gut health [as it binds to ammonia—I recommend lithium orotate as the other commonly available form lithium aspartate can be excessively stimulating].
I only have 2 cups of coffee with honey and cream spread between waking and about 2pm. No other stimulants, no exercise, didn’t get the Aspirin or all the other supplements listed in the previous e-mail yet (I only have a few 10mg Pregnenolone left so take 20mg/day until my order is here) and the Testavan (testosterone gel) is the newest type which provides a physiological release curve - so high T in the morning, tapering off towards almost zero in the evening. But alright, I will keep monitoring and then see what happens when I go off the testosterone :)
I eat a lot of ice cream now that the temperatures are so high, but how concerned should one be about ingredients that aren’t whole foods - such as things with E-numbers (I know to avoid soy lecithin) like emulsifiers, guar gum, carrageenan etc? There is also egg yolk in most ice cream.
Perhaps just make my own with cream, milk, sugar and fruit?
A slightly sensitive question…but my girlfriend and I have been together for almost 5 years so sex frequency is down to perhaps once/week and sometimes less frequent. But during the transition period when I’m off TRT, if the occasion should arise - and provided that I even have the desire to - would some Cialis be ok or would it suppress GABA too much?
No you should absolutely avoid those drugs. They will completely stop all progress for several days.
Ok, so here’s 4 days of data, with 5 days of no TRT and with the supplements we have discussed earlier. I will list temperature in C, if you want the F conversion let me know.
36.5 - 83 - after waking
37.0 - 98 - after breakfast
Short workout - 20mins taking it easy, 2 sets of 2-3 exercises
37.0 - 95 - after lunch
37.0 - 84 - after dinner
36.8 - 90 - before bedtime
Remaining measurements are taken at approx the same times.
36.8 - 80
36.7 - 92
37.0 - 82
36.6 - 70
37.0 - 72
36.6 - 79
36.8 - 82
Short workout (also 20mins easy stuff)
37.3 - 88 (added lots of extra sugar to a fruit bowl with cottage cheese…)36.9 - 75
37.0 - 78
36.6 - 77
36.9 - 85
36.6 - 75 - I missed my lunch and had to grab a protein bar instead, immediately reflected in a lowered temp
37.0 - 76
Had a beer (first in 3 weeks)
37.0 - 78
Libido was surprisingly good, at least for the first few days - but we will see if that changes (I expect it will). There is even some morning wood going on. I have been kinda moody today, though - short-tempered and quick to anger…which is very unlike me, and I hope this will pass. Notice some water retention in my face and ankles, but then again - I’m eating a lot now, adding unrefined sugar and honey to a lot of my foods, drinking sugary drinks and juices, and having ice cream most evenings. If I don’t eat as soon as I start to notice the slightest hunger, like today when I missed lunch due to unforeseen circumstances, my temperature drops and I feel low on energy. I am attending a wedding next Saturday, and there will be some alcohol involved - as usual - but my recovery is the most important and I’ll only have a couple of glasses of wine, at the most. Let me know if you need any other information.
So it does look like your pulse was being sustained by the TRT, it appears the longer you are going without it the more your pulse is dropping. I'm not sure exactly why that would be, but probably the T was aromatizing into estrogen which in turn could have been promoting excess adrenaline, and as adrenaline depletes dopamine and tyrosine contributes to depression and other mental health issues. The excess stress hormones would have given you a boost, kind of like using drugs, and made you feel a bit energetic, but now that you are lowering those stress hormones you aren't getting that high from them, and probably why you were feeling irritable. What's really strange is that your temps all stay within a very, very tight range. I haven't seen that before. They don't get high enough but they also don't drop very far at all—this might indicate very, very high levels of cortisol which can also be very aggravating. Normally when waking temps are that high in someone (who is healthy) their peak easily gets up to 37.2 to 37.5. But now that the effect of TRT is wearing off we can more directly address your foundational metabolic health. Have you begun using niacinamide or any other supplements? Those will show you effects on your temp and pulse which you can then use to promote healthy resting heart rate and temperature, which in turn will translate into improvements in mood and symptoms (assuming your diet is also sufficient).
Thanks, it does make a lot of sense. Fortunately, it was just that one day, though - yesterday and today I’ve been in a really good mood. I did a couple of days of 150mg of pregnenolone (overzealous) and that may have been too much, so yesterday and today I just did 100mg and that seems to be a good dose for well-being and mood. Or it could be something else, hard to tell nowadays with so many supplements involved. I notice libido being reduced now - but I expected that. I plan to get blood tests of testosterone, estradiol, FSH, LH - and possibly also TSH, FT3 and FT4 in about 3 weeks if you think that is a good idea, to see if there is any hope of recovery.
Today’s temp readings, if still relevant:
36.4 - 70
37.0 - 90
37.0 - 82
37.2 - 81
37.3 - 85
Mostly sedentary today. I try to measure within 30-60mins after eating a meal, but it was somewhat inconsistent during those 4 days for various practical reasons. Measuring just before eating shows a lowered temp some of the time (36.6-36.7).
I have focused on eating lots of fruits/berries and added sugar/honey, and have lowered my fat intake to facilitate that (still at probably 70-80g/day of fat) - as I don’t want to feel like I’m force-feeding (getting in enough calories from fruits is hard), and since sugars seem to be driving my temp/pulse the most I sacrifice some fats for that. I recall reading that you were using 4lbs of unrefined sugar per week during your healing phase, and 2lbs for “maintenance”? I guess I’m around 70-100g of added sugar per day right now, just to give you an idea.
You can't really overdose on pregnenolone, so that's just fine and if taking more makes you feel even better, then do it. The one side effect of using lots of pregnenolone is to actually suppress the libido, because that amount of pregnenolone lowers the stress hormones which have been sustaining what libido you do have, so it's actually a good thing even though it might be a bit frustrating.
Yes your numbers are still relevant, and that's great that they are already coming up very well. Do you see how your pulse jumped really high after breakfast? This occurs because of high adrenaline during sleep, then you eat some food which allows the high adrenaline to have a larger effect, but the introduction of food then allows the stress hormones to subside so the numbers drop, but then they begin to rise again later in the day due to high metabolic rate facilitated by the food and not by stress hormones—this is the point where healing occurs, because the stress hormones are not interrupting the healing process and with sufficient nutrients and calories the body is able to run the primary metabolic pathways which regenerate the body. That is what you want to have occur every day. Ideally your pulse would get back to 85-100 bpm at some point by the end of the day, but you're already on your way to great results.
So the way forward from now is simply to follow the plan with the supplements, and eat good food and sugars to maintain my temp+pulse readings? And take a blood test in another 3 weeks or so, as mentioned in the previous e-mail? How often should I check in with you?
Yes but as your temps and pulse stabilize you then move on to the more specific therapies of the relevant chapters, such as using thiols and sunlight for erectile dysfunction, and light therapy to the dorsal raphe nucleus for depression, etc. You can update me if you ever have issues, questions, or to share developments. Yes you can get blood tests but they need to be interpreted in context, so share them with me when you do.
I’ve been having some pretty massive water retention the last week or so, to the point where my eyes are really swollen when I wake in the morning and I can press a finger into my ankle and it leaves an indentation in the skin. My left thumb just starting swelling up and becoming very painful for the last couple of days for whatever reason, as I haven’t injured it - nor can I find any insect bites that may have caused an inflammatory reaction. Perhaps it is due to the heat wave we’ve been experiencing here, 30C+ is 5-8 degrees above the norm here in ******** and it affects both energy and sleep quality, or maybe my body is converting some pregnenolone into cortisol? I have stepped it down to 100mg again, just to see what happens.
Libido is still fine - meaning that it’s pretty much the same as it has been, considering I have been with my gf for 5 years. I was almost expecting erectile dysfunction, which I suffered from last time I tried going off TRT (with HCG and Clomid, where libido was also much lower), but no such issues which makes me optimistic for recovery now going on the 3rd week without the gel.
I seem to still be gaining weight (close to 99kg now - and waist has increased a total of 2.5 inches), but my appetite has been dropping noticeably lately so maybe that will regulate itself now that my body temp/pulse readings are staying consistently high? I still have confidence in this strategy being a better idea, but I also find it hard to reconcile with the mounting evidence of time-restricted feeding being so great for health [link to a study which showed time-restricted eating to alleviate certain metabolic markers]...not to mention the various metabolic and auto-immune issues being resolved with a meat-and-fat based diet: [link to an all-meat promoting diet program]
Maybe it’s more a function of the removal of various processed foods that are in most people’s diets (and even the exclusion of excessive amounts of phytate, oxalate etc from eating too much vegetables all the time?), and not necessarily the restricted feeding windows or eating meat? And that long-term it will backfire? I just see people having success eating like this for several years when their previous dietary approaches failed them, and lack a good explanation for it.
That's not a good sign, but yes heat stress does cause that in people with compromised metabolic health. Normally pregnenolone will help with it a bit, but I think it just shows how sensitive your health is at the moment. I think if you took thiamine with every meal, some niacinamide, and magnesium chloride it might help it go down. Let me know if you do this and it doesn't help. You can take magnesium chloride internally, but too much will only act as a laxative, so smaller doses are better (measure to taste by putting some in a glass of water until you can just barely taste it) and it's sometimes more helpful to apply to the skin, making a more concentrated solution in a little bit of water that tastes more strongly, but not too much which can irritate the skin, and applying it to the areas which are swollen.
I'm glad to hear you've not had any lapse in libido. That's really great.
Like I mentioned in a previous email, weight gain is a common development when the body is under so much physical stress. That being said, [the more you address your gut health as discussed in that chapter, such as addressing excess histamine, ammonia, and biotin deficiency, the less weight gain will occur. Also, the therapies in the chapter on GABA can also help reduce or reverse weight gain].
Studies on dietary restriction are not accurate because the indicators they measure to decide if it's successful are woefully misunderstood. For instance they might show reductions in cholesterol and so claim it to be healthy, but the body cannot make cholesterol under enough dietary stress and cholesterol is the foundation of all our hormones and steroids. If you read that page on the meat diet you will also see that those people have a history of extreme eating behaviors, dieting, veganism—yes people who eat meat and fat are eating foods which actually have lots of nutrition in them and also tend to be avoiding the other kinds of foods which cause problems, like excess PUFA and processed foods with additives and agricultural chemicals, but that doesn't mean that you should or even can limit your diet to that, and the people doing this are all suffering psychologically with no real experience in human biology and are not the kind of people who can help you heal from metabolic disease. If you look at anyone on a long term meat diet they have horribly weird skin and features, like one of the biggest proponents of it https://www.shawn-baker.com/about he's not even in his sixties but he has the skin and hair of a seventy-year old. Sure he's muscular but he looks like that, probably has no libido and probably can't sleep without pills and is probably an emotional nightmare. All you need to pay attention to is your temp, pulse, and symptoms.
Attaching a screenshot of the blood tests, with units and reference ranges. I once tried converting the units into the commonly used in the US, and it was a giant hassle, so I hope you can make sense of it anyway. I also think the names of the values should be intelligible.
Now, these tests were done approx 09:30 after waking at 7:00 and having breakfast, so I was pleasantly surprised…no, strike that…positively ecstatic about seeing LH/FSH and testosterone at those levels after only 5,5 weeks of no TRT!!! I had lower values than this using upwards of 2500IU of HCG twice weekly, using 25mg/day Clomid, and even after using a GnRH stimulation test back in 2016 and 2017! And since I have getting some morning wood lately, my mood is 200% more stable and positive, and I lost a ton of water weight in my face. My gf has commented on me looking several years younger - and she likes the less muscular look as well, so even if I just manage to stay at 8 and the very lower threshold of normal T, I will NOT be going back on TRT. TSH, FT3 and FT4 also looks good, but maybe you’d like to see it even higher? TSH of 1,3 seems to be a good indicator, though. My only concern is ferritin being so high, I can’t understand why when I have lowered my meat intake significantly to only 150g a few times per week, and my main protein sources are cheese and protein powders. Could it be my high vitamin C intake? Another concern is that I found a small nodule on the left testicle. The doctor said it was most likely nothing to be concerned about, but ordered an ultrasound just to be safe.
[we had a phone call on which we discussed his test results—the node turned out to be benign—and discussed using light therapy to increase the metabolic rate further as discussed in the chapters on depression, leanness, etc.]
The halogen lamp gives off quite a lot of heat, so I’m concerned about using them on my testicles. They have experimented with something like 45 degree C heat exposure as a male contraceptive, and maybe it’s just a nocebo effect but I think my libido has been dropping these last few days. I’m considering using something like this, although way more expensive it seems to have more research behind those specific wavelengths: [links to red lights] This one is cheaper, both literally speaking and how it looks and probably performs: [links to red lights]
I will use the halogen light on the rest of my body, though. It really revvs up my metabolism! On a positive note, the ultrasound showed a small “water cyst” about 3mm, so nothing cancerous and quite normal :)
[another phone call–advised not to heat up the testicles excessively and any discomfort is a sign of heat stress and should stop]
I’m observing that I’m eating less even though I eat and snack regularly, I just get full quicker - but my body temp is still staying consistently high at 37.0-37.2 thoughout the day. The coconut oil swish has definitely helped my joint/tendon pains, and it even seems like it is what is driving my metabolism higher (or spontaneously reducing my overall calorie intake). It is another 500kcals per day, after all. I’m still interested to know about the light therapy - i.e. getting some UV light once in a while since the winters here are so cold and dark.
Yes you can use a UV light, although it's not always necessary and isn't much if at all more effective than just a normal bright light. Or at least, a normal bright light will do more good than a UV, since we can't be exposed to UV lights for too long a time without getting burned. I'd primarily use a normal bright light (perhaps with some red in it too, like those infrared heat lamps) and then add a UV bulb on top of that occasionally. I just a cheap Exo Terra brand UVB bulb when I do (mostly just get sunlight). You must use caution if using a UV light as the risk of burning is far greater than sunlight and the burn from these bulbs is more painful than a normal sunburn.
That's fine if your appetite has dropped. It might mean that your gut is balancing out better. Just don't let yourself go hungry.
Hey, just got new blood tests yesterday, at 8:30 - fasted (awake since 7am). Doctor only wanted to look at hormones since those were the most important (thyroid must be good according to temp/pulse).
Not great, but still a doubling and both estradiol and SHBG seems good.
That is a really great testosterone level for someone who has been on TRT for so long! Your body is producing all of that on its own. Things are looking so great.
You will likely see a plateau or stall now as we go into wintertime, though, as the body downregulates the metabolic rate. It's normal. You can still make progress during the wintertime but it won't be reflected in obvious ways. Wintertime improvements are more about regeneration and restoration of nutrients, and when summer rolls around next year your body will restart all its active pathways and you'll make even more progress than you did this year.
Thanks, I was pleasantly surprised myself - at least it’s moving up :) Still not where I want to be in terms of strength, it actually feels like when you have a fit of laughing and feel really weak, but maybe I should just take a week or two of rest and do some light walking and stretching instead…it’s not very motivating to go to the gym and lose strength every time (even though it’s a minimalist program that only takes 20-30mins).
Strength has a lot to do with nitric oxide levels, and also electrolyte balance. When you're replete with both potassium and sodium your muscles are both more responsive to contractile stimulus and able to sustain the stress from physical exertion. The effect of electrolytes on muscle function can be demonstrated in the way preworkout and coffee promote an increase in workout performance, but in a negative, stress based way, because the dumping of potassium and thus exaggeration of sodium makes cells respond more strongly to contractile stimulus. But this also causes sodium loss after the effect of those stimulants wear off, and over time a person has such reduced levels of both potassium and sodium they are in a constant state of stress. To do it in a healthy way which doesn't involve potassium loss requires promoting both sodium and potassium retention by reducing stress hormone levels and stress itself, which you are doing, but it can be a bit tricky to get to the point where your body successfully holds on to the minerals consistently. This involves reducing excess nitric oxide and other techniques as discussed in the chapters Free Muscle, Hair Loss, and Erectile Dysfunction. Also, this may actually be a sign of experiencing positive benefits of the work you have been doing, which are reflected in the reduction of stress hormones, which may have made you feel strong but at the expense of your physical health, and this may actually be a positive development and reflects tissues which are actually restoring their potassium levels due to a decrease in stress hormones but thus reducing the contractile response of sodium. Physical strength and endurance is not a sign of health—but one which is a sign is muscle bulk and muscle retention. If you are retaining muscle bulk, even and especially if you're not working hard, that is a great sign of low stress hormones and an increase in metabolic health. If you see muscle bulk deteriorating rapidly or requiring strenuous effort to maintain, that is a sign of very high muscle catabolism due to high stress hormones. Even if you feel strong during the stress state it's actually very deleterious to your physical health, and in fact it's this very mechanism which has been responsible for your hair loss, erectile dysfunction, and other metabolic decline (including emotional), because these hormones also catabolize your other organs such as the testes, thyroid, thymus, etc. So I would evaluate your physical development by muscle size and ease of muscle retention, not actual strength and ability, which will fluctuate depending on the state of sodium/potassium balance and whether or not you have high stress hormones which manipulate it.