Hi Marrena,

I'm the one who's not seen any improvement in approximately eight weeks on the Orgasmic Diet.

As I said in my post about the Kirkland Signature fish oil, I was able to convince my doctor to run tests that corresponded to those listed in your book. After more than two weeks I received the results.

My Free Testosterone (Direct) was only 0.4 pg/mL, but according to the test and lab (LabCorp) anything over 0.0 is in the normal range. Now how can that be right? How do you measure low then? Are there negative results?

Free T4 was done by Dialysis/Mass Spec, so I don't think that is the same thing as equilibrium dialysis, which I was supposed to get. That level was 0.87 ng/dL.

My sweet doctor is kind of out of her league at this point, and I don't know what to do or if these levels are normal (the lab and my doctor say they are except for the DHEA). SHBG was 75 nmol/L. DHEA was elevated at 771 ng/dL, and she said that she she wanted me to take a different blood test because DHEA levels fluctuate.

I know how cautious you are when "dieters" e-mail you for advice that might be construed as medical, and I don't wish to make you uncomfortable. But even fsd.org doesn't give normal levels. There aren't any doctors on the FSD Web site in my city.

Do you have any recommendations for where I should go from here? I'm still taking the fish oil and a multi (and dark chocolate) and I'm still cold turkey off the caffeine and soy. I'm still trying!!!!

Thanks so much.

Colette

Hi Colette,
I'm 60 and undergoing hormone replacement for surgical menopause. After several years of frustrating treatment with my endocrinologist I finally decided to fly down to San Diego (I live in the S.F. Bay area) to see Dr. Irwin Goldstein who practices sexual medicine at the San Diego Sexual Medicine at Alvarado Hospital. Marrena had mentioned him and I had seen his name connected to FDA hearings regarding Intrinsa, the testosterone patch that has still not been approved in the U.S. He has a great website. At any rate he aims for a free testosterone level greater than .8. Hope this is helpful.
Pam

I'm not a doctor, but your free T is low. That is very odd that the lab doesn't have a normal range.

I will look into this further. What was your total T (and lab normal ranges)?

This is what the test says:

Testosterone, Free and Total 45 ng/dL
Limits 14-76

Free Testosterone (Direct) 0.4 pg/ML
Limits 0.0-2.2

Free T4 by Dialysis/Mass Spec 0.87 ng/dL
Please interpret with caution. Assay duplications did not meet quality standards, however insufficient serum was provided to allow repeat analysis.

Reference Range: Pubertal Children and Adults: 0.8-1.7

The lab did give normal ranges, and when my doctor called it was to report that the results are normal. But in lieu of any other explanation, I'm guessing that the normal ranges are too generous. Maybe hoping.

I should mention that on Saturday I stopped taking the magnesium, calcium, zinc, and iron and limited the supplements to six fish oil capsules and a multivitamin. And this morning I had a sex dream!!! It's the first one I've had since going on the diet. I wonder if any of the other supplements are counteracting what the fish oil is supposed to do.

So what now?

Colette

Colette,

Don’t give up! Many of us are frustrated that we can get practically a 0.0 on a test and doctors claim we are normal. I have been on Testosterone replacement for several years with only some improvement: My Total Testosterone has increased from 9 to 39 ng/dl but Free is not budged at all – it is 0.51 pg/ml. I have had email replies from Dr. Berman who says those numbers are still low despite what the lab’s reference range claim. I have also had a phone consultation from Dr. Irwin Goldstein in San Diego who also confirmed my Testosterone levels are still too low, my current dosage is inadequate and he also implied that Testosterone cream is not the most effective treatment. I gave him my history, other RX’s (none), my lab results including Testosterone, Free Testosterone, SHBG, Thyroid, Estrogen, Progesterone etc. Unfortunately, without being a patient on record he would not give me any specific advice that I could take back to my local doctor. I understand he cannot treat me without first a full evaluation but was desperately hoping he would at least point me to some research or offer some advice. I actually cried when I got off the phone from him.

Marrena – when I talked with Dr. Goldstein I also mentioned Dr. Berman’s site and your diet. I asked him if he thought there was any correlation of high dosage/high quality fish oil and/or any benefits to zinc etc. on lowering SHBG as I do think that is one of my issues why Total is increasing but my Free is not. I knew his name had been mentioned on your site so was also frustrated when he would not even comment on even the possibility that the fish oil etc might benefit.

Pam – I am very interested in hearing if you felt your visit to his clinic was worth it. I am considering going to San Diego for a visit but the costs are just so high that I would love to know if you felt like you got results.

Colette - keep trying. YOU know if your body is not functioning as it should. Keep trying along with the rest of us.

Marrena - one clarificaton on my previous post. I first asked Dr. Goldstein if he thought there could be a correlation with Dopamine and Fish oil because he asked me if I had my Dopamine levels checked and commented there are Prescription medications to increase/balance Dopamine. Second, I asked if thought there could be a correlation with Zinc and reducing SHBG therefore increasing Free Testosterone. I thought I had remember somewhere on your site or the hisandherhealth site where you mentioned he at one point was interested in your research on this subject so was dissapointed he would not even comment on the possibility.

Hi Mary,

I had a wonderful experience going to Dr. Goldstein for my evaluation. I was able to fly down and back in one day with about a 3 hour appt. There was a very thorough physical exam checking sensitivity, circulation, muscle tone etc., and I also met with the psychologist who works with him. He is very enthusiastic and kind, as were his staff. I am having all my labs at home, followed by phone consultations which he does not charge for. He does not take Medicare so I had to pay out of pocket for the initial evaluation. It was $1500. I am now struggling with a huge increase in my hives, which have been chronic for 30 years, while I try to get all my levels up. So though I have been enormously excited, it feels like there is just one hurdle after another in this very long process. I just met with my allergist today and she says there is a definite connection between allergies and hormones. There is a well documented allergy to progesterone itself, so I don't know if that is what I'm reacting to. I wish you the best.

Pam

Dr. Goldstein is fighting a more important fight than mine. He has been outspoken on the effects of hormonal birth control on female libido, and its other harmful side effects.

It may be that as a professional he does not want to recommend to patients any unproven techniques, although I do know several years back that he both was researching my diet and having patients try it (in particular to counteract the SHBG-rising effect of TRT). I am a scientist first and foremost--it may be that he had his patients try it with no observable result and he has therefore decided against the approach. Or that since then I have had to act in a silly, public way to get the word out, with a popular book and television appearances and he wouldn't want to be associated with that. Or it might be that it was several years ago and he has simply forgotten.

quote:

Originally posted by Colette:
This is what the test says:

Testosterone, Free and Total 45 ng/dL
Limits 14-76

Free Testosterone (Direct) 0.4 pg/ML
Limits 0.0-2.2

Free T4 by Dialysis/Mass Spec 0.87 ng/dL
Please interpret with caution. Assay duplications did not meet quality standards, however insufficient serum was provided to allow repeat analysis.

Reference Range: Pubertal Children and Adults: 0.8-1.7

The lab did give normal ranges, and when my doctor called it was to report that the results are normal. But in lieu of any other explanation, I'm guessing that the normal ranges are too generous. Maybe hoping.

I should mention that on Saturday I stopped taking the magnesium, calcium, zinc, and iron and limited the supplements to six fish oil capsules and a multivitamin. And this morning I had a sex dream!!! It's the first one I've had since going on the diet. I wonder if any of the other supplements are counteracting what the fish oil is supposed to do.

So what now?

Colette

Hmm...I think the issue is SHBG. Your total testosterone is good, you don't need TRT. I think it would help to get your SHBG down. The calcium/magnesium/zinc effect is long term, affecting SHBG, so I don't think quitting it for a few days would make a quick change in libido. Also to decrease SHBG--avoid hormonal birth control and focus on keeping carbs, especially bad carbs, down in the diet.

That's great about the sex dream! That's often how it starts.

Hi Colette

It took me several months to get benefit - so please don't give up... there can be many hiccups on the way.. but it's worth it!!! I'm currently reading an interesting book called The Miracle of Bio-identical hormones by Dr Michael Platt. He treats a wide range of health problems from fibromyalgia, migraines, infertility, low libido, ADHD, weight problems and PMS with bio-identical hormones (not synthetic ones) - DHEA, Progesterone Cream, Testosterone supplements and Thyroid treatment. The book is definitely worth a read - he's really big on the importance of hormonal balance. His clinic is in California.