Eureka? I think I found it! Low DHEA-S and T !!!

Holy schmokes - I am so excited this may be the answer that I'm emotionally attached to the possibility and am not reading/understanding this. (little bit like looking at a winning powerball ticket)

Just got back labs from last week.

I have in the gutter DHEA-S levels and less than optimal T.

Can the forum give me a sanity check please? I think about postponing ECV tomorrow so I can work on these.

Raise DHEA-S by about 6x, raise T by about 50% to the 'sweet spot' ~ 450 ish.

[flic.kr]


[pubmed.ncbi.nlm.nih.gov]

[www.ncbi.nlm.nih.gov]



Edited 1 time(s). Last edit at 05/19/2020 06:15PM by NotLyingAboutMyAfib.

Why are you so desperate to avoid a cardioversion? It's a safe, quick, trivial procedure.

You found two studies that might have some relevance, but it will take weeks or months to investigate. And your doctor may not even be willing to prescribe testosterone treatments if you're merely "less than optimal" (probably won't). Meanwhile, you'll continue to deal with AF just because you don't want to do a safe, quick, trivial procedure? Nope, sorry, fails the sanity check.

I'm getting the ECV tomorrow am if just to break the string of AF for a few days - but hoping for more.

MD ( a very good one ) is already onboard with T and DHEA. I've been taking quercetin for covid that has some anti-androgenic side effects.

My advice, as well, is to go get your ECV asap NLAMA. Improving documented deficient levels of DHEA-Sulfate and deficient Testosterone levels in men can bring a number of
important health benefits, but don't 'wing it' by yourself! Get a thorough hormonal work up by an experienced MD well-trained and board certified in a good AMA approved BHRT Fellowship program.

Any ideas you might have about 'curing', or even greatly just reducing, AFIB burden in a persistent Afibber via DHEA and Testo repletion alone is very unlikely to achieve what you are looking for as a presumed natural and effective anti-arrhythmic. Even though restoring healthy levels of these two important anabolic hormones can positively impact multiple physiological processes, and even help men lose some excess body fat should they be carrying more baggage around than is healthy, not to mention you may well put a spring back into your step compared to living with such frankly deficient levels of these key anabolic hormones such as represented by a very low 225ng/dl level of total serum testosterone.

It's great that your doctor (i presume your GP doc?) is willing to prescribe the therapy, but I wouldn't rely on a regular GP or family practice doc to manage hormone therapy, unless they are board certified in BHRT and have lots of experience treating with replacement therapy.

Also, just FYI, your assumption based on the chart you shared above showing mean levels of testosterone suggesting that the 'sweet spot' for testosterone treatment is only around 450ng/dl is way too low for most otherwise healthy men to sustain a truly robust therapeutic response. To be sure, since you said that this 'sweet spot' of 450ng/dl was about half again higher than what I presume is a recently tested level of total testosterone, that 450 ng/dl is still only a very modest improvement in testo levels over the very low 225ng/dl.

It is certainly better than a poke in the eye, NLAMA, compared to a dismal Total Testo of 225ng/dl. However, truly therapeutic testosterone repletion follows a threshold dosing protocol in which a majority of its potentially beneficial effects are only realized once more robust repletion occurs, typically only once one's total testo levels reach the upper quartile of the acceptable serum lab reference ranges for Total T.

For example, roughly a Total T level of from 0 to 375ng/dl represents 'severe to near-total testo deficits', and a range of from '375ng/dl to 550ng/dl' equals approx. a range still hampered by medium to important deficits. For healthy men, with total T levels ranging from '550ng/dl up to 650ng/dl', they often still show some degree of mild to moderate deficits, even though usually by this range a fair degree of significant benefits are usually appreciated as well.

However, also realize that for the majority of serum lab tests for most 'non-hormone' testing offered at your typical neighborhood blood lab, like Quest or Labcorp, the various broad reference ranges usually inherently reflect directly stable, if not optimal, therapeutic levels.

Also, keep in mind that these broad reference ranges reflect every person who got a particular serum test at that particular lab group over the most recent 12 month period. However, hormone lab reference ranges often change dramatically with aging and that includes some, like DHEA and Growth Hormone, that even start showing slight measured declines as early as 28 yrs to 30 yrs old in many young people. And most anabolic hormones start to show significant deficiency, combined with increasing symptoms of such deficits, within roughly 5 to 10 yrs plus after our prime reproductive years.

This reality leads to a major wrinkle when properly accessing hormone lab test results. Since most hormones (particularly anabolic hormones) will reach their optimum physiological levels for average height, weight and age in men when still in their early to mid reproductive years. And since it is extremely rare for anybody to be sent by their Doctor to get a hormone test during these prime peak reproductive years, thus it's almost universal that most broad hormone reference ranges seen in most hormone lab tests are greatly skewed to the left side of the given broad 12 month average reference range.

And this, in contrast to, say, a group of CBC or CMP blood lab tests in which the reference range levels are typically directly stable from mid-teens to very old age. it therefore can be very misleading to view such hormone lab results as reflecting 'optimal hormone levels' for your height, weight and age. Particularly, since our body size roughly remains stable throughout the majority of our adult years.

Thus, in the Total Testosterone graph you show above, since even the earliest age begins with 55yr. old men and above, it's obvious that this chart reflects Total T test subjects who already have significant Total T deficiencies, ... and it only gets worse as this graph extends up into the 80+yr old age range of men, assuming they have not had their Total T levels properly repleted years earlier?

So, in light of the above, while I encourage you to get a thorough hormone work up by a very experienced BHRT trained doc ... be sure and partner with a very experienced physician in this area of medicine. There are a lot of Docs who have only gone to a weekend seminar or two and then hang up their shingle as a BHRT trained doc, so dig deep for credentials with a long positive track record.

There is a lot of nuance involved in proper and fully safe BHRT management, so just like with carefully choosing an ablation EP, here too do not settle just for the most convenient physician to write you a script. And one way, for sure, to rule out a potential hormone doc is if he, or she, suggests that 450ng/dl of Total T is even close to the 'sweet spot' for optimal testo therapy.

Finally NLAMA, with the DHEA dosing above in your thread starter post, suggesting adding 6x to the levels of DHEA sulfate blood levels I assume you currently may have from a blood or saliva test, requires some real caution. Particularly in light of your persistent AFIB, so please do not run out and buy a bottle of high dosage 50mg DHEA tablets and start taking them in an effort to quickly restore your levels.

You might get away with it, but if your anabolic hormones are significantly depleted already for a long while, especially DHEA, it's best to ease into restoring to optimal levels over time. Jumping in too fast when many of your DHEA or Testo receptors have been 'asleep' or dormant a long while from long time depleted blood levels can be counter-productive. Just slowly restore DHEA in small 2.5mg/day to 5mg/day doses over a prolonged time up to a max of 20mg to 25mg eventually, as tolerated. If you rush it when you are severely depleted you can suddenly overload the limited number of currently active DHEA receptors and thus create a temporary pseudo-overdose reaction in which you can get outbreaks of acne, on your back, very oily hair and skin and most concerning in our case is potentially long runs of sinus tachycardia by rushing a depleted scenario.

And I'll be extremely surprised if you find that even fully optimum Testosterone and DHEA restoration results in conversion of your persistent AF to durable NSR. In none of the huge number of Afibbers I've followed with either PAF or persistent AF, and a fair number of whom were successfully taking BHRT too, was hormone therapy ever noted as part of their solution for AFIB. And I've been on robust BHRT for 18 years myself, with many helpful health results, but it never came close to touching either my long 16 years of PAF, and it certainly didn't touch my persistent AF once that took over my life in spite of urgently trying a barrel full of every 'hopeful' solution I could find ... until I threw in the towel of fruitless trigger chasing (in my case) and at long last made it to Natale’s table that gratefully ended, so far, my very long dance with the beast so many many years ago now.

This is just one example NLAMA , why an experienced doc is needed to oversee restoring your ''symphony' of hormonal interactions as well, and managing them all in tune!

Cheers and best wishes!
Shannon



Edited 1 time(s). Last edit at 05/21/2020 02:52AM by Shannon.

Shannon,

Thank you for the thorough and knowledgeable response. I'm new to this and this is at the urging of my 'very woke' primary MD who normally has a 6 month waiting list but took to me because of some gifts of wine and my knowledge of CAC regression strategies.

More than a few months ago, he suggest DHEA starting out at low amounts - about 10 milligrams a day. I had to buy a small accurate scale just to measure it. I also have the T patches. I'll have to check into his credentials to see if he has the qualifications.

I can't recall why I stopped taking it but it was either something I read or felt at the time. This is also exacerbated by my daily routine of taking quercetin (because of covid) which is anti-androgenic.

I am going to reread your post several times.

One thing to note is the 'sweet spot' graphic came from one of the papers I also linked. MD has not designated a # but notes "low" on my labs.

The T sweet spot reminds me a lot of the PUFA 3 sweet spot graphic.

[flic.kr]

I did get the ECV and am in NSR. Following the 12 step PDF (which should be a sticky in this forum) and the supplements to the letter.

Great to hear NLAMA! Am glad you got the ECV and hope it holds a good long while during which you can fully sort out your best options and move to put the final KaBosh on the whole AFIB business once and for all!

Will be glad to speak to you by phone on any of these topics, as it's easier for me to go more in-depth via phone at these days.

Rest up and enjoy your NSR!

Be well!
Shannon

I am so grateful to this forum and the people in it. Without it, there wouldn't be anything close to a path forward and I would be at the mercy of the men in white coats.

Thank you for the offer Shannon and after I've exhausted all other avenues, I may take you up on that.

All the best,

Shannon - they bumped me up to tomorrow AM - I'll report back what the plan is when I get back home.