LONGECITY

Anyone any experience with extensive hormone replacement?

Anyone any experience with extensive hormone replacement

I have read your works, and I am highly interested. Hope to see more.

I have read your works, and I am highly interested. Hope to see more.

There will be more to come. If you haven´t you might read the new medium articles, I have updated them recently.

Guides on how to replace individual hormones. (Brief overview of the benefits of hormone therapy, Cortisol, Thyroid, Male Sex Hormones, Female Sex Hormones, Growth Hormone)

Anyone any experience with extensive hormone replacement?

Great to see someone so knowledgeable wanting to share his learnings!

Yes. I've been on multiple hormone replacement for two years now. I started at age 45. My life has dramatically changed for the better.

For many years I have been interested in the use of hormones, but out of fear of side effects I never used them except for DHEA (great improvement in mood!). Then, because of a burnout (gradually over 15 years) and a suspected (by me) chronic infection in the gut, my health and happiness deteriorated. My digestion got compromised further and further. My energy levels were extremely low. Eventually I was not even able to walk for 500 meters without needing to rest.

Within three days of hormone therapy, I felt so much better. This was the result of the hydrocortisone and fludrocortisone. Lots of improvements have followed up to this day.

Still I do have fluctuating levels of energy (both gut and mindset related, which of course can still be hormone related). For example I am not able to ride the bike against a headwind for more than 10 minutes. My body does look like that of a top level athlete though.

My current protocol is as follows:

Upon waking
- 45 mg ERFA dessicated thyroid extract containing T4 and T3

- 0.6 ml transdermal testosterone cream (10%)

With breakfast (7:00h)
- 20 mg hydrocortisone
- 100 micrograms fludrocortisone
- 40 mg DHEA

- 50 mg pregnenolone

Somewhere in the morning

- HcG 100 iu, 3 times per week subcutaneous

- Melanotan II, 0.01 mg subcutaneous (very low dose!)

- Thymosin alpha-1 0.016 mg subcutaneous

12:00h
- 10 mg hydrocortisone

- 15 mg ERFA dessicated thyroid extract

16:00h
- 5 mg hydrocortisone

Before bed (22:00h)
- Growth hormone 0.25 mg (0.75 IU) (recently increased from 0.19 mg)

- Melatonine 0.2 mg

- ERFA dessicated thyroid extract 15 mg

About once every 5 months I see my doctor and get blood tests done (hormones and more).

What I do want to add is that fludrocortisone (a non natural hormone), has a side effect. It increases the need for potassium. This has been documented (see for example 'drug induced nutrient depletion handbook). I noticed that I more easily got muscle cramps. This has been mostly resolved by adding some potassium salt to my food.

My diet does contain quite some potassium of itself. It consists mostly of poultry, lots of vegetables, butter, olive oil, dried apricots, dried prunes and some white pasta (cannot tolerate whole grain pasta).

Great to see someone so knowledgeable wanting to share his learnings!

 

Yes. I've been on multiple hormone replacement for two years now. I started at age 45. My life has dramatically changed for the better.

 

For many years I have been interested in the use of hormones, but out of fear of side effects I never used them except for DHEA (great improvement in mood!). Then, because of a burnout (gradually over 15 years) and a suspected (by me) chronic infection in the gut, my health and happiness deteriorated. My digestion got compromised further and further. My energy levels were extremely low. Eventually I was not even able to walk for 500 meters without needing to rest.

 

Within three days of hormone therapy, I felt so much better. This was the result of the hydrocortisone and fludrocortisone. Lots of improvements have followed up to this day.

 

Still I do have fluctuating levels of energy (both gut and mindset related, which of course can still be hormone related). For example I am not able to ride the bike against a headwind for more than 10 minutes. My body does look like that of a top level athlete though.

 

My current protocol is as follows:

 

Upon waking
- 45 mg ERFA dessicated thyroid extract containing T4 and T3

- 0.6 ml transdermal testosterone cream (10%)

 

With breakfast (7:00h)
- 20 mg hydrocortisone
- 100 micrograms fludrocortisone
- 40 mg DHEA

- 50 mg pregnenolone

 

Somewhere in the morning

- HcG 100 iu, 3 times per week subcutaneous

- Melanotan II, 0.01 mg subcutaneous (very low dose!)

- Thymosin alpha-1 0.016 mg subcutaneous

12:00h
- 10 mg hydrocortisone

- 15 mg ERFA dessicated thyroid extract

 

16:00h
- 5 mg hydrocortisone

Before bed (22:00h)
- Growth hormone 0.25 mg (0.75 IU) (recently increased from 0.19 mg)

- Melatonine 0.2 mg

- ERFA dessicated thyroid extract 15 mg

 

About once every 5 months I see my doctor and get blood tests done (hormones and more).

What I do want to add is that fludrocortisone (a non natural hormone), has a side effect. It increases the need for potassium. This has been documented (see for example 'drug induced nutrient depletion handbook). I noticed that I more easily got muscle cramps. This has been mostly resolved by adding some potassium salt to my food.

 

My diet does contain quite some potassium of itself. It consists mostly of poultry, lots of vegetables, butter, olive oil, dried apricots, dried prunes and some white pasta (cannot tolerate whole grain pasta).

Interesting protocol.

So how long have you been on that high dose HC? Have you noticed any side effects? Have you had to increase the dose over time? 

To me this dose seems very/unhealthily high...

Well, first very impressed by al this coming from a soon-to-be licensed MD!

Beside the quick part of the text I did not go through all (sorry!) and obviously you have in depth knowledge, I am glad I met you.

What about the difference reference vs. optimal ranges? How to define "optimal" and importantly by group of chronological age? Against what you compare to check optimal ranges? Mortality? Some sort of biological clock? I feel great at 65 but beside being chronically deficient in DHEA-S since many years (at least since I start measuring 15 years ago, a small physiological dose keeps me in the (ref) range) I am not sure who decreed optimal ranges should be very different than reference when no particular phenotype is clearly present? Why it should be that my x hormone at say 70 should be similar to x at 25 ? And what about disease risks again segmented by chronological age?  Also I try to assess ratios of hormones rather than individual dosages and I keep doing this every year, do you agree? How it comes my T and free-T has been slowing rising since the last 15 years? So for the moment I am on DHEA and Vitamin D (for the latter a U curve is typical on mortality and risk of atrial fibrillation, AFAICR, so I am cautions also there, typically in the 40-50ng/ml in serum).

Sorry for the unstructured questioning and thank you for sharing your experience!

Interesting protocol.

So how long have you been on that high dose HC? Have you noticed any side effects? Have you had to increase the dose over time? 

To me this dose seems very/unhealthily high...

Indeed the dosage is high. This is the dosage I started out with. But after a month into the therapy the doctor allowed me to increase the dosage for a period of about 3 months to 25 mg in the morning, 15 mg @ noon and 5 mg @4PM). This was based on symptoms like a sore throat after starting HGH at day 30 (I was told not to start HGH from the beginning because this would increase cortisol requirements. Considering my extremely bad health at the time, HGH was postponed).

Then at my first follow up meeting at the clinic I got another doctor (the first one left the team) who said that this was too much hydrocortisone. He put me back on the initial schedule.

I've read part of your articles. The things your write about cortisone are especially interesting to me. You mention that metabolism of oral hydrocortisone or cortisone acetate fluctuates quite a bit from person to person. And this may lead to higher requirements for some people. Do you have a suggestion as how to estimate cortisone requirements? At the clinic, the doctors look for physical signs and ask for emotional and mental state to finetune the dosage.

I feel my lack of energy is in part caused by some underlying infection and/or damaged gut lining. I often react badly to food. I may feel better when taking more cortisol, but as you have said (and my doctor) this will be detrimental to long term health.

Indeed the dosage is high. This is the dosage I started out with. But after a month into the therapy the doctor allowed me to increase the dosage for a period of about 3 months to 25 mg in the morning, 15 mg @ noon and 5 mg @4PM). This was based on symptoms like a sore throat after starting HGH at day 30 (I was told not to start HGH from the beginning because this would increase cortisol requirements. Considering my extremely bad health at the time, HGH was postponed).

Then at my first follow up meeting at the clinic I got another doctor (the first one left the team) who said that this was too much hydrocortisone. He put me back on the initial schedule.

 

I've read part of your articles. The things your write about cortisone are especially interesting to me. You mention that metabolism of oral hydrocortisone or cortisone acetate fluctuates quite a bit from person to person. And this may lead to higher requirements for some people. Do you have a suggestion as how to estimate cortisone requirements? At the clinic, the doctors look for physical signs and ask for emotional and mental state to finetune the dosage.

 

I feel my lack of energy is in part caused by some underlying infection and/or damaged gut lining. I often react badly to food. I may feel better when taking more cortisol, but as you have said (and my doctor) this will be detrimental to long term health.

Well, 35mg HC per day will almost certainly be detrimental to your long-term health and you are likely making a big tradeoff between functionality/performance now and health/longevity down the line. I have a very special protocol I devised using body temperature, blood pressure, resting heart rate and the Circadian variation in all of these. If you are interested you can contact me via email. 

"After years of studying, researching, experimenting, testing I did a writeup about some stuff I have learned along the way." (Quote button wasn't available for your first post of this topic).

I've read a large part of your articles. They're very informative. Many things are in line with what I've heard and seen elsewhere. For example from books and videos published by Thierry Hertoghe.

You seem to be finetuning some aspects of hormone treatment. That is great because hormones are a very delicate instrument to play with.

The finetuning will give different outcomes from person to person. What I'm wondering is how you got to work this out for it to work on many people? Is this by contacting other people on hormone treatment and gathering data / feedback? From what I understand 'multiple hormone replacement therapy'* isn't regular textbook stuff and it also is a quite unconventional treatment. Did you get input from doctors in the field that already run clinics and did you then build on that?

(*Therapy/treatment beyond the regular sex hormones and HGH and with the aim of improving functioning of someone who would be considered 'healthy' by mainstream physicians).

(P.S. I send you an email about 9 days ago. It may be in your spam box. Thank you for your time).

"After years of studying, researching, experimenting, testing I did a writeup about some stuff I have learned along the way." (Quote button wasn't available for your first post of this topic).

 

I've read a large part of your articles. They're very informative. Many things are in line with what I've heard and seen elsewhere. For example from books and videos published by Thierry Hertoghe.

 

You seem to be finetuning some aspects of hormone treatment. That is great because hormones are a very delicate instrument to play with.

 

The finetuning will give different outcomes from person to person. What I'm wondering is how you got to work this out for it to work on many people? Is this by contacting other people on hormone treatment and gathering data / feedback? From what I understand 'multiple hormone replacement therapy'* isn't regular textbook stuff and it also is a quite unconventional treatment. Did you get input from doctors in the field that already run clinics and did you then build on that?

 

(*Therapy/treatment beyond the regular sex hormones and HGH and with the aim of improving functioning of someone who would be considered 'healthy' by mainstream physicians).

 

(P.S. I send you an email about 9 days ago. It may be in your spam box. Thank you for your time).

I am glad you found value in my articles. I disagree with some of Hertoghes approaches, esp. the way he treats adrenals.

Yes, it landed in my spambox I will answer it today

As to the scaling part, I don´t know yet. But I guess raising awareness is a good place to start.

I got input from textbooks, data on panhypopituitarism, my own experience, online fora, some endocrinologists I know. Then I progressively fine-tuned my approach.

I am glad you found value in my articles. I disagree with some of Hertoghes approaches, esp. the way he treats adrenals.

 

Yes, it landed in my spambox I will answer it today

 

As to the scaling part, I don´t know yet. But I guess raising awareness is a good place to start.

I got input from textbooks, data on panhypopituitarism, my own experience, online fora, some endocrinologists I know. Then I progressively fine-tuned my approach.

Do you believe that you could prove the efficacy of your approach in trials?

Do you believe that you could prove the efficacy of your approach in trials?

Unfortunately this is very hard to do.

• lots of money needed
• not much money can be made
• long-term follow-up required
• complex protocols
• needs to be approved by ethics comittee

However, I´d love to do that.

Unfortunately this is very hard to do.

• lots of money needed
• not much money can be made
• long-term follow-up required
• complex protocols
• needs to be approved by ethics comittee

However, I´d love to do that.

Thank you for the response. You have quite an intriguing way of mind. I am not doubting the power of hormones but I think there is some need for trials. But as far as I know, especially thyroid has been quite thoroughly proven?

Thank you for the response. You have quite an intriguing way of mind. I am not doubting the power of hormones but I think there is some need for trials. But as far as I know, especially thyroid has been quite thoroughly proven?

Absence of evidence is not evidence of absence however

Absence of evidence is not evidence of absence however

I agree. How'd you see some possibilities of sponsoring / introducing some extensive trials to convince the wider medical community?

I agree. How'd you see some possibilities of sponsoring / introducing some extensive trials to convince the wider medical community?

I highly doubt that anything like that is happening in the future. It would cost hundreds of millions of dollars to do a proper, multi-center large RCT with hormone replacement. Furthermore, nobody would make money from it, so why would anyone sponsor it? 

Well, first very impressed by al this coming from a soon-to-be licensed MD!

Beside the quick part of the text I did not go through all (sorry!) and obviously you have in depth knowledge, I am glad I met you.

What about the difference reference vs. optimal ranges? How to define "optimal" and importantly by group of chronological age? Against what you compare to check optimal ranges? Mortality? Some sort of biological clock? I feel great at 65 but beside being chronically deficient in DHEA-S since many years (at least since I start measuring 15 years ago, a small physiological dose keeps me in the (ref) range) I am not sure who decreed optimal ranges should be very different than reference when no particular phenotype is clearly present? Why it should be that my x hormone at say 70 should be similar to x at 25 ? And what about disease risks again segmented by chronological age?  Also I try to assess ratios of hormones rather than individual dosages and I keep doing this every year, do you agree? How it comes my T and free-T has been slowing rising since the last 15 years? So for the moment I am on DHEA and Vitamin D (for the latter a U curve is typical on mortality and risk of atrial fibrillation, AFAICR, so I am cautions also there, typically in the 40-50ng/ml in serum).

Sorry for the unstructured questioning and thank you for sharing your experience!

Sorry, I must have missed this message.

Thank you!

I have rewritten and restructured my guide so the answer to your question regarding reference ranges can be found in Section 8.

Unfortunately, reference ranges include the whole population and are not stratisfied.

Optimal ranges are mostly determined by signs and symptoms, and not numbers on a paper.

Unfortunately, I haven´t had my biological age measured.

Those are good questions, however, hormones decline as a byproduct of aging and restoring them, counteracts some parts of aging (e.g. tissue health, muscle mass, neural health, etc.)

Yes, you should keep monitoring your hormones. Restoring T to youthful levels is certainly beneficial. I wrote a guide on it here. How To Replace Male Sex Hormones

@Thingsvarious. Thank you for your reply.

I highly doubt that anything like that is happening in the future. It would cost hundreds of millions of dollars to do a proper, multi-center large RCT with hormone replacement. Furthermore, nobody would make money from it, so why would anyone sponsor it? 

You're likely right. Nobody would sponsor these if the molecules aren't available to be patented. But having to stick to practical experience only isn't the best path of action... I guess there wouldn't need to be massive trials, but some small-scale RCTs on each hormone and some major combinations would suffice. What do you think?

You're likely right. Nobody would sponsor these if the molecules aren't available to be patented. But having to stick to practical experience only isn't the best path of action... I guess there wouldn't need to be massive trials, but some small-scale RCTs on each hormone and some major combinations would suffice. What do you think?

There are countless smaller studies and pilot studies because these are harder to fund. Unfortunately, therefore the information available is highly scattered and disorganized and perhaps underpowered, but I agree

There are countless smaller studies and pilot studies because these are harder to fund. Unfortunately, therefore the information available is highly scattered and disorganized and perhaps underpowered, but I agree

I agree to an extent. Do you believe that a major systematic literature review of each major hormonal axes could take care of this disorganization? Assuming it's published in a proper journal, of course.
 

I agree to an extent. Do you believe that a major systematic literature review of each major hormonal axes could take care of this disorganization? Assuming it's published in a proper journal, of course.
 

Maybe, however, most doctors would still be scared of side effects (e.g. T3 and atrial fibrillation, HC and osteoporosis, sex hormones and cancers of sex organs), as there is a large body of literature against the use of hormones

Update:

I am on reboxetine (noradrenaline reuptake inhibitor) and I found that the T3 used in conjunction causes some racing thoughts. I wonder if anybody else had this experience? (e.g. on bupropion)

So I have been experimenting with T4 only treatment. Will update as to how different it is to T4/T3-combination therapy and also some proxies I notice for longevity (e.g. lipids, vital signs, IGF1, etc)

Update: After using HC for around 2 years, I was able to get off the HC, effectively resetting my HPA-setpoint to a higher baseline. I have now been off all HC for 4 months and I feel perfectly fine. Also, HC is the most dangerous, difficult, and most cumbersome hormone to replace so I am glad I was able to reset my HPA-axis.

Just got my blood results back. IGF-1 slightly high and ACTH and cortisol at the middle of the reference range. So these 2 axes have recovered perfectly after 2 years of replacing them -in fact, they are now higher compared to where they were before.

Now I have been off all the hormones for some time (the last I stopped was thyroid). LH and TSH are normal again, IGF-1 slightly elevated and cortisol at the 60th percentile. So, whatever the cause, it seems that I have more than recovered from 2 years of complete hormone replacement. Though, I used a special protocol to wean off involving some neuropharmaceuticals to kickstart things again.

However, if I again in the future need to hop back on hormone treatment, I am willing to do so as the benefits can be life-changing

Glad you were able to do so well.  Regarding HC.  It is of course dangerous.  However, from research I've seen, you can take ~5mg a day in the morning without affecting your natural production and messing up your HPA axis. But since you are in the 60%, no need of course.

Believe it or not, the thing that helped me the most, was 5 months of FMTs using a very carefully selected donor.   Very time consuming and expensive, but well worth it, since I suffer from multiple autoimmune diseases, including Crohns.  Now my levels are better in most areas, and almost all my autoimmune diseases have gone into remission.

Glad you were able to do so well.  Regarding HC.  It is of course dangerous.  However, from research I've seen, you can take ~5mg a day in the morning without affecting your natural production and messing up your HPA axis. But since you are in the 60%, no need of course.

 

Believe it or not, the thing that helped me the most, was 5 months of FMTs using a very carefully selected donor.   Very time consuming and expensive, but well worth it, since I suffer from multiple autoimmune diseases, including Crohns.  Now my levels are better in most areas, and almost all my autoimmune diseases have gone into remission.

Interesting. Thank you for sharing. Yes, causes surely differ between people

Will be sending out a newsletter very soon, how I came off all hormones and how I now feel even better than while I was on them. I used a combination of a basal insulin as well as a GLP-1 agonist to reverse structural and functional changes to POMC neurons induced by undereating + overexercising without gaining any fat