Why would my tryglicerides spike from 323 to 1300 in 6 months?

[Jenna]

For my husband:

HDL 21
Tri 1300
LDL 165

cholesterol 255>362 in 6 months

Any thoughts. The only thing he added was testosterone

edit to add-he was taking biotin but went off it for 2 weeks before bloodwork

[Ecstatic_Hamster]

@Jenna so testosterone replacement therapy (TRT) usually uses very high doses of esterified T for longer half life. And these high doses can aromatize heavily. One study found that 50% of men ended up with metabolic syndrome after TRT, vs. 35% in the control (non-TRT) group.

I think that it is entirely possible that he is on a dose that is too high. Also, niacinamide can help lower triglycerides. And so does aspirin.

He probably needs T3 also which will help a great deal. I find people with high triglycerides also have low metabolic rate usually.

https://www.sciencedirect.com/science/article/pii/S0022227520353748

Studies on plasma triglycerides (TG) were performed in 10 nonobese and 16 obese patients with hypothyroidism and in 13 with hyperthyroidism.

Nonobese, hypothyroid patients generally had normal levels of TG, but obese patients often had hypertriglyceridemia.

In most hypothyroid patients 1-thyroxine treatment lowered plasma TG, and most hyperthyroid patients had low TG.

One mechanism whereby thyroid hormones might decrease plasma TG could be to increase lipoprotein lipase (LPL). However, post-heparin LPL was not increased after therapy, nor was it increased in hyperthyroid patients. In contrast, hypothyroid patients had abnormally low levels of post-heparin hepatic triglyceride lipase. In hypothyroid patients without hypertriglyceridemia, clearance of chylomicrons was normal. A few obese, hypothyroid patients with fasting hypertriglyceridemia had low clearance of chylomicrons, which may have been due in part to competition for removal of excess endogenous TG. Thus, no evidence was obtained for a significant abnormality in chylomicron metabolism in hypothyroidism. Nonobese, hypothyroid patients had normal synthesis and clearance of very low density lipoprotein (VLDL)-TG. In contrast, VLDL-TG synthesis was increased in 8 obese, hypothyroid patients, and fractional clearance rates were relatively low compared to obese, euthyroid subjects. In striking contrast, hyperthyroid patients had remarkable facility in clearing VLDL-TG. Thus, TG metabolism is not grossly deranged in hypothyroidism, but thyroid hormones apparently can promote catabolism of VLDL.

[Jenna]

@Ecstatic_Hamster Thanks Hamster, I appreciate this so much! I have been following your posts on RPF for years. He has started t3/t4 and his tsh is low.

I suspected it was the T converting to Estrogen. What kind of T should he request from the compounding pharmacy? He's planning on switching over there for something better.

I don't understand the "esterfied" part. Of course his doctor is not even checking estrogen levels. If it were you, would you try dhea/prgesterone as well?

[Ecstatic_Hamster]

@Jenna testosterone base in olive oil and d-alpha tocopherols. 2 - 8mg per day, once a day in the belly button, is probably a good protocol.