T Nation

20 y/o, Concerning Bloodwork. Hypothyroid, Low T, High E2


#1

HISTORY:
-male, age 20
-work in engineering environment containing mercury, cadmium,
telluridium, and chemicals including IPA, methanol, and opticlear
-had 4 surgeries in the past 2 years due to football injuries
-No previous history of medical issues

PROBLEMS:

-I began lifting and dieting religiously in sophomore year of
highschool. By senior year, I was 6 foot 7 and 240 pounds with 12%
body fat. I had no issue gaining muscle and staying very lean. My
strength was good(squat/430, deadlift/550, bench/350).
-Played one year of college football from 2014-2015. Had to quit due
to injuries. 2 shoulder surgeries in 2015(labral repairs), one hip
surgery in 2014(labral repair), inguinal hernia repair in 2016.
-Weight dropped from 240 pounds down to 210 pounds. Muscle loss was
understandable due to over a year without lifting because of
surgeries.
-Began feeling very tired, feminine, emotional, mood swings, weak,
fatigued, low libido, and apathy over the past year. Lots of dry skin,
memory loss, trouble sleeping, trouble waking up, horrible
concentration.

Went to my doctor who performs holistic medicine/natural treatments
and full blood work panel AND salivary tests run. Results below:

SALIVARY TESTS:

Dr Notes on Cortisol:

“Ideally your morning cortisol should be 0.4 to 0.6. It is ideal if
the noon level decreases by about 50%. The afternoon level is ideally
lower and then the night level is lower still and does not increase.
You start off somewhat low and drop too much by noon and not as much
as ideal at midnight. We may add some adrenal support.”

SALIVARY CORTISOL X4, TIMES:

Cortisol Baseline: .259 ug/dL
Cortisol 1st Specimen: .044 ug/dL
Cortisol 2nd Specimen: .043 ug/dL
Cortisol 3rd Specimen: .045 ug/dL

BLOODWORK TESTS

Dr. notes on bloodwork:

“CoQ10 is really too low, should ideally be >2. DHEA-S low. Allergic
IgE elevated suggesting allergies are playing a role in your fatigue.
Kidneys and liver are stressed. You are hypothyroid with an elevated
TSH. Good news is there is much to improve.”

BLOODWORK RESULTS: (I have placed asterisks next to all numbers that
concern me or concern my doctor. Please feel free to point anything
else out that may be of concern).

Ferritin: 106 ng/mL (30-400)
CoQ10: 0.41 ug/mL (0.37-2.20) **********
Heavy Metals: Not going to include these numbers. They all came back
at either zero or bare minimal levels.
DHEA Sulfate: 161.6 ug/dL (164.3-530.5) **********
Thyroglobulin Antibody: 0.0 IU/mL (0.0-0.9)
Cortisol: 14.5 ug/dL
Pregnenolone: 148 ng/dL (adults: <151) **********
Cobalamins: 647 pg/mL (211-946)
Folate: 10.8 ng/mL (>3.0)

IMMUNOGOLOBULINS:
IgG: 908 mg/dL (700-1600)
IgA: 228 mg/dL (90-386)
IgM: 108 mg/dL (20-172)
IgE: 367 IU/mL (0-100) **********

Erthrocyte sedimentation rate: 2 mm/hr (0-15)\

COMP. METABOLIC PANEL
Glucose: 87 mg/dL (65-99)
Urea Nitrogen: 21 mg/dL (6-20) **********
Creatinine: 1.30 mg/dL (0.76-1.27) **********
Glomerular filtration rate/1.73 sq M.predicted.non: 79 mL/min/1.73 (>59)
Glomerular filtration rate/1.73 sq M.predicted.bla: 91 mL/min/1.73 (>59)
Urea nitrogen/creatinine: 16 (8-19)
Sodium: 146 mmol/L (134-144) **********
Potassium: 5.1 mmol/L (3.5-5.2)
Chloride: 103mmol/L (97-108)
Carbon Dioxide: 25 mmol/L (18-29)
Calcium: 9.9 mg/dL (8.7-10.2)
Protein: 6.6 g/dL (6.0-8.5)
Albumin: 4.3 g/dL (3.5-5.5)
Globulin: 2.3 g/dL (1.5-4.5)
Albumin/Globulin: 1.9 (1.1-2.5)
Bilirubin: 0.4 mg/dL (0.0-1.2)
Alkaline Phosphate: 54 IU/L (39-117)
Aspartate Aminotransferase(AST): 136 IU/L (0-40) **********
Alanine Aminotransferase (ALT): 101 IU/L (0-44) **********

Calcitriol: 45.5 pg/mL (19.9-79.3)

CBC With Differential/Platelet
Leukocytes: 3.7 x 10E3/uL (3.4-10.8)
Erythrocytes: 4.68 x 10E6/uL (4.14-5.80)
Hemoglobin: 14.5 g/dL (12.6-17.7)
Hematocrit: 43.8% (37.5-51.0)
Erythrocyte mean corpuscular volume: 94 fL (79-97)
Erythrocyte mean corpusclar hemoglobin: 31.0 pg (26.6-33.0)
Erythrocyte mean corpuscular hemoglobin concentrat: 33.1 g/dL (31.5-35.7)
Erythrocyte distribution width: 13.8% (12.3-15.4)
Platelets: 264 x 10E3/uL (150-379)
Neutrophils/100 leukocytes: 56%
Lymphocytes/100 leukocytes: 32%
Monocytes/100 leukocytes: 8%
Eosinophils/100 leukocytes: 3%
Basophils/100 leukocytes: 1%
Neutrophils: 2.1 x 10E3/uL (1.4-7.0)
Lymphocytes: 1.2 x 10E3/uL (0.7-3.1)
Monocytes: 0.3 x 10E3/uL (0.1-0.9)
Eosinophils: 0.1 x 10E3/uL (0.0-0.4)
Basophils: 0.0 x 10E3/uL (0.0-0.2)
Granulocytes .immature/100 leukocytes: 0%
Granulocytes.immature: 0.0 x 10E3/uL (0.0-0.1)

TESTOSTERONE, FREE AND TOTAL
Testosterone: 818 ng/dL (348-1197)
Testosterone.free: 14.3 pg/mL (9.3-26.5) **********

C-Reactive Protein: 0.4 mg/L (0.0-4.9)

Zinc: 62 ug/dL (56-134) **********

Thyroxine (T4) Free: 1.09 ng/dL (0.82-1.77)

Estrogens, Total: 92 pg/mL (40-115) **********

Triiodothyronine, Free, Serum: 3.3 pg/mL (2.0-4.4)

TSH(Thyrotropin): 9.030 uIU/mL (0.450-4.500) **********

Vitamin D, 25-Hydroxy: 70.3 ng/mL (30.0-100.0)

Thyroid Peroxidase (TPO) Ab: 21 IU/mL (0-34)

Reverse T3, Serum(Triiodothyronine.reverse): 14.1 ng/dL (9.2-24.1)

I met with my doctor for a follow up appointment on the bloodwork and
she had several comments:

  1. She is unsure what is causing the liver/kidney toxicity. She thinks
    there are 3 main possibilities or a combination thereof:

A) My job environment is causing this. I work with a lot of toxins in
my job environment in an engineering style facility. Lots of chemicals
and particles in the air. My bloodwork did not show any heavy metal or
toxins, but she said that toxins/metals often leave the blood quickly
and that a hair test would be needed to truly test me for toxicity.
B) I’ve had 4 surgeries in the past 2 years. She said that anesthesia
is well-known as being toxic to the kidneys and liver and that it
might be what’s causing the toxicity.
C) She commented that my diet may be affecting both the kidneys and
liver. I have always been a healthy eater, but in the past year I’ve
fallen off the bandwagon a bit due to depression regarding my injuries
and have eaten a lot of junk food.

She gave me a liver support supplement as well as a liver cleanser to take.

  1. I am clearly hypothyroid. She is starting me on a low dose of
    Nature Throid, a well-known prescription thyroid medication that
    hypothyroid family members of mine have used with great success.

  2. I brought up the fact that my estrogen is extremely high and my
    free testosterone is on the low end. She acknowledged this, but
    brushed past my comments and moved on to discussing my thyroid more. I
    asked her for an aromatase inhibitor and she put me on Estrodim, a
    natural supplement contain I3C and DIM.

  3. My nitrogen, creatinine, and sodium are very high. She didn’t seem
    to favor any particular reason why, but suggested multiple things
    including supplmentation, diet, and my thyroid.

Other things I noticed about the tests that she did not mention:

-Zinc is barely above the acceptable lowest level.
-Pregenolone seems high compared to the <151 reference given.

She has prescribed me NatureThroid, a natural thyroid medication that
hypothyroid members of my family have successfully used. She also
prescribed a liver cleanse, a liver support supplement, CoQ10, and
DHEA (every other day for DHEA).

I do have a varicocele on my left testicle with no testicular atrophy.
It is grade 2. I’ve seen two surgeons and neither suggested surgery
for the time being.

I am very concerned with multiple factors on this test, but
specifically my estrogen levels and free test levels. The high
estrogen levels explain so much of how I’ve been feeling in the past
year. I don’t feel like a man anymore sometimes. I feel very weak,
low-confidence, constantly scared and anxious, VERY emotional… I’ll
find myself crying to chick flicks or country songs sometimes. I have
zero aggression. Somebody could punch me in the face and I wouldn’t
even get mad. It’s like my competitive emotions are dead. In
highschool I had a ‘zing’. I felt competitive, motivated, and
energetic. I feel flat and almost womanly now. My doctor paid great
attention to my thyroid, but seemed to brush past the estrogen and
testosterone even though she admitted they weren’t good. I expressed
further concern about the estrogen and test and she said we should
wait to take any further action until I get my follow up blood test in
2 months. She first wants to see how my thyroid is affecting the rest
of my body and whether or not the medication will help.

QUESTIONS:

  1. Could my low thyroid be what’s screwing up my estrogen and
    testosterone and DHEA?
  2. I know the liver processes estrogens and removes them from the
    body. Could the toxicity in the liver be causing the high estrogen?
  3. Any comments on my test/estrogen ratios?

Feeling so confused right now. My doctor is not one of the typical
mainstream doctors who gives you a clean bill of health if you meet
the minimum recommended levels for bloodwork, physicals, etc… She’s
very holistic in her approach and has helped several of my family
members back to health. I’m very concerned about the test/estrogen
though and want to believe that fixing the thyroid will greatly
benefit the test/estrogen…but I’m not sure. Any comments would be
greatly appreciated.


22 Y/O Coming Off TRT After 4 Months. Advice?
#2

Anyone? Could really use some advice on this.


#3

Answering this from a blood lab waiting to get my levels checked.

There are a few websites that have reference to a couple of studies on test levels by age. Google it, I can’t link right now.

Your test levels don’the appear that bad, honestly. I was on the low end, and some treatment got me up to your level and I felt better. Your estrogen isn’t that bad either, and messing with your estrogen can have some bad sides.

Try the thyroid stuff first. I personally believe in trying the least amount of drugs, etc. to fix an issue. A lot of guys think test is some miracle drug, and are additional enticed by muscle growth potential, etc. Some of your issues can be explain psychologically, not necessarily hormonally


#4

Thank you. I’m on Nature Throid at the moment and will be having my blood tested again in 5 weeks. I definitely won’t be messing with any other hormones for the time being, and if the need eventually arises it won’t be without my doctor’s approval. However, do you really think my estrogen isn’t that high though? I’m at 90% of the maximum allowable amount, and that’s according to LabCorp standards which are pretty loose. I’m wondering if the higher estrogen is a result of the liver toxicity? Thoughts?

Also, I’m extremely confused as to why my DHEA-S is so low even though my estrogen is high. My doc has me adding DHEA intoy supplement regime, but I’m worried that it will only add to my estrogen count and put more stress on my already toxic liver.


#5

Honestly, not sure about estrogen level. I do know that when mine was put to below normal, I suffered, and now that it is about as high as yours, I’m still suffering a bit.

However, by lowering your estrogen a bit, your test levels will increase.

What’s your body fat like? High generally perpetuates high estrogen.


#6

That’s the weird thing. Both hypothyroidism and estrogen are commonly associated with high body fat. I am extremely lean though and have always been that way. I spent the last year eating a horrible diet and still have a six pack, very clear serratus muscles, and visible veins all over my arms and in my groin area.


20 Y/O: Hormonal MESS (TSH, E2, Test, Cortiosol)
#7

Your T4 doesn’t look bad, but you TSH is really high. I can’t recall, because I haven’t gone deep into it, but there are a number of illnesses that have this occurrence as an indicator.

Using your estrogen and low BF as an example, sex hormones are are not the end-all and be-all of these things. I’ve had low test ever since it’s been tested, and I got pretty strong naturally. There are a lot more factors that just those 2 hormones.

Case in point: T3 is sometimes prescribed in addition to anti-depressants for depression therapy. Thyroid issues cause a LOT of energy, mood and libido problems


#8

This looks good, what time of day?

Your liver is not clearing estrogens and AST/ALT point to this as well.
Are you taking any medications, Rx or OTC?

Progesterone tested? That is precursor to cortisol.

Your labs suggest that you were dehydrated for the lab work. For fasting lab work, drink water.

You can also edit any of your posts to add info or correct.

Take advantage of all possible safety measures to limit exposure to chemicals. Wash hands.

Have you been using iodized salt?
Do you take a vitamin product that contains iodine+selenium?
Outer eyebrows sparse?
Thyroid enlarged, sore, lumpy, asymmetrical?
Generalized hair thinning?
Body temperatures low? See thyroid basics sticky

Thyroid problems affect every cell and organ in your body. Combined with toxins, the effect of the toxins may be amplified.

CoQ10 and other fat based supplements should never be taken with a high fiber meal.

Supplements as above plus:
1000mg Vit-C 2-3 times per day with lots of water
5,000iu Vit-D3
high potency B-complex multi-vit with trace elements and iodine+selenium
magnezium+zinc supplements, see “ZMA” sold here
EFA’s: any of fish oil capsules, nuts, flaxseed oil/meal

Read stickies suggested in other thread.
Maintain this thread, you really do not want multiple threads!!!


#9

The blood was drawn around 8:45 in the morning.

I am not taking any medications other than the NatureThroid Thyroid Medication(which I just started last week upon my doctor’s recommendations due to my bloodwork). I have never taken medications of any sort before except for small amounts of pain meds after my surgeries, and I did not continue those for long.

Progesterone? I had my progenolone tested. Is that not the same thing? Forgive me, I’m new to all this.

I was definitely dehydrated. I have a bad habit of not drinking enough water and my doctor pointed this out as well. I’m going to begin carrying gallon jugs around during the day.

I have never used iodized salt. Is this needed in addition to the thyroid medication?

I do not take a vitamin product containing iodine/selenium.

My outer eyebrows are not sparse, although I do know that’s a common system of hypothyroidism. In fact, I have very thick eyebrows all the way across and constantly get comments on them.

I have no hair thinning whatsoever either.

My body temperatures is always in the 97 range which is slightly low, but it’s been that way since birth pretty much. Thank you for the link, I’ll be looking into that for sure. Very informative.

I am currently taking every one of the supplements you recommended and a few others.

My apologies for the double thread. I accidentally posted the other thread while I was trying to edit it, and then I tried to delete it but couldn’t find a delete button. Am I not able to delete threads after making them?


#10

You have good chance of recovery your e2 should be lower for better feeling. Follow what ksman tells he is real guru.


#11

You need to study the thyroid basics sticky. Iodine deficiency may be the root of many of your problems.