T Nation

21y/o, "Chronic Fatigue" Symptoms


#1

Before I get into the nitty gritty, I want to stress that I am 21… Yet feel like I am already ready to retire
Now, the backstory:

Been training since I was approx. 13 years old.
Relatively stress free, good libido, good sleep etc. up until about the beginning of this year.

Before going into my current issues; about November 2016, I had used a SARM (ldg-4033) and then proceeded to use a SERM (clomid) in case of any suppression and then got blood tests done on the 29/01/17 due to experiencing major anxiety, heart palpitations and aggression.

My issues seem to be similar with those of iodine deficiency (after a read through of the stickies) yet I’m still concerned with what seems to be the ever increasing Prolactin and SHBG.

I saw an endocrinologist back in May due to symptoms of:

  • Erectile Dysfunction / destroyed libido
  • Mood (very aggressive very easily as well as "depressed like symptoms - not actually depressed)
  • Energy has been shot dead
  • Strength in the gym (no increase in weeks)
  • Mental fog/memory issues (as can be seen with the 4 edits to this post)
  • Cold intolerance (very big for me as I’ve always been the type to be able to sit in the rain in winter)
    And today got shot down with no further help or information with what could help me on a better path.

Shortly I will trial with Iodine supplementation (and report back for any others with similar issues).
Also may as well add in that I have been following a mostly vegetarian diet since January.

I am aware most will target iodine here or other thyroid problems, however I would like to address SHBG and Prolactin too.


#2

Australia is seems…

Your high LH and low FSH is a notable pattern and not normal. Your TT is OK and cFT is mid-range with high SHBG.

E2 promotes increased SHBG and E2=69 is OK. Liver problems can increase E2 by reducing E2 clearance and can directly increase SHBG. AST/ALT do not show any liver issues. No clear reason in labs for high SHBG.

It is not hard to have multiple B vitamin deficiencies with a vege diet and essential fatty acid deficiency as well. Suggest fish oil and high potency B complex multi-vits with trace elements including 150mcg iodine and 150-200mcg selenium. Diet can also take cholesterol too low, cholesterol is foundation for all steroid hormones which also includes cortisol and Vit-D3 production.

Vit-D3: Many are suboptimal. How are you getting Vit-D3? Sunshine? Not milk. Many need 5000iu.

Watch/monitor prolactin as this could be early signs of a prolactin secreting pituitary adinoma. Prolactin is released during orgasm and hugging/cuddling babies, puppies or kittens. Avoid those for 3 days prior to labs.

Is sodium=144 reflecting dehydration? Drink water while fasting for labs.

TSH bad and getting worse. TSH lab ranges are mostly useless. If this is from not using iodized salt [not available there] or foods that are iodine fortified there, you need to supplement iodine and must be getting 150-200mcg selenium and should get on that prior to iodine.

Thyroid has a huge effect on energy hour to hour. Cortisol controls energy minute to minute. You should test ‘AM Cortisol’ and do labs at 8AM or 1 hour after waking up.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#3

Thanks for the reply @KSman, I forgot to mention that I would be checking my body temps, I will report back once all are done for today to make it clear, and keep on reading the stickies


#4

Alright so here are the temp readings
Wake up (12pm) - 36.1 C or 97 F
Afternoon (6pm) - 37 C or 98.6 F
Evening (11pm) - 37 C or 98.6 F

Been super tired/sleepy all day even after a decent sleep.
Ive been taking 2000iu of vit d3 (especially now that its winter)
The test with the high sodium wasnt actually fasted i believe, or at the very least I was drinking water as it was taken at 2pm, at the time I remember eating/adding quite a lot of sodium
However I do use iodized salt although perhaps not enough…

Ill do another days worth of temp monitoring for validity, and get cortisol checked asap but would labs for t3, t4, ft3 and ft4 be worth it to investigate deeper @KSman or just stick with fT3?

For now ill supplement Vit B in case and upping the Vit D3.


#5

You are cold earlier, but to get to 98.6 later which is a good thing. So a good prospect.

You have been using iodized salt. I thought that this was not used there, I see that it is available there. http://www.nutritionaustralia.org/national/resource/iodine-facts

If your iodine intake has been low, you can step-up iodine+selenium and watch body temps and skip lab work for a while.

No need to test T3, T4 if testing fT3, fT4


#6

Alright I’ll do that and evaluate after a while, and that should bring TSH down from 3.4, yet this still leaves me puzzled about SHBG and Prolactin :confused: