T Nation

22 Testosterone 260, TSH 5.33 in a Crash-Like State


#1

Background: I was a very healthy teenager and supremely fit. I took finasteride for three months in 2015 which set me on a downward spiral: I contracted dry eye disease (meibomian glands), which is linked to low androgen levels + something specific about the drug. I have had it ever since coupled with severe anxiety. I also suffer from a host of other things from having not dealt with these effects/and living under high stress for 3 years: no sexual function, testicular pain, joint cracking/pain, floaters and eye problems developed especially last year. etc.

I took a year out since July to try to deal with it. Labs 06/17:
TSH 3.1
testosterone 390
oestradiol 93 pmol/L
SHBg 22 (nmol/L) ,
Androstenedione 2 (nmol/L),
FT4 15.3 pmol/L,
cortisol (nmol/L) 371,
LH 3.3, FSH 7.3,
Growth Hormone 0.2

I have tried to holistically deal with these problems and was trying tongkat ali, ashwagandha, tribulus, maca. I had a treatment timetable for the year, with more and more extreme solutions to be employed downstream. I was trying to avoid stress, but I still had extreme anxiety which I couldn’t reason with.

Labs 09/2017
TSH 3.9,
TESTOSTERONE 363,
LH 2.5 ,
FSH 9,
PROLACTIN 160 (mU/L)

My TSH had got worse, so I was going to try and do a long water fast whilst researching the thyroid and maybe try supplementing with iodine/selenium/tyrosine but didn’t get round to it as I was bogged down with work, I added in Tianepentine which was the first thing to make my anxiety manageable.

Suddenly I crashed further than I normally do, my eyes really flared up , they are quite bad as I have to treat them every day with an eye bag, and they are due to low androgens/specific to propecia as androgens control eyes. I do believe if i raised T it would go away or use t cream on lids. Then I had testicular pain which has been ongoing for the last week, I even went to A&E, but was sent away. I realised I was crashing further than normal as all my symptoms were worse, so I went to GP and asked for testosterone and TSH so I could prove to them my levels are not normal. I think the tongkat ali etc, was slowly making my thyroid worse.

15/11/2017 TSH 5.33,
Testosterone 268,
fT4 18.8 (pmol/L),
oestradiol 57

They still sent me away, and said I am normal and none of my symptoms would be related although,now they say I have hypothyroidism but won’t do anything.

TL;DR: Finasteride 3 years ago for three months, have low T issues and permanent health effects from not dealing with it for so long.

I know my thyroid should be looked at, but I am so weak now.

I went to see somebody in the UK who said I could start clomid or sustanon with hCG, I am thinking the TRT route as I am really in a slump and haven’t had normal T for so long, and I have lots of eye issues due to hormones, (I believe people suffer side effects from clomid due to the roles hormones play in the eye, I got many floaters after allowing my stress to run havoc every day in the last year on a bad endocrine system.)

People don’t seem to do well on clomid or actually keep their gains, and it comes with more side effects. I did want to really look into thyroid, as if I’m correct that is easier to treat, worse comes to the worst I use NDT? I also wanted to try a 10 day water fast—obviously this could be complete hokey science, but doesnt seem that risky and might clean some of my health.

Now I’m too weak to do a week of research, so I am thinking of going on HRT, seeing if symptoms reverse, then sorting out thyroid when I have time, then maybe transferring over to HTPA restart.

Any thoughts would be really appreciated, as can’t really think atm. thanks


#2

So sorry to hear about your suffering, it never get’s easier hearing about people suffering because doctors fail to act.

You may need to go private, NHS doctors are bottom feeders, if they were good at what they do they would have their own practice. NHS doctors are similar to the VA doctors here in the USA, bottom feeders. You want great care go to great doctors and have great results. Your TSH is well above the threshold for high, doctors are either inexperienced or restricted from taking any action. That starts to change when you start paying for it, if the NHS gave treatment to everyone that needed it funding would run out. If the NHS approved TRT for you they would be paying for it for the next 60+ years, it certainly changes the meaning of free healthcare doesn’t it?

Who’s going to pay for the new navy aircraft carriers and new F-35’s, the government. Remind me who pays for healthcare in UK?


#3

Thanks system. Yes I agree.

I have gone private now, and was offered TRT or clomid; the doctor was only a specialist in sexual health and was not interested in the thyroid. I’m thinking of going on TRT then researching/treating the thyroid myself?


#4

Thyroid >>> Testosterone in my opinion. You may crash adding Testosterone if your thyroid already can’t keep up. @KSman can add to this


#5

@texas2006 , I am unsure what to do as still not out of this crash. Would you recommend iodine, selenium, tyrosine for thyroid. And perhaps NDT if my levels are still not great?


#6

Hypothroidism is a big deal. The basics are in the link below. If you are under 30 and after the your thyroid is straightened out and time is given for your endocrine system to balance and still test is low and symptoms do not improve I would recommend a restart (also in the link below). If you are over 30, or a restart fails, then TRT will be the only route for symptom relief. However, get the thyroid resolved first.


#7

@grungephreak My original plan was to try and see if no stress + t cycling herbs would = recovery. I had TSH 3.1 in my first test so didn’t immediately look at the thyroid. I think ashwagandha and perhaps tongkat ali aggravated the condition. It’s a bit hard to do research in this state, usually I am quite diligent, not that its helped me thus far.

I have ordered iodorol (iodine), tyrosine and selenium and will research the doses later this week (I need to try and de-stress a bit, as have been rushing around) and start supplementation next week. Do you think those 3 will be a good start?

I also was give clomid by the sexual health doctor so may take 12.5mg per week to see if I can tolerate it—I am not that keen to go on it as there seems limited success and I already have eye problems due to finasteride + time since with bad hormones.

I will try and sort out thyroid first, as I think you are right. It’s been nearly 3 years, although I am tempted to go on TRT in a few weeks so I have the strength to sort out the rest of my health, but can see I might not be able to handle it.


#8

VA doctors aren’t bottom feeders… They are overwhelmed… My private doctor provided services twice a week to the VA hospital because they are overwhelmed. Is he terrible because he is overwhelmed? He has to see four or five times the number of patients in a day at the va hospital. That is terrible…


#9

I think that is a great start. I am not sure how much benefit you would receive from tyrosine assuming you have a decent diet of protein. If you had hyperthyroidism I could see the benefit as the quick metabolic process and the reduced ability of intestinal absorption. Though the body will excrete and I do not know offhand of any toxicity concerns.

When your thyroid is straightened out the rest of the endocrine system may (likely if you are young) fall into line. Yes some people report issues with clomid but I do not know if it has any greater efficacy compared to nolvadex, just greater tolerability.

Its easy to be tempted to jump to a quick fix. Keep in mind your body is a magnificent specimen of biology. When there is an issue, it is best to solved one issue at a time to get to the root cause (except at the point of greater mortality risk). When you are treating related symptoms separately, you will likely never know the root cause. As many can say on this form, not separating issues and getting baseline functionality for future use in their healthcare decisions has been a regrettable mistake. With that said, it is your body, your health (physical and mental), and the decision is yours and yours alone.


#10

TSH = 3.1 is not actually considered normal. The cutoff for a lot of places is now 3.0. You have had a couple of tests come in above this number, which is not great. To really tell whats going on you need the following additional tests:

  1. Free T4 (with ranges, I see you have this)
  2. Free T3 (with ranges)
  3. Reverse T3 (with ranges)
  4. TPO antibody
  5. TG antibody

If your Free T4 is low along with your Free T3, and Reverse T3 is normal, you can try T4 (Levothyroid). If your Free T4 is fine and your Free T3 is low, you will need NDT or T3 (Armour or Cytomel). If your reverse T3 is high or your ratio of Free T3 / Reverse T3 is low you need T3 (Cytomel) to help flush.


#11

I totally agree: my thyroid has been out for three years, along with my testosterone. It has caused severe damage, especially over the last year as I pushed through to finish my degree and incurred immense stress every day. My values would have been horrific if I tested them then.

At 20 I went to the GP as I was experiencing hypothyroid symptoms and asked for a blood test; however, I was not aware of ranges and values. So, I accepted their statement I must be normal, but now I realise even a TSH of 3.1 is poor as 95% of the healthy population have a value below 2.5.
It is quite scary, also in the UK with the thyroid they will only prescribe T4; they have larger ranges than in the US. I went to an endo yesterday who said there was no hormonal basis for any of my symptoms; no point in getting T3, rT3 measured and that my testosterone was great.


#12

Update: I am going on TRT this week. Sustanon 250 125mg injection per week + hCG. I will see a thyroid specialist privately, in the new year, who prescribes NDT

I have been in this deeper crash ever since this post, and am incapable of doing anything. I am completely impotent and my faculties have deserted me. It coincided with a pain in my testicle which has not gone away, and I believe it is a varicocele; perhaps, formed from my sub-optimal health which is suppressing my T further. With this in mind, I do not think a restart would be effective in the short term, and I do need something guaranteed to work.

A T of 250 cannot be suppressed much further and now I do not think my testes are optimal now, so I am circumventing them. I pray that the thyroid can handle the TRT.

Although finasteride set me on this path, I do not blame it for all this as I could have mostly treated it, if I and those around me weren’t ignorant about hormones, as numerous signs were there.

Thank you for you guys support—I would like to have treated the thyroid first and then tried a restart, but it is too desperate now; therefore, I need a quick change, so I can actually start moving about. I was in the midst of applying for finance/algo jobs for the following year and had to cancel the last stages of quite a few, and have my backup final interview coming up, for Sept 2018, so I have time to hopefully sort this out. The back-up is a less stressful job, I will have weekends off etc, so may be better and ease me back into society.

I hope I can reverse some of the damage of these three years, and haven’t reduced life expectancy etc…: I am aiming for T above 600, TSH below 2. I do have a TPO NHS test next week.


#13

@KSman, I would love some of your wisdom, I am about to start a protocol, do you think this would be ok?
sustanon 250 125mg SC, single injection per week.
hCG 250 IU SC EOD.

Is this still the optimum hCG dose and do you use 29 or 31# needles?

I cannot get an AI as my doctor said he would wait until a month and then see if my blood tests warranted it.

I was thinking that sustanon contains longer acting esters, so once a week would be ok. I am a bit worried that it may be too low, but have I got it correct that hCG may cause a 20% T boost because I am young?
Many thanks.


#14

It’s difficult to say if this protocol is best without labs for SHBG, if low it’s a terrible protocol, if midrange then yes it looks good.


#15

I only have my SHBG value from June: 22 nmol/L (14.5-48.4), why would low SHBG mean it’s a bad protocol, I thought low SHBG was a good thing?


#16

Your SHBG is too low for weekly injections to be effective, high SHBG means a guy is holding on to most of his T a little too well which binds up most of his T effectively shrinking his free T making him feel as if he has low T, lower SHBG on the other hand means we excrete most of our T into our urine via our kidneys, effectively dumping it before it can become useful. Lower SHBG means we must inject T more often in smaller doses otherwise you will feel as if you still have low T, twice weekly and even EOD is best for guys with SHBG on the lower end of the scale.

Most doctors do not understand this, they’re two busy giving these cookie cutter protocols to everyone expecting it to work. My doctor was perfectly happy with me injecting once a week, it wasn’t until I took matters into my own hands injecting EOD that I started noticing I’m feeling my best. After you start TRT your SHBG will be even lower, it’s likely resting in the mid to upper teens.


#17

Ha thanks!—I will inject twice weekly then, splitting my dose, with a mind to maybe increasing it to EOD. I haven’t got used to injections yet, and need to get some finer needles,28 or 29#, if injecting more often. I guess as hCG is EOD it isn’t too bad. Do you leave the amount for the week in one syringe, and then keep changing the needles?

I was thinking sustanon has longer acting esters( I don’t know how that relates to low SHBG), so will see if twice a week is ok, my doctor was saying to use 1500IU of hCG a week which I thought was too much, but he’s not fixed in his ways which is good.

System, do you use hCG?


#18

No HCG, some guys just don’t feel anything from it, it’s like one of those things where some guys just don’t need an AI. Didn’t know you were on sustanon, weekly might be fine but wouldn’t hurt to do twice weekly. Don’t understand needle question, but you never reuse your syringes.


#19

You’ve convinced me to go twice a week :slight_smile:

Oh so you load your EOD T dose into separate syringes from the ampoule?

I think this is a nooby question so that’s why you don’t understand. I think I read that if you were doing 3 times a week for 100mg total you could load a .5ml syringe fully and inject 1/3rd of that 3 times for 100mg/week then toss the syringe.


#20

I believe the confusion has to do with how different things are in our countries, we use vials that have 3 months worth of T-cyp and are medically seal so one can insert another syringe on our next scheduled dose, we grab a syringe draw in our dose and inject. You have those ridiculous ampoules that aren’t medically sealed therefore you can’t save the leftover medicine.