T Nation

23, Suspect Subclinical Hypothyroidism, Need Advice


#1

Age; 23
Height; 5’ 11"
Weight; 170lb

Describe body and facial hair;
Large amount of hair on lower body, upper body hair quite sparse. Facial hair is slow to grow and thinner than others my age.

Describe where you carry fat and how changed; Carry fat on my lower stomach and love handles, also around my lower pectorals (some pubertal gyno present)

Health conditions, symptoms [history]; No diagnosed physical conditions; recently dealing with depression and anxiety related to the deaths of an immediate family member and good friend. Doctor attempted to prescibe me antidepressants but I turned them down.
My symptoms;
-low energy
-low libido
-mental fog
-extreme forgetfulness (spend a lot more time lately looking for phone/wallet/keys)
-low body temperature

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever
Standard multivitamins/preworkout etc. No hair loss or prostate drugs ever.

-lab results with ranges

TSH 2.75 (0.40-4.00)
TT 19.3 (10.0-35.0)
SHBG 41 (10-50)
Calculated free test 341 (225-725)
Albumin 48 (38-50)
Uric Acid 0.40 (0.18-0.44)
Ferritin 133 (30-400)

I understand now after reading the forums that there are other tests that I should have asked for, I will be going back in a few weeks after attempting an Iodine replenishment.

-describe diet [some create substantial damage with starvation diets]
Currently maintaining on around 2500kcals a day. Diet is reasonably consistent but have a few too many cheat days.
-describe training [some ruin there hormones by over training]
Full body 4x a week. Training has been terrible lately due to my lethargy.

-testes ache, ever, with a fever?
Not that I have noticed.

Body temperatures over the last 3 days, measured twice for accuracy.

9/9
AM 35.7 35.9
PM 36.4 36.4

10/9
PM 37.1 37.1

11/9
AM 36.1 36.2
PM 36.8 36.8

My iodine intake has been zero up until a few days ago. I have started having more iodised salt on my food while I wait for my iodine supplement to show up in the mail.


#2

Is there iodine+selenium in multi-vits?
Selenium essential with iodine replenishment.

Have you read these stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • thyroid basics
  • finding a TRT doc

Where are you? - affects your medical and diagnostic options.
Are you covered for these many labs?

Labs should include:
TT
FT
E2
prolactin - assuming that LH/FSH will be low
LH/FSH
fasting glucose
fasting cholesterol
AM cortisol - at 8AM
DHEA-S [added October 6th]
CBC
hematocrit
TSH
fT3
fT4 - please not T3, T4
rT3 - may need to fight to get that tested

prolactin can lower LH/FSH and T.
Any loss of width of peripheral vision? Should be near 180 degrees.

Prolactin can promote gyno. If elevated, a MRI can check to see if a prolactin secreting pituitary adinoma can be seen. Easily managed with 0.5mg/week Dostinex/cabergoline; so don’t panic. Prolactin is released during orgasms and hugging babies, puppies and kittens, so avoid for at least 48 hours before labs.

Do not be dehydrated for fasting labs, drink water. No black coffee or tea as caffeine may mess with cortisol levels. Try to be relaxed and not be pissed off with traffic jambs etc.

Are problems sudden onset or something that developed slowly?
Any blows to the head preceding this?

Your life has [had] a lot of stress, long commute and 12 hour shift work. This can wear down your adrenal glands and often young males will drive through low energy and do workouts with sheer will power and adrenalin when older guys with same labs would be disabled. This adrenalin driven life can make things worse then then thing break with adrenal fatigue. Too soon to guess where you are in that spectrum. Dealing with deaths also stresses the adrenals. Please see references to stress, rT3, adrenal fatigue and Wilson’s book in the thyroid basics sticky.

Thyroid hormone fT3 controls mitochondrial production of ATP inside your cells, regulating cellular energy levels as part of body temperature control loop. So very important. rT3 blocks fT3.

Vit-D25 is an essential hormone made from Vit-D3. Please take 5,000iu Vit-D3, find tiny oil based capsules. You could test Vit-D25 later on. You need to make sure that you are firing on all hormone cylinders as part of your recovery as any single gap could create a weak link.

Were you not using iodized salt?
If not, others in your home could be affected as well.


#3

Hey KSman, I appreciate the in depth reply, I will answer as best as I can.

Theres is no iodine or selenium in my multi-v, I will be changing that asap though. Is there a ratio of iodine;selenium I should be taking?

I have read the advice for new guys, things that damage your hormones and thyroid basics stickies.

I am in Australia, health care is quite good here and I should be able to request those labs free of charge hopefully.

I have a few others which I thought were unimportant but apparently they may be, so I will post them now,

Chol 4.8 (<5.5)
Trig 0.8 (<2.0)
HDL-C 1.8 (>0.9)
LDL-C 2.6 (<3.4)

Glucose 4.9 (<5.5)
Lipase 25 (13-60)

Electrolytes
Na 141 (134-146)
K 4.2 (3.4-5.5)
Cl 103 (95-108)
HCO3 31 (22-32)
Urea 5.9 (3.0-8.0)
Creat 82 (40-120)

Liver function
Bili 12 (<21)
ALP 55 (35-110)
GGT 17 (<41)
ALT 43 (<41)
ALB 48 (38-50)
TP 77 (65-88)

It is hard to tell whether there as been a sudden onset. I feel as if the symptoms have come on slowly but have been amplified by my emotional response to the recent stresses in my life.
I no longer work 12 hour shifts, however I have previously worked up to 2 weeks in a row doing 12 hour day and night shifts. I do believe that adrenal fatigue could be a factor due to this and other lifestyle factors (which I am in the process of changing).

I have started taking 5,000iu Vit-D3 as of today, I had been using 2,000iu daily for many months already.

I had not been using iodized salt until a few days ago. I will explain the situation to my family and suggest bloods and temperature monitoring.


#4

Small update;
Have been supplementing with 30mg of iodine daily for 20 days now. On average there has been around .5 of a degrees (celcius) change, from 36.4 to 36.9.

My next step will be to go back to the doctor and request more labs.


#5

KSman is the best here, but I’ll toss in my 2-cents.
Your issue sounds like adrenal fatigue, and based on your story it’s very likely. Overworking Adrenals can cause Thyroid issues. Nothing seems out of whack tested so far. Would be good to get Cortisol and DHEA tested when you get labs again. I believe there are home test kits also. Read up on Cortisol/DHEA and B12. Unfortunately with adrenal fatigue, it becomes a cycle, and after elevated cortisol wrecks everything else it just gets worse, so fixing it takes some time.

Recommend taking high dose b12, very helpful for brain, nerve and DNA regeneration, mood enhancement, etc. You can’t OD on b12, so find something with higher dose. You can also supp OTC DHEA to mitigate high cortisol (adrenal fatigue), but don’t know if you really need it without those labs.


#6

To eval DHEA status, test DHEA-S, never test DHEA.
DHEA is sold along with vitamins in USA, it is a controlled substance in the Common Wealth countries and hard to get.