29 Years Old - Low Vitamin D, Symptoms of Hormonal Problems

Pharma / TRT Testosterone Replacement
1

Hey folks,

I recently had some blood work ordered by my doctor at my request. It’s going to be a few weeks before I can arrange to speak to her again, and frankly, she’s just not very experienced in this arena. I was hoping that some of the knowledgeable folks on this forum might be able to give me a hand interpreting my results and giving me some suggestions on how to proceed from here.

First some demographics:

Age: 29
Height: 5’11"
Weight: 202lb
Waist Size: 36

Symptomatic history:

For my entire adult life I have had trouble with the following symptoms. Some have been improved by various therapies and lifestyle changes, others have proven largely untreatable or I have responded poorly to typical therapies, others have not been treated or really brought to my docs attention until recently. A lot of this stuff is very personal, but after a lot of reading on this board I get the feeling that ya’ll are understanding and reasonable adults, so…here we go.

Insomnia - better since starting Vitamin D3
Depression/Anxiety - unsuccessfully treated with ADs
Inconsistent libido/ED/infrequent morning wood - made much worse by ADs
Mood Swings
Difficulty gaining muscle and losing fat
Typically female fat distribution - hips, back of legs, low back, lower chest
Chronic joint and orthopedic pain/easily injured joints and connective tissue
Chronic sinus infections
Terrible snoring/sleep apnea - improved since losing a lot of abdominal fat around age 25
My testicles are often pulled in close to my body even when I’m not particularly cold, I’ve also had some very uncomfortable sensitivity.
Frequent night sweats

I also have a history of digestive problems/IBS that have largely been cleared up by cleaning up my diet

I have a family history of thyroid problems, heart disease and diabetes

I did some research before hand and suggested several tests that I would like; she declined most of them as unnecessary. She also threw in tests for Lyme and rheumatoid arthritis, Lyme was negative, rheumatoid hasn’t come back yet.

Tests performed:

CBC
WBC - 7.1 x10E3/uL 4.0-10.5
Hemoglobin - 15.4 g/dL 12.5-17.0
Hematocrit - 46.1 % 36.0-50.0

Lipid Panel
Total Cholesterol - 135 mg/dL 100-199
Triglycerides - 87 mg/dL 0-149
HDL - 50 mg/dL >39
VLDL - 17 mg/dL 5-40
LDL - 68 mg/dL 0-99

Sodium - 139 mmol/L 135-145
Potassium - 3.7 mmol/L 3.5-5.2
Chloride - 101 mmol/L 97-108
Co2 - 25 mmol/L 20-32
Calcium - 9.3 mg/dL 8.7-10.2

Blood Glucose (12 hours fasted) - 111 mg/dL 65-99

Testosterone
Serum Testosterone - 547 ng/dL 280-800
Free Testosterone (Direct) - 10.1 pg/mL 9.3-26.5

Vitamin D 25 Hydroxy - 26.4 ng/mL 32.0-100.0

Thyroid
TSH-ICMA - still waiting for results
Free T4 - still waiting for results

She is concerned about my Vitamin D and glucose. She prescribed 50,000 iu of D3 once a week and more tests for the glucose. I told her that I also wanted tests for estradiol and cortisol but she said they weren�¢??t indicated.

Lifestyle factors:

I spent most of my teenage and adult life very overweight. At my heaviest I weighed 285 lbs, waist size 48. Around age 24 I got sick and tired of being sick and tired and took up weight lifting, hiking and clean eating. I’ve never avoided fats and have eaten primarily meat, veggies, nuts and fruit since cleaning up my diet.

Currently I lift 4-6 times a week with 2-3 heavy sessions. I walk a LOT, I’m a college student, I walk to class, I walk to the grocery store, everywhere. (I do a lot of that walking in shorts and a t-shirt. I also hike, spend a lot of time gardening and go to the beach in the summer, so the vit D deficiency has me a little baffled.)

My diet is high protein, moderate-high fat, moderate-low carbs, I’m currently eating right around maintenance and from a wide variety of whole foods. I cook with sea salt and ad it to my drinking water. I usually only eat sugary deserts or junk food during one day on the weekends, if then.

Supplements are Grow!, Metabolic Drive, BCAA’s, creatine mono, zinc (100mg in the morning), D3 (1000 iu in the morning) and a B multi with thiamin, riboflavin, niacin, B6, folic acid, B12, biotin, pantothenic acid and calcium. I’ve been using the B for a few months and the D and zinc for about a month and a half.

I’m very frustrated, I feel like the damage that I did carrying around so much body fat is catching up with me.

My lifting always hits a brick wall, usually due to injuring a joint in some completely superficial fashion but resulting in set backs of weeks or months.

I lost a lot of weight dieting and exercising, I always tried to do it responsibly, but it has become really difficult to lose any of the body fat that I have left.

On top of that, I really just feel like shit on a day to day basis. I still feel like a sick fat guy even though I’m not carrying the weight around anymore.

My main concern at this point is metabolic syndrome, but I really want to see my thyroid numbers as well. Can you folks make any recommendations as far as further tests? How I should proceed? I’m likely going to go through LEF or something similar to get any additional tests unless my doc comes around to my reasoning.

Thanks for taking the time!

2

Hey mate, your situation rang true to me so I thought I’d hop in and offer what I know…

First off your Vit D is abysmally low…Around 80 is what you should be shooting for as optimum I believe. Your doc seems to be less of an idiot in that she is prescribing high amounts of Vit D (good), but I would spread that out to at least 3 days a week. Not sure what the half life and absorption capacity of Vit D is, but I have a hard time thinking that you can take that high a dose once a week and maintain a steady level.

I wouldn’t worry too much about the glucose truthfully…its probably a side effect from other issues anyway…

You really need your E2 and Cortisol, and more in-depth thyroid (ft3, Tt3, Tt4, Rt3) to get a better picture.

I would guess your E2 is high, which is fairly easily correctable with liquidex (arimidex/anastrozole) but you would want your E2 number to verify before going down that course.

Also with rapid weight loss and the stess induced often comes adrenal issues. A standard blood cortisol test doesn’t really tell you much. A one day, 4x, salivia test is the gold standard and will give you the whole adrenal picture.

Also check out www.stopthethyroidmadness.com when you get your thyroid levels back…dont accept “in range” as an answer…do your own research and use this board for guidance…

Good luck man…I know how frustrating that shit can be, cause looking at your above results, everything seems to paint a picture of health (albeit with low-normal T levels), which we know is not the case…

3

[quote]VTBalla34 wrote:
Hey mate, your situation rang true to me so I thought I’d hop in and offer what I know…

First off your Vit D is abysmally low…Around 80 is what you should be shooting for as optimum I believe. Your doc seems to be less of an idiot in that she is prescribing high amounts of Vit D (good), but I would spread that out to at least 3 days a week. Not sure what the half life and absorption capacity of Vit D is, but I have a hard time thinking that you can take that high a dose once a week and maintain a steady level.

I wouldn’t worry too much about the glucose truthfully…its probably a side effect from other issues anyway…

You really need your E2 and Cortisol, and more in-depth thyroid (ft3, Tt3, Tt4, Rt3) to get a better picture.

I would guess your E2 is high, which is fairly easily correctable with liquidex (arimidex/anastrozole) but you would want your E2 number to verify before going down that course.

Also with rapid weight loss and the stess induced often comes adrenal issues. A standard blood cortisol test doesn’t really tell you much. A one day, 4x, salivia test is the gold standard and will give you the whole adrenal picture.

Also check out www.stopthethyroidmadness.com when you get your thyroid levels back…dont accept “in range” as an answer…do your own research and use this board for guidance…

Good luck man…I know how frustrating that shit can be, cause looking at your above results, everything seems to paint a picture of health (albeit with low-normal T levels), which we know is not the case…[/quote]

Thanks a lot for the reply, that’s all pretty much along the line of reasoning that I’ve been following at the moment. I’m not going to be even a little bit surprised if my E2 test returns high numbers. My body shape and composition alone tell me that it likely will.

I’ll look into the 4x cortisol test, do you know if that is available through one of LEFs packages? Unless it’s related to the glucose or something obviously wrong shows up on the thyroid I think I’m going to have a hard time getting my doc to prescribe any further tests.

When I get the E2 done I’ll see about getting a broader set of thyroid tests done as well.

As for the vitD, any thoughts on underlying issues that can cause defficiency? I understand that it’s difficult to get vitamin D to optimum levels naturally, but I really put in the effort. I’m outside with at least partial exposure for hours every day up until winter kicks in. I was supplementing D3 for over a month before the blood test. My number being so low is really putting me off.

Instead of the 50,000 iu scrip I think I’m just going to pick up some 5,000 iu gell caps and take them once a day, or maybe two a day with two days off a week to get to the same levels that the once a week would give me. I have no clue what the absorbability or half life of D3 is, but I just can’t see taking it all at once as the best option. If the systems involved are working ok, any thoughts on how long it should take for levels of D25oh to get up to normal range on that kind of protocol?

My doctor is a nice lady, and she knows me well, but she’s only going to take these lines of thought so far. She’s a “by the tests” kind of doctor, and if I’m in range she’s not going to draw conclusions based on symptoms but will instead probably refer me to an endo. I’d like to have a really solid idea as to whats going on myself before moving on to a more expensive specialist.

Also, any thoughts on the cholesterol numbers? 135 seems really low to me for total cholesterol considering the composition of my diet.

Thanks again, I think this forum is going to be a really good tool in my arsenal as I try to get this shit dealt with.

4

I don’t think it is, but I could be wrong. You could do a google search and see what turns up. I did mine through Genova Diagnostics, but they won’t send the kit without a doctor request.

Some of the physicians or PA’s that frequent the board could probably tell you the diagnostic code associated with that and you could “suddenly” develop that symptom for your next visit.

Most North Americans are deficient. Darker skin hinders absorption of Vit D. The amount you were supplementing with was a low amount (yet surprisingly the amount recommended by a lot of retard doctors). My primary doc about died when I told him I was taking 6-10k iu per day.

Quality of Vit D also matters. Lots of bullshit products out there amounting to nothing more than candy. If the price isn’t that high for the Rx brand, I’d just go with that probably.

I don’t know a lot about cholesterol but I would guess it is one of your hormone systems not breaking down your ingested food correctly to produce the cholesterol your body needs. Thyroid is in the back of my mind, but don’t quote me on that. Some of the other guys on here would know a lot more about that.

I do know that your hormones are derived FROM cholesterol, which could be a reason why yours seem to be out of whack. May be a feedback loop, not sure.

5

Just read up here:

Low cholesterol can also impact body’s natural Vit D production. There’s [one of] your answers…or at least part of the story…

6

Man, thanks so much. As for the vitamin D - dark skin thing, that’s deffinitely not where I’m at. My family (on both sides) is of germanic-celtic descent. Light skin that turns red with a tan, strawberry blonde hair, freckles…too much resistence to sunlight is the last of my problems. I think I’ve got a lot of reading to do. Thanks again for the feed back.

7

[quote]VTBalla34 wrote:
Just read up here:

Low cholesterol can also impact body’s natural Vit D production. There’s [one of] your answers…or at least part of the story…

[/quote]

That website is awesome. I’m reading about cholesterol synthesis right now. It looks like at 135 mg/dL I am below typical circulating cholesterol levels, so there may be some sort of cholesterol regulation issue going on. Thyroid and adrenals both contribute.

8

Vit D is low as noted. Most people trying to boost their levels need 6,000iu daily. I personally have to take 17,000iu daily just to get to the 70s.

if your TSH comes back at >2 (>1 as well, but your doc will be even more reluctant) then ask for those other thyroid tests and use your symptoms as your reasons why.

you may need to find a new doctor. check out the finding a doctor sticky. call compounding pharmacies, etc.

test for E2 is important especially since you have excess body fat since fat increasing T to E2 aromatase.

low CHOL = low pregnenolone = low cortisol = malfunctioning Thyroid normally

100mg zinc is a lot. most just take 50mg daily. plus you need 2-4mg copper as extra zinc will lower your copper levels.

You electrolytes (sodium, potassium, chloride) are too low. do a search for aldosterone and salt test.

take your body temperature multiple times during the day and check out these sites (it will give you additional ammunition to request a cortisol check):

http://www.drrind.com/therapies/metabolic-temperature-graph

9

[quote]PureChance wrote:
Vit D is low as noted. Most people trying to boost their levels need 6,000iu daily. I personally have to take 17,000iu daily just to get to the 70s.

if your TSH comes back at >2 (>1 as well, but your doc will be even more reluctant) then ask for those other thyroid tests and use your symptoms as your reasons why.

you may need to find a new doctor. check out the finding a doctor sticky. call compounding pharmacies, etc.

test for E2 is important especially since you have excess body fat since fat increasing T to E2 aromatase.

low CHOL = low pregnenolone = low cortisol = malfunctioning Thyroid normally

100mg zinc is a lot. most just take 50mg daily. plus you need 2-4mg copper as extra zinc will lower your copper levels.

You electrolytes (sodium, potassium, chloride) are too low. do a search for aldosterone and salt test.

take your body temperature multiple times during the day and check out these sites (it will give you additional ammunition to request a cortisol check):

http://www.drrind.com/therapies/metabolic-temperature-graph[/quote]

Will do! Thanks for the info. I’ll cut back the zinc right away. I’m going shopping today to pick up new vit D. Making sure that I get oil base and high dose. I think I’m going to shoot for 10,000 iu daily.

I’ll also pick up a thermometer and get started on those temp readings.

So as far as tests, E2 and cortisol now and further thyroid tests when I have my TSH results? Is aldosterone something that I should have tested right away or wait to see results of further tests + changes to vitamin and mineral supplementation?

In the past I’ve taken black strap molasses as a supplement. It has .28 mg Copper, .36 mg Manganese, 2.39 mg Iron, 117.53 mg Calcium, 340.57 mg Potassium, 29.38 mg Magnesium, .10 mg B6 (Pyroxidine) and 2.43 mcg Selenium per 2 tsp serving (30-40 calories of various carbohydrates) according to http://www.whfoods.com/genpage.php?dbid=118&tname=foodspice. Good idea for upping trace minerals and electrolytes or should I look into a commercial supplement?

When I was fat I ruined my sense of taste with salt from fast food and hot sauce. Part of losing the weight for me involved purposefully avoiding a lot of salt and heat for quite some time. I’ve added both back in over time, but my salt intake could very well be low. I don’t eat much processed food at all and don’t use a tremendous amount of salt in cooking.

If I start working on these mineral deficiencies, how long should I wait to redo the CMP14+eGFR test? In other words, how long does it take to see an increase in the serum values for these minerals to know whether or not supplementation is working?

Thanks again. You guys have given me some great info all ready. Makes connecting dots a lot easier.

10

Sea salt does not contain iodine unless the package stated that it is iodized. You could very easily have an iodine deficiency. Get iodine in your diet.

Walmart USA has 5K vit-D3 oil caps. You also need fish oil and probably need some supplements. Whole foods is not necessary all that you need.

Low cholesterol levels are associated with increased all-cause mortality. Cholesterol is the foundation of all of the steroid hormones. Ditto for creating your own vit-D3. Note that vit-D25 is a steroid hormone. Change you diet.

I agree that you are estrogen dominant. Low T is strongly associated with insulin resistance. TT does not count at most if that is SHBG bound T which is not bio-active. Your FT is very low.

Your chronic infections can lead to adrenal stress or fatigue, and may be part of why your testes hurt. You also have chronic inflammation, review your anti-oxidant intake.

You need to test your LH/FSH levels. Get your own labs out-of-pocket at LEF.org if not from NY state.

Some meds will increase E2 and decrease T.

11

KSMAN - my sea salt claims that it contains iodine among other trace minerals, but I will start using some iodized table salt as well or find a sea salt that specifies the amount of iodine (I think there is an ancient lake bed salt mined in Utah that specifies full mineral profiles on the packaging).

As far as fish oil, I eat 3-6 servings of fatty fish weekly, how much fish oil should I try to get in above that? I have cod liver oil, is this a good option? I just started 10,000 iu daily of D3 gell caps and am taking them with a spoon full of cod liver oil per instructions to take with fats.

I’m working on increasing cholesterol in my diet, but I’ve been eating a moderate-high cholesterol diet for quite some time as is. Eggs, bacon, mayonaise, dark meat chicken, fatty cuts of beef and pork, salmon and sardines are all a part of my normal weekly diet. Should I look into organ meats?

I mentioned that I have a family history of thyroid problems. My mom has hypothyroidism and hardening of the thyroid. She’s working on getting me an appointment with her endo who she has a close relationship with and believes will be willing to order further tests. If that doesn’t pan out, LEF it is.

Thanks again, this forum is awesome, you guys are very generous with your knowledge.

12

Also, re: meds. The only prescription medicine that I currently take is pseudo-ephedrine for my sinus problems, but only as needed. I also take alleve once or twice a week. In the past I’ve been on fairly long term (month or longer) scrips of wellbutrin, prylosec and cortizone. I do use pot, but my understanding from reading what clinical literature is available out there is that it may have done damage when I was younger but probably isn’t doing much damage now as I have developed a high tollerance. Either way I’ll be quitting that in case it is causing some small increase in E vs T.

13

Manufactured sea salt looses the iodine in sea water. Salt deposits can have a good iodine and mineral profile and are an exception in the sea salt market place.

You need enough EFAs to balance out other fats. The vege oils in most mayo products is not healthy from an EFA point of view. Olive oil is also good as well. Hard to judge whether you are getting enough EFAs from what you describe, certainly you have a better EFA intake than most.

14

KSman - the sea salt I currently use is a celtic sea salt produced in the Breton non filtering method. Sea water dried, raked and packaged basically.

Here are the fats and proteins which I might eat in a typical week, I’ll list in order from most consumed to least.

Fats:
Grass fed Butter
Extra virgin olive oil
Smoked, uncured bacon (rendered down and used as fat)
Avocado oil
Mayonaise (currently using a soybean/sunflower oil based mayo, but switching to olive oil based)
Almond butter
High oleic sunflower seed butter
Dark chocolate

Animal Proteins:
Whole Eggs
Pork shoulder
Alaskan Salmon Filets
Chicken thighs
Smoked, uncured bacon
Ground beef
Venison
Sardines

any thoughts?

15

http://www.edenfoods.com/store/product_details.php?products_id=105365#nutrition

Eden sea salt. It claims that they do not remove the iodine from the salt. But, either way I’m adding in some plain old iodized table salt with most of my cooking.

16

As salt crystals grow, the crystal selects atoms and molecules that fit from an energy and mechanical fit point of view. This is often used as a method of purification. This normally eliminates iodine. [Dried up sea beds contain salt crystals and the residue, including iodine.]

17

KSman - got it, that makes sense. Thanks.

I just got my TSH results over the phone, doctors assistant first told me “normal” and with further probing gave me a number of 2.5 and a range of .5 - 4.8, but she didn’t specify the unit of measurment. Once the T4 numbers are in (wednesday at the latest they say) I’m going to have them fax me a complete copy of the labwork including the TSH and T4 numbers.

I’ve also been taking my daily temps today. So far they are
Waking (8:30 AM) 96.3 F
11:55 AM 97.6 F

I’ll take again at 5 and before bed and update this post with those numbers.
I didn’t take my waking temperature before my feet hit the floor (I took it about 5 minutes out of bed), so I will redo these again tomorrow in case the wait caused any serious change in temp.

thanks again!

18

Also, is it possible that I could begin noticing something after only a few days on 10,000 iu D3? I started on Friday morning. Since last wednesday I have had a killer pain in my left shoulder and scapular region and at some point during the day yesterday it just sort of went away. I’ll see how it feels after the gym today, but if that little change can start dealing with some of this joint pain I will be a very happy man.

19

TSH>1 = a possible problem
TSH>2 = an actual problem
TSH>3 = a serious problem

you need to find a doctor who know about thyroid issues, and you need more tests to see what is wrong.

check out 18 Summaries of Things We Have Learned - Stop The Thyroid Madness

20

Purechance: thanks, I was afraid of that. I’m trying to get an appointment with the same thyroid Doc who has been treating my mom’s hypothyroid problems. I’ve written him a long letter detailing all of my symptoms, blood tests, etc. etc., so hopefully he will be prepared to take me seriously. If he doesn’t, I’ll keep looking.