T Nation

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

It is extremely important that you do you own research, figure out your symptoms and problems, and go in armed with that knowledge. never depend on the doctor to look out after your best interest. You have to be your own advocate.

check out that website i posted earlier and start taking your temperature 1st thing am and then several times during the day.

low avg. body temp <98.4 = hypothyroid issues
fluctuating body temps (i.e. 96.5 at 8am, 98 at 11am, 97 at 3pm, etc. OR starting off high 98.4 then dropping quickly during the day) = adrenal/cortisol problems (i.e. - not enough of it)

I just started this myself and learned that I go from 96.2 to 98.8 over the course of the day. Big jumps an hour after I take my cortisol and then my temperature stays around 98.2 to 98.4 until I go to bed.

this doctor has a great website with some helpful information - http://www.drrind.com/therapies/metabolic-temperature-graph

also letters are useless.

think of your doctor as a simpleton with a limited attention span.

you MAY have success if you have a easy to read bullet point list of symptoms, and a bullet point list of possible causes. think partial sentences.

anything more and they won’t read it. Remember most of them have placed a premium on their own time (5 minutes per patient, get 'em in, get 'em out, write an easy script to solve all their problems, no need to do any digging or figure out the cause, if I don’t know anything about the situation then I will pawn it off on the mental state of my patient - i.e. it must just be in your head)

[quote]PureChance wrote:
also letters are useless.

think of your doctor as a simpleton with a limited attention span.

you MAY have success if you have a easy to read bullet point list of symptoms, and a bullet point list of possible causes. think partial sentences.

anything more and they won’t read it. Remember most of them have placed a premium on their own time (5 minutes per patient, get 'em in, get 'em out, write an easy script to solve all their problems, no need to do any digging or figure out the cause, if I don’t know anything about the situation then I will pawn it off on the mental state of my patient - i.e. it must just be in your head)

[/quote]

Slightly different situation. All of these warnings apply to the doctor whose care I am leaving. This new doc communicates with his patients via email on a regular basis, letters are cool. I understand the need for research and I have read pretty much everything that you guys have posted, but my wallet is highly encouraging me to find a doctor who will order the additional tests I need rather than going out of pocket. This guy is coming highly recomended based on personality and disposition which is what I want, a doctor that will listen, take me seriously and try to help me out regardless of disease code.

[quote]PureChance wrote:
It is extremely important that you do you own research, figure out your symptoms and problems, and go in armed with that knowledge. never depend on the doctor to look out after your best interest. You have to be your own advocate.

check out that website i posted earlier and start taking your temperature 1st thing am and then several times during the day.

low avg. body temp <98.4 = hypothyroid issues
fluctuating body temps (i.e. 96.5 at 8am, 98 at 11am, 97 at 3pm, etc. OR starting off high 98.4 then dropping quickly during the day) = adrenal/cortisol problems (i.e. - not enough of it)

I just started this myself and learned that I go from 96.2 to 98.8 over the course of the day. Big jumps an hour after I take my cortisol and then my temperature stays around 98.2 to 98.4 until I go to bed.

this doctor has a great website with some helpful information - http://www.drrind.com/therapies/metabolic-temperature-graph [/quote]

I checked this out, but I’m not sure of how to apply it to myself since I’m not on adrenal or thyroid support of any kind, he doesn’t really say what an unmedicated person’s temperature fluctuations should look like.

Here’s what I have so far today

8:30 AM (5 minutes after waking) 96.3 F
9:40 AM (after breakfast) 97.7 F
11:55 AM 97.6 F
4:24 PM 97.0 F
6:25 PM (15 minutes post workout) 96.5 F
8:28 PM (after dinner) 98.3 F
12:23 AM (before bed) 98.3

According to what I’ve read, the range is pretty large…average range between highest and lowest body temp should be around .9 F whereas mine is 2 F. It also seems like my AM temperature is very low. Any thoughts?

It would be good to have another person use that thermometer and see that they hit 98.6

DHEA-S. vit-D25 and pregnenolone can be low as a result of low cholesterol.

Elevated E2 and high SHBG could explain the low FT.

You need to have LH and FSH to understand the nature of what is happening. This needs to be done before TRT is started!

Get FT high and get near E2=22pg/ml and your insulin sensitivity should improve. You should take something like metformin to get things under control. You need to have a ‘blood sugar’ testing device.

You seem to have a thyroid issue from what we know so far. This probably means that you will be a transdermal non responder and would need to inject T. Read the injection protocol sticky.

Look at your diet from a glycemic index point of view.

hypothyroid + good cortisol levels = temperature is stable but low (i.e. 1 degree fluctuations / 97.2 waking to 97.9 noon back to 97.2 at night)

good thyroid + poor cortisol levels = temperature fluctuates greatly through out the day or big (1 -2 degree) difference days to day (i.e. - what you posted but goes above 98.6)

hypothyroid + poor cortisol levels = temperature fluctuates greatly through out the day or big (1 -2 degree) difference days to day AND temps are always low (under 98 degrees).

good thyroid + good cortisol levels = stable temperatures around 98.6 (i.e. 1 degree fluctuations / 98.2 waking to 98.9 noon back to 98.2 at night)

You need to keep taking your temperatures and give that data to your doctor along with your own self diagnosis and ask him to confirm or offer an alternative theory.

right now it would seem that you have problems with insufficient cortisol and problems with your Thyroid.

This site has some good information about adrenals and such. http://www.thyroid-rt3.com/

KSman -
No worries, I’m not in a rush to start TRT. I am of the mind set that all dietary and lifestyle interventions should be exhausted before starting any kind of medication. Based on everything I’ve read it doesn’t sound like even if I go for a medical strategy to treatment the answer is going to be as simple as T injections.

Here is a list I’ve put together of follow up tests I’d like to have done, if you can, take a look and let me know if this seems reasonable:

E2
Cortisol (4x saliva test)
DHEA-S
LH
FSH
B 12
Ferritin
ft3
Tt3
Tt4
Rt3

My doctor also wants me to have Hemoglobin A1c tested as a follow up on the hyperglycemia.
Additionally I want to have cholesterol, D25oh and electrolytes retested to see if dietary interventions are having any effect.

Make sense?

As for the hyperglycemia, I can’t help but believe that there is some factor other than diet at cause. On most days my non fruit and vegetable carb intake is probably between 50 and 100 g’s and less than 25% of my total calories. I mostly eat cruciferous vegetables (red and green cabbage, collared greens, broccoli, cauliflower), sweet potatoes and blue berries as carb sources. On workout days I will sometimes have two slices of high protein, high fiber toast or 4 small corn tortillas or a 1/2 cup bowl of oats or the equivellent from another low GI grain. I only eat sweets or junk food sparingly.

Anyway, I think at this point I am largely theorizing without evidence. My basic plan of action at the moment is to continue D3 mega dosing, continue increasing cholesterol, Na, iodine and electrolyte in take, continue taking and charting my daily body temps and get these follow up blood tests done. Hopefully at that point I’ll have a better picture as to what may be going on and whether or not dietary strategies are having an impact.

Thanks again for all the help

If you are going to start TRT at some point, you should have a PSA baseline. But often this is not done for guys who are younger than 40.

I would recommend adding:
Prenenolone - you have very low CHOL which could = very low pregnenolone. All hormones are derived from the initial conversion of CHOL to Pregnenolone via ACTH stimulation.
8AM Blood Cortisol
Total Iron Capacity
if you are running all of the Thyroid panels, you should also include Free T4 (ft4, ft3, rt3 are the three critical elements)
Magnesium is also a good test that is often overlooked.
and Homocysteine (Cardo) is good to check for overall heart health.

Finally got the last of my blood work from my first doc. Free T4 (mass spec) came in at 1.3 ng/dL with no range listed. It looks like I should have an appointment with a new doctor in December so I can get additional tests ordered.

Something is definitely working out of the few changes I’ve made so far. A persistent pain in my right elbow caused by a flared up forearm tendon isn’t yelling at me for the first time in over a month this morning, and that’s after a heavy row workout two days ago. I also feel like I’m looking a little bit leaner in the abdominal region when I hadn’t noticed any real changes to my physique in a couple of weeks. Sex drive is still in the dumps and I still can’t sleep solid through the night, but any improvement is a good thing.

ATG410,

I know it has been awhile since you wrote your post, but there is one thing I would suggest looking at…Candida/Systemic Yeast/microflora imbalance.
I first read about the imbalance from Paul Chek’s book, Eat, Move, and Be Healthy. The condition is not considered mainstream, but after reading this, changing my diet, and adding specific supplements against this condition, it has helped me dramatically. It really has changed my world…no more uncontrollable sugar cravings, minimal mood swings, no more snoring, no more sinus infections, no more distended stomach, substantially better regularity, more energy, significantly more mental focus and less brain fog, etc…

Net-net, I looked at doing these things because I categorized them in the do me no harm, but could only help me. Probiotics, yogurt, non pasteurized fermented sauerkraut,etc…vegetables, no sugars, no beer-no wine-no champagne…only clear alcohol if having a drink. By rotating my foods an diet around I have also learned that I can not tolerate protein powders well (any kind).

I’ve since taken it an extra step after testing out the Poliquin low tech stomach acid test. I now take the stomach acid pills with all my meals that have protein, in addition to all of the probiotics, yogurt, etc above. Essentially, looking back and putting the pieces together, it all makes logical sense now.
While this may or may not help you, if you’re earnest in your pursuit, you may want to look into this and see if any of the pieces fit for your symptoms you mention and/or feel.