T Nation

Adrenals, Thyroid, or Low T?


#1

-age: 31
-height: 6'2
-waist: 32"
-weight: 165
-describe body and facial hair: moderately hairy
-describe where you carry fat and how changed: i've been skinny my entire life. no weight fluctuations.
-health conditions, symptoms [history]: none
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: none
-describe diet [some create substantial damage with starvation diets] i don't eat very well. fast food when i'm at work. i eat better when i'm at home.
-describe training [some ruin there hormones by over training]: i don't lift weights. i never really exercised much due to always feeling tired. i did spend 3 months working out and eating healthy but i was still plagued by depression and fatigue.
-testes ache, ever, with a fever?: no
-how have morning wood and nocturnal erections changed: morning wood occasionally

I went to a doctor a few weeks ago for depression, fatigue, bouts of extreme fatigue(my body feels weak, my voice gets weak and I generally want to sleep). I suspect I have atypical depression; I just don't know what's causing it. My blood work came back 'normal' so I would like some advice on how to proceed. The blood work I had done was pretty basic, for example, it didn't include e2, ft, lh/fsh, etc. I'll be sure to request the proper bloodwork next time I go in. I've been lurking around the forums and soaking in a lot of information so I'll be prepared.

My tsh was 1.87 (.40-4.50), my total t was 517 (241-827) and t4, free was 1.6 (.8-1.8)

I took the advice of a few people on here who suggested calling a compound pharmacy but unfortunately the doctor wasn't accepting new patients so I agreed to see another doctor who worked there. He seemed to feel that my total testosterone was the only important number in regards to testosterone. I didn't feel like I was in the best hands. Should I go back to him and request more blood work or seek another doctor? I'm in the denver area if anyone know of anyone I could go see.


#2

Well from what you describe, your thyroid is fine and your blood work backs that up. Is your temperature 'normal' meaning do you get cold hands often or feel cold easily?

Your testosterone is 'okay', it could be higher for sure. The highest testosterone level I have ever had was 466 with the same range...

Ideally getting prolactin, lh, fsh and e2 as well as free t3 (just because there is a possibility you may be a bad converter) and cortisol will put things to rest as well as another total T and free T...You definitely want free T as well.

I'd like to know about your lifestyle...diet, sleeping patterns, do you like your job and home life, exercise? Do you get results while exercising (muscle growth)?


#3

More tests need to be done to determine thyroid health - namely, Free T3 and Reverse T3.

Also you need 8am cortisol draw (or 4x saliva cortisol test).

After those tests you can look at Free Test, E2, DHT, DHEA-S... that would be my recommendation. Simply don't know what's going on with so few labs.


#4

Wanting to fall over and sleep in the middle of the day is a classic low cortisol symptom. Likewise, low body weight can be an indicator of declining adrenal function. Testosterone might well turn out to be the primary culprit, but I'd look real closely at adrenal stuff first.

Any family history of autoimmune disorders or celiac?