T Nation

Ex-Endurance Athlete: Hypothyroidism and Low T


#1

Hi,

I'm a 38 year old male.

-height: 6'0"
-waist: 32.5"
-weight: 178 pounds
-describe body and facial hair: Ectomorph, thick black beard.
-describe where you carry fat and how changed: used to carry a lot of fat in the back and around the waist, now a lot less @ 12% BF
-health conditions, symptoms:

Got diagnosed with a metabolic syndrome at 23, high triglycerides and cholesterol @ 1,800 and 400 each, by 29 I was taking blood pressure meds and cholesterol meds @ 223#, started running then and got off the meds, dropped the pounds and a lot of muscle and a couple of years and marathons later started doing triathlons, after 8 half Ironmans started training for my first full Ironman and then my thyroid problems started or at least got worst, at first I didn't even knew what was wrong, I couldn't fall asleep at night and couldn't get up in the morning, couldn't recover from training, was cold all the time, had brain fog, etc. took me about 4 months of doctor visits and lab test to get a diagnosis of hypothyroidism, got on levothyroxine and still felt horrible for 1 year, then changed to Natural desiccated thyroid and also changed from endurance training to lifting weights in a CrossFit box, I suspected all that training and dieting, I was logging 18-20 hours of training per week and wasn't eating enough, had caused that so I started eating better and lifting. For a year I felt everything was going great, felt great, but a couple of months ago I started to feel my libido decrease. It all started after I began a deficit in my diet, but wasn't to big, I log my macros and I was loosing about half a pound per week, took me 6 months to go from 20% BF to 12%, but the libido was still low so I got tested for TT and was 140.

-Rx and OTC drugs: Natural desiccated thyroid (Erfa Thyroid 120 mcg), 6 pill of Nordic Naturals Omega 3, 5,000 UI of Vitamin D, 2 pills of curcumin, and 3 pills of ZMA at night

-lab results with ranges:

February 2015
TT - 140 (280-800)
FT - 3.0 (4.25 - 30.37)
E2 - 333.4 (<740)
LH - 378 (200-1200)
FSH - 229 (200-800)
SHBG - 47.14 nmol/L (20-60)
17 OH PROGESTERONE - 0.5 ng/mL
TSH - 1.18 (0.27 - 4.2)
fT4 - 0.89 (0.93 - 1.7)
Cholesterol - 223 (<200)
HDL - 44
LDL - 126
Triglycerides - 143

November 2014

fT3 - 3.02 (2.77 - 5.27)
TSH - 1.35 (0.27 - 4.2)
Cholesterol - 108
Triglycerides - 95
HDL - 36
LDL - 42

August 2014

Vitamin D(25OH) - 39.3

-describe diet: From July 2014 to November I was loosing half a pound per week, during that period at the end of it was when my libido got low, now I'm taking in 2,300 calories per day (55 F, 260 Carbs, 200 protein), gained 2 pounds in two months.

-describe training: 5-6 CrossFit sessions per week with two rest days, and 1-2 short intense runs
-testes: are normal and don't ache
-how have morning wood and nocturnal erections changed: this seldom happens anymore.

My doctor hasn't decided what treatment to give me, still waiting for more tests, I would love to hear the opinion of you guys in the forum so I could talk with more knowledge with him, I been reading a lot and have learned a lot here but still a lot more to learn.


#2

Why did total cholesterol 108–>223?
Both were fasting cholesterol?
108 was way too low, your sex and adrenal hormones are made from a cascade starting with cholesterol, ditto vit-D3

I suspect that you may still have some hypothyroid symptoms.

Please check your orad body temperature when you first wake up AND mid-afternoon

What is your history of using iodized salt?
You need iodine.
Did any doctors ever ask?

Please see the thyroid basics sticky:

  • note references to stress, starvation diets, rT3, adrenal fatigue

You have secondary hypogonadism. You should consider that a symptom and seek the cause:

Labs: - you have some
TT
FT
E2
LH/FSH
TSH
fT3
fT4
rT3
prolactin
CBC
fasting cholesterol
fasting glucose
AM cortisol [at 8 AM please]
DHEA-S

Stickies:

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

Great opening post and a very interesting story of dedication and determination!


#3

More:
With your history of hypothyroidism, you probably will not be able to absorb transdermal T. So self injecting is your best route.

178 pounds, 12%BF and low T with expected catabolic metabolism does not make any sense.

You are quite estrogen dominant, relative to your low FT.
SHBG is quite high, all considered.


#4

Thanks for the quick response!.

The cholesterol in November was low because two months before that he got me a two month treatment with a statin, was only two months.

I have this from August 2014, that’s when he put me on the statin until november.

Thyroglobulin 7.85 (1.4 - 78) ng/mL
ANTI Thyroglobulin 34.62 (10.0 - 115) UI/mL
ANTI TPO 9.81 (5.0 - 34.0) UI/mL
C-HDL 36 (>= 40) mg/dL
C-LDL 174 (< 130) mg/dL
COLESTEROL 242 (< 200) mg/dL
A1C 5.9 (< 6.0) %
triglycerides 170 (< 150) mg/dL
TSH 0.04 (0.27 - 4.20) UI/mL
T3 2.01 (0.8 - 2.00) ng/mL
T4 6.94 (5.1 - 14.1) ug/dL
fT4 1.26 (0.93 - 1.70) ng/dL
fT3 7.11 (2.77 - 5.27) pg/mL

Back then in August I was feeling free of thyroid problems, but since January I agree with you I’m feeling hypo.

I took my temp yesterday after waking up and today and was: 96.98 both days, will take this afternoon, but I train from 12:30-2:00pm, will wait until 4:00 to take it.

I live in the Caribbean and 90% of my meals are homemade and we use table salt normally (it has added iodine), he has never mentioned iodine to me. What iodine supplements do you recommend?

I have more test from February 2015

DHEA-SO4 179.1 (88.9 - 427) ug/dL
PROLACTINE 9.74 ng/mL
A1C 5.5 (< 6.0) %

Waiting for results on:

dihydrotestosterone
inhibin a
inhibin b
Saliva cortisol, 3 times in a day and saliva DHEA

Didn’t get this:

“178 pounds, 12%BF and low T with expected catabolic metabolism does not make any sense.”

Read the stickies, a lot of great info, thanks!


#5

If you are eating lots of sea food and [always used?] use iodized salt, I would not suspect an iodine deficiency. Foods grown there may have more iodine than many other locales.

If iodized table salt is sold side-by-side with non-iodized, one can have a mix up.

August labs: before statin drug <-- correct?
High fT3 would normally make one feel hot and loose weight. But body temperatures are low. That strongly suggests that the cause could be rT3. See the thyroid basics sticky.

Please explain: "178 pounds, 12%BF and low T with expected catabolic metabolism does not make any sense."
What is your body composition? Are you muscular?

Do you feel cold easily?


#6

Yes, we always have used the iodized salt. And I eat seafood at least once or twice per week, a lot of conch, shrimp, squid, fish, etc.

The August test are the pre-statin, I used the statin from August to November, my cholesterol and triglycerides are always on check when I’m below 185# without drugs, on August I was weighting 195#, when I started CrossFit I stopped caring too much about the diet and gained 10#, and since July I been using Myfitnesspal to track all my intake. I have someone helping me with the nutrition, he’s the one designing my macro intake, he says that the low T is normal after such a long deficit (the lowest I got was 40 fat, 160 carbs and 200 protein) and after this period of surplus I’m at now it will go back to normal, but I tend not to agree with him, I remember when trying to figure out what was wrong a couple of years ago when I discovered I was hypo my TT test was 280, but I had another doctor then and she dismissed it because it was “in range” and I didn’t had low libido then. And it’s been two months now of surplus and still my libido is very low and with everything I have read in this forums I see it shouldn’t be that low.

I was skinny fat, with 200# I used 32 pants, and with 178# I still use the same pants, I have become more muscular now, before when training hard for Ironmans I was 175# @ 16-18% BF and now 178# at 10-12%, I have very strong legs, but as most triathletes my upper body is very weak, right now my squat is @ 275#, but my shoulder press is @ 120#, before I started CrossFit in November 2013 I had never done weight training before.

I used to get cold a lot more, now I think I’m normal.

The doctor mentioned a drug that was for women originally and raises T indirectly, I don’t remember the name, do you know what could be?


#7

The doctor started me today on 50mg clomid eod for 1 month.


#8

As with some other guys; Clomid may make you feel worse as some get strong estrogenic side effects. Nolvadex does not do that.

Dose really appears to be too high. LH levels can be excessive and you get very high T–>E2 inside the testes and E2 levels can be very high and you cannot control T–>E2 inside the testes. High E2 may make your low libido worse.

Many doctors think that more is better when the opposite if often true.

Did you read all of those stickies? ?things that damage you hormones?