KSman, would appreciate some of your wisdom on the below:
Low Basal Body Temperature
Waking temperature taken under tongue was never above 36°C (97°F), of 15 intraday (11am, 2pm, 5pm for 5 days) only rose above 37°C (98.6°F) on one occasion.
Temperature is typically stable so doesn’t indicate adrenal fatigue and issue but would indicate hypothyroid.
P R Health Sci J. 2006 Mar;25(1):23-9. “Supraphysiological cyclic dosing of sustained release T3 in order to reset low basal body temperature.”
The use of sustained release tri-iodothyronine (SR-T3) in clinical practice, has gained popularity in the complementary and alternative medical community with a protocol (WT3) pioneered by Dr. Denis Wilson. The WT3 protocol involves the use of SR-T3 taken orally by the patient every 12 hours according to a cyclic dose schedule determined by patient response. The patient is then weaned once a body temperature of 98.6°F has been maintained for 3 consecutive weeks. The symptoms associated with this protocol have been given the name Wilson's Temperature Syndrome (WTS).
11 patients who underwent the WT3 protocol for the treatment of CFS. All the patients improved in the five symptoms measured. All patients increased their basal temperature. The recovery time varied from 3 weeks to 12 months.
When a high blood prolactin concentration interferes with the function of the testicles, the production of testosterone (the main male sex hormone) and sperm decrease. Low testosterone causes decreased energy, sex drive, muscle mass and strength, and blood count. If levels remain low for several years, bone strength may decrease (osteoporosis). High blood prolactin also causes difficulty in getting an erection, as well as breast tenderness and enlargement.
Hyperprolactinemia: This can result from a pituitary adenoma, renal or liver insufficiency, primary hypothyroidism, or some drugs (eg, neuroleptics). Hyperprolactinemia can suppress GnRH secretion through a central dopamine-related mechanism. In addition to hypogonadism, this condition can also manifest as galactorrhea and as gynecomastia in men.
Low levels of FSH are consistent with pituitary or hypothalamic disorders/imbalance.
Primary hypothyroidism: This can lead to hypogonadism through hyperprolactinemia. High thyrotropin-releasing hormone (TRH) level, which stimulates prolactin secretion.
Secondary/tertiary hypogonadism, also known as hypogonadotrophic hypogonadism, shows low testosterone and low, or inappropriately "normal," LH/FSH levels; causes include:
* Inherited or developmental disorders of hypothalamus and pituitary (no known familial history)
* Pituitary or hypothalamic tumours (unlikely due to number of scans)
* Hyperprolactinemia of any cause (mine is definitely elevated)
* Malnutrition or excessive exercise (decreased calorie intake and CK shows how hard I am working in the gym)
* Cranial irradiation (CT scans but I would expect them to be typically low level)
* Head trauma (mass effect of tumour or just brain surgery)
* Medical or recreational drugs (e.g. estrogens, GNRH analogs – neither are relevant)
In men with low FSH levels and gynecomastia, serum estradiol measurement is indicated to exclude an estrogen-secreting tumor (testes, adrenals)
If SHBG concentrations are decreased, more of the total testosterone is available to the tissues but Free T at 9.7 pg/mL is significantly below 2-3% it should be (I think it's actually 0.3%)
Low SHBG is associated with obesity, probably due to a loss of insulin sensitivity. SHBG is often a flag or warning signal of insulin and blood sugar issues. In other words, SHBG does not cause insulin resistance but does indicate it. Elevated insulin lowers SHBG.
Thyroid hormones act indirectly to increase SHBG production by liver via hepatocyte nuclear factor-4a. A hypothyroid man that goes on thyroid medication will often see his low SHBG rise. Thyroid hormones (triiodothyronine (T3) and thyroxine (T4) increase SHBG accumulation in HepG2 and increase cellular SHBG mRNA levels.
The higher the Vitamin D, the lower the SHBG but my Vitamin D is borderline problem zone – so this doesn't make sense.
Low SHBG and IGFBP-1 were both associated with an increased
prevalence of abnormal glucose tolerance and the metabolic syndrome.
Signs and symptoms are seen with excess GH and IGF-1 production that I have:
* Snoring – goes through periods where this can be bad or non-existent
* Thickening of the skin – on knuckles
* Acrochordon – skin tags under left arm
* Trapped nerves – numbness in hands/forearms but could also be Thoracic Obstruction
Cushing’s ruled out because of normal Cortisol (24 hour urine).
Acromegaly unlikely as no pituitary adenomas.
IGFBP-2 or IGFBP-2, to help confirm the GH deficiency?
I am going to make an appointment to see my GP and request the following blood panels. I will get a copy of the results and hopefully that will provide me with some insight and I can decide where I want to go from there.
Complete Blood Count:
White Blood Cell (WBC)
Red Blood Cell (RBC)
Mean Cell Volume (MCV)
Mean Cell Hemoglobin (MCH)
Mean Cell Hb Conc (MCHC)
Red Cell Dist Width (RDW)
Mean Platelet Volume
Vit D, 25-OH
Total Vit D, 25-OH D3
Iron, Total Binding Capacity
Iron, Binding Capacity