T Nation

Help with Wife’s Bloodwork

T Replacement
#1

Could use some help for my wife’s blood work. And ultimately symptom relief as I am stumped.

She is extremely cold ALL THE TIME. Sleeps like a rock even through her alarm clock and has trouble getting up in the morning. Tired all day, she said it feels like she is always walking through quicksand. Libido is low, but not non-existent.

She’s seen a few naturopathic doctors in the past and has a sleep study coming up in a few days. Her PCP and endocrinologists haven’t found anything noteworthy, but they didn’t test anything either lol.

Here is some recent blood work. We’ve tested her thyroid 3 or 4 times in the past. FT4 is usually mid range, but this last test seemed a little low. I couldn’t find FT3, but I am 100% certain we’ve tested it and it’s come out mid range as well.

TSH: 0.8 (0.4-4.0)
FT4: 0.9 (0.5-1.6)

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#2

Curious to see these results, Other than the cold hands that’s how I felt before getting my cpap.

#3

More than cold hands. She is freezing head to toe every day. And I’m usually too warm.

#4

Do you notice any signs of sleep apnea?

I’d consider taking testosterone and I have given thyroid to patients with a fT3 of 3.6. Sleeps like a log, but has trouble getting up, tired all day, extremely cold all the time…

#5

No signs of sleep apnea that I’ve noticed. But she does sleep directly on her face sometimes Haha. And she gets sleep paralysis where she is conscious and knows she is on her face but can’t move. I’m a little concerned because she has extremely sensitive skin, and a CPAP might not be tolerated well.

She actually did do a trial of testosterone for 6 months. It was compounded cream of Testosterone/DHEA 4/200mg/mL 0.5gm daily. That got her testosterone up over range after 4 weeks, then they backed it down so it was mid range. She tried that for a solid 5-6 months but didn’t get any positives from it.

#6

Hormonally I’m not sure if there are more tests we can do. Or maybe it’s just not hormones? I personally don’t know too much about womens’ hormones to help her that much in that area.

One thing she hasn’t tried is a thyroid medication, but it’s always been too close to in range to justify it. But perhaps it could help?

#7

Most women need higher levels. This is another example of treating numbers over symptoms.

Good luck, hope you get to the bottom of this.

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#8

At what point would you have androgenic concerns? I know it’s easy to add more testosterone to men until symptom relief is met as they typically don’t mind the androgenic side effects. But I know most women would be hard to convince to keep their testosterone over range?

#9

Free T4 is the first to be effected by changes in thyroid function, sort if an early warning system.

Also women are way more sensitive to changes in thyroid function than men.

#10

She is likely going to try 30mcg/day starting after her sleep study. It just seems like her numbers are pretty solid so it wouldn’t do much. At least that’s what I’ve seen with most of the guys on this forum that try thyroid meds with good numbers. Worth a shot anyway.

#11

When they start experiencing them.

I have found the opposite. Regardless of the number, they are happy if they are feeling well.

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#12

It’s thyroid thyroid thyroid. Normal does not equate to optimal. Thyroid to women is what testosterone is to men from a clinical standpoint on how they feel and function. Believe me she needs thyroid and follow the free T3 during treatment. Until she gets her thyroid optimal she will not feel better

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#13

I had the same issues blood work was always “normal”. I now take T3 and T4 and feel like a human again. I’d recommend starting with thyroid. Like everyone else says, that drives women more than anything else.

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#14

Thanks guys, she said she will give that a try right after her sleep study.

I’ll report back.

In the meantime, if anyone can think of any other tests she can do, that would be helpful.

#15

@theBeth can I ask what your dose is? And also, if you started with “normal” lab ranges, what are they now after the medication?

#16

Hi galgenstrick,

I would just like to add a few comments for any assistance it may provide. We only have access to the symtoms mentioned and are also led in a direction into hormonal issues. Not so holistic a presentation. Furthermore, asking questions in this forum will lead to answers biased by the interest of this forum.

Thyroid issues? Well, I don’t think so. The tests are similar to what you are trying to achieve with such medication. Obviously, most diagnosed patients like to have more suppression.

Have you checked the basics - for anemia, or iron defiency? Much more common and therefore highly likely. And for that reason, check the other cellular building blocks like folic acid or cobalamines? Another thing that comes to mind, since we are into hormones, is cortisol - worth checking out since the symtoms of adrenacortical insufficency can be similar to your description (secondary to prolonged stress of any origin).

I do not intend to get into a heated debate about thyroid issues here. Do what you want with this information. I hope you find the answers you are looking for.

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#17

Yeah, she had iron tested in the past, several years ago. But it’s probably a good time to check it again. I’ll have her check those other things as well.

You are right, the thyroid numbers are good, which is why I’m stumped. I have a lot of experience with thyroid disease and the symptoms because I have it myself. And she has all the symptoms of under active thyroid times 10.

#18

Good! Please keep me/us posted on the progress!

In my experience, it occasionally happens that symtoms of thyroid deficency arise before you see them in the labs. I have met patients with symtoms by the book, but normal labs - then, two-three weeks later show very deranged labs. Thyroid patients are indeed a very misunderstood group. Thyroid labs (TSH) normally fluctuates within normal ranges, but the trend over time can provide hints of direction (not to be expected here since the values are looking good).

Re iron deficiency, I would recommend having a fasted complete iron checkup, instead of just a single screening test (too many interacting variables).

#19

Thanks for the tip.

I forgot to add to this thread that her TPO antibodies are slightly elevated at 17 with reference range <9.

#20

Keep searching…she won’t feel any better until she gets thyroid. Normal labs are not a optimal level and the normal range is not a healthy range. Stuck on normal but yet the majority of men started testosterone with “normal levels”. Treat the symptoms not the number. Men seem to understand this with testosterone but won’t apply out to the other hormones.

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