T Nation

Hypothyroid, T-Levels Dropping?


#1

Age: 29
Height: 5'11"
Waist: 31
Weight: 187lbs
Body type: Ectomesomorph, plenty of body hair, facial hair is medium-thin
Fat storage: Waist, and around the pectoral
Disorders: Recently diagnosed with hypothyroidism
Rx: 88mcg Synthroid, 50,000u Vitamin D (weekly)
Supplements: L-Lysine (daily), Vitamin B12 (daily)

Typical diet: 5oz chicken/fish, avocado/nuts, sweet potato/rice (4x a day)
Training: 5 days a week, olympic lifts, followed by squat, deadlift, heavy row, or
bench.

Symptoms: Testes: Sometimes ache. Ultrasound showed something on epididymis.
Doctor told me not to worry.
Headaches: Accompanied by pressure above the left eye.
Morning wood and nocturnal erections changed: varies from month to month. Some months I want to screw everything in sight morning and nights, others, not so much. This is a not so much month.
Nipples: Slight tingling after eating carbohydrates
Lethargy: no sleep is enough
Depression: Has seemed to decrease after synthroid
Social withdrawal: could care less, been cutting off ties
Apathy

In a nutshell...

A few months ago after a routine checkup, my doctor said my TSH levels were elevated (5.380). After having the TSH, FT4 and FT3 checked again, he believed me to be hypothyroid, and sent me to an endocrinologist. He also told me I was Vitamin D deficient (which I now take 50,000u a week for).

An endocrinologist checked my results, told me I was negative for Hashimoto's, and subclinical hypothyroid. He suggested 88mcg of Synthroid, but that it was my decision and sent me on my way with an RX. I spent a few weeks contemplating taking the medicine, even after reading stopthethyroidmadness, deciding to try it out. Shortly after, in the beginning of October 2013, I became extremely sick after a 600 mile motorcycle trip. Fevers, and cold sweats (though my body temperature was only at 97.9), headaches, coughs, and something I had never had before, numerous extremely painful mouth ulcers, plagued me.

I saw another doctor on October 15 to deal with the pain, he thought it was viral, and RX'd me some antibiotics just in case. I informed him about the Synthroid, and how I wanted another blood test. To my shock, my blood work showed my testosterone levels had dropped significantly, TSH levels had decreased, but Absolute Eosinophils was extremely elevated at 14L (norm being 15-500 cells/uL)

After having been put on antibiotics, I am now feeling a little better, but mouth ulcers haven't fully healed yet (almost 2 weeks). I came across a T-Nation sticky about body temperature and Iodine, and checked my temperature today: 96.7 F. Again, a little shocked. I am heading back to the doctor in a few days, but I want to go in with a little bit of knowledge and perhaps some questions/tests that may clarify some things. Looking at my results below (similar results are dated to show the before and after) what do you guys suggest I ask/test for?

Data is dated to show before and after. I started taking Synthroid On 9/15/13 after all the August results, so the fluctuations in TSH have nothing to do with the medicine.

I appreciate any help.

----------- CBC with differential/platelet -----------
Test Result Units Reference Date
WBC 4.7 x10E3/uL 3.8 - 10.8 8/08/13
WBC 7.2 x10E3/uL 3.8 - 10.8 10/15/13
RBC 4.64 x10E6/uL 4.20 - 5.80 8/08/13
RBC 5.17 x10E6/uL 4.20 - 5.80 10/15/13
Hemoglobin 14.4 g/dL 13.2 - 17.1 8/08/13
Hemoglobin 16.3 g/dL 13.2 - 17.1 10/15/13
Hematocrit 42.8 % 38.5 - 50.0 8/08/13
Hematocrit 47.0 % 38.5 - 50.0 10/15/13
MCV 92 fL 80.0 - 100.0 8/08/13
MCV 91 fL 80.0 - 100.0 10/15/13
MCH 31.0 pg 27.0 - 33.0 8/08/13
MCH 31.6 pg 27.0 - 33.0 10/15/13
MCHC 33.6 g/dL 32.0 - 36.0 8/08/13
MCHC 34.7 g/dL 32.0 - 36.0 10/15/13
RDW 12.7 % 11.0 - 15.0 8/08/13
RDW 12.6 % 11.0 - 15.0 10/15/13
Platelets 196 x10E3/uL 140-400 8/08/13
Platelets 225 x10E3/uL 140-400 10/15/13
Neutrophils 46 % 8/08/13
Neutrophils 58.7 % 10/15/13
Lymphs 43 % 8/08/13
Lymphs 31 % 10/15/13
Monocytes 9 % 8/08/13
Monocytes 9.8 % 10/15/13
Eos 2 % 8/08/13
Eos 0.2 % 10/15/13
Basos 0 % 8/08/13
Basos 0.2 % 10/15/13
Neutrophils (Absolute) 2.1 x10E3/uL 1500 - 7800 8/08/13
Neutrophils (Absolute) 4.226 x10E3/uL 1500 - 7800 10/15/13
Lymphs (Absolute) 2.0 x10E3/uL 850 - 3900 8/08/13
Lymphs (Absolute) 2.239 x10E3/uL 850 - 3900 10/15/13
Monocytes (Absolute) 0.4 x10E3/uL 200 - 950 8/08/13
Monocytes (Absolute) 0.706 x10E3/uL 200 - 950 10/15/13
Eos (Absolute) 0.1 x10E3/uL 15 - 500 uL 8/08/13
Eos (Absolute) 1.4 x10E7/uL 15 - 500 uL 10/15/13
Baso (Absolute) 0.00 x10E3/uL 0 - 200 8/08/13
Baso (Absolute) 0.014 x10E3/uL 0 - 200 10/15/13
Immature Granulocytes 0 % 8/08/13
Immature Grans (Abs) 0.00 x10E3/uL 8/08/13

----------- Vitamin B12 & Folate -----------
Test Result Units Range Date
Vitamin B12 482 pg/mL 211 - 946 8/08/13
Folate (Folic Acid), Serum 9.4 ng/mL > 3.0 8/08/1

----------- THYROID & PITUITARY -----------
Test Result Units Range Date
TSH 5.380 uIU/mL 0.4 - 3.0 8/08/13
TSH 7.570 uIU/mL 0.4 - 3.0 8/13/13
TSH 3.870 uIU/mL 0.4 - 3.0 8/28/13
TSH 2.330 uIU/mL 0.4 - 3.0 10/15/13
Prolactin 16.0 ng/mL 2.0 - 15.2 8/08/13
Prolactin 5.0 ng/mL 2.0 - 15.2 10/15/13

T3 114 ng/dL 71 - 180 8/13/13
T3 Free 3.1 pg/mL 2.0 - 4.4 8/08/13
T4 6.6 ug/dL 4.5 - 12.0 8/13/13
T4 Free 1.11 ng/dL 0.82 - 1.77 8/08/13

----------- Thyroid AB -----------
TPO Ab 7 IU/mL 0-34 8/08/13
Thyroglobulin Antibody <1.0 IU/mL 0.0 - 0.9 8/08/13
Parathyroid, Intact 20 pg/mL 15-65 8/08/13

----------- Testosterone, Free and Total -----------
Test Result Units Range Date
Testosterone, Serum 490 ng/dL 348 - 1197 8/08/13
Testosterone, Serum 297 ng/dL 348 - 1197 10/15/13
Free Testosterone (Direct) 13.8 pg/mL 9.3 - 26.5 8/08/13

----------- Lipid Panel with LDL/HDL Ratio -----------
Test Result Units Range Date
Cholesterol, Total 157 mg/dL 100 - 199 08/08/13
Triglycerides 74 mg/dL 0-149 08/08/13
HDL Cholesterol 48 mg/dL >39 08/08/13
VLDL Cholesterol Cal 15 mg/dL 5-40 08/08/13
LDL Cholesterol Calc 94 mg/dL 0-99 08/08/13
LDL/HDL Ratio 2.0 ratio units 0.0 - 3.6 08/08/13

----------- FSH and LH -----------
Test Result Units Range Date
LH 4.5 mIU/mL 1.5 - 9.3 8/08/13
LH 6.6 mIU/mL 1.5 - 9.3 10/15/13
FSH 2.1 mIU/mL 1.6 - 8.0 8/08/13
FSH 2.0 mIU/mL 1.6 - 8.0 10/15/13

----------- Metabolic Panel -----------
Test Result Units Range Date
Glucose, Serum 83 mg/dL 65 - 99 8/08/13
Glucose, Serum 88 mg/dL 65 - 99 10/15/13
BUN 16 mg/dL 6 -20 8/08/13
Creatinine, Serum 1.04 mg/dL 0.6 - 1.35 8/08/13
Creatinine, Serum 1.02 mg/dL 0.6 - 1.35 10/15/13
eGFR If NonAfricn Am 97 mL/min/1.73 >/= 60 8/08/13
eGFR If NonAfricn Am 99 mL/min/1.73 >/= 60 10/15/13
BUN/Creatinine Ratio 15 8-19
Sodium, Serum 141 mmol/L 135-146 8/08/13
Sodium, Serum 146 mmol/L 135-146 10/15/13
Potassium, Serum 3.6 mmol/L 3.5 - 5.3 8/08/13
Potassium, Serum 4.4 mmol/L 3.5 - 5.3 10/15/13
Chloride, Serum 104 mmol/L 98 - 110 8/08/13
Chloride, Serum 105 mmol/L 98 - 110 10/15/13
Carbon Dioxide 23 mmol/L 19 - 30 8/08/13
Carbon Dioxide 23 mmol/L 19 - 30 10/15/13
Calcium Serum 8.6 mg/dL 8.6 - 10.3 8/08/13
Calcium Serum 9.7 mg/dL 8.6 - 10.3 10/15/13
Protein, Total, Serum 6.4 g/dL 6.1 - 8.1 8/08/13
Protein, Total, Serum 7.9 g/dL 6.1 - 8.1 10/15/13
Albumin, Serum 4.2 g/dL 3.6 - 5.1 8/08/13
Albumin, Serum 5.0 g/dL 3.6 - 5.1 10/15/13
Globulin, Total 2.2 g/dL 1.9 - 3.7 8/08/13
Globulin, Total 2.9 g/dL 1.9 - 3.7 8/08/13
A/G Ratio 1.9 1.0 - 2.5 8/08/13
A/G Ratio 1.7 1.0 - 2.5 10/15/13
Bilirubin, Total 0.6 mg/dL 0.2 - 1.2 8/08/13
Bilirubin, Total 0.6 mg/dL 0.2 - 1.2 10/15/13
Alkaline Phosphatase, S 88 IU/L 40 - 115 8/08/13
Alkaline Phosphatase, S 113 IU/L 40 - 115 10/15/13
AST (SGOT) 18 IU/L 10 - 40 8/08/13
AST (SGOT) 18 IU/L 10 - 40 10/15/13
ALT (SGPT) 9 IU/L 0.40- 4.50 8/08/13
ALT (SGPT) 12 IU/L 0.40- 4.50 10/15/13

----------- Numbers that jump out -----------

Testosterone, Serum 490 ng/dL 348 - 1197 8/08/13
Testosterone, Serum 297 ng/dL 348 - 1197 10/15/13
Eos (Absolute) 1.4 x10E7/uL 15 - 500 uL 10/15/13
FSH 2.0 mIU/mL 1.6 - 8.0 10/15/13
TSH 2.330 uIU/mL 0.4 - 3.0 10/15/13
*increase dosage?


#2

Duplicate post, so I may as well use it to ask... test E2 next?


#3

So what is your iodine intake history? <<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Imune levels may be indication an infection.

So you stopped the T4 med. May have been too much at once, might have been better to ramp up the dose.
Body temps can be a guide to thyroid meds dose.
If temps are low and fT3 fT4, TSH are good, rT3 may be a factor
Dose should take TSH near 1.0, but your thyroid gland may be TSH changed.
Thyroid is large, asymmetric or lumpy?

Try to increase cholesterol.

"Nipples: Slight tingling after eating carbohydrates "
Yes, check E2.
Watch prolactin

"Headaches: Accompanied by pressure above the left eye." Keep watching/reporting.


#4

I don't know anything about T-levels (except I would like to have more) but I am hypothyroid and have been on thyroid replacement for 4-5 years. Generally, most people will start slow and ramp up when starting to take. I had similar symptoms you describe (lethargy, unmotivated, very tired, especially in winter). I am almost same size as you and I started at 50 for a few months, then went to 75, then 100 and then convinced my doc to put me on 125 which is where I have been for 2 years now. She wants to see me once a year to check blood levels, but as long as nothing is crazy out of whack and I feel good, she is content to dose me according to my symptoms, not pre-determined blood levels. I think this is much more common today and allows you to customize your dose. But, be aware that when you are over-dosed, resting heart rate increase, you get night sweats, some people have anxiety, and I personally sleep less which can be great sometimes, but not enough quality sleep decreases GH and T levels so this is not something you want.

I also find that if I am not exercising regularly, 125 is too much. I cut down to around 90 if not working out. I just started 5X5 last week and I think 125 is going to be a pretty good place for me.

Based on the workout schedule you describe, I doubt that 88 is going to be enough for you long term. But, I would strongly recommend you ramp up slowly if your blood levels are in the mid-normal range.

As for your vitamin D levels, if you are eating a balanced diet with plenty of fish and veggies, and you spend a few hours a week in direct sunlight, you should NOT be vitamin D deficient living in Florida. My personal opinion is the vitamin D hype is overblown, unless you are living in a northern climate and get very little sunlight. Just remember that vitamin D and its precursors are fat-soluble which means you need to be eating fat to absorb.

Hope this is helpful.


#5

Never been a salt guy or a fish guy, so I would have to say almost non-existent.

Haven't done an ultrasound. Originally just went with what the doctor said, "seems fine."

----------- Temperatures (in ear, electronic) -----------
88mcg Synthroid, 1000mg L-Lysine, 50,000u Vitamin D, 2500mcg B12

Temperature Time Date Notes
96.2 11:00 10/24/13 Waking up
97.4 16:57 10/24/13 After washing car
97.2 21:49 10/24/13 Working on computer

Started taking 50mg Iodoral 10/24/13

96.7 12:10 10/25/13 Waking up
97.5 16:00 10/25/13 Working on computer
98.0 22:00 10/27/13 After 1 hour motorcycle trip + nausea
96.8 10:30 10/28/13 Waking up