T Nation

Hypothyroidism, But with Few Symptoms


#1

As per the stickies, I’ll give my info:
-26 yrs old
-6’1
-201.6lbs, 14.2% BF this morning
-32.5in waist
-around 13.5-15% body fat, with a very healthy beard and male pattern baldness (balding has slowed down alot the past few years.)
-Carry fat around the stomach and lower back area
-Diagnosed with Hypothyroidism in August 2015.
8/15: 4.94 TSH

-Rx:.25 mcg Levothyoxine

-lab results with ranges
8/15:
TSH: 4.94(.40-4.50 Range)
Cholestrol, total: 206mg/dl (125-200 range)
HDL: 52
LDL: 132
Triclygerides: 110
ALT: 18u/l (range 9-46)
AST: 24u/l (10-40 range)

4/16:
TSH: 2.87
Cholesterol: 181 mg/dl
HDL: 42
LDL: 113
Triclygerides: 214 (range <150)
ALT: 145 (Range 14-67)
AST 50 (range 6-58)

5/16:
ANA: positive
ANA Titer: Less than 1:40
(So no autoimmune disease)

-I meal prep all meals Mon-Fri. Weekends include a few cheat meals(1-2), but nothing too crazy.
Been tweaking diet lately, because I wasn’t losing any weight at around 2800 calories… Ever since dropping below 2500, I appear leaner, but weight is staying above 200.
-Desk job 9 hrs a day, train 1-2 clients, workout, then sit on my ass at home.
-Train 6 days a week, 1 body part per session. No longer than 60 minutes lifting, with 15 min cardio some days.
-Rarely have morning wood. Like maybe once every week. Do wake up in the night with nocturnal erections tho. Never have a problem getting it up, unless I’m drunk. Never have a problem not wanting to have sex with my girlfriend. Can only finish 1-2 times a day, and with a few hours inbetween.

So I went in for a routine physical in August 2015, and Doc decided to do labs because I haven’t in a few years. Found out my TSH was high. He has never tested for T3, T4 or rT3.
I would say that for the most part I don’t have any symptoms of hypothyroidism. I work 10-12 hr days, workout, and wouldnt say I feel exhausted, or even overly tired.
The only symptom that I could see is that its been hard for me to lose weight, but I have recently realized that I need somewhere around 2300 calories to see any kind of weight loss.

After starting levothyoxine, I started to feel better, but already felt good so the change wasn’t big. Testicle size did increase however.

I mentioned to my Doc over email my desire to get my TSH closer to 1, but he ignored that question. Should I just double my dose of 25 mcg Levothyoxine?
Also, after all labs ruled out and autoimmune, the doc just said I’m all good and no reason to further run any labs.

So I guess my question is where do I go now?


#2

Please post oral body temperatures as per the thyroid basics sticky. Body temps can be your dosing guide.

Were you getting cold easily? Now?
Outer eyebrows sparse?
Had you been using iodized salt?

Sometimes docs end up treating thyroid problems with Rx hormones when the problem was only an iodine deficiency. Did doc ask about iodine?

Sounds like you would not characterize your life as stressful.


#3

@ksman I just stumbled upon your thread yesterday, and this morning temperature was 97.1 right upon waking at 4:30am,

-Outer eyebrows certainly not sparse.
-I’ve always “ran hot,” but maybe the past year not as hot. Still don’t consider myself one to get cold easy.
-Pretty sure I use iodized salt. Are the store brand packages of Salt and Pepper combo Iodized salt? Quick google has me thinking yes
Doc never mentioned iodine.

Life certainly isn’t stressful.

I have to mention that I’ve been talking the following supplements for about 2+ years (before being diagnosed hypothyroid)
Magnesium, Coq10, Vit B12, Zinc, Fish Oil, Vit D.


#4

Also, body temp as a dosing guide for what?


#5

@KSman
Updated temp readings:
6/1- AM: 97.1. PM: 97.4
6/2: AM: 95.9 PM: 97.6
6/3: AM: 96.4 PM: 98.1
6/4: AM: 96.1 PM: 97.2
6/5: AM – PM: 97.6
6/6: AM: 96.3 PM: 97.3 (99.3 at one point. Feeling under the weater)
6/7: AM 98.3 (Still feel under the weather)


#6

You are taking Levothyoxine and wanted to get near TSH=1.0
Many have found that they need to get TSH a lot lower to stop hypo symptoms.
Levothyoxine should improve body temperatures. You can use body temperatures as a guide to your Levothyoxine dosing. Too much might warm you up too much or make you feel edgy or overstimulated.

Iodized salt? Go to store and inspect packaging. You live with wife/GF and she uses same salt?


#7

I live alone, but googling both Kroger and Walmart store brand salt and pepper shows that they’re iodized.

Should I just make an appointment with my doc and demand that my Levothyoxine dose be increased? Right now I’m taking 25 mcg (smallest dose prescribed) and the next dose up is 50mcg. Should I just double my dose on my own?


#8

Based on your body temps, yes. Would be good if your doc was good with your finding out what works for you based on how you feel.

I need to point out that when T4 medication does not work, is can involve these factors:

  • some do not convert T4–>T3 very well in peripheral tissues and need a T4+T3 product
  • some have elevated rT3 that blocks fT3, yielding hypo symptoms
  • low ferritin can reduce T4–>T3

Your low body temperatures are a symptom.

When one has elevated rT3, when you take more T4, you get more T4–>rT3 and things can get worse. You really need labs for TSH, fT4, fT4. If you have mid-range fT3 and body temperatures are low, you really need to suspect rT3 and have that tested. There is a lot in the thyroid sticky re fT3, rT3, stress, adrenal fatigue and Wilson’s book as resources.

When rT3 is a problem, you reduce rT3 by elimination of T4 by taking a T3 only medication, depressing TSH so the thyroid is not making [much] T4. Then T4–>rT3 is managed. This needs time release T3 and this is only available from a compounding pharmacy.


#9

Hey,

Sorry to disturb, but what do you think about my levels?

S-TSH 4 (ref 0.3-4.2)
S-T4 free 22.2 (ref 12-22)
S-T3 free 8.3 (ref 3.1 - 6.8)

18 years old and got Low T as well.


#10

bktt,

please create your own thread so we can serve you better. Stick to the one thread so over time you case is not spread out and context lost.

TSH should be closer to 1.0
T3, T4, fT3, fT4 should be mid-range or a bit higher.
The lab ranges are rather useless and this misleads doctors.

Provide more info about your self and medical issues. What medications how taken.

How are you feeling and how has this been changing over time?

The stickies for this forum are found here:
About the T Replacement Category

see links:
advice for new guys
things that damage your hormones

There is a ‘thyroid basics’ link there for you to read.
Your labs are quite odd as fT3, fT4 are high relative to mid-range and TSH is high but should be lower because of fT3, fT4.
The only explanation that comes to mind for this thyroid profile would be elevated rT3. But this may not hold up to additional data.

What is you history of [not] using iodized salt?
Are your outer eyebrows sparse?
Get cold easily?
Stress a major factor in your life? accidents? surgeries? infections?


#11

So what exactly should I ask my doctor to test?


#12

Please answer my questions first.


#13

I already did answer your questions above. I also updated my temperature log.


#14

see 4th above this post


#15

I already answered your questions above.


#16

I got twisted up with bktt’s post!

TSH
fT3
fT4 [please not T3, T4]
rT3 -see below

If fT3 is mid-range and body temps low, suspect rT3.

When T4 meds not working, you can try a higher dose. If that then is not working, problem may be rT3 and that can be tested.

Seems logical to increase dose and see what happens.

rT3 can be elevated by:

  • stress
  • starvation diets - can be long lasting
  • allergies
  • inflammation/infections
  • accidents