T Nation

Hypothyroidism, Hypogonadism & Adrenal Issues - JoeMatts Recovery Log

Been lurking this place for the past few years but have never posted.

My health problems are extensive but I’ll try and keep things short. My situation, in chronological order:

Age 15—16:

Developed bilateral varicoceles at 15 years old — a year later, depression, low libido, erectile dysfunction, loss of muscle mass, brain fog + adhd diagnosis, sensitivity to cold, etc, all followed.

Age 21:

Went to family physician with above symptoms; all labs normal apart from 320ng/dl total testosterone w/ 45 SHBG, and thus low free testosterone. Doctor said it was fine, so I decided to pursue testosterone via the private sector.

Age 21—25:

Spent four years on trt using various protocols with little to no success: testosterone mono, testosterone + hcg, testosterone + hcg + ai, high dose test with above range levels, low dose test with mid-range levels, tried keeping e2 @ 22 pg/ml with ai, tried letting it fall where it falls, etc, etc — all not no avail. I always spent multiple months on each protocol with bloods every four to six weeks. Towards the end of my time on trt, my serum am cortisol dropped below range, four point saliva was low across the day, TSH was rising to the 3-4 region, progesterone was undetectable and I had the classic symptoms of adrenal insufficiency and hypothyroidism. I decided to cease therapy to see how I felt off testosterone.

Now, age 26:

Been off testosterone for just over a year.

Current symptoms include:

Always feel cold, body temperature is low (96.4 waking, rising to 97.8 by mid-afternoon), pulse is 55 bpm despite doing no cardio / not being fit, sex drive is absent, diffuse hair and eyebrow loss, erections are inconsistent, daily heart arrhythmia (diagnosed benign premature ventricular contraction), exercise intolerance (feel like I’m going to pass out upon exertion), lightheaded upon standing, loss of muscle mass, rapid skin sagging / facial aging / under eye bags.

Current labs, one year post-testosterone:

TSH: 3.1 (0.27 - 4.2) mIU/L
Free T3: 5.16 (3.1 - 6.8) pmol/L
Free T4: 14.5 (12 - 22) pmol/L
T4 Total: 82.9 (66 - 181) nmol/L
rT3: 10 (10 - 24) ng/dl
Anti-Thyroidperoxidase: <9.0 (<34) kIU/L
Anti-Thyroglobulin: 14 (<115) kIU/L

AM Serum Cortisol: 542.0 (113 - 570) nmol/L
DHEA Sulphate: 8.270 (5.73 - 13.4) umol/L

FSH: 1.6 (1.5 - 12.4) IU/L
LH: 5.99 (1.7 - 8.6) IU/L
Oestradiol: 55.3 (41 - 159) pmol/L
Testosterone: 19.2 (8.64 - 29) nmol/L
Free Testosterone - Calc: 0.340 (0.2 - 0.62) nmol/L
Prolactin: 551 (86 - 324) mU/L
Progesterone: 1.5 (0.7 - 4.3) nmol/L

Have had the above labs run four other times and they mostly looked the same.

Treatment Plan:

TSH above 3, elevated prolactin and low body temps suggest hypothyroidism. Even though cortisol and dhea-s look solid, many of my symptoms also suggest adrenal dysfunction and, as mentioned prior, serum am cortisol was always below range on trt — usually around 120 nmol/L (113 - 570).

My plan is to trial levothyroxine, starting with 25mcg per day, increasing the dose every four weeks based primarily on body temperature and pulse, but will also get bloods run too. If I don’t convert well I will transition to armour thyroid. Everything is self-treated as no doctor in my country will touch me with everything being within range.

If anyone managed to make it through the wall of text, I’d greatly appreciate some input.

Thanks,
Joe.

How’s your cholesterol? What about sleep? Snore? Alcohol? Other drugs?

Too low

Too low
Im not saying that’s the only problem but it is one of them, I am no expert about it but for sure some guys will help you here

That was only for a very short time — the majority of my time on trt - probably over two years - was spent without an ai, with estradiol usually sat around 185 pmol/l (40 - 155).

Estradiol is low now because free testosterone is low.

Appreciate the input though dude.

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Total Cholesterol 4.32 mmol/L (Range: 0 - 5)
LDL Cholesterol 2.17 mmol/L (Range: < 3)
Non HDL Cholesterol 3.21 mmol/L (Range: < 4)
HDL Cholesterol 1.11 mmol/L (Range: > 1.1)

When my cortisol was low on trt I’d wake up every single night after four hours around 3am, unable to go back to sleep. This went away when I came off and cortisol levels returned, but now I have the opposite problem in that I can sleep for 10+ hours unbroken without feeling rested. Most nights I get 9 hours. The gf says I don’t snore.

No smoking, no alcohol, weights three days a week (380 squat, 455 deadlift and 180 bench @ 175, 5’11, so at a semi-decent level). I log my diet everyday via cronometer to make sure I hit all micronutrients; calories are 3.5k per day.

Cheers dude.

Then probably that was not the problem, try to do the ratio between TT and E if the number sits between 16 to 20 some people claim it is good, cause sometimes your TT was too high even with an 185 E, the ratio could be off, just an idea man
Cheers

Honesty dude, I tried every single ratio and every single protocol, but after four years of tinkering and tweaking, there comes a time where you realize it has to be something else. That’s when I started looking into thyroid and adrenals, and discovered cortisol was below range, TSH was elevated, body temps were low, etc, and most of my symptoms matched. I might look at restarting trt if sex hormones don’t raise in response to thyroid, but for now I’m not too focused on those hormones after years of chasing my tail. I really do appreciate the advice nonetheless.

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Well I guess that rules out hashi’s and apnea. And it adds to your hypothyroid thinking.

One more question, do you have any addiction, weed, porn, alcohol, meth, etc, if so, how often?