T Nation

Hypothyroidism Induced by TRT?


#1

Hi,

@KSman

I have been following the IR advice for iodine and been taking 50mg of it for the past 2 weeks and 400 mcg of selenium alongside it prior to taking these bloods. Also i started taking 0.5mg anastrazole after starting these bloods feeling slightly better but you reckon i need a higher dose? What to do about the thyroid and prolactin, and what dose to use for the AI? How do the pre and post bloods look in general. Please advise me info! Only taking 70mg 2x per week. These bloods were drawn 1 1/2 day after injection because i didnt care about measuring t but measuring thyroid and e2. Please remember i was secondary hypo for 5 years before starting trt

Here are my labs pre-trt
Lab Test Results
Phosphorus, Serum

Test Low Normal High Reference Range Units
Phosphorus, Serum 5.0 2.5-4.5 mg/dL

Magnesium, Serum

Test Low Normal High Reference Range Units
Magnesium, Serum 2.2 1.6-2.3 mg/dL

Tsh

Test Low Normal High Reference Range Units
Tsh 3.440 0.450-4.500 uIU/mL

Luteinizing Hormone(Lh), S

Test Low Normal High Reference Range Units
Lh 3.5 1.7-8.6 mIU/mL

Fsh, Serum

Test Low Normal High Reference Range Units
Fsh 1.2 1.5-12.4 mIU/mL

Cbc With Differential/Platelet

Test Low Normal High Reference Range Units
Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL
Immature Granulocytes 0 Not Estab. %
Baso (Absolute) 0.0 0.0-0.2 x10E3/uL
Eos (Absolute) 0.1 0.0-0.4 x10E3/uL
Monocytes(Absolute) 0.6 0.1-0.9 x10E3/uL
Lymphs (Absolute) 2.1 0.7-3.1 x10E3/uL
Neutrophils (Absolute) 2.4 1.4-7.0 x10E3/uL
Basos 1 Not Estab. %
Eos 2 Not Estab. %
Monocytes 12 Not Estab. %
Lymphs 40 Not Estab. %
Neutrophils 45 Not Estab. %
Platelets 218 150-379 x10E3/uL
Rdw 13.7 12.3-15.4 %
Mchc 34.1 31.5-35.7 g/dL
Mch 31.5 26.6-33.0 pg
Mcv 93 79-97 fL
Hematocrit 44.9 37.5-51.0 %
Hemoglobin 15.3 13.0-17.7 g/dL
Rbc 4.85 4.14-5.80 x10E6/uL
Wbc 5.3 3.4-10.8 x10E3/uL

Vitamin D, 25-Hydroxy

Test Low Normal High Reference Range Units
Vitamin D, 25-Hydroxy 61.1 30.0-100.0 ng/mL

Comp. Metabolic Panel (14)

Test Low Normal High Reference Range Units
Glucose, Serum 72 65-99 mg/dL
Bun 10 6-20 mg/dL
Creatinine, Serum 1.02 0.76-1.27 mg/dL
Egfr If Nonafricn Am 99 >59 mL/min/1.73
Egfr If Africn Am 114 >59 mL/min/1.73
Bun/Creatinine Ratio 10 9-20
Sodium, Serum 142 134-144 mmol/L
Potassium, Serum 3.7 3.5-5.2 mmol/L
Chloride, Serum 102 96-106 mmol/L
Carbon Dioxide, Total 23 18-29 mmol/L
Calcium, Serum 9.2 8.7-10.2 mg/dL
Protein, Total, Serum 6.6 6.0-8.5 g/dL
Albumin, Serum 4.5 3.5-5.5 g/dL
Globulin, Total 2.1 1.5-4.5 g/dL
A/G Ratio 2.1 1.2-2.2
Bilirubin, Total 0.3 0.0-1.2 mg/dL
Alkaline Phosphatase, S 78 39-117 IU/L
Ast (Sgot) 22 0-40 IU/L
Alt (Sgpt) 24 0-44 IU/L

Lipid Panel With Ldl/Hdl Ratio

Test Low Normal High Reference Range Units
Cholesterol, Total 133 100-199 mg/dL
Triglycerides 69 0-149 mg/dL
Hdl Cholesterol 53 >39 mg/dL
Vldl Cholesterol Cal 14 5-40 mg/dL
Ldl Cholesterol Calc 66 0-99 mg/dL
Ldl/Hdl Ratio 1.2 0.0-3.6 ratio units

Testosterone Free Ms/Dialysis

Test Low Normal High Reference Range Units
Testosterone, Serum (Total) 291 ng/dL
% Free Testosterone (Dialysis) 1.6 %
Free Testosterone, Serum 47 pg/mL

Estradiol, Lcms, Endo Sci

Test Low Normal High Reference Range Units
Estradiol, Serum, Ms 12 pg/mL

Cortisol, Serum Lcms, Endo Sci

Test Low Normal High Reference Range Units
Cortisol, Serum Lcms 14 ug/dL

Dhea-Sulfate, Serum

Test Low Normal High Reference Range Units
Dhea-Sulfate, Lcms 205 ug/dL

Igf-1

Test Low Normal High Reference Range Units
Igf-1(Bl) 246 ng/mL

Prolactin, Serum (Icma)

Test Low Normal High Reference Range Units
Prolactin, Serum (Icma) 13 ng/mL

Sex Hormone Binding Globulin

Test Low Normal High Reference Range Units
Sex Hormone Binding Globulin

4 weeks later i suspected thyroid issues:

Phosphorus, Serum
Phosphorus, Serum
4.1NORMAL
Reference Range: 2.5-4.5 mg/dL
Magnesium, Serum
Magnesium, Serum
2.2NORMAL
Reference Range: 1.6-2.3 mg/dL
Thyroxine (T4) Free, Direct, S
T4,Free(Direct)
1.09NORMAL
Reference Range: 0.82-1.77 ng/dL
Triiodothyronine (T3)
Triiodothyronine (T3)
117NORMAL
Reference Range: 71-180 ng/dL
TSH
TSH
7.320HIGH
Reference Range: 0.450-4.500 uIU/mL
Luteinizing Hormone(LH), S
LH
0.1LOW
Reference Range: 1.7-8.6 mIU/mL
FSH, Serum
FSH
<0.2

Reference Range: 1.5-12.4
CBC With Differential/Platelet
WBC
5.7NORMAL
Reference Range: 3.4-10.8 x10E3/uL
RBC
5.27NORMAL
Reference Range: 4.14-5.80 x10E6/uL
Hemoglobin
17.0NORMAL
Reference Range: 13.0-17.7 g/dL
Hematocrit
49.7NORMAL
Reference Range: 37.5-51.0 %
MCV
94NORMAL
Reference Range: 79-97 fL
MCH
32.3NORMAL
Reference Range: 26.6-33.0 pg
MCHC
34.2NORMAL
Reference Range: 31.5-35.7 g/dL
Neutrophils
48NORMAL
Reference Range: Not Estab. %
Immature Granulocytes
0NORMAL
Reference Range: Not Estab. %
Lymphs
39NORMAL
Reference Range: Not Estab. %
Monocytes
11NORMAL
Reference Range: Not Estab. %
Eos
2NORMAL
Reference Range: Not Estab. %
Basos
0NORMAL
Reference Range: Not Estab. %
Platelets
224NORMAL
Reference Range: 150-379 x10E3/uL
Neutrophils (Absolute)
2.7NORMAL
Reference Range: 1.4-7.0 x10E3/uL
Immature Grans (Abs)
0.0NORMAL
Reference Range: 0.0-0.1 x10E3/uL
Lymphs (Absolute)
2.3NORMAL
Reference Range: 0.7-3.1 x10E3/uL
Monocytes(Absolute)
0.6NORMAL
Reference Range: 0.1-0.9 x10E3/uL
Eos (Absolute)
0.1NORMAL
Reference Range: 0.0-0.4 x10E3/uL
Baso (Absolute)
0.0NORMAL
Reference Range: 0.0-0.2 x10E3/uL
RDW
13.9NORMAL
Reference Range: 12.3-15.4 %
Vitamin D, 25-Hydroxy
Vitamin D, 25-Hydroxy
50.1NORMAL
Reference Range: 30.0-100.0 ng/mL
Vitamin D deficiency has been defined by the Institute of Medicine and an Endocrine Society practice guideline as a level of serum 25-OH vitamin D less than 20 ng/mL (1,2). The Endocrine Society went on to further define vitamin D insufficiency as a level between 21 and 29 ng/mL (2). 1. IOM (Institute of Medicine). 2010. Dietary reference intakes for calcium and D. Washington DC: The National Academies Press. 2. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. JCEM. 2011 Jul; 96(7):1911-30.

Lipid Panel With LDL/HDL Ratio
Cholesterol, Total
139NORMAL
Reference Range: 100-199 mg/dL
Triglycerides
103NORMAL
Reference Range: 0-149 mg/dL
HDL Cholesterol
53NORMAL
Reference Range: >39 mg/dL
LDL/HDL Ratio
1.2NORMAL
Reference Range: 0.0-3.6 ratio units
VLDL Cholesterol Cal
21NORMAL
Reference Range: 5-40 mg/dL
LDL Cholesterol Calc
65NORMAL
Reference Range: 0-99 mg/dL
Comp. Metabolic Panel (14)
Calcium, Serum
9.4NORMAL
Reference Range: 8.7-10.2 mg/dL
Glucose, Serum
88NORMAL
Reference Range: 65-99 mg/dL
BUN
12NORMAL
Reference Range: 6-20 mg/dL
Protein, Total, Serum
6.8NORMAL
Reference Range: 6.0-8.5 g/dL
Albumin, Serum
4.3NORMAL
Reference Range: 3.5-5.5 g/dL
Bilirubin, Total
<0.2

Reference Range: 0.0-1.2
Alkaline Phosphatase, S
84NORMAL
Reference Range: 39-117 IU/L
AST (SGOT)
23NORMAL
Reference Range: 0-40 IU/L
Potassium, Serum
4.2NORMAL
Reference Range: 3.5-5.2 mmol/L
Sodium, Serum
142NORMAL
Reference Range: 134-144 mmol/L
Chloride, Serum
101NORMAL
Reference Range: 96-106 mmol/L
Creatinine, Serum
1.06NORMAL
Reference Range: 0.76-1.27 mg/dL
ALT (SGPT)
27NORMAL
Reference Range: 0-44 IU/L
Carbon Dioxide, Total
23NORMAL
Reference Range: 18-29 mmol/L
BUN/Creatinine Ratio
11NORMAL
Reference Range: 9-20
Globulin, Total
2.5NORMAL
Reference Range: 1.5-4.5 g/dL
A/G Ratio
1.7NORMAL
Reference Range: 1.2-2.2
eGFR If NonAfricn Am
94NORMAL
Reference Range: >59 mL/min/1.73
eGFR If Africn Am
109NORMAL
Reference Range: >59 mL/min/1.73
Estradiol, LCMS, Endo Sci
Estradiol, Serum, MS
69NORMAL
Cortisol, Serum LCMS, Endo Sci
Cortisol, Serum LCMS
15NORMAL
DHEA-Sulfate, Serum
DHEA-Sulfate, LCMS
203NORMAL
IGF-1
IGF-1(BL)
258NORMAL
Prolactin, Serum (ICMA)
Prolactin, Serum (ICMA)
25HIGH
Hook effect or prozone effect has been ruled out by performing additional dilution analysis on all prolactin testing. Reference Range: Children and Adult Males: 3 - 18

Testosterone Free MS/Dialysis
Testosterone, Serum (Total)
1214HIGH
% Free Testosterone (Dialysis)
3.0NORMAL
Free Testosterone, Serum
364HIGH
Sex Hormone Binding Globulin
Sex Hormone Binding Globulin
39.2NORMAL

TSH is 7.32 even after doing the iodine advice above. Prolactin is 25, cortisol is 15, e2 was 69


#2

On the TSH question, higher dosages of iodine can cause elavated TSH. I would wait until after the iodine supplementation to test thyroid. How long after? I would like to know as well.

More comprehensive thyroid labs are really needed to know whats going on, TSH is just the signal that the pituitary gland sends to the thyroid, and doesn’t tell us what is really going on. I would suggest adding these to your next labs:

TSH
Free T4
Free T3
Reverse T3
Thyroid antibodies

Ksman is also going to want to see some oral body temps, waking and mid-day without eating, drinking, or talking for 30 minutes beforehand.