T Nation




30 y/o male, been training for 10 years.
6’0", 190lbs, ~16%BF
285lb bench, 250lb squat, 275lb deadlift (hx of lower back surgery)

-Inability to put on lean muscle mass—I gain almost exclusively fat (this is not my norm).
-Strength has hit a plateau
-Difficulty concentrating, in a fog (I’m a fighter pilot—not a good thing)
-No sex drive/interest. Trashed a great relationship because of this.
-Erectile dysfunction
-No energy at all during day—heavy reliance on caffeine
-I can sleep all day. 10, 12, 14 hours is no problem—I still wake up tired.
-Possible inflammation in lower neck. I feel constant pressure/ache below my Adams Apple, like my trachea is being gently squeezed.
-Irritability, easily stressed, anxious. Nothing excites me anymore. ‘No fucks given’ attitude—and not in the good way.
-Morning oral temperature in the mid-high 96s.
-Cholesterol and BP have been rising over the last six months. HR is stable in the mid-50s.

Attempted corrective actions:
-Initially suspected low testosterone, so I went to the flight doc and had testosterone labs done. He only drew total test: 426. That was the morning after a heavy squat workout, so I’m sure it is actually lower.
-Did a half-assed thyroid panel. TSH of 3.21 and Free T4 of 1.17. TSH seems high.

Our flight docs are pretty green, so I figured I’d ask for a sanity check here before demanding an endocrinology consult and potentially getting grounded. Thoughts?


TSH of 3.21
Free T4 of 1.17

TSH should be closer to 1.0
fT4 seems a bit below mid range, need lab units

"Possible inflammation in lower neck. I feel constant pressure/ache below
my Adams Apple, like my trachea is being gently squeezed"
That is where your thyroid is.

Thyroid looks enlarged?
Lumpy or asymmetrical?
Sore - yes
Low body temps? -yes

What is your history of [not] using iodized salt?
Restaraunts typically do not use iodized salt or put i shakers.
Processed foods and prepared meals - same problem.
Find out what what is used at your base.

Thyroid labs:
fT4 [want free thyroid hormones, not T3, T4]
If you can get these:
thyroid autoimmune panel

Please follow these links in 2nd post of 1st forum topic:

  • advice for new guys
  • things that damage your hormones
  • thyroid basics explained

Low thyroid function causes weight gain, low energy, low initiative, mood problems
You might have an iodine deficiency.


You can do labs on your own via lef.com and get the blood work done here: https://www.labcorp.com/wps/portal/findalab


With LEF, its cheaper to get a membership then the labs.

There are some other sources for DIY labwork. Perhaps others will provide references.
we can provide better responses to your lab work than most doctors.