MASc Mech Eng - retired
The concern with an adinoma is blocking growth that puts optic nerves at risk. The adinomas do reduce LH/FSH, so a cabergoline trial should involve tracking LH/FSH and T. This might also improve dopamine and mood.
DHEA-S is high. DHEA is an adrenal hormone and adrenals may be part of the game. Lab AM Cortisol is done 1 hour after waking up.
LH and FSH are typically similar numbers. LH is released in pulses with a short half-life. So a lab result might be a peak or trough. Often FSH is a better indicator of LH status than LH itself, then suggesting secondary hypogonadism tendencies.
CBC is a bit thin and typical of low T levels.
Getting thyroid function fixed or TRT should lower cholesterol.
SHBG seems high, but FT allows for that. E2 now low, as little FT for FT–>E2.
First thyroid labs did not make sense.
Second set shows strong fT4 but low fT4, indicating impaired fT4–>fT3 conversion. Ferritin was strong, so low ferritin is not the cause.
You have not checked oral body temperatures and we need a discussion of how you get your iodine. In vitamins, dairy, sea food or iodized salt - which can be found there.
In this case, T4 meds would not seem to offer any value.
https://www.google.com/search?q=deiodinase+deficiency
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.