T Nation

Low T Problem - Full Lab Info Provided

Some new lab results came in today:

B12: 355 g/L (180-700)
B9: 39 nmol/L (8-39)
Calcium: 2.32 nmol/L (2.15-2.50)
HbAlc: 34 mmol/mol (27-42)
Zinc: 14 mcmol/L (10-16)
Magnesium: 0.81 mmol/L (0.7-0.95)
S-transglut antibodies: <8 AU/ml (<8)
S-IgA: 0.9 (unit and ref range missing)
Gliadine antibodies: <18 AU/L (<18)

I’ll carry on supplementing Vitamin D (15000 IU/day)), iodine (0,5 mg/day), calcium (750 mg/day) and magnesium (750 mg/day) for another two weeks and check thyroid and T levels again. If I’m lucky, I’ll see some kind of improvement.

http://www.unc.edu/~rowlett/units/scales/clinical_data.html

Cortisol µg/dL 27.59 nmol/L

Cortisol = 11.7 is low for 9AM; 10 is the bottom level for the curve at that TOD

Ferritin ng/mL 2.247 pmol/L

Ferritin = 36, I think that we see that 80 or above is needed. But we need others to comment.

Stay with a lower iodine dose to see how that works. If no issues… you can see that I was taking 50mg/day for a few days… see my linked thread above. That amount can alter your digestion as a lot of bacterial cannot handle that, use some probiotics after.

your B12 level is terrible. Ideal is what? something like in the top 25% of the range.

yes. ferritin is terrible (Total Iron Binding Capacity test would validate that).

cortisol doesn’t look to good either.

Thanks for the input guys!

  1. Ferritin: I think levels are ok. The unit on my labsheet was mcg/L which is exactly the same as ng/mL, so 82 shouldn’t be terrible. I believe optimal levels are around 100?

  2. B12: from what I understand, it’s difficult to overdose on this but the difficult part is knowing how much to supplement… I’m thinking something like 1000 mcg per day?

  3. Cortisol: Not sure what I can do about that… I guess if the thyroid issue resolves, cortisol levels will improve?

Not going to review above for context. When RBC, hematocrit, ferritin and/or are low, one needs to suspect blood loss from conditions of the gut. If you have digestive problems, let us know. If you take anti-acids let us know. Gut problems can lead to low B12 too. Low T can also lead to thinner blood.

I did have digestive problems up until a few weeks ago, when I realized I was eating way too much fibre (40+ g a day). Since cutting down it, I feel a lot better. I’ve been eating a high-fibre diet for years after the advice of a doctor, so I’m hoping I haven’t suffered any intestinal damage from it…

I don’t take any anti-acids.

Below are some more test results:

B-Leucocytes: 4.7 10^9/L (3.5-.8.8)
RBC: 4.3 10^12/L (4.2-5.7)
Hb: 141 g/L (134-170)
Hematocrit: 0.42 (0.39-0.50)
MCH: 33 pg (27-33)
MCV: 97 fL (82-98)
MCHC: 335 g/L (317-357)
B-Trombocytes: 176 10^9/L (145-348)

RBC and hematocrit are lowish, suggesting a possible iron problem.

Ok, any theories besides gut problems? Could low B12 be the cause? The reason I’m asking is because, unfortunately, my doc (and most likely all other docs as well) think these values are fine and I really need to present valid arguments to warrant further testing.

B12 is made in the gut by bacterial and then must be absorbed. Gut conditions can interfere with both as can low stomach acid or anti-acids. Gut conditions can lead to blood/iron losses.

Low RBC and hematocrit can also be from low T levels. We do see guys here with both issues. So these need consideration.

You can take pro-biotics in case the flora in your gut is adverse.

I see, thanks for the info. Since reducing fibre intake, my stomach feels a lot better so I don’t think there are any gut issues. For now I’ll just keep supplementing vit D, calcium, magnesium, iodine and B12 and check blood levels in a few weeks time to see if T levels etc have improved.

thyroid needs cortisol to function.
testosterone need cortisol to function.

it is normally recommended to fix cortisol issues first, then thyroid, then hormones.

have you read the stopthethyroidmadness.com site? they have some great info.

Got it, I’ve been reading stopthethyroidmadness.com and Dr Guy Abraham’s research at www.optimox.com and feel less apprehensive now about taking mg doses of iodine. Iodoral isn’t available in Sweden and customs will probably confiscate anything I order from overseas so I’ll have to use Lugol’s solution instead, which works just as well.

Dosage is a problem since, as far as I know, no doctor here tests iodine levels and will only suspect a deficiency if goiter is present. This means I essentially have to rely on symptomatic dosage, i.e if I start getting palpitations, headaches, fever, brain fog etc, I’ll reduce the mg.

I’ve been taking 16 mg per day for two days now but I have absolutely no idea if I should take a higher dose to load up, for how long etc. I read in KSman’s thread that he took 50 mg for two days, then cut down to 25 mg so I might try that protocol as well. Any advice would be appreciated as I’m really shooting in the dark here…

I was taking 12.5mg daily for awhile, but felt that was too much so I reduced it to EOD, then back up to 12.5 daily.

There were side effects (hence my initial reduction), but I found out after an exchange with KSman that those can easily be attributed to bromine excretion. lack of Iodine enables bromide (and other halogens) to set up house in iodine receptors. taking iodine pushes the bromide out of your system. body odor, swollen lymph nodes, rashes, etc. can be caused by the bromide dump.

do a search for bromide iodine deficiency or combinations like that.

It was a leap of faith for me to start on the 12.5mg daily, but I think I would be hard pressed to take anymore then that.

Ok, how long did the bromine excretion symptoms last for you? The reason I’m asking is because I’m trying to get an idea of possible symptoms to look for and the duration in order to attribute them to bromine excretion (=good) or iodine excess (=not good)

Will google what you mentioned, thanks.

the body odor started with my feet and then spread to my underarms. completely reeked and no amount of deoderant seemed to help. it seemed to last around a week for each one. I am still taking the same dose and don’t have those problems anymore.

still trying to figure out the balance of my T3-only medication and my Hydrocortisone meds and what impact the extra iodine is having. I believe I can reduce my T3only meds but want to wait for me blood draw on Monday.

New blood test from 15th April:

S-Calcium: 2.55 mmol/L (2.15-2.50)
S-25-OH-vitamin D: 174 nmol/L (25-105)
S-TSH: 3.41 mE/L (0.20-4.00)
S-fT4: 12 pmol/L (9-22)
S-fT3: 3.2 pmol/L (2.5-5.6)
S-TPO antibodies: 0.6 kE/L (<5.6)
S-Tg antibodies: 2.2 kE/L (<4.1)
S-Testosterone: 12 nmol/L (>10 nmol/L)

Thoughts and conclusions:

  1. Vitamin D is up at optimal levels now after only one month of 15000 IU supplementation which is great (last blood test showed 49 nmol/L (19.6 ng/ml) which is severe deficiency).

  2. I still have major thyroid problems (freezing all the time, low body temp) as proven by the TSH value, despite being on 80 mg of iodine (Lugol’s) per day for one month. From what I understand, it takes 3 months of high-dose iodine supplementation to achieve optimum levels, so I guess I’ll just have to carry on and see what happens.

  3. Testosterone is obviously still way too low, but I can’t really affect that directly since I don’t want TRT. The treatment offered is either injections every 12 weeks or gels which I refuse.

  4. Both thyroid antibody tests came back negative, but I have read multiple articles stating that iodine supplementation can trigger Hashimoto’s and since I haven’t responded to iodine supplementation, I haven’t ruled out Hashimoto’s yet.

At the moment I feel I should just carry on supplementing iodine and see where that takes me in two months. My doctor is pushing me to start T4 treatment but I want to avoid that if this problem can be solved by iodine supplementation. Any input is appreciated!

I have no idea what the ideal range for FT3 is in pmol/L for pg/mL it is 3.3 to 3.9 (on a full lab scale of 2.3 - 4.2). based on that it seems that your FT3 is a little low.

knowing your Reverse T3, Ferritin, and 8am Cortisol could also help.

your Thyroid needs iodine, ferritin, and selenium to fully function and not enough cortisol can cause major problems.

if you get the extra tests and can confirm the need then you can take thyroid meds, which you can then wean off of later on.

  1. Based on the data at http://www.unc.edu/~rowlett/units/scales/clinical_data.html (courtsey of KSman), 3.32 pmol/L should be 2.078 pg/ml according to my calculations i.e not good.

  2. Ferritin and 8 am cortisol were 82 mcg/L (20-375) and 323 nmol/L (240-730) from previous tests (see page 1). 82 mcg/L is the same as 82 ng/ml so ferritin is ok, but cortisol is too low.

  3. As for rT3, my doctor refused testing so I’ll have to do some work to get that value.

Sorry for bumping, but I’m wondering if my slightly elevated calcium level should also be a cause for concern?

yes it can.

high calcium levels may be a sign of too much d25-OH (I think, but am not certain). I know there is some connection between D25-OH and Calcium, but haven’t done enough research on that exact topic.