T Nation

Low Test & Questionable Thyroid


#1

Hey guys, I'm new here and was hoping for some help/advice (Yes I read the stickies). Just took my temperature at 3:30 p.m. and it was 97.6 degrees. I will take it in the morning after I wake and see where it is at. I also started taking Iodoral today at 25 mg...I will see if it helps.

My Story:
25 yrs old
160 lbs
5'11

Plagued by fatigue and feeling awful since puberty. At age 17 I started getting labwork done and noticed that my T levels were low. I have 8 years worth of labs but am having trouble interpreting everything.

Symptoms:
-brain fog
-fatigue
-cold hands/feet and cold intolerance
-low sex drive
-low drive in general
-very little facial/body hair
-difficult time putting on muscle despite working out religiously 3-4 x per week (compound heavy lifts, 3-4 sets per workout at 6-8 reps per set). Calorie intake was sufficient (2500-3000 calories per day).
-social anxiety
-hoarse voice (kind of shaky and unconfident sounding)
-depression

Labwork:

09/06/13 - I had been on Clomid for 5 days - stopped taking it because it caused panic attacks.
T3 Free 3.2 (2.3-4.2 pg/mL)
T3 Total 83 (60-181 ng/dL)
T3 Reverse 17.8 (9.2-24.1 ng/dL)
T4 Free 1.1 (0.9-1.8 ng/dL)
TSH 1.39 (0.34-4.82 uIU/mL)
DHT 35 (30-85 ng/dL)
Estradiol 24.4 (7.6-42.5 pg/mL)
Free Testosterone 10.1 pg/mL (9.3-26.5 pg/mL)
Testosterone Total 503 (348-1197 ng/dL)
LH 5.500 (1.7-8.6 mIU/mL)
FSH 2.5 (1.5-12.4 mIU/mL)

07/30/13
Estradiol 15.7 (7.6-42.6 pg/mL)
Testosterone Free 7.4 (9.3-26.5)
Testosterone Total 410 (348-1197 ng/dL)
SHBG 36.4 (16.5-55.9 nmol/L)

09/12/12
AST (SGOT) 19 (13-34 U/L)
ALT (SGPT) 18 (5-42 U/L)

06/15/11
T3, Free, serum 2.9 (2.0-4.4 pg/mL)

06/20/11
Cortsol AM 7 (13-24 nM)
Cortisol Noon 10 (5-10 nM)
Cortisol Afternoon 13 (3-8 nM)
Cortisol Night 11 (1-4 nM)
Insulin Fasting <3 (3-12 uIU/mL)
Insulin Non-Fasting <3 (5-20 uIU/mL)
Progesterone 21 (22-100 pg/mL)
Total Salivary SigA 12 (25-60 mg/dL)

10/30/2010
TSH 1.67 (.40-4.10 uIU/mL)
Free T4 1.4 (0.9-1.8)
DHEA Sulfate 226 (80-560)
Cortisol AM 22 (7-18 ug/dL)
Prolactin 16.0 (2.5-17.0 ng/mL)
T3 Free 3.1 (1.8-4.2 pg/mL)
Testosterone, Free 11.2 (9-30 ng/dL)
Testosterone, Total 430 (240-950 ng/d)

10/14/2010
Testosterone Total 419 (270-1730 ng/dL)
TSH 1.11 (0.40 -4.10)

08/26/10
ACTH 13 (5-48 pg/mL)
Testosterone Total, 379 (241-827 ng/dL)
Testosterone Free, 15.46 (5.00-21.00ng/dL)
% Free Testosterone, 4.08% (1.50-4.20)

08/10/09
FSH 2.2 (1.1-12.5 mIU/mL)
Prolactin 8.74 (3.28-19.68 ng/mL)
LH 3.3 mIU/mL (0.8-7.6)
TSH 0.57 (0.49-4.67 uIU/mL)
Free T3 2.7 (1.5-3.5 pg/m)
Free T4 1.35 (0.71-1.85 ng/mL)

07/06/09
TSH 1.757 (0.450-4.500 uIU/mL)
T4 8.2 (4.5-12.0 ug/dL)
T3 77 (85-205 ug/dL) - this is the only time one of my thyroid hormones has been out of range.

06/30/09
T4 Free 1.47 (0.61-1.76 ng/dL)
TSH 1.070 (0.450-4.500 uIU/mL)
Testosternoe Total, 384 (241-827 ng/dL)

08/08/07
Testosterone Free, 440 (350-1030 ng/dL)

I know that is a lot of info to take in...and my readings seem to be all over the place. From a thyroid standpoint can you guys deduce anything? I have had to quit my job because the brain fog and fatigue are too much. I think I probably have Adrenal Fatigue...and have had it for a long time - what can I do to help this, besides reducing stress?


#2

Any labs done in docs office after thyroid is palpated are suspect!

Temperature when you wake up is good. During the day, you cannot be talking, eating, drinking or exercising for a while.
Cold hands and feet are indicating functional hypothyroidism. fT3 looks perfect, but can be blocked by elevated rT3. rT3 can be high from chronic stress/infection/parasites/over training/starvation diets. Get Wilson’s book from amazon.

So why are you not discussing iodine history? With all of those labs, has a doc ever asked about iodine?

AM cortisol was really bad. Progesterone is the precursor of cortisol. You can get KAL [2%] OTC progesterone from good health food shops or amazon.

FSH is the best indicator, it is low. Need to have all of your labs, including liver AST/ALT. At your age, MRI might be justified looking for problems with pituitary. Any bad blows to the head when you were growing up?

DHEA seems low for a young man.


#3

[quote]KSman wrote:
Any labs done in docs office after thyroid is palpated are suspect!

Temperature when you wake up is good. During the day, you cannot be talking, eating, drinking or exercising for a while.
Cold hands and feet are indicating functional hypothyroidism. fT3 looks perfect, but can be blocked by elevated rT3. rT3 can be high from chronic stress/infection/parasites/over training/starvation diets. Get Wilson’s book from amazon.

So why are you not discussing iodine history? With all of those labs, has a doc ever asked about iodine?

AM cortisol was really bad. Progesterone is the precursor of cortisol. You can get KAL [2%] OTC progesterone from good health food shops or amazon.

FSH is the best indicator, it is low. Need to have all of your labs, including liver AST/ALT. At your age, MRI might be justified looking for problems with pituitary. Any bad blows to the head when you were growing up?

DHEA seems low for a young man.

[/quote]

All of the thyroid tests were performed several days after the Dr. appointment, so I don’t think palpation is an issue.

I haven’t had anyone suggest iodine…which is surprising because I have been to see probably 20+ different doctors over the past eight years. I should probably start supplementing with DHEA more. I was using it a while back…around the time of the test (almost 2 years ago) and didn’t really notice much alleviation of symptoms…maybe I wasn’t taking enough. How much is recommended per day? I think the bottle I have is 50 mg per pill.

I did have a MRI or CAT scan of my pituitary…I can’t remember which it was. It was performed by an endocrinologist I found that actually listens to me. He said my pituitary looked fine. I have had several concussions over the years (4 that I can remember)…most of them when I was a child.

I have found a doctor that is willing to prescribe me TRT and possibly thyroid hormones. He wrote me a prescription for Test Cyp 100 mg per week, self injections as well as 300 IU HCG 2-3 x per week and Arimidex 0.5 mg EOD. I have not filled the prescriptions yet b/c going on Testosterone is a big and lifelong commitment.

I do have a couple of questions about TRT:

1). TSH is released by the pituitary. If you go on TRT you are suppressing the pituitary…does that mean that your thyroid will become suppressed as well?

2). Does TRT affect HGH levels? Same line of reasoning as question 1, HGH produced by pituitary.

I do feel stressed out all of the time…probably because of the elevated cortisol levels. I am going to have another 24 hr salivary cortisol test performed soon. On a side note…my cold hands and feet tend to get better during meditation and also from taking L-Tyrosine.


#4

I also added my AST & ALT numbers to the first post.


#5

Morning body temperature?

TRT and TSH are not directly coupled. But low of one can lower the other in some cases.

Some think that TRT can increase hCG, but don’t count on that. You need IFG-1 labs to determine GH status.

You will never feel DHEA as a health boost, does not mean that it is not needed. 25mg might be excessive, do labs.

Your elevated rT3 and stress go hand in hand. Get Wilson’s book on adrenal fatigue.