heartburn and refux: Using heart burn medications can cause multiple mineral deficiencies. If magnesium deficient, you might get leg or foot cramps or be able to tighten a muscle and have it start to contract by itself. Can also affect Vit-B12 absorption. Your B12 is good! You are taking magnesium!
AM cortisol very low: - labs should be 8AM or 1 hour after waking up.
ACTH might be low and causing this. ACTH can be tested. Then you get ACTH injection and wait for a while, then cortisol is tested and should be quite high. If cortisol is then low, the problem is in your adrenal glands. I did see that one high reading, may not happen again. Were you freaked out by the blood samples?
Anti-TPO is high
This is thyroid auto-immune disease.
Can easily be caused by a history of selenium deficiency and low iodine intake would make that worse.
TSH=1.62, 1.82: Should be closer to 1.0
Thyroid lab ranges are useless.
TSH can be up from iodine deficiency and from thyroid been attacked by anti-bodies.
Body temperatures are good. fT3 is there and doing its job and overcoming whatever rT3 is there.
Please provide your long term history of using your iodized salt.
Any iodine or selenium in your vitamins ? - history and amounts
Do you feel cold easily?
Is your thyroid enlarged, sore or lumpy?
Are your outer eyebrows sparse?
IGF-1 is very low for your age.
DHEA-S is low for your age. DHEA is an adrenal hormone. DHEA-->T inside your testes. Pregnenolone-->DHEA in your adrenals.
Lower LH/FSH, IGF-1 indicating low GH and perhaps low ACTH can be pointing to the pituitary that appears good on a MRI. You need to test ACTH. When there are three or more pituitary insufficiencies, the term 'pan hypopituitarism' can be found. Noting that the pituitary has no problem creating TSH.
With low cortisol and low DHEA we also look for a possible connection there as well. Then your history of stress can be a factors and your current health problems are a stress. Exercise when your natural energy levels can be very stressful and harmful. We see that many young guys can train on adrenalin.
Back to thyroid and auto-immune: In your current state, you should avoid larger amounts of iodine. You should select vitamins that have 200mcg selenium and be on that for a couple of months to see what happens to anti-TPO. Large dose iodine now could lead to Hashimoto's thyroiditis. Vitamin C and other anti-oxidants are helpful. Natural source Vit-E may also help with the free radical damage that is the cause.
With TT=16, SHBG was elevated, perhaps as a result of elevated E2 earlier.
FT was decent, FT can change hour to hour.
On TRT with high T levels, we see that guys do very well near E2=80pmol/L. Getting E2 lower would require anastrozole. You could ask for 0.25mg twice a week and TT, FT, E2 should improved. SHBG is slow to respond. Or go right to TRT.
Two years ago: Was there a blow to your head before this started?
TRT: -ask for
Self-inject 50mg T subq twice a week, #29 1/2" 0.5ml insulin syringes
250iu hCG subq EOD #31 5/16" 0.5ml
0.5mg anastrozole at time of T injections
You are growth hormone deficient. Can you get on GH injections if a second IGF-1 lab comes in low? At your age, GH levels should be good and can only get worse with age.
You are DHEA deficient and your DHEA levels should be at a lifetime peak at age 25. Try to get 25mg DHEA. Take with meals that have lower fiber and higher fats/oils. Same for Vit-E, Vit-D3 and fish oil.
In your climate, you need 5000iu Vit-D3, take 25,000iu for 5 days and 5000iu after that.
Hopefully you can get off of the AD meds in time.
This is about the most I have ever provided. You have a lot of work to understand it all.
Please read the stickies found here: https://forums.t-nation.com/t/about-the-t-replacement-category/38/2?u=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.
KSman is simply a regular member on this site. Nothing more other than highly active.