T Nation

My Results - What Do You Think?

T Replacement
#1

Hi Chaps,

37 years old. Used to be a fit lad. I found myself slowing down in my early twenties and was eventually diagnosed with hypothyroidism. Have taken T4 everyday for last 15 plus years.

I just ordered another set of tests as I have been trying to get back in the gym again, but I just seem to be fragile. As soon as I do slightly too much, eat too little or sleep less than perfectly, I keel over.

My results:

Total Testosterone 6.1 nmol /L (8.4-28.7)
LH 2.5 iu /L (1.0 - 10)
FSH 6.4 iu /L (1.0 - 10)
SHBG 17 nmol /L (17 - 66)
Prolactin 248 mu /L (0 - 375)
Free Testosterone 0.16 nmol /L (0.21 - 0.70)
Free Androgen Index is 35.9. (above 34)
Bio available Testosterone 3.76 nmol /L (3.5 - 12.0)

TT is obviously low, FT is obviously low, BT is obviously low. SHBG is low.

What are your thoughts on this? And what should I be aiming for in pursuing it with a Doc?

I am overweight and unfit and I would like to crack on now :slight_smile:

thanks guys

#2

In the UK? Docs there are mostly ignorant or hostile to hormone health.
Can you afford to pay for things out of pocked if needed?

You seem to have primary hypogonadism, testes do not work. Should have a physical exam to check for vascular problems or growths.

You need to do a lot of reading as a start.
Please read these stickies:

  • advice for new guys
  • thyroid basics
  • finding a TRT doc

Energy:
Check your body temperatures to eval your overall thyroid function. You might be under-medicated.
When you first wake up your oral body temp should be 97.7+, 97.3 is a problem and also check to see if you are 98.6F [37C] in the mid-afternoon.

Your fragile vitality could be adrenal related. Read the thyroid basics sticky, noting references to fT3, body temperature, TSH, fT3, fT4, rT3, adrenal fatigue, Wilson’s book.

Many with hypothyroidism cannot absorb T transdermals. Not known how that works out if thyroid meds are good. So injections would then be only option.

When not on TRT, LH and T are pulsatile, so FT and Bio-T labs are not good criteria. Your TT definitely demands TRT.

FSH and LH are usually similar numbers, but LH moves a lot. FSH is the better indicator. [FSH can be high with a FSH secreting testicular tumor]. Your FSH and low T suggests that your testes are the problem.

#3

Thanks for the reply; appreciate it.

Well, after years of reading about how negative docs are in the UK, Im going to find out. I have an appointment with a consultant on the 11th! - I’ll report back.

I’ve already had a conversation with a private doctor who said that if another blood panel showed the same thing, he’d prescribe me nebido - but it’s 950 gbp upfront and 750 every quarter. So it’s fixable over here even if your GP is not keen - but at a price!!

#4

Check your body temperatures. Low-T may be the symptom and treating the symptom and not the disease is a poor option.

#5

Hi KSMan,

You raise good points, thank you. I had stupidly omitted, from my OP, the thyroid results from that batch of tests:

Free T3 5.2 pmol/L (3.5 - 6.5)
Free T4 23.0 pmol/L (11.0 - 23.0)
TSH 0.99 mu/L (0.35 - 5.5)

For the benefit of others reading this who are going through the same thing:

I am fortunate to have private medical insurance. In the UK, however, you’re required* to see your National Health Service (“NHS”) General Practitioner (“GP”- family doctor) practice who then write you a referral letter for you to see the specialist of your choice thru the private medical scheme. (Yes, we think that makes no sense either :slight_smile:

Yesterday, I went to see a GP with some trepidation - as I was expecting a battle for referral. On the contrary - the Dr couldn’t have been more helpful!

She was completely sympathetic, mentioning that her husband has hypothyroidism and empathising with the symptoms I was describing. She investigated the specialist I’d chosen and thought he was a great choice. She ordered additional blood tests (Vit D, ESR and a bunch of others I can’t remember without the notes) so that I could take them all with me on the day - and she wrote the referral letter and a handy summary for him of everything so far.

Of course we had a discussion about ‘symptom versus problem’, and I made the point that I chronically abuse stimulants and sugar in order not to feel like crap - so absolutely accept that it may be lifestyle related, BUT we agreed that my fragility after even moderate exercise that’s surrounded by optimum nutrition and sleep is at least worth investigating. (for example - wary of KSMan’s pointer towards ‘adrenal fatigue’, I’ve cut out all stimulants and sugar, and have spent the last three weekends horizontal on a sofa, which is boring and a bit sad)

So - next stop, the endocrinologist this weekend. I’ll post back findings/ experience here.

Cheers!

*yes, there are ways around this, before someone jumps to correct me - however seeing your GP for referral is the ‘normal’ process