T Nation

Subclinical Hypothyroid, High Cholesterol and BP


#1

I'm curious has anyone here been treated for subclinical hypothyroid with TSH levels below 10 or even 5 mU/L?

Despite bathing my thyroid in iodine my TSH levels are increasing from last year:
Aug 2013 - 2.3
Dec 2013 - 3.9 (fT4-12.1 (10.5-20) fT3-5.6 (3.5-6.5)
Nov 2014 - 3.99 mU/L (0.30-5.5)

My morning temps are almost always low 35.8-36.1C (96.4-97 f) and midday temps are usually 36.4-36.7 (97.5-98 f) with the occasional 37c (98.6). My girlfriend also takes her temp and is always perfect so I know my thermometer is fairly accurate and consistent. As i sit here after sleeping for 4 hours in the middle of a saturday (which happens more than I'd like to admit) I"m at 36.2C.

I'm going to see if my GP will order fT4 fT3 and rT3 on my recent labs.

Also of concern is my lipid profile and BP

Cholesterol 5.56(2-5.2) Dec 2013
Cholesterol 5.8 Nov 2014

LDL 3.31 (1.5-3.4) Dec 2013
LDL 3.15 Nov 2014

HDL 1.12 >0.9 Dec 2013
HDL 0.94 >0.99 Nov 2014

Triglycerides 2.48 (0.45-2.29) Dec 2013
Triglycerides 3.76 (<2.21) Nov 2014

My BP ranges from 130/90 - 150/105 with an average of 140/95

I eat a pretty good diet high in fiber and I'm not overweight as far as bodyfat goes. I'm 5'7 and 195lbs but I don't have a belly.

Current protocol:

Test Cyp 25mg EOD yields TT 833 ng/mL
Anastrazole 0.25 EOD yields E2 21pg
hCG 250 units EOD

I'd appreciate any comments from those that have been down this road and how your response was to treatment if any.


KSman is Here
KSman is Here
#2

I assume that you have been getting selenium in your diet.

Any thyroid antibody tests?

Any factors for things that increase rT3?

Those new labs should be quite helpful, but the antibody tests would be useful as well.

Thyroid feels different?


#3

My diet is high in selenium. I eat 6 out of the top 10 foods regularly.

My thyroid doesn’t feel any different. I don’t palpable anything unusual but I’m sure it’s a difficult organ to feel when it’s normal.

I have had extreme mental stress lately so yes there is cause for elevated rT3

I will request tests on the same samples tomorrow for fT3/4 and rT3 as well as thyroid antibodies.

I wish I could convince my doc to get me on 25 mcg levothyroxine. I’m sure I’d feel 100% better.


#4

If rT3 is elevated, there are enzyme pathways causing that which favor higher fT4–>rT3

If you then take L-thyroxine, you will get more fT4–>rT3 and things can get worse. In that case, you would decrease fT4–>rT3 by taking T3 and you would then pursue other actions as per Wilson’s book on ‘Adrenal Fatigue’.

If rT3 is elevated, cortisol might be low and in that case, one might take a cortisol type drug as an other bridge while trying to resolve the causes.


#5

You could try supplementing vit K-2

https://www.lef.org/magazine/2009/1/vitamin-k-protection-against-arterial-calcification-bone-loss-cancer-aging/page-01


#6

The Dr. refused to order further tests. I am getting really tired of fighting for everything with these people. They haven’t got a clue how to treat endocrine disorders.

I’ll have a closer look at the K2 but I’ve gotta say I’m very skeptical of taking vitamins/minerals in the form of pills.


#7

I called the lab to ask about paying for my own tests and they said it isn’t even allowed without a Dr. requisition. Not only that but a reverse T3 test isn’t even available. I guess feeling sick is something I have to live with.


#8

[quote]C27 H40 O3 wrote:
I called the lab to ask about paying for my own tests and they said it isn’t even allowed without a Dr. requisition. Not only that but a reverse T3 test isn’t even available. I guess feeling sick is something I have to live with.[/quote]

http://www.privatemdlabs.com/lab_tests.php?view=search_results&show=2405&category=14&search=thyroid%20checkup#2405

Use the coupon in the upper right to get an extra %10 off.


#9

Thanks for the coupon but I’m in Canada.


#10

Vit-K2:

My dad had an irregular heart beat. Heart specialist wanted to put him on a drug to correct that. Dad reads about the side effects and method of operation and thinks that there were fundamental problems. He reads LEF articles and then gets vitamin K2 and that corrected the problem.

He as already taking a lot of vitamins and eating lots of green veges. So that was not enough. Perhaps some age related decline in absorption.

What is with the attitude about vitamin products? “skeptical”?

Supplements can increase HDL, but that might not be a conversation that you want.


#11

I can weigh in on a few items. My TSH was just over 5 when I went to my Doc and asked to be treated. I started on 75mcg a day of Synthroid. I woke up on day 7 and felt really, really good but chalked it up to placebo. It’s now been 2 years and I can’t believe I suffered as long as I did without getting my hypothyroidism taken care of. So, to answer your question, I was able to have my subclinical hypothyroidism treated (no goiter present) with a TSH of approx 5 and it made a tremendous difference.

My bp is so hugely variable I don’t even think it’s a helpful metric anymore. In the last 4 months, I have been measured by a nurse at 112/60, by a second nurse at 150/92, and by my home unit at 134/80. I’m either as healthy as a horse or about to keel over from hypertension…I give up caring about my bp anymore.

My lipids are great so I can’t help you there.

Lastly, 5’ 7" 195 is heavy. Do you carry the weight especially well?


#12

KSman, I truly appreciate your input. I’m not convinced that my BP is due to age related or inflammation processes such as atherosclerosis and calcification. I believe it is solely because of TRT and possibly muscle mass since I’ve been very consistently normotensive until just the past few months since I went up to 100mg/wk of Tcyp. I’ve lowered it to 70mg to see if anything changes. The rest of my protocol I will continue with.

As for my “skepticism” it’s mainly due to the many studies that have shown how frequently vitamins and minerals of various sorts can be much more harmful than once thought. The findings mainly show how necessary it is to focus on a food containing the wanted micronutrient to avoid these risks. Of course some I feel are fine, like Vit D and B vits but that may be found risky too one day. A good example is Vit E at one time cardiac patients were told to load up only to learn many years later that oops! huge corrolation with cancer!

Short term I’m fine with but taking a daily multi I feel is just too much risk. If I thought I could benefit from short term therapy such as with Vit-K I would be all for it but otherwise I would focus on how I can get it from a natural “live” food.

Dr. Pangloss, I suspect I too would benefit from synthroid. If I had the power I would self prescribe 25mcg daily and see how I felt after several days or weeks. In canada the diagnostic code for Subclinical hypothyroid requires a TSH of >10 mU/L otherwise a physician might be questioned for prescribing synthroid. So stupid. Maybe I can take an herb that harms my thyroid to bring my TSH up haha. Just kidding.

Yes I am pretty heavy for my frame considering when I was running regularly I was down to 156lbs. I’ve been back to lifting a little heavier since I sorted out my 10year chronic back pain. Since I work out 4-5 x wk I’ve added a fair bit of muscle. I could lose a little fat but only if I’m interested in taking pictures of myself, which I’m not.


#13

Well, according to the Dr. I saw today there isn’t a hope in hell of getting prescribed levothyroxine or even further testing. His opinion was that if there were thyroid antibodies the TSH would be much higher. I told him that most of the experts agreed that over 3.5 was a pretty clear indicator of thyroid dysfunction. He said if they were truly the experts in the field then the diagnostic criteria and test ranges would reflect that.

To some degree I want to agree as I feel sluggish and crappy but not like a truly sick person. On the other hand if I could possibly feel much better without negative permanent consequences of making a wrong diagnosis and taking unnneeded meds I would prefer to medicate.

You guys are lucky in the US to have so many shady pharmacies to order drugs from. None of that flies in Canada. They’re just too regulatory about drugs and drug quality to allow it.


#14

[quote]C27 H40 O3 wrote:
You guys are lucky in the US to have so many shady pharmacies to order drugs from. None of that flies in Canada. They’re just too regulatory about drugs and drug quality to allow it. [/quote]

The shady pharmacies aren’t domestic, they’re all Canadian, European, and Asian, lol.

Just find a pharmacy that sells steroids and they will most likely sell T4 in their ancillary section.

Oh, and I found this for you: http://www.naturesintentionsnaturopathy.com/medical-testing/medical-laboratory-testing.htm


#15

Those ones that claim to be in canada aren’t. They just call it Canada pharmacy. It’s a sham. There is however a legit canadadrugs but they charge a premium and require prescriptions.


#16

[quote]Dr. Pangloss wrote:

Just find a pharmacy that sells steroids and they will most likely sell T4 in their ancillary section.
[/quote]

I don’t think it would make it past customs.


#17

Midday temp of 96.2f and not a damn thing I can do about it. What’s the point of checking if doctors won’t do anything? Iodine didn’t do anything but mess up my guts.


#18

Get some vitamin K-2 and see what happens. Worst that could happen is nothing and then knowing that its not K-2 related.


#19

When I look at your numbers, I’m a little concerned with the lipid profile. A high cholesterol reading in and of itself doesn’t really bother me, but when triglycerides and LDL’s are high and HDL is low, then we need to take a second look. The trig’s in particular are something that you really should work to address.

A ‘pretty good diet’ is usually code for ‘I eat a lot of fast food’. The fact that you’re relatively heavy for your height, but have a solid body composition probably means that it’s just something that has slipped over a certain time frame. You are probably consuming too many fast-burn carbs…added sugars, refined grains, etc. I’m not a ‘carbs are bad’ type of a guy, but I do believe they have a time and place. They also tend to have an appropriate volume. Start on 150 grams/day of carbs and see how you feel. Reduce the amount of refined carbs. Take that to zero if you can. Eat the bulk of your carbs post workout, when your body is ready to turn it back into muscle glycogen.

You’re also going to want to turn up the cardio. Try to put in 3 hours of real cardio a week. Do a day of 100M sprints. Do a day of hilly hiking. If you can swim/bike ride a day, that’s good, too. I think the other things are very important, but you need to address the lipid profile.


#20

I’m being treated for hypothyroidism with labs less indicative of hypo than you (my TSH is 2.98), so doctors willing to prescribe more “radical” treatments exist. I got lucky finding such a doctor personally, but if I were you I’d search one out. Here are two lists to start with : http://www.thyroid-info.com/topdrs/canada.htm and http://www.thyroidchange.org/patient-recommended-doctor-list-canada.html.