T Nation

Subclinical Hypothyroid or Misdiagnosed?


#1
First I would like to say that I wish I would have come to this forum like 5 months ago. 

I’m 33 years Old and have been listing for at least 14 years.

Here is where my story, I’ll try my best to keep it short as possible.

This past January I was running a Epi Cycle 30/30/40/40. The first 2 weeks things were fine and I say about the 3rd week is when I started feeling some sides (Lethargic,occasional light head). I didn’t think much of these sides until one day I was out at a convention center for a expo when all of a Sudden I started to feel Off Balance and like I was going to pass out. I thought maybe I didn’t eat enough so I went to grab some food and I sat down for a while, it went away so I didn’t think anything of it. A week later the same thing happened to me at a theme park when I was with the family, this time that feeling lasted for over an hour.
I stopped the cycle started Tamoxifen and set up an appointment with my doctor. Doctor said I might have Vertigo based on Symptoms below, he ordered a Blood Test

Symptoms (these symptoms only happen in social areas never at home)
Light Headed
Off Balance
Nervousness
Pressure in front area of face above nose in between eyes
Brain Fog
Anxiety
Sensitive to Lights(Like my office lighting)

Blood Test 2/09/2016
FREE T4 1.4 0.8-1.8
TSH W/Reflex to FT4 5.54 0.40 - 4.50

Doctor Said that I may be sub Hypo and prescribed me with 50 mcg of T4, said to start off with only 25mcg and up after 7 days to full dose. Well I immediately started to have more issues, now I was having heart palpitations and racing heart along with panic attacks at work.

I went back to this doctor after 2 weeks to tell him I’m feeling crappier now, he said maybe I do have vertigo which will go away and told me to taper off the T4. After this I went looking for another doctor.

Blood Test Results for New Doctor (25 Days on T4) 03/16
Thyroglobulin Antibodies <1 < or > = 1 IU/mL
Thyroid Peroxidase Antibodies <1 <9 IU/ML
Free T4 1.3 0.8- 1.8 ng/dL
TSH 8.24 0.40 - 4.50 MIU/ml

My doctor placed me on Nature Throid and shes been helping me increase my dose slowly over the last few months. This is probably the first week where I’m starting to feel better. My temp is still in the low 97 range but it used to be low 96’s.

So I’ve been trying to figure out what happened with my Thyroid.
At the time of my issues in January, I was working lots of overtime, exercising everyday,restricting my calories and getting very little rest. I did notice that anytime I got up from say sitting at my desk, I would be light headed for about 5 seconds.
Prior to being diagnosed I didn’t have any of the typical HYPO symptoms. As I remained on the Thyroid meds I started to experience more hypo symptoms.

Could I have screwed myself by getting a blood test so soon right after a cycle? When I got my blood test I was running Nolva. Could my off balance issues just be caused by Anxiety? I’m wondering if that small dose of T4 just suppressed my natural thyroid hormones?


#2

There are stickies found here: About the T Replacement Category

Please study the thyroid basics sticky.

  • you can eval overall thyroid function by checking oral body temperatures
  • body temperatures can be a thyroid med dosing guide

Have you been using iodized salt long term to support thyroid function?
Are your outer eyebrows sparse?
General hair thinning?
Feel colder easier now?
Thyroid sore, enlarged, asymmetrical, lumpy?

We know that the increased/restored metabolic demands of TRT can whack some folks when thyroid functions is not able to support metabolic demands.

Please see these stickies too:

  • advice for new guys
  • things that damage your hormones

Do these labs:
TT
FT
E2
prolactin
LH/FSH
AST/ALT
CBC
fasting glucose
fasting cholesterol

Any changes to vision?
Reduced width of peripheral vision? - should be ! 180 degrees

Sleep effected?

Take thyroid meds when you wake up, better with more time before eating.


#3

Thank you KSman for the reply.

I have been reading all the sticky’ the last few days.

**For the last two months I’ve been keeping tracking of my body temperature upon waking up, afternoon and later in the evening. It fluctuates between 97.0 - 98, a few times it was 96.5. ***

Have you been using iodized salt long term to support thyroid function?

***I haven’t used any iodized in a long time, when salting food I stick to sea salt. I currently purchased Iodine liquid (J.Crows) from Amazon, but have read mixed reviews online about making things worst/better. ****

Are your outer eyebrows sparse?

No problems with eye brows

General hair thinning?

my hair has been getting thin for the last 6years,so I couldn’t say if this was due to high TSH

Feel colder easier now?

Before I was diagnosed, I was feeling colder in the winter

Thyroid sore, enlarged, asymmetrical, lumpy?

*I didn’t start feeling anything until they started me on T4. It would feel sore and almost a choking feeling at times. I had a ultra sound done about 3 weeks ago, they found a nodule less then a cm…doc blew it off.

We know that the increased/restored metabolic demands of TRT can whack some folks when thyroid functions is not able to support metabolic demands.

**I’m not on any TRT, last blood test done showed normal T levels per Endo

Do these labs:
TT
FT
E2
prolactin
LH/FSH
AST/ALT
CBC
fasting glucose
fasting cholesterol

*** I’ll look up my blood labs and post when I get home***

Any changes to vision?
Reduced width of peripheral vision? - should be ! 180 degrees

Well my vision doesn’t like bright lights, it takes a while for my eyes to adjust. As of lately since they upped my dose, my eyes get irritated and tired almost like reading a book too long without prescription glasses on.

Sleep effected?

My Sleep has improved since I’m not working out late at the gym anymore, I know get about 7hrs. I used to only average about 4-6 hours a night

Take thyroid meds when you wake up, better with more time before eating.

I take my thyroid meds at 5am and usually wait at least a hour before breakfast time*

Can it be possible that I didn’t have a thyroid issue and adding thyroid meds had suppressed my natural hormones? I know this happens with Test.


#4
  • but Epi Cycle does then fit the picture

When hypo for a long time, thyroid nodules can result and someone can progress to hyperthyroidism.

TSH does not cause hair thinning or most other symptoms, its the low fT3 that is the problem.

  • that is why selenium is essential

I see people been harmed by not using iodized salt all of the time. Iodized salt was introduced almost 100 years ago for very important reasons.

We see a strong association with hypothyroid or subclinical leading to secondary hypogonadism. And as hypo slows down every cell and organ in your body, the testes may be affected too.

Reduced peripheral width is an symptom of a pituitary tumor. Your other head/facial symptoms make be vigilant for such things. Prolactin lab test for prolactin secreting pituitary adinoma.


#5

Thanks KSman,Your knowledge is very much appreciated.

Here are my labs from 6/2/2016

TT 527 250-1100 Ng/DL
FT 89 35.0-155 Pg/ml
E2. 22. < or = 39 pg/ml
Prolactin 16.9. 2.0 - 18.0 Ng/Ml
LH. 3.3. 1.5 - 9.3 miu/ml
FSH. 1.7. 1.6- 8.0 miu/ml
AST 21. 10-40 u/l
ALT. 26. 9 - 46 u/l
CBC. 84. 65-99. Mg/DL
Ferritin. 66 20-345 ng/ml
Vitamin B12. 714. 200-1100 pg/ml
Magnesium Phosphate 5.1. 2.5 -4.5 mg/DL
ACTH plasma. 21. 6-50 pg/ml
Cortisol, total. 11.9. 4.0-22.0 mcg/DL

TSH. 5.1. 0.40-4.50
Total T4. 5.9. 4.5 - 12.o mcg/DL
Free T4 Index(T7) 2.1. 1.4-3.8
Free T4. 1.1. 0.8-1.8
Free T3. 2.6. 2.3-4.2
Total T3. 79. 76-181 ng/DL
T3. Uptake. 35. 22-35%

I’m not sure why the labs aren’t showing properly spaced out between ranges.


#6

Natural guys secrete LH and FT in pulses and both have short half life, so any single lab result might be a trough or a peak. Suspect the latter in this case. LH/FSH are typically near each other. FSH has a longer half life and is thus a better indication of LH status than LH itself. But we do see some contrary results some times.

Thyroid labs are very comprehensive. Definitely hypo.
But the big question is if this was strictly from iodine deficiency. If so, perhaps you can recover and not need thyroid meds.

So you doc(s) never asked about iodine or iodized salt? That seems to be normal.

Cortisol at 8AM? Might be a bit low, but may improve with time with better thyroid status.

Hematocrit?
RBC?

CBC is a group of blood counts, not a single item.

Prolactin shows some in-range elevation. Keep tracking this.

Thyroid meds do suppress TSH, TSH is high because T3, T4 are low. But sometimes also from elevated rT3.


#7

None of my doctors have never asked or mentioned anything about Iodine or Salt.
I think I will start self medicating with two drops of J Crows Lugols Solution I purchased from Amazon.

RBC. 4.70 4.20-5.80
Hemoglobin 14.8 13.2-17.1
Hematocrit 44.2. 38-50%
WBC. 6.6 3.8-10.8

Could my elevated magnesium be due to supplementing with it?

Current vitamins
Magnesium
Vitamin D
Selenium
Glucosamine
Fish Oil
Iron
B Complex Vitamins
GNC mens Multi


#8

You can take less magnesium.
Also in B-complex GNC products?


#9

If rT3 is elevated, its from tT4–>rT3. Then when you take T4 or T4+T3 medication, fT4–>rT3 increases.


#10

I take natures bounty b complex, which consist of Vitaimn C,B6 & B12.

From your knowledge, once Thyroid Hormones are normal does one go back to being like everyone else?

I’ll keep posting updates once I start adding iodine.


#11

Maybe not. Sometimes. Often there is more than one issue.