25 Y/O, Hypothyroid, Low T, and Adrenal Fatigue...Please Help

Pharma TRT
1

Long time lurker, first time poster.

Background:

Diagnosed hypothyroid seven years ago. I was on Unithroid (T4) up until this past February when I decided to learn more about my condition and had my Doc investigate why I was hypo. I also requested adding Cytomel (T3) to my Unithroid b/c a lot of thyroid support sites and books I’ve read advocated the addition of T3. Definitely noticed an improvement.

My search for the underlying cause yielded Hashimoto’s as the culprit, which has since helped me adjust my diet to accommodate this variable. However, even though my thyroid numbers improved significantly after the addition of cytomel, along w/ a few symptoms I also assumed were normal to my disposition, I still knew something was up w/ my adrenals.

I decided to have my Doc test my T levels b/c I read that some hypos have issues w/ T as well. Turns out I’m one of them.

July 2, 2010
Total T: 187 ng/dL (250-1100)
Free T: 35.7 pg/mL (35-155)
T3 Total: 1.29 (.87-1.78)
Free T4: 1.24 (.58-1.64)
TSH: .02 (.3-4.20)
DHEA Sulfate: 428 (7-391)

I decided to go on Alpha Male stacked w/ Receptor Max (remember reading one of the authors here say that their T always tested better when on it) along w/ Rez-V and ElitePro (I’ve taken these last two for awhile now – especially Rez-V). I also cut back on heavy lifting volume and tried to dial in my sleep and diet.

Most recent T results:
Total T: 3.44 ng/mL (1.75-7.81)
Free T: 7.4 pg/mL (9.3-26.5)

After seeing this, I continued my Testosterone education and found this forum where I discovered the additional tests a lot of Docs fail to request.

Ferritin: 113.2 (19-323)
Vitamin B12: 921 (180-914)
Transferrin: 175 (180-329)
Iron: 106 (33-164)
Prolactin: 3.92 (2.64-13.13)
Progesterone: .8 (male reference range – .1-.8)
LH: 1.3 (1.24-8.62)
FSH: 3.44 (1.27-19.26)
Estradiol: 34 (0-47)
Dihydrotestosteron: This test was canceled due to insufficient sample
SHBG: 37.3 (14.5-48.4)
di-OH Vit D: 69.9 (10-75)

Still waiting on a few others. But having seen this, I know some stuff is out of range and definitely affects my life.

For the last couple years I’ve dealt w/ fatigue issues, libido issues (almost non-existent at this point), and ED issues. I also go through periods where I have to force myself to go out in order to maintain a social life. Often times I’d prefer to sit at home and read or watch TV by myself.

I’ve also had periods where I feel on top of the world and nothing can stop me. And others where I feel like I’m pretty worthless. I’m still fairly lean but have always carried more fat around my chest, low back, and obliques. Considering how strict I am w/ diet and training discipline, I know I should be more lean than I am.

For a long time I assumed the way I felt paradigm towards life was “my normal,” but having found this board, I realize there are others out there, and change is possible.

One thing about me…and I realize it’s the same for a lot of you on here…I definitely go through hormonal fluctuations. When I first went on the Receptor Max, I had morning wood for the first time in a long time, along w/ stronger erections. I was also more cut, energetic, and positive. It has since worn off.

At the time of my last blood test, I felt better than my normal, but not the peak (first week of Receptor Max), so I definitely think some of my ranges are worse than the test show.

Most recently I’ve learned I’m gluten-intolerant (hashimoto’s related), so I took that out of my diet last week (I was mostly gluten-free up until then, minus weekend cheats). I’m hoping this helps stem a lot of the inflammation in my body, and clears up my adrenals, so they can function properly. I’m hoping to stay off TRT.

Any input/suggestions? A lot of you guys have already been a huge help to me w/ your posts to others in similar positions, and I hope to find better direction w/ my specific case. My Doc is great in the sense that she’s open to all of my suggestions and gets advice from specialists per my requests. However, she is one of those Docs that thinks bc I’m in the reference range, I’m fine (even though it’s the low end). The first thing I’d like to try is bringing my estradiol down and seeing if that raises the T? Any thoughts?

Appreciate it…

Kerbs

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Your E2 is too high and relative to your FT levels, way too high. Lower E2 and FT might improve. You would benefit from 0.5mg anastrozole per week in divided doses. Read and understand issues re anastrozole over-responders.

There is a problem when you switch labs, another unknown.

TT increased, but FT is still tanked. You need to improve FT to feel better. When FT is below range, TRT is justified even if TT looks good. Most of your TT is SHBG bound T that is not bio-active and it cannot release T to any tissues.

Taking DHEA?

Are you using iodized salt?

Are you taking any meds that might increase E2 levels?

You really look like someone who needs and would benefit from TRT. You might be able to make some headway. Your approach is excellent.

At your age, your pituitary should be scanned with a MRI to check for an adinoma or other physical problem.

Do not test DHT, it simply will be low… then what? If you improve T status, DHT will improve.

Do you feel that you have unresolved symptoms of hypothyroidism?

You could consider hCG mono therapy.

You could try the SERM Nolvadex as a challenge and see if LH/FSH levels and T increase. If not, the top end of the HPTA would appear to be broken. You could try clomid, but there is a risk of deep estrogenic sides for some. If the top end of the HPTA is not working, you will not get very far attempting to ‘recover’ and would be better off injecting T.

If you are short, stocky and hairy, your T levels were high as a teen. If tall and little body hair, you have always been a lower-T guy. If one has been high T then gets levels like yours, life is hell. If one’s T levels never were high, then the same low T levels are more tolerable.

Your low prolactin is unusual. Possibly in association with something abnormal in your pituitary… just speculation.

Have you lost any peripheral vision? Check each eye. This can indicate pituitary problems as the optic nerves go right past the pituitary.

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This is just an observation but has anyone else ever noticed that everyone on here is absolutely perfect in terms of diet?

4

KSman…I really appreciate the feedback.

Concerning your questions…

  • Taking DHEA? NO
  • Iodized Salt? NO – (have read iodine supplementation is bad for Hashimoto’s)
  • Meds that increase E2? NO
  • Unresolved thyroid issues – Complicated – Many hypo symptoms are similar to low T symptoms, so I generally have to rely on labs for managing the thyroid. Since the addition of cytomel, labs have been consistently better and in range, and I’ve felt better (but not 100%). I’m confident I’ve addressed thyroid as well as I can in terms of medication and diet. I think my issues now are more T related (even though I realize everything adrenal related is interconnected)
  • Peripheral vision – NO problems

Concerning body type…Have always been tall (6’3 235 and fairly lean for the last couple years). Body hair is normal but have had periods of bald spots on legs. Never have been a hairy guy. The men in my family grow very weak beards. I suspect low T has always been a norm for me – especially w/ the thyroid issues.

I also went on Accutane early in college, and many of my issues started after taking that. I always assumed my problems were thyroid related and just accepted them as “my normal.” I only started to learn more about the thyroid and the rest of adrenals after working a night shift for nine months (finished that 3 mos ago). Had sleep problems and auto-immune issues due to the stress of waking up for work around one in the morning.

Again, have definitely noticed an improvement since dropping gluten from the diet (caffeine too). My plan moving forward is to stay consistent w/ my diet, manage workouts better, and improve gut issues. Have not consulted w/ my Doc yet, but I think will suggest either anastrozole or nolvadex as the next step, and see if bringing down E2 helps boost natural production. Any have better success w/ one over the other?

If those alone don’t do anything, will then consider hCG mono therapy.

Thanks again.

5

Yes, iodine supplements can make this condition worse in some cases.
Is an iodine deficiency good for Hashimoto’s?

What gut issues? Using probiotics?

Natural high DHEA-S is a significant piece of data relative to potential adrenal problems.

6

Hashimoto’s is not due to iodine deficiency nor is a deficiency necessarily good. Supplementing with it is most likely to make matters worse, by aggravating an already weakened thyroid gland. Supplementing often enlarges the thyroid, causes tenderness, and the whole body becomes shaky and exhausted for several days.

Concerning gut issues, I’ve experienced periods of an inflamed and leaky gut (alternating between diarrhea and constipation – mostly constipation). I’ve read that constipation can impair hormone clearance and cause elevations in estrogen, which in turn raises thyroid-binding globulin (TBG) levels and decreases the amount of free thyroid hormones available to the body. Also, low thyroid function slows transit time, causing constipation and increasing inflammation, infections and malabsorption.

My guess is stress in the gut provoked a lot of the autoimmune issues I’ve dealt w/ in recent months. I’m hoping the elimination of gluten coupled w/ the probiotic I take everyday (30 billion cfu) resolves this issue; thus, improving absorption in the GI tract and mitigating the overactive immune response in my body.

Is it likely that my high DHEA-S is converting to estrogen, thus causing my high E2?

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I personally had issues on DHEA 50mg daily (DHEA-S levels of 148 pre-supplement up to 400-600 post supplements), but it took me a year to figure out that was contributing to my estrogen problem.

On 50mg DHEA I had to take .75mg Arimidex daily at specific times or else my prostate started aching and swelling. Once I stopped the extra DHEA, I was able to reduce my Arimidex down to .25mg daily or EOD with no prostate issues.

everyone’s body/genetic code is different. mine seemed to convert exceess DHEA to T to E2 in an extremely fast cascadng action.

I also stopped Revertasol which I see that you were on as well. Revertasol is suppose to be an anti-aromatase supplement, but I wonder if it reacts the opposite in certain people with certain genetic markers and increases aromatase?

all I know is that stopping the DHEA (and possibly Revertasol) had a major positive impact for me.

I would recommend considering cutting out all “extra” supplementation until you can get to the core issue and address it.

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There seems to be a link between accutane and bowel diseases, at least the lawyers thing so: accutane lawsuit - Google Search

This might also be of interest: Vitamins and Supplements Rooted in Science - Life Extension
Could help the gut recover.

9

Ha, just as I click on the link, I see a commercial for a class action lawsuit for accutane users suffering from similar issues as me.

I recently read something about glutamine and gut health but have yet to buy any. Plan to head out right now and get some. Thanks.

PureChance, thanks for the advice. I think I will cut all supps for a bit, get retested and go from there.

10

Discussing options w/ my doc tomorrow. Any advice regarding estrogen control. Should I try nolvadex first to see if I can restart everything then maybe try anastrozole once off the nolvadex to manage E2? Or just go ahead w/ the anastrozole first?

Or…with my numbers, should I just go ahead and jump into hcg monotherapy w/ anastrozole? Any advice regarding a good starting point for dosing, so I can discuss it w/ my doc if we decide on this approach? Is there no going back if monotherapy is the route I take first?

Lastly, anyone out there have experience w/ any of these protocols while also taking thyroid medication (I’m currently on 175mcgs unithroid and 15mcg cytomel)? Wondering if you’ve had to adjust thyroid doses once on TRT. Thanks.

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No!!! Nolvadex and hypothyroidism do not go well together! Stick to anastrazole.

EDIT-I added in a link for you. Tamoxifen increases the thyroglobulin concentration=not good. Scroll down to the bottom and it gives you a list of things that interfere with your thyroid hormones. You have to register at Medscape but it’s free and takes like 2 seconds. Definitely worth it IMO.

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Thanks for the link JL. Great site.