Started changing the way I apply my cream since a few days ago… instead of to the shoulders/chest, I started applying to my forearms and inner upper arms where skin is thin and blood vessels are visible.
Feeling better today, perked up a little. I know I am close to getting myself dialed in… it’s just a matter of making sure I get the T I need, plus keeping stress levels down. Doctor wants to see me for a follow up next Monday, will be interesting to see what his next move is going to be.
Got myself a liquid thermometer (don’t think digital is accurate) and started recording body temps, got 97.2 at noon reading. Have a hard time believing I can hit 98.6 unless my adrenals are messing around with my temperature. A clear hypothyroidism indication, along with TSH level above range at 4.6, way above the “optimal values” of between 1 and 2.
Why is it that I don’t feel the classic hypothyroidism symptoms, though? I mean, I feel fine. Not great, but not terrible. Just OK. Weren’t for the low T finding in 2010, I would have no idea that something is not right.
EDIT: After playing around with the thermometer, I had to shake it and try again, and got a reading of 98.4 not long after the first time. Took afternoon and evening readings and both were 98.4 again. Disregarding the initial and erroneous 97.2 reading.
More body temp data the last 3 days:
Aug 23:
Waking: 97.4
Noon: 98.4
Aftn: 98.4
Evng: 98.4
Bedtime: 98.0
Aug 24:
Waking: 97.2
Noon: 99.3 (recall measuring temp too soon after eating hot food)
Aftn: 98.2
Evng: 98.8
Bedtime: 97.5
Aug 25:
Waking: 97.5
Noon: 98.6
Aftn: 98.6
Evng: 98.2
Bedtime: 97.3
If ONLY looking at the waking temps, one can conclude that I am slightly hypothyroid (<97.8). HOWEVER, I DO hit 98.6 during the day. If using Dr. Rind’s method, averaging only the noon, afternoon, and evening temps, I am in the 98.4-98.8 range for daily average temperatures in those 3 days. If I throw out the likely erroneous 99.3 reading, I get a more stable 98.4-98.5 range.
Daily average temps appear to be more or less stable, so adrenals seem to be OK.
Only problem seems to be low waking temps and high TSH. If not for hitting 98.6 during the day, I would take this as a cue to push for thyroid meds. But I don’t know if I really need those meds for now. Maybe I can convince my doc to switch me to T injections, and if I DON’T feel better, then I could ask for a “trial” of lowest-dose Armour or Cytomel.
Am I making sense?
DOCTOR APPOINTMENT UPDATE:
Doc was also surprised at the low T result, but said that if I am feeling well and erections are good, he’s not motivated to change my prescription. However, if T is still low at next round of testing (we will retest in a month, more on this in the next paragraph), he may move me to injections. He said he’s flexible and is not “married” to the the creams. I’m willing to wait another month on the cream and have myself retested.
The high TSH got my doctor’s attention. After rambling a bit about the pituitary-thyroid gland interaction (something I already know), he said he wants me to take my waking body temperatures every morning for 1 month and report the results to him in our next appointment. He ordered a full thyroid panel and a lipid panel (as well as testosterone), and the blood work will be done on Sept 23. If my TSH comes back still-high or my body temps come in too low for his liking, he will put me on thyroid hormones.
Morning temps stayed the same (97.2-97.5), but the last 2 days I did NOT hit 98.6. Maybe 98.0-98.4 at best, stayed in the 97’s most of the day. Felt like shit both days. Headache, fatigue, wanting to crawl into bed and shut the world out.
Not to be Captain Obvious, the closer I get to 98.6 and the longer I stay above 98.4, the better I feel… very telling. Good to have more data on myself and how that correlates with how I feel.
MORE LABS.
Lipid numbers look not-so-good at best, terrible at worst. Lab’s own assessment is that I have dyslipidemia. I even have insulin resistance. High homocysteine.
You’d think I’m a fat guy with a heart attack waiting to happen, but I’m not… I’m thin and athletic. Looks like under-the-hood things aren’t so good.
TCHOL 198 <200 mg/dL
HDL-C 64 >39 mg/dL
LDL-Ct 126 <100 mg/dL
TRIG 113 <150 mg/dL
N-HDL-C 134 <130 mg/dL
LP(A) 33 <30 mg/dL
Lp-PLA2 DSX 176 <200 ng/mL
NTPROBNP < 6 < 125 pg/mL
SDLDL 33 <21 mg/dL
sdLDL:LDL - Ratio 26 <26
HDL2 17 >11 mg/dL
LDLP 1424 <1000 nmol/L
HDL Particle Number 37.7 >= 30.5 umol/L
Small LDL Particle Number 724 <= 527 nmol/L
LDL Size 21.0 > 20.5 nm
Large VLDL-P 2.8 <= 2.7 nmol/L
VLDL Size 48.0 <= 46.6 nm
Large HDL-P 7.2 >= 4.8 umol/L
HDL Size 8.8 >= 9.2 nm
LP-IR SCORE 51 <= 45
TSH 4.78 0.27-4.20 uIU/mL
T3 107 80-200 ng/dL
T4 7.2 4.5-11.7 ug/dL
Free T4 1.24 0.93-1.70 ng/dL
UA 5.6 2.0-6.9 mg/dL
%A1C 5.1 <5.7 %
FibrinC 247 <391 mg/dL
VIT D 54 30-100 ng/mL
APO A1 155 >131 mg/dL
Apo B: Apo A1 Ratio 0.60 0.61-0.80
APO B 92 <60 mg/dL
CYST C 0.78 <0.96 mg/L
FFA 0.27 <0.60 mmol/L
GLUC 87 70-99 mg/dL
hsCRP 0.8 <1.0 mg/L
Homocysteine 11 <11 umol/L
Insulin 11 3-9 uU/mL
2 weeks of body temp data… “NT” = “Not Taken”:
Date Waking Day_Max
8/23/2013 NT 98.4
8/24/2013 97.2 99.3 <— this reading may be an error, took temp too soon after eating hot food
8/25/2013 97.5 98.6*
8/26/2013 97.2 98.6*
8/27/2013 97.4 98.5
8/28/2013 97.4 98.8*
8/29/2013 97.2 98.6*
8/30/2013 97.2 98.4
8/31/2013 97.3 98.4
9/1/2013 97.4 NT
9/2/2013 97.5 98.2
9/3/2013 97.2 97.9
9/4/2013 97.0 NT
9/5/2013 97.0 98.4
9/6/2013 97.2 98.6*
9/7/2013 97.4
The asterisk * next to max temp means I hit the 98.6 target for that day.
Thoughts on this so far?
Note: this may be hard to read because it doesn’t show the TABs in between the values.
You need to address the elevated insulin and homocysteine. You may have some insulin resistance, even though fasting glucose was good. We know that DHEA was good.
Yes, thyroid might be off. Can you discuss iodine here? Perhaps was in a different thread.
As always, you do no want to be treating an iodine deficiency with a life time of thyroid meds.
If you are iodine deficient, others in your home may also be. Check their waking temperatures.
Your low T levels on T cream are sort of expected with your thyroid problems - Classic. Might be better to start injections as per the standard protocol. Increased T levels can improve endothelial function, homocysteine and insulin sensitivity. But you need to keep E2 levels in the lower 20’s. E2 is toxic to the endothelium. Doc’s do not understand the thyroid effects on transdermal T absorption. Point out to doc that poor absorption is a symptom of thyroid problems.
You high TSH and lowish other hormones is consistent with iodine issues. But in your case, you should also have labs for thyroid antibodies.
KSman,
I already tried iodine supplementation for about 6 weeks. Began with Iodoral 12.5 mg ED and worked up to 37.5-50 mg, and took selenium with it.
Body temps did not budge an iota. Little or no change in how I felt. Pre-IR, my TSH was 3.6. Now, 3 months later, it is closer to 5. Kept everything in this thread.
Should I try IR again and ask my doc for a better iodine deficiency test before he puts me on thyroid meds?
I will ask for injections on my next visit.
If you did a good iodine replenishment, it is safe to assume that low iodine is not holding you back at this time. I am not aware of good iodine tests. I think that urine testing has some history for population based testing because is it non invasive. Maybe there is some iodine testing info at STTM.
Too much thread to review!
New labs:
TT 545 (348-1197 ng/dl)
TSH 3.53 (0.45-4.5 uIU/ml)
T4, Free 1.12 (0.82-1.77 ng/dl)
T3, Free 3.3 (2.0-4.4 pg/ml)
TPO 5 (0-34 IU/ml)
TgAb <1.0 (0.0-0.9 IU/ml)
Well, it looks like I’m absorbing the creams just fine (applying to my forearms works better than shoulders/chest). TSH came down some. I may be a LITTLE hypo, but not hypo enough to prevent me from absorbing the creams and/or pushing my body temp below 97 degrees. Not sure I want to jump on thyroid hormones, but I’ll just ask for injections because it’s much cheaper than creams and see what the doctor says.
I feel like I’m trying to hit a moving target…
“Moving Target”? how are you feeling - what issues are you chasing? Concerning move from compound cream to injections I thought the compound creams were priced reasonably compared to Androgel. Are they still considerably more expensive than injections?
My primary goal is to keep my libido high and get rid of ED. Still working on it.
Compound creams are expensive, but it depends on whether your insurance pays for the brand gels (Testim, Androgel).
If insurance pays, the co-pays for Testim and Androgel ($30/mo) are a little less than what I pay for compound creams ($55/mo). But if insurance does not cover, then Testim and Androgel are like $400/mo.