Blood Work Results - Some Opinions Needed

Pharma TRT
101

This morning I woke up and felt not too bad a little tired but I did not notice my usual symptoms that I have during the day feeling extremely hot, sweating… So I decided to take only my T4+T3 combo pill (40mcg T4 + 10mcg T3). Within an hour my symptoms started showing. It has been 3 hrs now approximately and I am gradually feeling worse and worse.

Just going by this I think the T3 that I am taking is not doing me any favors at all. So from tomorrow, I am just going to take T4 at 100mcg. This is what I was on before, but then wanted to try T4+T3 which looks like it is making my situation worse. I guess I will find out what T4 meds only will do if I have the same symptoms.

Ft3 numbers were good before I started taking thyroid meds, so all this is making me think.

102

Hmmm, well, you have similar symptoms to me in that yo uhave low body temps but constantly feel warm. I have attributed this to my abnormally high cortisol levels (high adrenal function) but this isn’t the case for you.

Thyroid hormones do put additional strain on your adrenals, and if your adrenals are suboptimal they won’t support exogenous thyroid. I’m not sure why your FT3 would go down while on meds.

Can you give a brief timeline of your ft3 scores in conjunction with thyroid meds? I.e., were they crappy at first, then OK with t4-only, then crappy again with t4 t3? Don’t have time to scroll back through 5 pages just yet.

103

Here is a summary

2011 results:

February -

Free T4 - 16.6 (10-19)
Free T3 - 5.1 (3.5 - 6.5)
TSH - 8.33 (0.5-4)
FSH - 2 (1-10)
LH - 2 (1-10)
TT - 13.9 (8.3-30.2)
SHBG - 29 (13-71)
FT - 304 (225-725)

Doctor prescribed me 50mcg T4 daily.

2 months later
Free T4 - 20.4 (10-19)
Free T3 - 6.1 (3.5 - 6.5)
TSH - 3.37 (0.5-4)

Started feeling bad again a month later went back for another blood test
Free T4 - 21.9(10-19)
Free T3 - 5.0 (3.5 - 6.5)
TSH - 4.40 (0.5-4)

Doctor prescribed me 100mcg T4 daily.

T4 meds kind of worked at the start as I did feel an improvement. But after the initial 2-3 months I have started feeling worse than ever before.

June 2011 - Now in Czech Republic (so maybe their ranges or scaling is different) as before I was in Australia. Suddenly Ft4 is in range still on 100mcg, surprising.
Free T4 - 14 (7-16)
TSH - 1.83 (0.34-5.6)

July 2011 - Saw Endo

Free T4 - 23.02 (9-25)
T3 - 1.53 (1.3 - 3.10) (NOT FREE T3)
TSH - 2.3 (0.27-4.2)
FSH - 16.6 (1.5- 12.4)
LH - 23.0 (1.7 - 8.6)
Testosterone - 10.74 (7.57 - 31.40)
DHEAS - 1.58 (4.3 - 12.2)
SHBG - 30.1 (15.4 - 63.8)
E2 - 107 ( 28-156)

Doc gave me 90mcg T4 and 10mcg T3. Been taking that ever since and I am feeling probably even worse than before!
LH and FSH are way high compared to tests in February which I don’t understand.

Today I only took 50mcg of T4 and honestly I think I felt better. I am just gonna stick with 50mcg for now of T4 maybe might do 75mcg. Endo wants me back next month to draw blood and check levels. But since I am going to change protocol now and do without the T3 no point getting blood drawn. No point seeing her anyway I am looking for someone else.

Bought some zinc and magnesium today and will supplement 100mg of zinc and 1gram of magnesium daily. Still waiting on DHEA if it makes it through.

It has got me thinking if all my problems (thyroid,hashi’s,LH and FSH) are not related to DHEA-S being so low.

104

OK, I remember more now, thanks for the summary.

First off - no, not everything is linked to low DHEA. DHEA is the precursor to Test. Therefore, right now your pituitary is screaming for more T (high FSH/LH) but your body simply can’t make any with no DHEA. It would be useful to test cholesterol and pregnenolone (and maybe progesterone) to see which link of your chain is the broken one. (Cholesterol has two pathways… CHOL->pregnenolone->DHEA->test and CHOL->preg->progesterone->cortisol). --side note, your T levels were always about this low, not sure why LH/FSH waited until now to be raised.

In your first test, fasting CHOL looked fine as I remember, meaning pregnenolone might be your culprit.

However, hashi’s is not related and is a separate problem. I have done SOME research on hashi’s, not exhaustive, and your results are common. People take thyroid meds then begin to feel worse and back off. The research I read suggested that the right move is to actually increase your dosage (read it at STTM website). Your symptoms will vary between hyper- and hypo-thyroid as antibodies attack your thyroid glands and spill T4 into your bloodstream, but leaving your thyroid very weak and uncapable of producing T4 on its own. Essentially you want to shut your thyroid production off.

STTM recommends higher doses of dessicated (T4 plus T3) thyroid, but they recommend that for everything, T3-only MAY be a better choice in my opinion (though I’m no doctor). Either way you need some t3 direct support.

Do some more research, there has to be some hashimoto’s message boards for people who have it. This condition is going to mess around with your body pretty substantially until you figure out the right medication/dosage. Thyroid labs are virtually useless while the gland is under attack.

105

Hmmm…

Cholesterol has always been above top range so here should be no issue with not enough cholesterol. Usually my HDL is on the low end but my LDL is above limit.

I have no idea why LH and FSH suddenly are so high now. Unfortunately I don’t have preg or prog tests done.

Interesting about raising doses when you feel worse. It has only been one day at the moment so I can go back to regular dose no prob.

What I can do is take two of my T4+T3 pills. This will give me 80mcg T4 with 20mcg T3. I don’t think the stuff I have is slow release so taking it all at once might not be the best. But if I take it too late in the day it will probably cause issues with my sleep. What ya think give it a shot?

My highest Testosterone measured ever was 14.7nmol/L so a lot better than 10.7 but still nothing fantastic.

Also the reason I mentioned DHEA could be causing all of my issues is I read an article stating that low DHEA can cause autoimmune disease as well as Hypothyroidism. Then when I put together me taking T4+T3 meds I might just be overdosing my body. But this is all just speculation at the moment.

106

[quote]iroczinoz wrote:

Also the reason I mentioned DHEA could be causing all of my issues is I read an article stating that low DHEA can cause autoimmune disease as well as Hypothyroidism. Then when I put together me taking T4+T3 meds I might just be overdosing my body. But this is all just speculation at the moment.[/quote]

Any link? I’d be curious to read that as I’ev never heard that.

low DHEA absolutely causes low T, never heard of a connection to hypothyroid.

107

[quote]scj119 wrote:

[quote]iroczinoz wrote:

Also the reason I mentioned DHEA could be causing all of my issues is I read an article stating that low DHEA can cause autoimmune disease as well as Hypothyroidism. Then when I put together me taking T4+T3 meds I might just be overdosing my body. But this is all just speculation at the moment.[/quote]

Any link? I’d be curious to read that as I’ev never heard that.

low DHEA absolutely causes low T, never heard of a connection to hypothyroid.[/quote]

I found it, here it is http://www.life-enthusiast.com/twilight/shealy/dhea.htm

On a side note do you think a Varicocele could have any negative effects on Testosterone or DHEA-S? From all the information I have read it seems like there is a mixed opinion. Some say yes others say no. It is not really giving me pain that bad only here and there. If anyone has had one removed and can give me some feedback if it improved hormone levels? Fertility seems to be the biggest reason why people get them removed as well as pain. Had no problems with fertility thus far.

108

[quote]iroczinoz wrote:

[quote]scj119 wrote:

[quote]iroczinoz wrote:

Also the reason I mentioned DHEA could be causing all of my issues is I read an article stating that low DHEA can cause autoimmune disease as well as Hypothyroidism. Then when I put together me taking T4+T3 meds I might just be overdosing my body. But this is all just speculation at the moment.[/quote]

Any link? I’d be curious to read that as I’ev never heard that.

low DHEA absolutely causes low T, never heard of a connection to hypothyroid.[/quote]

I found it here it is http://www.life-enthusiast.com/twilight/shealy/dhea.htm [/quote]

That article to me, has a few problems. First is that the most recent reference is 1996 so it is a bit old. Second is that the point of the article is to sell you something (his Yinergy stuff), so the results are skewed towards making you think DHEA is the problem. Third is that his “study” was done on only 10 people. Some specific passages:

" Additionally DHEA is intimately related to thyroid function - primary thyroid disease, especially low thyroid production, leads to low DHEA levels" - I think this was the statement you were referring to. He actually said hypothyroid leads to low DHEA, I think that you were reversing this statement in your head.

“It is likely that six hours or more of airplane travel will at least temporarily deplete DHEA. One otherwise healthy young woman had a DHEA level of only 180 ng/dL two days after flyÃ?­ing to the United States from Australia. Twelve days later it had rebounded to 560 ng/dL.” - Basically he is pointing out how DHEA is prone to spikes and valleys (as we often say here) but yet still considers it a useful test… and rules out DHEA-S because ACTH raises DHEA (not DHEA-S) and because DHEA predicts AIDS better than DHEA-S… lol

“Thus, I initially recruited seven men with low DHEA levels and had them use natural progesterone cream one teaspoon twice a day. At six weeks, DHEA levels had increased in six of seven men. By twelve weeks this increase in DHEA had stabilized at 30 to 100 percent above baseline. Most men also reported becoming more horny! When I published this material, a French professor of endocrinology wrote that there is no known pathway for progesterone to be converted to DHEA! Fortunately, hundreds of my patients do not know there is no pathway, so they have usually responded with significant increases in DHEA with the use of progesteron cream. Indeed, I have a patent on this process, Patent Number 5,609,617.” - seems pretty obvious to me… progesterone increases cortisol, which in turn bumps up thyroid and DHEA/sex hormone numbers. But, saying that wouldn’t increase his sales of DHEA increasing products.

None of his information is straight inaccurate, but it is phrased in ways intended to convince you to buy something.

109

[quote]scj119 wrote:

[quote]iroczinoz wrote:

[quote]scj119 wrote:

[quote]iroczinoz wrote:

Also the reason I mentioned DHEA could be causing all of my issues is I read an article stating that low DHEA can cause autoimmune disease as well as Hypothyroidism. Then when I put together me taking T4+T3 meds I might just be overdosing my body. But this is all just speculation at the moment.[/quote]

Any link? I’d be curious to read that as I’ev never heard that.

low DHEA absolutely causes low T, never heard of a connection to hypothyroid.[/quote]

I found it here it is http://www.life-enthusiast.com/twilight/shealy/dhea.htm [/quote]

That article to me, has a few problems. First is that the most recent reference is 1996 so it is a bit old. Second is that the point of the article is to sell you something (his Yinergy stuff), so the results are skewed towards making you think DHEA is the problem. Third is that his “study” was done on only 10 people. Some specific passages:

" Additionally DHEA is intimately related to thyroid function - primary thyroid disease, especially low thyroid production, leads to low DHEA levels" - I think this was the statement you were referring to. He actually said hypothyroid leads to low DHEA, I think that you were reversing this statement in your head.

“It is likely that six hours or more of airplane travel will at least temporarily deplete DHEA. One otherwise healthy young woman had a DHEA level of only 180 ng/dL two days after flyÃ??Ã?­ing to the United States from Australia. Twelve days later it had rebounded to 560 ng/dL.” - Basically he is pointing out how DHEA is prone to spikes and valleys (as we often say here) but yet still considers it a useful test… and rules out DHEA-S because ACTH raises DHEA (not DHEA-S) and because DHEA predicts AIDS better than DHEA-S… lol

“Thus, I initially recruited seven men with low DHEA levels and had them use natural progesterone cream one teaspoon twice a day. At six weeks, DHEA levels had increased in six of seven men. By twelve weeks this increase in DHEA had stabilized at 30 to 100 percent above baseline. Most men also reported becoming more horny! When I published this material, a French professor of endocrinology wrote that there is no known pathway for progesterone to be converted to DHEA! Fortunately, hundreds of my patients do not know there is no pathway, so they have usually responded with significant increases in DHEA with the use of progesteron cream. Indeed, I have a patent on this process, Patent Number 5,609,617.” - seems pretty obvious to me… progesterone increases cortisol, which in turn bumps up thyroid and DHEA/sex hormone numbers. But, saying that wouldn’t increase his sales of DHEA increasing products.

None of his information is straight inaccurate, but it is phrased in ways intended to convince you to buy something.[/quote]

Yeah I noticed he was trying to offload some compound he swears by so you are right a lot of it could be a bit skewed. Oh well I thought I would just throw it out into the open and see what people think of it.

110

[quote]iroczinoz wrote:
Yeah I noticed he was trying to offload some compound he swears by so you are right a lot of it could be a bit skewed. Oh well I thought I would just throw it out into the open and see what people think of it.
[/quote]

Yeah man, it never hurts to look as many places as you can. As I say at my job “there’s no such thing as bad data, some is just more useful than others”. As long as you read things with the appropriate filters, you can usually learn something from just about everything.

111

Okay still waiting for the DHEA losing hope now. I have however been taking magnesium and zinc for the past week. I have also decided to source some Arimidex and take that and lower my E2, it might also help my Testosterone levels a little. Either way I have nothing to lose since my E2 is towards the higher end of the scale. Might just try and shoot for mid range or slightly lower.

Won’t be able to have any tests for E2 so I will monitor how I feel.

I am only going to buy 30 tablets for a test to get my E2 down by half, so instead of 107 be around the 50 mark. What dosing should I go for?

I was thinking .25mg E3D or should I go .5mg E3D.
.25mg E3D the 30 pills will last me a year
.5mg E3D I’ll get roughly 30 weeks supply.

scj - I did not stop taking the T3 I kept with my dosage. Last couple of days have been alright. I 'll am supposed to get blood work done to check my thyroid at the end of the month.

112

I would do no more than 0.5 mg/week to start…use the least amount that will benefit you, this is a good starting point…

I would wait about a month after starting before getting any other tests done so you have a chance to balance everything out prior.

113

[quote]VTBalla34 wrote:
I would do no more than 0.5 mg/week to start…use the least amount that will benefit you, this is a good starting point…

I would wait about a month after starting before getting any other tests done so you have a chance to balance everything out prior.[/quote]

Sounds like a plan! Do you think I would need to continue using the Arimidex to keep levels in place? Since if I come off arimidex they will slowly rise again right?

As I mentioned in your thread ksman brought up some good points worth trying. I am going to try everything possible to get things in check till the end of the year. January I fly to Australia again. Have another doctor I will visit to see if I get anywhere and have some checks done to see if anything has improved.

The shitty endo here wants to see me in December so I might ask for blood test to check levels, if she does not want to do them I’ll pay out of pocket. Don’t really want to see her again but that is probably my only way to get blood tests at the moment, unless I source another doctor which I will try.

My plan

Zinc 100mg daily
Magnesium 1gram daily
Vitamin C 1gram daily
Arimidex to lower E2 I’ll take .5mg a week and see how things go. If I see no adverse effects I’ll stick with it until I have tests done to check E2 which might be a couple of months. But at that dose it should be relatively safe dosing. If I get sore I’ll lower even further.

Ksamn suggested supplementing CoQ10 to raise Pregnenolone and in turn might also raise DHEA-S values (if my pills don’t arrive)

I’ll see the urologist to seek his advice on the Varicocele if it could be causing and of my issues. From what I have read there is no definitive answer. So the only way to find out is to have it removed and see what happens. I just don’t like unnecessary surgery but it looks like there is no other way to find out.

If by next year I have no improvement I might just go down the route of self treating but sourcing the products is going to be hard and probably a little more expensive. The only concern I have with this is that I don’t know what kind of grade the drugs would be and what the source is… So that would really be a concern that worries me a lot. I would feel a lot better walking into a pharmacy and buying testosterone and HCG than buying it off a guy in a locker room. This is a path I would least like to go down.

Test in Australia on the black market is roughly $170 for 10ml @ 100m a ml. So $17 bucks a week for test, Arimidex + HCG if I want to take that and it might cost me like $30 a week to self treat. No huge issue money wise just the concern what kind of stuff I am being sold.

I have some Nolva on hand that I bought back in Oz that I have not used. I wanted to take that since my LH and FSH were at 2 at the start of the year. Now they are really high so would there be any point in taking Nolva, probably not. Since I bought it for a high price it sucks that there is probably no use in taking it.

If a miracle happens and I find a good doctor that would be a blessing.

or maybe I could fly to the USA meet with a switched on doctor get the prescriptions I need. Then buy a years supply of medication and treat myself. Get blood drawn pay out of pocket expenses here in Czech and send him the results and treat like that. Does anyone know if something like this is even possible?

114

The best thing you have going for you is your desire to see this thing through. I have confidence you’ll figure it out, but it will take time. Those seem like high doses to me (I take 50mg zing and 250mg magnesium) but I can’t say that they’re too high, you may know more about zinc/magnesium than I do.

I don’t think Nolva is right for you (unless the recent LH and FSH is a lab error - I don’t know the quality of labs over there, and we have no idea what caused it to raise).

I really hope your DHEA makes it through, and that it solves your problems. Again, if you haven’t done it, I’d try to look for any website or message boards dedicated to hashimoto’s treatment. It’s a serious condition.

edit - I hope you get this figured out, you’re an asset to the boards. I wish everyone who posted here was as invested in their health as you are, it helps a lot when you are bringing your own info to the table and not asking to be spoonfed.

115

[quote]scj119 wrote:
The best thing you have going for you is your desire to see this thing through. I have confidence you’ll figure it out, but it will take time. Those seem like high doses to me (I take 50mg zing and 250mg magnesium) but I can’t say that they’re too high, you may know more about zinc/magnesium than I do.

I don’t think Nolva is right for you (unless the recent LH and FSH is a lab error - I don’t know the quality of labs over there, and we have no idea what caused it to raise).

I really hope your DHEA makes it through, and that it solves your problems. Again, if you haven’t done it, I’d try to look for any website or message boards dedicated to hashimoto’s treatment. It’s a serious condition.

edit - I hope you get this figured out, you’re an asset to the boards. I wish everyone who posted here was as invested in their health as you are, it helps a lot when you are bringing your own info to the table and not asking to be spoonfed.[/quote]

Thanks man!

I have found a thyroid forum where they discuss all the associated diseases etc… Hashi’s from what I have read can really be havoc on the system. From what I have read and been told. Training can trigger flare ups with the antibodies (so unless I stop training this is unavoidable) Eating Oatmeal (high fiber foods) can hinder the absorption of the thyroid meds so you need to take more to compensate.

A person on the forum looking at my labs thinks I am not hypo but sees me hyper according to lab values (not looking at TSH) so that is interesting. He has suggested to get a test for TSI to settle this and make it conclusive if I am in fact Hyper or not. Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the person’s hyperthyroidism. To stop the onslaught of Antibodies you have to have the correct dosage in place, if in fact I do have Hashi’s.

Another few interesting points were made: I recommend either a sonogram or RAIU (radioactive uptake) as your Thyroglobulin and TPO are high which could indicate suspicious nodules. Cancer to be specific.

There are binding, blocking and stimulating antibodies and immunoglobulins which work to put the body to rights thus giving the appearance of lab results in normal range.

So even though you test positive for ANTI TP and ANTI TG this does not necessarily mean Hashi’s it could mean other things.

So more work to be done, doctor is going to go nuts when I ask for these other tests. Don’t know if she will come to the party. Just makes it more and more difficult when you are fighting a stubborn doctor.

This is hypothetical:
Went HYPO because of Varicocele - Body trying to cool down (read that this is possible)
Taking thyroid meds - making me even more hyper but being masked by the TSH level - as above, not sure if that is possible for it to work like this.

LH,FSH could be lab error (will test again back in OZ) - or by taking thyroid meds something has woken up and started working again. That is the only thing that has changed.

Wrote an email to a Endo here in Czech who had an article about male hormones and what he recommends. I would have gone to see him if he had some ideas he is 200km away. He replied back saying that even though I have lowish Testosterone I am still in range. The LH and FSH values elevated suggests to him that it is a compensation for Primary Hypogonadism. He said that my liver markers are elevated and that could be contributing to my fatigue. He them referred me to a Urologist and said that Varicocels have shown to lower the production of androgens.

So I really have to bite the bullet and get surgery to remove this Varicocele. Otherwise, I will never know if it is or it is not effecting me. Waiting to hear back from Urologist to see when he can see me.

Cholesterol Elevated was also mentioned - so I might try and source some pregnenolene to see if that helps.

What a mine field, add stubborn doctors into the mix and you have a very very complicated journey ahead.

on a side note: Every time I log into the forums the Avatars that people use are not visible. If I am not logged in everyone’s avatar is visible.

116

Hashi’s can lead to hyper lab values as part of your thyroid is destroyed and it releases large amounts of T4 into your bloodstream. Your wildly fluctuating TSH values is something that makes me think Hashi’s outside of your TPO/ATA tests.

TSI will test for graves. Adding more tests to your bloodwork never hurts. Cast as wide of a net as possible.

Good luck with your surgery. Keep us posted.

117

Here is a post from the thyroid forum regarding my numbers.

You are fluctuating way to much re the Free T4, what few Free T3 I have seen and the TSH.

This is very very typical pattern on the journey to full-blown hyper. Sometimes your FREE T4 has almost been over the top. When you see that and at the same time you see TSH “in” range you have to wonder because usually the TSH would be way way down.

This happens because of antibodies. Their job is to fight each other i.e. antibodies versus autoantibodies and the same w/immunoglobulins. They bind and block receptor sites in an attempt to set the body to rights thus giving very strange lab results re the “numbers”.

I may have left out some important information right from the start. I totally forget about until my wife reminded me. In July 2009 I got infected with Chicken Pox (how this happened not sure) but I must have never got chicken pox as a kid. So I got it in my 30’s was down and out for 2 weeks.

Urologist tomorrow will see what he says.

118

In addition to antibodies, you may have a large amount of RT3 blocking T3 receptors. However I’m not sure why on the recent labs, your TSH would go down with a similar FT4 score. This is what makes me think of hashi’s… you shut down your thyroid production because your exogenous intake was high enough to give you most of whta you need, and your body stopped attacking your thyroid.

Having more FT3 labs would be a big help…alas

119

[quote]scj119 wrote:
In addition to antibodies, you may have a large amount of RT3 blocking T3 receptors. However I’m not sure why on the recent labs, your TSH would go down with a similar FT4 score. This is what makes me think of hashi’s… you shut down your thyroid production because your exogenous intake was high enough to give you most of whta you need, and your body stopped attacking your thyroid.

Having more FT3 labs would be a big help…alas [/quote]

Maybe I am starting to get confused but my last blood draw still showed antibodies present. So the attack is still continuing I think, or am I missing something?

120

Saw urologist today. Went in because of my Varicocele but left with a host of other tests.
In short…

Urologist was sound in her knowledge of male hormones. She had a look at my blood work and the 1st thing she said was that my testosterone is low. She went on to say that if I was 70 years old that would be acceptable but not at 33. WOW did she really just say that I thought I was dreaming for a second.

I did not really say anything and let her do the talking. She went over all the hormones and explained how it all works. Sounded like she was a member of Tnantion hahaha…

Had ultrasound done right there on the spot and she looked at my kidneys. She is concerned with the elevation markers. She also noted on the ultrasound that I have fluid left over on the kidney which should not be there 13mm. There was actually another spot with fluid she noticed. So she referred me onto someone else to have that checked.

She also referred me to have a CT scan to check passages where hormones pass through or something like that. Supposed to drink heaps, take a tablet the night before and a tablet in the morning before the CT. Also not to eat much at night before the test.

She also sent me to get my sperm counts checked since we plan on having another baby.

She said to hold off for the time being on my Arimidex and just wait for all the tests to come through. She does not want me to take Arimidex yet because it may interfere with other values. But she noted that she knows what I was planning in taking arimidex, good point but to hold off.

The Varicocele she said at the moment should be the least of my concerns. The stuff above is more important. The Varicocele should have no effect on being Hypo she said.

She said I am out of whack and something funky is going on. Will be seeing her in mid September and by then would have results for all my other referrals. After that we will see what happens if anything, but got my fingers crossed she seems to be a little more switched on then the rest I have seen.