Hypothyroid?

Pharma / TRT Testosterone Replacement
1

Ok, so I came here pretty certain I have hormone issues, not surprisingly assuming it’s testosterone and looking for TRT options. I have to say what a great find! The information here and the support from people is outstanding. Thank you for all Iâ??ve learned so far.

Having, assumed a test issue, I realise now, of course, that it could be any number of issues. One of the stickys lead me to home in on thyroid and sure enough measuring my body temperature am/pm, Iâ??m showing as low (Lowest/highest) :

am: 95.6/97 (Lowest/highest)
pm: 96.4/96.8

Now, from here, I’ve learned that this is almost certainly an indication of hypothyroidism. And I now realise that I have NO Iodine in my diet. None. Unless I have a cheat meal out which is hardly ever. I’ve bought some potassium iodide and selenium to see if I can bring my temp back up. The plan is to start this week when the stuff arrives.

Iâ??m now full of questions. Specially though, am I starting in the right place? I understand that there could be other issues such as TPO or adrenal fatigue. Should I go and test for these?

I had some bloods done 18 months ago and they showed TSH at 3.8 miu/L (0.25-5) and fT4 at 16.3pmol/L (9-23). This was just a general test because I was struggling with fatigue and the doctor homed in on Iron which was out of range.

Iâ??m happy to get a more specific one.

For the past three months Iâ??ve been taking DAA/glycine/magnesium before bed to try and improve my sleep and it certainly had a positive impact. Morning wood returned and body composition has improved. Iâ??m off it at the moment.

-age - 47
-height - 5â??10â??/177.8cm
-waist - 32 (UK)
-weight 12st 8/79.8kg/176lb
-describe body and facial hair - body is hairy above knees, shins and calves hair free, balding (MPB most likely)
-describe where you carry fat and how changed - belly mainly.
-health conditions, symptoms [history] - Iâ??ve always considered myself healthy
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever - NOPE
-lab results with ranges - I have some from 18 months ago. Can post if necessary.
-describe diet - last two years has pretty much been calorie deficit. Currently on 1700. Although Iâ??ll go over that at weekends but not excessive. I donâ??t drink. Rarely eat out and donâ??t touch processed foods. Very clean basically meat and veg. MFP food diary is here : Marcusparticus's Food Diary | MyFitnessPal.com
-describe training - resistance training 4x per week.
-testes ache, ever, with a fever? - occasionally.
-how have morning wood and nocturnal erections changed - very rarely have it (except recently when taking DAA/Glycine/Magnesium before bed - which has gone again since stopping a couple of weeks back.

Thanks in advance for any help offered.

Mark

2

Dairy seems to be the major source of iodine there. Iodized salt might be available. UK is different.

You will need to get labs and might have problems getting docs to do things.

Labs:
TT
FT
E2
CBC
fasting cholesterol
fasting glucose
TSH
fT3
fT4 [please not T3, T4]

Have you read the “things that can damage your hormones” sticky?

Do need labs and ranges. Can’t get too far on guess work.

When you do iodine replenishment, your TSH will increase and labs will be distorted.

Are you getting any essential fatty acids?

3

Thanks so much for your input.

I’ve now booked my bloods. I should have some results in a couple of weeks which I will post.

I take 5 double strength fish oils per day. And a multi vit.

And yes, I realise now that I’m getting some Iodine from my diary.

I’ll not start any IR until after my results.

Thanks again

4

I am not convinced that dairy source iodine is sufficient. Levels are lower with organic milk that indicates that this depends on the feed that the cows receive and not added at the dairies where things could be controlled and consistent.

Ping me later on the KSman is here thread, its hard to tail all threads here.

5

KSMAN, thanks for your on-going assistance - itâ??s really appreciated. Heart felt thanks.

My GP here was very helpful and I had a fairly comprehensive broad panel done. It doesnâ??t include as much detail as youâ??d like but itâ??s a start.

After my bloods I then started IR. Although looking at my fT4 levels Iâ??m guessing itâ??s not an Iodine issue.

Looking at my results, they correlate with bloods I had done 2 years ago. So Iâ??ve had an on-going condition.

Bottom line, I think my GP will take further testing seriously and Iâ??d like to stay in the driving seat if I get an endo referral (I met a dead end two years ago because I handed over control - Iâ??ll not do that again) and your advice and others on this forum would be most helpful in forming a forward plan.

Iâ??ve done some research and Iâ??ve joined some dots together but Iâ??m new to all this and could easily be taking myself round in circles. Would really value feedback.

My body temp is rarely above 97. Never 98. I recorded for a while and then got bored of seeing the same numbers.

date am/pm

17th Apr 96.8
18th Apr 96.8/96.4
19th April 95.6/96.7
20th April 97/97.3
21st April <97/97
22nd April 96.8/96.8
23rd April 97.1

Iâ??m still checking it twice daily and had not seen an improvement since starting IR but then itâ??s only been 3 days.

Here are my results.

Serum folate 14.2 ng/ml [4.5 - 32.2]

Serum Iron level 18.0 umol/L [11 - 28]
Serum transferrin 2.86 g/L [2 - 3.6]
Transferrin saturation index 28% [15.0 - 50]
Serum ferritin 388 ng/mL

Serum testosterone 24.9 nmol/L [8.64 - 29.0]

Serum Vitamin B12 760 pg/mL [191 - 663]

Prostate-specific antigen 1.31 ng/mL [0.0 - 1.9]

Haemoglobin concentration 155 g/L [135 - 175]
Total white blood count 3.6 109/L [4 - 11]
Platelet count 192 109/L [135 - 450]
Red Blood Cell Count 5.42 1012/L [4.5 - 5.5]
Mean cell volume 85 fL [80 - 100]
Haematocrit 0.46 L/L [0.38 - 0.5]
Mean cell Haemoglobin level 28.6 pg [27 - 34]
Red blood cell distribution width 13.2 [10 - 15]
Neutrophil count 1.4 109/L [2 - 7.5]
Lymphocyte count 1.6 109/L [1 - 4]
Monocyte count 0.5 109/L [0.1 - 1]
Eosinophil count 0.1 109/L [0 - 0.5]
Basophil count 0.0 109/L [0 - 0.2]

Serum alkaline phosphatase level 63 u/L [30 - 130]
Serum total protein level 71 g/L [60 - 80]
Serum albumin level 47 g/L [35 - 50]
Serum globulin level 24 g/L [17 - 35]
Serum alanine aminotransferase level 52 u/L [0 - 41]
Serum total bilirubin level 7 umol/L [0 - 20]

Serum cholesterol 7.44 mmol/L
Serum triglyceride 1.59 mmol/L [0.3 - 2.3]

Serum calcium level 2.28 mmol/L [2.2 - 2.6]
Serum adjusted calcium concentration 2.21 mmol/L [2.1 - 2.6]
Serum inorganic phosphate level 1 mmol/l [0.8 - 1.5]

eGFR calculated 59 mL/min

Serum HDL cholesterol 1.29 mmol/L [0.9 - 1.45]
Serum cholesterol/HDL ratio 5.77

Serum LDL cholesterol 5.42 mmol/L

Plasma glucose level 5.1 mmol/L [3 - 6]

Serum urea level 9.4 mmol/L [2.5 - 7.8]
Serum sodium level 142 mmol/L [133-146]
Serum potassium level 4.4 mmol/L [3.5 - 5.3]
Serum creatinine level 115 umol/L [59 - 104]

Serum TSH level 4.24 miu/L [0.25 - 5]
Serum free T4 level 17.3 pmol/L [9 - 23]

Serum 25-Hydroxy vitamin D3 45.9 nmol/L

6

fT4 is a reservoir for T4–>T3 conversion and its fT3 that is active and if fT3 is low, or fT3 is blocked by rT3, body temperatures will be low.

Labs: - to add to above list
rT3
thyroid antibody panel

Your TSH is very high. Should be closer to 1.0, the ranges are stupid.

Endo’s are typically a waste of time and money.

What drugs or other the counter [on the shelf] meds to you take. Kidneys look distressed. Ask doc what other tests and urinalyses.

Please read these stickies:

  • advice for new guys
  • thyroid basics
  • things that damage your hormones

Hair loss below the knees is a symptom of long term lower T levels. TT is not so bad. But we do not know what your FT levels are. Elevated E2 lowers by increasing SHBG that bind to T, T+SHBG, lowering fT.

Symptoms of low thyroid function:
dry skin
feel cold easily
general hair loss
sparse outer eye brows
low energy, brain fog, mood/depression
many aspects similar to low T

7

Hey thanks.

My thinking too re thyroid. I’ll get those labs.

My kidneys seem to be struggling. I take very little and what I do take I was off two weeks before the bloodtest. I take fish oil, magnesium, glycine, daa and a multi vit usually.

I read that hypothyroidism can slow renal blood flow. My blood pressure is low too. So in my simple view,
my kidneys aren’t getting to flush junk out fast as they could. So yep, more kidney tests.

My neutrophils are low. The diagnosis was neutropenia. I can see from older tests this has been on going. The only thing I’ve picked up on is that the lower body temp is slowing progress down in the bone marrow. More tests needed.

I’ve read and read the stickies. So damn useful. Thanks for putting these together.

As for T, my thinking was to focus on the others issues first. Unless you feel it’s worth progressing as in it could be a cause of all this crap.

Thanks for your help.

MS

8

Quick update …

Labs ordered. Should have results in a week or so. Have gone private because GP cannot do T3, rT3 and TPO until I’m TSH 5+. I’ve included FT and E2 as well.

She did go for a further FBC to check out my WBC/Neutrophils. She seems to think it might be something to do with me being on a calorie deficit at times. Maybe she’s hoping it’ll go away although now that I’m eating ‘normally’ again. I’ve had the same readings on past tests.

Doc wants to put me on a statin to get my LDL down. That’s my biggest concern TBH. I fielded it well and have referral to bio chemist. I’ve read that there is a relationship between thyroid hormones and cholesterol. Am hoping I’ll have my TH results by then.

I’ll start Vit D3 supplementation after the next set of tests. A part of me wonders if it’s all down to D3 deficiency. But that is unlikely.

GP says to revisit kidneys in 3 months.

And she seems to have no concern over my ALT levels.

BTW, didn’t do iodine replenishment today and I feel much better. Have felt really drained past few days on 75mg. I calculate that I’ve taken in 300mg or so. I’ll start again with a reduced dose once I’m done with the latest bloods as I’ve heard it’ll mess with TSH results.

Thanks for your ongoing support.

9

Iodine can affect digestion//absorption. Never have seen doses over 50 before.

I asked about drugs/meds… kidneys.

TRT often reduces cholesterol levels. If you were to normalize T and thyroid, things would change.
TRT improves hematocrit

Don’t forget the roll of selenium in T4–>T3 and reduction of damage from free-radicals that come with low selenium intake and possible development of thyroid autoimmune disease.

Can’t comment on cholesterol levels. I am not familiar with SI units for this and lab ranges not shown.

10

KSMAN, where can I get more information on this statement?

“Don’t forget the roll of selenium in T4–>T3 and reduction of damage from free-radicals that come with low selenium intake and possible development of thyroid autoimmune disease”

Thanks, MS

11

I had these results back from a recent blood test.

I can see my TSH is sky high. fT4 is within range, fT3 is within range too and rT3 is high on the scale.

Is my rT3 getting in the way of my fT3?

Is my fT3 low enough to cause my TSH to be so high.

My TPO is within range - so no Hashimotos causing erratic results?

I’m assuming Test and E2 are all fine?

Lots of questions …

Help would be most appreciated. Thanks MS.

Here are my results:

TOTAL THYROXINE(T4) 105 nmol/L 59 - 154

THYROID STIMULATING HORMONE *9.61 mIU/L 0.27 - 4.2

FREE THYROXINE 17.2 pmol/l 12.0 - 22.0

FREE T3 4.6 pmol/L 3.1 - 6.8

THYROID ANTIBODIES

Thyroglobulin Antibody 12.5 IU/mL 0-115(Negative)

Method used for Anti-Tg: Roche Modular

Thyroid Peroxidase Antibodies 8.6 IU/mL 0 - 34

Method used for Anti-TPO: Roche Modular

SPECIAL PATHOLOGY

REVERSE T3 22 ng/dL 10 - 24

Please note change to reference range 29/10/14

Result from Referral Laboratory ID [894].

ENDOCRINOLOGY

TESTOSTERONE 18.2 nmol/L 7.6 - 31.4

Reference Ranges apply to adults

SPECIAL PATHOLOGY

Free Testosterone 6.67 pg/ml 4.0 - 30.0

ENDOCRINOLOGY

17-Beta OESTRADIOL *76 pmol/L 99 - 192

12

Still taking 75mg iodine? May be messing with your gut flora and affecting digestion/absorption.

TSH can be elevated from high dose IR, best to do labs after letting things settle down.

Keep watching temperatures.

LDH can be increased by the lower metabolic rate of hypothyroidism. Mitochondria burn fat and fT3 regulates mitochondrial metabolic rates and hence body temperature. Suggest that you avoid statin drugs for now as these can lower CoQ10 levels and that can cause damage to mitochondria and makes things worse even as you take comfort in lower LDH numbers. LDH often climbs with hypogonadism and TRT or recovered T levels] can lower LDH.

LABS: LH/FSH, fT would complete the picture.

Thyroid: Your TSH is insane. Do not know if distorted by IR. What are current body temps?