Low T Problem - Full Lab Info Provided

Your increased bilirubin is just a consequence of Gilbert’s syndrome that you suffer from. It is not dangereous. Actually, unconjugated bilirubin has an antioxidant activity.

You definetely don’t need thyroid biopsy. It is only indicated when ultrasound reveals nodules to rule out cancer.

I am in similar situation that you are describing. I suffer from low T levels and was diagnosed with subclinical hypothyroidism (TSH at 6). I will be starting treatment (Levothyroxinum 50 mg) soon and I am curious what this will do to my T levels. There is definetely connection between thyroid hormones and testosterone on hypothalamo-pituitary level (low T3 and T4 increases thyroliberin. Thyroliberin stimulates secretion of prolactin which in turn decreases production of gonadal hormones).

How are you able to persuade doctors to run all those test? Does your insurance cover it or are you paying for them yourself?

Ok, keep us posted on what happens to your T levels if you manage to fix thyroid issues! My TSH isn’t as high as yours, but I definitely have hypothyroid symptoms. As far as having a biopsy is concerned, I’ve heard stories of people having nodules that weren’t detected by ultrasound, so I’m not sure. What I’m trying to find out is whether or not I have a thyroid inflammation.

I’m paying for some of the tests myself, but most of the time it’s just a case of me seeing different doctors who who pick up on different aspects of my symptoms/blood results. Kind of scary really to see the difference in what doctors choose to follow up on - you’d think there should be some kind of standard protocol that they follow but no…

Here’s an update from the last two months:

  1. Pituitary MRI with contrast showed nothing abnormal.

  2. Chest X-ray showed nothing normal (ordered by my doc as he suspected a blood disorder due to night sweats)

  3. Abdomen ultrasound showed vascular changes on my liver, but hepatitis blood tests were negative. Will discuss this with my doc later in the week although he seems clueless.

  4. Thyroid ultrasound showed nothing abnormal. Still haven’t decided if I should do a biopsy as well. Still considering it…

  5. Testicular ultrasound showed microcalcifications and very small hydroceles. I was told this was clinically insignificant but I am still going to see a urologist since the semen analysis showed I am subfertile.

  6. Sleep study ruled out sleep apnea but since I have problems with waking up all the time, my doc will evaluate further to find out if I have narcolepsy. I’m apparently going to get hooked up for a neurological exam, that’ll be fun.

  7. The people on the Addison’s board, having looked at my insulin tolerance test result from 2004, insist that my adrenals are permanently fried and that I need to be on cortisone for the rest of my life. I don’t feel too good about hearing that, but I will keep investigating by showing the test results to various docs.

[quote]landslide wrote:

  1. The people on the Addison’s board, having looked at my insulin tolerance test result from 2004, insist that my adrenals are permanently fried and that I need to be on cortisone for the rest of my life. I don’t feel too good about hearing that, but I will keep investigating by showing the test results to various docs.[/quote]

what are your symptoms of low cortisol? symptoms are most important. Like I said before, your thyroid seems fine and I am not sure if thyroid hormone would do anything for you except causing you to feel anxiety and give your pains all over (especially if you have low cortisol).

The symptoms I recognize in the link below are chronic fatigue and low blood pressure that falls when standing. Not sure about the definition of muscle weakness - I mean, I do weight training but I never get stronger and I’m not that strong to begin with, but I’m not sure if that would qualify as muscle weakness…

However, I DON’T have loss of apetite, weight loss, nausea, vomiting, diarrhoea, salt cravings or hyperpigmentation.

http://endocrine-system.emedtv.com/adrenal-insufficiency/adrenal-insufficiency-symptoms.html

[quote]landslide wrote:

  1. The people on the Addison’s board, having looked at my insulin tolerance test result from 2004, insist that my adrenals are permanently fried and that I need to be on cortisone for the rest of my life. I don’t feel too good about hearing that, but I will keep investigating by showing the test results to various docs.[/quote]

Have you had pregnenolone tested? As I recall from page 1, your CHOL is fine, but your body may have a tough time with preg creation because you are low on both sides of the cholesterol chain (test/corsitol). You might be able to fix things by supplementing this.

CHOL breaks down to pregenenolone which has two pathways. One pathway is preg->progesterone->cortisol. The other is preg->DHEA->T(which breaks down further into estrogen and DHT). If your body is not making enough pregnenolone that could cause low T/DHEA/cortisol/everything.

Haven’t had prgnenolone tested. That test isn’t even available in Sweden as far as I know. I believe one can be tested for progesterone, but I’m not sure if it would be useful in my case.

[quote]landslide wrote:
Haven’t had prgnenolone tested. That test isn’t even available in Sweden as far as I know. I believe one can be tested for progesterone, but I’m not sure if it would be useful in my case.[/quote]

Well I would certainly try pregnenolone supplementation before reverting to hydrocortisone. It could boost all of your down-the-line hormones (cortisol, T, etc.). Directly supplementing cortisol is a last resort as it virtually shuts off whatever natural production your body has.

I see… and would the supplementation be permanent or can it be used to “kicktstart” one’s hormones?

[quote]landslide wrote:
I see… and would the supplementation be permanent or can it be used to “kicktstart” one’s hormones?[/quote]

That I’m not sure of. You can prob google it or wait for someone else to weigh in.

A lot of people are able to essentially reboot their system (kickstart it) with preg supplementation. This may be needed to be done for a long time (couple years) before everything is back online and requires you to work on other hormones while your cortisol line is optimized.

Others have to be on it for life.

Well, I don’t intend to supplement anything until I find out more about what’s going on. Today I found out that i have two 1/2 inch hemangiomas in both the left and right liver lobes (four hemangiomas in total). I’m schedule for a re-check in six months (to see if they’ve grown i guess). I’ve been told these hemangiomas are “harmless” but I think that’s only applicable in a life vs death context as opposed to a context of quality of life. My own guess is that it could be one contributing factor to my chronic fatigue, which is most evident when I work out. Anyway, I’m not really sure how to proceed with this one. Haven’t been able to find out much about hemangiomas on the net. Perhaps I’ll try to find a hepatologist, but that will take time.

I’ve been reading a bit about exercise-induced hypogonadism and it sounds like a strong possibility in my case given the fact that my problems started after I went too far with the long-distance running and poor eating habits. I don’t know if I’ll be able to restore my T levels to healthy levels but things like this do sound promising:

http://www.fertstert.org/article/S0015-0282(97)81384-2/abstract

In the study, hypogonadism was reversed in a male runner by using Clomid. From reading KSMan’s recommendations, Nolvadex seems to be a better option than Clomid but the big issues for me are dosage and duration of treatment. Also, I like doing cardio (cycling and running) and I don’t want to cut that out simply because my body seems to have a hard time with endurance training and maintaining testosterone levels.

Sorry for bumping but can anyone point to reliable source for Nolvadex dosing where the purpose is to restore FSH and LH?

Landslide I don’t know of the dose. I don’t know if it is better than clomid but it does raise fsh and lh. I may take some of that as well…plus it is relatively safe with few side effects and doesn’t really mess up your system that much (like an aromatase inhibitor would). What I am going to do is most likely buy it off an online pharmacy and tell me doctor what I am going to do and have him monitor the levels. I am not sure if Nolvadex is used as much as something like Clomid is to restore fsh and lh levels. But it is less expensive to buy and easier to find. My guess would be the standard breast cancer dose??

Maybe like 20mg for 2 months?

Ok, thanks for the input. I’ll have to run this by several doctors to see what they have to say. This isn’t something I want to mess around with given the amount of unknown factors. Anyway Retionoid, it’d be interesting to hear about your results if you decide to go ahead with a Clomid/Novaldex trial on your own.

Btw, are you in a simliar situation i.e do you suspect cardio overtraining has permanently messed up your hormones?

[quote]landslide wrote:
Ok, thanks for the input. I’ll have to run this by several doctors to see what they have to say. This isn’t something I want to mess around with given the amount of unknown factors. Anyway Retionoid, it’d be interesting to hear about your results if you decide to go ahead with a Clomid/Novaldex trial on your own.

Btw, are you in a simliar situation i.e do you suspect cardio overtraining has permanently messed up your hormones?[/quote]

Idk what caused it my dad had hormonal problems (gynecomastia with lactation and fertility issues) and my sister has hormonal issues (hair growth on face). I have the least physically apparent issues. However when I was 13 I took accutane and starved myself to lose weight for months and threw up food…so that could have caused issues?

Landslide, I am using 50mg of iodine (with selenium) to try and do the same thing. I know iodine helps tremendously with estrogen dominance (thyroid disease, fibrocystic breast disease, breast cancer) so perhaps it may work the same in the hypothalamus as tamofixen or clomid will (by blocking estrogen from binding to the hypothalamus which reduces fsh/lh). I will keep you posted as I am getting a new test in about 2 months.

I did a search and came across this thead. I felt I could help this young fella given my experience and similarities. This is my first post. Take it as a grain of salt if you’d like.

I used to be very active in sports, weightlifting, social life etc. I was 23 at the time. I began working a full time job and immediately noticed something was off. My cognition and memory were terrible. I had cold intolerance, primarily cold hands and feet, often turning blue under extremely cold temps. I had NO sex drive, despite being with some HOT women.

I was basically FUBAR. That lead me on a journey of discovery. After 6 months of playing the doctor game, I self diagnosed low testosterone. I was referred to an endo where she put me on andro gel which “sucks” and a small dose of levoxyl b/c my thyroid was subpar. I later had her switch me to test enanthate since the gel was terrible.

Still felt terrible and still slept 14 hours a day without feeling any better. Well, now, I’m probably 75% well and can attribute my feeling better to a few things.

Number 1, if you have low testosterone or low thyroid for a prolonged period of time, your body will be able to sustain itself. However, when your reserves (your adrenals) runout, you’ll start to notice “something” is wrong. Usually its too late. So, what can you do? Well, let me ask you this. Would you like to recover your adrenals, only to crash again because your genetically low T levels, or hypothyoid? or would you like to be on testosterone, feel better and recover your adrenals “faster” and feel better overall?

I asked myself the same thing and chose option #2. Like you, I resisted testosterone therapy for 1 year. I felt horrible during that time. After 1 year of testosterone therapy, I felt better. Much better than the year before. And 3 years later, I’m 75% back. I’m not 100%, however I am almost certain I know now enough to guide myself to victory.

If I was you and knowing what I know now, this is what I’d do:

  1. Get on bioidentical testosterone cream or weekly testosterone injections. This will be standard for awhile until you have enough energy to possibly consider coming off and you’ve completed steps 2,3, and 4.

  2. Recover your adrenals. Take it from me. You can play with sythroid T4 or naturthroid and armour T4+T3 or Cytomel T3 only or sustained release, but until you are able to produce “Enough” cortisol to sustain your lifestyle, you’ll need support. I’ve done the natural route and when I didn’t know what I was doing, did 1 week of hydrocortisone cream to no avail. I’d recommend supplementing with hydrocortisone over the course of the day to suppress your adrenal activity. 20-30mg.

Why not less? Well, your adrenals need to recover, by supplementing with less, your adrenals will need to work during the day. Good? No, not if they’re exhausted.
Give them time to sleep and recover. Also, isocort and herbs of sorts were NOT helpful. Only the real thing works, hydrocortisone (i.e. Cortef)

  1. If you’re still feeling crappy, I’d say T3 only therapy. You could go with T4+T3, however, when your body is under extreme stress, as it has been for sometime, it’ll start converting t4 to reverse T3, which will bind to your thyroid receptors making them inactive to stimulation, slowing your metabolism and basically making your thyroid inactive, despite “good” thyroid labs. T3 only, titrated up, will slow your thyroid hormone production.

This will allow less T4 conversion and allow your body to discharge reverse T3. Basically resets your metabolism. Some see results after a few weeks, others take 12 to 15 weeks. You’ll need cortisol utilize your T3, so if your body isn’t producing enough, you’ll want to stay on hydrocortisone until leveling your body out. The best way to tell if you’re at the right dose is symptoms and objective temperature reading. If your temperature is steady, which yours is not, you have hypothyroidism. But if its all over the place, like mine and yours, you have adrenal problems.

When your temperature stabalizes, that means you have enough cortisol to stabalize your metabolism and its onging temperature. Think of cortisol as a shuttle to your cells which hold temperature constant. If there are not enough shuttles, there will not be enough thyroid, which will create a rise and fall in temperature. Make sense? Fine tune your T3 dose until this happens. Leave for a week or two, and then start coming off.

Stay on your cortisol during this time. If your temp starts to fall, unable to reach 98.6. Stay on the dose until it stabalizes. Keep lowering the dose until one of two things. Either your completely off thyroid, and your temp stays at 98.6 or you cannot go any lower on your thyroid dose. If you cannot get off thyroid without temperature dropping, you most likely are hypothyroid.

  1. Start weaning off cortisol if and when you can. You adrenals take time to recover so go based on how you feel. If you start to feel crumbing or your cold hands and feet, you’re not ready. Stay on until you can successfully get off without any residual symptoms.

  2. Start recovering testosterone or remain on longterm test therapy. Personally, I like the latter. Why? Your body will start lowering T production in your 30’s which isn’t good. So if you can keep your levels steady in the optimal youthful ranges forever, you’ll be WAYYYYYY ahead of the game. And, you’ll be running circles around your buddies and feeling very good, when you have a six pack and they have a beer gut. Test helps everything as long as your safe and monitor it correctly.

Okay, I’m done now.

You still around your e2 seemed way too high same with SHBG. Your results look like mine. You still around?