TSH stimulates the thyroid gland and in turn produces thyroid hormone T4, which is then converted to other hormones like fT4, fT3 and rT3, these must be balanced or everything becomes dysfunctional. fT3 needs to be at least midrange, but is best to have higher, rT3 if healthy will be below 15 ng/dL.
The strange thing is, I am relatively lean with low stomach fat.
I’m 6’ 2 and 205 pounds currently.
I have actually lost weight over the last few months.
The only symptoms inline with hypothyroidism that I’m experiencing is tiredness, however I am still able to lift heavy in the gym, just harder to get there than it used to be due to the lack of motivation.
My appetite is high.
Blood pressure and pulse are excellent.
With my high SHBG and high TSH, where do I go from here?
They call that subclinical hypothyroidism, it doesn’t mean you should have to live with it. I think when you go on TRT your thyroid will break, subclinical hypothyroidism will quickly turn into full blown hypothyroidism because your metabolic rates are low because T is suboptimal.
If you’re testosterone was optimal, your thyroid will no longer be able to manage.
Those with thyroid problems have the biggest appetite because their metabolism is slow and nutrients from food is not absorbed well, so they body is still hungry.
You need to quit wasting time with sick care doctors who only care about ranges. You need to seek a doctor out who fixes hormonal problems for a living. This doctor will address everything, nutrition, make sure they are no mineral and vitamin deficiencies and then prescribe TRT and thyroid and isn’t a reference range hugging robot who can diagnose and paying attention to the symptoms because that’s is part of the diagnosis.
No endocrinologist will do all of that, because insurance companies will not allow it. You want to optimise your health, you have to pay for that on your own.
If I’m not absorbing nutrients and I have hypothyroidism, why is weight gain associated with hypothyroidism?
Not everyone will have the same symptoms, your body may just be super efficient. I’m not seeing any thyroid hormone testing. Your testosterone status is no good, you won’t hear anyone tell you otherwise.
I have read cases of women who have none of the usual symptoms of hypothyroidism. Some men lose facial hair when they are diagnosed with low testosterone, yet my hair is unaffected.
My TT as of recently is 97 ng/dL and 119 ng/dL, I have erections, good mental function except at night when T is lower and have lost all the muscle mass gained on TRT. Most guys lose the erection first or when dropping below 500 ng/dL and here I am at 97 ng/dL with erections.
I have sex daily and have absolutely no issue with erections anytime of the day even when tired.
You came here for other reasons, you have motivation motivation, feel tired and have notice a decrease in libido. This can be explained by your testosterone labs.
You have to choose if you want to go through life the way you feel now or how you felt when younger. I don’t think sick care doctors are the answer, they care about normal and you should care about optimal.
I absolutely agree with you on my health coverage. It is worthless, except the time when my appendix burst and they did an emergency appendectomy to save my life.
Where do I find a specialist outside of my health provider? I know nothing about this.
This is how our medical system works, the sick care system springs into action to save your life, it excels are treating acute conditions and is poor a treating chronic conditions. The reference range keep going down every couple of years, we need to pay attention to healthy ranges, but the insurance institutions would rather degrade the human condition for profit.
By doctors denying medical treatment, they are in fact creating a consumer for tomorrow where expensive treatments and surgeries are needed. TRT treats and prevents many diseases and yet is very difficult to get a prescription.
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Dont go overboard now.
Many people have TSH above 1.5 (actually 50% of the healthy population) and are perfectly fine.
A TSH over 3 can be a sign that something is wrong or developing with your thyroid, but your TSH level might also perfectly fine at the next blood check.
To exclude an immunologic cause for the slightly elevated TSH get anti thyroid antibodies checked; anti ThyroidPeroxidase antibody and anti Thyreoglobulin antibody.
A hypoechoic structure of the thyroid gland in ultrasound is also suggestive of an immunologic process as seen in eg Hashimotos disease. Maybe your report says something about this.
Selen, iodine and boron deficiencies are very unlikely with a healthy diet as long as you don’t use any medication or supplements that mess with absorption. Chronic proton pump inhibitors for stomach issues for example can cause absorption issues or chronic high dosees of flavonoids (eg quercetin) can lower iodine serum levels.
If you want to check iodine status you need to check it in urine, not in blood.
Sorry if it has been asked and answerd already, but how is your sugar status (fasting glucose and HbA1c) and your iron status (ferritin)?
High stress, job, kids, marriage? We tend to ignore the basis for every diagnosis and only focus on lab results; a proper anamnesis. But it’s a T forum.
Regarding T; free T is somewhat in the lower range. It’s measured right and not calculated? Keep in mind that measured freeT is frequently underestimated. Also the meaning of free T is not as clear as we think. Don’t get me wrong I think it had some merit but it’s a bit more ambiguous as many people think. %free T is irrelevant.
And your doc seems pretty reasonable. If you want to optimize you have to do that on your own, the medical system is not designed for this. If it gets unbearable test thyroid hormone replacement or TRT if you find a doc willing to test this. But be prepared that things can also develop in the wrong direction. It’s trial and error.
And apologizes if this all has been discussed before.
Thanks for taking the time to write this.
Yeah, lots of stress, 3rd kid - almost 2 years old.
I have a desk job, so I’m at a desk for 7 hours a day.
I’m going to request a full Thyroid Panel blood test as well as estrodial, dopamine and fasting glucose.
I may have to argue with them to give me the test but that’s fine. It took me 2 months of arguing back and forth before I got them to test my SHBG/Free T. Now that my Free T shows low, they just keep saying how my total testosterone is good/high therefore, you’re fine.
Actually i was not correct by saying that your free T is lowish, yout total T and free T is perfectly fine.
Your levels converted:
total T is 29.8 nmol/l
free T is 353 pmol/l
Please compare your values to the population distribution.
and this one is from Medscape
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You are referring to a population that is more sick than ever, testosterone is lower with each new generation. The range used to go all the way to 1500, not anymore because of the decline that is occuring, just wait and see what the normal ranges will be in 10-20 years.
I see someone coming into the forum then repeating what you are saying, I think people associate normal with healthy and this is part of the problem.
You have failed to consider to effects of xenoestrogens and EDC’s disrupting hormone production or what it is doing at the receptor level or if it is interfering with gene expression. Shorter length AR gene CAG repeat numbers will dictate how sensitive a particular subject is to testosterone.
There is no harm is trying TRT to see if if resolves the systems, after all we are treating the symptoms and not the numbers, he is not here because of his numbers, he is here seeking help because he has symptoms.
Thanks, wouldn’t the conversion be 374 pmol/l free testosterone?
I’m beginning to be more concerned about my Thyroid. I’m under the impression that if my Thyroid is off, fixing that will help bring hormonal balance - SHBG/Free T.
Something that I’m confused about is my “bioavailable Testosterone”. It appears to be rather high compared to the norm. What relevance does this have?
@KeepAwaySheeple is here to get some help, right. If he turns to a Thyroid forum than the members will tell him to get on thyroid hormone replacement. If he turns of a candidosis forum than everybody will tell him that his problem is candida overgrowth. If her turns to a Wilsons Disease forum and post maybe a borderline coeruloplasim level, then he will be told that he urgently needs to remove the exessive copper out of his system etc etc.
The problem will all of this forums - as much as a appreciate this platform here for exchange - is that people are strongly biased towards their own personal stories and there limited set of knowledge. One can get so fixed on T that all of a sudden everybodies problem is low T and TRT solves everything. Even if we dont know anything about their lifes except some lab numbers. T doesnt solve everything.
One of the most important things that you learn when doing academic research is to be aware of and to eliminate bias. Thats why in all experiments, be it in molecular biology or medicine, there is always a properly designed control experiment/group in place. When you keep saying that ‘you have seen’ X many people on this forum that this perception is highly biased and doesnt withstand any scientific scrutiny.
T concentrations decline and sperm concentrations decline, thats a fact. Endocrine disruptors are one hypothesis that could potentially explain this, but it still is a theory at least on the population level. And whats the consequences of declining T levels on a population basis for you, put everyone that doesnt fit to average T levels 50 years ago on TRT?
And does anything point towards the direction that EDCs are the reason for his symptons? I would say no. When you believe in the free hormone hypothesis - and the hypothesis has definitly some merit - than his freeT is kept in homeostasis, so his HPT axis works and his freeT levels are perfectly fine. Same for TSH. When you say that everything above 1.5 is a problem, than again 50% of the population do need to be medicated with thyroid medication. I dont think thats the soltuion.
Although we we are on average getting older than we have ever gotton during the entire history of the human species I agree that we might not be living the most healthy lifes. But I would rather turn to the obvious, the hectic life that we are living in, we get 100 mails per day, get phone calls and people try to catch you at the same time via Skype. We live a sedentary life style compared to 50 year, the rates of type 2 diabetes and obesity skyrocket in the last decades.
Do you have kids? Married? Life can be quite stressful when your kids are awake multiple times per night. When you need to get them in time to their day care and you have an important meeting at 8 am sharp. Kids come first, then you try to free at least some time for your marraige and then there isnt much left for yourself.
To convert pg/ml to pmol/l you have to multiply by 3,467. So it should be 353.6.
Regarding the bioavailableT:
Unfortunately nobody will be able to provide you the final answer (although some try to tell you that they know the truth). The role of freeT and bioavalableT is not unambigously known. There is evidence that only the non-SHGB-non-Albumin bound fraction (thats your freeT) is physiologically active and there is some evidence that the non-SHBG bound (so freeT plus T bound loosely to Albumin) is the relevant one. Your SHBG is high, but your system seems able to compensate for this by increasing totalT and therefore keeping freeT in a good spot.
I agree with your physician that your labs are fine but that doesnt mean that I absolutely know that they are. In medicine reference ranges are essential, simply because your personal setpoint at which you operate perfectly is not known. And in comparison to a healthy population you do great in your lab work.
My personal opinion (and thats not more than an educated opinion) is that I would re-test in a month. Re-test TT, freeT etc and Thyroid hormones and anti thyroid antibodies and then take it from there. Use the time in between to focus on other things and relaxation knowing that you are not ignoring your symptoms but just getting more data to make an informed decission later.
If things are not improving after (at least for the moment) accepting that your labs are ok, then you can always run a testrial on TRT or Thyroid hormone replacement in a couple of months.
This is your opinion and you know nothing of my personal experience, but personal experience is better than none at all. I would consider my knowledgeable limited.
It’s not just T concentrations declining, we now have people not conforming to their proper gender given at birth. You cannot and should not make a comparisons between someone seeking treatment and compare them to an unhealthy population and that is what doctors are doing.
Ones health status can be determine by sperm count alone because when health declines, sperm decline as well.
Cost of hormone-disrupting chemical exposure in Europe in billions
I got my doctor to order some more tests. I asked for a full Thyroid panel but she refused and only ordered Free T4 and TPO. They ran some other tests as well.
TPO - negative
Free T4 - 1.6 ng/dl (0.8 - 1.7)
WBC - 4.3 K/uL (3.7 - 11.1)
Neutrophils % - 46 (42 - 76)
Neutrophils Auto Count - 1.9 K/uL (1.8 - 7.9)
Lymphocytes % - 42 (15 - 47)
Red blood cells, hemoglobin were all a little above the middle of the ranges.
FT4 is pointless for those who have conversion disorders when they fail to convert enough T4 to fT3 and instead piles on the fT4.
It would be best if fT3 and rT3 were tested, because it doesn’t matter how much fT4 you have, if the other two are out of balance you are not going to be doing well.
FT4 isn’t even the active hormone.
High ft4 could mean it’s not being converted to t3 or it could mean you have plenty. No way to tell without ft3. I’d get ft3 tested along with the other thyroid labs on your own and see where you’re at.