I’m in my early 40s, diagnosed with hypothyroidism that has been treated for about a decade, overweight (working on that and have lost 80lbs in the last year). Ive been noticing a growing intensity in symptoms that are common with hypothyroidism and low t so I’ve had my PCP order some tests. She ordered 2 testosterone tests and 1 SHBG.
Results:
TT - 265 ng/dl and 321ng/dl (264-916)
FT - 9.6 pg/ml and 8.1 pg/ml (6.8-21.6)
SHBG - 24.1 nmol/L (16.5-55.9)
My tsh has been .85 to 1 for several years.
Communicated symptoms of low libido, low energy, decreased mood, brain fog and that they’ve gotten worse.
I know LH and FSH also need to be tested. If I’ve understood everything I’ve read, prolactin and estradiol really should be as well.
From what I’ve read without knowing LH and FSH it looks like potential mixed or secondary hypogonadism, correct? I’m trying to get a good understanding of all this in order to figure out what I need to do to correct any issues.
No way to know without them. It could be a case of extreme dieting and weight loss. What are you eating every day? How much excercise? Surprisingly intense exercise lowers T levels to a degree and it’s a double whammy if nutrition and sleep are lacking.
I’ve been doing a looser keto. No junk food, no fast food, usually aiming for 55% fat, 35% protein, 10% carbs. Weighing food and tracking in myfitnesspal usually aiming for 1700 calories.
As far as exercise, it is definitely not where it should be. Mostly cardio outside of work, walking 8-10 miles a day 5 days a week. 2.5 years ago I tore my proximal and distal bicep tendons, labrum, and rotator cuff. I’ve had to have 3 surgeries so no gym lifting. Lifting has been pretty limited with restrictions from orthos and rehab.
Sleep could be better but average would be 6-7 hours. Always feel well rested when i wake up and that takes a nose dive mid afternoon.
Just a guess but I would feel like crap and exhausted if my carb intake was only 10% of total macros, especially if I were in a calorie deficit as well. It won’t boost your T levels but upping your carbs could give you more energy to get through the day.
you are similar to when I started TRT. i was like 212/7 on total/free
shitty exercise recovery - all well now with TRT.
my doses range from 140-200mg T/week. always tuning something. +HCG
I get that added carbs could help with energy levels but the afternoon crash was there prior to doing low carb.
The doctors office called today and told me that the 321 result was perfectly normal. Small town so I’m going to have to do some research to find a more thorough doctor. I’ve got an order for LH, FSH, prolactin, and estradiol through an online company. Im going for that draw tomorrow. If those come back normal then im going to put in orders for the rest of the thyroid tests my PCP neglects.
On the thyroid side I’ve got like 6 aunts from both sides of the family with thyroid issues and a cousin with hashimotos, PCP has only tested tsh for the past 3 years.
I do snore some. Haven’t had a sleep study yet. Sleep has been pretty uninterrupted, usually wake up to go to the bathroom. Sleep study is definitely something I’ve talked about with my doctor.
I thought hormones were my issue with brain fog and crashing but turns out I was having 90 episodes an hour per my sleep study. I had no clue. Now with my CPAP I no longer have the tired foggy feeling. Just one possibility.
Went for bloodwork for LH, fsh, prolactin, and estradiol yesterday.
Got the results back
LH 5.1 (1.5-9.3)
FSH 3.9 (1.6-8)
Prolactin 6.1 (2.0-18)
Estradiol 36 (<39)
Messaged my doctor about more in depth thyroid and getting an at home sleep study but I’ve been using my galaxy watch 4 to track sleep. I’ve been having very few sleep interruptions. Hopefully I’ll get something figured out as it seems like my doctor is stuck on the old school potential side effects of testosterone supplmentation.
Just a little update: I’ve got a sleep study coming up but have been tracking my o2 while i sleep, never drops below 91. Also has a scrotal ultrasound and found a varicocele that has caused some atrophy and has been a nice source of pain for a couple months so I’m seeing a urologist in a few weeks. The joys of living in the rural midwest, ALL specialists are months out for appointments.
Let’s be clear, there’s no doubt, you have low-T. Secondary is the most common.
Keto isn’t for everyone, you deprive the body of carbohydrates for fuel. This can lead to low-T, which amounts to starvation if you cut too much carbohydrates out of your diet.
Finding a doctor up to date in this area of medicine within the sickcare system isn’t going to be easy, especially in the Midwest. If you do find a doctor willing to prescribe TRT, the cure may be worst than the disease.
The guidelines are outdated, so clinical experience is needed to correct these shortcomings.
I had t tested prior to keto and it wasn’t much higher than it is now. I believe it was 364 like 4 years ago. I agree about the whole sickcare situation. The urologist I’m seeing does have positive reviews with TRT but if that doesn’t work out there is a semi local men’s health optimization clinic ran by an NP that has workes with trt friendly uros and endos in Boston and Chicago, after moving back to the midwest. From what I’ve seen her protocol is usually starting around 150mg a week and adjusted up or down based on numbers, symptoms, and goals.
Its been a long drawn out process but i finally got a referral to a urologist for another problem, looks like his protocol might not be the best (200mg 1x a week) but after the 2nd visit he agreed that my numbers were too low.
Everybody has this notion that more is better. It’s not. If you start too high you could immediately be forced into a side effect situation and then fine tuning becomes hard. It’s better to start at a low or mid range dose for dialing in purposes.