Road to Recovery (Horrible Hormone Panel, Anxiety, Etc.)

Pharma TRT
41

some feedback as per request in another thread

  • cut back on your training, as @hardartery commented it’s not a healthy sport what you do and your are already suffering from the consequences of overtraining combined with dieting. Hit the gym max 3 times a week and mix weightlifting and cardio and give your body enough time for regeneration

  • depression and anxiety disorders are not necessarily linked to low T or hypothyroidism. Especially if it runs in your family there might just be a genetic predisposition. I don’t think you can finally ‚solve’ this, but you can learn about behavioral pattern which do you good or which do you bad (psychotherapy is a great way to learn about this) and you can rely on drugs such as SSRIs. A combination of both is a very good start and over time you will be able to drop one or the other

  • stay on the SSRI as it stabilizes you, but if possible find a way to stop the mitrazapine, even if this means that you need to up the SSRI dose

  • Thyroid: You might actually be subcl hypothyroid, but your higher TSH and your low T might just be caused from overtraining and dieting. The higher TSH might indicate an occult Hashmimotos disease. You should test anti TPO antibodies and anti TG antibodies to investigate further. Forget rT3 as it is a symptom of systemic inflammation or starvation. If you have lab values or not doesn’t make a difference as your symptoms and your TSH will guide a potential therapy with thyroid hormones.

  • regarding thyroid hormone therapy: you can either wait for another month of less training and good nutrition (please stop all the supps, they are no long term solution anyway) and retest (there is a tendency that TSH has gone down over the last months) or if you don’t want to wait start with T4 therapy. Typical dose to start is 25 mcg and you would titrate up every 4 weeks by 25 mcg until symptoms resolve (typically somewhere between 75 to 150 mcg) and TSH is between 0.5 and 1.5. If you don’t get full symptom relief on T4 when TSH is below 1.5 than add T3.

  • regarding T: There is a good chance that your T levels come back to higher levels when you reduce your training. There is also a good chance that (in case you are really subcl hypothyroid) the T4 therapy will increase T levels.
    If reducing stress on your body by cutting back in your training amount and T4 therapy doesn’t show benefits regarding T then start TRT, but only then.

Take care!

1 Like
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Thank you very much for responding @johann77. It is very appreciated!

  1. I will do that, and to be honest I have been doing that for 2 weeks now. Because I just can’t regenerate my body after more than 3 trainings.

  2. That is what bugging me the most. I have been told that it runs in my family (only from mother’s side) and multiple members of my family are on SSRIs. I have done behavioral psychotherapy, and I have been told how to ideally deal with any problems in life and it has helped me greatly. However, after the competition my hormones from contest prep were horrible and I think it has intensified my already existing problem that I am prone to anxiety. I was in a constant figh mode and we ended our relationship with my psychologist on a bad note (him thinking that I am hypochondriac and doesn’t want to deal with any problems.). But I think from therapy point of view I have done my homework.

  3. I have been weening of 3,5mg of Mirtazapin for 7 seven days, I have implemented 600 mg of Magnesium bysglicinate and 3 g of L-tryptofan to my “sleeping stack” and I am able to sleep. But only time will tell if I can function without Mirt. I am more tense last two days wihthout an apparanet reason. If it can’t be done, I will add another 5 mg of cipralex, in total 10 mg of cipralex. I just hate the idea of me being relied on SSRI’s I take it as my life’s biggest failure, and that is why I am searching for every possible way to not use them and use T or thyroid hormones instead. I just don’t want to end up as a dampen person without any goal in life.

  4. I will do these labs and post them as soon as possible. In terms of Thyroid therapy. I have been reading the Stop the thyroid madness book and they celebrate T3 the most. And the book shows that many patients don’t convert T4 to T3 efficiently and the T4 creates more problems. Would’nt it be better to start with T3 since it is the active hormone? Brain has the biggest amount of T3 receptors and the adequate amount of T3 should help with adequate production of norepinephrine, epinephrine, serotonin and etc. In the book there are many people who are on NDT or only T3 and they have significantly got better. I just want to know your opinion before I do any action.

And again Johann77 thank you for your input!

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I think that with the measures taken you are on a good way to recovery.

Dont worry about the dose increase for your SSRI, it helps you to stabilize and thats what you need right now. You can taper it down later when you figured out the rest.

Regarding T3; no, donf start on T3. I strongly recommend to start on T4 and to monitor TSH. There are good reasons why no medical association recommends T3 only treatment for hypothyroidism. T4 T3 combo is an option if T4 doesnt work.

With regard to T3 rT3 i highly recommend to watch this video

Take care!

Problem w/Hormones & Libido for Long Time
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Thank you again @johann77 for your insights!
There are multiple studies and also opinions on how to treat hypothyroidism. I am influenced by the Stop the thyroid madness books (1st and 2nd) and the author strongly advocates to use NDT or T3 and she is against T4 alone. But there are no studies at her side. So I have already ordered Thyroid S (NDT) and also T4. I will try T4 first and as you instructed I will begin with T4 only if symptoms won’t resolve I’ll switch to NDT.

I will add some more bloodwork that I have done throughout some years. Can you please give them a look and tell me if there is a really hint of hypo?
My first bloodwork
18.5. 2017
TSH: 4,390 mU/l 0,4 - 4 HIGH
fT4: 14,3 pmol/l 11,5 - 22,7
fT3: 4,4 pmol/l 2,4 - 5,7
S_Anti TPO: < 0,3kU/l 0,0 - 5,6
S_Anti TG: 1,3kU/l 0,0 - 4,1
S_SHBG: 25,8 16,2 - 68,5

28.7. 2017
TSH: 2,940 mU/l 0,4 - 4
TT: 24,1 nmol/l 6,073 - 27,1
E2: 179 pmol/l 0 - 172 HIGH
I was on HCG that time (Felt great libido, energy wise but I was again in tense). I didnt test fT3, fT4 becouse of money :/). I have tested TT, E2 and HCG helped me to raise these numbers.
7.11. 2017 (That time I was on Nolvadex to “complete my PTC”. Again no fT3, fT4
TSH: 5,010 mU/l 0,4 - 4 HIGH
TT: 27,9 nmol/l 6,073 - 27,1 HIGH
E2: 119,3
After this bloodwork I havent used anything for a year.

13.07 2018 (Year without anything)
TSH: 2,750 mU/l 0,4-4
E2: 82,2 pmol/l 0- 172
TT: 14,8 nmol/l 6,073 - 27,1
27.8. 2019

And this one was three months after the first competition (unfortunately probably the last). And it was the most horrible time of my life.

TSH: 3,420 mU/l 0,4 - 4
E2: 90,0 pmol/l 0 - 172
TT: 7,8 nmol/l 6,073 - 27,1

The latest lab work is above in a previous post. My TSH was all the time elevated so I think there is some kind of connection between my symtomps and wonky thyroid? My shipment will arrive in 3 weeks and I want to do one last final very thorough lab work and start with T4 or NDT. What is you opinion about my bloodworks.

Thank you again!

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I think you can give T4 a shot and see how you develop.

Realisticly there is a 50:50 chance that you will benefit from thyroid hormone substitution. TSH is consistently borderline high. Just give it a try.

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Hello again !,

Can someone please give me an opinion about my labs? I have just tapered down my AD (currently 1 week off) (in the morning: Vitamin C (sustained release) 2000mg, before sleep: magnesium Bisglycinate 400- 750 mg and L-Tryptofan 3mg).
Results:
TSH: 3,270 (ref. 0.4-4), BORDER LINE HIGH
fT4: 14,8 (11,5- 22.7).,
fT3: 4,3 (2.6- 5.7),
Iron: 20.4 umol/l (12.5 - 32.2), QUITE LOW
Ferritin 65,9 ug/l /20-250), QUITE LOW
Magnesium: 1.00 mmol/l (0,73- 1.06),
S_Transferin 2,47 g/l (1,74- 3,64),
Vit. B12 279 pmol/l (138 - 652), QUITE LOW
Folate acid 16,5 nmol/l (12.0 - 46.4). QUITE LOW
Albumin: 45,6 g/l
Progesteron: 1.08 nmol/l (0.22 - 4.39)
Estradiol: 143 pmol/l 0-172)
Testosterone: 15,1 nmol (6.073 - 27.1) BETTER
Folitropin: 6.8 U/l (1.27 - 19.26)
Lutropin: 5.3 U/l (1.24 - 8.62)
DHEA-SO4 7.05 umol/l (4.60 - 16.10) QUITE LOW
SHBG: 24,7 nmol/l (16.2 - 68.5)
4 points saliva cortisol test is quite low: Morning (6:00) 15,3 (ref. ran. 13- 24), Noon (12:00), 3,5 (ref. r. 5-8), Afternoon (17:00) 6,2 (4-7), Evening (22:00) 1,5 (1 - 3).
Total cortisol burden: 26,5

I want to start supplementing with vit B12 (methycobalamin) and folate supp. I want to add elementary iron to the mix. Also I want to supplement with DHEA, because starting with cortisol would mean lowering my testosterone levels. I am starting to think that testosterone is not my primary problem, becouse it is keep getting better.
Do you think that supplementing these supp can help me to balance me out? I know that DHEA won’t transfer to cortisol only but many other sex. hormones, but maybe it can help me to kickstart my own production of “everything”. Low iron, low vit. B12, low cortisol according to saliva test, TSH border line high it is all leading to subclinical. hypothyrodism. I just don’t know if I fucked my system up with these two BB competition or if I have problems with thyroid and these hormones since my childhood.

I don’t want to start with TRT, because my already low adrenals would get a big kick and my thyroid wouldn’t also help that matter. Also I could use only patches because it is the only way in the Czech Republic to get TRT. The absorption of the patches is not that good if your thyroid isn’t good, atleast that’s what I read in the forums here. Same with the T4 or Thyroid S medication. There is no point to supplement it when my cortisol is low, I would get hyper with increasing the dose. I don’t want to take cortisol (Hydrocortisone or ACE). Or would you recommend to supplement with low doses of Ace or Hydrocortisone, try Thyroid -S with it?
When I tapered down my AD I was horny for like 4 days, had sex multiple times a day with my girlfriend, and I have energy to do many things throughout those days. I am training 3 times a week (full body).
After three days my heart started to pound really hard and I felt adrenaline spike. and last three days I am tired, but no bad mood. I think I just need to soldier through the mild withdrawals from AD and never compete in BB show again because my endocrine system and CNS is unfortunately really sensitive to everything. Also I think if I can fix the values and have the right amount of the vitamins and minerals I can live a quite wonderful life without TRT or thyroid medication. I just dont want to end up on AD again.
What are your opinions?
Thanks in advance!

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Almost perfect average for men your age. Absolutely no need to supplement with DHEA; could do more harm than good.

And please forget the salivary cortisol test. If at all, it confirms normal cortisol levels and virtually excludes adrenal insufficiency.

1 Like
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Your idea of low needs some realignment, these iron levels aren’t even remotely considered low.

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Hey there, update from the last time. In a nutsheel it is slowly getting worse and worse.
Two weeks after I stopped AD, I felt perfect in terms of energy, strength, libido. I enjoyed all things in my life (gym, work, girlfriend not necessary in that order :D). On Saturday three weeks ago I had debilitating headache like never before. On Monday I suddenly out of nowhere felt adrenaline rush and since then I feel the rush, tightness in my back and chest. Really sensitive to loud sounds and if I move I feel my heart pounding fast. Tired, out of breath easily. Cold feets, hands No bad mood, just starting to be irritated by this constant tense feeling. No racing thoughts. No libido because of tense feeling, when I want to achieve errection it can be done.

Gym 3 times a week: Fullbody, I am relatively strong Basic lifts (8x4 Bench 264 lbs, 8x4 Deadlift 374 Lbs, 8x4 Squat 352 lbs)
Going to sauna 2x times a week (4x15 min in Finnish Sauna then 4x in a cold pool) - during these session I really feel without tense feeling and sauna helps me. 5 minutes after the session tense feeling comes again.
Because of Corona all the gyms are closed so I havent had any physical activity for 4 days and I try to rest, but constant tense feeling and endless tiredness, cold feed and hands.

My supps: Vit B12 (liquid form- 1,25 ml), Vit C (2000 mg), Iron (18mg) before breakfast. During breakfast: Folate (1000mcg - one tablet), Vit D3 (3-5000IU).
Evening:: Mag. bisglycinate - 500mg and L-tryptofan 700mg 1 hour before bedtime. Fortunately I am able to sleep 6-7 hours.

I really don’t know that to do anymore. I virtually have no problems in my life. I enjoy doing my work, having supportive girlfriend, doing what I like. But I am tired, tense feeling, starting to feel not to be myself again. I am able to go through that because of my will, but it is only a matter of time to be really irritated and start to have problems because of it.

3 options in my head:

  1. MY TSH has been Borderline high all the time, get on the NDT (I have bought Thyroid-S) start with half a grain in the morning and after two weeks upp the dosage to 1 grain and eventually end with 2-3 grains split in two or three dosages (The highest in the morning, the lowest in the evening). Aim to have T3 at the top of the range, and T4 half of the ref. range) and just pray that the tiredness, being out of breath, cold feet and tense feeling will go away.
  2. There are limited TRT options in the Czech Republic, there is a private clinic which offers testosterone gels only. But I have wonky thyroid so probably I wouldn’t absorb it well. I need to fix my thyroid first. I dont want to do it underground although I have options to get it from I THINK legitimate source.
  3. Accept that it is a mental thing and I am genetically predisposed to have anxiety. Can someone recommend me specific AD’s which has the least sideeffects in terms of tiredness, libido? Mirtazapin and Cipralex were an epic failure. I was lifeless constantly tired and absolutely without libido. But somehow without that intense feeling but I just dont want to make this compromie yet.

I just want to do whatever it takes to avoid psych meds and find an alternative route. Even if it is mental problem I just want to find something which doesn’t ruin my libido and I don’t want to be tired all the time. What do you think guys? What is your opinion? @johann77@ @systemlord @dextermorgan @ncsugrad2002 @TRT_Phoenix @dbossa

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What antidepressant did you take and for how long were you on it?
How long did you wean off of it?

The one with the least side effects when coming off is Wellbutrin. When coming off antidepressants you really need to wean off them by very tiny amounts over a long period of time.

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Thanks for a reaction Dexter. I was on cipralex (escilatopram) 10 taken in the morning and 10 mg Mirtazapin taken before sleep. I was on mirtazapin for 3 months (October - December I tapered it from 10 mg and the last taken amount was 2,5mg I tapered it over 2 months). On cipralex I was for 4,5 month (October - till the first week of February) I tapered to 3,5mg and then quit (tapered over 2 months).
I know you will say it is a really fast taper but I wanted to get rid of this shit. Now I have to suffer I guess for many months.

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Or you could just take it and slowly decrease the mg every over time and have little to no withdrawals. I did that with Effexor, Lexapro, Hydrocodone, Tramadol and even Oxycontin after previously doing what you’re doing. I did it over a 6-9 month period. The most important part of the taper is when you get down to the very small amounts.

I personally think you are going through shit that you don’t have to and the mentality of “I just want to get off” makes zero sense if that means going through hell for extended periods for basically no reason. Those drugs aren’t going to hurt you if you have to stay on a little longer. That said, I’ve done it your way several times before realizing so don’t take what I’m saying as anything negative towards you. There’s just a better way.

54

I don’t take anything negatively I just want opinions and understand why I am feeling like this. Thank you for your response. I am off 6 weeks. What would you recommend to me? Hop on 5 mg of cipralex and see if my symptoms vanished? And after let’s say 4 weeks try to lower it by 10% for one month?

You wouldn’t try a trial of thyroid meds to see if my symptoms get better and finally get my TSH under 3,5? Maybe I have subclinical hypothyroidism and that is why I have these symptoms. Just a thought.

55

If your issues are neurotransmitter related it takes a very long time for them to go back to normal which is why a very slow taper from antidepressants is the way to go. If it were me that’s what I would do (and have done).

Even if you got thyroid under control it’s not going to alleviate the issues from coming off the antidepressants. I would go on a low dose AD for a few weeks then try the thyroid meds while you slowly taper. It’s not an ideal situation but it’s the current situation.

56

Wow. I think all you need is to eat, sleep, and take about 175mg a week EOD shots. Once you get that dialed in the rest will follow.

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As I wrote in the previous post, in the Czech Republic there aren’t private clinics which offers injections. Only gels.
Also based on what do you think I need test (based on my labs, symptoms)?