# Really need advice



## kris90 (Dec 13, 2013)

Hi all,

I could really use some advice. I'm a 23 year old active male in very good shape. I feel like from my teenage years to present I have suffered from chronic fatigue, brain fog, trouble concentrating, and forgetfulness (which has gotten worse). I have also always had a lower libido even through puberty. Well now add a few more symptoms to the list: morning headaches, dizziness, digestion problems (frequent bowel movements, or urges), anxiety, depression, and dry skin. I am in very good shape (lift weights 5x a week) but I have to watch my diet in order to stay that way (only eat about 2000-2500 calories per day). If I cut carbs completely out of my diet, I can lose weight pretty rapidly. To me, it seems as though I may have hypothyroidism.

Here is my most recent bloodwork results:

Nov 6, 2013:
TSH: 4.36 (0.35 - 5.00 mIU/L)
FT4: 20 (12 - 22 pmol/L)
FT3: 5.1 (2.6 - 5.7 pmol/L)

To me, it seems odd that my TSH is elevated (I heard anyone over 2.5 should be suspicious) yet my thyroid hormones are at the high end of the range? If T4 and T3 are normal/high, why wouldn't my TSH be suppressed? The doctor didn't understand this and said my thyroid looked good.

I have some previous bloodwork from the past year I will post below. It shows you the fluctuations, even though I got bloodwork measured at the same time each time.

Aug 11, 2012:
TSH: 5.69 (range: 0.35 - 5.00 mIU/L)

Aug 20, 2012:
TSH: 3.76 (range: 0.35 - 5.00 mIU/L)
FT4: 14 (range: 12 - 22 pmol/L)
FT3: 4.3 (range: 2.6 - 5.7 pmol/L)

March 16, 2013:
TSH: 4.86 (range: 0.35 - 5.00 mIU/L)

I really don't know what to make of all this, and obviously the symptoms are there. I am suspecting Hashimoto's as I've read there are times you may go through "hyperthyroid" periods, and times of "hypothyroid" which happens in the end. I asked my doctor to get the anti-bodies checked, but he said no and that they don't do that anymore, yet he wasn't willing to treat me.

Can anyone help me figure out what's going on here? Anyone with Hashimoto's had a similar experience? Currently in transition to a new doctor, so when I see her I will ask for the anti-bodies.

Edit: Almost forgot to add.. On my latest bloodwork, my WBC is slightly low along with Neutrophils. It's 0.1 outside the range, and my doctor never addressed this. After some research, low WBC is common in those with auto-immune diseases.


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## Octavia (Aug 1, 2011)

Wow, your November 6 results are interesting...as you are aware. Your FT3 and FT4 are fabulous, but your TSH is not. Have you had your thyroid antibodies tested? I'm also wondering about testosterone levels.


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## kris90 (Dec 13, 2013)

Octavia said:


> Wow, your November 6 results are interesting...as you are aware. Your FT3 and FT4 are fabulous, but your TSH is not. Have you had your thyroid antibodies tested? I'm also wondering about testosterone levels.


Thanks for your reply. Unfortunately I haven't had the antibodies tested as my doctor refused, but once I switch doctors, it will be the first thing I will ask.

It's funny you mention that, my testosterone levels are actually very low. I had those checked as well. Here are my results:

November 9, 2013:
Bioavailable Testosterone: 3.7 (2.7 - 19.2 nmol/L)

November 20, 2013:
LH: 2.0 (2.0 - 9.0 IU/L)
FSH: 1.0 (2.0 - 12 IU/L)

And then in the past, my Total Testosterone levels were:
12.0 (7.6 - 31.4 nmol/L)

I know this may be explaining a lot of my symptoms, and I'm VERY knowledgeable in the endocrine system especially the gonadal system, so this is a perfect example of hypogonadal hypogonadism (secondary hypogonadism caused by low pituitary hormones).

My doctor again refused to treat me (lack of knowledge), and I know most would disagree with what I'm doing, but I decided to self-treat. I put myself on human grade pharmaceutical HCG, and I am going to see how my body responds. So far it's been a week and a notice a boost in my libido, and my mood has somewhat improved. I am going to run it for 3 more weeks, and then switch to Clomid for a couple months. I will be getting bloodwork done midway through to see if my T levels increased, and after treatment to see if I fixed myself. If I don't fix myself, I will probably be asking a doctor for TRT.

As for my thyroid, I am very confused with a high TSH and high/normal levels of T3 and T4, so I want to wait for more bloodwork (antibodies).


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## Octavia (Aug 1, 2011)

Yes, you need those antibodies tested. Is your new doctor an endocrinologist?

I completely understand your frustration and your motivation to self-treat...just be aware that it will impact your labwork and may make things look better than they are.

We have some other people here who are more knowledgeable than I am about low testosterone...I'm sure they'll be along.


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## joplin1975 (Jul 21, 2011)

I'm only seeing this second hand (my husband struggles with low T), but I do know it is critically, super duper, totally important to get a thorough exam by (preferably) a urologist for testicular cancer before doing anything to treat low. So, I hope you do get cleared for that -- especially given your age.


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## kris90 (Dec 13, 2013)

Octavia said:


> Yes, you need those antibodies tested. Is your new doctor an endocrinologist?
> 
> I completely understand your frustration and your motivation to self-treat...just be aware that it will impact your labwork and may make things look better than they are.
> 
> We have some other people here who are more knowledgeable than I am about low testosterone...I'm sure they'll be along.


Thanks again, and I agree about the antibodies. I did get a second opinion from a naturopathic clinic that uses bioidentical hormones. They believe I have some sort of auto-immune disease.

My new doctor is not an endocrinologist, but she knows more about the thyroid, and it's who my wife sees. My wife was actually recently put on 50mcg of Synthroid for her thyroid. My current doctor now doesn't seem to think there is anything wrong with my thyroid whatsoever, although he does believe my T levels are on the low side. So he did refer me to a Urologist, and I have an appointment in February, so we'll see, I may or may not go depending on if I fix myself. My priority now is to figure out my thyroid/possible autoimmune disease.


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## Andros (Aug 26, 2009)

kris90 said:


> Hi all,
> 
> I could really use some advice. I'm a 23 year old active male in very good shape. I feel like from my teenage years to present I have suffered from chronic fatigue, brain fog, trouble concentrating, and forgetfulness (which has gotten worse). I have also always had a lower libido even through puberty. Well now add a few more symptoms to the list: morning headaches, dizziness, digestion problems (frequent bowel movements, or urges), anxiety, depression, and dry skin. I am in very good shape (lift weights 5x a week) but I have to watch my diet in order to stay that way (only eat about 2000-2500 calories per day). If I cut carbs completely out of my diet, I can lose weight pretty rapidly. To me, it seems as though I may have hypothyroidism.
> 
> ...












First and foremost, I believe you would do well to find a better doctor.

You clearly have antibodies and that is why the November labs are so strange. There are binding, blocking and stimulating antibodies to the receptor sites. It is my hunch that you are hyperthyroid.

So, these antibodies tests are essential.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

TSI is stimulating and Trab is blocking; hence the high TSH when the FREES indicate hyper.

Also, you would do well to get an ultra-sound to make sure you don't have cancer. Males are more prone to it and cancer does go hand and hand w/hyperthyroid. Actually, RAIU (radioactive uptake scan) would be a better choice under the circumstances.

http://www.ncbi.nlm.nih.gov/pubmed/12876418
The above on hyper and cancer was rare in 2003 but not so rare now. Probably due to better diagnostics or poorer environmental factors or both.


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## kris90 (Dec 13, 2013)

Andros said:


> First and foremost, I believe you would do well to find a better doctor.
> 
> You clearly have antibodies and that is why the November labs are so strange. There are binding, blocking and stimulating antibodies to the receptor sites. It is my hunch that you are hyperthyroid.
> 
> ...


Thank you for the insight. Wow, so you think the antibodies for hyperthyroid would be better to get checked than for hypothyroid? This is crazy, I never thought I would be hyper, since I have all the symptoms of hypo. What about last year when my T4 and T3 levels were lower?

I will definitely look into all this. You have me a bit concerned.


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## kris90 (Dec 13, 2013)

I just realised I have a swollen lymph node on my right side under my jaw. Could this be related? Its a little tender and sore.

EDIT: actually, there's 2 swollen lymph nodes side by side in this area. They seem to move around (almost slippery). Anyone think it's related to my thyroid?


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## kris90 (Dec 13, 2013)

Hi all,

I know it's been a while, but I am still struggling with hypothyroid symptoms (they almost seem to flare up this time of year). I will post all the bloodwork since my last post.

*December 21, 2013:*
TSH: 2.71 mIU/L (0.35-5.00)
FT4: 17 pmol/L (12-22)
Thyroglobulin AB: <20 kIU/L (<41)
Thyroid Peroxidase AB: 20 kIU/L (<35)
Thyroid Binding Inhib IG: <1.0 IU/L (<1.0)

*March 11, 2014:*
TSH: 2.35 mU/L (0.3-5.60)

*October 16, 2014:*
TSH: 2.94 mU/L (0.3-5.60)
FT4: 10.7 pmol/L (7.0-17.0)
FT3: 4.0 pmol/L (3.3-6.0)

*December 4, 2014:*
TSH: 4.29 mU/L (0.3-5.60)
FT4: 11.5 pmol/L (7.0-17.0)
FT3: 4.6 pmol/L (3.3-6.0)

Symptoms are: always feeling cold (especially hands and feet) despite normal temperature, constant fatigue even with good sleep, brain fog/forgetfulness/fuzzy thinking, dry skin, hair is greying (I'm only 24). My mother and her father both have hypothyroidism.

Just wanted to get opinions on my labs? I know I have it for sure, but doctor's are still not willing to let me try Synthroid. I'm going for yet another panel in February, and then the Endocrinologist will decide whether to treat me.

I also have secondary hypogonadism (low testosterone due to low LH/FSH) which I am 99.9% sure is caused by my hypothyroidism. I am treated with HCG because Clomid did not work. I have found about 6 studies that can connect low LH/FSH to primary hypothyroidism, yet the doctors shut me down.


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