# Hypothyroidism and/or Hypogonadism?



## Saskman84 (Dec 9, 2015)

Hi folks,

I just discovered this forum. For the past 6 months I have been frequenting testosterone related forums thinking hypogonadism was my main issue. I would like to get some members advice on thyroid, because its something that is new to me.

I have suffered from all low testosterone and hypothyroid symptoms since I was 15-years old. Especially erectile dysfunction and absent sex drive. Exhaustion. Work out hard so I dont gain weight. Fatigue. Brain fog. Its all there.

About 6 months ago, at the age of 31 I finally got referred to a specialist who is a urologist- not an endocrinolgist. He noticed that my testosterone levels were just under 200 or 7.4 in Canadian terms. He put me on a drug known as clomid or clomifene citrate, then after seeing my estradiol skyrocket, I am not on anastrozole which is an estrogen block used to treat breast cancer in women.

What he doesn't notice is that my thyroid is 4.97 miu/L, its hovered between 4 and this since I started getting bloodwork done. In Canada, the high range is 5.0 but from what I read, the high range should be 3.0- especially if someone is having symptoms.

So my dilemma now is, what is the source of my problems? After two weeks on Clomid I felt like a new person but it waned off. Four days on anastrozole has not gotten me anywhere- yet. After 3 months on Clomid my Thyroid TSH went to 2.5 from 4.5, but now back up to the ceiling.

Really would like to know if any members can relate? Is 4.97 MiU/L the source of my hypogonadism? Do I have hypogonadism as well as hypothyroidism? From what I read, having a high TSH is more of having a thyroid problem itself rather then with the pituitory gland?

Any suggestions or help would be wonderful. Thanks


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## Andros (Aug 26, 2009)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm
(Copy and paste into your browser)

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin and Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/
(Copy and paste into your browser)

TBII
http://www.ncbi.nlm.nih.gov/pubmed/9364248
http://en.wikipedia.org/wiki/Anti-thyroid_autoantibodies
(Copy and paste into your browser)

Blocking TRAbs (also known as Thyrotropin Binding Inhibitory Immunoglobulins (TBII)) competitively block the activity of TSH on the receptor. This can cause hypothyroidism by reducing the thyrotropic effects of TSH. They are found in Hashimoto's thyroiditis and Graves' disease and may be cause of fluctuation of thyroid function in the latter. During treatment of Graves' disease they may also become the predominant antibody, which can cause hypothyroidism.

What a shame. Most if not all of this could be related to thyroid.

It will be necessary to get an ultra-sound of your thyroid. Men especially are prone to thyroid cancer.

And I am going to list a lot of info which I pray you will read as it will help you advocate for yourself.

Your TSH could actually be higher if you have the Trab antibodies.

Welcome to the board; you will find much support and credible info here.


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## joplin1975 (Jul 21, 2011)

Hypogonadism can stress the system and can impact thyroid...and vice versa. As suggested above, you'll need to test more than TSH to figure out the chicken vs egg question.


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## Saskman84 (Dec 9, 2015)

Thanks folks for your suggestions already.

I have scheduled an appointment with a regular physician tomorrow locally, will request a full panel on the thyroid an ultrasound be done. I would also like to see my Cortisol levels.

I should say that when I began taking Clomiphene Citrate for hypogonadism, my TSH went from 4.5 to 2.4 MIU/L- the best thyroid number I ever had since I started getting it done two years ago. I am just wondering if its the estradiol that skyrocketed that ruined my positive initial results.


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## Saskman84 (Dec 9, 2015)

Hi Folks,

I am having difficulty convincing a doctor that 4.96 miu/L is underactive (despite having all the symptoms)

It was hard to prove hypogonadism until i saw a specialist, despite having levels that a 100 year old man would have.

I have a friend in Canada whose relatives often send me my prescriptions, since they are so cheap there. Levothyroxine is cheap here but I can't get a prescription because of the faulty reference ranges. Does anyone think that I should start taking this as a self trial? If so, can anyone recommend an amount for me to start (I seem to think 100 mcg from what I've read online)- I am 180lbs.


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## joplin1975 (Jul 21, 2011)

I don't think any of us would advise starting prescription meds without being under the care of a doctor. But I especially wouldn't advise it until you know your free t4 and free t3 levels (minimally). And I most definitely wouldn't advise starting at 100mcgs. With thyroid meds, you start really low, get regular lab work (that means TSH, free t4 and free t3), and slowly (at 6-8 week increments) increase if your labs and symptoms support the increase.


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## Saskman84 (Dec 9, 2015)

thank you for your advice. today i had blood drawn, including for tsh, t3, t4 and thyroid antibodies. today i also started taking 50 mcg of thynorm (thyroxine sodium) which my friend brought me back from India since I do not have a perscription here in Canada. 200 pills for less then 5 dollars!!

my tsh at last draw was 4.96 miu/L, the best it has been is 3.5 in one year. it seems general consensus today is anything over 3, with symptoms, can and/or should be treated with sodium thyroxine?

i have been feeling unbelievably terrible this month, since starting anastrozole with my clomid. i decided to cut anastrozole out entirely and reduce the clomid for hypogonadism to 12.5.

i wanted to try to treat my thyroid before switching to exogenous hormone replacement therapy, in case the issues are connected, many whom seem to think are. ive battled underactive thyroid symptoms since i was 15-years old, with no reprieve until now, so i do feel a little desperate...


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## evej13 (Dec 28, 2015)

Hi SaskMan,

I'm also in Sask! It's very hard finding a doctor here who will first of all test anything besides TSH, and secondly will prescribe NDT. I first got ill a long time ago, with what essentially felt like a very very bad flu. This progressed to anxiety and panic attacks. Docs here all said it was just stress, and I remained undiagnosed for 16 years. I finally researched myself, to try to figure out what was going on. That took 5 years! First I found a lady in the States who thought I might be hypothyroid and sent me thyroid glandulars, that eventually got stopped at the border. The glandulars helped a bit. Then, I found a DR (again in the States), who ran all kinds of blood tests, and told me I was "frankly hypothyroid". He sent me Levo, and again, after awhile, that got stopped at the border too. I was seeing an MD in Calgary at the time, who had tried many different tests and different types of therapies. He saw I was getting better from thyroid meds, and agreed to a trial of NDT for me, despite the fact that my TSH was at a "normal" level - at that time neither he nor I knew anything about FT3 and FT4, etc. Eventually, all my symptoms disappeared!! I now see an MD in Sask, who is willing to prescribe NDT, but doesn't have a lot of experience with it.

I'm just happened to see your post on this forum, and hope what I've said is helpful. If you keep looking, you will find someone who will run tests besides simple TSH. But, it sometimes takes a lot of patience... Just, don't give up - he or she is out there!

Best Wishes,

Eve


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## Saskman84 (Dec 9, 2015)

evej13 said:


> Hi SaskMan,
> 
> I'm also in Sask! It's very hard finding a doctor here who will first of all test anything besides TSH, and secondly will prescribe NDT. I first got ill a long time ago, with what essentially felt like a very very bad flu. This progressed to anxiety and panic attacks. Docs here all said it was just stress, and I remained undiagnosed for 16 years. I finally researched myself, to try to figure out what was going on. That took 5 years! First I found a lady in the States who thought I might be hypothyroid and sent me thyroid glandulars, that eventually got stopped at the border. The glandulars helped a bit. Then, I found a DR (again in the States), who ran all kinds of blood tests, and told me I was "frankly hypothyroid". He sent me Levo, and again, after awhile, that got stopped at the border too. I was seeing an MD in Calgary at the time, who had tried many different tests and different types of therapies. He saw I was getting better from thyroid meds, and agreed to a trial of NDT for me, despite the fact that my TSH was at a "normal" level - at that time neither he nor I knew anything about FT3 and FT4, etc. Eventually, all my symptoms disappeared!! I now see an MD in Sask, who is willing to prescribe NDT, but doesn't have a lot of experience with it.
> 
> ...


Hi Eve,

Wow. Ironic story, thanks for sharing. I live in rural Saskatchewan, in Estevan to be exact. My specialist I see is located in Swift Current, I have to go to Regina to buy drugs at Costco and sometimes get tests done, and soon I will go to Saskatoon for another analysis.

i am not sure what NDT is? the local doctors think that having a TSH level of 4.96 miu/L is totally normal. they also told me the same about my testosterone levels, and nobody ever said a thing about my higher then normal cholesterol levels which I have had since a teenager.

today i did get bloodtests for all thyroid counts done, including antibodies. i also started without doctors approval, generic levothyroxine that my friend brought from india. i have 200 pills of 100mcg so it should last a long time, as i only plan to take 50 daily.

for your MD in Calgary, did you have to see a private doctor? i too have had anxiety and panic attacks since I was an early teenager, up until now. my temp is always below 97, usually 96 and tsh and testosterone have never been normal, now that I learn what normal is. the doctor who is a urologist put me on hormone therapy, but it seems its quite possible the real problem could be thyroid, or vice versa!

i am very happy to hear you found help.. too often I have heard people having to seek help in the US privately over here in Canada.


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## Saskman84 (Dec 9, 2015)

evej13 said:


> Hi Saskman,
> 
> NDT is natural desiccated thyroid. It's made by ERFA here in Canada. Some people just don't do as well on the synthetic T4 (Synthroid or Levo) as they do on ERFA because they don't convert T4 to T3 very well. I'm one of those.
> 
> ...


Hi Eve,

Yes, I did convince my doctor to give me a t3 and t4 , antibodies, but he has said he is not that familiar with thyroid problems. I told him that thyroid ranges are the same as testosterone ranges, out of date and the in range does not equal normal. I told him about the 2003 American Endocrinologists who suggest that anything over 3.0 miu/L is the pathway to thyroid disease and warrants a trial of levothyroxine. He suggested that I seek a GP who may know more, but the GP knows even less then he does and was becoming offended when I was giving him medical details. So I called back my specialist and told him and he sent me a new blood req form.

I was thinking of checking out a private clinic in Calgary, though I am guessing they are quite expensive. Fortunately my friend from India was able to bring me back thyroxine sodium because it doesn't seem easy to get a prescription for it.

Panic attacks are truly terrible! I am just greatful to know the rootcause of my anxiety and panic could have been due to faulty hormones. After only 1-day on 50mcg of THyroxine Sodium, I feel more relaxed and I had energy after my 12-hour night shift. I woke up wide awake. Perhaps its all in my head, but I am hoping things will get better.

Did your anxiety go away when you began treatment?

I will post the ranges of my thyroid panel when I get them back in March.

[/QUOTE]


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## evej13 (Dec 28, 2015)

Hi Saskman,

I've also seen doctors who were offended when you seem to know more than they do. I don't quite get that, but it happens a lot. And, I agree that it's tough to get prescriptions for thyroid meds sometimes. Keep looking though, you will find someone. The clinic I went to in Calgary was quite expensive, unfortunately. And, I know there are more than one. The one I went to was integrative.

My panic attacks were completely gone until I made the mistake with Calcium... for many years. What I found, when i was first diagnosed, and treated with Synthroid (I'm now on natural desiccated thyroid) was that symptoms disappeared one at a time. I don't recall the exact order anymore, but I remember being surprised when, one day I woke up and did NOT feel nausea! Then a few weeks later, I woke up with ZERO panic! Progress felt a bit slow sometimes, but I was ecstatic as each of those symptoms slowly went away.

Best Wishes,

Eve


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## Saskman84 (Dec 9, 2015)

evej13 said:


> Hi Saskman,
> 
> I've also seen doctors who were offended when you seem to know more than they do. I don't quite get that, but it happens a lot. And, I agree that it's tough to get prescriptions for thyroid meds sometimes. Keep looking though, you will find someone. The clinic I went to in Calgary was quite expensive, unfortunately. And, I know there are more than one. The one I went to was integrative.
> 
> ...


Hi Eve,

I would like to get an MRI of my pituitary gland and one of my thyroid as well. A common cause for the rare disorder of having both hypogonadism and hypothyroidism is hypopituitarism, which often results from some form of usually non-cancerous tumor on the pituitory gland. My doctor seems to think since my prolactin is normal, this isn't the cause, but on the Internet I see others who still seems to think that doesn't guarantee anything. For my own mind, I need this. I am going to Calgary at the end of this month to write a test, so if I could get this done that would be awesome.

Can you recommend anyone? Maybe the same place that you went?

I should say that since I started Thyroxine sodium a few days ago, I have felt more relaxed and less anxiety.


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## evej13 (Dec 28, 2015)

Hi Saskman,

Sounds reasonable to me to get an MRI of your pituitary. Possibly an ultrasound of your thyroid?

Seems to me that knowing your TSH, FT3, FT4 would also give you a hint as to whether there's pituitary involvement or not, as there are definite patterns that suggest whether you have primary or secondary hypothyroidism. Also, can't forget about the thyroid antibodies as well.

I don't think we're allowed to actually give names on the forum itself, but I think I can PM that info to you.

Glad you're feeling less anxiety already. Hope that continues for you! 

Best Wishes,

Eve


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## Saskman84 (Dec 9, 2015)

kremer5 said:


> Sorry to go a bit off topic, but how are you responding to the clomid? Have you had tests done after starting the clomid? And you said that after taking clomid, your TSH dropped? Libido any better?
> 
> It's difficult to tell if the gonad issue came before the thyroid issue, or the other way around. Nonetheless, maybe work on one at a time and get your numbers to an appropriate level and then go back to the other hormonal system. I would advise against playing with both at the same time if possible


Hi Kremer

When I first started on 50 mg of Clomid about 6 months ago, for about a week or so I felt extremely good. I actually felt normal. Everything improved. My TSH seemed to drop to 2.50 miu/L from 4.5, but on the following bloodwork, my TSH was back up to 4.96 miu/L. So its possible Clomid initially made a difference. I am guessing that due to Estrogen levels which skyrocketed, Clomid became ineffective and remainds that way. Barring a miracle recovery on Clomid, on March 3rd I may try Testosterone synthetic depending on bloodwork. I plan to compliment T with HCG for fertility purposes.

With Clomid, initially my T was over 800, but the following few blood tests showed it done to about 600 with high estrogen.

I am now only on 12.5, anxiety has gone done since I dropped the dose.

There is no question I have an underactive thyroid and hypogonadism. Both are proven by bloodwork. I wonder if they are related, or one is causing the other or one condition (long term) created another problem. I always wondered why I wouldn't sweat when I was working out, the few times in my life I had unexplained weight gains, the constant feeling of tiredness, ED, wrestlessness, inability to concentrate, all my life story. Its been pretty terrible but aside from a couple problems I am in good shape.

I have ruled out thyroid antibodies, they came back negative. I will soon see early March my T3 and T4 levels, as well as updated testosterone and about 13 other tests my urologist regularly takes.

Whatever I'm experiencing is definetely not normal, its never gotten better since I was 15 or 16- almost 32 now. But judging by the reaction I initially had to Clomid, I'd say my problem is certainly hormonol based.

I should also say, I've restarted my regiment of 25mcg of Thyroxine Sodium without perscription. As I felt last time I started, immediately better. I wonder if its placebo or not, but I feel more calm and less tired. Hoping its the drug and I will stay on it for some time to evaluate its impact to my health..


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