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Hypothyroidism & low testosterone [tribulus terrestris questions] - Hypo - 05-05-2013 05:37 AM

Good day James,

For a long time I've been trying to get myself feeling good, positive and energetic, and most recently it seems some things have started to work. Before going to an MD I diagnosed myself as having hypothyroidism en hypoadrenia. I have been taking your Thyroid, Adrenal, Sugar Balance, and Live-R-Ight formulas for quite a while but those didn't seem to really help.

I went to an MD for the first time this January. Based on lab tests in January and February my MD prescribed Thyrax (T4) which I have been taking for 6 weeks now. I'll have a new blood test soon to see to what extent the Thyrax has improved my values, but I must admit I've gradually started to feel better, more energetic, more happy and much more 'clear' in my mind.

However, I still do have quite many of the classical hypothyroidism symptoms; my basal body temperature never goes over 36.5-Celsius (and is often lower), my hair is coarse/brittle, my skin dry, eyebrows thin, skin yellowish, cold feet, etc. From the other hand, perhaps it's only logical that those symptoms need more time to resolve than 'how I feel'.

Based on my labs I have also started to take Tribulus Terrestris a couple of weeks ago. My testosteron (nmol/L, reference range: 8.0-31.0) read 13.1 on JAN22 and only 12.1 on FEB27. Because I felt considerably worse on FEB27, yet my thyroid values were actually better that day, I 'concluded' perhaps the low testosterone is/was much more of an issue, especially for a guy at 26 years of age. I therefore started to take 1000mg Tribulus Terrestris ('standardized extract, min 45% saponins') 3 times a day, and have been doing so for a couple of weeks now.

Like I mentioned above, I'll soon have a new lab test. Of course I'm very curious to see if perhaps my Testosterone reading has much more improved than the thyroid readings. At this point I am unable to say whether my 'feeling good' is attributable to an improved Testosterone value, improved thyroid values, or both.

My questions for now are as follows:
1) What do you think about my own 'diagnosis' that the low Testosterone might have been more important than my low thyroid?
2) Does using Tribulus Terrestris long-term diminish it's effect? (Also: is my current dosing too low/high?)
3) Do you have other suggestions for things I can do/take to improve my Testosterone level?
4) Would you perhaps happen to have some other remarks given my story and (other) lab values (please see below)?

I look very much forward to your thoughts!

Many thanks in advance.



For the sake of completeness, my full labs;
----------------------------------------------------------------
VARIABLE [] UNITS [] REFERENCE RANGE [] 27FEB 22JAN
Free T4 [] pmol/L [] 10.0-24.0 [] 16.3 18.9
T3 [] nmol/L [] 1.1-3.1 [] 1.4 --
TSH [] mU/L [] 0.300-4.800 [] 5.340 H 6.490 H
TPO antibodies [] kU/L [] 0-35 [] -- 14.7
L.H. [] U/L [] 2.0-9.0 [] 4.6 7.3
F.S.H. [] U/L [] 1.5-12.5 [] 16.2 H 18.3 H
SHBG [] nmol/L [] 20-55 [] 40.0 38.0
Testosteron [] nmol/L [] 8.0-31.0 [] 12.1 13.1
VitamineD25(OH) [] nmol/L [] 50-250 [] -- 174
ACTH [] ng/L [] 0-75 [] -- 17
Cortisol [] µmol/L [] 0.100-0.600 [] 0.511 0.705 H
Hb [] mmol/L [] 8.5-11.0 [] -- 9.9
Ht [] L/L [] 0.400-0.500 [] -- 0.453
Erytrocyten [] x10^12/L [] 4.50-5.50 [] -- 5.03
MCV [] fL [] 80-100 [] -- 90
MCH [] fmol [] 1.70-2.10 [] -- 1.97
MCHC [] mmol/L [] 19.0-22.5 [] -- 21.9
Leukocyten [] x10^9/L [] 4.00-10.00 [] -- 4.55
Natrium [] mmol/L [] 136-144 [] -- 142
Kalium [] mmol/L [] 3.6-4.8 [] -- 4.4
Ureum [] mmol/L [] 2.5-7.5 [] -- 5.0
Kreatinine [] µmol/L [] 64-104 [] -- 69
eGFR [] ml/min/1,73m2 [] >60 [] -- >60
Calcium [] mmol/L [] 2.15-2.55 [] -- 2.63 H
Bilirubine Total [] µmol/L [] 0-17- [] -- 20 H
Bilirubine Geconj. [] µmol/L [] 0-5 [] -- 5
Albumine [] g/L [] 34-48 [] -- 55 H
Alkalische Fosfatase [] U/L [] 0-115 [] -- 62
Gamma GT [] U/L [] 0-55 [] -- 15
ASAT [GOT] [] U/L [] 0-35 [] -- 26
ALAT [GPT] [] U/L [] 0-45 [] -- 18
Glucose [] mmol/L 3.1-6.4 [] 4.0 5.2
Cholesterol [] mmol/L 3.90-7.30 [] 5.48 --
Triglyceriden [] mmol/L 0.80-2.30 [] 1.09 --
HDL-Cholesterol [] mmol/L 0.90-1.41 [] 1.17 --


RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - James - 05-16-2013 12:24 AM

(05-05-2013 05:37 AM)Hypo Wrote:  Good day James,

For a long time I've been trying to get myself feeling good, positive and energetic, and most recently it seems some things have started to work. Before going to an MD I diagnosed myself as having hypothyroidism en hypoadrenia.

You did not mention what you based your diagnosis of improper thyroid and adrenal function on.

I have been taking your Thyroid, Adrenal, Sugar Balance, and Live-R-Ight formulas for quite a while but those didn't seem to really help.

I went to an MD for the first time this January. Based on lab tests in January and February my MD prescribed Thyrax (T4) which I have been taking for 6 weeks now. I'll have a new blood test soon to see to what extent the Thyrax has improved my values, but I must admit I've gradually started to feel better, more energetic, more happy and much more 'clear' in my mind.

Hypothyroidism has numerous causes so it can be difficult to determine the cause sometimes. Your TSH though is very high, which does indicate hypothyroidism. But again, there can be any causes and not enough information given to determine possible causes.

However, I still do have quite many of the classical hypothyroidism symptoms; my basal body temperature never goes over 36.5-Celsius (and is often lower), my hair is coarse/brittle, my skin dry, eyebrows thin, skin yellowish, cold feet, etc. From the other hand, perhaps it's only logical that those symptoms need more time to resolve than 'how I feel'.

Or the cause of the hypothyroidism is not being addressed and the T4 is merely masking the problem.

Based on my labs I have also started to take Tribulus Terrestris a couple of weeks ago. My testosteron (nmol/L, reference range: 8.0-31.0) read 13.1 on JAN22 and only 12.1 on FEB27. Because I felt considerably worse on FEB27, yet my thyroid values were actually better that day, I 'concluded' perhaps the low testosterone is/was much more of an issue, especially for a guy at 26 years of age. I therefore started to take 1000mg Tribulus Terrestris ('standardized extract, min 45% saponins') 3 times a day, and have been doing so for a couple of weeks now.

Like I mentioned above, I'll soon have a new lab test. Of course I'm very curious to see if perhaps my Testosterone reading has much more improved than the thyroid readings. At this point I am unable to say whether my 'feeling good' is attributable to an improved Testosterone value, improved thyroid values, or both.

One of the problems you are going to run in to is the fact that hormone tests, including thyroid and testosterone both fluctuate quite a bit throughout the day making both tests not very accurate. Testosterone levels in particular can fluctuate almost instantly.

My questions for now are as follows:
1) What do you think about my own 'diagnosis' that the low Testosterone might have been more important than my low thyroid?

Again, you did not mention what your basis was for the self diagnosis of either condition. Without having a more complete list of symptoms it is very difficult to narrow down possible problems and causes. All that is known for sure based on thyroid tests and symptoms is that your thyroid is not functioning properly. Why is unknown since there are many causes including being overweight, diet, hypothalamus or pituitary function, halogen exposure, cortisol levels, etc.

2) Does using Tribulus Terrestris long-term diminish it's effect?

No.

(Also: is my current dosing too low/high?)

The dosage is fine. Remember to take it on an empty stomach though for better absorption, at least 20 minutes before meals. In addition, simply raising testosterone will not do much if a person has high aromatase activity. Therefore, if you are trying to get your testosterone levels up then I also recommend taking an aromatase inhibitor as well such as nettle root.

3) Do you have other suggestions for things I can do/take to improve my Testosterone level?

Nettle root. Also if you are overweight reducing body fat will help a lot. Avoiding alcohols can also help as some are very estrogenic.

4) Would you perhaps happen to have some other remarks given my story and (other) lab values (please see below)?

You may want to try adding bitters to your regime as well, which will help the liver break down excess estrogen. This in turn can also help improve thyroid function as estrogens are suppressive to the thyroid.

The other thing that concerns me is the high calcium levels, which can cause various problems as well such as brain fog, high blood pressure, constipation, etc. High calcium is generally from hyperparathyroidism or pseudohyperparathyroidism. The first is often due to nodules that form as a result of low vitamin D levels. The second from an excess intake of phosphorus sources such as beef, milk, colas, etc. You can try taking a vitamin D3 supplement and reduce your intake of high phosphorus foods then have this rechecked in a few months to see if your calcium levels are still above normal.


I look very much forward to your thoughts!

Many thanks in advance.



For the sake of completeness, my full labs;
----------------------------------------------------------------
VARIABLE [] UNITS [] REFERENCE RANGE [] 27FEB 22JAN
Free T4 [] pmol/L [] 10.0-24.0 [] 16.3 18.9
T3 [] nmol/L [] 1.1-3.1 [] 1.4 --
TSH [] mU/L [] 0.300-4.800 [] 5.340 H 6.490 H
TPO antibodies [] kU/L [] 0-35 [] -- 14.7
L.H. [] U/L [] 2.0-9.0 [] 4.6 7.3
F.S.H. [] U/L [] 1.5-12.5 [] 16.2 H 18.3 H
SHBG [] nmol/L [] 20-55 [] 40.0 38.0
Testosteron [] nmol/L [] 8.0-31.0 [] 12.1 13.1
VitamineD25(OH) [] nmol/L [] 50-250 [] -- 174
ACTH [] ng/L [] 0-75 [] -- 17
Cortisol [] µmol/L [] 0.100-0.600 [] 0.511 0.705 H
Hb [] mmol/L [] 8.5-11.0 [] -- 9.9
Ht [] L/L [] 0.400-0.500 [] -- 0.453
Erytrocyten [] x10^12/L [] 4.50-5.50 [] -- 5.03
MCV [] fL [] 80-100 [] -- 90
MCH [] fmol [] 1.70-2.10 [] -- 1.97
MCHC [] mmol/L [] 19.0-22.5 [] -- 21.9
Leukocyten [] x10^9/L [] 4.00-10.00 [] -- 4.55
Natrium [] mmol/L [] 136-144 [] -- 142
Kalium [] mmol/L [] 3.6-4.8 [] -- 4.4
Ureum [] mmol/L [] 2.5-7.5 [] -- 5.0
Kreatinine [] µmol/L [] 64-104 [] -- 69
eGFR [] ml/min/1,73m2 [] >60 [] -- >60
Calcium [] mmol/L [] 2.15-2.55 [] -- 2.63 H
Bilirubine Total [] µmol/L [] 0-17- [] -- 20 H
Bilirubine Geconj. [] µmol/L [] 0-5 [] -- 5
Albumine [] g/L [] 34-48 [] -- 55 H
Alkalische Fosfatase [] U/L [] 0-115 [] -- 62
Gamma GT [] U/L [] 0-55 [] -- 15
ASAT [GOT] [] U/L [] 0-35 [] -- 26
ALAT [GPT] [] U/L [] 0-45 [] -- 18
Glucose [] mmol/L 3.1-6.4 [] 4.0 5.2
Cholesterol [] mmol/L 3.90-7.30 [] 5.48 --
Triglyceriden [] mmol/L 0.80-2.30 [] 1.09 --
HDL-Cholesterol [] mmol/L 0.90-1.41 [] 1.17 --



RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - Hypo - 05-17-2013 05:36 AM

(05-16-2013 12:24 AM)James Wrote:  
(05-05-2013 05:37 AM)Hypo Wrote:  Great hearing from you, James. Thanks a ton.

Good day James,

For a long time I've been trying to get myself feeling good, positive and energetic, and most recently it seems some things have started to work. Before going to an MD I diagnosed myself as having hypothyroidism en hypoadrenia.

You did not mention what you based your diagnosis of improper thyroid and adrenal function on.

Symptoms:
- low and rather unstable body temperature (typically between 35.8 and 36.6 Celsius, but after having been in de sun during the day it does get 37+)
- always cold feet (most days I can't sleep without having taken a warm foot bath just before going to bed)
- yellowish skin
- thinning (outer) eyebrows
- dry skin
- dry/coarse hair
- barely sweating
- brain fog (although this has improved a lot lately)
- resting heartrate: 60 bpm
- general fatigue / lethargic feeling / feeling far less energetic than my friends
- craving salt (I eat lots of Celtic sea salt, perhaps too much..)
- allergies (too much salicylates give me eczema in the knee or elbow cavities)
- numb pain in my back around the left kidney area, typically in the morning when waking up.
- feeling more energetic as the day passes, particularly past 6.00pm. At bedtime I often do feel energetic and 'clear in my head'.
- My BMI is 22.7 and I would say I got a healthy balance of muscles and fat, but compared to others my body definitely has an above average tendency to store calories (as fat). I eat very healthy (no candy, chips, fastfood, etc.), but that really isn't too difficult because I stopped craving that stuff a long time ago already.


I have been taking your Thyroid, Adrenal, Sugar Balance, and Live-R-Ight formulas for quite a while but those didn't seem to really help.

I went to an MD for the first time this January. Based on lab tests in January and February my MD prescribed Thyrax (T4) which I have been taking for 6 weeks now. I'll have a new blood test soon to see to what extent the Thyrax has improved my values, but I must admit I've gradually started to feel better, more energetic, more happy and much more 'clear' in my mind.

Hypothyroidism has numerous causes so it can be difficult to determine the cause sometimes. Your TSH though is very high, which does indicate hypothyroidism. But again, there can be any causes and not enough information given to determine possible causes.

It does seem the basis of my weak thyroid and adrenal performance is pituitary-related and congenital. When I was about 16 I went to an MD because of growth retardation. The X-ray of my carpal bones showed my 'biological age' was only 12 at the time. I never was treated for this though; we simply 'waited out the time' and I developed just fine/normally. I just seem very young for my age. I know my grandfather and one uncle experienced very similar 'growth retardation' when they were that age. And perhaps also relevant to know; my grandfather experienced the 'hongerwinter' which might have predisposed my genes to go 'low-thyroid'.

Also, my current MD requested the blood test results of my old MD (from when I was 16) a couple of weeks ago. Those values confirmed my thyroid has been underperforming probably all my life: TSH 7.4, T4 13.8, FSH 3.0, testosteron 0.8.


Or the cause of the hypothyroidism is not being addressed and the T4 is merely masking the problem.

Based on my labs I have also started to take Tribulus Terrestris a couple of weeks ago. My testosteron (nmol/L, reference range: 8.0-31.0) read 13.1 on JAN22 and only 12.1 on FEB27. Because I felt considerably worse on FEB27, yet my thyroid values were actually better that day, I 'concluded' perhaps the low testosterone is/was much more of an issue, especially for a guy at 26 years of age. I therefore started to take 1000mg Tribulus Terrestris ('standardized extract, min 45% saponins') 3 times a day, and have been doing so for a couple of weeks now.

Like I mentioned above, I'll soon have a new lab test. Of course I'm very curious to see if perhaps my Testosterone reading has much more improved than the thyroid readings. At this point I am unable to say whether my 'feeling good' is attributable to an improved Testosterone value, improved thyroid values, or both.

One of the problems you are going to run in to is the fact that hormone tests, including thyroid and testosterone both fluctuate quite a bit throughout the day making both tests not very accurate. Testosterone levels in particular can fluctuate almost instantly.

My questions for now are as follows:
1) What do you think about my own 'diagnosis' that the low Testosterone might have been more important than my low thyroid?

Again, you did not mention what your basis was for the self diagnosis of either condition. Without having a more complete list of symptoms it is very difficult to narrow down possible problems and causes. All that is known for sure based on thyroid tests and symptoms is that your thyroid is not functioning properly. Why is unknown since there are many causes including being overweight, diet, hypothalamus or pituitary function, halogen exposure, cortisol levels, etc.

I'd say my pituitary is the main cause behind my low thyroid and adrenal performance, but that over time this has extra burdened and probably further weakened my adrenals. (Still, this is largely speculative.)

2) Does using Tribulus Terrestris long-term diminish it's effect?

No.

Awesome, great to know.

(Also: is my current dosing too low/high?)

The dosage is fine. Remember to take it on an empty stomach though for better absorption, at least 20 minutes before meals. In addition, simply raising testosterone will not do much if a person has high aromatase activity. Therefore, if you are trying to get your testosterone levels up then I also recommend taking an aromatase inhibitor as well such as nettle root.

3) Do you have other suggestions for things I can do/take to improve my Testosterone level?

Nettle root. Also if you are overweight reducing body fat will help a lot. Avoiding alcohols can also help as some are very estrogenic.

Great, I'm taking that occasionally already, but will up the intake.

4) Would you perhaps happen to have some other remarks given my story and (other) lab values (please see below)?

You may want to try adding bitters to your regime as well, which will help the liver break down excess estrogen. This in turn can also help improve thyroid function as estrogens are suppressive to the thyroid.

The other thing that concerns me is the high calcium levels, which can cause various problems as well such as brain fog, high blood pressure, constipation, etc. High calcium is generally from hyperparathyroidism or pseudohyperparathyroidism. The first is often due to nodules that form as a result of low vitamin D levels. The second from an excess intake of phosphorus sources such as beef, milk, colas, etc. You can try taking a vitamin D3 supplement and reduce your intake of high phosphorus foods then have this rechecked in a few months to see if your calcium levels are still above normal.


The high calcium levels were most certainly caused by large yogurt consumption (typically 1 liter every day during the many months prior to the blood draw). But I am consuming far less yogurt now, and I'm pretty sure that my calcium levels aren't any problem (anymore). But my MD has stopped including calcium in my blood tests so the data needed to make this an official conclusion is lacking..

I look very much forward to your thoughts!

Many thanks in advance.

The day after I opened this thread I had a new blood test done. I added the results below in blue. (I also added the 'Prolactine line', forgot that one in the first post.) Interestingly I still felt very good that day (with a body temperature of 37 degrees Celsius and a resting heart rate of 80), but the blood test results aren't really showing this is due to improved thyroid values. It does seem the Tribulus terrestris has been working though.

I must add that May 5th (the day of the blood test) was the last day I felt 'really good'. The night before ànd the night after May 5th I was very insomniac (I felt a bit 'hyper'), and after those nights I have 'fallen back' into my old less-energetic me (with a 60bpm heartrate and 36.6ish body temperature), despite still taking 50mcg Thyrax. Perhaps my adrenals couldn't handle the increased metabolism and put their foot on the breaks?

I have been working on my adrenals so long already, with all kinds of vitamin B and C, iron, your Adrenal Tonic, preventing blood sugar spikes, moderate (or no) exercise, etc. I am afraid the only road left is the one with steroids which I know you really oppose because of the likely adrenal atrophy.. Any thoughts on what else I can do to support/heal my adrenals? Could short-term steroid usage be helpful if it can allow the adrenals to rest (and heal) like some others argue..? If so, what would 'short-term' encompass? Several weeks? 2 months tops?

One last tribulus terrestris questions: might tribulus terrestris make it more difficult for the body to produce other hormones? e.g. because tribulus terrestris forces the body to use a certain steroid hormone to create testosterone instead of something else? I am wondering if tribulus terrestris is in any way hard on the adrenals?

Your thoughts are enormously appreciated.


For the sake of completeness, my full labs;
----------------------------------------------------------------
VARIABLE [] UNITS [] REFERENCE RANGE [] 6MAY 27FEB 22JAN
Free T4 [] pmol/L [] 10.0-24.0 [] 18.4 16.3 18.9
T3 [] nmol/L [] 1.1-3.1 [] 1.5 1.4 --
TSH [] mU/L [] 0.300-4.800 [] 3.830 5.340 H 6.490 H
TPO antibodies [] kU/L [] 0-35 [] -- -- 14.7
L.H. [] U/L [] 2.0-9.0 [] 7.6 4.6 7.3
F.S.H. [] U/L [] 1.5-12.5 [] 20.3 H 16.2 H 18.3 H
Prolactine [] µg/L [] 4.0-15.0 [] 21.3 H 17.1 H 15.2 H
SHBG [] nmol/L [] 20-55 [] 49.5 40.0 38.0
Testosteron [] nmol/L [] 8.0-31.0 [] 27.5 12.1 13.1
VitamineD25(OH) [] nmol/L [] 50-250 [] -- -- 174
ACTH [] ng/L [] 0-75 [] -- -- -- 17
Cortisol [] µmol/L [] 0.100-0.600 [] 0.511 0.705 H
Hb [] mmol/L [] 8.5-11.0 [] -- -- 9.9
Ht [] L/L [] 0.400-0.500 [] -- -- 0.453
Erytrocyten [] x10^12/L [] 4.50-5.50 [] -- -- 5.03
MCV [] fL [] 80-100 [] -- -- 90
MCH [] fmol [] 1.70-2.10 [] -- -- 1.97
MCHC [] mmol/L [] 19.0-22.5 [] -- -- 21.9
Leukocyten [] x10^9/L [] 4.00-10.00 [] -- -- 4.55
Natrium [] mmol/L [] 136-144 [] -- -- 142
Kalium [] mmol/L [] 3.6-4.8 [] -- -- 4.4
Ureum [] mmol/L [] 2.5-7.5 [] -- -- 5.0
Kreatinine [] µmol/L [] 64-104 [] -- -- 69
eGFR [] ml/min/1,73m2 [] >60 [] -- -- >60
Calcium [] mmol/L [] 2.15-2.55 [] -- -- 2.63 H
Bilirubine Total [] µmol/L [] 0-17- [] -- -- 20 H
Bilirubine Geconj. [] µmol/L [] 0-5 [] -- -- 5
Albumine [] g/L [] 34-48 [] -- -- 55 H
Alkalische Fosfatase [] U/L [] 0-115 [] -- -- 62
Gamma GT [] U/L [] 0-55 [] -- -- 15
ASAT [GOT] [] U/L [] 0-35 [] -- -- 26
ALAT [GPT] [] U/L [] 0-45 [] -- -- 18
Glucose [] mmol/L 3.1-6.4 [] -- 4.0 5.2
Cholesterol [] mmol/L 3.90-7.30 [] -- 5.48 --
Triglyceriden [] mmol/L 0.80-2.30 [] -- 1.09 --
HDL-Cholesterol [] mmol/L 0.90-1.41 [] -- 1.17 --



RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - Hypo - 05-19-2013 10:31 AM

PS. My MD says the (high) cortisol values indicate there's nothing wrong with my adrenals. To what extent is she correct?


RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - Hypo - 05-24-2013 12:54 PM

PPS. Since I'm unable to edit my prior posts I'll add the information I previously forgot here;

Some other symptoms I previously forgot to mention:
- premature ejaculation
- depression
- I accumulate bodyfat predominantly on the front of my torso
- I don't 'feel' much emotions



RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - James - 05-26-2013 07:29 PM

(05-05-2013 05:37 AM)Hypo Wrote:  Great hearing from you, James. Thanks a ton.

My questions for now are as follows:
1) What do you think about my own 'diagnosis' that the low Testosterone might have been more important than my low thyroid?

It looks more like low thyroid is still more of an issue. You have virtually all the symptoms of hypothyroidism.

Also keep in mind that a single reading on testosterone means nothing as levels can fluctuate in a second. The only way to tell where testosterone levels are at is with a series of readings that can allow you to kind of average the range the level is within. Otherwise, it is like checking your weight every day and thinking you are doing better on the day that you are down a few pounds.

The other thing I see in your labs that is a bit of a concern is that you have has consistently high prolactin levels. Unless you are nursing the other main reasons for this would be a benign pituitary tumor or low dopamine. Elevated prolactin also suppresses the libido by suppressing dopamine. So people may mistake the low libido for a drop in testosterone. Have the doctors looked in to why your prolactin is elevated?


Again, you did not mention what your basis was for the self diagnosis of either condition. Without having a more complete list of symptoms it is very difficult to narrow down possible problems and causes. All that is known for sure based on thyroid tests and symptoms is that your thyroid is not functioning properly. Why is unknown since there are many causes including being overweight, diet, hypothalamus or pituitary function, halogen exposure, cortisol levels, etc.

I'd say my pituitary is the main cause behind my low thyroid and adrenal performance, but that over time this has extra burdened and probably further weakened my adrenals. (Still, this is largely speculative.)

The high prolactin could indicate a pituitary issue as well.

4) Would you perhaps happen to have some other remarks given my story and (other) lab values (please see below)?

It looks like some things are normalizing. The main thing I see that is of concern is still the elevated prolactin levels.

The other thing that concerns me is the high calcium levels, which can cause various problems as well such as brain fog, high blood pressure, constipation, etc. High calcium is generally from hyperparathyroidism or pseudohyperparathyroidism. The first is often due to nodules that form as a result of low vitamin D levels. The second from an excess intake of phosphorus sources such as beef, milk, colas, etc. You can try taking a vitamin D3 supplement and reduce your intake of high phosphorus foods then have this rechecked in a few months to see if your calcium levels are still above normal.[/b]

The high calcium levels were most certainly caused by large yogurt consumption (typically 1 liter every day during the many months prior to the blood draw). But I am consuming far less yogurt now, and I'm pretty sure that my calcium levels aren't any problem (anymore). But my MD has stopped including calcium in my blood tests so the data needed to make this an official conclusion is lacking..[/color]

Dairy can cause elevated serum calcium. Ironically, not from its high calcium content since the protein in dairy blocks calcium absorption. The rise in serum calcium is due to bone breakdown from the high phosphorus content that triggers pseudohyperparathyroidism.

The day after I opened this thread I had a new blood test done. I added the results below in blue. (I also added the 'Prolactine line', forgot that one in the first post.) Interestingly I still felt very good that day (with a body temperature of 37 degrees Celsius and a resting heart rate of 80), but the blood test results aren't really showing this is due to improved thyroid values. It does seem the Tribulus terrestris has been working though.

Again, the high prolactin level would be my biggest concern in your lab tests. If not from a pituitary tumor or nursing then low dopamine would likely be the problem, which can also cause other problems such as depression and lack of libido. Dopamine also plays a role in energy and our drive to do things.

I must add that May 5th (the day of the blood test) was the last day I felt 'really good'. The night before ànd the night after May 5th I was very insomniac (I felt a bit 'hyper'), and after those nights I have 'fallen back' into my old less-energetic me (with a 60bpm heartrate and 36.6ish body temperature), despite still taking 50mcg Thyrax. Perhaps my adrenals couldn't handle the increased metabolism and put their foot on the breaks?

Possible, but there was also another increase in your prolactin levels in your last lab test, which would also decrease your energy, libido, alertness and mood.

There is also a link to the thyroid here as both dopamine and thyroid hormones as well as some adrenal compounds require tyrosine for their formation. Maybe you are not getting enough tyrosine to support the formation of all these hormones and neurotransmitters. A lack of dopamine can also increase your prolactin levels. I recommend adding a gram of tyrosine 3 times daily at least 30 minutes before meals. Take it on an empty stomach since amino acids compete for receptor sites and other amino acids could interfere with absorption.


I have been working on my adrenals so long already, with all kinds of vitamin B and C, iron, your Adrenal Tonic, preventing blood sugar spikes, moderate (or no) exercise, etc. I am afraid the only road left is the one with steroids which I know you really oppose because of the likely adrenal atrophy.. Any thoughts on what else I can do to support/heal my adrenals? Could short-term steroid usage be helpful if it can allow the adrenals to rest (and heal) like some others argue..? If so, what would 'short-term' encompass? Several weeks? 2 months tops?

Be careful with the iron. It is easy to overdo iron, which can also cause a variety of problems. And your hemoglobin and hematocrit are within normal and there are no ferritin levels listed.

For now I would add the extra tyrosine since tyrosine is involved in the formation of thyroid hormones and adrenal neurotransmitters and low levels could be a cause of your elevated prolactin.


One last tribulus terrestris questions: might tribulus terrestris make it more difficult for the body to produce other hormones? e.g. because tribulus terrestris forces the body to use a certain steroid hormone to create testosterone instead of something else? I am wondering if tribulus terrestris is in any way hard on the adrenals?

No and no. Tribulus simply helps the body normalize and produce what it needs rather than forcing levels artificially high. So it is not going to deplete hormones, it is simply gong to help the body function normally.

Your thoughts are enormously appreciated. [/color]

You're welcome. I glad you added the prolactin levels because that was a very important piece of the puzzle.


For the sake of completeness, my full labs;
----------------------------------------------------------------
VARIABLE [] UNITS [] REFERENCE RANGE [] 6MAY 27FEB 22JAN
Free T4 [] pmol/L [] 10.0-24.0 [] 18.4 16.3 18.9
T3 [] nmol/L [] 1.1-3.1 [] 1.5 1.4 --
TSH [] mU/L [] 0.300-4.800 [] 3.830 5.340 H 6.490 H
TPO antibodies [] kU/L [] 0-35 [] -- -- 14.7
L.H. [] U/L [] 2.0-9.0 [] 7.6 4.6 7.3
F.S.H. [] U/L [] 1.5-12.5 [] 20.3 H 16.2 H 18.3 H
Prolactine [] µg/L [] 4.0-15.0 [] 21.3 H 17.1 H 15.2 H
SHBG [] nmol/L [] 20-55 [] 49.5 40.0 38.0
Testosteron [] nmol/L [] 8.0-31.0 [] 27.5 12.1 13.1
VitamineD25(OH) [] nmol/L [] 50-250 [] -- -- 174
ACTH [] ng/L [] 0-75 [] -- -- -- 17
Cortisol [] µmol/L [] 0.100-0.600 [] 0.511 0.705 H
Hb [] mmol/L [] 8.5-11.0 [] -- -- 9.9
Ht [] L/L [] 0.400-0.500 [] -- -- 0.453
Erytrocyten [] x10^12/L [] 4.50-5.50 [] -- -- 5.03
MCV [] fL [] 80-100 [] -- -- 90
MCH [] fmol [] 1.70-2.10 [] -- -- 1.97
MCHC [] mmol/L [] 19.0-22.5 [] -- -- 21.9
Leukocyten [] x10^9/L [] 4.00-10.00 [] -- -- 4.55
Natrium [] mmol/L [] 136-144 [] -- -- 142
Kalium [] mmol/L [] 3.6-4.8 [] -- -- 4.4
Ureum [] mmol/L [] 2.5-7.5 [] -- -- 5.0
Kreatinine [] µmol/L [] 64-104 [] -- -- 69
eGFR [] ml/min/1,73m2 [] >60 [] -- -- >60
Calcium [] mmol/L [] 2.15-2.55 [] -- -- 2.63 H
Bilirubine Total [] µmol/L [] 0-17- [] -- -- 20 H
Bilirubine Geconj. [] µmol/L [] 0-5 [] -- -- 5
Albumine [] g/L [] 34-48 [] -- -- 55 H
Alkalische Fosfatase [] U/L [] 0-115 [] -- -- 62
Gamma GT [] U/L [] 0-55 [] -- -- 15
ASAT [GOT] [] U/L [] 0-35 [] -- -- 26
ALAT [GPT] [] U/L [] 0-45 [] -- -- 18
Glucose [] mmol/L 3.1-6.4 [] -- 4.0 5.2
Cholesterol [] mmol/L 3.90-7.30 [] -- 5.48 --
Triglyceriden [] mmol/L 0.80-2.30 [] -- 1.09 --
HDL-Cholesterol [] mmol/L 0.90-1.41 [] -- 1.17 --
[/quote]
[/quote]


RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - Hypo - 05-27-2013 06:44 AM

(05-26-2013 07:29 PM)James Wrote:  
(05-05-2013 05:37 AM)Hypo Wrote:  Great hearing from you, James. Thanks a ton.

My questions for now are as follows:
1) What do you think about my own 'diagnosis' that the low Testosterone might have been more important than my low thyroid?

It looks more like low thyroid is still more of an issue. You have virtually all the symptoms of hypothyroidism.

Agreed.

Also keep in mind that a single reading on testosterone means nothing as levels can fluctuate in a second. The only way to tell where testosterone levels are at is with a series of readings that can allow you to kind of average the range the level is within. Otherwise, it is like checking your weight every day and thinking you are doing better on the day that you are down a few pounds.[/b]

The other thing I see in your labs that is a bit of a concern is that you have has consistently high prolactin levels. Unless you are nursing the other main reasons for this would be a benign pituitary tumor or low dopamine. Elevated prolactin also suppresses the libido by suppressing dopamine. So people may mistake the low libido for a drop in testosterone. Have the doctors looked in to why your prolactin is elevated?

I'm not nursing. I asked my doctor (a woman) about this but she responded it's not much of an issue. She claims tumor-induced elevated prolactin levels would be much higher (i.e. in the multi-hundreds). She doesn't think my prolactin levels are much of a problem.

Again, you did not mention what your basis was for the self diagnosis of either condition. Without having a more complete list of symptoms it is very difficult to narrow down possible problems and causes. All that is known for sure based on thyroid tests and symptoms is that your thyroid is not functioning properly. Why is unknown since there are many causes including being overweight, diet, hypothalamus or pituitary function, halogen exposure, cortisol levels, etc.

Do I understand correctly that you feel the below list of symptoms is somehow 'incomplete'? (Or did you not notice me mentioning these symptoms before?)
(I have now separated the symptoms into hypothyroidism- en weak-adrenals-symptoms)

Symptoms indicating hypothyroidism:
- always cold feet (most days I can't sleep without having taken a warm foot bath just before going to bed)
- yellowish skin
- thinning (outer) eyebrows
- dry skin
- dry/coarse hair
- barely sweating
- brain fog (although this has improved a lot lately)
- resting heartrate: 60 bpm
- water retention (prints on my skin [e.g. of wearing tight socks or after sitting bare-legged on a rough surface] stay visible very long)

Symptoms pointing towards weak adrenals:
- craving salt (I eat lots of Celtic sea salt, perhaps too much..)
- allergies (too much salicylates give me eczema in the knee or elbow cavities)
- numb pain in my back around the left kidney area, typically in the morning when waking up.
- feeling more energetic as the day passes, particularly past 6.00pm. At bedtime I often do feel energetic and 'clear in my head'.

Symptoms signaling both hypothyroidism and weak adrenals:
- low and rather unstable body temperature (typically between 35.8 and 36.6 Celsius, but after having been in de sun during the day it does get 37+)
- general fatigue / lethargic feeling / feeling far less energetic than my friends
- My BMI is 22.7 and I would say I got a healthy balance of muscles and fat, but compared to others my body definitely has an above average tendency to store calories (as fat). I eat very healthy (no candy, chips, fastfood, etc.), but that really isn't too difficult because I stopped craving that stuff a long time ago.
- I accumulate bodyfat predominantly on the front of my torso
- depression

Other symptoms/issues/clues:
- premature ejaculation
- I feel like I often can't 'feel' much emotions (anger, love, desire, etc.)


I'd say my pituitary is the main cause behind my low thyroid and adrenal performance, but that over time this has extra burdened and probably further weakened my adrenals. (Still, this is largely speculative.)

The high prolactin could indicate a pituitary issue as well.

4) Would you perhaps happen to have some other remarks given my story and (other) lab values (please see below)?

It looks like some things are normalizing. The main thing I see that is of concern is still the elevated prolactin levels.

To me the only things that seem to be normalizing are the TSH and testosteron, the former being notorious for being a poor indicator of a patient's 'health'. At the same time the level of T4, T3, and my hypothyroidism symptoms don't really seem to be improving.

I'm wondering if perhaps I'm stuck in a 'high rT3/T3-ratio'-mode; one in which the majority of T4 keeps getting converted to rT3, thus blocking the effectiveness of T4 supplementation. (In short the 'high rT3/T3-ratio'-theorem is that stressors increase T4-to-rT3 conversion (at the expense of the T4-to-T3 conversion) and that chronically high levels of rT3 may be a stressor in itself resulting in even more T4-to-rT3 conversion. rT3 is virtually inactive but fits in the same receptors as T3, with the following end-result: a chronic shortage of T3 at the cell-level.

I'm thinking my body may be lowering TSH not because it's feeling there's enough T3 in the cells, but only because it's noticing it doesn't need more T4 (since that is only resulting in more rT3, not more T3). (Perhaps you're familiar with this website?; http://www.thyroid-rt3.com/ ) Of course this is all very hypothetical since the rT3 values are missing. (And I have no idea what your opinion is about this theorem in the first place.) Still it does seem that all the T4 I'm swallowing isn't significantly raising my T4 and T3, so in that sense an 'over-conversion' from T4 to rT3 seems quite plausible.


The other thing that concerns me is the high calcium levels, which can cause various problems as well such as brain fog, high blood pressure, constipation, etc. High calcium is generally from hyperparathyroidism or pseudohyperparathyroidism. The first is often due to nodules that form as a result of low vitamin D levels. The second from an excess intake of phosphorus sources such as beef, milk, colas, etc. You can try taking a vitamin D3 supplement and reduce your intake of high phosphorus foods then have this rechecked in a few months to see if your calcium levels are still above normal.[/b]

The high calcium levels were most certainly caused by large yogurt consumption (typically 1 liter every day during the many months prior to the blood draw). But I am consuming far less yogurt now, and I'm pretty sure that my calcium levels aren't any problem (anymore). But my MD has stopped including calcium in my blood tests so the data needed to make this an official conclusion is lacking..[/color]

Dairy can cause elevated serum calcium. Ironically, not from its high calcium content since the protein in dairy blocks calcium absorption. The rise in serum calcium is due to bone breakdown from the high phosphorus content that triggers pseudohyperparathyroidism.

Ah good to know

The day after I opened this thread I had a new blood test done. I added the results below in blue. (I also added the 'Prolactine line', forgot that one in the first post.) Interestingly I still felt very good that day (with a body temperature of 37 degrees Celsius and a resting heart rate of 80), but the blood test results aren't really showing this is due to improved thyroid values. It does seem the Tribulus terrestris has been working though.

Again, the high prolactin level would be my biggest concern in your lab tests. If not from a pituitary tumor or nursing then low dopamine would likely be the problem, which can also cause other problems such as depression and lack of libido. Dopamine also plays a role in energy and our drive to do things.

I must add that May 5th (the day of the blood test) was the last day I felt 'really good'. The night before ànd the night after May 5th I was very insomniac (I felt a bit 'hyper'), and after those nights I have 'fallen back' into my old less-energetic me (with a 60bpm heartrate and 36.6ish body temperature), despite still taking 50mcg Thyrax. Perhaps my adrenals couldn't handle the increased metabolism and put their foot on the breaks?

Possible, but there was also another increase in your prolactin levels in your last lab test, which would also decrease your energy, libido, alertness and mood.

There is also a link to the thyroid here as both dopamine and thyroid hormones as well as some adrenal compounds require tyrosine for their formation. Maybe you are not getting enough tyrosine to support the formation of all these hormones and neurotransmitters. A lack of dopamine can also increase your prolactin levels. I recommend adding a gram of tyrosine 3 times daily at least 30 minutes before meals. Take it on an empty stomach since amino acids compete for receptor sites and other amino acids could interfere with absorption.


Awesome!

I have been working on my adrenals so long already, with all kinds of vitamin B and C, iron, your Adrenal Tonic, preventing blood sugar spikes, moderate (or no) exercise, etc. I am afraid the only road left is the one with steroids which I know you really oppose because of the likely adrenal atrophy.. Any thoughts on what else I can do to support/heal my adrenals? Could short-term steroid usage be helpful if it can allow the adrenals to rest (and heal) like some others argue..? If so, what would 'short-term' encompass? Several weeks? 2 months tops?

Be careful with the iron. It is easy to overdo iron, which can also cause a variety of problems. And your hemoglobin and hematocrit are within normal and there are no ferritin levels listed.

Great reminder, but just FYI: I'm not taking iron supplements; I'm only making sure that I'm consuming enough (natural) iron rich foods (e.g. red meat, spinach, etc.) combined with natural vitamin C to support absorption. (Because iron levels are supposedly crucial for proper adrenal function.)

For now I would add the extra tyrosine since tyrosine is involved in the formation of thyroid hormones and adrenal neurotransmitters and low levels could be a cause of your elevated prolactin.

One last tribulus terrestris questions: might tribulus terrestris make it more difficult for the body to produce other hormones? e.g. because tribulus terrestris forces the body to use a certain steroid hormone to create testosterone instead of something else? I am wondering if tribulus terrestris is in any way hard on the adrenals?

No and no. Tribulus simply helps the body normalize and produce what it needs rather than forcing levels artificially high. So it is not going to deplete hormones, it is simply gong to help the body function normally.

Your thoughts are enormously appreciated. [/color]

You're welcome. I glad you added the prolactin levels because that was a very important piece of the puzzle.


Thanks once again, James. And I share the gladness about adding the prolactin levels. You're wonderfully knowledgeable! :-)

Anything else I may try doing/taking to support dopamine levels (apart from the Tyrosine)?


For the sake of completeness, my full labs;
----------------------------------------------------------------
VARIABLE [] UNITS [] REFERENCE RANGE [] 6MAY 27FEB 22JAN
Free T4 [] pmol/L [] 10.0-24.0 [] 18.4 16.3 18.9
T3 [] nmol/L [] 1.1-3.1 [] 1.5 1.4 --
TSH [] mU/L [] 0.300-4.800 [] 3.830 5.340 H 6.490 H
TPO antibodies [] kU/L [] 0-35 [] -- -- 14.7
L.H. [] U/L [] 2.0-9.0 [] 7.6 4.6 7.3
F.S.H. [] U/L [] 1.5-12.5 [] 20.3 H 16.2 H 18.3 H
Prolactine [] µg/L [] 4.0-15.0 [] 21.3 H 17.1 H 15.2 H
SHBG [] nmol/L [] 20-55 [] 49.5 40.0 38.0
Testosteron [] nmol/L [] 8.0-31.0 [] 27.5 12.1 13.1
VitamineD25(OH) [] nmol/L [] 50-250 [] -- -- 174
ACTH [] ng/L [] 0-75 [] -- -- -- 17
Cortisol [] µmol/L [] 0.100-0.600 [] 0.511 0.705 H
Hb [] mmol/L [] 8.5-11.0 [] -- -- 9.9
Ht [] L/L [] 0.400-0.500 [] -- -- 0.453
Erytrocyten [] x10^12/L [] 4.50-5.50 [] -- -- 5.03
MCV [] fL [] 80-100 [] -- -- 90
MCH [] fmol [] 1.70-2.10 [] -- -- 1.97
MCHC [] mmol/L [] 19.0-22.5 [] -- -- 21.9
Leukocyten [] x10^9/L [] 4.00-10.00 [] -- -- 4.55
Natrium [] mmol/L [] 136-144 [] -- -- 142
Kalium [] mmol/L [] 3.6-4.8 [] -- -- 4.4
Ureum [] mmol/L [] 2.5-7.5 [] -- -- 5.0
Kreatinine [] µmol/L [] 64-104 [] -- -- 69
eGFR [] ml/min/1,73m2 [] >60 [] -- -- >60
Calcium [] mmol/L [] 2.15-2.55 [] -- -- 2.63 H
Bilirubine Total [] µmol/L [] 0-17- [] -- -- 20 H
Bilirubine Geconj. [] µmol/L [] 0-5 [] -- -- 5
Albumine [] g/L [] 34-48 [] -- -- 55 H
Alkalische Fosfatase [] U/L [] 0-115 [] -- -- 62
Gamma GT [] U/L [] 0-55 [] -- -- 15
ASAT [GOT] [] U/L [] 0-35 [] -- -- 26
ALAT [GPT] [] U/L [] 0-45 [] -- -- 18
Glucose [] mmol/L 3.1-6.4 [] -- 4.0 5.2
Cholesterol [] mmol/L 3.90-7.30 [] -- 5.48 --
Triglyceriden [] mmol/L 0.80-2.30 [] -- 1.09 --
HDL-Cholesterol [] mmol/L 0.90-1.41 [] -- 1.17 --



RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - James - 05-27-2013 08:39 PM

(05-19-2013 10:31 AM)Hypo Wrote:  PS. My MD says the (high) cortisol values indicate there's nothing wrong with my adrenals. To what extent is she correct?

Cortisol is only one compound secreted by the adrenals so this is not an indicator.


RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - James - 05-27-2013 08:46 PM

(05-24-2013 12:54 PM)Hypo Wrote:  PPS. Since I'm unable to edit my prior posts I'll add the information I previously forgot here;

Some other symptoms I previously forgot to mention:
- premature ejaculation

Premature ejaculation can indicate low serotonin. High levels inhibit it.

- depression

Depression has numerous causes including low serotonin, low dopamine, low thyroid, etc.

- I accumulate bodyfat predominantly on the front of my torso

That's the high cortisol.

- I don't 'feel' much emotions

That can also be from low neurotransmitters such as dopamine.



RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - James - 05-28-2013 02:21 AM

[quote='Hypo' pid='7124' dateline='1367753847']

The other thing I see in your labs that is a bit of a concern is that you have has consistently high prolactin levels. Unless you are nursing the other main reasons for this would be a benign pituitary tumor or low dopamine. Elevated prolactin also suppresses the libido by suppressing dopamine. So people may mistake the low libido for a drop in testosterone. Have the doctors looked in to why your prolactin is elevated?

I'm not nursing. I asked my doctor (a woman) about this but she responded it's not much of an issue. She claims tumor-induced elevated prolactin levels would be much higher (i.e. in the multi-hundreds). She doesn't think my prolactin levels are much of a problem.

Levels would increase as a tumor grew and therefore will not be high immediately. Since your levels have been slowly increasing this is still something to keep an eye on. Although it is more likely that your dopamine levels have simply been dropping, which can also elevate prolactin.

Again, you did not mention what your basis was for the self diagnosis of either condition. Without having a more complete list of symptoms it is very difficult to narrow down possible problems and causes. All that is known for sure based on thyroid tests and symptoms is that your thyroid is not functioning properly. Why is unknown since there are many causes including being overweight, diet, hypothalamus or pituitary function, halogen exposure, cortisol levels, etc.

Do I understand correctly that you feel the below list of symptoms is somehow 'incomplete'? (Or did you not notice me mentioning these symptoms before?)
(I have now separated the symptoms into hypothyroidism- en weak-adrenals-symptoms)

Symptoms can have a lot of cross over. For example, there are many causes of depression, mental fogginess, etc. so people need to be careful about jumping to conclusions on symptoms. For example, you mention water retention under hypothyroidism although this can again have multiple causes. In your case I would say it is most likely from the adrenal dysfunction as the adrenals are the glands responsible for maintaining water balance in the body.

Symptoms indicating hypothyroidism:
- always cold feet (most days I can't sleep without having taken a warm foot bath just before going to bed)
- yellowish skin
- thinning (outer) eyebrows
- dry skin
- dry/coarse hair
- barely sweating
- brain fog (although this has improved a lot lately)
- resting heartrate: 60 bpm
- water retention (prints on my skin [e.g. of wearing tight socks or after sitting bare-legged on a rough surface] stay visible very long)

Symptoms pointing towards weak adrenals:
- craving salt (I eat lots of Celtic sea salt, perhaps too much..)
- allergies (too much salicylates give me eczema in the knee or elbow cavities)
- numb pain in my back around the left kidney area, typically in the morning when waking up.
- feeling more energetic as the day passes, particularly past 6.00pm. At bedtime I often do feel energetic and 'clear in my head'.

Symptoms signaling both hypothyroidism and weak adrenals:
- low and rather unstable body temperature (typically between 35.8 and 36.6 Celsius, but after having been in de sun during the day it does get 37+)
- general fatigue / lethargic feeling / feeling far less energetic than my friends
- My BMI is 22.7 and I would say I got a healthy balance of muscles and fat, but compared to others my body definitely has an above average tendency to store calories (as fat). I eat very healthy (no candy, chips, fastfood, etc.), but that really isn't too difficult because I stopped craving that stuff a long time ago.
- I accumulate bodyfat predominantly on the front of my torso
- depression

Other symptoms/issues/clues:
- premature ejaculation
- I feel like I often can't 'feel' much emotions (anger, love, desire, etc.)


There are definitely different issues going on, but it does not look like all of them are related.

4) Would you perhaps happen to have some other remarks given my story and (other) lab values (please see below)?

It looks like some things are normalizing. The main thing I see that is of concern is still the elevated prolactin levels.

To me the only things that seem to be normalizing are the TSH and testosteron, the former being notorious for being a poor indicator of a patient's 'health'. At the same time the level of T4, T3, and my hypothyroidism symptoms don't really seem to be improving.

TSH simply shows if the thyroid is underactive or overactive. Your T3 came up slightly, and is still in normal range. Your T4 dropped a little temporarily, but also came back up and as with T3 has been within normal range all along.

Overall I would say the hypothyroid symptoms are likely stemming at least in large part from the adrenal issues. The adrenals do play a big role in thyroid function. Unfortunately, one test I did not see that they did is rT3, which if high can still cause hypothyroidism even with normal TSH, T3 and T4 levels. Poor adrenal function can lead to an increase in rT3.

Again, one thing that may help with improving your adrenal issues is supplementing with tyrosine, which is needed for the formation of various adrenal compounds. It is also required for the formation of thyroid hormones.


I'm wondering if perhaps I'm stuck in a 'high rT3/T3-ratio'-mode; one in which the majority of T4 keeps getting converted to rT3, thus blocking the effectiveness of T4 supplementation. (In short the 'high rT3/T3-ratio'-theorem is that stressors increase T4-to-rT3 conversion (at the expense of the T4-to-T3 conversion) and that chronically high levels of rT3 may be a stressor in itself resulting in even more T4-to-rT3 conversion. rT3 is virtually inactive but fits in the same receptors as T3, with the following end-result: a chronic shortage of T3 at the cell-level.

Yes, I agree. High rT3 could explain a lot.

I'm thinking my body may be lowering TSH not because it's feeling there's enough T3 in the cells, but only because it's noticing it doesn't need more T4 (since that is only resulting in more rT3, not more T3).

TSH increases with hypothyroidism. It does this to help stimulate the thyroid to create more thyroid hormones.


(Perhaps you're familiar with this website?; http://www.thyroid-rt3.com/

No, I have not seen the website.


Of course this is all very hypothetical since the rT3 values are missing. (And I have no idea what your opinion is about this theorem in the first place.) Still it does seem that all the T4 I'm swallowing isn't significantly raising my T4 and T3, so in that sense an 'over-conversion' from T4 to rT3 seems quite plausible.

Again, high T3 could explain the hypothyroid symptoms despite the normal thyroid values.

I must add that May 5th (the day of the blood test) was the last day I felt 'really good'. The night before ànd the night after May 5th I was very insomniac (I felt a bit 'hyper'), and after those nights I have 'fallen back' into my old less-energetic me (with a 60bpm heartrate and 36.6ish body temperature), despite still taking 50mcg Thyrax. Perhaps my adrenals couldn't handle the increased metabolism and put their foot on the breaks?

Possible, but there was also another increase in your prolactin levels in your last lab test, which would also decrease your energy, libido, alertness and mood.
[b]
I was thinking another possibility could be that if you had recently started on the medication this could have over stimulated you initially. When the body adjusts thought there would be a drop in energy.


Anything else I may try doing/taking to support dopamine levels (apart from the Tyrosine)?

There are a few herbs that can help raise dopamine if you can find them. My favorite is bupleurum, or you can use magnolia bark.


RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - Hypo - 05-28-2013 03:51 AM

James you can't imagine how much your help is appreciated.

Concerning the high prolactin levels; I'll keep an eye on that (I'll have another blood test by the end of July).
I have the feeling my prolactin levels have been elevated probably all my life (since I have been feeling this way all my life --I only recently realized it isn't normal) and that the current increasing trend in the prolactin levels is just some mere coincidence. But I'll definitely be careful if the next blood test yields an even higher value.

Enormous thanks for now!


RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - Hypo - 05-30-2013 02:11 PM

Hello James,

New question:
I am realizing there has also been a huge correlation (rho = 1) between my 'feeling good' and getting (considerable full body) sun exposure.
Looking back I can conclude that -since starting the Tribulus Terrestris- those days I felt really good perfectly coincide with days on which (or prior to which) I experienced considerable sun exposure.

And apparently vitamin D is very important for T3 usage at the cell-level. Perhaps this is another clue?

Interestingly;
- I've always eaten quite a lot of (fatty) fish regularly.
- I've been taking this D3 supplement for a while now: http://www.iherb.com/Bio-Tech-Pharmacal-Inc-D3Plus-180-Capsules/43987 (with extra stuff that should support the D3 absorption).
- and my vitamin D levels were perfectly in range during the January blood test.

Hence I'm wondering;
1) Despite my 'OK' vitamin D blood levels, could it be possible that I'm somehow vitamin D deficient at the cell-level?
2) Does skin exposure to sunlight generate other vitamins/hormones in addition to vitamin D?
3) Might I have problems absorbing sufficient vitamin D from food?


RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - James - 06-02-2013 04:06 AM

(05-30-2013 02:11 PM)Hypo Wrote:  Hello James,

New question:
I am realizing there has also been a huge correlation (rho = 1) between my 'feeling good' and getting (considerable full body) sun exposure.
Looking back I can conclude that -since starting the Tribulus Terrestris- those days I felt really good perfectly coincide with days on which (or prior to which) I experienced considerable sun exposure.

And apparently vitamin D is very important for T3 usage at the cell-level. Perhaps this is another clue?

I have not seen any real evidence to back that up. It is known that vitamin D plays a major role in immune regulation and therefore can help with autoimmune thyroid disorders. But that is it that I have seen.


Interestingly;
- I've always eaten quite a lot of (fatty) fish regularly.
- I've been taking this D3 supplement for a while now: http://www.iherb.com/Bio-Tech-Pharmacal-Inc-D3Plus-180-Capsules/43987 (with extra stuff that should support the D3 absorption).

The other ingredients help with calcium absorption, not D absorption.

- and my vitamin D levels were perfectly in range during the January blood test.

Hence I'm wondering;
1) Despite my 'OK' vitamin D blood levels, could it be possible that I'm somehow vitamin D deficient at the cell-level?

Yes, it is still possible to be deficient for several reasons. There are disorders such as Crohn's that can cause problems with absorption. And the D3 sold as supplements is inactive D3. If there are problems with the kidneys this can prevent the conversion of the inactive D3 in to active D3.

2) Does skin exposure to sunlight generate other vitamins/hormones in addition to vitamin D?

Just D as far as I know.

3) Might I have problems absorbing sufficient vitamin D from food?

It is possible in certain health conditions such as intestinal disorders or cystic fibrosis.



RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - Hypo - 06-03-2013 01:47 AM

(06-02-2013 04:06 AM)James Wrote:  
(05-30-2013 02:11 PM)Hypo Wrote:  Despite my 'OK' vitamin D blood levels, could it be possible that I'm somehow vitamin D deficient at the cell-level?

Yes, it is still possible to be deficient for several reasons. There are disorders such as Crohn's that can cause problems with absorption. And the D3 sold as supplements is inactive D3. If there are problems with the kidneys this can prevent the conversion of the inactive D3 in to active D3.

Thanks James, but are you sure you properly interpreted my question?

If 'proper vitamin D blood levels' can be accompanied by vitamin D deficiency, then I suppose this means that the vitamin D level measured in a bloodtest is some inactive form of vitamin D??

If so, is there any way in which I might support my kidneys converting the inactive vitamin D to active vitamin D?



RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - James - 06-09-2013 01:13 AM

(06-03-2013 01:47 AM)Hypo Wrote:  
(06-02-2013 04:06 AM)James Wrote:  
(05-30-2013 02:11 PM)Hypo Wrote:  Despite my 'OK' vitamin D blood levels, could it be possible that I'm somehow vitamin D deficient at the cell-level?

Yes, it is still possible to be deficient for several reasons. There are disorders such as Crohn's that can cause problems with absorption. And the D3 sold as supplements is inactive D3. If there are problems with the kidneys this can prevent the conversion of the inactive D3 in to active D3.

Thanks James, but are you sure you properly interpreted my question?

If 'proper vitamin D blood levels' can be accompanied by vitamin D deficiency, then I suppose this means that the vitamin D level measured in a bloodtest is some inactive form of vitamin D??

Yes, the blood test for vitamin D tests for levels of inactive, not active, vitamin D.

If so, is there any way in which I might support my kidneys converting the inactive vitamin D to active vitamin D?

Some of the most supportive herbs for the kidneys are nettle leaf, schisandra berry and licorice root.



RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - Hypo - 06-10-2013 03:00 AM

OK, this all makes a lot of sense if exposing the skin to sunlight does yield the active vitamin D (without any conversion being required in the kidneys). Is that the case?


RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - Hypo - 07-10-2013 09:03 AM

Hi James,

Not sure if you still got time to answer questions in this forum section, but if you do, I'd very much appreciate your thoughts on my newest labs:

VARIABLE [] UNITS [] REFERENCE RANGE [] 27 JUNE 6MAY 27FEB 22JAN
Free T4 [] pmol/L [] 10.0-24.0 [] 21.7 18.4 16.3 18.9
T3 [] nmol/L [] 1.1-3.1 [] 1.4 1.5 1.4 --
TSH [] mU/L [] 0.300-4.800 [] 1.200 3.830 5.340 H 6.490 H
TPO antibodies [] kU/L [] 0-35 [] -- -- -- 14.7
L.H. [] U/L [] 2.0-9.0 [] 6.6 7.6 4.6 7.3
F.S.H. [] U/L [] 1.5-12.5 [] 18.8 H 20.3 H 16.2 H 18.3 H
Prolactine [] µg/L [] 4.0-15.0 [] 9.4 21.3 H 17.1 H 15.2 H
SHBG [] nmol/L [] 20-55 [] 51.1 49.5 40.0 38.0
Testosteron [] nmol/L [] 8.0-31.0 [] 22.6 27.5 12.1 13.1
VitamineD25(OH) [] nmol/L [] 50-250 [] -- -- -- 174
ACTH [] ng/L [] 0-75 [] -- -- -- 17
Cortisol [] µmol/L [] 0.100-0.600 [] -- -- 0.511 0.705 H
Hb [] mmol/L [] 8.5-11.0 [] -- -- -- 9.9
Ht [] L/L [] 0.400-0.500 [] -- -- -- 0.453
Erytrocyten [] x10^12/L [] 4.50-5.50 [] -- -- -- 5.03
MCV [] fL [] 80-100 [] -- -- -- 90
MCH [] fmol [] 1.70-2.10 [] -- -- -- 1.97
MCHC [] mmol/L [] 19.0-22.5 [] -- -- -- 21.9
Leukocyten [] x10^9/L [] 4.00-10.00 [] -- -- -- 4.55
Natrium [] mmol/L [] 136-144 [] -- -- -- 142
Kalium [] mmol/L [] 3.6-4.8 [] -- -- -- 4.4
Ureum [] mmol/L [] 2.5-7.5 [] -- -- -- 5.0
Kreatinine [] µmol/L [] 64-104 [] -- -- -- 69
eGFR [] ml/min/1,73m2 [] >60 [] -- -- -- >60
Calcium [] mmol/L [] 2.15-2.55 [] -- -- -- 2.63 H
Bilirubine Total [] µmol/L [] 0-17- [] -- -- -- 20 H
Bilirubine Geconj. [] µmol/L [] 0-5 [] -- -- -- 5
Albumine [] g/L [] 34-48 [] -- -- -- 55 H
Alkalische Fosfatase [] U/L [] 0-115 [] -- -- -- 62
Gamma GT [] U/L [] 0-55 [] -- -- -- 15
ASAT [GOT] [] U/L [] 0-35 [] -- -- -- 26
ALAT [GPT] [] U/L [] 0-45 [] -- -- -- 18
Glucose [] mmol/L 3.1-6.4 [] -- -- 4.0 5.2
Cholesterol [] mmol/L 3.90-7.30 [] -- -- 5.48 --
Triglyceriden [] mmol/L 0.80-2.30 [] -- -- 1.09 --
HDL-Cholesterol [] mmol/L 0.90-1.41 [] -- -- 1.17 --

The good news: prolactin levels have dropped considerably. So I guess a pituitary tumor is unlikely, and the Tyrosine supplementation you suggested actually is working! Thank you so much!

My testosterone dropped a bit even though I haven't lessened my tribulus terrestris supplementation.

My doc is a little worried about the consistently high FSH levels; she suggests having a fertility-test done, just to be sure. I'm not much worried about that though; my uncle and grandfather faced the very same symptoms when they were young and both started big families.

Although my mood is great most of the time, I still do experience several classic hypothyroidism symptoms: fatigue, dry hair and skin, yellowish skin and cold feet (usually I wake up simply because my feet are cold even though I'm lying underneath multiple blankets in summer time..).
I feel the improved sex hormone levels may well be responsible for my improved mood, but that there's not necessarily an improved thyroid situation (given the presence of the here above mentioned hypothyroidism symptoms). My MD has promised me that next time (in +- 2 months) my rT3 levels will be tested, and that the stored 22-JAN-sample will be used to determine its rT3 as well. Obviously I'm very curious what results these tests will yield.

Any other thoughts/lessons/things-to-work-on raised by these newest labs?


RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - Hypo - 09-18-2013 01:43 AM

Hi James,

Hope all is well.

I was wondering if you could shed your light on my newest lab results;

VARIABLE [] UNITS [] REFERENCE RANGE [] 3SEP 27JUN 6MAY 27FEB 22JAN
Free T4 [] pmol/L [] 10.0-24.0 [] 43.3H 21.7 18.4 16.3 18.9
T3 [] nmol/L [] 1.1-3.1 [] 2.7 1.4 1.5 1.4 --
TSH [] mU/L [] 0.300-4.800 [] 0.006H 1.200 3.830 5.340H 6.490H
TPO antibodies [] kU/L [] 0-35 [] -- -- -- -- 14.7
L.H. [] U/L [] 2.0-9.0 [] 5.5 6.6 7.6 4.6 7.3
F.S.H. [] U/L [] 1.5-12.5 [] 20.3H 18.8H 20.3H 16.2H 18.3H
Prolactine [] µg/L [] 4.0-15.0 [] 14.5 9.4 21.3H 17.1H 15.2H
SHBG [] nmol/L [] 20-55 [] 65.3H 51.1 49.5 40.0 38.0
Testosteron [] nmol/L [] 8.0-31.0 [] 20.6 22.6 27.5 12.1 13.1
VitamineD25(OH) [] nmol/L [] 50-250 [] -- -- -- -- 174
ACTH [] ng/L [] 0-75 [] -- -- -- -- 17
Cortisol [] µmol/L [] 0.100-0.600 [] -- -- -- 0.511 0.705H
Hb [] mmol/L [] 8.5-11.0 [] -- -- -- -- 9.9
Ht [] L/L [] 0.400-0.500 [] -- -- -- -- 0.453
Erytrocyten [] x10^12/L [] 4.50-5.50 [] -- -- -- -- 5.03
MCV [] fL [] 80-100 [] -- -- -- -- 90
MCH [] fmol [] 1.70-2.10 [] -- -- -- -- 1.97
MCHC [] mmol/L [] 19.0-22.5 [] -- -- -- -- 21.9
Leukocyten [] x10^9/L [] 4.00-10.00 [] -- -- -- -- 4.55
Natrium [] mmol/L [] 136-144 [] -- -- -- -- 142
Kalium [] mmol/L [] 3.6-4.8 [] -- -- -- -- 4.4
Ureum [] mmol/L [] 2.5-7.5 [] -- -- -- -- 5.0
Kreatinine [] µmol/L [] 64-104 [] -- -- -- -- 69
eGFR [] ml/min/1,73m2 [] >60 [] -- -- -- -- >60
Calcium [] mmol/L [] 2.15-2.55 [] -- -- -- -- 2.63H
Bilirubine Total [] µmol/L [] 0-17- [] -- -- -- -- 20H
Bilirubine Geconj. [] µmol/L [] 0-5 [] -- -- -- -- 5
Albumine [] g/L [] 34-48 [] -- -- -- -- 55 H
Alkalische Fosfatase [] U/L [] 0-115 [] -- -- -- -- 62
Gamma GT [] U/L [] 0-55 [] -- -- -- -- 15
ASAT [GOT] [] U/L [] 0-35 [] -- -- -- -- 26
ALAT [GPT] [] U/L [] 0-45 [] -- -- -- -- 18
Glucose [] mmol/L 3.1-6.4 [] -- -- -- 4.0 5.2
Cholesterol [] mmol/L 3.90-7.30 [] -- -- -- 5.48 --
Triglyceriden [] mmol/L 0.80-2.30 [] -- -- -- 1.09 --
HDL-Cholesterol [] mmol/L 0.90-1.41 [] -- -- -- 1.17 --

Since about June my 'regimen' hasn't changed very much; I try focusing on getting enough vitamin C, D, A, as well as zinc and selenium (because those supposedly support the proper transport and conversion of thyroid hormones); and I'm still taking 75mcg of T4 as my MD prescribed, 1000mg of Tribulus Terrestris plus 250mg of nettle-root extract 3 times a day, and on average 2 times 1000mg of L-Tyrosine (as you recommended in hopes of getting my prolactine levels down).

I must say I have felt very well last 1.5 weeks, however that was after the 3rd of September (i.e. after, not on the day of the latest blood drawing. I can't say I felt particularly well on the day of the 3SEP blood drawing).

What do you think of my blood values? It seems T3 has finally gone up which is great (although I am aware these lab test supposedly can't say a lot about true free T3 levels). But although my testosterone went up very good immediately after I started taking Tribulus Terrestris and nettle-root extract (a couple of weeks before the 6 May test), it has gradually declined ever since, even though I haven't lowered my Tribulus Terrestris and Nettle-root extract intake).

Are the very high T4, very low TSH and pretty SHBG worrisome in your opinion?

I think my MD is going to lower the T4 dosing giving these values. Would you agree with her?

Thanks a ton for your thoughts.


RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - Hypo - 09-19-2013 03:09 AM

PS. something I forgot to mention; there are actually two dietary changes I did make a couple of weeks before my 3SEP bloodtest:
  1. I started eating sourdough bread instead of yeast bread (because that should supposedly improve the absorption of zinc)
  2. I started taking 3 times 3000mg of ascorbic acid (I know that's a lot yes..). Before that I tried getting sufficient vitamin C from natural sources and also a Now foods Acerola supplement, for over year, but that just didn't seem to work. I kept having bleeding gums (a sign of vitamin C deficiency?), and also, I'm sensitive to salicylates, so I would get eczema from too much fruits and acerola anyway..

Perhaps these factors might explain the changed thyroid hormone levels?


RE: Hypothyroidism & low testosterone [tribulus terrestris questions] - James - 09-30-2013 06:06 PM

(06-10-2013 03:00 AM)Hypo Wrote:  OK, this all makes a lot of sense if exposing the skin to sunlight does yield the active vitamin D (without any conversion being required in the kidneys). Is that the case?

No, this is not the case. Here is a link explaining more about the production of vitamin D by sunlight:

http://www.ncbi.nlm.nih.gov/pubmed/18290718