Hypothyroidism, Low Testosterone
09-16-2006 07:20 PM
Hypothyroidism, Low Testosterone
More dam good in put From Dr. Marianco.
Originally Posted by fenstermaker
I am a 38 year old male that is post Graves. The treatment I received for Graves was iodine radiation which in turn zapped my Thyroid completely. Currently on 175mcg of synthroid. I have never felt "normal" since. That was about 6 years ago. I put on about 45 pounds and have never been able to lose the weight.
I insisted my Dr check more of my levels than my T3, T4 to see why I feel like crap all the time.
My results came back a follows:
fsh=2.8 in range
LH=4.6 in range
IGF-II=1107 in range
GH= 1.7 in range
Test Total = 196 Low
Test Free %= 2.32
Test Free = 45
After this test result in the beginning of Aug 2006, My Dr put me on Androgel. 2.5 grams daily.
That is when I started my research and found this site. Since my readings, I thought the amount he started me on was very low for a guy my age and size. 38 6'3" 245lbs.
Included in my reading from you guys, you insisted that I make my Dr check my levels again in approx four weeks.....I had to make my Dr agree to this and he did new results are as follows:
Alkaline phosphatase 62
Bilirubin total 0.9
Bilirubin Direct 0.2
Protein, Total 7.1
Estrogens Total 96
Test, Total 176
Test % free 2.30
Test, free 40.5
So I recieved a note from my Dr with the test results to increase the Androgel to 5 grams daily and run new tests in 3 months.
I am not thrilled by the new test numbers but I have you talk about the possibility of Test dropping in the first stages. I am not convinced my Dr is completely ready for this challenge that I am facing and he has not suggested that I seek another Dr.
So if anyone can give some input on the relationship of Post Graves to the low test situation I am facing, or if there is no relationship between the two. Also if anyone can suggest a good Doc in the Columbus, Ohio area.
Thanks for sharing you thoughts and time to post, for it has helped me get ready for this TRT journey that I was not aware even existed. The personal situations that you all talk about help relate for us new guys in this problem.
Good thyroid hormone actilvity is necessary for testicular steroid hormone production - e.g. testosterone production.
Low thyroid hormone activity often results in insulin resistance.
Insulin resistance is another factor that reduces testosterone production. It interferes with LH production and may also directly reduce testicular testosterone production.
The bests tests for available thyroid hormone activity are:
Free T3, Free T4, and TSH.
The free T3 is the most important of the three since it measures the most active thyroid hormone. T3 is about 4 to 10 times more active than T4. It is what the brain measures to determine how much TSH to release.
Synthroid (T4) is not as effective in treating hypothyroidism as a combination of T4 and T3 such as Armour Thyroid. In studies comparing T4 versus T4+T3, patients strongly preferred T4+T3 even if there were no difference in the lab levels. They simply felt better. Armour Thyroid is safer to use versus the available T4+T3 combinations since the thyroid hormone in Armour Thyroid is bound to thyroid binding globulin, and is then slowly released into the body when it is absorbed. Thus Armour Thyroid is a long-acting version of thyroid hormone. This is in contrast to the other T4+T3 combinations or T3 (Cytomel) itself. The problem is the sudden rise in T3 from these has a higher risk of causing problems including cardiac arrhythmias. It is technically more difficult and requires closer physician monitoring to use other T4+T3 combinations and T3 in treating hypothyroidism.
A good starting point is that a person may often show signs and symptoms of hypothyroidism when the free T3 is less than 310 pg/dL.
More important than blood levels of thyroid hormone is whether or not there are still signs and symptoms of hypothyroidism with treatment. There are a large number of people with normal thyroid hormone levels (normal free T3, free T4, TSH), yet who still have signs and symptoms of hypothyroidism. These people have thyroid hormone resistance and need extra thyroid hormone treatment.
When it comes to LH and FSH, the question is not whether or not the values are in range, but whether or not the appropriate amount of testosterone is being made in response to the LH level. This helps determine if one has a problem with the pituitary's production of LH (secondary hypogonadism) or if the problem lies in testicular production (primary hypogonadism) or if there is both primary and secondary hypogonadism.
Since there are multiple factors which can affect testosterone production both from the hypothalamus-pituitary and testicular ends - such as other hormone imbalances - the LH and FSH may not so much be useful except to determine if a pituitary tumor is present or if HCG can be used as TRT (as with secondary hypogonadism).
Total testosterone is the best test for clinical purposes. The tests for free testosterone are not uniformly accurate enough. Free testosterone can also be normal yet a person has all the signs and symptoms of hypogonadism.
A good target for total testosterone during TRT is at least 650 ng/dl, measured at the midway point between injections or at least four hours after applying transdermal testosterone, or any time if pellets are implanted.
Its better to measure estradiol than total estrogens to get an idea of the total estrogen activity. Estradiol level is in essence the total estrogen level but with greater weight placed on estradiol itself and less weight placed on the other estrogens (which are much weaker than estradiol).
During testosterone replacement, the total testosterone is determined by how much testosterone the testes make plus how much external testosterone is absorbed. There is a point where the external testosterone dose is high enough to shut down testicular testosterone production but not enough to make up the difference. In this case, the total testosterone actually is lower with TRT than without. The solution is to increase the external testosterone dose to a point where it is high enough to increase total testosterone rather than reduce it.
When it comes to Androgel, a dose of 5 grams of gel causes a substantial percentage of men to worsen in hypogonadism (i.e. lower total testosterone). Many men do respond well and have really good levels - e.g. 750 ng/dl and above. But to reduce the risk of worsening testosterone levels, starting at 10 grams then lowering the dose if total testosterone, DHT, estradiol levels go too high or of side effects occur, may be preferrable.
When a person has had hypothyroidism for a long time, absorption of transdermal testosterone may be difficult. This is because there is a build-up of mucin (a glue-like substance) in the skin of people with hypothyroidism, which causes the skin to become thick. This is called myxedema. It can be subtle, not obvious to most physicians, who are not use to pinching the skin of their patients to gauge the thickness of the skin. Myxedema impairs absorption of transdermal testosterone - impairing treatment with transdermal testosterone.
When myxedema is present, it is better to go to testosterone injections for TRT.
Any statement I make on this site is for educational purposes only and is subject to change. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, you will have to make an appointment. Thank you.
09-19-2006 03:18 PM
Are you Diesel?
Your LH is 4.6, thats not "in range." Thats your problem. Also your free test is low, you might want to get your SHBG checked.
I dont know how they measured the estorodiol, but 96 is up there also.
09-19-2006 03:38 PM
Sorry Chuck the post was on a different site and I put it here for Dr. Mariaco's answer. Fenstermaker is not a member here.
Originally Posted by Chuck Diesel
10-08-2010 05:23 AM
I supply all kinds of steroid bulk like testosterone series,naandrolone series,boldelone series,winstrol.Anavar and so on ,if you need ,pls contact me
Yesterday 08:58 PM
guess im late getting to this post. i have another friend with thyroid issues so im looking into all this again. good thread. anyway, i just read this article about how to suppress the thyroid to combat hyperthyroidism in 10 days using large doses of lithium:
so hopefully people will at least explore other options before zapping the gland. also, theres a dr brownstein who talks about other nutrients that can reduce thyroid function. anyway, of course armour or naturthroid is way better than synthroid for some types of hypo; there are people for who synthroid works fine, but only because they dont have the issue with conversion that others have. armour gets around that, but as i recall with my friend who i talked into switching after his hair kept falling out years after starting synthroid, it took several weeks or months before the symptoms were reversed. also, his doc, who resisted the change and didnt understand armour, was really skimping him on the dosage. again, dr brownstein has info on his site or in his books about how hypothyroid was treated before bloodtests, and how deceptive blood tests caused a reduction in dosage protocalls after they came out; his argument rests on the idea that thyroxin builds up in cells which is not adequately measured by blood tests, and thus more can be ideal in some situations though only a few doctors he knows would help patients out with higher doses. finally, he said something about how taking thyroid hormone is way different from actually stimulating the thyroid with iodine ect; taking the hormone did not deliver the cardiac benefits and i think he said something about a cascading effect on other glands as a result of a stumulated thyroid that is producing its own thyroxin
Today 12:49 PM
Wow you said a mouth full yes Dr. Brownstein he is in my area in MI. I know the women that helps him wright his books. She was dying from Brest Cancer and he cured her with Iodine. She is a Natural Path and in a Coffee Club where the old mods hang out from STTM forum.
Dr. Jeffrey Dach is great at Thyroid and low Testosterone I get his News E-Mail here is a link to one of them.
I can't take more then one 12 mg. pill of Iodoral I go into Bromide Detox and it makes me sick as a dog. Still I take one / day at bedtime it helps with thyroid and the meds I take for it.
I don't take Armour type meds any more and will never go back on them. All the forums are down on Synthroid saying it does not convert into T3.
But when the FDA a few yrs. ago pulled Armour off the market and let us to fend for our self's. We could not find Armour type meds the demand was to high and Labs could not keep up.
So we mod. from STTM went on Synthroid and added 5 mcgs of T3 4x's / day to this and dam if it works better then Armour for me.
Later a study came out saying this.
Today 02:01 PM
interesting. i remember reading something about armour; there was this one guy who said the fillers put into it actually work against its absorption or something. dont remember the details. i think in the event that the gland was zapped, you dont have to worry about causing hypo from large doses of potassium iodide (which is a rare occurance for anyone from what i read) but this company that makes this stuff called iosol supposedly gets around even that possibility. the argument they make is that potassium iodide stains the gland like it stains clothing, and thus causes a counter reaction in some people (yet over in asia, people will take in GRAMS of iodine a day from seaweed are fine). apparently, pure iodide is labeled with a skull and crossbones at any pharmacy, and potassium idodide is only considered less toxic by some people (even though most people are fine with the huge doses. anyway, iosol doesnt stain clothing (or the gland supposedly). i wonder if you could take 12mg doses of that without feeling sick.
Originally Posted by pmgamer18
Today 02:11 PM
My Dr. and I talked about this but I am secondary due to a head injury and my Pituitary dose not tell my body to make enough hormoens so doing more Iodine is not going to be much help to me.
Originally Posted by thescience
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