thyroid issues causing low testosterone?

[smc252]

How does someone differentiate secondary (pituitary) hypogonadism from thyroid-related hypogonadism?

Aren't both of them directly pituitary related? :think:

My TSH is now rebounding and I am going hypothyroid. FSH/ACTH are at the bottom of the scale.

I suppose one obvious answer would be to correct the thyroid problems and wait to see if the low testosterone issue fixed itself. I have read that overtime thyroxine replacement can bring levels back closer to normal.

Are there any reliable ways to tell, in the mean time, where my issues stem from? I have a few great doctors working with me, just hoping to bring more info to the table. :food:

-Steve

 

[pmgamer18]

Can you post your test with the units and ranges if you have low T and low LH and FSH with good E2 levels then your Secondary and should have an MRI to see if you have a Tumor.

I am Secondary do to a head injury my Testosterone, Cortisol, Thyroid, DHEA-S and Aldosterone levels are all low. If your not Secondary and you have low T with low LH and FSH and high E2 treating the E2 and getting it down can bring up your T levels some 200 to 300 points. This is done first then work on the low cortisol levels when you have your Adrenals supported then add in some Armour when all is fixed then recheck your T levels you my find them back up.

 

[smc252]

e2 was at 23 last I checked.You've seen my test stuff except the newest thyroid test, which is still hypo on 50mcg. (I just upped it to 100mcg, and have finally started to BARELY notice it.)
My prolactin is at 8 still, but I can squeeze a tiny bit of fluid out of my nipples. eek?

Does anyone have first-hand experience of having just the thyroid issues lower testosterone into the 300s and free in the lower 50%? My FSH was low, 3 I think, test is low/low-normal, acth unreadably low, dhea 3-5X as high as normal, cortisol after 2hrs awake was ~20, thyroid went hyper for no real reason and I had a .001 tsh. I've had chronic pain that comes and goes, that didn't set-in immediatly after the accident.. It seems to point to pituitary stuff but doctors aren't seeing a connection.

I just want stuff to show them, so we can all understand what really could be going on.

I am still trying to distinguish pituitary problem from something causing the pituitary to have problems. If that makes any sense. I've been doing most of the research work, with my doctors not knowing a TON about endocrinology. I'm still working with Dr. Nys, a great osteopath.

Just saw a neurologist today and he didn't think I had any brain damage at all. He told me he wished most of his other patients came in, in as good (neurological, I hope) shape as me.
I guess one of my docs from my really depressed days thought I may be bi-polar, and apparently that is on all my charts now. But at the end, the neuro told me he was 100% sure I was not bi-polar, and I have been sure this was always the case. Glad to hear a true expert tell me I was right all along

Dr John, do you have any comments on the cause/effect relationship of the thyroid and pituitary?

 

[JanSz]

e2 was at 23 last I checked.You've seen my test stuff except the newest thyroid test, which is still hypo on 50mcg. (I just upped it to 100mcg, and have finally started to BARELY notice it.)
My prolactin is at 8 still, but I can squeeze a tiny bit of fluid out of my nipples. eek?

Does anyone have first-hand experience of having just the thyroid issues lower testosterone into the 300s and free in the lower 50%? My FSH was low, 3 I think, test is low/low-normal, acth unreadably low, dhea 3-5X as high as normal, cortisol after 2hrs awake was ~20, thyroid went hyper for no real reason and I had a .001 tsh. I've had chronic pain that comes and goes, that didn't set-in immediatly after the accident.. It seems to point to pituitary stuff but doctors aren't seeing a connection.

I just want stuff to show them, so we can all understand what really could be going on.

I am still trying to distinguish pituitary problem from something causing the pituitary to have problems. If that makes any sense. I've been doing most of the research work, with my doctors not knowing a TON about endocrinology. I'm still working with Dr. Nys, a great osteopath.

Just saw a neurologist today and he didn't think I had any brain damage at all. He told me he wished most of his other patients came in, in as good (neurological, I hope) shape as me.
I guess one of my docs from my really depressed days thought I may be bi-polar, and apparently that is on all my charts now. But at the end, the neuro told me he was 100% sure I was not bi-polar, and I have been sure this was always the case. Glad to hear a true expert tell me I was right all along

Dr John, do you have any comments on the cause/effect relationship of the thyroid and pituitary?

Test FreeT3 and FreeT4 to figure out thyroid.
What is that you are taking for thyroid?
You should be taking Armour Thyroid and then stop looking at TSH.

 

[hardasnails1973]

Test FreeT3 and FreeT4 to figure out thyroid.
What is that you are taking for thyroid?
You should be taking Armour Thyroid and then stop looking at TSH.

I think once free t-3 and free t-4 is in optimal range it may be advisbialbe to test total t-3 and t-4. If one has low total t-3 and t4 and high ft3 and ft4 they still could be hypo same would apply with testosterone levels ..

 

[smc252]

I know exactly what I am doing with the thyroid meds, I know all about armour too.

I just want to know if anyone has gotten significantly lower testosterone from a thyroid isssue or if the impact is more or less minimal... Or if anyone has any studies or facts about it... Is it permanent or temp?

 

[Megazoid]

Thought i would give some input here. I believe my low testosterone was caused by thyroid. I got a varicocele that caused a knock on effect on my whole endocrine system.

Testicles have 3 purposes: Testosterone production (from the leydig cells), Sperm Productions (and also a small amount of Estridol from the sperm production cells) and TRH (Thyroid releasing hormone).

Varicocele caused reduced circulation to the testicles which in turn causes over-heating then a whole cascade of events. Even though no actual testicular damage occured (my LH/FSH remained the same as before the varicocele) my TSH went from being 0.65 to 2.3/2.5 in the space of 3 months. I got all the symptoms of either 1) Hypothyroidism 2) Hypogonadism.

My testosterone dropped from 25nmol (roughly 700+ i believe) to 15nmol (about 400/500) in this time frame.

Because thyroid controls metabolism and body temp, it also regulates blood circulation. Reduced blood circulation can cause lower testosterone i believe.

I was diagnosed with hypothyroidism and adrenal fatigue/stress. I have been put on pred and l-thyroixine which i will be starting soon (alongside a whole bunch of other vitamins, DHEA, etc). I will post updates and blood work as i get them. Dr M (my doctor) believes once thyroid/adrenal issues are addressed sex hormones WILL rise again.

 

[smc252]

Sounds like we are in a similar situation, are your docs admitting that you suffer low testosterone or are they pulling the whole "in the range" bull**** on you too?

 

[Megazoid]

The whole "in your head...in the normal range..." crap with me too.

 

[JanSz]

Thought i would give some input here. I believe my low testosterone was caused by thyroid. I got a varicocele that caused a knock on effect on my whole endocrine system.

Testicles have 3 purposes: Testosterone production (from the leydig cells), Sperm Productions (and also a small amount of Estridol from the sperm production cells) and TRH (Thyroid releasing hormone).

Varicocele caused reduced circulation to the testicles which in turn causes over-heating then a whole cascade of events. Even though no actual testicular damage occured (my LH/FSH remained the same as before the varicocele) my TSH went from being 0.65 to 2.3/2.5 in the space of 3 months. I got all the symptoms of either 1) Hypothyroidism 2) Hypogonadism.

My testosterone dropped from 25nmol (roughly 700+ i believe) to 15nmol (about 400/500) in this time frame.

Because thyroid controls metabolism and body temp, it also regulates blood circulation. Reduced blood circulation can cause lower testosterone i believe.

I was diagnosed with hypothyroidism and adrenal fatigue/stress. I have been put on pred and l-thyroixine which i will be starting soon (alongside a whole bunch of other vitamins, DHEA, etc). I will post updates and blood work as i get them. Dr M (my doctor) believes once thyroid/adrenal issues are addressed sex hormones WILL rise again.

Have you asked Dr M why L-thyroxine= (T4)
and not Armour Thyroid?
Post your
FreeT3
FreeT4

 

[Megazoid]

JanSz, i am still awaiting the arrivial of the results, it's been almost 2 weeks and still nothing.

JanSz, he said this in an email reply:

--- CUT ---

1. I will generally choose what I believe will work best for a person
- whether it be Levothyroxine versus Armour Thyroid or a combination
of both. Everyone always will convert T4 to T3. The most important
question is whether or not T3 will be tolerated by the adrenal
glands. Armour Thyroid forces a fixed amount of T3 on the adrenal
glands. This can be very difficult to tolerate and may itself cause
adrenal fatigue. Thus for people with severe adrenal fatigue - such
as those with significant mental health issues such as severe
depression or anxiety - Armour Thyroid is much more dificult to
tolerate. Since everyone will always convert T4 to T3, and since the
adrenal glands will determine how much is converted, then giving pure
T4 (Levothyroxine) is much more easily tolerated. The adrenal
gland's state of health will determine how much will convert to T3 -
thus not stressing the adrenals when they are most fatigued and
having more T3 when they are stronger. However T3 one will get from
T4 will then be determined by the ultimate dose of T4 (Levothyroxine)
and adrenal health. This is a point missed by many others. Further,
the problem of Levothyroxine is that few doctors will go to the
higher doses needed to adequately treat hypothyroidism. For example,
the average hypothyroid patient will need a dose of 300 mcg a day.
Few doctors go above 150 mcg a day, thus undertreating the patient
and giving the patient the false idea that perhaps Armour Thyroid
would be better.

 

[nallepuh]

Testicles have 3 purposes: Testosterone production (from the leydig cells), Sperm Productions (and also a small amount of Estridol from the sperm production cells) and TRH (Thyroid releasing hormone).

Ive never heard this b4.
Trh is the hypothalamus signal for pituary to realese tsh so that the thyriod starts production of thyriodhormones. Where did u hear/read about trh beeing produced in the testicles?

fyi
Trh also stimulate production of prolactin and therefor perhaps could inhibit normal testosterone production i guess.
Cheers.

 

[pmgamer18]

Marianco is on the money again even at STTM we tell people to address there low adrenals and get them supported first before going on Armour because it will build up in the blood if your cortisol levels are to low and make you dam sick. We need cortisol to carry Thyroid hormones into the cells from the blood.

JanSz, i am still awaiting the arrivial of the results, it's been almost 2 weeks and still nothing.

JanSz, he said this in an email reply:

--- CUT ---

1. I will generally choose what I believe will work best for a person
- whether it be Levothyroxine versus Armour Thyroid or a combination
of both. Everyone always will convert T4 to T3. The most important
question is whether or not T3 will be tolerated by the adrenal
glands. Armour Thyroid forces a fixed amount of T3 on the adrenal
glands. This can be very difficult to tolerate and may itself cause
adrenal fatigue. Thus for people with severe adrenal fatigue - such
as those with significant mental health issues such as severe
depression or anxiety - Armour Thyroid is much more dificult to
tolerate. Since everyone will always convert T4 to T3, and since the
adrenal glands will determine how much is converted, then giving pure
T4 (Levothyroxine) is much more easily tolerated. The adrenal
gland's state of health will determine how much will convert to T3 -
thus not stressing the adrenals when they are most fatigued and
having more T3 when they are stronger. However T3 one will get from
T4 will then be determined by the ultimate dose of T4 (Levothyroxine)
and adrenal health. This is a point missed by many others. Further,
the problem of Levothyroxine is that few doctors will go to the
higher doses needed to adequately treat hypothyroidism. For example,
the average hypothyroid patient will need a dose of 300 mcg a day.
Few doctors go above 150 mcg a day, thus undertreating the patient
and giving the patient the false idea that perhaps Armour Thyroid
would be better.

 

[smc252]

Phil, I read my high DHEA may have come after having high cortisol. DHEA lowers serum cortisol, doesn't it? Maybe it's a control mechanism in the adrenals, as you may remember, my acth is unreadably low..

This would explain my very low response to 50mcg, and now I am on 100mcg... Still tired and grumpy. Tried to workout 2 days ago, and am still hurting from it

 

[JanSz]

JanSz, i am still awaiting the arrivial of the results, it's been almost 2 weeks and still nothing.

JanSz, he said this in an email reply:

--- CUT ---

1. I will generally choose what I believe will work best for a person
- whether it be Levothyroxine versus Armour Thyroid or a combination
of both. Everyone always will convert T4 to T3.
The most important
question is whether or not T3 will be tolerated by the adrenal
glands. Armour Thyroid forces a fixed amount of T3 on the adrenal
glands. This can be very difficult to tolerate and may itself cause
adrenal fatigue. Thus for people with severe adrenal fatigue - such
as those with significant mental health issues such as severe
depression or anxiety - Armour Thyroid is much more dificult to
tolerate. Since everyone will always convert T4 to T3,
and since the
adrenal glands will determine how much is converted, then giving pure
T4 (Levothyroxine) is much more easily tolerated. The adrenal
gland's state of health will determine how much will convert to T3 -
thus not stressing the adrenals when they are most fatigued and
having more T3 when they are stronger. However T3 one will get from
T4 will then be determined by the ultimate dose of T4 (Levothyroxine)
and adrenal health. This is a point missed by many others. Further,
the problem of Levothyroxine is that few doctors will go to the
higher doses needed to adequately treat hypothyroidism. For example,
the average hypothyroid patient will need a dose of 300 mcg a day.
Few doctors go above 150 mcg a day, thus undertreating the patient
and giving the patient the false idea that perhaps Armour Thyroid
would be better.

Marianco is on the money again even at STTM we tell people to address there low adrenals and get them supported first before going on Armour because it will build up in the blood if your cortisol levels are to low and make you dam sick. We need cortisol to carry Thyroid hormones into the cells from the blood.

Phil;

It is true that STTM advocates addressing Adrenals first and supporting them up to 20mg of Corteff daily, which is 100% of their production, but no more.
Stop The Thyroid Madness :: View topic - How to Start Hydrocortisone or Isocort
but
then they advocate use of Armour Thyroid because many people are not able to convert T4 into T3.
T4-Only Meds Do Not Work
Stop The Thyroid Madness » T4-Only Meds Do Not Work

If what Dr Marianco states is true we do not need Armour.

Additionally, I do not see anything being said by Dr Marianco about FreeT3 and FreeT4.
From his writting I infer that FreeT3 will be as high as allowed by adrenals rather than being close to the top range (forced by external supply).

All this is different than I have seen on STTM board. But I have not read it for at least six months, so possibly some changes occured in mean time.

Please figure it out and describe the current thinking on STTM board, since you moderate it (thank you).
Possibly you can contact Chris to chime in.
==========================================
Stop The Thyroid Madness » T4-Only Meds Do Not Work

The theory was that T4 would convert to the T3 needed for the body. But in nearly ALL patients on T4 meds, the T4 does NOT convert into an adequate amount of T3, leaving you with symptoms that neither you OR your uninformed doctor realize are related to inadequate treatment—poor stamina compared to others, chronic low grade depression, thinning hair or outer eyebrows, feeling cold when others are warm, cholesterol problems, aches and pains, hard or small stools, easy weight gain, memory problems, foggy thinking, a diagnosis of Chronic Fatigue Syndrome or Fibromyalgia, difficulty conceiving………the list is long and pathetic. In other words, healthy thyroids are NOT meant to rely SOLELY on T4-to-T3 conversion!

 

[pmgamer18]

Most people have low cortisol with low DHEA not sure about high but high is just a stage to low cortisol levels or Adrenals Fatigue or worse.

 

[pmgamer18]

We are talking about one person and why his Dr. put him on T4 only med just reread what Dr. M said.

Phil;

It is true that STTM advocates addressing Adrenals first and supporting them up to 20mg of Corteff daily, which is 100% of their production, but no more.
Stop The Thyroid Madness :: View topic - How to Start Hydrocortisone or Isocort
but
then they advocate use of Armour Thyroid because many people are not able to convert T4 into T3.
T4-Only Meds Do Not Work
Stop The Thyroid Madness » T4-Only Meds Do Not Work

If what Dr Marianco states is true we do not need Armour.

Additionally, I do not see anything being said by Dr Marianco about FreeT3 and FreeT4.
From his writting I infer that FreeT3 will be as high as allowed by adrenals rather than being close to the top range (forced by external supply).

All this is different than I have seen on STTM board. But I have not read it for at least six months, so possibly some changes occured in mean time.

Please figure it out and describe the current thinking on STTM board, since you moderate it (thank you).
Possibly you can contact Chris to chime in.
==========================================
Stop The Thyroid Madness » T4-Only Meds Do Not Work

The theory was that T4 would convert to the T3 needed for the body. But in nearly ALL patients on T4 meds, the T4 does NOT convert into an adequate amount of T3, leaving you with symptoms that neither you OR your uninformed doctor realize are related to inadequate treatment—poor stamina compared to others, chronic low grade depression, thinning hair or outer eyebrows, feeling cold when others are warm, cholesterol problems, aches and pains, hard or small stools, easy weight gain, memory problems, foggy thinking, a diagnosis of Chronic Fatigue Syndrome or Fibromyalgia, difficulty conceiving………the list is long and pathetic. In other words, healthy thyroids are NOT meant to rely SOLELY on T4-to-T3 conversion!

 

[JanSz]

We are talking about one person and why his Dr. put him on T4 only med just reread what Dr. M said.

After rereading
Dr. Marianco said:
Everyone always will convert T4 to T3.

STTM said:
But in nearly ALL patients on T4 meds, the T4 does NOT convert into an adequate amount of T3

Short version #1
Everyone always will convert

Short version #2
nearly ALL does NOT convert

 

[smc252]

Seeing my T3 being very low still, and T4 also very low.. Seems I will need to replace both.

I plan to get T4 elevated first, and then checking T3.

Then it's time to add T3 untill I am happy.

 

[JanSz]

Seeing my T3 being very low still, and T4 also very low.. Seems I will need to replace both.

I plan to get T4 elevated first, and then checking T3.

Then it's time to add T3 untill I am happy.

Keep eye on Adrenals.

 

[smc252]

Keep eye on Adrenals.

For sure, I got all the basics down

I am already thinking something is wrong with them, as my free t4/t3 hardly came up. Gonna go for armour next time I talk to my doctor.

 

[pmgamer18]

For sure, I got all the basics down

I am already thinking something is wrong with them, as my free t4/t3 hardly came up. Gonna go for armour next time I talk to my doctor.

Yes do a saliva test that checks your cortisol levels 4 x's in a day. If your low you need to support your Adrenals first before taking Armour. Here is a link that helps you see how they are doing by taking your temps 3 x's a day and doing an avg. If your avg. temp goes up or down more then 2ths your adrenals are not supported. Then thyroid hormone will build up in your blood and you need cortisol to carry it into the cells. So you will start to feel bad as you get higher up on Armour most can't do more then 90 mgs. My wife ended up in the ER she thought she was having a heart attack. We later found out her Adrenals are bad from taking Synthroid for 15yrs.

 

[JanSz]

We later found out her Adrenals are bad from taking Synthroid for 15yrs.

According to Dr M three things can be said about Synthroid

1. doctors prescribe to small dose (less than 300mcg)

2. Everyone always will convert T4 to T3.

Right here:
http://anabolicminds.com/forum/901863-post11.html

3. supplying T4 (rather than T3 directly as in Armour) protects Adrenals.
Quote: Since everyone will always convert T4 to T3, and since the
adrenal glands will determine how much is converted, then giving pure
T4 (Levothyroxine) is much more easily tolerated.

What was the maximum dose of Synthroid that your wife was taking?

Your wife's adrenals when bad was not result of using Synthroid.

Adrenals may go worse when overdosing Armour.

 

[nallepuh]

couple of questions.

If u have weakend adrenals so yr convertion of t4 to t3 may not be optimized, upon treating adrenals conversion of t4 to t3 will increase to normal and no thyriod meds will be needed if u have a good t4 level allrdy?

Does thyriodhormones bind to albumin and shbg or just albumin and thyriodbindingglobulin? If it do not bind to shbg what is the mechanism between increased shbg when hyperthyriod and lowered shbg when hypothyriod?

I have been told i have low aldosteron levels (by not completely trustworthy check up) and im wondering if this could cause my thyriod to increase t4 since not enough t3 is beeing converted?

Some1 posted fixing aldosteron levels (think with florinef)made his e2 levels go down, he had to cut arimidex doze in half. What is the effect of aldosteron on estrogen levels or vice versa?

complicated questions i guess but u guys know everythingelse so have to try

cheers

 

[JanSz]

couple of questions.

If u have weakend adrenals so yr convertion of t4 to t3 may not be optimized, upon treating adrenals conversion of t4 to t3 will increase to normal and no thyriod meds will be needed if u have a good t4 level allrdy?

Does thyriodhormones bind to albumin and shbg or just albumin and thyriodbindingglobulin? If it do not bind to shbg what is the mechanism between increased shbg when hyperthyriod and lowered shbg when hypothyriod?

I have been told i have low aldosteron levels (by not completely trustworthy check up) and im wondering if this could cause my thyriod to increase t4 since not enough t3 is beeing converted?

Some1 posted fixing aldosteron levels (think with florinef)made his e2 levels go down, he had to cut arimidex doze in half. What is the effect of aldosteron on estrogen levels or vice versa?

complicated questions i guess but u guys know everythingelse so have to try

cheers

This is definitely complicated issue.
You already know quite a lot about it.
I would appreciate if you posted links to good supporting evidence of the description of what you posted (first three paragraphs).
.
.
sex hormone binding globulin (SHBG)
corticosteroid binding globulin (CBG)
thyroxin-binding globulin (TBG)

 

[nallepuh]

This is definitely complicated issue.
You already know quite a lot about it.
I would appreciate if you posted links to good supporting evidence of the description of what you posted (first three paragraphs).
.
.
sex hormone binding globulin (SHBG)
corticosteroid binding globulin (CBG)
thyroxin-binding globulin (TBG)

As my post was in form of questions im wondering what kind of evidence u are hoping for?

If u can specify what u want maybe i can provide something. The information i included in my questions was a result of studying the internet trying to understand my bodys reaction, its not concluded on only clinical trials etc, just what i gathered from looking into it generaly on the internet. some info im sure came from here.

 

[smc252]

All good topics, but all I'd like to see and read about is how thyroid issues directly effect testosterone..

I do not believe SHBG attaches to anything BUT sex hormones, but I know for a fact albumin attaches to thyroid hormones. With thyroid issues, it is usually elevated.

 

[JanSz]

All good topics, but all I'd like to see and read about is how thyroid issues directly effect testosterone..

I do not believe SHBG attaches to anything BUT sex hormones, but I know for a fact albumin attaches to thyroid hormones. With thyroid issues, it is usually elevated.

Keep on going.

 

[nallepuh]

(talking bout high t4 while on thyriod meds without t3)

Management, where this problem is believed to be present, consists in discontinuing some or all T4 and substituting with T3, preferably in divided doses. Since poor conversion may be associated with a raised sex hormone binding globulin (SHBG) and high levels of exogenous oestrogen, re-appraisal of any HRT may need to be considered. Ensuring correct levels of vitamins A & B, Iron and Magnesium (as above), is also mandatory.

I wonder if its the high t4 initself that causes high shbg since most of u hypothyriod guys do not have a high shbg. So low t3 on its own is prolly is not a cause for rasied shgb.

i find this site to be really good about thyroid issues.

Thyroid-Disease.org.uk - Home

 

[JanSz]

(talking bout high t4 while on thyriod meds without t3)

Management, where this problem is believed to be present, consists in discontinuing some or all T4 and substituting with T3, preferably in divided doses. Since poor conversion may be associated with a raised sex hormone binding globulin (SHBG) and high levels of exogenous oestrogen, re-appraisal of any HRT may need to be considered. Ensuring correct levels of vitamins A & B, Iron and Magnesium (as above), is also mandatory.

I wonder if its the high t4 initself that causes high shbg since most of u hypothyriod guys do not have a high shbg. So low t3 on its own is prolly is not a cause for rasied shgb.

i find this site to be really good about thyroid issues.

Thyroid-Disease.org.uk - Home

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