Well, for the sake of boredom, fun, and just curiosity to see what some of the greater minds of AM think, I've decided to create this thread. For those who know me, you know I've been dealing with some medical stuff for a while, now, and despite thinking I've found an answer or a solution, I've repeatedly found myself at more crossroads. If you don't want to read this thread, I don't blame you at all; what I'm going through is an absolute mess and certainly doesn't lend itself to a quick answer. However, if you're intrigued, feel free to read my story and if there's something that sticks out to you, please, chime in. Even if you just need some help or just want to chat due to whatever frustrating circumstances you may be facing in your own life, you can do that here, too. I'd love to find out what's wrong with me and fix the problem, but if I can help anyone else or even just make someone else's day not feel quite as bad, I'd love to do that, too.
The Big Back Story:
A long, long time ago, in a state in the middle of the US, a happy boy existed. From the time he was born, he was very active. Until about the age of 8 or so, he was incredibly skinny. About that time, though, he started getting a bit chubbier, though it was nothing to worry about. As he got older, he never seemed to get rid of that chubbiness, despite constantly playing sports and being active and rarely touching a video game or spending a moment inside. Once high school hit, the urge to lose the weight was even more important. He played baseball year round, weight-trained and even started running 7-9 miles nightly. He didn't know a lick about nutrition, but he did know that eating less was supposed to mean losing weight. So, he practically starved himself for a portion of time and only ate some fruit, vegetables and little more. He wasn't obese by any stretch, but he didn't have the body of someone who did what he did. He also had become a master at knowing how to hide what fat he had by sucking his gut in and dressing to keep people from knowing there was anything underneath (a quickly developing, muscular chest helped by allowing shirts to stick out at that point, instead of the stomach).
Once he got to college, he no longer had baseball to play. So, weight-training became a new passion. From that came some great physical changes, but no significant loss of fat. Around the age of 19, fat-burners became a topic of interest, since nothing else seemed to work and understanding the most basic concepts of food at a macro-nutrient level wasn't something he even knew to contemplate studying. He was still very active, ate pretty well, but couldn't get the results he wanted. Finally, in his senior year of college, he was convinced to start playing basketball (for the first time since early high school, really) because a close friend played a lot of pickup games at the rec. It started off as just an opportunity to run somewhere other than on a track or a treadmill, but slowly, it became a new passion. It was a great new outlet for aggression and competitiveness that weight-training didn't always provide. Eventually, it was common to play for 2-3 hours a night, 4-5 nights each week. He could literally run 10+ games in a row, with only a 2-3 minute break in between while the losing team would leave and to get a quick drink of water. Despite the amazing endurance, he still carried a lot of extra fat.
Nothing much changed through the transition to grad school. Basketball was still very regular. Weight-training was just as common. And he even started eating a bit healthier, to boot, since he lived on his own and not in the dorms, anymore. About midway through the second year of grad school, he started to focus more on bodybuilding and not just weight-training. At age 18, it started off with lifting about 3 times a week with a lot of compound movements and a variety of reps/sets over the years. At this point, it transitioned into more of a "body-part-per-day" style that relied on a lot of 3 and 4-by-twelves; along with some superset days, too, in hopes of burning off that fat. It was around this time that nutrition really started getting researched. This was partially due to involvement on online forums and not just relying on Men's Health, anymore. The transition to MD from MH played a role, too. At age 23, he started to get the brachial artery showing up on the bicep. When flexing his abs, they showed up, too. If he just relaxed, though, there was still some fat, though all things considered--not as much as what was to come.
It was finally at this time, at age 24, that he realized what a caloric maintenance level was and that one actually had to surpass that to gain muscle. For the nearly 10 years he'd been lifting, he was trying to lose fat. It never crossed his mind that he'd actually have to take in enough to build muscle. At this time, he realized he was pretty ignorant. Despite training and being active and working hard for 10 years, it was the next 2 in which he'd learn exponentially more. The concepts of counting calories, cycling calories and carbs, learning complex versus simple carbohydrates, learning what good fats were and many other things were new and implemented. The best he'd previously looked had been on Spring Break at age 23; right around 200-205 lbs. A few months later, he'd managed to drop back down to about that level from 225 or so with his first ever EC stack (still before all the food knowledge was learned). From that point, he gained to around 230 without really understanding how. He slowly started whittling it back down and hit 214 over a couple months. He then attempted his first ever keto diet and managed to lose 6.4 lbs in a month without having one single cheat from his diet. At 208, he looked the best he'd ever looked (though he seemed to be carrying a tad more fat compared to March '09; now in May '10).
He allowed himself a cheat meal at the completion of a month and then got back to it, but no matter what he did, he couldn't seem to lose a pound. It had always been hard, but this was literally impossible. After another couple weeks of no success and major headache, his friend asked him how long he'd been trying to cut. "Well, about 5 months, though admittedly my entire life." His friend suggested perhaps he try to bulk because his body was stressed from all that time trying to cut. It seemed to make enough since, so that led to the first ever attempt of a bulk. At the start of the bulk, he was 220 lbs. He implemented Max OT training and was eating between 3,000 and 3,500 calories per day. He gained exponential strength and also added 24 lbs in 7 weeks. Sitting at 244 lbs, he'd never weighed more. His waist had gone from 35" up to 36.25" and that didn't sit well with him, but he could still see his abs; though covered with more fat than he'd like. On the bright side, his bench had moved up to 365x5 and he was leg-pressing 1,200 pounds for reps. At that point, though, he knew it was time to try cutting again. What he found was a lot more of the same; losing a pound or two, but gaining it right back despite having a diet completely on point and no cheat meals.
By the time the new year hit, he tried an all out cut attempt with a keto diet and a ridiculous supplement regimen with fat-burning occurring from multiple pathways. There was a 6 week drop that first week (likely mostly glycogen), but after that, a consistent gain of 1 pound every other day or so. It was at that point that he finally decided that something had to be wrong. Previously, he thought that he was always doing something wrong--he could work harder, eat better...something! But now he finally knew, it was beyond his own doing.
Cliffs:
- I've always been active
- Weight training / running regularly since age 14
- Always carried extra weight since about age 8
- Been very hard to lose weight, but possible
- Finally got some abs and the brachials showing up at age 23
- Hit a sticking point where I literally couldn't lose weight
- Did my first ever bulk; added 24 lbs in 7 weeks
- Tried to cut again; same sticking point
- Realized that it might be a medical issue January '11
2011 - The Medical Quest
On January 21, 2011, I had a full hormonal blood panel done and was diagnosed with hypothyroidism. Leading up to the blood tests, I'd been researching this and was suspicious of it (because prior to this point, I had heard the term "metabolism" tossed around frequently and knew that everyone had their own; some good, some bad, but I never knew that it could actually be changed). It sucked to find out I'd be taking medication the rest of my life, but hey, it's just another pill, right? More than being upset about that, I was thrilled to finally have an answer. I thought, "I'll just start taking this pill, doing everything else I already do and pretty soon, hello body I've always dreamed of." It didn't go that way.
Despite adding in the 50mcg of T4 I'd been prescribed and running and lifting hard, the scale wasn't budging and the mirror wasn't changing, either. In 6 weeks, I had his blood draw and saw my TSH drop from 5.67 down to 3.94. I talked to the doctor about it, explained the problems I was still having and was told to just keep taking the same dose and to come back in 3 months for another blood draw. Needless to say, I found an endocrinologist at that point. I was thrilled when the endo said he'd bump the dose up to 112mcg/day from 50. It was the same story--come back in 6 weeks for blood work. In that time, my TSH dropped down to 2-something (need to get the copy of that lab work, actually). More of the same.
It was at this time that I found a companion who offered some help and advice and led me to start looking into Reverse T3. When reading about it, it seemed to be the perfect culprit. So, I had blood work done and sure enough, rT3 was 41, high out of range (ref: 11-32). My endocrinologist, however, told me this test was completely meaningless and advised me to continue taking the 112mcg of T4, daily, despite all research pointing out that in instances of rT3 dominance that T4 is simply converted into more rT3 and that T3 is needed to defeat this cycle. So, I decided to supplement T3 only at 100mcg/day at that point and cut out T4 (I haven't touched T4, since). Research suggested that it would take roughly 12 weeks for the rT3 to clear, but once it did, it would be back to normal. Blood work roughly one month after starting T3-only supplementation provided this: rT3 - 55 LOW (ref: 90-350) along with a TSH at 0.13 (now technically hyper-thyroid, though those symptoms obviously weren't experienced). So, these numbers pointed toward things going in the right direction, though the experiences obviously weren't seen.
It was around this time that other options were explored. Adrenal fatigue due to overuse of stimulants was one and pituitary or hypothalmus problems were also considered. An afternoon cortisol draw showed cortisol in range, though a bit low. An 8 AM cortisol draw showed it in range. However, a 24-hour cortisol test showed it significantly high out of range: 96.9 (ref: <60). The doctor argued, however, that the reason it was high was due to high total urine volume. ACTH was recently measured and that came back in range. Between those two things, the current doctor now thinks everything is fine, too, though it obviously isn't.
The most recent venture has been pursuing the possibility of sleep apnea. A consult with a specialist yesterday has led to a sleep study being scheduled for Thursday night. Sleep Apnea was one of the things that was considered initially, as it is often related to thyroid problems, however, it just seemed like it would be impossible for that to lead to so many problems. In 5 days, this should be answered.
Cliffs:
- January 11 was diagnosed hypothyroid
- 50mcg T4/day brought TSH down but did nothing
- 112 mcg T4/day did the same
- started dosing T3 only at 100mcg/day in July
- rT3 went low out of range, TSH and Free T3 all look stunning, but still no results
- 24-hour cortisol came back significantly high, but doc dismissed it due to high overall urine content
- 8 AM cortisol blood test showed normal; as did ACTH
- currently pursuing sleep apnea as a culprit; sleep study scheduled in a few days
Things worth noting:
- Hypothyroidism
- Temperature consistently around 96-97F (though it can get up to 98.6 on occasion, for short times)
- Long overuse of stimulants (over 1g caffeine/day at some points)
- Stimulant free since May 20, 2011
- 24-hour cortisol came back high out of range, though one-time draws haven't shown anything high
- Hair growth has slowed to nearly a halt over the last year (used to need haircuts every 2 weeks)
- Hair thinning a bit, shedding not terribly, but more than it ever did
- When on T4, my urine was dark yellow no matter how much water I drank (never was the case before; not the case now on T3)
- Energy levels are lower than what they were when I was in college/grad school, though it may be highly psychological now, too
- Neck is 17.5" and I do snore, so sleep apnea may be an issue and within a week, I can hopefully say one way or another
- Even if sleep apnea is happening, I still worry about hypopituitarism because of the initial hypothyroidism and low body temperature
So, if you've read through all of that, or even just the cliffs and you're in for a good mystery, feel free to join in. I'll upload all of my labs whenever I can, so those can be seen, as well.
The Big Back Story:
A long, long time ago, in a state in the middle of the US, a happy boy existed. From the time he was born, he was very active. Until about the age of 8 or so, he was incredibly skinny. About that time, though, he started getting a bit chubbier, though it was nothing to worry about. As he got older, he never seemed to get rid of that chubbiness, despite constantly playing sports and being active and rarely touching a video game or spending a moment inside. Once high school hit, the urge to lose the weight was even more important. He played baseball year round, weight-trained and even started running 7-9 miles nightly. He didn't know a lick about nutrition, but he did know that eating less was supposed to mean losing weight. So, he practically starved himself for a portion of time and only ate some fruit, vegetables and little more. He wasn't obese by any stretch, but he didn't have the body of someone who did what he did. He also had become a master at knowing how to hide what fat he had by sucking his gut in and dressing to keep people from knowing there was anything underneath (a quickly developing, muscular chest helped by allowing shirts to stick out at that point, instead of the stomach).
Once he got to college, he no longer had baseball to play. So, weight-training became a new passion. From that came some great physical changes, but no significant loss of fat. Around the age of 19, fat-burners became a topic of interest, since nothing else seemed to work and understanding the most basic concepts of food at a macro-nutrient level wasn't something he even knew to contemplate studying. He was still very active, ate pretty well, but couldn't get the results he wanted. Finally, in his senior year of college, he was convinced to start playing basketball (for the first time since early high school, really) because a close friend played a lot of pickup games at the rec. It started off as just an opportunity to run somewhere other than on a track or a treadmill, but slowly, it became a new passion. It was a great new outlet for aggression and competitiveness that weight-training didn't always provide. Eventually, it was common to play for 2-3 hours a night, 4-5 nights each week. He could literally run 10+ games in a row, with only a 2-3 minute break in between while the losing team would leave and to get a quick drink of water. Despite the amazing endurance, he still carried a lot of extra fat.
Nothing much changed through the transition to grad school. Basketball was still very regular. Weight-training was just as common. And he even started eating a bit healthier, to boot, since he lived on his own and not in the dorms, anymore. About midway through the second year of grad school, he started to focus more on bodybuilding and not just weight-training. At age 18, it started off with lifting about 3 times a week with a lot of compound movements and a variety of reps/sets over the years. At this point, it transitioned into more of a "body-part-per-day" style that relied on a lot of 3 and 4-by-twelves; along with some superset days, too, in hopes of burning off that fat. It was around this time that nutrition really started getting researched. This was partially due to involvement on online forums and not just relying on Men's Health, anymore. The transition to MD from MH played a role, too. At age 23, he started to get the brachial artery showing up on the bicep. When flexing his abs, they showed up, too. If he just relaxed, though, there was still some fat, though all things considered--not as much as what was to come.
It was finally at this time, at age 24, that he realized what a caloric maintenance level was and that one actually had to surpass that to gain muscle. For the nearly 10 years he'd been lifting, he was trying to lose fat. It never crossed his mind that he'd actually have to take in enough to build muscle. At this time, he realized he was pretty ignorant. Despite training and being active and working hard for 10 years, it was the next 2 in which he'd learn exponentially more. The concepts of counting calories, cycling calories and carbs, learning complex versus simple carbohydrates, learning what good fats were and many other things were new and implemented. The best he'd previously looked had been on Spring Break at age 23; right around 200-205 lbs. A few months later, he'd managed to drop back down to about that level from 225 or so with his first ever EC stack (still before all the food knowledge was learned). From that point, he gained to around 230 without really understanding how. He slowly started whittling it back down and hit 214 over a couple months. He then attempted his first ever keto diet and managed to lose 6.4 lbs in a month without having one single cheat from his diet. At 208, he looked the best he'd ever looked (though he seemed to be carrying a tad more fat compared to March '09; now in May '10).
He allowed himself a cheat meal at the completion of a month and then got back to it, but no matter what he did, he couldn't seem to lose a pound. It had always been hard, but this was literally impossible. After another couple weeks of no success and major headache, his friend asked him how long he'd been trying to cut. "Well, about 5 months, though admittedly my entire life." His friend suggested perhaps he try to bulk because his body was stressed from all that time trying to cut. It seemed to make enough since, so that led to the first ever attempt of a bulk. At the start of the bulk, he was 220 lbs. He implemented Max OT training and was eating between 3,000 and 3,500 calories per day. He gained exponential strength and also added 24 lbs in 7 weeks. Sitting at 244 lbs, he'd never weighed more. His waist had gone from 35" up to 36.25" and that didn't sit well with him, but he could still see his abs; though covered with more fat than he'd like. On the bright side, his bench had moved up to 365x5 and he was leg-pressing 1,200 pounds for reps. At that point, though, he knew it was time to try cutting again. What he found was a lot more of the same; losing a pound or two, but gaining it right back despite having a diet completely on point and no cheat meals.
By the time the new year hit, he tried an all out cut attempt with a keto diet and a ridiculous supplement regimen with fat-burning occurring from multiple pathways. There was a 6 week drop that first week (likely mostly glycogen), but after that, a consistent gain of 1 pound every other day or so. It was at that point that he finally decided that something had to be wrong. Previously, he thought that he was always doing something wrong--he could work harder, eat better...something! But now he finally knew, it was beyond his own doing.
Cliffs:
- I've always been active
- Weight training / running regularly since age 14
- Always carried extra weight since about age 8
- Been very hard to lose weight, but possible
- Finally got some abs and the brachials showing up at age 23
- Hit a sticking point where I literally couldn't lose weight
- Did my first ever bulk; added 24 lbs in 7 weeks
- Tried to cut again; same sticking point
- Realized that it might be a medical issue January '11
2011 - The Medical Quest
On January 21, 2011, I had a full hormonal blood panel done and was diagnosed with hypothyroidism. Leading up to the blood tests, I'd been researching this and was suspicious of it (because prior to this point, I had heard the term "metabolism" tossed around frequently and knew that everyone had their own; some good, some bad, but I never knew that it could actually be changed). It sucked to find out I'd be taking medication the rest of my life, but hey, it's just another pill, right? More than being upset about that, I was thrilled to finally have an answer. I thought, "I'll just start taking this pill, doing everything else I already do and pretty soon, hello body I've always dreamed of." It didn't go that way.
Despite adding in the 50mcg of T4 I'd been prescribed and running and lifting hard, the scale wasn't budging and the mirror wasn't changing, either. In 6 weeks, I had his blood draw and saw my TSH drop from 5.67 down to 3.94. I talked to the doctor about it, explained the problems I was still having and was told to just keep taking the same dose and to come back in 3 months for another blood draw. Needless to say, I found an endocrinologist at that point. I was thrilled when the endo said he'd bump the dose up to 112mcg/day from 50. It was the same story--come back in 6 weeks for blood work. In that time, my TSH dropped down to 2-something (need to get the copy of that lab work, actually). More of the same.
It was at this time that I found a companion who offered some help and advice and led me to start looking into Reverse T3. When reading about it, it seemed to be the perfect culprit. So, I had blood work done and sure enough, rT3 was 41, high out of range (ref: 11-32). My endocrinologist, however, told me this test was completely meaningless and advised me to continue taking the 112mcg of T4, daily, despite all research pointing out that in instances of rT3 dominance that T4 is simply converted into more rT3 and that T3 is needed to defeat this cycle. So, I decided to supplement T3 only at 100mcg/day at that point and cut out T4 (I haven't touched T4, since). Research suggested that it would take roughly 12 weeks for the rT3 to clear, but once it did, it would be back to normal. Blood work roughly one month after starting T3-only supplementation provided this: rT3 - 55 LOW (ref: 90-350) along with a TSH at 0.13 (now technically hyper-thyroid, though those symptoms obviously weren't experienced). So, these numbers pointed toward things going in the right direction, though the experiences obviously weren't seen.
It was around this time that other options were explored. Adrenal fatigue due to overuse of stimulants was one and pituitary or hypothalmus problems were also considered. An afternoon cortisol draw showed cortisol in range, though a bit low. An 8 AM cortisol draw showed it in range. However, a 24-hour cortisol test showed it significantly high out of range: 96.9 (ref: <60). The doctor argued, however, that the reason it was high was due to high total urine volume. ACTH was recently measured and that came back in range. Between those two things, the current doctor now thinks everything is fine, too, though it obviously isn't.
The most recent venture has been pursuing the possibility of sleep apnea. A consult with a specialist yesterday has led to a sleep study being scheduled for Thursday night. Sleep Apnea was one of the things that was considered initially, as it is often related to thyroid problems, however, it just seemed like it would be impossible for that to lead to so many problems. In 5 days, this should be answered.
Cliffs:
- January 11 was diagnosed hypothyroid
- 50mcg T4/day brought TSH down but did nothing
- 112 mcg T4/day did the same
- started dosing T3 only at 100mcg/day in July
- rT3 went low out of range, TSH and Free T3 all look stunning, but still no results
- 24-hour cortisol came back significantly high, but doc dismissed it due to high overall urine content
- 8 AM cortisol blood test showed normal; as did ACTH
- currently pursuing sleep apnea as a culprit; sleep study scheduled in a few days
Things worth noting:
- Hypothyroidism
- Temperature consistently around 96-97F (though it can get up to 98.6 on occasion, for short times)
- Long overuse of stimulants (over 1g caffeine/day at some points)
- Stimulant free since May 20, 2011
- 24-hour cortisol came back high out of range, though one-time draws haven't shown anything high
- Hair growth has slowed to nearly a halt over the last year (used to need haircuts every 2 weeks)
- Hair thinning a bit, shedding not terribly, but more than it ever did
- When on T4, my urine was dark yellow no matter how much water I drank (never was the case before; not the case now on T3)
- Energy levels are lower than what they were when I was in college/grad school, though it may be highly psychological now, too
- Neck is 17.5" and I do snore, so sleep apnea may be an issue and within a week, I can hopefully say one way or another
- Even if sleep apnea is happening, I still worry about hypopituitarism because of the initial hypothyroidism and low body temperature
So, if you've read through all of that, or even just the cliffs and you're in for a good mystery, feel free to join in. I'll upload all of my labs whenever I can, so those can be seen, as well.