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what ive written below was back a couple months ago since then ive got back to about 170lbs and my sex drive is almost back to normal but my testosterone is stil low and my thyroid also. body temp went up alittle now fluctuates between 96.0 thru 97.2 i also didnt mention that i was diagnosed with lymes disease around 5 years ago and my latests labs came back negitive.. im also working with hardasnails an with his help so far my libido increased and my sleep is some what better.
this is a great forum and i would like dr.m opinion on my case if he does not mind .
I am 26 years old and recently found out that I have low testosterone and low T3 total. About a year ago I started a very low calorie and fat diet, only taking in about 1600 calories and under 20 grams of fat a day. I went from 180 lbs to 145 lbs in six months. I was lifting weights and doing cardio 5 to 6 times a week as well as playing hockey 1 to 2 times per week. I have been battling fatigue for 7 years ever since I began taking Paxil for a panic disorder. I ballooned up to 240 lbs after being on Paxil for 6 months and after a 1 1/2- 2 years I got off of it. I went back down to 175 lbs and stayed there until I started my extreme dieting. Two to three months into my extreme dieting I began to experience cold intolerance, low libido, bouts with fatigue, and depression which was also worsened by job related stress.I also started checking my morning body temp.On average it was 95.5 sometimes going as low as 93.9.i started eating around 2500 cals around 60-70g of fat a day and my temp is up to 96.5-96.9 give or take. I finally got my doc to look more into my thyroid and test level and here is my latest blood results.saw an endo doc,got an mri of the brain and pituatary every thing is perfect .the doc dismissed my thyioroid and trew testosteron gel at me. i really would like to avoid trt if i could
tsh 2.13
>0.40-4.50miu/l
t4total 7.7
>6.5-12.5ug/dl
t4 free calculated 2.7
>0.4-3.8ng/dl
t4 free direct dailysis1.5
>0.8-2.7t3 free tracer dialysis
free t3 dialysis 261
>210-448pg/il
t3 total 100
>97-219ng/dlt3uptake 35
>33-35%
t3,total 66
>97-219 ng/dl
thyroid peroxidase ab <10
>35 iu/ml
thyroglobulin ab<20
>20iu mltestosterone220
>241-827 ng/dl
testosterone free 31.4
>46.0-2241.0pg/ml
bioavailable testosterone 67.2
>110.0-575.0ng/dl
dihydrotestosterone 24
>25-75 ng/dl
shbg 27
>7-49nmol
albumin serum 47
> 3.6-5.1 g/
growth hormone– 0.6
>….<10.0 ng/ml
Lh 1.4
>1.5-9.3
fsh 3.5
>1.6-8.0miu/ml
prolactin 6
>2.0-18ng/ml
cortisol total serum 14.1
>am 4.0-22.0—-pm 3.0-17.0
psa total .35
<=4.0 ng/ml
igf-1 254
>126-382 ng/mlafter these came back he sent me to an endo doc and he is sending me for a pituitary mri and a whole **** load of more blood work but the first thing out of his mouth was putting me on androgel before making any descisions i will post the rest of my blood work here when i get it back but that wont be for a couple weeks just wanted to see if you guys had any thoughts on what this could be is is some more blood work from that day.
non fasting glucose 66
>65-139mg/dl
sodium139
>135-146mmol/l
potassium4.2
>3.5-5.3mmol/l
chloride101
>98-110mmol/l
carbon dioxide27
>21-33mmol/lUREA NITROGEN 32
>7-25mg/dlcreatinine 0.91
>0.50-1.30mg/dlBUN/CREATININE RATIO 35—->6-22
calcium 9.7
>8.6-10.2
protein total 7.9
>6.2-8.3g/dlALBUMIN 5.4
>3.6-5.1g/dlglobulin,calclated 2.5
>2.1-3.7g/dlA/G RATIO 2.2
>1.0-2.1bilirubin,total 0.7
>0.2-1.2mg/dl
alkaline phosphatase 53
>40-115 u/l
ast 33
>10-40 u/l
alt 32
>9-60u/l
egfr non african>60
>=60 ml/min/1.73
uric acid 5.1
>4.0-8.0mg/dl
folate serum 18.7
>5.4ng/ml
iron,total 88
>45-175 mcg/dl
tibc 433
>250-425mcg/dl
transferrin saturation 26
>20-50%
ferritin 169
>20-345ng/mmy cbc is also fine except for slightly low
rbc 4.06
>4.20-5.80
hemoglobin 12.7
>13.2-17.1
hematocrit 35.6
>38.5-50%
also i have never used anabolics or any other suppliments and i truly belive ive had som borderline thyroid issues for some time but the docs only ever tested my tsh..like i said before the stress and the extream diet i never had libido issue so im not really sure why all this started any insight would be greatly appreciatedSTARVATION diets often leads to compensatory survival response of lowering of thyroid hormone signaling to reduce metabolism and prevent excessive loss of muscle and fat. Lowered thyroid signaling may then cause symptoms and signs including anxiety, depressed mood, cold intolerance, insomnia, low body temperature, etc., etc. Starvation or dieting may also mean the occurrence of nutrient deficiencies which complicates a condition.
PANIC DISORDER may have multiple pathophysiologies. The primary ones are an excessive increase in norepinephrine signaling – the primary distress signal, hypothalamic-pituitary-adrenal axis dysregulation (resulting in a loss of cortisol, progesterone, DHEA, testosterone, estradiol, etc. – which may help reduce stress/norepinephrine signaling). Hypogonadism may contribute since testosterone is a very calming signal. Norepinephrine signaling may be increased as a compensatory response to impaired energy production through mechanisms including suboptimal thyroid signaling, suboptimal cortisol signaling, suboptimal ferritin (which results in impaired citric acid cycle related metabolism, etc.), insulin resistance (with impaired entry of glucose into cells), etc., etc.
PAXIL rarely increases weight rapidly – particularly a 50+ pound weight gain. Generally, the serotonin-reuptake inhibitors may cause an insidious weight loss that may take over 2 years before it becomes excessive. Weight gain over 50+ pounds also means one has to continuously buy new clothes as one outgrows one’s existing clothes. To gain one pound of weight rapidly also requires a very noticeable increase in eating. For example, one pound of weight is equivalent to about 7 McDonald’s Big Mac hamburgers. 50 pounds in 6 months means eating the equivalent of 350 extra Big Mac hamburgers in 6 months. This is eating an extra 2 hamburgers a day. Thus, I would suspect such a person may have significant psychological issues that would allow dyscontrol over eating. Rapid weight gain may, however, indicate an underlying signaling or metabolic issue such as hypothyroidism or insulin resistance which may predispose a person to weight gain, which would then be compounded by treatment with Paxil.
HYPOGONADISM may be primary or may occur secondary to other signaling problems (such as hypothyroidism, suboptimal LH production) or metabolic/nutritional issues (e.g. suboptimal vitamin A, iron, etc. etc.)
HYPOTHYROIDISM from a behavioral perspective may be present when Total T4 < 8.0, Free T3 < 330.
GROWTH HORMONE is very difficult to monitor accurately with a single point blood draw, given its very short half-life. It is better to do a 24-hour urine measurement. Be that as it may, measuring IGF-1 allows a good estimation. An IGF-1 level > 250 indicates good growth hormone signaling.
HYPOGLYCEMIA from a behavioral perspective (my perspective), is a blood sugar under 93, assuming no significant insulin resistance (which would then raise the upper limit for what is considered low blood sugar). Hypoglycemia indicates impaired gluconeogenesis. The major signal for this is cortisol.
ALBUMIN which is above the reference range usually indicates dehydration.
HYPOTHALAMIC-PITUITARY-ADRENAL AXIS DYSREGULATION with low cortisol production and possibly low adrenal cortex signals such as DHEA, Pregnenolone, testosterone, estradiol, progesterone, etc., if monitored with a blood test, should include more than just only cortisol. I prefer at least initially monitoring cortisol, pregnenolone, progesterone, DHEA-s, (and in women, total testosterone and estradiol) with a comprenhensive metabolic panel. The time labs were taken is highly important as well as food status. Usually it is done in the morning, fasting.
@DrMariano 778 wrote:
STARVATION diets often leads to compensatory survival response of lowering of thyroid hormone signaling to reduce metabolism and prevent excessive loss of muscle and fat. Lowered thyroid signaling may then cause symptoms and signs including anxiety, depressed mood, cold intolerance, insomnia, low body temperature, etc., etc. Starvation or dieting may also mean the occurrence of nutrient deficiencies which complicates a condition.
PANIC DISORDER may have multiple pathophysiologies. The primary ones are an excessive increase in norepinephrine signaling – the primary distress signal, hypothalamic-pituitary-adrenal axis dysregulation (resulting in a loss of cortisol, progesterone, DHEA, testosterone, estradiol, etc. – which may help reduce stress/norepinephrine signaling). Hypogonadism may contribute since testosterone is a very calming signal. Norepinephrine signaling may be increased as a compensatory response to impaired energy production through mechanisms including suboptimal thyroid signaling, suboptimal cortisol signaling, suboptimal ferritin (which results in impaired citric acid cycle related metabolism, etc.), insulin resistance (with impaired entry of glucose into cells), etc., etc.
PAXIL rarely increases weight rapidly – particularly a 50+ pound weight gain. Generally, the serotonin-reuptake inhibitors may cause an insidious weight loss that may take over 2 years before it becomes excessive. Weight gain over 50+ pounds also means one has to continuously buy new clothes as one outgrows one’s existing clothes. To gain one pound of weight rapidly also requires a very noticeable increase in eating. For example, one pound of weight is equivalent to about 7 McDonald’s Big Mac hamburgers. 50 pounds in 6 months means eating the equivalent of 350 extra Big Mac hamburgers in 6 months. This is eating an extra 2 hamburgers a day. Thus, I would suspect such a person may have significant psychological issues that would allow dyscontrol over eating. Rapid weight gain may, however, indicate an underlying signaling or metabolic issue such as hypothyroidism or insulin resistance which may predispose a person to weight gain, which would then be compounded by treatment with Paxil.
HYPOGONADISM may be primary or may occur secondary to other signaling problems (such as hypothyroidism, suboptimal LH production) or metabolic/nutritional issues (e.g. suboptimal vitamin A, iron, etc. etc.)
HYPOTHYROIDISM from a behavioral perspective may be present when Total T4 < 8.0, Free T3 < 330. GROWTH HORMONE is very difficult to monitor accurately with a single point blood draw, given its very short half-life. It is better to do a 24-hour urine measurement. Be that as it may, measuring IGF-1 allows a good estimation. An IGF-1 level > 250 indicates good growth hormone signaling.
HYPOGLYCEMIA from a behavioral perspective (my perspective), is a blood sugar under 93, assuming no significant insulin resistance (which would then raise the upper limit for what is considered low blood sugar). Hypoglycemia indicates impaired gluconeogenesis. The major signal for this is cortisol.
ALBUMIN which is above the reference range usually indicates dehydration.
HYPOTHALAMIC-PITUITARY-ADRENAL AXIS DYSREGULATION with low cortisol production and possibly low adrenal cortex signals such as DHEA, Pregnenolone, testosterone, estradiol, progesterone, etc., if monitored with a blood test, should include more than just only cortisol. I prefer at least initially monitoring cortisol, pregnenolone, progesterone, DHEA-s, (and in women, total testosterone and estradiol) with a comprenhensive metabolic panel. The time labs were taken is highly important as well as food status. Usually it is done in the morning, fasting.
thank you so much dr m..ive since been eating alot more my lastest test i got from zrt labs had dhea s and estradiol and they both came back good but my test and t3 were still low..my old labs were taking in the morning and i was fasting.
my blood sugar seems ok in the morning it is 85-90…1hr after eating its stays the same and 2hrs after its 80- 85 ish.
also i very very rarly get panic attacks only get them now if i drink to much lol.and my mod is pretty good only time im depressed is when i feel run down other then that im a pretty happy personoverall i feel ok i can still excercise still play hockey competitvely twice a week ..lift 2 to 3 times a week and ride my bike 15miles 4-5 times a week if its nice out.but when im not active and im home or at work i feel so run down at times and i dont get the gains i feel i should from working out and excercising..
@charliebizz 1028 wrote:
would i benefit from somthing like tribulus..has anybody have any success with products like that.
Tribulus Terrestris is suppose to increase LH, resulting in an increase in Testosterone. However, studies are not so convincing.
In my experience, I haven’t found it useful. But then people’s responses to it may vary. As the saying goes, “Your mileage may vary.”
Here is a review:
http://altmedicine.about.com/od/herbsupplementguide/a/tribulus.htm
@DrMariano 1041 wrote:
Tribulus Terrestris is suppose to increase LH, resulting in an increase in Testosterone. However, studies are not so convincing.
In my experience, I haven’t found it useful. But then people’s responses to it may vary. As the saying goes, “Your mileage may vary.”
Here is a review:
http://altmedicine.about.com/od/herbsupplementguide/a/tribulus.htm
ok well thats out the window lol thanks dr.m.im trying to get ride of these problems as natural as possible but i elive my throid is really holding me back but at the same time i feel ive had a thyroid problem for atleast 7 years but my test symptoms only started about a year ago after my crash diet and losing my job and benefits. i really need to get my throid going and im hoping my test will come up on its own but im not to sure how to do it
@charliebizz 1055 wrote:
ok well thats out the window lol thanks dr.m.im trying to get ride of these problems as natural as possible but i elive my throid is really holding me back but at the same time i feel ive had a thyroid problem for atleast 7 years but my test symptoms only started about a year ago after my crash diet and losing my job and benefits. i really need to get my throid going and im hoping my test will come up on its own but im not to sure how to do it
It is important to find a health practitioner for guidance.
When conventional physicians can’t help, then alternative health physicians, including naturopathic doctors may be helpful.
Generally, I do not often prescribe herbal products, and even then, only a select few, since the mechanisms of action are often unclear. I prefer knowing what is happening
@DrMariano 1059 wrote:
It is important to find a health practitioner for guidance.
When conventional physicians can’t help, then alternative health physicians, including naturopathic doctors may be helpful.
Generally, I do not often prescribe herbal products, and even then, only a select few, since the mechanisms of action are often unclear. I prefer knowing what is happening
thats the other thing when i do get my benifits back finding a good doc on long island to help me out…do you think based on my numbers would it be possible to get my testosterone back to normal with out hrt.last test i took a month ago my test went up to 300 so it might be going back up slowly but im not sure.the both tests were taking at around 7am.im not sure what it used to be but i think i was normal until the crash diet i hit puberty at the same time as every one else i get plenty of facial hair and body hair deep voice the whole 9.and i also never had cold intolerance acne problems and all that good stuff till the diet and excersice addiction lol.my libido is getting better some spontanous erections and morning wood but still not 100% and my pimples seem to be clearing up so maybe i am slowly getting better but my body temp still low
@charliebizz 1060 wrote:
do you think based on my numbers would it be possible to get my testosterone back to normal with out hrt.
Testosterone replacement can generally achieve restoration to adequate testosterone levels. It depends on the technique used. Transdermal testosterone, for example, is not well absorbed by some people, particularly those who are hypothyroid. Injected testosterone can definitely increase testosterone levels.
@DrMariano 1064 wrote:
Testosterone replacement can generally achieve restoration to adequate testosterone levels. It depends on the technique used. Transdermal testosterone, for example, is not well absorbed by some people, particularly those who are hypothyroid. Injected testosterone can definitely increase testosterone levels.
i was wondering if i can get the levels up without hrt
Since your thyroid is the main cause and with out proper thyroid function zinc absorption will be altered. With out proper zinc metabolism due to low thyroid function may result in low testosterone as well as elevated rt3 levels. One may work on increasing the D1 enzyme by supporting the pathway with proper nutrients. One product that I found that helped me in the past was biotics research medi-stim as it contains all the cofactor for proper t4 to t3 conversion. If you can find a good practioner when you get your insurance to focus on your thyroid issue may resolve your testosterone. I have personally revived alot of young guys testosterone levels by adjusting lifestyle, stress management, educating about nutrient diet, supplements to support other hormones system. No matter how good natural approach may be some times their just needs to have medical intervention when all other areas are exhausted. It was not until I got my thyroid adjusted that I finally was able to metabolize zinc and to get benefits from it. I was taking 100 mgs a day and still testing low serum levels. I was like WTH ? That is why I started researching zinc metabolism and how to optimize it. The results concluded proper fat ratio and also functioning thyroid were the key.
With out medical insurance and not knowing when one is going to get it. Taking matters into ones own hand is not recommended but with my self desperate time desperate measures. From clomid challege it will indentify if you are primary vs secondary and from their you can determine on what next steps need to be taken. We already know you total ft3 is low, but we do not know if your conversion of t4 to t3 is altered of that your total thyroid is low. With out proper evaluation its just a shot in the dark. I did identidied you as hypothyroid through muscle testing and also now the lab confirms it, We also speculated that your adrenals where out of balance and they where because your DHEA was low in the salvia. Right now we are at a cross roads with out any further data clincally its just a crap shot now.
Doing the clomid challenge might shed some light on current reason why T is low.@hardasnails1973 1523 wrote:
With out medical insurance and not knowing when one is going to get it. Taking matters into ones own hand is not recommended but with my self desperate time desperate measures. From clomid challege it will indentify if you are primary vs secondary and from their you can determine on what next steps need to be taken. We already know you total ft3 is low, but we do not know if your conversion of t4 to t3 is altered of that your total thyroid is low. With out proper evaluation its just a shot in the dark. I did identidied you as hypothyroid through muscle testing and also now the lab confirms it, We also speculated that your adrenals where out of balance and they where because your DHEA was low in the salvia. Right now we are at a cross roads with out any further data clincally its just a crap shot now.
Doing the clomid challenge might shed some light on current reason why T is low.i never did a saliva test…. and how am i gonna get labs after i do the clomid to see what happen
@charliebizz 1531 wrote:
i never did a saliva test…. and how am i gonna get labs after i do the clomid to see what happen
Zrt I believe I can drop ship the blood spot test to you so it can by pass NY laws.
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