Inactive thyroid effecting testosterone

[DirtyDusty]

Went to Dr. the other day to get my T. levels checked. When I told him my symptoms, that I was always tired loss of libido, and can't lose weight even with strict diet and workout routine. He done a some lab work, but told me he didn't fool with TRT. He wouldn't even check it, but they called from the Dr.'s office today and said I have hypothyroidism. I am only 36 do I asked how it could happen and they said it didn't matter, just start taking the prescription of synthroid and come back in 30 days to get my levels checked again.

Question is, should I go to another Dr. and get my T levels checked? Or should I wait until I get my thyroid levels back in check, then worry about T. levels?

[Rusty11]

Definitely take the synthroid and follow up. Symptoms of low t and hypothyroidism are very similar. See how you feel in 4-6 weeks and go from there.

[VenicePump]

Definitely take the synthroid and follow up. Symptoms of low t and hypothyroidism are very similar. See how you feel in 4-6 weeks and go from there.

Interesting I never knew that... so does testosterone improve your thyroid even in a normal person?

[DirtyDusty]

Can low testosterone cause hypothyroidism? Or vise versa?

[Rusty11]

Let's put it this way: If you have hypothyroidism, you are at a greater risk of having low T levels.

[powerlifterty16]

Let's put it this way: If you have hypothyroidism, you are at a greater risk of having low T levels.

but what about the inverse?

[ZenFitness]

but what about the inverse?

No, low T does not cause thyroid issues.

OP, did they give you the actual thyroid numbers? FWIW I'm 37 with low T - whether thyroid or low T, your age is not uncommon.

[DirtyDusty]

I finally got a copy if my test results. TSH was 5.439, thyroxine Free was 0.86. I also had a couple of other things out if wack. Potassium was high,5.2, Anion Gap was low, 7.0 with a ref. range of 8.0-16.0, and RDW was low 12.0 out if a 12.1-14.9 ref. range.

Anyone with any medical background have an idea what this points to? I don't see the doc. for another three weeks, but he didn't mention anything about the other conditions. I checked on seeing an endocrinologist, but I need a referral and 6 mon. wait.

[HRTstudent]

I finally got a copy if my test results. TSH was 5.439, thyroxine Free was 0.86. I also had a couple of other things out if wack. Potassium was high,5.2, Anion Gap was low, 7.0 with a ref. range of 8.0-16.0, and RDW was low 12.0 out if a 12.1-14.9 ref. range.

Anyone with any medical background have an idea what this points to? I don't see the doc. for another three weeks, but he didn't mention anything about the other conditions. I checked on seeing an endocrinologist, but I need a referral and 6 mon. wait.

first of all, I like the idea of going after thyroid BEFORE testosterone . oftentimes it is the thyroid responsible for the more "downstream" testosterone issues.

but beyond that, I would urge you to read the web site called ''stop the thyroid madness''. basically, it advocates using t3+t4 combination therapy as opposed to just t4, which is synthroid .

symptoms of low testosterone are very ambiguous. but still, it wouldn't hurt to get it checked and if your doctor is unwilling to even check something that has good reason to be checked, then I wouldn't hesitate to drop them. in fact, I wouldn't even consider going back.

I'd also be more interested in hearing about your diet, lifestyle, and symptoms than what your blood says.

[Schwarzenegger]

TSH ref value (0.4-5.0microU/mL) - Yours = 5.439
Thyroxine, free, serum ref value (0.8-1.8 ng/dL) - Yours = 0.86

Since your TSH levels are slightly above normal it indicates that your hypothalamus/pituitary axis is functioning normally to counteract the low thyroxine levels. The low circulating Thyroxine is feedback detected by the hypothalamus/pituitary and so the TSH is released to stimulate the thyroid to produce more thyroxine. Your body is trying to bring the thyroxine levels back to normal. IF lets say for example ur TSH levels were low as well, it would indicate a pituitary or hypothalamus problem, or both. - BUT obvs not the case here just an FYI

However, your thyroxine levels are still on the low end even with the overproduction of TSH. This indicates a problem with the thyroid gland itself. There are many causes for this that can only be determined with more testing, immunohistochemistry, biopsy in some cases, etc. I'd continue as the doc suggested with synthroid and see if it has any effect on when u go back. The results of your follow up will help hone in on what's really going on.

[DirtyDusty]

Late follow up, but I was giving it time to see if treatment was going to help. Had TSH levels checked again, and Dr. Finally agreed to check my T. Levels.

Tsh- 3.940. ref.range [0.350-4.940]
Thyroxine Free- 0.90. [.70-1.48]
T. Serum level 349. [240-871]

Dr. Said tsh levels where good enough and wouldn't up the dose of synthroid . Said T levels where good too. I have called around trying to find another Dr. Who had some experience in Low T. but have had no luck. They did send me for a sleep study and said I had mild sleep apnea, so now I am sleeping with a mask. Been on cpap for 3 weeks, but can't really tell a difference in tiredness, or libido.

[jasondd1]

Late follow up, but I was giving it time to see if treatment was going to help. Had TSH levels checked again, and Dr. Finally agreed to check my T. Levels.

Tsh- 3.940. ref.range [0.350-4.940]
Thyroxine Free- 0.90. [.70-1.48]
T. Serum level 349. [240-871]

Dr. Said tsh levels where good enough and wouldn't up the dose of synthroid. Said T levels where good too. I have called around trying to find another Dr. Who had some experience in Low T. but have had no luck. They did send me for a sleep study and said I had mild sleep apnea, so now I am sleeping with a mask. Been on cpap for 3 weeks, but can't really tell a difference in tiredness, or libido.

Your total test is on the low range. There are many on here who are on trt with higher numbers. Mine were right at your numbers and my doc said it was imperative that we get them up in a hurry.

[thisAngelBites]

Your TSH is still too high, although lots of docs just go by the reference range. I would argue it needs to be at 2.0 at the highest, and for lots of hypothyroid people, they would still feel awful at that level and would need to be closer to 1.25-1.5. That TSH is basically your pituitary yelling at your thyroid to make more hormone. Your T4 (thyroxine) is definitely too low as well.

You can go back to the Stop the Thyroid Madness website that HRTstudent recommended, look for the articles explaining why a TSH like yours is not low enough, and why your T4 should be be in the top 1/3-1/3 of the reference range and go back to the doc and explain that you're wondering why you feel so awful if your thyroid is sorted and your T is fine. And explain you found this info online (print out the articles and take them with you unless you feel you understand them and can advocate for yourself to the doc). Ask if he would be willing to trial a slightly higher dose of levothyroxine to get you more T4, and a lower TSH to see if it helps.

Agree to go over the signs of having too much T4 in your body, and agree that should you get any symptoms you will immediately lower the dose back to what it was before, and you will ring and make an appointment to come back in to discuss with the doctor.

The website also has a section for finding more progressive thyroid docs (I think - I know Mary Shomon's about.com thyroid website definitely has a doc finder), in case you want to explore that some more. I would not give up yet on your thyroid yet, because it is not where it needs to be, and for some people, they even feel worse getting only some of the thyroid they need, and don't really start to feel better until they get the dose high enough.

And as was previously said, low thyroid seems to influence T levels, so you may really still just need to your thyroid properly dosed!

Dr. Said tsh levels where good enough and wouldn't up the dose of synthroid.

[thisAngelBites]

Oops, I mistyped - you shoudl probably be aiming for your T4 to be in the upper third to upper half of the ref range.

[EverettCD]

DirtyDusty

I was diagnosed as Hypothyroid when I was in Junior High (11 or 12 years old, I don't remember). I have been on synthetic T4 ever since. My low testosterone signs/symptoms started around 30 years old. Both my PCP that originally started my TRT & the Urologist I currently see stated that my low testosterone is caused by my hypothyroid most likely. After a lot of reading on the interweb I am fairly certain that is the case. I would get your hypothyroid treatment dialed in before you commit yourself to TRT for the remainder of your life. Hopefully your current Dr will be more receptive to you & attempt to improve your hypothyroid treatment, if not do what you need to do & find a better Dr.

It can be very difficult to be patient while you're searching for a good Dr but it will pay off big time in the end.

The above mentioned website Stop the Thyroid Madness™ - Hypothyroidism and thyroid mistreatment is great. Print & take as much information from there as you need & take it to your Dr.

[Rusty11]

Give me a tsh of 2.0 and I'm a raging lunatic-irritated, dropped 30 lbs, on toprol because my heart was pumping through my chest, insomnia, panic attacks, etc... We're all different. I've had levels between 1.5 and nearly 20. After I had radiation iodine treatment 15 yrs ago, I've been on synthroid with a tsh of 3.0-3.5. Feel great in every way. I'm not a fan of the "stopthemadness" site. Synthroid is not the devil and is quite effective, FOR SOME, in regulating the thyroid. That site is a bit over the top for my taste.

But a combo of sleep apnea, higher tsh and lowish test level is certainly causing you issues.
You'll need to take one at a time. Also, I'm sure you've read all of the things that can interfere with your med. I started taking a multi vitamin that contained iron and my tsh went up to 8.0. I was shocked because I felt fine. Anyway, check out the site and discuss t4 med alternatives with your doc. Good luck.

[thisAngelBites]

Rusty, I agree there are a lot of people who are fine on synthroid (you and my husband both!). But there are lots of people who aren't (like me, who doesn't convert well from T4 to T3).

I think the problem is that doctors often undertreat thyroid. When they overtreat, the symptoms become clear quickly, and there is a change that is noticeable and the meds can be scaled back.

When they undertreat, the patient notices nothing, or even gets worse, and the doc decides the amount of thyroid replacement based on the test results. The STTM website advocates (and rightly, I argue) treating someone who is frankly hypo by increasing their dose until they get resolution of symptoms, and to keep until they go slightly hyper, and then to lower the dose a bit to what they call "the sweet spot".

I think this model in particular helps those who can be within range and still feel like death warmed over. The people who are treated with synthroid and then feel fine with a TSH of 3 don't really go searching online, because their doctor has pretty well solved the problem. But there is a large subset of people who are not okay at 3 (as you say, we are all different) and many docs refuse to do anything further, except anti-depressants, and in this case, a sleep study. I think that is why STTM is a little over the top. Those people suffered at the hands of their doctors, when a simple fix was available and safe.

I do disagree with those STTM people that everyone needs combo T4 and T3. But I think they are onto something that a lot of docs have not worked out, and which causes people needless poor health. There are at least tens of thousands of people on the thyroid boards I have been on, who are treating themselves, because their doctors rely strictly on TSH (which reference ranges are vastly different in different countries) and they are not getting the relief that they need from slightly higher doses of T4, with no hyper symptoms, and that just doesn't make any sense.

I probably should have not spoken with such certainty, because as you point out, I don't know what his particular healthy TSH value is. But the poor guy has basement levels of free T4 and the doctor said he won't give him anymore, and that is a crime, on my view. There is little to no risk to up the dose of T4 and bring his free T4 levels up and his TSH down, and to watch so that he does not go hyper, and to see if this gets him some relief from his symptoms, and that would answer the question. No downside, possibly huge upside.

Hypothyroidism can cause night breathing problems that look similar to sleep apnea (not to mention increased weight, which also contributes to sleep apnea), which resolve when the patient has enough thyroid hormone. So in this case, the sleep apnea might be secondary to hypothyroidism, and this needs to be investigated (it's a shame the treating doctor did not consider this). Dusty, it might be helpful to find a more knowledgeable physician in any case.

[Rusty11]

Hi Angel. What a nice, detailed post. I was going to say in my post that I don't disagree with you, but I forgot I really do agree with what you are saying. Way back when, I spent hours on a couple of thyroid message boards and I saw how many people were having a very difficult time getting their thyroid in check. So yes, I do realize that I am fortunate. But, it wasn't 'til I had the ablation that I became stable. Prior to that, it was three years of hell. I'm sure many find the answers they're looking for on the STM site. I don't like rap, either. So, my opinion is just that...MY opinion.

[thisAngelBites]

Hi Rusty, you are up early!

About your post, I took you to be pointing out that we are all different, which I agree with, and I thought perhaps given this it was not wise to make categorical pronouncements about people's TSH. There was more to my thinking but my first post was not detailed enough as I was in a hurry. I just really wanted to emphasise it is far from clear that they thyroid is fine, so it might be better to prod the doc, or to find a better one.

The STTM people are militant for sure, and their thinking doesn't apply to everyone. But I have a feeling it MIGHT apply to this guy - I hope he explores it further instead of just trying to get TRT. It would be nice to have a free T3 test as well, Dusty. I forgot to mention that earlier.

[raj1]

Would not be surprised if the OP was deficient in Iodine. Typical doctors...prescribing drugs instead of trying to get to the bottom of the problem.