New Guy Here. TSH 3.9. Very fatigued, stomach/digestion issues, brain fog, little motivation, etc.

Hello everyone,

My name is Cody and I am a 31 year old male. I've been struggling with stomach issues and fatigue for years, with little help from the many doctors I have seen. Thankfully I have found this forum, which seems like the place I should be.

Long story short, I have had stomach issues for years. Feeling bloated, gassy, eating half a meal and feeling full, feeling like I need to go to the bathroom multiple times per day, but about half of those times I just end up sitting on the toilet for 20 minutes and nothing comes out. Or some comes out but I feel like I haven't totally "emptied" myself. Endoscopy and colonoscopy came back clean. Stomach would feel full even hours after eating, a bloated/full feeling.

A year or two after the stomach issues started bothering me, I got chronic fatigue symptoms. It would take me sometimes 2-3 hours to get out of bed, which is not normal for me. I was an early riser my entire life. The type who as soon as my eyes opened I HAD to jump out of bed. I would go to my laptop (I work online) and work with complete mental focus and drive for 2-4 hours no problem.

So, I would be very groggy in the mornings, no motivation to get out of bed and work, when I did wake up I would have no mental focus, no drive, lots of brain fog, and basically just zone out. I would wake up, take an hour or two to even get moving and then I would just sit around feeling exhausted and often times lay down and take a nap. After breakfast I would feel very fatigued and often take a nap as well.

My sex drive is also much lower, when it used to be high, as in 2-4 times per night 3-5 nights per week. Now it's less than half of that. I also feel my semen volume is much lower.

The past 6-12 months I have also had a dropping left eye when I am sleepy. It open about 25% less than my right eye. I also have very bad dry/red eyes when I wake up. To the point that I Have to rub my eyes with my fingers before they will physically open.

I never get a post workout high anymore. Before after a heavy squat or press session I would leave the gym feeling completely pumped up. Like I wanted to run after every girl I saw, and I just felt amazing. I never get that feeling for the past year or so. Even after a great gym session I feel nothing. No euphoria, no excitement. I also put on fat much easier than in the past. I was skinny most of my life. Now fat is very easy for me to put on.

I've also had chronic post nasal drip for years and years, though I Have no idea if it is related or relevant at all. Just thought I'd add that.

The past 2 months I have gone Paleo and feel much better, though still not 100%. My issues also seem to be slowly creeping back up on me, so I fear I will end up in the same position I was a few months ago. I have also mostly (still working on it) regularized my sleep schedule.

I know that's a lot to read, I just wanted to lay everything out there and HOPE that someone here can help me and point me in the right direction.

To make things a little easier to digest;

Total Testosterone: 592
Free T: 137
TSH: 3.9

Many of the symptoms below have gotten much better since going Paleo, but are not gone. I feel I still have a long ways to go before being back to 100%.

Stomach Issues:
- Feeling bloated and gassy
- Going to the bathroom multiple times per day
- Often times not feeling like I have totally "Emptied" myself after going to the bathroom
- No hard stools in years
- Feeling full and bloated after eating half a meal

Fatigue Issues
- Very groggy and slow to wake up in mornings (used to be very energetic and early riser)
- No drive or ambition
- Brain fog and loss of mental focus
- Feeling tired and fatigued right after waking up
- Taking naps very soon after waking up
- Being very fatigued and napping right after breakfast

Other symptoms
- Left eye drooping. Opened about 25% less than right eye (90% gone away since going Paleo)
- Very bad red and dry eyes after waking up and at night. Can't open eyes without rubbing them (80% gone since going Paleo)
- Chronic post nasal drip for many years.

I know I need more blood work done, but my main problem is 1. Not having a doctor who can treat me. And 2. Only having Medi-Cal/Medicaid for insurance.

If I need to provide more info please don't hesitate to ask. I'm willing to share anything and REALLY appreciate any help you guys can give.

Thanks.

- Cody

EDIT: Most of my fatigue symptoms started to appear about 4 years ago, shortly after moving to Thailand. Thought I should include that as well.

Welcome to Excelmale. Let me ask a very blunt question: despite having California Medicaid, are you able and willing to pay for the diagnostic tests that may be necessary to determine what is causing your poor health? Who ordered the three labs you posted? What was said in regard to your GI issues Finally, do you have other blood work? Your TSH is a blinking red light calling for additional thyroid labs.

Hi CoastWatcher,

I am definitely willing and *probably* able, though obviously I would want to keep costs down as much as possible. If we are talking less than $500 or so it is no problem. If we are talking $1,000 or more, it could take me a little time.

I Know DefyMedical has very reasonable prices, I just wasn't sure if he handled this type of issue? I've been wary to pay anything out of pocket because I've had very little success with doctors in the past, and I have very little trust in them. Though, none of them were of the caliber of Dr. Crisler, or even close to it.

My current doctor, a nurse practitioner, ordered the tests at my request. She's very helpful when she can be, she just isn't very knowledgeable about male hormones. Though, in her defense, she did say my TSH was a bit on the high side and she prescribed me a medication ( I believe it was levothyroxine, though I don't remember for sure) but I opted against it because I wanted to consult with a specialist before I started taking medications for my thyroid. I just wasn't sure if I could trust her judgement or not because I've read so many horror stores about doctors in this area.

My stomach issues were never resolved. My GI doctor told me if I became a vegan all of my stomach issues would be solved. That was what he told me on our very first visit before any tests or anything. He was a vegan himself. He also prescribed me what he said was a strong antibiotic to wipe out the bacteria in my gut, then gave me 1 week of Align probiotics to replenish it with good bacteria. From what I've read since then, I feel that may not have been a good idea.
Though, like I mentioned, going Paleo has mostly cleared them up. However, the past couple of weeks they have been resurfacing a bit. Possibly due to breaking the diet and drinking a few times around the holidays?

Thanks CoastWatcher, I really appreciate your help!

Other Bloodwork:

Albumin 4.4
Alk Pos 61
Alt 25
Anion Gap 6
AST 20
Bilirubin Total 0.6
BUN 13
Calcium 13
Carbon Dioxide 28
Chlroide 104
Creatinine 1.13
eGFR 81
Glucose 91
Potassium 3.9
Sodium 138
Total Protein 7.2

CBC WITH DIFF
Basophils .5
Eosinophils 1.3
HEmatocrit 45.8
Hemoglobin 15
Lymphocytes 48.7
MCH 29.5
MCHC 32.8
MCV 90.1
Monocytes 6.1
Neutrohils 43.4
Platelet Count 121
RBC 5.08
RDW 13.3
WBC 6.2


That is all of the blood work that I have, I am unsure if the doctor has more that she did not print out for me.

Can you provide ranges for your testosterone, free testosterone, and TSH? Every lab calibrates differently.

CodyS said:

Hi CoastWatcher,

I am definitely willing and *probably* able, though obviously I would want to keep costs down as much as possible. If we are talking less than $500 or so it is no problem. If we are talking $1,000 or more, it could take me a little time.

I Know DefyMedical has very reasonable prices, I just wasn't sure if he handled this type of issue? I've been wary to pay anything out of pocket because I've had very little success with doctors in the past, and I have very little trust in them. Though, none of them were of the caliber of Dr. Crisler, or even close to it.

My current doctor, a nurse practitioner, ordered the tests at my request. She's very helpful when she can be, she just isn't very knowledgeable about male hormones. Though, in her defense, she did say my TSH was a bit on the high side and she prescribed me a medication ( I believe it was levothyroxine, though I don't remember for sure) but I opted against it because I wanted to consult with a specialist before I started taking medications for my thyroid. I just wasn't sure if I could trust her judgement or not because I've read so many horror stores about doctors in this area.

My stomach issues were never resolved. My GI doctor told me if I became a vegan all of my stomach issues would be solved. That was what he told me on our very first visit before any tests or anything. He was a vegan himself. He also prescribed me what he said was a strong antibiotic to wipe out the bacteria in my gut, then gave me 1 week of Align probiotics to replenish it with good bacteria. From what I've read since then, I feel that may not have been a good idea.
Though, like I mentioned, going Paleo has mostly cleared them up. However, the past couple of weeks they have been resurfacing a bit. Possibly due to breaking the diet and drinking a few times around the holidays?

Thanks CoastWatcher, I really appreciate your help!

Click to expand...

First of all, you do need a doctor who understands hormones and how they fit into your general health. I would, by all means, call Defy and determine what a consultation is going to cost. You have many of the labs they need to begin treatmwnt, the others can be obtained quickly and at reasonable cost. They will not mislead or upsell you. What medications/supplements are taking? Your gastroenterologist simply whacked you with a potent antibiotic, fed you probiotics and said, boom, be a vegan and you'll be cured?

"Most of my fatigue symptoms started to appear about 4 years ago, shortly after moving to Thailand."
Hmmm Anyone look into things you MIGHT have picked up there? Parasites? Other things common to that part of the world and not over here?
Ever get a complete thyroid panel ran? FT3, FT4, RT3 etc.?
https://www.excelmale.com/forum/showthread.php?5700-Thyroid-BW-Question
Additional thyroid info here also:
http://hypothyroidmom.com/
Reasonable basic thyroid panel for FT3 and FT4 here if you have to self pay:
http://www.discountedlabs.com/thyroid-panel-tsh-free-t3-free-t4/
If you do run thyroid labs and you are not near optimal levels and are told that you are "within range" and all is good ..... Run from that DR and find one that understands being in range is NOT the same as being optimal and feeling your best.....

Reference range was
TSH .5-5.0
Total T 300-1080
Free T I do not know because they gave me the number over the phone. They said my Free T was good at 137, but I do not know the reference range.

No other medications or supplements except for Vitamin D. 5000 4-6 days per week. I started taking this about 2 months ago.

GI doctor was useless. Told me I should become vegan. Then he did a colonoscopy and endoscopy on me (I was around 25 years old) and said everything came back good. Then he gave me a antibiotic and 1 week supply of Align probiotic samples he had in his office. I went back to him one last time I believe and then I stopped seeing him because I did not think he was helping, nor capable, of helping me.

Orrin Israel,

I had a stool sample tested in Bangkok, I believe for H. Pylori, that came back negative. I can not say exactly what they tested for as I do not have the paperwork any longer. I just know they said everything looked fine. I did have stomach issues before going to Thailand, but chronic fatigue symptoms started to appear while in Thailand. It was around the time I had a bad bout of diarrhea and took antibotics, though I do not remember if my fatigue started before or after that. It could be totally unrelated.

Thanks for all of the help guys, it's appreciated.

One symptom I forgot to mention until just now, as I was looking at some Thyroid slides Nelson linked me to, is I intermittently have trouble swallowing food without it getting stuck in my throat. My throat often times feels constricted or swollen, so when I swallow food it will get stuck and I have to wash it down with water. Sometimes to the point where I feel like I am choking.

Depression and irritability are also symptoms, with the depression having gotten much, much worse for the last 6 months of last year. I have recently mostly come out of it. It was my first bout of what I feel is *real* depression, something I had never experienced before.

Hi Cody, I'm with Orrin in that a first step is to rule out exotic disease and parasites with an infectious disease doc.

Probiotics: One week of Align is useless. The G.I. might have pumped you with antibiotics because he was aware of the issues regarding unclean scopes which have finally caught the attention of the FDA.

Choose naturally fermented food products with multiple live cultures and consume them daily. Green Valley Organic plain Kefir is lactose free and should go down easily. Bio-K while not a food is a potent fresh liquid probiotic available as both dairy and non-dairy. Work up to raw unpasteurized sauerkraut. Certain misos and fresh sugar free kambucha might help. Fresh ginger tea is helpful for GI

Gas and bloating can result from mixing incompatible food groups in the same meal.

Your insurance is a tremendous asset. I would seek out an understanding open-minded primary care physician who is willing to order serum levels on vitamins, minerals, and test for food allergies. He doesn't have to be an expert just willing to explore possibilities which you bring to his attention.

Diet and environmental are two things you can work on right away. Even if they are not the cause you might at least stabilize and or strengthen.

This site is a tremendous resource for nutrition and supplementation. You do NOT need an armful of capsules or powders. Post whatever you are now taking.

L-Glutamine powder is one I would start on right away. Even though the following list is for those living with HIV you may find many suggestions pertinent for GI
http://www.medibolics.com/Vitamins2.htm

Paleo may be inappropriate for you. We are unique biochemical machines. What is ideal for one may not be good for another.

You look athletic. Your protein requirements will be higher than for those who are sedentary. Try each of theses proteins individually for a week or so to see which agrees with you the most:

organic cottage cheese, organic whole eggs or egg whites, wild fish ( canned pink Alaskan salmon, quality sardines in evo, skipjack are all low cost). Costco has the best prices on these including organic chicken.

Almost everyone seems to benefit from daily steamed broccoli or broccolini. Again Costco is a great source.
Other items I buy from Costco at significant savings are lemons, walnuts, chia, quinoa, frozen org.tart cherries, bagged salads and select vitamins.

On the environmental side check to see if you are exposing yourself to mold, seen or unseen, solvents, fumes or other nasties.

FWIW I had a rather large thyroid nodule (4cm) on my right side that did not push out, but rather pushed in. The tech that did my 1st ultrasound even asked if I had problems swallowing..... As my nodule did not push out it was not apparent that I had issues like a person with a large goiter. Based on the size, I had it for awhile and I had a good DR at that time that missed it. Not saying you have one but you need to see someone that has a good understanding of thyroid issues (after getting the RIGHT labs done).

One book many people recommend for educating yourself about thyroid disease is Stop the Thyroid Madness.
https://www.excelmale.com/forum/showthread.php?932-Stop-the-Thyroid-Madness

CodyS said:

Reference range was
TSH .5-5.0
Total T 300-1080
Free T I do not know because they gave me the number over the phone. They said my Free T was good at 137, but I do not know the reference range.

No other medications or supplements except for Vitamin D. 5000 4-6 days per week. I started taking this about 2 months ago.

GI doctor was useless. Told me I should become vegan. Then he did a colonoscopy and endoscopy on me (I was around 25 years old) and said everything came back good. Then he gave me a antibiotic and 1 week supply of Align probiotic samples he had in his office. I went back to him one last time I believe and then I stopped seeing him because I did not think he was helping, nor capable, of helping me.

Orrin Israel,

I had a stool sample tested in Bangkok, I believe for H. Pylori, that came back negative. I can not say exactly what they tested for as I do not have the paperwork any longer. I just know they said everything looked fine. I did have stomach issues before going to Thailand, but chronic fatigue symptoms started to appear while in Thailand. It was around the time I had a bad bout of diarrhea and took antibotics, though I do not remember if my fatigue started before or after that. It could be totally unrelated.

Thanks for all of the help guys, it's appreciated.

Click to expand...

Maybe it is glandular fever (Epstein Barr). Did you get a sudden onset of fever, sweating and fatigue before this started? It can reappear over the years with chronic fatigue.

I know how you feel. I have IBS and also suffer from fatigue. I have not found cures but gladly I have found ways to manage these problems.

I would run these tests as mentioned before:

- Free T3, free T4, and thyroid antibodies to ensure your thyroid is not the problem

- An urea breath test for H Pylori (I have had ALL symptoms you mentioned when I was diagnosed with H Pylori).

I would avoid:

Wheat, broccoli, beans, milk products. Try these suggestions:

How to Manage Bloating

When I have that feeling of not being fully "empty" after defecating, I take a low dose of Zofran at night. It makes me sleep deep and it has been shown to decrease that "false urgency feeling".

http://www.dailyrxnews.com/ondansetron-relieved-diarrhea-ibs-patients

http://fodmapmonash.blogspot.ca/2015/08/-Other-IBS-treatments.html

So do you live in CA or Thailand?

Thanks Nelson.

Now I am back in California after being gone for nearly 3 years. I've been back for around 6 months.

I have cut out everything except for brocolli that you mentioned. Is this something I should cut out 100%? Or only when I have flare ups?

I think not eating 4 hours before helps, and the past week or so I haven't been following that.

I am also reading through your links.

Thanks for all of the help.

Just a thought from personal experience, I also had severe GI issues for about a year. It was to the point that I was violently ill 3-4 times a week, bloated, had trouble eating, etc. I went to a doc who ran $2500 worth of tests and ruled out IBS, parasites allergies and the usual suspects. I also saw a GI specialist who also could not figure out what was wrong. I had all kind of diagnostic imaging dine as well. I started changing things in my diet until I could try and pinpoint what it was. It turns out that my body had developed an intolerance to cruciferous vegetables, broccoli and brussel sprouts being the main culprits. I cut them out of my diet and slowly reintroduced them 6 months later. I can eat them in reasonable amounts now. There is quite a bit of information and books you can read, if you suspect food intolerance

Hi Cody, glad you joined, and pleased you posted up your information. There's a lot to digest with this (sorry, I couldn't resist), as there could be a myriad of things going on with your stomach/GI tract. However, stomach acid issues can definitely have a correlation with thyroid issues; sometimes indirectly, which can also involve B12, Vitamin D, electrolytes, and more ...

The thyroid can even get the back door from Cortisol, stemming further from iron, ferritin, & vitamin C deficiencies. Sadly, this is one area where one variable will compound the next variable, etc., and at the end of the day it effects thyroid hormone from converting (FT4 -> FT3), and/or with FT3 getting to the cells adequately.

As noted in other posts, we definitely need more labs to see a truer picture. All the iron & ferritin related labs, B12 IMO should be included, plus D3, electrolytes, and the thyroid labs already noted. There's some decent info on the STTM, regarding stomach acid, here's the link ... http://www.stopthethyroidmadness.com/stomach-acid/

See what more you can find out. I think you need to at least consult a few other physicians for second opinions.

Thanks everyone.

Chris, can you recommend a doctor who does telemedicine whom I should consult with?

The folks from Defy Medical.

Email [email protected]

In Santa Monica, Dr Rand McClain is a good one: http://psrmed.com/contact-us.html

x2 with Nelson!!