Miklu's Labs

[Miklu]

so i would like some advice and opinions about my labs, i'm going to update these when i get more bloodwork done.
i'm 20yo, not on trt or thyroid meds. i saw my new doctor first time last monday who is specialized low testosterone and thyroid patients and told me to get some labs done and then contact him.

here are thyroid and testosterone results.

FT3 3.90 (3.5-6.5) pmol/l
FT4 9.65 (10-21) pmol/l
TSH 3.33 (0.40-4.00)mIU/l
Thyroid Peroxidase Antibodies 38 ( MAX 60)kU/l

LH 4.51 (1.5-9.3) IU/l
Prolactin 224 (53-360)mIU/l
FSH 0.9 (1.4-18.1) IU/l
E2 77.6 ( max 146.0) pmol/l
FT 155 pmol/l
TT 9.4 (8.4-28.7) nmol/l
SHBG 28.7 ( 17-66)nmol/l

thanks in advance

 

[Bass]

well looks like you have a thyroid issue, and your LH and FSH are low, in fact all your levels are with the exception of SHBG. have you done an MRI for pituitary gland to rule in/out tumors? I know you're young but any AAS use or testicle injuries in the past? are you any medication?

 

[Vettester Chris]

Yeah, there's definitely some trouble in the thyroid department. A healthy level of FT4 an FT3 would be in the 50% to 80% area of the range values. Your FT4 is on the negative at -32%, your FT3 is positive, but only at 13%. This tells me that your conversion process, or deiodinase D2 function is good, but the body is demanding more T3 to achieve balance, which reflects both (T4 and T3) being below normal, but the FT3 being to the right on the scale due to the body's demand. This definitely reflects hypothyroidism.

Again, the obvious is that you are not producing enough thyroid hormone. Your TSH is mildly elevated, but I wouldn't be surprised if it was higher at one point, just depending on how long this has been going on. The question is: What is causing this? Your doctor covered the TPO antibody, looking for autoimmune at the enzyme level, but you definitely need to take it a step further with getting the TgAb antibody, which is more on protein level of the thyroid, and responsible for production of both T4 and T3.

There's several additional labs that you should take a look at. Instead of posting them all, just take a look at http://www.stopthethyroidmadness.com/recommended-labwork/ .. There's no reason not to get all of them, but I'd be really interested in the MTHFR genetic profile, iron/ferritin, & the cortisol 4x. Way too young for this, so work closely with your physician to find some answers. Please keep us updated with your progress.

 

[Miklu]

well looks like you have a thyroid issue, and your LH and FSH are low, in fact all your levels are with the exception of SHBG. have you done an MRI for pituitary gland to rule in/out tumors? I know you're young but any AAS use or testicle injuries in the past? are you any medication?

MRI was normal and several different doctors have watched it. I've never done any AAS or PEDs and there shouldn't be any kind of testicular injuries, not that atleast i'm aware of. Currently i'm not on any medication but i've start to think that i've always had some symptoms of low t and hypothyroidism. My mother said i've always had cold hands and feet and i remember i couldn't get even one push up when we had these tests in school 7-8 years ago. Also i've had almost my whole life problems with motivation and i've been tired, depressed and felt weak so long i don't remember when it all started. And back to the question: i've seen different psychologies from age 14 to this day and used SSRI meds but they never did shit, also i've used different prescription acne meds few years back. Sorry for long post.

 

[Miklu]

Yeah, there's definitely some trouble in the thyroid department. A healthy level of FT4 an FT3 would be in the 50% to 80% area of the range values. Your FT4 is on the negative at -32%, your FT3 is positive, but only at 13%. This tells me that your conversion process, or deiodinase D2 function is good, but the body is demanding more T3 to achieve balance, which reflects both (T4 and T3) being below normal, but the FT3 being to the right on the scale due to the body's demand. This definitely reflects hypothyroidism.

Again, the obvious is that you are not producing enough thyroid hormone. Your TSH is mildly elevated, but I wouldn't be surprised if it was higher at one point, just depending on how long this has been going on. The question is: What is causing this? Your doctor covered the TPO antibody, looking for autoimmune at the enzyme level, but you definitely need to take it a step further with getting the TgAb antibody, which is more on protein level of the thyroid, and responsible for production of both T4 and T3.

There's several additional labs that you should take a look at. Instead of posting them all, just take a look at http://www.stopthethyroidmadness.com/recommended-labwork/ .. There's no reason not to get all of them, but I'd be really interested in the MTHFR genetic profile, iron/ferritin, & the cortisol 4x. Way too young for this, so work closely with your physician to find some answers. Please keep us updated with your progress.

okey, i will try to get those bloodwork done as soon as possible, by the way i sent those labs results to my doctor and he agreed that we should first get my thyroid fixed before we start to think what to do those low test levels, he replied to my message before i saw your post so i didin't ask him yet about those other labs. also my rt3 results are on the way, but it is gonna take few weeks propably before i get them because it will be send to germany or some other country.

 

[paco]

Miklu, did you ever use Accutane (also known as isotretinoin) to treat acne? Accutane is very effective, but is known to have significant side effects. It worked great for me, but I honestly wish my doctor had better informed me of the risks. However, it sounds like there may be more to what you're dealing with than just past use of Accutane, if so.

http://articles.mercola.com/sites/articles/archive/2012/12/12/acne-drug-accutane.aspx

 

[Miklu]

Miklu, did you ever use Accutane (also known as isotretinoin) to treat acne? Accutane is very effective, but is known to have significant side effects. It worked great for me, but I honestly wish my doctor had better informed me of the risks. However, it sounds like there may be more to what you're dealing with than just past use of Accutane, if so.

http://articles.mercola.com/sites/articles/archive/2012/12/12/acne-drug-accutane.aspx

yes, i did do 6 month accutane "cycle" few years back, before that i had used one much milder Rx acne drug twice for 6 months and acne always came back so doctor prescribed accutane and it worked pretty well but later when i found out side effects of it, i started to wish too that i wouldn't never started to take it.

 

[Miklu]

So we decided with my doctor to start thyroxine (levothyroxine) 50mcg daily and raise it to 100mcg slowly and then take labs six weeks from now (tsh,ft4,ft3, all four iron labs, tgAb and 4x saliva test atleast.) I know there are better options than t4 only medication and i'm going to discuss about it with my doctor.

 

[Miklu]

so i've been taking t4 med now 11 days, first 50mcg and now couple days ago i started taking 75mcg and last few days i've had little bit shortness of breath and i thought it goes away but today couple hours after i took t4 my throat has been tight and feels like someone is squeezing my wind pipe and feeling like i have "lump" in my throat, also i guess my throat is swelled up. what should i do? reduce the dose back to 50mcg?

 

[Vettester Chris]

I'll post more later, as I've got a ton on my plate today. T4 meds are just a bad way to go, and I have no idea why physicians keep going that route??? Research Natural Dessicated Thyroid medications. There's so many negative complaints on Levothyroxine, which is just a synthetic T4 only med.

 

[Miklu]

yes, i just send mail to my doctor about that but would it be ok to go with thyroxine until i get NDT because i already have little bit more energy and i feel slightly better. and it's gonna take few weeks to get Rx for NDT. also would it be ok to take those ferritin/iron and saliva tests as soon as possible even if i'm using thyroxine until i get that NDT or does using t4 only med affect results and should i stop using them right know? sorry about asking so much questions but i just wanna make sure i'm doing everything right from the beginning and that bloodwork shows right results.

 

[HarryCat]

I'll post more later, as I've got a ton on my plate today. T4 meds are just a bad way to go, and I have no idea why physicians keep going that route???

Because it actually works for a lot of people. I spent 4 years wasting time trying to get NDT to work, checking my adrenal function, taking iron supplements, the whole STTM thing. Finally I had enough and tried straight T4, I'm finally starting to feel well again. Although I did have to try several different brands of T4 until I found one that worked.

I appreciate the fact that a lot of people don't do well on T4 only, but I wouldn't rule it out without trying it.
And yes, doctors should allow their patients to try NDT if they don't do well on T4, but the reverse is also true.

 

[Vettester Chris]

Because it actually works for a lot of people. I spent 4 years wasting time trying to get NDT to work, checking my adrenal function, taking iron supplements, the whole STTM thing. Finally I had enough and tried straight T4, I'm finally starting to feel well again. Although I did have to try several different brands of T4 until I found one that worked.

I appreciate the fact that a lot of people don't do well on T4 only, but I wouldn't rule it out without trying it.
And yes, doctors should allow their patients to try NDT if they don't do well on T4, but the reverse is also true.

Well, Harry, if T4 synthetic is working for you, that's excellent! You said you went through several brands of T4 ... What wasn't working with the other T4's? Maybe one version had a touch more corn starch or providone than the other (got to love that providone)? Figuring something had to be different with the composition, or something changed biologically/metabolically? I dunno ... Did you try some different NDT's as well?

Do you have a theory on why a synthetic T4 only, which carries no T3, T2, T1 or calcitonin, would work over a NDT? Obviously, most in the know would think adrenals or iron would be a factor, but you mentioned that you covered that. Sorry you don't subscribe to that whole STTM "thing", but I tend to lean with Dr. Rind, Dr. Lam, and countless others that articulate the research and science to this subject.

I'm not saying T4 "CAN"T" work, I just say (as many do) it's a bad way to go. It's not as if STTM or any of these supporting physicians have a personal stake in NDT medications, they're just reporting their data and experiences. Either way, I'm glad one of the T4's works for you, and please feel free to expand further; possibly in the Introductions Forum, BW Forum, and Thyroid Forum. Welcome aboard!

 

[HarryCat]

Well, Harry, if T4 synthetic is working for you, that's excellent! You said you went through several brands of T4 ... What wasn't working with the other T4's? Maybe one version had a touch more corn starch or providone than the other (got to love that providone)? Figuring something had to be different with the composition, or something changed biologically/metabolically? I dunno ... Did you try some different NDT's as well?

I tried unithyroid (which doesn't have povidone), synthroid, and am now taking Tirosint. On the NDT side I tried Armour, before and after the reformulation, Naturthroid and Westhroid.

Do you have a theory on why a synthetic T4 only, which carries no T3, T2, T1 or calcitonin, would work over a NDT? Obviously, most in the know would think adrenals or iron would be a factor, but you mentioned that you covered that. Sorry you don't subscribe to that whole STTM "thing", but I tend to lean with Dr. Rind, Dr. Lam, and countless others that articulate the research and science to this subject.

Check out http://tiredthyroid.com/medications.html, she does a much better job talking about why certain medications might be better for some people than others, than I could do.

I'm not saying T4 "CAN"T" work, I just say (as many do) it's a bad way to go. It's not as if STTM or any of these supporting physicians have a personal stake in NDT medications, they're just reporting their data and experiences. Either way, I'm glad one of the T4's works for you, and please feel free to expand further; possibly in the Introductions Forum, BW Forum, and Thyroid Forum. Welcome aboard!

What physicians experience in their practices is inherently skewed because patients self select by stop seeing a physician if the treatment prescribed doesn't work. I am a prime example of this since it is sometimes easier to go find another physician in order to try a different treatment than to try and convince the one you are currently seeing to try something she doesn't believe in. It also can work the other way where physicians will only chose to treat patients that fit into their treatment protocol.
My current thyroid physician is a prime example of this, several years ago he wrote a popular book about hypothyroidism and as a result his practice was swamped and he had to close it to new patients. I could not get in to see him then, but low and behold a few years later he is accepting new patients again. Why is that? Obviously there were a certain number of patients for which his one size fits all treatment program didn't work and patients left to go find treatment elsewhere.
He is a proponent of treating all hypothyroid patients with a combination of about 98% T4 and 2% T3, but I found that even 2% T3 was too much for me so I am on T4 only.
Didn't mean to hijack Miklu's thread, sorry.

 

[Miklu]

naah, it's ok. i'm glad t4 only works for you and i appreciate that you posted about it, now i know it can actually work well and is worth try if everything else fails
here in finland, we only have one t4 and t3 med so trying different brand wouldn't be option for me legal ways. BUT we luckily have Armour and Erfa thyroid so that's great, i would find it huge plus to take thyroid med sublingually and no need to wait 3-4 hours to take my multivitamin.

 

[Miklu]

So i finally got rt3 test result even though i guess it doesn't tell very much right know because my ft4 and ft3 are so low. i still haven't got NDT or any other labs done but i'm working on it, doc is so busy it's going to take some time. i'm still currently on 50mcg of t4 and feeling little better, no shortness of breath, no rapid heartbeating or anything else so i'm going to stick on this until i get NDT.
Anyway here is the result:

S-rt3 0.15 nmol/l MAX 0.95

 

[Miklu]

got some bloodwork done

Ferritin 71.9 (28-370) µg/l
Transferrin 2.55 (2-3.6) g/l
Iron 19.7 (9-34) µmol/l
%saturation of transferrin 32.19 (15-50) %
S -tTGAbA <0.6 Max 7.0 EliA U/ml
P -IgA 1.60 (0.7-4) g/l
Antithyroglobulin <15 MAX 60 kU/l

also my doctor saw that one of my old bloodwork showed that i might have gluten sensitivity so that's why he ordered me to take those two tests. i don't know how to interpret these results so comments? i'm currently 75mcg of synthroid, side-effects are gone but i still don't feel that much better. also i'm going to try gluten-free diet to see if it has any effects. and i'm going to do 24h saliva test next week sunday.

 

[ratbag]

Chris, I believe the understanding on NDT with regard to T2, T1 or calcitonin changed a few years ago. Have a look here:
http://www.tiredthyroid.com/blog/2012/03/31/desiccated-thyroid-t4-t3-t2-t1

Do you have a theory on why a synthetic T4 only, which carries no T3, T2, T1 or calcitonin, would work over a NDT? Obviously, most in the know would think adrenals or iron would be a factor, but you mentioned that you covered that. Sorry you don't subscribe to that whole STTM "thing", but I tend to lean with Dr. Rind, Dr. Lam, and countless others that articulate the research and science to this subject.

 

[HarryCat]

Your iron labs don't look too bad, I happen to be re-reading the Stop The Thyroid Madness book right now and it says that you only need to be concerned if your ferritin is below 50 and iron saturation below 25%.
I'm a little confused about what the difference might be between S -tTGAbA and Antithyroglobulin. In the US TgAb is the abbreviation for thyroglobulin antibodies. I suppose it doesn't really matter since your test results are OK.

 

[Miklu]

Your iron labs don't look too bad, I happen to be re-reading the Stop The Thyroid Madness book right now and it says that you only need to be concerned if your ferritin is below 50 and iron saturation below 25%.
I'm a little confused about what the difference might be between S -tTGAbA and Antithyroglobulin. In the US TgAb is the abbreviation for thyroglobulin antibodies. I suppose it doesn't really matter since your test results are OK.

ok, yea i just read from sttm site that iron article and you're right, they ain't that bad so i guess insufficient iron levels can be ruled out. also i eat eggs, red meat and other foods that contain iron regularly enough so i guess it won't become problem.

when i post labs, i translate results to english because i assume you don't understand finnish so some misunderstandings might come

S -tTGAbA/S -tTGAbG means in english: Tissue Transglutaminase IgA, IgG, which will be taken to diagnose if person has celiac disease
so this is not same as TgAb.