Thyroid Guidance

[Bosscwx]

Guidance please:

Been suspecting my thyroid was high for years but different doctors would tell me I'm in the normal range. I just learned "normal" range is subjective and I should be much lower. Ive been on TRT since November and its helped greatly but I'm still struggling with fatigue and I feel exhausted much of the time. My most recent lab work. Also doctor didn't order reverse T3 despite my request to do so.

TSH 3rd GEN: 6.46 UIU/ML ----- optimal 0.5-1
Free T3: 3.3 pg/mL --------------- optimal 3.8-4.4
Free T4: 0.87 ng/dL -------------- optimal 1.4-1.77
TgAb: 3 IU/mL --------------------- normal 0-0.9
TPOAb: 354 IU/mL --------------- normal 0-34

I think this indicates Hashimoto's. Unsure what to do.

Trough 5/23/19
Test: 651
Free: 14.3 ng/DL 2.2%
BioAval: 336 ng/DL 51.6%
SHBG: 33.2
Estradiol: 29.6 using Roche ECLIA
Hermatocrit: 46.8
PSA: 1.5

Peak 5/25/19
Test: 1288
Free: 34.9 ng/dL 2.71%
BioAval: 817 ng/dL 63.5%
SHBG: 30.3
Estradiol: 63.2 using Roche ECLIA
Hermatocrit: 43.7
PSA: 1.25

 

[Vince Carter]

Yes I think you need to flesh out the possibility of Hashi's, would be easiest to retest things just to verify, and rule out lab error. RT3 is probably not useful at this point with it having been omitted.

 

[Dansk]

clearly hashi's, you need to seek medical guidance.

 

[Systemlord]

It would be nice to see an iron panel, I started TRT with a severe iron and potassium deficiency, I was always fatigued and exhausted on TRT. I would hit the low 400's and feel low, then push for 500 and feel more fatigued.

Damn dude, your TSH has a story to tell and doctors seem to be ignoring it, definitely looks like hashimoto's. It's difficult to locate a good thyroid doctor these days that treats the symptoms as well as labs, most doctors fixate on labs as if it is the word of god.

Private care is sometimes needed to escape these managed healthcare doctors operating on narrow insurance guidelines.

Men should be using the LC/MS/MS method for E2 testing, the Roche ECLIA method picks up on other steroids (C-reactive protein) and falsely elevates estrogen.

Peak 5/25/19
Test: 1288
Free: 34.9 ng/dL 2.71%
BioAval: 817 ng/dL 63.5%

Trough 5/23/19
Test: 651
Free: 14.3 ng/DL 2.2%

Your Free T is looking much lower on trough and would be a problem for most men, levels look to be swinging considerably. There are some men who respond poorly to TRT when levels are swinging, I notice even minor swings and this translates into feel unwell.

Recommended more frequent dosing.

 

[Vince]

You're Labs definitely show hashimoto's. Number one you need to give up grains. Since you have an autoimmune disease, the odds of you getting another one is much greater.

Do lots of research and find a thyroid doctor. You may have to go to a preventive doctor to get the right treatment.

 

[Bosscwx]

Update: I was prescribed levothyroxine today which should help. Ive been told to avoid gluten but I feel I eat fairly healthy already and not much breads or beer. I currently take 150mg IM weekly and want to go 3x weekly but working on getting a prescription to do so. I'm concerned with my Estradiol but as noted it isn't the E2 test.

 

[Checkdis]

Update: I was prescribed levothyroxine today which should help. Ive been told to avoid gluten but I feel I eat fairly healthy already and not much breads or beer. I currently take 150mg IM weekly and want to go 3x weekly but working on getting a prescription to do so. I'm concerned with my Estradiol but as noted it isn't the E2 test.

I have similar high TPO values, but my Thyroid does not reflect it yet like yours.

You mind coming back in time and providing follow up blood work with your treatment course. Curious how your values will look with the Levothyroxine.

 

[Bosscwx]

I have similar high TPO values, but my Thyroid does not reflect it yet like yours.

You mind coming back in time and providing follow up blood work with your treatment course. Curious how your values will look with the Levothyroxine.

I should get another set of labs in 4-6 weeks. I’ll follow up.

 

[Checkdis]

I should get another set of labs in 4-6 weeks. I’ll follow up.

Awesome thank you, I am currently doing a Gluten free diet, but I am not taking any medication. Going to see how my numbers reflect the diet before messing around with my thyroid.

 

[OMI100]

Here are 3 GREAT sites to do some research if you have not done so already:
https://www.tiredthyroid.com/
Stop the Thyroid Madness™ - Hypothyroidism and thyroid mistreatment
AND
Start Here - Dr. Westin Childs | Thyroid & Health Supplements That Work
Developed by a DR.
Detailed and clear with hyperlinks to any related research or studies that support his discussion.
Look at the BLOG post. He also has a YouTube channel where each BLOG is discussed.
Here is the link to his Hashies BLOGs:
Hashimoto's Thyroiditis Archives - Dr. Westin Childs | Thyroid & Health Supplements That Work