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Subclinical Hypothyroidism

When people mention adrenal fatigue, I usually think of it as cortisol issue. Too high or too low are problematic. I’d get some 8am fasting cortisol, acth, aldosterone, and renin tests. Have to keep searching for the problem.

Cortisol had occurred to me. My muscles are constantly sore. I know I overtrain way too much and too hard for being my age, go to failure way too often, take stimulants just so I can train hard. I'm sure that is a big part of it.

I've had the regular blood cortisol test done, never the 8am fasting cortisol or more involved tests.

Need to do more research and keep searching for the answers. It's not in my nature to give up...ever.
 
Cortisol had occurred to me. My muscles are constantly sore. I know I overtrain way too much and too hard for being my age, go to failure way too often, take stimulants just so I can train hard. I'm sure that is a big part of it.

I've had the regular blood cortisol test done, never the 8am fasting cortisol or more involved tests.

Need to do more research and keep searching for the answers. It's not in my nature to give up...ever.

don’t give up. There IS an answer in there somewhere. Been going through similar shit myself but I think I’m finally making progress and on the way to health again. We just have to find out why we have these problems and it requires a lot of patience
 
Believe me, if I could add another compound to get back to feeling normal, I would do it. The only question is, what compound? But that, indeed, is how I got in this situation in the first place.

After 28 years of taking testosterone and virtually every other anabolic steroid, HGH, thyroid meds, HCG and HMG and FSH when I wanted to make my wife pregnant, stimulants to get up, and benzodiazepines to get to sleep at night, plus a handful of vitamins and other supplements, I realize I've hopelessly complicated things, and it's difficult to nearly impossible to know how they are all interacting together. Too many variables in the equation.

Should have just kept things simple, like my first cycle 28 years ago: 500mg Sustanon per week for ten weeks. Then at least there would be fewer variables to consider. But I had to make things complicated, and after many years, now I am paying the price by not being able to figure out exactly what is wrong with me.

And I do understand that adrenal fatigue is not a real diagnosis, but the symptoms people describe do make me think of that condition.

I also worry about any added "placebo." Are you romanticizing about the past and the way you feel? I'd commit every felony in the book to feel like an eighteen year old again too but im not sure how either of us get there. Not here to discourage against any endeavor however.
 
I guess what im trying to get at is no one can help you with your symptoms of "feeling like crap" or "lethargic" no matter how many tests you run. I've read your symptoms, you really need to start being able to diverge in more detail with either a new doctor or your current doctor about the subject. Whats life like at baseline? With no stress? Etc.
 
Putting more thought into your thyroid numbers, I would consider cortisol. Best way to test it is with a 24hr saliva test, blood test doesn't offer much insight. If memory serves me correctly, with "adrenal fatigue" at first, the thyroid will output more hormone but as lack of cortisol production continues and the body becomes drained, tsh will drop to reduce t4 and t3 as the body can't handle the stimulation or energy production. That would explain explain the low tsh with low t3, t4.
 
Putting more thought into your thyroid numbers, I would consider cortisol. Best way to test it is with a 24hr saliva test, blood test doesn't offer much insight. If memory serves me correctly, with "adrenal fatigue" at first, the thyroid will output more hormone but as lack of cortisol production continues and the body becomes drained, tsh will drop to reduce t4 and t3 as the body can't handle the stimulation or energy production. That would explain explain the low tsh with low t3, t4.

That's very interesting, thanks. Low cortisol might explain many of the symptoms I am feeling, as well as my low TSH with low T3 and T4.

My muscles are sore all the time, and although I still work out all the time, I don't recover from exercise as well anymore. I have some tinnitus and am cold easily, perhaps from the low thyroid.

If I do take T3, as I did yesterday, I am exhausted and need stimulants to function.

If I don't take T3, like today, I am full of nervous energy and I'm flying without taking any stimulants at all.

I took stimulants for many years, which may contribute to the "adrenal fatigue" or whatever we want to call it.

Another factor might be my use of Valium to get to sleep. I have used and been prescribed Valium (diazepam) for 4 years now, because I have insomnia and can't get to sleep without it. I only use it at bedtime, 10mg per night. I do note that Valium can lower cortisol levels. I wonder if that also is a big cause of the problems. I know it was a mistake to ever start taking the Valium, and that is a huge mistake that I regret but am dependent on now, another complicating factor with all of this.

 
Just a note for anyone who might be able to help with my thyroid issues. I was taking T-3 at 25-50mcg per day for the last couple of years, until I started feeling unwell (lethargic, sleepy) and tried to come off it starting in February. Being off T-3 makes me anxious and nervous, but if I try to take T-3 or T-4 I get very sleepy and depressed. So I have been off thyroid meds for three months now, with no improvement in numbers or symptoms.

For the last 3 months my thyroid numbers have been stuck at the same low levels for both T-3 and T-4, but TSH is also low. On the advice of others here, I had Reverse T-3, antibodies, and DHEA checked (still waiting to see my doctor so I can have cortisol measured.)

My Reverse T-3 is high out of the normal range, and my DHEA sulfate is at the very low end of the normal range, with T-3, T-4, and TSH all still at the same low numbers.

May 28:

T3, FREE 2.6 NORMAL 2.3-4.2 pg/mL
T4, FREE 1.1 NORMAL 0.8-1.8 ng/dL
TSH 1.23 NORMAL 0.40-4.50 mIU/L
Reverse T3 26 HIGH 8-25ng/dL
THYROGLOBULIN ANTIBODIES <1 NORMAL <=1iu/ml
THYROID PEROXIDASE ANTIBODIES <1 NORMAL <=9iu/ml
DHEA SULFATE 58 NORMAL 38-313 mcg/dL

I should mention that taking T-3 used to make me feel "up", but now just makes me feel groggy and sleepy. I actually have to take more caffeine, ephedrine, yohimbine, or another stimulant if I try to take more T-3. I've been taking stimulants for years to help with alertness and workouts, but am trying to avoid them now because they raise my blood pressure and make me jittery and anxious.

Is this a sign of some kind of adrenal "fatigue" or insufficiency, as I've seen others mention? Perhaps I've just taken too many stimulants for much too long, and overtaxed the ability of my body to keep up with it all?

Any thoughts will be appreciated. My next step is to check cortisol with the 24-hour saliva test, just to try to figure out what is going on with me.
 
Just a note for anyone who might be able to help with my thyroid issues. I was taking T-3 at 25-50mcg per day for the last couple of years, until I started feeling unwell (lethargic, sleepy) and tried to come off it starting in February. Being off T-3 makes me anxious and nervous, but if I try to take T-3 or T-4 I get very sleepy and depressed. So I have been off thyroid meds for three months now, with no improvement in numbers or symptoms.

For the last 3 months my thyroid numbers have been stuck at the same low levels for both T-3 and T-4, but TSH is also low. On the advice of others here, I had Reverse T-3, antibodies, and DHEA checked (still waiting to see my doctor so I can have cortisol measured.)

My Reverse T-3 is high out of the normal range, and my DHEA sulfate is at the very low end of the normal range, with T-3, T-4, and TSH all still at the same low numbers.

May 28:

T3, FREE 2.6 NORMAL 2.3-4.2 pg/mL
T4, FREE 1.1 NORMAL 0.8-1.8 ng/dL
TSH 1.23 NORMAL 0.40-4.50 mIU/L
Reverse T3 26 HIGH 8-25ng/dL
THYROGLOBULIN ANTIBODIES <1 NORMAL <=1iu/ml
THYROID PEROXIDASE ANTIBODIES <1 NORMAL <=9iu/ml
DHEA SULFATE 58 NORMAL 38-313 mcg/dL

I should mention that taking T-3 used to make me feel "up", but now just makes me feel groggy and sleepy. I actually have to take more caffeine, ephedrine, yohimbine, or another stimulant if I try to take more T-3. I've been taking stimulants for years to help with alertness and workouts, but am trying to avoid them now because they raise my blood pressure and make me jittery and anxious.

Is this a sign of some kind of adrenal "fatigue" or insufficiency, as I've seen others mention? Perhaps I've just taken too many stimulants for much too long, and overtaxed the ability of my body to keep up with it all?

Any thoughts will be appreciated. My next step is to check cortisol with the 24-hour saliva test, just to try to figure out what is going on with me.

Can't remember if you said this but have you tried a T3/T4 combo? also have you had your iron panel and ferritin checked?

I'd immediately begin supplementing DHEA at 25mg right now as that is likely one small piece of the puzzle
 
I too had the same thing happen years back. Dealing with various endos cause they didn’t want to listen and getting anxiety for the first time in life because I thought something was wrong. I gave up the fight one Anxiety went away and my new health plan provider only prescribes T4 and tests TSH. Got tired is spending money on all these tests as well. I now wish I didn’t, I eat clean and do cardio daily but still can pack on weight too Easy should venture away from my routine.

Even at my current lowest dose possible Now, I’d kill for your numbers. I guess what I’m trying to say, don’t give up and you’ll find your answer. Be patient and find a good endo that will actually listen to you and not just go off a checklist. Keep us Updated, this post may have giving the motivation I need to Go on my own and look for my answer.
 
Can't remember if you said this but have you tried a T3/T4 combo? also have you had your iron panel and ferritin checked?

I'd immediately begin supplementing DHEA at 25mg right now as that is likely one small piece of the puzzle

Thanks for the input, I appreciate it.

Haven't tried a T3/T4 combo; haven't had iron or ferritin checked. I've been on test for 28 years, but I've never done a therapeutic phlebotomy, as my hematocrit/hemoglobin had always been in range, although at the top of the range. So I haven't crashed my ferritin by donating blood, as many guys do, but I have no idea if my levels are good or bad.

Taking T3 or T4 separately used to make me feel up and good; now make me feel down and sleepy and depressed. So I stopped taking them, but I feel anxious and nervous off them.

I used to take DHEA, as my levels have always been low, but never felt anything from it, good or bad. I cut it out last year when I developed gynecomastia after stopping my long-term use of DHT compounds (Proviron, Masteron), just in case that was part of the problem by raising E2. But it may have had nothing to do with my gyno issues. Maybe DHEA would be the right thing for me now.
 
I too had the same thing happen years back. Dealing with various endos cause they didn’t want to listen and getting anxiety for the first time in life because I thought something was wrong. I gave up the fight one Anxiety went away and my new health plan provider only prescribes T4 and tests TSH. Got tired is spending money on all these tests as well. I now wish I didn’t, I eat clean and do cardio daily but still can pack on weight too Easy should venture away from my routine.

Even at my current lowest dose possible Now, I’d kill for your numbers. I guess what I’m trying to say, don’t give up and you’ll find your answer. Be patient and find a good endo that will actually listen to you and not just go off a checklist. Keep us Updated, this post may have giving the motivation I need to Go on my own and look for my answer.

Thanks, I appreciate hearing from someone else who has suffered similar problems.

That's just it, being off the thyroid meds causes me anxiety. Being on them makes me less anxious, but sleepy and depressed. And of course I've gained weight, lost muscle and put on fat despite not changing my diet.

I know hypothyroidism is linked to both anxiety and depression issues; many people get lethargic with hypothyroidism, but other people like me become anxious. My endocrinologist wanted me to stop taking the T-3, which I was taking on my own, and referred me to a $400 per hour psychiatrist. But I don't want to start taking anti-depressants or anti-anxiety meds; I just want my thyroid issues fixed, as I see them as being at the root of the problem.
 
Thanks for the input, I appreciate it.

Haven't tried a T3/T4 combo; haven't had iron or ferritin checked. I've been on test for 28 years, but I've never done a therapeutic phlebotomy, as my hematocrit/hemoglobin had always been in range, although at the top of the range. So I haven't crashed my ferritin by donating blood, as many guys do, but I have no idea if my levels are good or bad.

Taking T3 or T4 separately used to make me feel up and good; now make me feel down and sleepy and depressed. So I stopped taking them, but I feel anxious and nervous off them.

I used to take DHEA, as my levels have always been low, but never felt anything from it, good or bad. I cut it out last year when I developed gynecomastia after stopping my long-term use of DHT compounds (Proviron, Masteron), just in case that was part of the problem by raising E2. But it may have had nothing to do with my gyno issues. Maybe DHEA would be the right thing for me now.

Things like Armour Thyroid, etc. are generally more effective for most people than T4 or T3 separately. The reason for T3 only is mostly to get the reverse T3 down. T4 on its own is rarely the best solution. T3/T4 is usually the most effective one.
 
Things like Armour Thyroid, etc. are generally more effective for most people than T4 or T3 separately. The reason for T3 only is mostly to get the reverse T3 down. T4 on its own is rarely the best solution. T3/T4 is usually the most effective one.

I can believe that. Years ago (2001-2007, before Operation Raw Deal), I remember taking the dessicated thyroid tabs (little red baked bean tabs supposed to be like Armour Thyroid) that IP China used to sell, and I remember liking them very much back then.

The thing is, taking T3 used to make me feel good and up; now taking either T3 or T4 makes me feel down and lethargic and sleepy. But if I don't take anything, like today, I am really up but anxious and nervous and irritable and don't feel well, possibly because of thyroid's effects on serotonin.

Now my levels of both free T3 and T4 are low, but my TSH is also low and my body has high levels of Reverse T3, the inactive antagonist to T3.

I don't know why my reverse T3 is high. Perhaps it's because of cortisol levels and adrenal fatigue/insufficiency. I'm an old stimulant user/abuser, have used caffeine/ephedrine/yohimbine for years, and will reach for a stimulant when I start feeling tired and bad. But all the stimulant use raises my blood pressure and is probably doing me no good in the long run. I feel sore all the time, don't recover well from workouts, have to use stimulants to get going in the morning, and Valium to get to sleep at night.

The answer is perhaps to get off everything and let my body recover. But that is hard to do as a 52-year-old man who has been using drugs a long time, and who has a six-month-old baby who won't let me sleep at night and who needs my care during the day. So I am stuck between a rock and a hard place, trying to decide how to proceed with all this.
 
Endocrinologist says as long as I am somewhere in the normal range, I am euthyroid and I am fine. Doesn't matter if you are low or high end of scale. Oh, and those high Reverse T-3 numbers? Well, Reverse T-3 doesn't matter much. He suggested I should try meditation. :-/

Good to know that the fact that I've been so miserable doesn't matter much, and it's all in my head. Hey, let me find another wall to go beat my head against!

I am so, so tired of doctors who don't want to do their jobs.

Never mind me, just venting here. Hey, have a great weekend! I won't.
 
Endocrinologist says as long as I am somewhere in the normal range, I am euthyroid and I am fine. Doesn't matter if you are low or high end of scale. Oh, and those high Reverse T-3 numbers? Well, Reverse T-3 doesn't matter much. He suggested I should try meditation. :-/

Good to know that the fact that I've been so miserable doesn't matter much, and it's all in my head. Hey, let me find another wall to go beat my head against!

I am so, so tired of doctors who don't want to do their jobs.

Never mind me, just venting here. Hey, have a great weekend! I won't.

See a functional medicine doc as I mentioned before. The odds are that you will not find someone in the mainstream that is going to give you any answers or satisfaction. Sadly your experience is the norm.
 
See a functional medicine doc as I mentioned before. The odds are that you will not find someone in the mainstream that is going to give you any answers or satisfaction. Sadly your experience is the norm.

Thanks, I will definitely do that. I tried to work within the traditional, conventional medical establishment, but that has gotten me nowhere, just like many men have found with TRT and other practices that traditional medicine tends to frown upon or distrust.

I hate to spend even more money on my own, if my insurance won't cover it, but at this point that is my only option for being happy or healthy again.

At least the endocrinologist did grudgingly agree to test my ACTH, although he wouldn't do 24-hour saliva cortisol. But I have to wait 8 weeks or so until things open back up again because of the COVID-19 shutdown.
 
Thanks, I will definitely do that. I tried to work within the traditional, conventional medical establishment, but that has gotten me nowhere, just like many men have found with TRT and other practices that traditional medicine tends to frown upon or distrust.

I hate to spend even more money on my own, if my insurance won't cover it, but at this point that is my only option for being happy or healthy again.

At least the endocrinologist did grudgingly agree to test my ACTH, although he wouldn't do 24-hour saliva cortisol. But I have to wait 8 weeks or so until things open back up again because of the COVID-19 shutdown.
High rt3 is important. Whether rt3 can occupy t3 receptors and block t3 or not is a debatable topic but regardless, if you have high rt3, it means you body is busy converting t4 to rt3 instead of t3 while your t3 sits suboptimal. One example of why one might have elevated rt3 is from the flu or other illness. When you get sick, you body goes into rest mode to recover, so you'll convert more t4 to rt3 instead of t3 to slow the body and metabolism down so it can heal.

At this point you should really do a 24hr cortisol test. Cortisol is an important part of energy and metabolism, if your adrenal glands can not produce enough cortisol to meet energy demands, then your body will convert less t3 as there is no point in having good t3 numbers if other parts of your body can't keep up.

Are you in a state that doesn't allow you to order your own lab work online? Id order my own 24hr cortisol saliva test.
 
High rt3 is important. Whether rt3 can occupy t3 receptors and block t3 or not is a debatable topic but regardless, if you have high rt3, it means you body is busy converting t4 to rt3 instead of t3 while your t3 sits suboptimal. One example of why one might have elevated rt3 is from the flu or other illness. When you get sick, you body goes into rest mode to recover, so you'll convert more t4 to rt3 instead of t3 to slow the body and metabolism down so it can heal.

At this point you should really do a 24hr cortisol test. Cortisol is an important part of energy and metabolism, if your adrenal glands can not produce enough cortisol to meet energy demands, then your body will convert less t3 as there is no point in having good t3 numbers if other parts of your body can't keep up.

Are you in a state that doesn't allow you to order your own lab work online? Id order my own 24hr cortisol saliva test.

Thanks, I really appreciate the information on RT3 and the good advice.

I can order my own labwork online, but so far I've only done regular bloodwork. I wasn't sure how doing the 24hr cortisol saliva test differed from just going in to get bloodwork. How do I submit the saliva samples?
 
Thanks, I really appreciate the information on RT3 and the good advice.

I can order my own labwork online, but so far I've only done regular bloodwork. I wasn't sure how doing the 24hr cortisol saliva test differed from just going in to get bloodwork. How do I submit the saliva samples?

This should be of some help. I thought privatemdlabs used to offer saliva testing but doesn't appear so anymore.

Don't rely on a dr to tell you about your health. As long as lab work is in range, a dr will always tell you your fine and that couldn't be farther from the truth. Research, take control of your health, educate your dr, force them the inability to deny your health concerns/issues.

 

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