Need Advice! 23 Year old male

[Vettester Chris]

THANK YOU! A lot of this stuff makes sense & I will ABSOLUTELY bring it up to the doctor tomorrow. So basically my adrenals could be very comprimised which could bleed into T production. ANother question -- If a restart was deemed to be the best route, would this help with the adrenals or would the adrenals deem it useless. Furthermore, would the comprimised adrenals render any T therapy kind of "useless"

Well, for the part I've addressed, the adrenals are compromising the productivity of the "Thyroid", if in fact there is adrenal insufficiency (although hypothyroidism can be correlated with hypogonadism, but that's another talking point). The thyroid markers, including TSH should prompt a physician to look in that area.

Cortisol and the adrenals work in similar fashion as the testes and testosterone. You see the LH & FSH values (?). Those are both hormones produced in the pituitary, and it works on what's called a negative feedback loop with the testes. For testosterone, if "everything" is working good, the pituitary axis will recognize when test serum levels are dropping and it will produce LH, which then signals the testes to make more testosterone (FSH for the sperm). The adrenals and cortisol are similar, with the pituitary producing ACTH, which should increase/decrease as the demand for cortisol is given.

There, I spoon fed some of it after all, but I would encourage you to research this subject anywhere and everywhere. There's tons of stuff just right here at Excel Male!! You can get lost for days with everything!! IMHO, considering your age, etc., both areas (adrenals & pituitary) should be examined, along with proper labs. Being your LH & FSH is also low, I think this warrants it. Yeah, the varicocele subject is noted, but if this were primary, I would think the gonadotropins (LH * FSH) would be much higher (?). We've got TSH that is also nowhere near where it should be in relation to the thyroid hormone levels, and that is also a pituitary produced hormone. Again, I would hope the doctor will see flashing lights with all of this ... Keep us posted

 

[Zach Hess]

RIght im gonna look into the stuff now. The only thing thats weird is my TSH value is relatively normal. But like you said other labs are low + cold body temps, etc.

 

[Vettester Chris]

RIght im gonna look into the stuff now. The only thing thats weird is my TSH value is relatively normal. But like you said other labs are low + cold body temps, etc.

In relation to your thyroid hormone (T4 and T3), your TSH should be way up there, talking > 4.5! A classic episode of overall thyroid down-regulation, which as stated is more times than not resulted from adrenal fatigue. There's a great book from Dr. Wilson, -Adrenal Fatigue, 21 Century Stress Syndrome. You can get it on Kindle/Amazon. Lots of knowledge to gain in that book!

 

[Zach Hess]

Maybe im missing what you are saying but isnt it GOOD that my TSH is where its at now -- given that "normal" range are .5-3.0 and closer to 1 is considered "optimal" -- isnt higher TSH correlated w/ hypothyroidism?

 

[Zach Hess]

I have just been doing some further research and it appears I definitely show some of the signs of Adrenal Fatigue. Thanks for pointing that out, this honestly makes a lot of sense as there was a period of time in my life were I was depressed and very stressed out that could have caused this. I will talk to the doctor about this tomorrow.

 

[Zach Hess]

But then again looking at them I only have a couple of the symptoms. I dont have brain fog, my work has not been effected etc. Most of my symptoms related to adrenals are: Tough to sleep thru the night(I also wake up to pee but even when I dont I can wake for a couple mins to toss & turn), diminished sex drive, ED, lack of muscle mass/strength, inflammation(in terms of gut, body at times) was depressed a while ago(which might have caused all this)

Sorry for all these posts im trying to piece things together haha.

 

[Vettester Chris]

Maybe im missing what you are saying but isnt it GOOD that my TSH is where its at now -- given that "normal" range are .5-3.0 and closer to 1 is considered "optimal" -- isnt higher TSH correlated w/ hypothyroidism?

No ... Like I explained, this works on a negative feedback loop. See, if a doctor would have pulled just the TSH, he/she would no doubt say your thyroid looks great!! It would be like if someones LH was 6.0, going just by that number we would think, wow, he must have normal/high testosterone. That TSH value of yours would be just about perfect if only both your Free T3 and Free T4 were in the 50% to 80%tile of their respective reference ranges. Your Free T4 is like in the 10% area of the range, and Free T3 is dipping below the reference range, it's like -10% without looking.

TSH is just a hormone to stimulate the thyroid to produce actual thyroid hormone (T4 & T3). Your free serum numbers is your thyroid hormone, just like testosterone is testosterone, regardless of LH. However, we can use these stimulating hormone numbers to get snapshots of how the overall picture looks, and possibly where to search when there's an imbalance. Hope some of this is making sense (?)

 

[Zach Hess]

Gotcha. With my T3 and T4 my TSH SHOULD be elevated, that would mean less of a problem, but because it ISNT, there is concern. *Im piecing it together* Just a lot to take in. I think all of this is kind of started when I depressed for about 3-4 months 2 years ago overseas.

 

[Vettester Chris]

Gotcha. With my T3 and T4 my TSH SHOULD be elevated, that would mean less of a problem, but because it ISNT, there is concern. *Im piecing it together* Just a lot to take in. I think all of this is kind of started when I depressed for about 3-4 months 2 years ago overseas.

Bingo!! You now have the concept of how the feedback loop works. If everything is working correctly, 1 will be up, the other will be down or vice verse. TSH is only in the game to demand the thyroid to produce more hormone. Once achieved, TSH will reduce accordingly. Now you understand that it wouldn't be a good thing to just use the TSH lab for diagnosis, and LOL so many doctors do just that!

 

[Zach Hess]

Lots of conflicting stuff

"There are some who are claiming that one should first fix any adrenal exhaustion. However, I feel this is likely misguided IF the man is low testosterone in the first place. The above study shows that a man likely needs ample testosterone in order to dampen his stress response. Again, the authors pointed this out by saying "in contrast, our data demonstrate that the effect of testosterone in young men is to inhibit rather than augment the cortisol response to CRH stimulation." [3]" Peak Testosterone

 

[Vettester Chris]

I would say First: Identify what exactly needs corrected and/or underlying issues .. Second: Determine a game plan with the doctor at that point with what needs corrected first, second, and thereafter. Every situation is different, and depending on the urgency of any one (1) area, the physician will use his/her discretion on how to proceed forward.

 

[Zach Hess]

LABS AS OF THIS AM:

Total T : 270ng
Free T 32.2
Bio T: 83.9

TSH : 3.544
Free T4: 1.19
Free T3: 2.19
FSH: 2.38
LH: 1.96
Cortisol: 20.58
E2: 23.9

The doctor has recommended clomid 50mg 3x per week & levothyroxine 25mg( forgot dosing as I got it over the phone. Thoughts?

 

[Vettester Chris]

Turn around and walk out!! He doesn't even know if there's an underlying issue in the pituitary, but will throw you on Clomid for fun! I won't even get started on the Levo T4 he wants to give you, that would be a 1/4 grain protocol at best, and that protocol sucks even when your thyroid hormone will reach the cells. In your case, I think other areas need addressed, I've noted them thoroughly in previous posts.

Maybe others would encourage you to go that route, but I won't. In the end, it's your choice though.

 

[Vettester Chris]

Did you ask him about Reverse T3 and antibodies, and other things that are being discussed?

 

[Zach Hess]

I understand where your coming from and see that your trying to help(and appreciate it). But I've done research and stil dont get the "underlying issue in the pituitary" - what do you mean by this. Even if this issue was solved, from questions I asked and what she said, thats won't necessarily solve the problem with testosterone. Maybe im lost in all this info, but if you are informed and know the research - please don't hesitate. I have had an MRI of my pituitary, and she mentioned the other labs regarding this don't show issues. So im sorry for being lost. Im trying to be as proactive as I can with this whole ordeal.

**Also note that the TSH went up w/ the lower T3 and T4 - from what we discussed, this is good right and means the feedback loop is working better?**

Also - are there any negatives for trying clomid beside the vision side effects. From what ive researched it wont F my natural test production.

 

[Zach Hess]

Also, my cortisol & e2 results look normal for the most part from what i researched

 

[Vettester Chris]

Ok, the MRI is where I was going with that. Fine, run your protocol, keep us posted ...

 

[Zach Hess]

I'm sorry for getting a bit confused, but are you saying that from the tests ive run(MRI + bloodwork) it looks like I don't have adrenal issues or an issue with the pituitary. Because thats what im taking it as.... (Sorry this is a good amount to take in & research) Im trying to best interpret my labs from today regarding E2, cortisol, TSH, FT3, FT4.

In addition -- I don't have most of the symptoms of adrenal fatigue as I thought I did upon further research.

**I've also had an MRI of my abdomen in January that revealed normal adrenals "Adrenals: Normal." , a complete metabolic panel & and a CBC** Sodium & potassium levels were well w/in range (one way to test adrenals -- see I have researched on my own!!)

 

[CoastWatcher]

Well, Chris has offered his opinion, which is all he can do. If you have confidence in your doctor, after your own study and consideration of the points that have been raised in this thread, you should follow the advice that your physician has tendered. No one else here can make that decision for you. Keep us posted.

 

[Zach Hess]

Yeah true. I'm just trying to get any opinions i can to make the best informed decision. I want to fully understand everything that anyone says. I also wanted to make sure Chris has all the right information IE: my labs, MRIs, etc. I think he missed the MRI before, etc.