I'm 40 yr old male. In good overall health. Been binge drinker (alcoholic) before, quit 2 years ago.
My situation is complicated, so I would divide this post into sections, for ease of understanding:
1) While drinking, my health wasn't at all bad. Used daily supplements:
Vit. A 10,000 iu
B Complex 50 mg
C 500 mg
Milk Thistle
Dandelion Coffee
Zn 15 mg
Bran/fiber for constipation.
2) Health deteriorated last couple of years (since quitting!). Symptoms:
- Extremely dry, brittle, thin, falling hair.
- Pale face. Though hands/palms light red in tone (i.e normal).
- Chronic constipation. Fiber supps don't work as well as while drinking!
- Most times sweating, breathless, while others feel normal room temp.
- Severe insomnia.
- Confusion, short memory, irritability, with frequent panic attacks.
3) Lab tests a year ago:
- the "usual" high Total Bilirubin (slightly above range).
- severe vitamin D deficiency (15 ng - bottom of range).
- high Vitamin A (at top end of range 86 mcg/dl).
- sign of mild liver cirrhosis (endoscopy).
- Zn high end of range. Cu and Ceruloplasmin bottom of range.
4) Lab tests this week:
- Vit. D shot up well into normal range (at 60 ng, after taking 50,000 IU cap, weekly / 20 weeks).
- Liver function test, normal, except for high TB.
- Ca bottom of range. Mg normal range.
- Fe 23 umol/L (range 8-32).
- Ferritin 58 ng/ml (range 24 - 336). During the drinking years, was around 200 ng.
- TSH 1.6 mlU/L (range 0.43-4.10).
- FRT4 12 pmol/L (7.5-21.1).
- Still waiting results for Vit A, Cu, Zn.
At start I thought I was hypothyroid (as I gained weight of 20 pounds). So took Kelp capsules and powder. Instantly my health recovered within two days, and began to experience deep sleep, almost drowsy all day! Then the Kelp (high iodine content, backfired, with same symptoms as above, but even more severe).
Stopped Kelp. Went for Iron syrup, 50 mg elemental, for 4 days. Again felt great. Hair condition significantly improved, as well as sleep, breathing. Yet men are not advised to take extra Fe, since it is pro-oxidant, damaging to liver (Fe stores - accumulation, etc).
The short of it, my doctor has little interest in my condition. Keeps saying: everything seems normal, or within normal range.
Can anyone suggest a cause for this mixed-up state of health. What's wrong with my health?
Is it hyperthyroidism, hypothyroid, anemia.
Thank you.
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tka700man
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Hi Marz. Thanks and sorry for lapse. Done B12 test few times. Results which do not have right now, yet recall as being always at top end of range. No issue there i'm afraid.
It'll probably take along time for your liver to get back to "normal" and the liver is responsible for so many processes that it is not surprising that some of them are failing.
If you can digest it (pancreatic/proteolitic enzymes or lipase?) fat is a good antidote to constipation (rather than fibre which tends to make everything dry, bulky and painful).
It takes a long time, so don't rush in with high doses of something for a short time and then give up. Moderate doses of whatever you need, as much as possible from diet (you probably need zinc - pumpkin seeds and oysters) and plenty of clean drinking water. Eat liver occasionally for iron, gentler than a supplement and you aren't over the top of the range. if lots of high-iodine kelp was too much, try sea vegetables in a stew or casserole a few times a week.
Your TSH is OK and FT4 is low, so not primary hypo, (but could be secondary hypo) any other hormone deficiency symptoms? Diabetes?
I would also get a Free T3 blood test and this is an excerpt of why:-
FT3 = FREE T3
T4 converts to T3 and is the only thyroid hormone actually used by the body's cells.
The approx. reference range for Free T3 is 4 to 8.3
We at Thyroid UK believe that you need to know your Free T3 level too because this will often show low if you are not converting, and high if you have blocked receptor cells. Even if you are converting, the body needs the extra T3 that a normal thyroid produces. There has been some research to show that people feel better on a mixture of Thyroxine (T4) and Triiodothyronine (T3). Effects of Thyroxine as Compared with Thyroxine plus Triiodothyronine in patients with hypothyroidism – The New England Journal of Medicine Feb.11, 99 Vol. 340.
Well, your doctor didn't do all the right tests, did he. He didn't do the FT3 (they rarely do) but that could be low - especially as your FT4 is so low. Which would mean, as your TSH is 'nice', that you have a pituitary problem.
And he didn't do your anti-bodies - TPOab and TgAB - which would mean you have Hashimoto's Thyroiditis, autoimmune hypo. The antibodies could give you symptoms even before the thyroid hormones got too low.
Over-indulging in things like alcohol, tabacco, drugs, is often a sign that something is wrong in the body, or something is missing, and you are craving these things in an effort to feel well. Then, when you stop, all the symptoms that you've been avoiding come flooding back in force. Plus you were supplementing vits and mins, which would have helped camoflage the symptoms even more. However, the kelp wouldn't have helped! You feel well on it at first, but then... as you found out.
Most of your symptoms are hypo-like symptoms - although I've never managed to find out what the red palms signify! So, I think you should persist in looking into the thyroid - although you sound more hypo than hyper.
As you've been deficient in so many other things, you are more than likely to be low in magnesium. Taking some magnesium citrate would help with the constipation, as would taking vit C - vit C helps with most things!
So, what exactly are you taking at the moment - if anything?
Goosie, red palms = liver damage. He needs to find out what his GGT and alkaline phosphatase levels are. Ferritin is low which is somewhat odd because damaged liver cells = high ferritin, high B12... everything is leaking. High ceruloplasmin as well.
Since T4 is converted to T3 mostly by the liver, if the liver is damaged then conversion will be compromised. And you are right: fT3 should be tested. Cirhosis is not reversible. Fatty liver is. So once someone has cirhosis, they have to stay 100% away from booze.
Well GK, I have the red palms, but I Don't have liver damage. Dr D did all the tests to find our why I had red palms, but couldn't find anything. So there must be other reasons for them.
I have no medical training. Anything I suggest should be researched and double checked first. You follow my suggestions at your own risk!
Chronic constipation. Fiber supps don't work as well as while drinking!
C 500 mg
Vitamin C will help with constipation if you take enough. Your dose of 500mg is not a high dose. I would suggest buying Vitamin C powder (ascorbic acid powder) from Amazon or other supplement sites - plenty of brands are available. Mix the powder with water, drink it through a straw, and rinse your mouth thoroughly with water after taking it. Being an acid it isn't good for your teeth, and it can be a bit unpleasant to get down too, but it is the cheapest and easiest way of getting vitamin C. If that doesn't appeal to you, buy some ordinary supplements and take several a day. Don't buy fizzy vitamin C supplements. Start with 1000mg per day, take that dose for 2 or 3 days and see how you feel. Then increase by 1000mg and repeat. Eventually you will get to a dose that will cause diarrhoea. Once you get there, reduce your dose by 500mg or 1000mg and keep to that dose. I wouldn't take more than 5mg in total though, but that is a personal preference. I take about 3mg myself.
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Fe 23 umol/L (range 8-32).
- Ferritin 58 ng/ml (range 24 - 336). During the drinking years, was around 200 ng.
Ferritin is the molecule your body stores iron in when it is not "in use". There are certain conditions under which the body will preferentially store iron in ferritin rather than making it available to the body for use. Inflammation or infection will raise ferritin and lower serum iron.
When you were drinking a lot your gut was almost certainly badly inflamed. So, your high level of ferritin when you were drinking was probably caused by inflammation. I don't know which alcoholic drinks contain iron, so depending on what you drank that may have been part of it too. But my money would still be on inflammation in the gut.
Now that you have stopped drinking the inflammation in your gut has probably reduced a lot. So the ferritin your body was storing has started to be used up, possibly in repairing damage to your body from the drinking, instead of being kept in store. As a result your ferritin is now quite low. There is disagreement about what is optimal for ferritin. I aim to go for mid-range (about 180 for the reference range you quoted). Some people suggest going quite a bit lower (about 100 - 120 for men). The choice is yours... You would probably feel better if you took iron supplements, and it may help your hair problems and your breathlessness. But be aware iron supplements might make you constipated. If it does you could increase your Vitamin C to compensate.
If you take iron supplements you need to get regular blood tests - every 3 months might be okay, but it really depends how fast you absorb it. Too much iron is poisonous because the body can't get rid of it very easily.
I wonder since you have cirrhosis whether iron supplements might be bad for your liver. So I would suggest doing lots and lots of research before you even consider taking iron supplements of any kind. If you look at the link above the ferritin or haem/heme supplements that are suggested may work better and be safer for you than standard iron supplements.
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If your B12 level is high, it might be due to the 50mg B Complex you take. I would bet that the B12 that is in the supplement is cyanocobalamin. There are four different kinds of vitamin B12.
Cyanocobalamin, hydroxocobalamin, methylcobalamin, and adenosylcobalamin.
Cyanocobalamin is the least bio-available. It might get as far as your blood stream and then do little else. Another comment... The 50mg B Complex makes no sense biologically. Why would the body need exactly the same amount of every B vitamin? It is just a convenient selling point, but it really isn't a good product. (Did it come from Holland & Barrett, by any chance?)
I would like to suggest you try the following instead (both available from Amazon :
Take one a day of both of them. The first one, you just swallow. The second one (the methyl B12) needs to be put into the mouth and allowed to dissolve as slowly as possible.
There may be some side effects from the methyl B12 to begin with - mouth ulcers, spots, perhaps. But they do wear off eventually.
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My final comments... I'll put in another post cos this is getting too long.
If you used alcohol to help you "deal with" stressful circumstances in the past, and your "crutch" (the alcohol) has now been taken away, then your body might be over-producing cortisol and adrenaline permanently as a response to the stress of dealing with things you have previously ignored or dealt with with alcohol. This could cause quite a few of the things you have been dealing with :
- sweating.
- Severe insomnia.
- Confusion, short memory, irritability, with frequent panic attacks.
At start I thought I was hypothyroid (as I gained weight of 20 pounds).
Weight gain, sweating, severe insomnia, the mental symptoms... All could be explained by too much cortisol and adrenaline. And high cortisol makes the body resistant to thyroid hormone, making you feel hypothyroid.
Did you go through alcohol withdrawal with medical help? Or did you go it alone?
The woman in the program is tested for cortisol, and hers comes out very high indeed. She is given advice on how to lower it. You might benefit from doing what is suggested to her.
2) Get the same saliva test given to the woman in the program. It's a very good test, and many of us on this forum have done it.
Thank you all for trying to help/explain my condition. All content noted, appreciated.
I been under so much psychological stress for months now, that I - honestly - cannot fully comprehend or respond to each comment/recommendation separately. Classic case confusion.
My intrinsic view (call it confused if you like) of what happened to my general state of health:
1. when I was heavy drinker, my life - in general - was much better (as in bearable). I needed all the health supplements I can get to support alcohol, like A, Bx, C, Zn, etc. Now that it's been a while that I don't drink, and staying with same level of supplementation, was probably a mistake!
During my long years of binge drinking, I consumed junk food, healthy meals from time to time, was in better state of mind (happier), was more active, etc.
Now that I quit, and eating close 90-100% healthy diet, meals, etc. Why should I have continued with the supplementation? I do not need it in presence of daily fresh cooked, healthy foods/meals?
2. Liver toxicity? No sign, yet who can tell, even my doc can't. Says: overall health good, except for hi TB, low WBC (described it as "strange". No explanation).
My regimen of supplements of late:
No Vitamin A supps at all. Avoided eggs, liver. Anything with preformed vit A.
Bx 50 daily - addicted to it, can't stop! Very much believe it helps with stress.
C 500 caps (sometimes 1000 mg).
D3 50,000 weekly.
No Ca, No Mg. All forms Ca, increase constipation.
As to Mg, any dose makes me feel unwell next day, reason unknown!
No Zn. Taking Cu 2 mg every other day. Plus high Cu content foods (Sesame, etc).
E 400 every other day.
I am thinking - as I've done alot of research on this via Mayo Clinic, Merck Manual etc - that my problem lies in the thyroid. Something in my food, supps that I am taking makes my thyroid functioning at sub-optimal rate. I do not care what the lab results show (normal ranges etc), my ill state of health (mental and physical - eyes, fatty face, brittle hair) are all related to the thyroid, one way or another.
An imbalance of Zn/Cu, or Zn/Fe, or vitamins A/D, causes thyroid function issues. And that's what I think I have. Thyroid. Only need confirmation of specific cause. So i can deal with (convince doc to diagnose and treat).
Thank you all for your input, wishing you the best of health.
tka, I Don't doubt it's your thyroid. You really do need to see that FT3, so your next step, to my mind, should be to get that tested.
Have you had your Zn/Cu tested? If not, I'd be interested to know why you think you need to supplement your Cu but not your Zn. Zn deficiency is more common than Cu deficiency, and excess Cu can make your really bad!
'Bx 50 daily' Is that a B complex? 50 mcg? Not enough of anything to do anything.
If you're taking all that vit D3, you should really be taking vit K2 with it.
Yep, just did Zn/Cu test, waiting for result, as mentioned earlier.
I got hi serum levels of Zn, while very low Cu. Even when I overdosed on Copper (4-6 mg per day), tests still show bottom of range! Ceruloplasmin (Copper carrying protein) also very low (Please see * note below).
And yes it is my view that this all has to do with some thyroid malfunctioning. But, what are the main parameters of thyroid malfunction? It's either hypo or hyper. And that's where the confusion sets in.
Interesting to find, one of the main features of presence of a thyroid problem, is facial features. And the simplest way to detect that is from photos/pictures! Over last 12 months, been to many parties, social gathering, etc. As expected in such settings, people do take group photos. I'm the only one, with abnormal face, everyone else looks normal. What's abnormal: tired, puffy face, eyes. All folks, old and young, have normal facial features. Even overweight men, women you can see their features as normal being (deflated, rested, or whatever you call it). My face stands out in every image, as sick, tired, in an unusual, medically baffling way!
I thought probably was the lack of sleep, or stress. Yet even with meds to support restful sleep, anxiety, face/image same. You may think that i am just being self-conscious. Nope. Family and relatives ask: you look terribly tired, what happened to that once-handsome face!
Ref the Bx 50. that's in mg not mcg. U know the popular B complex supplement dose at every health food shop.
As for K2. Not taken - far as I'm aware - anything with this ingredient in it. Why should I, when as I understand, it is readily available in many green foods , meats, etc.
Alright back to thyroid testing. Could it be that diagnosing or examining the thyroid, is NOT straight forward science? Lab results that seem perfectly normal for some, may not be for others.
I plan on consulting a specialist in thyroid issues. Until I find one, should know in advance what tests, exams to ask for. The usual TSH, T4, in no way sufficient indicator of underlying thyroid problem.
* I like to discuss this persistent Copper deficiency issue separately, but do not know where to post the subject.
OK, well, that’s very strange about the copper, but I’m afraid I have no idea who or where you could go for that.
‘what are the main parameters of thyroid malfunction? It's either hypo or hyper. And that's where the confusion sets in.’
Well, between the two, that gives you quite a bit of lea-way!
Hyper would be a suppressed TSH, <0.01, with FT4 and FT3 way over-range. That’s not you. Hypo is low FT3 - bottom of the range, Under the range, anything that's too low for you and gives you symptoms . It's not really confusing at all.
But you’re forgetting Hashi’s, which swings between the two, and can also give you hypo and hyper symptoms at the same time. To know if you have that, you need to get your TPO antibodies and TG antibodies tested.
It is very rare to find the reason for our hypothyroidism – unless it’s due to Hashi’s – which is the most common reason. Finding the reason for our Hashi’s is equally difficult, and you won’t find a doctor anywhere interested is spending time on it – especially not in the UK.
Yes, I know about the moon face, baggy eyes, etc. Unfortunately, doctors don’t know about it. And, no, I don’t think you’re just being self-conscious. My once-pretty face has also disintegrated! And it’s not just age. And it’s heart-breaking.
OK, so, have you had your Bs tested? More than just the B12, I mean. Because if you have a particular deficiency, then a B complex is not going to address it because there won’t be enough of anything in it. And beware of taking too much B complex because too much B6 can be bad.
‘As for K2. Not taken - far as I'm aware - anything with this ingredient in it. Why should I, when as I understand, it is readily available in many green foods , meats, etc’
Ah, now that is a very interesting question. Why do you think you take any vitamin or mineral when it is readily available in many foods? Why do hypos have to take bucket-loads of vitamins and minerals? Because, when you are hypo, you usually also have low stomach acid, and can therefore not rip the food apart to extract and absorb the vitamins and minerals, and end up with a load of deficiencies.
Low iron, which you also have, can also lead to low stomach acid. So, you’ve got the double whammy there! Therefore, it would be a good idea to take some vit K2 (NOT K1, which is for blood clotting) with your vit D3, to make sure that any calcium gets into the bones, and not the tissues, which could give you a heart attack or kidney stones. Vit D3 raises calcium levels.
‘Could it be that diagnosing or examining the thyroid, is NOT straight forward science? Lab results that seem perfectly normal for some, may not be for others.’
Absolutely!!! It is NOT a straight forward science. And doctors know so little about it that it becomes extremely difficult to get diagnosed and properly treated. Those whose labs don’t fall into a strict, extreme pattern that doctors can recognise can go undiagnosed for years – if you can even get your doctor to do the labs. But they know so little about it that they rarely do the right labs – or any at all.
I sincerely hope you manage to find your specialist in thyroid issues. And if you do, will you let us know, please, because we’re all looking for one.
As I said before, you need
TSH
FT4
FT3
TPOab
TgAB
Minimum. If you have consistent TSH low in the range (not suppressed, around 1.0) but also low FT4/FT3, then you must ask to have your pituitary tested – sorry don’t know which tests for that, but an endo should know! Because in that case, it will be your pituitary – or even your hypothalamus – at fault, not the thyroid gland itself. However the results are the same – hypothyroidism. In that case it will be called secondary – or central – hypothyroidism.
There are many routes to take, it’s just that doctors don’t want to take them!
Many thanks GG for a thorough comment, valuable info and suggestions. Will try to follow as I can, when I get the right doc to look at my case, tests/results.
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