PLEASE Help for hypothyroid guy starting NP school

Hey guys! This forum is amazing, such an incredible resource! I'm a 27 year old male. RN beginning a Psychiatric Nurse Practitioner program in May. Lots of stuff going on and I'd love some feedback.

First labs. I can get numbers later but FT3 is low out of range, FT4 is just barely in range, TSH totally normal around 1.5. WBCs are low and have been going lower over the past few years. Ferritin is 49 but was 7 last year. Serum B12 has ranged from low to off the charts. Serum folate is okay. Testosterone very low but has also fluctuated.

Wanted to see FM doctor but can't afford it. I ended up seeing a semi alternative doc but his knowledge is limited and I ended up explaining a ton of physiology to him.

Symptoms are many but crushing fatigue, slow progressive weight gain, worsening anxiety and sleep issues are the most difficult to deal with.

Two months ago he put me on 1/2 grain NDT twice a day. I feel no better, still very low pulse and temp. Money is limited so can't do anymore labs right now. I'm relocating for school and seeing him tomorrow. What should I request? Increase NDT and/or add T3? He didn't seem to keen on rxing T3 but I feel like it could help. Will I be okay buying either/or myself? I just want to feel better, especially as I begin this rigorous accelerated program. Hope some of you geniuses can help me out! I'll be so grateful!

6 Replies

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  • Welcome to the forum, Josh1989.

    I think you are under medicated. Ask for NDT dose to be increased. There is T3 in NDT so no need to add T3 at this stage. Most people taking NDT will be comfortable with FT3 in the upper third of range which will almost inevitably suppress TSH <0.1. FT4 will usually be low in range but that isn't important when FT3 is good.

    labtestsonline.org/understa... will explain high and low FBC evaluations.

    Ferritin is optimal halfway through range. Low levels of iron/ferritin may make it difficult to tolerate NDT dose increases. You can supplement iron with 1,000mcg vitamin C to aid absorption and minimise constipation. Retest 4-6 months after supplementing and take iron 4 hours away from NDT.

    Why is B12 fluctuating. Are you stopping and starting supplementing?

    Hypothyroid men may have low testosterone levels. Perhaps your doctor will prescribe testosterone.

    health.usnews.com/health-ne...

    hypothyroidmom.com/hypothyr...

    You might be interested to know that hypothyroidism can cause significant psychiatric illness.

    healthunlocked.com/thyroidu...

    hypothyroidmom.com/when-thy...

  • Wow! Thank you so much! I have been fascinated with thyroid/endocrine physiology for some time now and can't wait to consider it in my psychiatric practice. Your advice and resources are so helpful. B12 has fluctuated for no reason, some interesting research on that. I will continue supplementing iron. Should I accept testosterone even if thyroid is the root etiology? Should I advocate for increasing to 2 grains daily? I will likely not be able to see him for a very long time after today.

  • Josh1989,

    NDT is usually increased in 1/2 grain increments at 2-4 week intervals. If you won't be seeing your doctor for some time you can ask him to prescribe 2 grains. If he won't you'll have to find another doctor or self medicate.

    I would accept testosterone if you can get it. You can wean off it as levels improve.

  • Thank you so much. How difficult is it to get my own NDT? I tried Thyrogold a couple of years ago with no improvement in symptoms or labs. Therefore now I'm wary about buying online.

  • Josh1989,

    I'll PM you some sources. I think it unlikely that US online pharmacies will ship to USA.

    ThyroGold, assuming you took sufficient, does contain active T4 and T3 so should improve labs.

  • Thank you so much. At work but am going to message you later.

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