Low Androgen / Low DHEAS / Low Testosterone & a Benign Thyroid Nodule - Extreme Fatigue - Feel Like Death :(

[Sparkle44]

Hi I would welcome any thoughts on my blood results as I have to wait 6 weeks before I see the Endocrinologist to discuss them.

My hormone levels are outside the normal range (Androgen/testosterone/DHEAS) and they are continuing to fall.

I feel like death! I have zero energy; my hair is falling out; skin haggard; brain fog! So many symptoms!

Below are my blood results from 8/02/2018

I am 45 years old & I am not going through the menopause & my periods are extremely regular - pin point accuracy each month!

(Normal ranges are in brackets)

Free Androgen index 0.5 (1.0-6.0)

Testosterone 0.3 nmol/L (0.5-2.6)

DHEAS 0.9 nmol/L (1.6-7.8)

SHBG 59 nmol/L (40-140)

FSH 2.2 Iu/L

LH 3.2 Iu/L

TSH 2.0 (0.3-5.5)

Free -T 13.9 (9-25)

Cortisol 157 (130-580)

Prolactin 423 (100-510)

Total protein 75 g/l (60-80)

ESR 8 (1-15)

Oestradil 553. Pmol/l

C-reactive protein <2 mg/L (<5)

MCV 94.2 f/l (77.0-95.0)

MCHC 327 g/l (320-370)

I also had an ultrasound of my goitre on 30th January 2018 and they found the following:

The right lobe of thyroid contained a subcentimeter avascular benign nodule.

Conclusion - benign thyroid nodule!

** although, not sure how they know it’s benign as I haven’t had a biopsy, so this worries me!!**

I have other blood results so let me know what would be helpful in developing a hypothesis.

Endocrinologist said during my first appointment on the 8-02-2018 that there is no clear pathway for Endocrinology! In other words, questioning why I had been referred to Endocrinology??? He said women’s testosterone & androgen should be low and they are not keen on giving women testosterone! I literally am so fatigued I don’t take for granted waking up the next day! I am in desperate need of help!!! - He gave me this view before my blood results were back but he was aware that my androgen/ testosterone & DHEAS were low / outside the normal range, as that’s why I was referred to Endocrinology!

The only other diagnosis I have which I was given in November 2017 is Primary Lymphedema.

I look forward to your response.

Thanks,

Wendy

[Clutter]

Sparkle,

You need to add the lab ref ranges (the figures in brackets after the results) if you want members to interpret your test results.

TSH 2.0 indicates thyroid may be beginning to struggle but NHS won't diagnose hypothyroidism until TSH is over range, usually >4.5 - 5.5 or FT4 is below range.

Thyroid nodules <1 cm are rarely malignant and <1 cm is usually too small to fine needle aspirate or biopsy. If the nodule grows it will usually be FNA biopsied when it is >1.5cm or 2cm.

Do you have any results and ranges for vitD, ferritin, B12 and folate?

[Sparkle44 in reply to Clutter]

Hi Clutter,

Thanks for your response. I will add the ranges if it will help for my blood results.

Ferritin / folate / B12 results were done in December 2017:

Ferritin 30.6 ug/L. (13-150)

Folate 6.2 ug/L (3.9-26.8)

B12 799 ng/L (197-771)

Wendy

[Clutter in reply to Sparkle44]

Sparkle44,

Ferritin is optimal halfway through range. You can raise ferritin by eating iron rich food, liver once a week is good. You can also raise ferritin by supplementing iron with 1,000mg vitamin C but should retest 4-6 months later as too much iron is not good.

Folate is low in range. You can raise it by eating more leafy green veg.

B12 is mildly over range but you won't overdose on B12 as excess is excreted in urine.

For abnormal results Google for help ie "low Free Adrogen Index", "low testosterone", "low DHEAS". All the other results where you have added ranges are within normal range.

[Sparkle44 in reply to Clutter]

Thanks very much this is really helpful! Wendy

[Shalee in reply to Sparkle44]

Has your Dr. ruled out Graves Decease?

[Sparkle44 in reply to Shalee]

Hi Shalee, no.. Graves Disease hasn’t been mentioned. Do you think this could be a possibility for my poor health? I will google it and check it out. Many thanks Wendy

[Sparkle44 in reply to Shalee]

I have just checked out Graves Disease & don’t think it fits with me. My symptoms are closer to hypothyroidism rather than hyper, but thanks anyway x

[Shalee]

He has to do a ultrasound on your thyroid but so many times they miss it with blood work! Graves will be you very sick ! Your thyroid can cause problems all over including your heart,liver,spleen,kidneys excetra!

[Shalee]

That also can make you ill....my daughter has that! Prayers your way hope they find what ails you! 🙏

[Sparkle44 in reply to Shalee]

Thank you so much Shalee! I will get it checked out by GP! Best wishes & thanks again x

[Barrister]

Your Cortisol seems quite low. Maybe ask for ACTH and a short synacthin test to see if your adrenals are working properly. Last year I became extremely ill, I felt like I was dieing, and that isn’t being dramatic, because when I had a SST, it was almost zero. Clemmie

[Sparkle44 in reply to Barrister]

Hi Clemmie, I know exactly how you feel!! What was causing your symptoms and have they improved. If so, what helped? Wendy x

[Barrister in reply to Sparkle44]

I was diagnosed with adrenal failure/ insufficiency so I’m now taking hydrocortisone 4 times a day for the rest of my life. Definitely feeling a lot better but still have good and bad days.

[Sparkle44 in reply to Barrister]

I am sorry to hear that!! I am wondering if this is what is going on for me and if that’s why my androgen level is still dropping? I just want to feel better!!

[Apollo11]

Selenium supplementation may help you. I have been taking it for a couple of months now, felt quite ill / no energy before Christmas but since starting Selenium it seems to have helped quite a bit. Trouble is the thyroid needs this trace mineral which is now severely lacking in European soil / food.

[Sparkle44 in reply to Apollo11]

Thanks Apollo this is really helpful. Plus it’s good to hear it’s helping! Anything that helps me to function & feel less wiped out will be a God send right now! I’m about to spend my second day in bed. Slept 9.5 hours and don’t feel like I slept 5 mins. I feel so weak like my body is just giving up!!

[SlowDragon Ambassador]

You need vitamin D and both TPO and TG thyroid antibodies tested plus FT3

Private tests are available

NHS will refuse to test antibodies or FT3 as TSH is in range

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting. This gives highest TSH and most consistent results. (Patient to patient tip, GP will be unaware)

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's

Low cortisol and low hormones suggests something going on

Any gut symptoms like IBS or obvious reaction to gluten or dairy or nightshades (tomato, peppers, aubergine and/or potato)

Ever had whiplash or any head injury?

[Sparkle44 in reply to SlowDragon]

Hi slow dragon,

Thanks for your reply! I had the FreeT3 (free triiodothyronine) done on 8-2-2018. My results were - 4.4 (normal range 3.5-6.5pmol/L)

I don’t think I had the TPO & TG?? I am due to see the Endocrinologist again on 6-03-2018 so will ask him about these tests if he is still not clear what is going on. Someone suggested I might have Adrenal insufficiency, what are your thoughts about this?

I do have IBS and I have had whiplash in the past.

Wendy

[SlowDragon Ambassador in reply to Sparkle44]

Ask GP or endo to run coeliac blood test before changing to strictly gluten free diet

Essential to also test TPO and TG thyroid antibodies

Plus request vitamin D tested too

Definitely mention whiplash (though many endocrinologist are unaware there can be connection)

Your FT3 is on low side - suggests poor conversion. Can be linked to low vitamins or gluten intolerance and leaky gut

Endocrinologist likely to poo poo the effectiveness of gluten free diet, but majority patients find it helps, often significantly

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels can affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly.

Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's gut connection is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask for coeliac blood test first

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

[Sparkle44 in reply to SlowDragon]

I am so grateful for all your advice and amazing knowledge!! Thank you so much for taking the time to provide your detailed advice! You are a star!!! I will defo check out all you have mentioned! I am just praying I start to feel energised soon! I instinctively started cutting out gluten last year and will continue to do so as my body defo feels better without gluten x

[SlowDragon Ambassador in reply to Sparkle44]

It does have to be absolutely, watch out for cross contamination, e.g. You need separate toaster if toasting GFree bread

Look out for shared butter, jam, cutting board etc etc

Get antibodies tested now and then, assuming they are high (Hashimoto's) again in 6-12 months

Eating out at friends or family can be tricky.

Eating out at restaurants is getting easier all the time

it's good to get coeliac test FIRST

Heavy periods are classic sign of being hypo and can cause low ferritin. Your ferritin is too low at moment.

My own thyroid story on my profile

[Sparkle44 in reply to SlowDragon]

So just looked up Hashimoto’s disease and I have almost all of the symptoms!! I will defo discuss this possibility with Endocrinologist!!

Hashimoto’s Disease Symptoms:

Fatigue

Depression

Cold sensitivity

Constipation

Pale, dry skin

Brittle nails

Unexplained weight gain

Fluid retention

A puffy face

Hair loss and dryness

Joint pain and stiffness

Muscle weakness

Enlargement of the tongue

Forgetfulness

Enlargement of the thyroid gland (goitre)

In women, heavy menstrual bleeding (menorrhagia)