This is my first real post on this forum. I'd appreciate if experienced members could take a look at my labs and history and let me know what they think.
I'm a 46-year-old male from Canada but living in France for the past 10 years. I've had deteriorating health issues for close to 5 years (likely longer) and only recently did I figure out that most of my symptoms we coming from hypothyroidism and low cortisol (crushing fatigue, muscle weakness, low body temp, poor sleep, dry skin, blurred vision, weight loss, irritability, etc.) Worse in the morning, generally better in the pm.
I was able to source NDT (Thyroid-S) independently (doctors have been useless) and started taking it in March. I saw marked improvement after 10 days, and as I increased from 1 grain to 3 gradually I felt better than I had in a really long time, but that didn't last. I had a good 6 weeks or so before starting to feel worse again. I figured it was perhaps because of conversion issues as I have high RT3 (0,36 ng/ml (0.17 - 0.44)), so I decided to start taking T3. I gradually switched from the NDT to T3-only. At the moment I'm taking 100 mcg / day split in 5 doses 25mcg 730am 25mcg 1130am 25mcg 330pm 12.5mcg 10pm 12.5mcg 330am.
So this includes a dose at 330am because I have low cortisol and I'm trying the Paul Robinson's CT3M.
Right now I'm using sketchy Indian T3 from bodybuilding websites - it's definitely T3 but I think it might be underdosed vs what's advertised. I have Tiromel on the way.
While some of my symptoms have improved since May, I honestly feel like crap and at this point I'm not sure even sure T3 is helping.
Other symptoms have not improved or even gotten worse, I have severe vocal fatigue after a normal amount of conversing, my throat really hurts at the end of the day. This was definitely not as bad before starting T3.
I know it can take time to clear RT3. I'm not sure what the best move is, because I also have really high SHBG and low testosterone, which is probably only getting worse because of the T3 I'm taking.
I had 2 different 4-point saliva cortisol tests over the past 18 months, with a slight increase on the second on, but still low cortisol (both tests were prior to starting thyroid meds) :
feb 8 2023
8am 0.2280 µg/dL (0.113 - 0.803)
8:30am 0.2750 µg/dL (0.2 - 1.076)
10am 0.2070 µg/dL (0.083 - 0.574)
8pm 0.0040 µg/dL (0.032 - 0.322)
jan 18 2024
8am 0.268 (0.127-0.373)
8:30am 0.451 (0.223-0.729)
2pm 0.070 (0.054-0.206)
8pm 0.034 (0.001-0.079)
They are 2 different labs which explains the different ranges, I now realize is a bad idea to change labs.
I had a synacthen test which was normal.
These are lab results from before I started taking any thyroid medication:
RT3 0,36 ng/ml (0.17 - 0.44)
TSH 1.64 (0.27 - 4.2)
FT3 3.09 (2 - 4.4)
FT4 1.22 (0.93 - 1.7)
B12 400 pmol/L (145-569) - latest md I consulted said this lab's range is ridiculously too low
Selenium 129.9 (70 - 150)
Anti-TG : 16 UI/mL (<115 IU/ml)
TPO : 17 UI/mL (< 34 IU/ml)
TSH antireceptor 1,43 UI/L (< 3.1 IU/L)
Theses are my latest labs, taken while I was taking NDT, before I started T3 :
Blood cortisol 8:10am : 15.50 (7.4 - 23.30)
Saliva Estradiol (Estrogen) 3.37 (0,4 à 3,3 pg/mL)
Blood Estradiol 24.3 (11.3 - 43.2)
Saliva DHEA 326.8 (68 à 397 pg/mL)
Blood SDHA (DHEA) 6.45 (1.2 - 8.98)
SHBG 114 (18-54)
ANDROSTANEDIOL GLUCURONIDE 39.8 (8.5 -80)
PREGNENOLONE 79 (40 - 120)
IGF1 101,0 ng/ml (72 -225 median 139)
Free cortisol (urine) : 26 µg/24h (N: 6 - 62 µg/24h)
Free testosterone : 39,7 pmol/l (N: 30,0 - 87,0pmol/l)
Bioavailable testosterone : 3,0 nmol/l (N: 2,7 - 12,0)
Total testosterone 7.88 (2.49 - 8.36)
24h urine iodine : 122 µg/l (N: >100 µg/l)
Sodium 140 (136-145)
Potassium 4.4 (3.4 - 4.5)
Vitamin D 56 (30-60)
Vit B9 1843 (1187 - 2854)
Iron 16.1 (5.8 - 34.5)
Transferrin 2 (2-3.6)
TIBC 50 (50-90)
Transferrin saturation 32% (20-40%)
Ferritin 168 (30-400)
FSH 3.4 (1.5 - 12.4)
LH 5.4 (1.7 - 8.6)
Prolactin 10.2 (4.04 - 15.2)
Vit A 2.23 (1.46 - 2.84)
Vit B6 110 (51 - 183)
Zinc 12.8 (11 - 24)
Prior to starting T3, the last doctor I saw was an expensive "functional medicine" doc which seemed knowledgeable at first but I'm not too sure anymore. He prescribed DHEA (20mg /day) as he said this would help lower SHBG and raise testosterone, but nothing about the hypo or low cortisol symptoms. I started taking the DHEA plus other supplements he has prescribed (zinc, B12, CoQ10, berberine, glutamine). Within 7-10 days of taking the prescribed stack my fatigue had worsened and I had really bad leg pain, so I dropped the DHEA and zinc, took about 3 weeks for leg pain to subside.
I wasn't sure whether the DHEA was the cause because I had read it could lower cortisol, but I think the zinc might also be part of the problem since I read it could also lower cortisol in a much more potent way than DHEA. I tried DHEA last week for 3 days and it definitely has a negative impact. I'm wondering if it's perhaps converting to estrogen (which seems already high on saliva lab) instead of testosterone.
Could this also be indicative of low copper? I have low-normal zinc but can't seem to tolerate supplementing for some reason...
Someone reached out on another forum saying I could perhaps try Proviron to help lower my SHBG and hopefully free up my testosterone.
I'm taking ACE and pregnenolone but honestly can't say that it's helping at all, my temps are all over the place, I feel cold as soon as ambient temps are not hot or if I'm not moving. My BP is normal at 120/80 or slightly below, my HR has increased slightly since taking T3 which is a good thing as it was super low - sometimes low 50s.
I'm waiting on some HC cream which I think I'll be trying out soon and ditching the ACE, would appreciate input from anyone using that as well.
Thanks for reading this long post, and let me know if you have any advice. I also have more labs available, I just included what I felt was pertinent.