Undiagnosed Thyroid? And Training

[NotesFromUnderground]

Hi, this is my first post.

I used to run a lot—training up to 20 km. Then, after a period of work-related and personal stress, my body seemed to crash. It felt like I had fallen into depression. I felt strangely cold from within, had difficulty articulating words, gained weight, and experienced severe muscle pain lasting for days or even weeks after minimal exercise. My metabolism slowed down, and I felt like I could hardly eat. My smartwatch showed that my heart rate had dropped to a level typical of elite athletes, but my level of training didn’t support that, and for a time, my face became "puffy".

By the time I was able to see a doctor—several months after this "crash"—I was already starting to feel a bit better. My test results were said to be normal (T4 levels). A few months later, I had another test, including T3, which was also considered normal, but I remember my T4 to T3 conversion was poor.

Now, 2.5 years later, I’m still gaining weight, and training (except for walking and swimming) remains almost impossible due to the pain I experience afterwards. I still get brain fog from time to time, and I can't handle stress the way I used to. But overall, I’m okay—apart from the weight gain, which is really stressing me out, and feeling tired all the time.

I have been taking dietary supplements (following advice from this forum). I don’t know what to do next, but getting back to exercise is my priority—it has always been a source of joy, helping my sleep and mood.

If anyone has any advice, I’d really appreciate it.

[greygoose]

Hi NotesFromUnderground, welcome to the forum.

Just telling us that your blood test results were considered 'normal' is telling us nothing. Do you have the actual numbers: results and ranges? Doctors will tell you everything is 'normal' if the results are anywhere within the range, but the ranges are too wide.

Have you had antibodies tested? And did you get your nutrients tested before starting supplements? If you don't need something is not going to help you and could be dangerous. Also, nutrients have co-factors that need to be taken if they are to help. So, can you tell us exactly what you are taking?

The more information we have, the better we'll be able to help you.

[NotesFromUnderground in reply to greygoose]

Hi, thank you for your quick reply. I'll post an image of the results from about 2.5 years ago, three months after the 'crash'. By that time, I felt better. Of course, I do not know what the tests will be now. The column to the right shows my results; the column to the left shows the range considered normal. 'Fritt' means 'free'. I was taking vitamin D supplements at the time, as recommended by the doctor. Usually, the dark winters in Sweden mean we all need a bit of extra support. I understand you need the results, but it seems like the thyroid temporarily crashed and recovered, although not completely. I have the experience that I cannot stress my body in any way; then the symptoms return.

I could add that 2019, thyroid function was tested but then only P-TSH (same as above) and P4 (2019: 13 pmol/L). I´ve learned about something called "exercise intolerance" and I do seem to have developed that, and on a daily basis for years, I feel tired, beyond normal levels.

Results.

[greygoose in reply to NotesFromUnderground]

FT4: 15 pmol/l (Range 12 - 22) 30.00%

FT3: 4 pmol/l (Range 3.6 - 6.3) 14.81%ua

Weeeee-eellllll, your results were in-range, obviously. But that does not make them 'normal' Your FT3 was much too low for good health. 'Normal' (euthyroid) would be around 50% through the range, with your FT4 a little bit higher. With those results you were hypo.

However, a TSH of 1.7 is unequivocally 'normal' - though a little on the high side - but it does not correspond to the other results. One would expect it to be much higher with that low FT3.

Can you remember what time of day you had the blood draw for those tests?

Did you happen to have any sort of accident or blow to the head around the time you started to feel unwell - or any time before, come to that?

Because it rather looks like the problem might lie with your pituitary or your hypothalamus, rather than the thyroid itself. Not enough TSH is being produced to stimulate the thyroid to make adequate thyroid hormone. It's what we call Central Hypo. But, doctors know nothing about that, so they don't pick up on it.

So, your doctor recommended taking vit D - and he was right because it was low - but did he also recommend it's cofactors: vit K2-MK7 and magnesium? Vit D won't do anything for you without the right amount of magnesium.

So, what are you taking now?

[NotesFromUnderground in reply to greygoose]

Hi, I have a faint memory of the tests being done in the morning, but I can't be sure. No blow to the head or accident. Lots of training, though, and lots of stress in general. I wondered if elevated cortisol levels could have influenced thyroid function/TSH levels. But since I stopped training, it should have returned to normal, I guess, and not this exercise intolerance that I experience now. I didn't know about central hypothyroidism. I need to read up on that; it seems complex. Thank you.

[greygoose in reply to NotesFromUnderground]

Not that complex once you understand the basic of how the thyroid works. Don't let it intimidate you. But reading up on it is a very good idea so that you know what you're talking about when you confront your doctor - because s/he won't know!

[NotesFromUnderground in reply to greygoose]

Reading about everyone's struggles here, it’s clear that primary hypothyroidism can be difficult to treat properly. Central hypothyroidism seems even more complicated—not only to diagnose but also to manage effectively. If the issue lies not in the thyroid gland itself but in the signaling from the pituitary or hypothalamus, pinpointing the actual cause seems even more challenging. I really appreciate your time and effort.

[greygoose in reply to NotesFromUnderground]

But it's really not. Whatever the cause of hypothyroidism there's only one 'treatment', and that is thyroid hormone replacement. You just replace the missing hormones because there are no cures, whatever the cause.

The difficulty lies in the ignorance of the doctors treating us. They have next to no knowledge of how it all works.

It doesn't matter if the problem stems from a failing thyroid or the HPT axis, there's nothing you can do about either of them except replace the hormones that the thyroid can no-longer make for whatever reason. But doctors make it complicated because they don't know what they're doing but pretend they do!

Of course it is more difficult to get a diagnosis of Central Hypo because most doctors have never even heard of it - they certainly don't learn about it in med school. But there are doctors that know because we have quite a few people on here that have been diagnosed with CH. I would suggest that when you have decided that that is the most likely cause of your problems, you reach out to these people - through a post - asking for details of their enlightened doctors.

You're never certain of being able to pinpoint the cause of your hypothyroidism, be it Primary, Secondary or Tertiary. But that doesn't really matter because the chances of you being able to reverse it are slim to non-existent. You just take the thyroid hormones in a large enough quantity to make you well (but, admittedly, that's where the difficulties lie...).