Thoughts on this please

[Clementik]

Hi,

been on 100mcg levo for 12 weeks then endo tested me, normally they test me after 6-8 weeks but now gave me extra time to try to lose some weight too due to low testosterone which they think is more due to my fatty liver and lower SHBG rather than pituitary problem.

Had tested FT3, FT4, TSH, LH, FSH, Testosterone, SHBG, Prolactin, Cortisol, IGF-1, Ferritin, Albumin.

Unfortunately I have just access to this results

TSH 4,59 (0,34 - 5,6)

FT3 6,1 (don't have range)

FT4 12,8 (7,7 - 15,1)

Been told to increase from 100mcg to 125mcg and retest in 6 weeks with Liver profile and Prolactin.

Prolactin I have out of range

Prolactin 551 (55,4 - 276)

9 months ago was 255

LH, FSH borderline low but in range

SHBG, Testosterone improved

SHBG 25 (10 - 50) was 13 before

Testosterone 10,5 (10 - 27,6) was 7 before

I lost 11,8kg of weight (10%+) - so they think if i lose more result will be even better

Face pace walking (10k steps a day) plus very light weight lifting helped a lot but stoped before testing as I felt that higher TSH and been not able to continue

Cortisol 409 (don't have range but been told it's in range)

Albumin 46 (35 - 50)

IGF-1 and Ferritin results don't have

They also said pituitary MRI do not need as hypogonadism improving with weight loss and prolactin not over 1000 but will be monitored. Have blood test form for 6 weeks time to check FT3, FT4, TSH, Prolactin and liver profile. Going to try loss another 10kg and this levo increasment from 100mcg to 125mcg maybe the last one and i can be on final dose after one year hopefully.

Have facial and forehead pains but more linked to nasal problems rather than pituitary, got ENT appointment in 9 days due to my chronic swollen turbinates in nose.

Have some symptoms and some of them are weird

brain fog and forgetfulness, dry hands, low libido, muscle tension, limited to exercise, tired/weak.

often skipped heartbeats, resting pulse bellow 60, rapid changes in blood pressure and heart rate when standing or moving look like mild autonomic dysfunction and constant dizziness also maybe some circulation issue in legs and head ?! getting loss in that but ECG fine even 24h jolted monitor was ok.

High fasting/morning glucose level and feel bad after high carb meal or eating sweets. last HbA1c - 39 but my body handle glucose fine just fasting is high must have some kind of insulin's resistance.

Hope this will improve with new dose which I started from today and also for first time mixing brands i trying 100mcg accord brand with 25 mercury pharma asi i'm tired to cut this little crumbly tablets.

By the way better to treat my problems with specialist rather than GP's can see huge difference.

I started gluten free since new years and avoid sugar in any form and eating low carbs plus recently get rid of dairy too. Feeling better but still not there and some of the symptoms making me worry.

I'm 32 y.o male with anxiety for all my life

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If you guys can share your thoughts on my current TSH, F3, F4 and levo increment from 100mcg to 125mcg or some thoughts on my journey.

Also if anyone hypothyroid got high prolactin ? It can be common in hypothyroid males i read but with dose increasment should go back to normal range and my going up rather than down.

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I felt bad since 2017 till 3/2024 i been told multiple times my thyroid is ok then my TSH was 8 finally high enough for them not to say is ok anymore later find out i had positive antibodies. Been happy to find my problem and what it cause finally after 7 years of struggling then though is enough just to take medicine but i been wrong without life style changes it been still hard.

Love you all and wish you all the best with your journey

SlowDragon

[Jackblack46]

With a total test of 10.5 and SHBG of 25, I would imagine your free test is low? I would look at lowering your prolactin.

[Clementik in reply to Jackblack46]

It been borderline low, still in range ...

Can you help how to lower prolactin ?

[SlowDragon Administrator]

Prolactin is often high with Hashimoto’s

pmc.ncbi.nlm.nih.gov/articl...

Your high TSH suggests you need next increase in Levo

Was test done early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

Free T4 (fT4) 12.8 pmol/L (7.7 - 15.1) 68.9%

Ft4 is currently quite high in range

Ft3 …..obviously need range

Very well done on your weight loss and changing to gluten free and dairy free too.

If you’re staying dairy free you need to look at eventually changing to lactose free Levo

But don’t change brand at same time as changing dose

Only change one thing at a time

Vencamil is lactose free and mannitol free. originally only available as 100mcg only, but 25mcg, 50mcg and 75mcg tablets became available Sept 2024

Prior to March 2023 Vencamil was called Aristo

Vencamil often very well tolerated/best option for many people

How to get prescription written for Vencamil

healthunlocked.com/thyroidu...

How to get Vencamil stocked at your local pharmacy

healthunlocked.com/thyroidu...

Posts discussing Vencamil

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu....

[Clementik in reply to SlowDragon]

so my prolactin of 551 is ,,normal'' when Hashi ...?! Just read it now that study shame just 17% of them been males and just 2/3 been with high prolactin but giving it good view into problem, thanx for that

Yes it was done at 8:20 just two glasses of water with last levo 23h before test

Sorry but don't have range for FT3

and what's than mean if my FT4 is 68,9% you described quite high in the range ?? what's that mean ? is it good time to increase ?

My TSH should be keep bellow 3 if still feel bad under 2,5 closer to 1 my endo say is that sound how it should be ?

Thank you, to lose weight with low testosterone and not being even on my final dose of levo been quiet hard specially on low carbs.

so that little tablet is not lactose free ? I don't even know that, I mean i eat 99% gluten free, 99% dairy free so I will probably not change medication as i really like accord one but you say not to do increasment and changing brand at same time but till now I was on 100mcg accord and added 25mcg mercury pharma is that ok ? or good approach ?

thanx for your answer you always helpful and i learn something new here from you

[SlowDragon Administrator in reply to Clementik]

Yes try the increase and see how you get on

[Yorkshirelass11 in reply to SlowDragon]

I've had hypothyroidism for 2.5 years now and not felt very well even with medication. Pharmacy was giving me different brands of it without me knowing that different brands of levothyroxine was made up differently. I approached my doctor after researching my medication to let him know that when ever I was taking the accord I was feeling very poorly going into an hypo cold like wrapping loads of blankets around me sitting in front of fire till my temperature rose. Sore area around heart. Pain top right of chest. Very bad slugishness all the time, low mood, pins and needles in right arm and hand. So asked to be kept on Aristo. Pharmacy couldn't order it in not available from their supplier. So rang company Aristo,told to order vencamil, told doctor and Pharmacy. No medication for nearly a week had bloods done. Came back abnormal. Doctor wanted to put me on higher dosage. Explained about missing medication and that I thought I was being over medicated and wanted to drop to lower dosage. Since being on vencamil 50mcg everything has settled down appart from I've been left with pins and needles in my right arm and hand very regularly throughout the day.

[SlowDragon Administrator]

How much vitamin D are you taking as maintenance dose

Ideally you still want vitamin D a bit higher around 100nmol

[Clementik in reply to SlowDragon]

I taking 4000ui a day and once a week 8000ui, not sure how my vitamin levels are but was 33 vitamin D and i had muscle pains but after vitamin D therapy goes to 78 and felt improvement ... I got at home bluehorizon test but not done it yet as still endo or GP testing my hormones but now I got another endo test in 6 weeks but in between after 3-4 week will do that blue horizon test to check vitamins and if my tsh do not drop to low maybe be around 100 or 125 now but my be very wrong tho

[SlowDragon Administrator in reply to Clementik]

You could save the Blue Horizon test as testing at 3-4 weeks is early

Perhaps just test vitamin D in 2-3 weeks

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

[Clementik in reply to SlowDragon]

I need to check D, B12, Folate, Ferritin, Magnesium

[sparkly]

Well done on the weight loss. I'm basically the female version of you. I had fatty liver for years and couldn't lose, only gain. I basically had metabolic syndrome.I had low testosterone and low shbg. I starting testosterone replacement 3 years ago and it was life changing. Gave me the energy to start strength training and walking. It also got rid of brain fog, got rid of all my aches and pains and gave me a general well-being feeling.

Is there a reason why they won't prescribe testosterone? As a young male testosterone is important and you are only just in range.

My shbg has slowly risen over the last 3 years but that is likely down to my increasing t3 dose.

Your last lot of bloods are also not really the norm. Tsh of 4.12 but ft3 6.1 and your on thyroxine. You'd expect your ft3 to be low, not on the high side.

I'd push to get on TRT, this would hopefully start to make you feel more yourself. You've jumped through their hoop and lost a good amount of weight, they should prescribe now.

Also, something else that i think helped with fatty liver was taking berberine supplement, 1 before each meal.

Cycling it, 2/3 months on then have a break for a month before taking again. Also my cholesterols are now normal, kidneys normal, crp normal.

High protein diet, hydration, exercise and minimal alcohol are massive factors.

[Clementik in reply to sparkly]

Hi sparkly, thank you for your comment ... I was able to lose weight but it been hard and start to feel worst a bit feels like i was against something more, then had dizziness etc ... after i lost 11,5kg my testosterone go from 7 to 10,5 and shbg from 13 to 25, will see if i will be able to lose more weight and if it will improve even more as my bmi still 34 so still lot to work with ... when I read what everything you had improved after testosterone sound like i need it too hahaha in my case it's getting better but I'm still not on my final dose of levothyroxine yet either or this one i increased two day ago may be the final so will wait 6-8 weeks and see how my hormone are then if not improvement needed give it some extra time it can all sort out when on final dose for few months then if not testosterone 15+ or 12+ at least after more weight lost and extra time while on final dose levo then will ask for TRT

I'm only on T4, I want my tsh bellow 2,5 best between 1-2 , FT4 in higher half of range and FT3 slightly above mid range but my current results are bit messed up due to changing lifestyle a lot and diet, weight loss etc all together

as i said i will keep eye on it and will do everything I should do and see if being on final dose will improve it if not will ask for TRT of course I'm still young want to enjoy life

Got berberine on my list as i read it can help with insulin resistance as i having high morning glucose level with good HbA1c

CRP will check soon, my cholesterol improved since on levo a lot , kidneys test been ok just slightly higher BUN