Can anyone help me with my scary / puzzling / crazy blood results?

[Jessie]

Hi Jessie,

Apologies, this got lost in the shuffle. Interesting take RE: the bacterial overgrowth. I have not tried any antiseptics / antibiotics / charcoal etc. - I have used carrot salad, but there is only so much that can do I guess...

I don't have any obvious symptoms of infection that I would notice. Sorry to be graphic but: no acne, no fungal problems, no foul smells from anywhere, no ENT problems... but it is possible that there could be something in the GI tract that is a problem.

List of tests I was going to look into:
- blood test (hence this thread)
- allergy test (came back with no allergies present)
- food sensitivities test (not done yet)
- fertility test (was supposed to be today, but I chickened out due to these blood test results. I don't think my mind could take it if things came back looking bad).
- stool sample test - I know it's gross to talk about this, but it could give a clue as to any digestive issues that I was not outwardly aware of. Haven't looked into this yet.

I haven't tested FFAs but I would be surprised (based on my knowledge). I've been comparatively very low PUFA for over a decade, and have been high carb moderate fat (animal fat mostly) for c. 2 years. Not that this necessarily means FFAs are low, but still...

All liver biomarkers looked good - Alanine Aminotransferase (ALT), Albumin, Alkaline Phosphatase (ALP), Gamma GT, Globulin, Total Protein - all well inside the normal ranges. I didn't post these since there was little of interest there, and I didn't want to create a table too large to focus on.

Yes, my view on Total T and free T is generally that - once everything else is in order, then testosterone will probably be okay... still though, not nice to come back with a lower free T number. I notice my Total T translated to 666 ng/dL, which gave me a fright haha!

I worded that kinda poorly. What I meant is a high bacterial load can increase byproduct breakdown when they eat. Particularly some types of fiber, like fermentable soluble fiber. They break these food particles down and they essentially "belch," or "fart."

This byproduct breakdown process is what renders endotoxins. It's not really a typical infection, you're not really sick in the classical sense. But it can elicit a chronic low-grade immune response which is very inflammatory.

 

[Jessie]

On a side note, I've actually seen in a few studies where red light can reduce thyroid antibodies. So if you have a red light device, might be worth putting to use.

 

[BigShoes]

That’s not gyno, not even mild. By that standard. 90% of male population has gyno.
Taking thyroid is the last measure one should take to raise their metabolism. There are much more effective measures, especially at a young age.

Hello @GreekDemiGod. Thanks for your comment.

Personal topic that is close to my heart (literally). Apologies for anyone squeamish or shy - I will remove the photos / delete the post if it upsets anyone, but:

Age 24-25 - severe tenderness (verging on pain) appeared in my right nipple, which went away after about 6 months. But a small hard lump grew, and remained ever since. I went to an endocrinologist, who confirmed it was likely due to prolactin (apparently I've had metabolic issues longer than I realized). This is me age 25, not long after it happened:

Notice the lighter shading / mound around the nipple area on the left side of the photo (my right), just a couple of centimeters in radius. That is gyno.

Luckily, it is not obvious to most people (no one has ever commented on it), but it is most assuredly gyno. After it developed, I used to have to flick my nipples before a photo shoot (literally) or make sure I was cold, otherwise the puffiness would show through and look weird.

Before any of the gents ask - no, I have never used any PEDs. I know gyno is common in the bodybuilders who use testosterone, which aromatizes into estrogen when overused, which can cause very bad gyno issues. I was just a regular gym goer with an obsession with low body fat - I wish I could go back and slap some sense into myself, but don't we all......

In addition, I would say that a very significant portion of the male population *do* have gynecomastia. It is a trend that I have observed over the years since I first noticed the pain in my own and became so self-conscious about it. *Many* men have visible puffy nipples poking through under their t shirt - this is NOT normal (common, but not normal). Next time you go out in town, just look around...

I have had many theories about this over the years:
- exposure to plastics and xeno-estrogens in our food, and modern soaps / detergents
- poisoned tap water / birth control pill residue / other organic compounds in the water supply
- grain-based / seed oil based diets - & lots more soy consumption than ever before
- over-use / addiction to pornography and lewd content (prolactin release on orgasm)
- probably lots of people walking around with wrecked metabolisms (like mine) and high systemic inflammation - thus leading to high estrogen and serotonin in the gut, which then leads to high prolactin too. Estrogen and Prolactin are highly influential in breast development.


On your second point: I agree that there are other measures to raise metabolism, and that thyroid should be a last resort. I have been very reluctant to use thyroid for a long time now...... Some things I have already tried for months and literally years are as follows:
- Diet: 1:3 protein : carb ratios, high carb / sugar macros, gelatin, higher calorie surpluses, caffeine, dairy, eggs, organic meat, liver and oysters, all manner of sugars and sugar types, lots of potato
- Supps / Medicine: Aspirin, caffeine, B complex, calcium carbonate supps, magnesium, fat soluble vitamins, and since finding RP: Progesterone (10mg), Pregnenolone (10mg), DHEA (2mg) for a short spell
- Lifestyle: Getting to bed early, lots of gentle walks in nature, removal of screens and over-stimulating activities, stress management, reducing workout volume
- Red Light Therapy
- Massage Therapy
- Breathing awareness and "buteyko" type work to raise CO2 - "meditation"
- Prayer


Whilst there have been many positives to a lot of these approaches, the downward spiral in general well-being has continued. Is there anything I haven't tried that you would suggest?

Cheers.

 

[Sefton10]

Much of your background and many of your symptoms match up with mine, although I'm a bit older at 43. They're not as comprehensive, but my labs are quite similar too. Essentially, a hypothyroid/Hashimoto's profile.

I spoke with Ray over email around a year ago, and he told me antibodies will go down slowly over time as inflammation is removed or reduced and TSH comes down. I've managed to get my Vitamin D up quite well through supplementation, but the classic hypo symptoms, although improved a little, still persist. My thyroglobulin antibodies are still high.

In the last 2 weeks, I've started low and slow with Tyromix (easy to get to the UK) and have started supplementing selenium with myo-inositol. It's a bit controversial here and in Hashimoto's circles, but I started adding 200mcg of iodine too as I realised how little I was getting from diet (no dairy etc.).

I still haven't got a handle on the folate/B12 relationship, but that's something I'm exploring too, as they are really out of whack. It's been really helpful seeing others' responses to your post, as so many of our issues overlap.

 

[BigShoes]

Much of your background and many of your symptoms match up with mine, although I'm a bit older at 43. They're not as comprehensive, but my labs are quite similar too. Essentially, a hypothyroid/Hashimoto's profile.

I spoke with Ray over email around a year ago, and he told me antibodies will go down slowly over time as inflammation is removed or reduced and TSH comes down. I've managed to get my Vitamin D up quite well through supplementation, but the classic hypo symptoms, although improved a little, still persist. My thyroglobulin antibodies are still high.

In the last 2 weeks, I've started low and slow with Tyromix (easy to get to the UK) and have started supplementing selenium with myo-inositol. It's a bit controversial here and in Hashimoto's circles, but I started adding 200mcg of iodine too as I realised how little I was getting from diet (no dairy etc.).

I still haven't got a handle on the folate/B12 relationship, but that's something I'm exploring too, as they are really out of whack. It's been really helpful seeing others' responses to your post, as so many of our issues overlap.

View attachment 47438

Hello @Sefton10 - thanks for the comment! I'm very sad to hear you're experiencing the same situation - it's not nice at all.

Good to know you have managed to raise Vitamin D nicely - may I ask how much you were taking daily (IU)? I am not overly concerned about the vitamin D level in itself - whilst it is an issue to be sorted, I'm pretty certain I can bring it up to optimal through supplementation. I eat animal foods so should have no problem retaining, and was previously at 44ng/dl last year (110nm/L), so should be okay. As you have found though, I don't see the Vitamin D deficiency as the root cause of the symptoms, and don't think it will be a cure-all.

Interesting that you mention the folate and B12 - I did not have folate tested, but I suspect something funny is going on there for me too... I have vitiligo unfortunately (another soul-destroying symptom, but I have gotten used to it. Fortunately I was already pale, so no one can really tell) - the more I research about it, the more I believe it is to do with B9 and copper metabolism issues... it's a super complex issue that I don't believe anyone has gotten to the bottom of - but I don't believe the whole "autoimmune" line given by the medical consensus.

Funnily enough, I have also recently bought some Tyromix. But honestly, I don't think it is ideal. The reason being: it is in a carrier fluid, so it can be very hard to know the exact dosage you are taking. I would rather go with cynomel / cynoplus etc. - but very hard to get hold of here.

I have also supplemented some iodine in the past (small amounts), but haven't done for quite some time. I eat potatoes quite a lot, and I now try my best to have 1 cup of milk per day - so hopefully I will make up for any deficiencies quickly.

I'm glad the responses have helped - people have been so great to me here and I'm very grateful. I've seen a lot of your posts on other threads too actually, and I really like your outlook and input on things.

Cheers!

 

[Peatress]

“Limiting water intake (or using salt generously) helps to inhibit prolactin secretion.” Ray Peat

Aging Eyes, Infant Eyes, and Excitable Tissues

Ray Peat

raypeat.com

 

[Momma]

“Limiting water intake (or using salt generously) helps to inhibit prolactin secretion.” Ray Peat

Aging Eyes, Infant Eyes, and Excitable Tissues

Ray Peat

raypeat.com

Thank you for this.

 

[Sefton10]

Good to know you have managed to raise Vitamin D nicely - may I ask how much you were taking daily (IU)?

I started off at 10k for a few weeks then tapered down to 5k.

Interesting that you mention the folate and B12 - I did not have folate tested, but I suspect something funny is going on there for me too.

I’m hoping @redsun might chime in here as he usually has some good knowledge around these vitamins and their relationships.

Funnily enough, I have also recently bought some Tyromix. But honestly, I don't think it is ideal. The reason being: it is in a carrier fluid, so it can be very hard to know the exact dosage you are taking. I would rather go with cynomel / cynoplus etc. - but very hard to get hold of here.

Even the pills can be hard to dose unless you crush them up as the thyroid can be unevenly dispersed. If you give the Tyromix bottle a good shake each time the dose per drop shouldn’t too far off.

 

[Peatress]

“Limiting water intake (or using salt generously) helps to inhibit prolactin secretion.” Ray Peat

Thank you for this.

 

[aniciete]

I started off at 10k for a few weeks then tapered down to 5k.

Do you take any k2 with that dose?

 

[Sefton10]

Do you take any k2 with that dose?

Yes but it’s not a big dose

 

[BigShoes]

Do you take any k2 with that dose?

Some while back, I saw user @baccheion on a vitiligo thread recommending D:K2 dose as: 2mcg K2 for every 10 IU of D3.

This seems sensible to me, although it has been difficult to confirm through the literature. By @Sefton10 's D3 dose of 10,000 IU of D3, that would "require" 2mg K2 ->

10k IU D3 : 2mg K2 mk4

I'm not trying to peddle his supplements (in fact, I usually look for more readily-available alternatives), but for every 10k IU of D3, you would "require" just 1 drop of Idealabs' Kuinone (c. 2mg per drop).

 

[BigShoes]

Quick update:

(1) I've actually put the brakes on with thyroid supplementation. I'm unsure about it's necessity (and safety) for me, as well as reading some horror stories from people on here around the consequences of raising the metabolism when the body can't support it (e.g. rapid dental health decline!). Not necessarily a definite 'no' for trying T3/T4, but I'm still unsure.

(2) I've got some selenium tabs (200mcg), so am giving this a try to see what will happen.

Pulse and temperature log for the past week:

Measure	Time \ Day	06/02/2022	07/02/2022	08/02/2022	09/02/2022	10/02/2022	11/02/2022	12/02/2022
Pulse	Waking	75	78	75	71	70	75	75
Pulse	Mid Morning	80	82	83	85	83	79	88
Pulse	Afternoon	82	80	80	100	85	89	85
Temps (Axilla)	Waking	97.20	97.20	97.75	97.75	97.35	97.5	97.60
Temps (Axilla)	Mid Morning	97.35	97.20	97.55	97.40	97.40	97.65	98.00
Temps (Axilla)	Afternoon	97.30	97.40	97.40	97.65	97.30	97.65	97.40

Pulse was taken with an "oximeter" on the middle finger. Temps were taken as an average between the left and right axilla, hence the two decimal places (these were usually similar).

Some notes:
(i) quite high waking pulse - always above 70... stressed sleep, I guess? I certainly never feel rested upon waking, and haven't done for many years.
(ii) pulse usually in the 80s, which is fine, but could possibly be driven by the stress hormones - as mentioned, I often have cold hands.
(iii) waking temperatures are usually a little low (c. 0.5F below the 97.8-98.2) but did have a few days where I got very close to 97.8
(iv) temps never rise above 98.0F - the mid-morning temperature rise to 98.2-98.6 does not seem to be happening
(v) I measured my temperature under 97 (96.9F) for the first time in the past two weeks just this morning (14 Feb) - an anomaly.

It's possible that axilla measurements are slightly inaccurate. But I did measure my temperature orally a few times (with a different thermometer!), and got almost identical readings - so they seem to be accurate enough.

I'm not sure if there are other / better / safer ways for me to try to boost the metabolic rate / get out of the "stressed" metabolism state than just taking thyroid - bearing in mind I have already tried to implement a lot of the more general dietary / supplementation guidelines.

I will have been working in my "career" for 10 years to the day by the end of this week - sometimes I feel like the health problems might all go away if I just spent a year in the sunshine closer to nature but maybe that's wishful thinking.

I hope everyone here is doing really great. Thanks for reading, and for all of your help.

 

[Vinny]

Very interesting. Some symptoms are same. Will chime in again another time with details. Following your other thread too.

@BigShoes
I will have been working in my "career" for 10 years to the day by the end of this week - sometimes I feel like the health problems might all go away if I just spent a year in the sunshine closer to nature but maybe that's wishful thinking.

Lived for 13 years in Cyprus (300+ sunny days per year). It didn`t do a ***t. You can try anyway, for experimentation.....

 

[BigShoes]

Hi everyone,

Thanks once again for your help.

Quick update - I started thyroid replacement just over a week ago - c. 1/6 of a cynoplus and 1/6 of a cynomel - approx. 10mcg T3 and 20 mcg T4 per day for the past week (what a pain it is to break pills into 6 ...)

I haven't really noticed any positives yet, but it's still early. I did notice a slight up-tick in libido, and less hair on the comb in the morning, but this may just be the ebb-and-flow of life.

Worryingly though, for the last couple of days I have been experiencing some itchiness in my right nipple (see post #43 for appearance). Whilst things still look the same (no additional growth that I can notice) and it is not that bad yet, this is a classic feeling of the onset of gynecomastia - which I guess is estrogen and prolactin related.

After a quick search, I have seen other users on this forum (@GorillaHead and @Abc123 and more) mention gyno on-set from NDT and Levothyroxine (respectively). This was scary to read. I guess thyroid hormone itself is going downstream and being converted to more estrogen, and causing further elevations in prolactin?? Not good...

The nipple itchiness may be a total coincidence. It has very occasionally come and gone over the years, and is often coinciding with times of poor sleep and stress (I am currently in a bout of getting to sleep well after 2am - not good... but my stress levels are otherwise quite low).

After some more searching - I have seen that gynecomastia in men appears to be a common symptom of HYPER-thyroidism (e.g. here: Gynecomastia as a presenting symptom of Graves’ disease in a 49-year-old man). I wonder if even 1/2 grain of T4 is too much for me? In which case, is it even beneficial at all?? Am I even truly hypothyroid?? I still have not understood why the T3 and T4 blood tests can supposedly be in the normal range, but I can still be classed as hypo by Peat standards. The endocrinologist I visited here in the UK diagnosed me with euthyroid autoimmune thyroiditis. Meaning:

- TSH in the normal range (I know *we* know that 2.7 is quite high, but the medical establishment says "normal")
- T3 and T4 in the normal range
- Very high Thyroglobulin and Thyroid Peroxidase Antibodies

The Peat line of thinking seems to be: when TSH is elevated for long periods of time and the thyroid is under stress, the antibodies appear in response to the inflammation. i.e. it is not just 'random autoimmunity' (as the medical establishment opinion says) but it is in response to the inflamed state of the gland from the TSH pounding, and the thyroid's inability to keep up. I don't really buy this explanation though - because how would Graves' Disease even exist if this was the cause of the autoimmunity in the gland? People with Graves have a low TSH level (i.e. the pituitary is NOT kicking the thyroid into doing more work), so why the autoimmunity?

The Doctor's Recommendation: "take some time off work + diet and exercise adjustments. You will not benefit from levothyroxine, due to T3 and T4 being in the normal range."

... I'm in agreement with the first part of the statement - time off work is always nice and diet (MORE food) and exercise (LESS exercise) adjustments could certainly help.

However, I initially disagreed with the second half of the statement whole-heartedly. I had been pretty convinced by DR, RP and the like that thyroid replacement would do me some good, provided I was getting enough calories and micronutrients.

Nevertheless, I am still quite pensive... perhaps I am being too cautious, but any slight negative symptom that appears (e.g. nipple itching) is enough to make me panic and reconsider the whole thing...

Two quite unique symptoms that I have that appear to be associated with HYPER-thyroidism, rather than HYPO-:
- mild gyno (which appeared around age 24)
- vitiligo (which appeared around age 19-20)

Anyway, I'm rambling now. Thanks for reading, and for everyone's help. I'll continue on 10mcg T3 and 20mcg T4 for a while longer, try to get to bed earlier, and keep eating... I expect some replies will say to drop the T3/T4, but I am so sick and tired of being this sick and tired... I need to do *something*

Cheers.

P.S. thank you @Peatful and @Momma for tagging me in the other thread RE: the chocolate milk I promise I am getting around 300g of sugar in!

 

[BigShoes]

Very interesting. Some symptoms are same. Will chime in again another time with details. Following your other thread too.


Lived for 13 years in Cyprus (300+ sunny days per year). It didn`t do a ***t. You can try anyway, for experimentation.....

Hi Vinny,

I hope all is going okay.

I'm really sad to hear you're experiencing similar symptoms. There are certainly worse ailments out there, but I wouldn't wish this on my worst enemy, that's for sure... (I don't have any enemies, just a turn-of-phrase).

Haha yes I had thought that this might be a bit of a myth. Sunshine and the outdoors are certainly a good thing, but it's obviously not true that all those people living in hot countries are without health issues such as these...

 

[Peatful]

Hi everyone,

Thanks once again for your help.

Quick update - I started thyroid replacement just over a week ago - c. 1/6 of a cynoplus and 1/6 of a cynomel - approx. 10mcg T3 and 20 mcg T4 per day for the past week (what a pain it is to break pills into 6 ...)

I haven't really noticed any positives yet, but it's still early. I did notice a slight up-tick in libido, and less hair on the comb in the morning, but this may just be the ebb-and-flow of life.

Worryingly though, for the last couple of days I have been experiencing some itchiness in my right nipple (see post #43 for appearance). Whilst things still look the same (no additional growth that I can notice) and it is not that bad yet, this is a classic feeling of the onset of gynecomastia - which I guess is estrogen and prolactin related.

After a quick search, I have seen other users on this forum (@GorillaHead and @Abc123 and more) mention gyno on-set from NDT and Levothyroxine (respectively). This was scary to read. I guess thyroid hormone itself is going downstream and being converted to more estrogen, and causing further elevations in prolactin?? Not good...

The nipple itchiness may be a total coincidence. It has very occasionally come and gone over the years, and is often coinciding with times of poor sleep and stress (I am currently in a bout of getting to sleep well after 2am - not good... but my stress levels are otherwise quite low).

After some more searching - I have seen that gynecomastia in men appears to be a common symptom of HYPER-thyroidism (e.g. here: Gynecomastia as a presenting symptom of Graves’ disease in a 49-year-old man). I wonder if even 1/2 grain of T4 is too much for me? In which case, is it even beneficial at all?? Am I even truly hypothyroid?? I still have not understood why the T3 and T4 blood tests can supposedly be in the normal range, but I can still be classed as hypo by Peat standards. The endocrinologist I visited here in the UK diagnosed me with euthyroid autoimmune thyroiditis. Meaning:

- TSH in the normal range (I know *we* know that 2.7 is quite high, but the medical establishment says "normal")
- T3 and T4 in the normal range
- Very high Thyroglobulin and Thyroid Peroxidase Antibodies

The Peat line of thinking seems to be: when TSH is elevated for long periods of time and the thyroid is under stress, the antibodies appear in response to the inflammation. i.e. it is not just 'random autoimmunity' (as the medical establishment opinion says) but it is in response to the inflamed state of the gland from the TSH pounding, and the thyroid's inability to keep up. I don't really buy this explanation though - because how would Graves' Disease even exist if this was the cause of the autoimmunity in the gland? People with Graves have a low TSH level (i.e. the pituitary is NOT kicking the thyroid into doing more work), so why the autoimmunity?

The Doctor's Recommendation: "take some time off work + diet and exercise adjustments. You will not benefit from levothyroxine, due to T3 and T4 being in the normal range."

... I'm in agreement with the first part of the statement - time off work is always nice and diet (MORE food) and exercise (LESS exercise) adjustments could certainly help.

However, I initially disagreed with the second half of the statement whole-heartedly. I had been pretty convinced by DR, RP and the like that thyroid replacement would do me some good, provided I was getting enough calories and micronutrients.

Nevertheless, I am still quite pensive... perhaps I am being too cautious, but any slight negative symptom that appears (e.g. nipple itching) is enough to make me panic and reconsider the whole thing...

Two quite unique symptoms that I have that appear to be associated with HYPER-thyroidism, rather than HYPO-:
- mild gyno (which appeared around age 24)
- vitiligo (which appeared around age 19-20)

Anyway, I'm rambling now. Thanks for reading, and for everyone's help. I'll continue on 10mcg T3 and 20mcg T4 for a while longer, try to get to bed earlier, and keep eating... I expect some replies will say to drop the T3/T4, but I am so sick and tired of being this sick and tired... I need to do *something*

Cheers.

P.S. thank you @Peatful and @Momma for tagging me in the other thread RE: the chocolate milk I promise I am getting around 300g of sugar in!

You have your temp data above
Post 53


Since you already started
You could stop
Wait three weeks or so
Take temps daily
Keep a food log
Restart the thyroid
Take temps daily
Keep a food log
And then adjust your food to meet your energy needs


Personally
I feel like you were already in an energy deficit
Look at your data above
Again post 53
If already in a deficit
Adding thyroid that requires more energy will indeed produce signs and symptoms

Measures this by taking daily temps along side of your food intake

Adjust accordingly


People need to eat in a small surplus to heal and settle their adrenals down

If pushing the petal
Make sure you have gas in the tank

 

[BigShoes]

Thanks Peatful. Good point on the temps - I guess those values are highly improbable for someone who is hyper-

I sincerely doubt I'm in an energy deficit, but who knows... my weight is certainly stable, and has probably increased by 5lbs in the past few months. I can say, I am having well in-excess of 300g of sugar, probably closer to 400g. And that's aside from potatoes and incidental carbs in other foods.

The awful itch in my nipple is still there today, and I don't know if I can feel it starting on the left side too (although it may just be a phantom feeling because of the worry / hyperfocus on the symptom).

Obviously, this is not a good sign. Further elevated prolactin and / or elevated estrogen is most likely the cause. I had thought that *this* was the pathway:

So I am guessing that the additional thyroid (only 20mcg of T4 per day and c. 10mcg T3) is leading to more DHEA and / or testosterone, that is pretty immediately being converted into more estrogen through aromatization... and prolactin comes into the equation in correlation with that. But at this point, who knows - it's just my theory.

Difficult to know for sure that thyroid is the cause as well, because I also started using Idealabs' Tocovit (vitamin E) last week too (although I thought that was supposed to be an anti-estrogen), and have not been sleeping well. But it seems pretty likely.

Everything I try either makes the problem/s worse, or leads to additional unintended consequences and further compounds things. What an absolute nightmare. Driver, stop this train, I want to get off

Back to the drawing board.