Intro: Male, 32, 6 ft 1, 78kg, lean / fit physique, BMI 22.5
Symptoms: Low energy / extremely lethargic, tired all the time, reduced libido / no morning wood, severe premature ejaculation, hair loss starting (both crown and minorly on front of shins), low quality hair (dry and coarse), puffy eyes (the hypothyroid kind, not the bulging hyPERthyroid kind).
Long suspected thyroid issues / metabolism issues, hence why I am here - TSH was historically 1.37 (1.5 years ago) now 2.7. Lots of very concerning things going on in the bloods.
I was given bare bones testing via NHS around 18 months to 24 months ago. TSH and T4 were normal, so I was gaslighted by the NHS into believing that it was all in my head / just need to sleep more / stress less. But now, symptoms have worsened to the point where I have no interest in work anymore, and just want things to end.
Blood Panel:
I have tried to order this into something somewhat coherent - the lab sent it back to me in alphabetical order... There were some other indicators in the tests but all were normal, and less interesting. I have gone with: Heart / Diabetes indicators, Cholesterol, Sex Hormones, Thyroid Hormones, plus a couple of other notes. I have also tried to put a conversion value in to help people assess for certain tests (e.g. testosterone), and have given my general opinion / concern:
My thoughts:
- EXTREMELY high thyroid antibodies. Apparently Ray Peat does not believe in autoimmune thyroid conditions. I found this (apparent) quote from him on the forum: "When TSH is too high for a long time, it causes inflammation in the gland, and the antibodies are in reaction to that." But something is clearly very wrong there.
- How can T3 and T4 be in the normal range?? Is their reference range too liberal??
- High TSH of 2.7 - seems that the pituitary is working hard to kick the thyroid into gear.
- High prolactin, higher than optimal estrogen (gut related?).
- reasonable testosterone total, but relatively low free T - due to higher SHBG?? How to improve?
- Very high LDL cholesterol... but very low triglycerides??? How is this possible? Very concerning. High LDL in itself suggests low thyroid function, but very low triglycerides suggests hyPERthyroidism... would thyroid hormone supps tank this value even further??
Overall, I'm very concerned. I'm also concerned because these were private blood tests. I will now have to go to an endocrinologist to recommend treatment. I expect they will want to put me on levothyroxine (T4 only) at BEST - and more likely say "they are in the required ranges, so just monitor it".
For the record, I have been extremely fatigued for around 2 years... I always chalked it up to too much weightlifting, not going to bed as early as I should, the lockdowns etc.. But as I improved those aspects of my lifestyle, my situation did not improved... in fact, it has gotten worse. I am strongly considering signing myself out of work to figure out how to fix this stuff, or at least, find a path forward. But am quite worried about my job / career falling through.
Any help would be hugely appreciated. Thanks
Symptoms: Low energy / extremely lethargic, tired all the time, reduced libido / no morning wood, severe premature ejaculation, hair loss starting (both crown and minorly on front of shins), low quality hair (dry and coarse), puffy eyes (the hypothyroid kind, not the bulging hyPERthyroid kind).
Long suspected thyroid issues / metabolism issues, hence why I am here - TSH was historically 1.37 (1.5 years ago) now 2.7. Lots of very concerning things going on in the bloods.
I was given bare bones testing via NHS around 18 months to 24 months ago. TSH and T4 were normal, so I was gaslighted by the NHS into believing that it was all in my head / just need to sleep more / stress less. But now, symptoms have worsened to the point where I have no interest in work anymore, and just want things to end.
Blood Panel:
I have tried to order this into something somewhat coherent - the lab sent it back to me in alphabetical order... There were some other indicators in the tests but all were normal, and less interesting. I have gone with: Heart / Diabetes indicators, Cholesterol, Sex Hormones, Thyroid Hormones, plus a couple of other notes. I have also tried to put a conversion value in to help people assess for certain tests (e.g. testosterone), and have given my general opinion / concern:
Biomarker | Result | Normal | Unit | Date | My Opinion | Converted Value |
HbA1c | 32 | 20 - 42 | mmol/mol | 2023-01-26 10:38:30 | Fine | |
hs-CRP | 0.2 | 0 - 5 | mg/L | 2023-01-26 10:38:30 | Fine - but is this because of Aspirin use? | |
LDL | 3.63 | 0 - 3 | mmol/L | 2023-01-26 10:38:30 | HIGH - Thyroid?? Hypothyroid?? | |
HDL | 1.33 | 0.91 < | mmol/L | 2023-01-26 10:38:30 | Fine | |
HDL Ratio | 4 | 0 - 6 | 2023-01-26 10:38:30 | Fine | ||
Total Cholesterol | 5.3 | 0 - 5 | mmol/L | 2023-01-26 10:38:30 | HIGH - Thyroid?? Hypothyroid?? | |
Triglycerides | 0.77 | 0.84 - 1.94 | mmol/L | 2023-01-26 10:38:30 | LOW TriGlycerides?? HOW IS THIS POSSIBLE? | |
Oestradiol (Oestrogen) | 123 | 41 - 159 | pmol/L | 2023-01-26 10:38:30 | Not sure - not great... gut inflammation? | 33.5 pg/ml |
Prolactin | 330 | 86 - 324 | mU/L | 2023-01-26 10:38:30 | NOT FINE - inflammation? gut? PTH? | 15.56 ng/ml |
Free Testosterone (calculated) | 0.41 | 0.2 - 0.62 | nmol/L | 2023-01-26 10:38:30 | Not The Best… SHBG?? | |
Sex Hormone-Binding Globulin | 44.4 | 16.5 - 55.9 | nmol/L | 2023-01-26 10:38:30 | A Little High… Is This Why Free Test so Low? | |
Testosterone (total) | 23.1 | 8.6 - 29 | nmol/L | 2023-01-26 10:38:30 | Okay…would be nice >700. Fix the others, and this should fix itself. | 666 ng/dL - Anti-christ? Awful |
Luteinising Hormone (LH) | 4.3 | 1.7 - 8.6 | iu/L | 2023-01-26 10:38:30 | Fine | |
Follicle Stimulating Hormone (FSH) | 2 | 1.5 - 12.4 | IU/L | 2023-01-26 10:38:30 | Too Low… Pituitary Over-work? Low Libido Link? Sperm production reduced... | |
Cortisol (9am) | 359 | 166 - 507 | nmol/L | 2023-01-26 10:38:30 | Fine?? | |
Thyroid Stimulating Hormone (TSH) | 2.7 | 0.27 - 4.2 | mIU/L | 2023-01-26 10:38:30 | Not Fine by RP Standards - was 1.37 18 months ago | |
Thyroxine (T4, free direct) | 17.7 | 12 - 22 | pmol/L | 2023-01-26 10:38:30 | ??? - How can these be normal range? | |
Triiodothyronine (T3, free) | 4.8 | 3.1 - 6.8 | pmol/L | 2023-01-26 10:38:30 | ??? - How can these be normal range? | |
Thyroglobulin Antibodies | 383 | 0 - 115 | IU/mL | 2023-01-26 10:38:30 | NOT FINE - 4x the limit | |
Thyroid Peroxidase Antibodies | 400 | 0 - 34 | IU/mL | 2023-01-26 10:38:30 | NOT FINE - 12x the limit | |
Vitamin D (25 OH) | 67 | 50 - 200 | nmol/L | 2023-01-26 10:38:30 | Not Fine - treat with Mg and D3 and Summer Sun. Easily explainable, not enough outside time and stopped supplementing. easy to treat (ish). | 27 ng / dL |
Creatinine | 102 | 59 - 104 | umol/L | 2023-01-26 10:38:30 | A Little High… kidney issue? |
My thoughts:
- EXTREMELY high thyroid antibodies. Apparently Ray Peat does not believe in autoimmune thyroid conditions. I found this (apparent) quote from him on the forum: "When TSH is too high for a long time, it causes inflammation in the gland, and the antibodies are in reaction to that." But something is clearly very wrong there.
- How can T3 and T4 be in the normal range?? Is their reference range too liberal??
- High TSH of 2.7 - seems that the pituitary is working hard to kick the thyroid into gear.
- High prolactin, higher than optimal estrogen (gut related?).
- reasonable testosterone total, but relatively low free T - due to higher SHBG?? How to improve?
- Very high LDL cholesterol... but very low triglycerides??? How is this possible? Very concerning. High LDL in itself suggests low thyroid function, but very low triglycerides suggests hyPERthyroidism... would thyroid hormone supps tank this value even further??
Overall, I'm very concerned. I'm also concerned because these were private blood tests. I will now have to go to an endocrinologist to recommend treatment. I expect they will want to put me on levothyroxine (T4 only) at BEST - and more likely say "they are in the required ranges, so just monitor it".
For the record, I have been extremely fatigued for around 2 years... I always chalked it up to too much weightlifting, not going to bed as early as I should, the lockdowns etc.. But as I improved those aspects of my lifestyle, my situation did not improved... in fact, it has gotten worse. I am strongly considering signing myself out of work to figure out how to fix this stuff, or at least, find a path forward. But am quite worried about my job / career falling through.
Any help would be hugely appreciated. Thanks
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