Help With Blood Work Interpretation

Broco6679

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Hello everyone. I got some bloods doen to investigate my current symptoms which I will detail further down the post.

Bloods:

Albumin 44.1 g/L (Range: 35 - 50)
SHBG 26 nmol/L (Range: 18.3 - 54.1)
FSH 1.51 IU/L (Range: 1.5 - 12.4)
LH 4.3 IU/L (Range: 1.7 - 8.6)

Oestradiol 117 pmol/L (Range: 41 - 159)

Testosterone 13.8 nmol/L (Range: 8.64 - 29)
Free Testosterone - Calc. 0.317 nmol/L (Range: 0.2 - 0.62)
Free Androgen Index 53.08 Ratio (Range: 24 - 104)

Prolactin 197 mU/L (Range: 86 - 324)

DHEA Sulphate 7.020 umol/L (Range: 5.73 - 13.4)
Progesterone 0.325 nmol/L (Range: 0.64 - 4.7)

TSH 1.83 mIU/L (Range: 0.27 - 4.2)
Free T3 6.09 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 15.500 pmol/L (Range: 12 - 22)

Symptoms:

Rapid hair loss, eyebrow thinning, cold extremeties, slow heart rate, zero libido, zero appetite and major digestive issues.

I'm not really sure how to proceed based upon these bloods. Testostosterone is lowish, progesterone is extremely low and thyroid looks relativly okay. My diet and lifestyle is already 'Peat' based; high calorie, high carb, zero pufa, micronutrient focused eating.

Does anyone have any suggestions? I'm considering supplementing progesterone to get it up, though progesterone deficiency alone doesn't really explain my issues. Thanks.
 

boris

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You are highly likely hypothyroid. Cold extremeties means high adrenaline (hypo symptom). Low pulse (hypo symptom). Thinning eyebrows (hypo symptom). Low appetite is a sign of high cortisol. Digestive issues (high adrenaline draws blood out of the intestine). TSH should usually be under 1.

Did you test basal temperature and achilles tendon relaxation reflex to accurately diagnose hypothyroidism?

I would supplement thyroid before diving into progesterone or other things.
 
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Broco6679

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You are highly likely hypothyroid. Cold extremeties means high adrenaline (hypo symptom). Low pulse (hypo symptom). Thinning eyebrows (hypo symptom). Low appetite is a sign of high cortisol. Digestive issues (high adrenaline draws blood out of the intestine). TSH should usually be under 1.

Did you test basal temperature and achilles tendon relaxation reflex to accurately diagnose hypothyroidism?

I would supplement thyroid before diving into progesterone or other things.


Thank you for your advice!

My waking temp is usually 35.8, and rises to 36.5 after a meal but will quickly drop to 36.2. I haven't had a the achilles test that you mentioned performed.

I do have some NDT which my doctor scripted me when my TSH got up to 3.8. I've been too scared to try it as I already get adreneline-induced heart rate increases, my heart generally 'pounds' even when heart rate is low, and my resting heart rate is very unstable also suggesting adrenal issues. From what I've read people who reprot similar symptoms seem to have their adreneline symptoms exacerbated when they try thyroid.
 

Kunstruct

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TSH should usually be under 1.
I have not seen so far anyone with TSH under 1 on this forum, but then again the majority here do not do bloodwork at all regularly. I had access to talking with people in the medical system, common is 1.x. I know someone had 0.005 TSH in real life, but that is hyperthyroid.
 

Kunstruct

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Estradiol is not that high, rather ok, prolactin is not high, a pretty good number.
 
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Broco6679

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Estradiol is not that high, rather ok, prolactin is not high, a pretty good number.

That's the highest I have seen both for a while too - they're usually ~ 80 and 100 respectively.

Regarding your reply to the other commenter, funily enough I actually had a TSH of 0.8 before all of these issues started. I do agree with you though, I haven't seen many other people on here with a TSH < 1. You could also argue that the type of people to search out thyroid issues and this forum are unlikely to belong to the healthy population, so their TSH isn't representivive of good health.
 
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Broco6679

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I really don't know where to go. My fT3 is at the top of the reference range so I do have a decent (though some would argue sub-optimal) level of thyroid in my blood, it just appears it's not reaching the tissue.

Would further increasing thyroid hormone via supplementation acutally help if the issue is the tissue isn't uptaking said hormone? I'm just concerned that taking thyroid will make my eratic heart rate and adreneline symptoms much worse leading to a panic attack.
 

boris

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I really don't know where to go. My fT3 is at the top of the reference range so I do have a decent (though some would argue sub-optimal) level of thyroid in my blood, it just appears it's not reaching the tissue.

Would further increasing thyroid hormone via supplementation acutally help if the issue is the tissue isn't uptaking said hormone? I'm just concerned that taking thyroid will make my eratic heart rate and adreneline symptoms much worse leading to a panic attack.

TSH, temperature, pulse rate, and other indicators in hypothyroidism
"Because the actions of T3 can be inhibited by many factors, including polyunsaturated fatty acids, reverse T3, and excess thyroxine, the absolute level of T3 can't be used by itself for diagnosis. “Free T3” or “free T4” is a laboratory concept, and the biological activity of T3 doesn't necessarily correspond to its “freedom” in the test. T3 bound to its transport proteins can be demonstrated to enter cells, mitochondria, and nuclei. Transthyretin, which carries both vitamin A and thyroid hormones, is sharply decreased by stress, and should probably be regularly measured as part of the thyroid examination.

When T3 is metabolically active, lactic acid won't be produced unnecessarily, so the measurement of lactate in the blood is a useful test for interpreting thyroid function. Cholesterol is used rapidly under the influence of T3, and ever since the 1930s it has been clear that serum cholesterol rises in hypothyroidism, and is very useful diagnostically. Sodium, magnesium, calcium, potassium, creatinine, albumin, glucose, and other components of the serum are regulated by the thyroid hormones, and can be used along with the various functional tests for evaluating thyroid function."
 

Kunstruct

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That's the highest I have seen both for a while too - they're usually ~ 80 and 100 respectively.

Regarding your reply to the other commenter, funily enough I actually had a TSH of 0.8 before all of these issues started. I do agree with you though, I haven't seen many other people on here with a TSH < 1. You could also argue that the type of people to search out thyroid issues and this forum are unlikely to belong to the healthy population, so their TSH isn't representivive of good health.

Weird ting is most talk about about under 1 TSH is how everyone should be but they do not have it, or if they maybe had it once they do not do constant bloodwork to check it.
 

boris

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Yes, TSH is not a very accurate marker for hypothyroidism since it get's influenced by many factors.
 
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Broco6679

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TSH, temperature, pulse rate, and other indicators in hypothyroidism
"Because the actions of T3 can be inhibited by many factors, including polyunsaturated fatty acids, reverse T3, and excess thyroxine, the absolute level of T3 can't be used by itself for diagnosis. “Free T3” or “free T4” is a laboratory concept, and the biological activity of T3 doesn't necessarily correspond to its “freedom” in the test. T3 bound to its transport proteins can be demonstrated to enter cells, mitochondria, and nuclei. Transthyretin, which carries both vitamin A and thyroid hormones, is sharply decreased by stress, and should probably be regularly measured as part of the thyroid examination.

When T3 is metabolically active, lactic acid won't be produced unnecessarily, so the measurement of lactate in the blood is a useful test for interpreting thyroid function. Cholesterol is used rapidly under the influence of T3, and ever since the 1930s it has been clear that serum cholesterol rises in hypothyroidism, and is very useful diagnostically. Sodium, magnesium, calcium, potassium, creatinine, albumin, glucose, and other components of the serum are regulated by the thyroid hormones, and can be used along with the various functional tests for evaluating thyroid function."


Thank you for the Peat quote! Whilst the information itself is extremely valuble, i often have difficulty applying Peat's work to my own situation as like he said, many different things can be casuing the hypothyroid issue, yet I'm not sure how to determine what that is so it can be rectified

All of the biomarkers at the end of teh quote fall middle of the range on my bloods apart from cholesterol which is low-normal. Again this makes my thyroid function look relativly okay on paper (I know the whole point of your comment was that on paper doesn't matter, and I completely agree) which gives me no real avenues to pursue.

Everywhere I look I find conflicting informtion. Some say you need to take preg and/or prog before thyroid supplemenation; others say neither will work without using thyroid if one has hypothyroid issues. I have quite high levels of stress and anxiety which is likely the cause, yet again the information is conflicting. Some say the hypothyroid state is what causes teh excess adreneline to compenaste for the energy deficiency, otherys say excess adreneline and cortisol from stress is what induces the hypothyroid state.

I love this forum and find it an invaluble tool for investigating my health, but I often find myself overwhelmed and at a loss at how to proceed given the conflicting nature of a lot of the advice given.
 

boris

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Some say the hypothyroid state is what causes teh excess adreneline to compenaste for the energy deficiency, otherys say excess adreneline and cortisol from stress is what induces the hypothyroid state.

Yes that's confusing. Stress hormones lower thyroid function and low thyroid function raises stress hormones. It's kind of a negative feedback loop.

Sometimes you might need to lower estrogen before thyroid can have an effect (mostly in the case of thyroid nodules) I think that's were the progesterone advice came from.
Personally I found that no amount of reading or advice was as valuable as trying it out for myself and feeling my body react to different measures.

Thyroid is pretty safe when you make sure to measure pulse and temps. When you see or feel a negative effect you just stop taking it.

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If you have high levels of stress you may have elevated free fatty acids which block thyroid function (PUFA gets stored up to 4 years). No flush niacinamide, aspirin and a pure vitamin e (no oils) could help too.
 
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Broco6679

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Yes that's confusing. Stress hormones lower thyroid function and low thyroid function raises stress hormones. It's kind of a negative feedback loop.

Sometimes you might need to lower estrogen before thyroid can have an effect (mostly in the case of thyroid nodules) I think that's were the progesterone advice came from.
Personally I found that no amount of reading or advice was as valuable as trying it out for myself and feeling my body react to different measures.

Thyroid is pretty safe when you make sure to measure pulse and temps. When you see or feel a negative effect you just stop taking it.

-
If you have high levels of stress you may have elevated free fatty acids which block thyroid function (PUFA gets stored up to 4 years). No flush niacinamide, aspirin and a pure vitamin e (no oils) could help too.

Thank you for the explanation and advice!

e2 was 115 on the bloods I listed above, but previously it's 75 and 80 so I don't think high e2 is my issue. From what I understand progesterone directly antagonises e2, so it could be that whilst my e2 is low, my extremely low progesterone is still producing estrogen dominance.

I am very stressed at the moment, but that's mainly centered around the fact I'm balding at such a young age and my overall health is rapidly declining. Over the past two years my face looks like its aged ten years; my hair has thinnined (diffuse but only located to the top), my foreheard has developed wrinkles and now has a 'shiny' and tight look (calcification?), my eyebrows are thin and my face is bloated. It could well be stresss hormones blocking thyroid uptake into the cells since my thyroid labs are normal, but i have no idea how to fix that.

Can I ask why you recommend starting thyroid over progesterone?
 

boris

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Thyroid will help you restore cellular energy production and with that will come naturally the protective hormones instead of the aging hormones. From what I hear especially for males progesterone is tricky to find the right dosage. I don't think it's dangerous, but according to Peat it could have unwanted side effects if taken too much (penis shrinkage). 5 mg of progesterone is safe for a male according to Peat. Some males reported shrinkage from doses over 10-15mg.
 
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Broco6679

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Thyroid will help you restore cellular energy production and with that will come naturally the protective hormones instead of the aging hormones. From what I hear especially for males progesterone is tricky to find the right dosage. I don't think it's dangerous, but according to Peat it could have unwanted side effects if taken too much (penis shrinkage). 5 mg of progesterone is safe for a male according to Peat. Some males reported shrinkage from doses over 10-15mg.

Ah okay, that makes sense. I think my main concern that if it's something else that's causing my issue - vitamin deficiency, chronic stress, other nutriional issue, hormonal imbalance etc - taking thyroid hormoe will just make things worse. I read about people who have stress responses and symptoms of excess adreneline when taking thyroid, and since I already have these symptoms I imagine that is also going to happen to me too.

I guess I just need to try it and see. I actually have a good brand of NDT available so I may try 1/4 grain every morning, slowly increasing every two weeks or so and see how I get on. Does this seem reasonable?
 

boris

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I think well fed, after a large nutritious meal is very safe.

[...]I think my main concern that if it's something else that's causing my issue - vitamin deficiency, chronic stress, other nutriional issue, hormonal imbalance etc - ?[...]

Probably yes, but just getting your temperature to good levels (37 celsius) will help. Many functions of the body won't work right when you're cold. It will also raise your appetite!

For me it helped greatly with digestive issues. Before I would often have runny stools immediately after eating, 6mcg T3 after a meal gets my gut working again.
 
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Kunstruct

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e2 was 115 on the bloods I listed above, but previously it's 75 and 80 so I don't think high e2 is my issue. From what I understand progesterone directly antagonises e2, so it could be that whilst my e2 is low, my extremely low progesterone is still producing estrogen dominance.

I believe people have issues understanding the 117 pmol/L value, it is pmol/L x 0.273 = pg/mL, which is 31.941 which rounded is 32 pg/mL
 
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Kunstruct

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My waking temp is usually 35.8, and rises to 36.5 after a meal but will quickly drop to 36.2. I haven't had a the achilles test that you mentioned performed.

Are you confident in your thermometer? Some IR ones show me with absurdly low temp, which is not real. Might consider a mercury one, takes a long time but is more reliable.
 
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Broco6679

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Are you confident in your thermometer? Some IR ones show me with absurdly low temp, which is not real. Might consider a mercury one, takes a long time but is more reliable.

I actially just bought a new thermometer and my temps are now coming back at 36.6 c which is much higher than my usual. The enviroment in which I am taking my temps with the new thermometer is much warmer however, and my extremeties still feel extremely cold.
 
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Broco6679

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I think well fed, after a large nutritious meal is very safe.



Probably yes, but just getting your temperature to good levels (37 celsius) will help. Many functions of the body won't work right when you're cold. It will also raise your appetite!

For me it helped greatly with digestive issues. Before I would often have runny stools immediately after eating, 6mcg T3 after a meal gets my gut working again.

If those other afformentioned causes are indeed resposible, will taking thyroid actually incease my temps? I'd assume that my body has enough thyroid hormone, but its just not being transported into the cell to be utilised for whatever reason.
 

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