My Husband's Labs

[denise]

Several years ago, my husband discovered that, almost certainly because he'd taken Lexapro, his luteinizing hormone (and therefore his testosterone) had tanked. He took low level Clomid for a while, because I guess that can help jump start the pituitary into doing its job again. He took it, to good effect, for a year or so, but then stopped, in the hope that things would function on their own again.

For the last few months, I've noticed that his depression had gotten really bad and encouraged him to get some labs done. He got them back today, and I'm not quite sure what to make of them.

Some more details: he lost a ton of weight with low carb about 15 years ago, and until about 6 years ago was maintaining doing low carb (and inadvertently low calorie). Over the last 6 years, he has intermittently done strict LC to try to shed some weight he gained before and after his divorce 6-7 years ago, and despite the fact that he can no longer stick to it for longer than a few weeks, he still thinks it's his best bet for weight loss. The idea of eating even 2000 calories a day is unfathomable to him, never mind eating lots of sugar! He is constantly cold, and whenever I've stuck a thermometer in his mouth (lol) his temps are low.

As you can see on his labs, his TSH is pretty good and prolactin is fine. Obviously his T is bad. Is it possible that his hypo symptoms are really just low T symptoms? I'd appreciate any suggestions. He's willing to be a guinea pig for anything I want to give him, and I'd love to get him started on a combo of @haidut 's Pansterone and
Andosterone, but I'm concerned about the fact that he's going to be reluctant to eat enough when his metabolism starts revving. He's already experimented a little with Pansterone, and a couple times, even 2 drops made him jittery and anxious.

 

[tara]

As you can see on his labs, his TSH is pretty good and prolactin is fine.

I can't see the TSH? Were any other thyroid hormones measured?
I think the TSH can sometimes be low in conditions that do not mean good thyroid function too.
You temps were low - do you have numbers? Resting heartrate? (With my digital thermometer, I've found it typically takes more than 5 mins to stabilise - the first beep can show a lower temp by nearly 2C. )

The idea of eating even 2000 calories a day is unfathomable to him, never mind eating lots of sugar!

but I'm concerned about the fact that he's going to be reluctant to eat enough when his metabolism starts revving.

That seems like a relevant concern. Do you mean he never eats as much as 2000 cals a day? Because he has little appetite, or because he is in the habit of severely restraining it? Either way, I guess that would be a key factor contributing to keeping metabolism and mood depressed. I'd be very cautious about trying to force metabolism - energy consumption - up without providing corresponding fuel.

Can he be tempted to add in more juice/fruit/milk?

 

[denise]

Strange, I guess I forgot to add the TSH one. I'll add it now. It was 1.066.

No other thyroid hormones were done. This doctor is too mainstream to have ordered them.

His temps when I've checked are usually in the low 97s. The thermometer I use is actually surprisingly quick and accurate, even without a 5-minute warmup. (I've tested it on myself quite a bit. When it varies, it's generally only by maybe 2 tenths of a degree F.) I haven't thought to have him check his pulse too, but that's a good point. I'll see if I can get him to do a few days' worth of tracking.

I once put a typical day's worth of calories for him into Cronometer, and it came up around 1700. I'm sure some days it's higher, but when he's eating like he wants to, that's about what it comes to. It's partly lack of appetite and partly habit out of a fear of weight gain. He sees other people eating heaps of food and can't really believe it's normal or possible (at least not without packing on the pounds).

As for him adding juice/fruit/milk, I really don't know. I've told him that I'm afraid these supplements will backfire if he doesn't feed himself properly, but his idea of properly is still quite different from mine, and I don't want to be pushy or a nag. But we'll see. Thanks for your thoughts.

 

[denise]

His doc called and suggested his getting on Wellbutrin, btw. My knee-jerk reaction (to this and all pharma anti-depressants) is Eff No, but he's more willing to consider it.

 

[tara]

I once put a typical day's worth of calories for him into Cronometer, and it came up around 1700.

This is a pretty sure sign that his metabolism is running slow, whatever his TSH is. A strong metabolism would be burning through a lot more than this (like of the order of 1000 cals more). Low temps also tend to indicate lowish metabolism.

I've told him that I'm afraid these supplements will backfire if he doesn't feed himself properly, but his idea of properly is still quite different from mine, and I don't want to be pushy or a nag.

I agree with you that they could backfire. And I understand it's tricky giving advice. Maybe you can find some good information on this that you think he might be able to take in and leave it lying around for him to read so he can get the idea from another source? Depression and the other effects of low metabolism are probably a bigger problem than a bit of extra fat.
In case you haven't seen it, some of my ideas on calorie needs come from youreatopia (discussion here: Recovery From Undereating - Youreatopia). Not saying your husband is anorexic, but the effects of energy deprivation probably apply anyway.

His doc called and suggested his getting on Wellbutrin, btw. My knee-jerk reaction (to this and all pharma anti-depressants) is Eff No, but he's more willing to consider it.

Bupropion acts as an norepinephrine-dopamine reuptake inhibitor (NDRI). It is an atypical antidepressant, different from most commonly prescribed antidepressants such as selective serotonin reuptake inhibitors (SSRIs).[10]

https://en.wikipedia.org/wiki/Bupropion
It's not an SSRI, but I'd be cautious about this too, if it were me. There was some discussion recently (this week) about withdrawal issues from dopamine-agonists - not sure if it applies to this drug, not quite the same mechanism of action, but I'd be investigating sifde-effects and withdrawal effects before considering taking something like that.
Lisuride - Liquid Lisuride (maleate) For Lab/research Use
There are lots of reports here of people using it in large and tiny doses. There is also discussion around of other drugs sometimes prescribed as antidepressants - IIRC, tianeptine, ondansetron. You could search here for reports and thoughts about them. I've not read much here about welbutrin/bupropion though.

I'm not recommending for or against it, but note that cyproheptadine has some antiserotonin effects - and is sometimes used to help people recover pro-survival appetite in anorexia. Lots of discussion of it here.

In addition to good nutrition, other health and metabolism supporting factors include getting regular sun on the skin, and attending to breathing (ie eliminating or reducing unaware hyperventilation).

 

[ddjd]

his luteinizing hormone (and therefore his testosterone) had tanked.

is it always the case that total testosterone and LH correlate, i.e. they go up and down together?

 

[Luckytype]

This, while older is pretty interesting.

A good low tsh, a good low prolactin level which means something is keeping it supressed and not yet in due stress mode, but with low T and low temps and presumably low cellular function hence tsh not getting the "push the gas pedal" call.

Watching this to learn more

 

[meatbag]

Strange, I guess I forgot to add the TSH one. I'll add it now. It was 1.066.

No other thyroid hormones were done. This doctor is too mainstream to have ordered them.

His temps when I've checked are usually in the low 97s. The thermometer I use is actually surprisingly quick and accurate, even without a 5-minute warmup. (I've tested it on myself quite a bit. When it varies, it's generally only by maybe 2 tenths of a degree F.) I haven't thought to have him check his pulse too, but that's a good point. I'll see if I can get him to do a few days' worth of tracking.

I once put a typical day's worth of calories for him into Cronometer, and it came up around 1700. I'm sure some days it's higher, but when he's eating like he wants to, that's about what it comes to. It's partly lack of appetite and partly habit out of a fear of weight gain. He sees other people eating heaps of food and can't really believe it's normal or possible (at least not without packing on the pounds).

As for him adding juice/fruit/milk, I really don't know. I've told him that I'm afraid these supplements will backfire if he doesn't feed himself properly, but his idea of properly is still quite different from mine, and I don't want to be pushy or a nag. But we'll see. Thanks for your thoughts.

Adrenaline can also lower the TSH value and I've read (on here and from Peat) that this is what can cause coldness especially in the extremities even if TSH (which is not a perfect test) is low. I think you could get a sense of this by taking the temperature and pulse rate before eating breakfast and then after to see how eating effects it since eating a meal should lower adrenaline. Salty food might help in getting the adrenaline down from what I've read.
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SARHA JOHANNESON MURRAY: And isn't it correct, Dr. Peat, that while someone might be taking T4 and not really converting it much to T3, their TSH would still lower?

RAY PEAT: Yea, and the stress hormones will lower it too. So you can't really diagnose anything by TSH alone, even though that’s how some doctors do it.

SARHA JOHANNESON MURRAY: Especially when someone who is low thyroid they are usually running on excessive adrenaline. And excessive adrenaline will lower the TSH and give you a false positive, rather than a false negative.

RAY PEAT: And high cortisol lowers it. And also at the same time causes the liver to turn thyroxin into reverse T3, which interferes even more than thyroxin with the active T3 function.

SARAH JOHANNESON MURRAY: It blocks the real T3 from actually doing anything.

Herb Doctors: Current Trends On Nitric Oxide:Ray Peat

 

[vulture]

is it always the case that total testosterone and LH correlate, i.e. they go up and down together?

As far as I remember you could have low T and high LH, and it might point to a testicle issue. Basically high LH is asking more T but testicles can't meet the demand.
I'm having a similar problem. I suspect is stress related (I was under heavy stress for years), specially if he was hypocaloric for too long. I'm about to try T3 along with hypercaloric diet (Peating) and then introduce HCG and see how my T levels change.