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Old 01-31-2013, 01:20 PM   #1
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Am I sub-clinical

I am a 41yo male. I have been taking Levothyroxine 25mcg since 8 Jan. I have learned since then that they should have tested my Free T3 and Free T4. I asked my doctor to run the test and was told that because I am sub-clinical I don't need the other test. My TSH was 3.861 (ref .358-3.74). That doesn't seem sub-clinical to me thoughts?

other symptoms:
fatigue
mental fog
cold hands/feet
joint pain
general crappyness <---I think that's a word.

thanks,

at

 
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Old 02-02-2013, 06:08 PM   #2
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Re: Am I sub-clinical

Hi, general crappyness is definitely as good a word as any for this I think! Just so you know .25mcg is pretty much a nothing dose, .50mcg is a starter dose. The TSH of 3.861 does suggest and match your symptoms as a normal person would have a TSH of 1, the higher the TSH the more crappy you feel in my opinion!
Yes, the frees should be tested and when on meds they are a lot more reliable to go by.
Your symptoms may also be related to sluggish adrenals which can affect the thyroid so maybe check in with a naturopath and get this addressed first as in my own experience, adrenal fatigue prevents thyroid meds working properly, and thyroid meds have contraindications stating that they must not be prescribed if adrenal Insufficiency is present.
Also, maybe look at getting iron, vit d3, antibodies for hashi, cortisol testing (min a.m./p.m. But preferably 4 blood draws or 24 hr saliva test)
If you PCP is not willing to fully address this, find yourslelf a thyroid savvy doc who prescribes natural thyroid (dessicated) these are generally the ones who look at the whole picture and not just the TSH. You can go into a compounding pharmacy and ask which docs prescribe compounded thyroid and try to get in and see one! Good luck

 
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Old 02-03-2013, 02:48 AM   #3
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Re: Am I sub-clinical

What you describe, medication based nothing more than a high TSH test doesn't sound like standard care to me. You should have a free T3 and T4, a test for antibodies, an thyroid ultrasound. You should also have you testosterone checked, because that'll also make you feel 'crappy'

 
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Old 02-03-2013, 11:50 AM   #4
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Re: Am I sub-clinical

I'm sorry I forgot to post that my testosterone was tested and it is marginally low 226 on a 280-800 scale. I started a 2mg Androderm patch yesterday. I talked to my doctor and she said the other tests were not needed and that before we do anything else we should wait for my next blood test the first week of March. If I don't feel better regardless of the numbers I'll push harder for the other test. I am not able to change my doctor at this point . Thank you all for you information.

at

 
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Old 02-03-2013, 01:19 PM   #5
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Re: Am I sub-clinical

Hi at28, if you do a search on thyroid and testosterone there are a number of papers that suggest the thyroid worsens/becomes even more sluggish taking testosterone replacement, and that there is a need for an Increase in thyroid meds at the same time to counteract the negative affect on the thyroid. Given your symptoms you already need a raise and with additional testosterone you may need even more.
Read up on it and then arm yourself with info. Approach your doc in a gentle manner and tell her you are concerned because your TSH is already high and your thyroid dose is the smallest amount possible. Pity you have no option but to see this one.

 
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Old 02-03-2013, 01:32 PM   #6
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Re: Am I sub-clinical

That's good. From my experience many of the beneficial effects of returning to normal testosterone will take several months to appear. Testosterone effects a lot of things in the body and your brain. Some of these respond quickly over hours and others respond over months. So some patience is needed.

Also my suggestion would be to switch to something like androgel with a pump. You can be in range clinically and still have too little for you. That allows you to tweak your dose so you feel just okay without going over. My experience with too much is increased muscle mass. As my doctor said, you've gained weight and it ain't fat.

One of my experiences was that initially I recovered over about three months, and then started feeling crappy again, upping my dose slightly fixed that. I think you body gets used to low testosterone and compensates. Once you are no longer hypo, that wears off and you need more.

Also you are 40, young. You more than a 70 year old man needs because your metabolism is higher. And I don't think the reference ranges from the lab are age adjusted. Meaning a 20 year old should b at the upper range, and at 50 around the middle of the range.

Um... and also, important, is if your low testosterone is due to central (pituitary) or primary (nads ain't working). If the former, standard care says you get an MRI of your pituitary to rule out a tumor.

 
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Old 02-03-2013, 01:35 PM   #7
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Re: Am I sub-clinical

That's good. From my experience many of the beneficial effects of returning to normal testosterone will take several months to appear. Testosterone effects a lot of things in the body and your brain. Some of these respond quickly over hours and others respond over months. So some patience is needed.

Also my suggestion would be to switch to something like androgel with a pump. You can be in range clinically and still have too little for you. That allows you to tweak your dose so you feel just okay without going over. My experience with too much is increased muscle mass. As my doctor said, you've gained weight and it ain't fat.

One of my experiences was that initially I recovered over about three months, and then started feeling crappy again, upping my dose slightly fixed that. I think you body gets used to low testosterone and compensates. Once you are no longer hypo, that wears off and you need more.

Also you are 40, young. You more than a 70 year old man needs because your metabolism is higher. And I don't think the reference ranges from the lab are age adjusted. Meaning a 20 year old should b at the upper range, and at 50 around the middle of the range.

Um... and also, important, is if your low testosterone is due to central (pituitary) or primary (nads ain't working). If the former, standard care says you get an MRI of your pituitary to rule out a tumor.

 
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