Low Testosterone linked to thyroid perhaps?

[lepiricus]

Looking for a little advice here fellas...

age 26 male 185lbs, 6'
full head of hair, infact... fairly hairy in general most than other guysl for sure
prescription meds: modafinil 200mg/day, for lethargy (this helps alot)
supplements: whey protein, CEE, fish oil, multi-vitamin

I basically suffer from typical hypothyroid and low testosterone symptoms that include brain fog, fatigue to the point I nap almost daily, low semen volume, weak erections (not impotent, just much weaker than when I was a teenager) and not getting any stronger in the gym for weeks.

recent blood work:

Cholesterol: 120 mg/dl
Triglycerides: 52 mg/dl
HDL: 35 mg/DL "low" supposed to be >39
Non HDL cholesterol: 88
LDL Calculated: 71 mg/dl
Cardiac Risk Factor: 3.5 "low" range 4.4-5.0
EKG heart bpm: 45.....marked sinus bradycardia but otherwise normal
chronic low body temp, 96.5 to 98.5(after sprinting), average 97.1 thru typical day wake up temp is in the 96's usually.

I am not particularly heat senstive or sweat alot. I do not "feel cold" in normal conditions, but I am greatly effected when working outside in the winter. I can hardly stand the cold and cant seem to warm up.

IGF-1 is 193 range 114-492
Prolactin is 8.6, normal but forgot range
T4 is 0.96 range 0.86-1.76 subclinical low
TSH is 0.88 range 0.35-5.5 subclinical low
psa was 0.4 i think, something completely normal though
total testosterone is 354 ng/dl low for my age, range 242-827 ng/dl

I have not had a sensitive E2 or SHBG done

To summarize I have a low but "great" lipid profile, slow heartbeat even though I am no no means an elite athlete. Low-normal testosterone levels, low core avg temp, but test "normal" for thyroid function.

LH, FSH, cortisol are completely midline normal, as well as CBC, normal sized testes, trying to eat surplus in calories, HIIT sprinting 2x a week, lift 3x a week, off 2x a week. sonogram of thyroid showed normal. I have not had a MRI done.

Basically, I am confused and so is my endocrinologist. My TSH suggests hyperthyroidism, but T4 suggests Hypothyroidism. There is a condition I have read about that says this is possible with secondary or central hypothyroidism which is bascially a pituitary disorder that causes entire thyroid system to be underactive.

I am curious why my testosterone is low, is it because of?
1. thyroid issues
2. cholesterol issues
3. pituitary
4. other

My inclination is that its thyroid related because of my bradycardia and low body temperature and fatigue

I have read some studies that link low t4 and t3 to low testosterone. I can't find them now to show my doctor (pubmed search was not kind to me). Basically they stated low t3 = low testosterone. I, however, have read much on this board that t3 is catabolic and would eat muscle so I am confused here, anyone ever heard of this thyroid / testosterone connection

My doc is debating whether to go on HRT, growth hormone or try thyroid medication. I am not wanting HRT for obvious age and fertility issues but I am willing to give about anything else a shot.

What should I ask my endo about? I would like to go in next time and have an idea of what to do/ask for. I am a little confused and would like to hear your experienced input.

[Southpaw80]

I had Grave's disease and my thyroid was removed over 25 years ago. I'm 46 and I've experience all the symptoms you described over the past couple of years. I was able to convince my doctor to increase my T4 dose, even though my blood work results were all within the normal range. Since the increase in dosage, my body temp has gone up from 97 to 98.2, my pulse up from 62 to 72, I lost a few lbs, have more energy and get morning wood once in a while. My T level before the T4 increase was 384 (270-1070)and 6 weeks after the increase, T level went up to 450. I know T is still too low, but my doctor won't prescribe TRT. She thinks 450 is normal.

Southpaw80

[luke77]

I'm not an expert but I would suggest having an mri done. The combo of possible thyroid malfunction and low testosterone suggests something with the pituitary might not be right.

[lepiricus]

Southpaw80: Thanks for your anecdote about t4 increasing testosterone. I have read that elsewhere but cannot find it now.

Luke77: I think my endo has knocked around the idea of doing an MRI, but my blood tests don't really point to that direction and I have heard it can very expensive. But, it may very well come down to that

I failed to mentionI have had thyroid antibodies tested, and it came back normal so its not autoimmune

I wounder if I should ask for more tests like sensitive E2 or DHT, could abnormalities in those present as hypogonadism and hypothyroidsim?

[pmgamer18]

First you need to fix Thyroid if it is a problem then after a time get tested again and add E2 and Total E to the test. If your levels are still this low you need to go on TRT. Get some sprem tested and if it is good freeze some so you can have kids later. Do this as a back up most men on TRT can have kids.
Phil

[lepiricus]

Thanks for the advice guys. I have wrote all this down and will bring it up with my endo when she calls with my IGF-1 and free Testosterone labs.

[luke77]

BTW, it sounds like you have a good endo...I would trust her and listen to her advice.

[SinginHawk]

FORGET the THS. FORGET the TSH. Go by your T4 free and T3 free T4 total and T3 total.

These endos are hung up on TSH. Get your levels up in the upper part of the ranges, especially T3 free. From your symptoms you are Hypothyroid and YES low Thy can cause low T.

I have gone through this for a long time. I will say it again, FORGET the TSH you have to go by how you feel and not the TSH number.

[luke77]

Originally Posted by SinginHawk

FORGET the THS. FORGET the TSH. Go by your T4 free and T3 free T4 total and T3 total.

These endos are hung up on TSH. Get your levels up in the upper part of the ranges, especially T3 free. From your symptoms you are Hypothyroid and YES low Thy can cause low T.

I have gone through this for a long time. I will say it again, FORGET the TSH you have to go by how you feel and not the TSH number.

Do you have any evidence (a study, perhaps) that shows that low thyroid can cause low t? I'm not trying to challenge you, I'm legitimately curious, because I have low T3 and T4 and low testosterone as well.

Thanks,
Luke

[pmgamer18]

I had some info but because I don't have Thy. problems did not keep it but remember reading it you treat the low Thy. then test for low T in a lot of cases getting Thy. helps get T levels back up.
Phil

[lepiricus]

Originally Posted by pmgamer18

I had some info but because I don't have Thy. problems did not keep it but remember reading it you treat the low Thy. then test for low T in a lot of cases getting Thy. helps get T levels back up.
Phil

I saw something very very similar, but I am kicking myself for not keeping it. I remember testosterone levels went up 20% or so when the thyroid was "normalized".

I am fairly confident my problems are hypothyroidism. The only thing that makes me hesitate is the fact that my lipids are very low which I have come to understand is atypical of hypothyroid sufferers. Low lipids also don't provide a good base for your body to produce testosterone so that must contribute to the low test as well I'm sure. Should I ask for a t4/t3 combo like thyrolar? or try for cytomel?

[pmgamer18]

I think I remember SWALE posting that he uses Armour. Start on that first and go from there. Unless there is something I missed hear.
I have this link on Thy.
http://tinyurl.com/98duq
Phil

[luke77]

I don't see why you wouldn't want to start on just t4 (synthroid), since most people convert t4 to t3 well - and then switch to a combo product if your symptoms persist.

[lepiricus]

Originally Posted by luke77

I don't see why you wouldn't want to start on just t4 (synthroid), since most people convert t4 to t3 well - and then switch to a combo product if your symptoms persist.

From my understanding, synthroid is indeed the most prescibed drug to treat hypothyroidism. This is not often best choice though from many things I have read. There are many anecdotes about t3 combined with t4 relieve symptoms much better than t4 alone.

I found this write up from Avant Labs about cytomel supplementation. It states that induced "hyperthyroidism" can raise SHBG 150% and total serum testosterone 42%. I am assuming a similar hormone resoponse would occur from someone going from hypo to normal as this has shown to happen from going normal to hyper.cytomel

[luke77]

I've seen that article before; however, I have also read that using a t4/t3 combo is more likely to cause side effects than plain t4. I don't have any studies to back that up because I don't remember where I read it, but it's something to consider. Probably your best bet is to discuss all options with your endo.