RunningMan's Blood Tests - Elevated TSH

Member Stories Lab Tests
#1

I had my blood tests done a few months ago so I wanted to post the results and get some feedback.

I posted my story in the Members Stories section but I’ll summarize here:
I am now in my youngs thirties. I started Propecia in September of 2000 while in my early twenties. I had almost no side effects for 7 years besides that my ability to sustain an erection slightly decreased several months after starting the medication. Then I finally developed major side effects in 2007 and quit in December 2007. It’s been about 2.5 years being off and I haven’t recovered. My side effects include:

  • erectile dysfunction
  • low libido (used to be sky high)
  • dry skin (used to be oily)
  • wrinkles on penis skin
  • emotional flatness (I used to have a really bad temper, now I hardly ever get angry. I also don’t get pumped up or excited by much anymore.)

I went to an andrologist this May and got my bloodwork done. He told me that everything is fine, and recommended that I should see a psychologist. My initial TSH test came back high, so he had me do another one, and it came back within range (barely). On the second test, I also tested for thyroid antibodies, but I was ok in that department.
My doctor said that my TSH was starting to get high and I should get it tested every 3 months to keep an eye on it, but that it wasn’t responsible for my symptoms.

To me it seems that my testosterone is on the low side, and my SHBG, estradiol, and TSH are on the high side. Furthermore, I found some of my lab results from physicals I did years ago, and my TSH used to be way lower. So that tells me something.

5/12/2010 (Tests ordered by andrologist)
Testosterone Total - 536 (250-1100 ng/dL)
Testosterone Percent Free - 1.56 (1.50-2.20%)
Testosterone Free - 83.6 (35.0-155.0 pg/mL)

LH - 2.1 (1.5-9.3 mIU/mL)
FSH - 4.1 (1.6-8.0 mIU/mL)

SHBG - 38 (8-48 nmol/L)
Prolactin - 7.3 (2.0-18.0 ng/mL)
Estradiol - <50 (<=54 pg/mL)

TSH - 5.21 (0.40-4.5 mIU/L) HIGH
T4 Total - 8.2 (4.5-12.5 UG/DL)
T4 Free - 1.5 (0.8-2.7 ng/dL)

5/28/2010 (Follow up tests ordered by andrologist)
TSH - 4.22 (0.40-4.50 mIU/L)
Thyroid Peroxidase AB - 19 (<35 IU/mL)

I had several blood tests done throughout the years during physicals that included TSH. As you can, my TSH used to be drastically lower than it is now.
9/27/2004 (On Propecia, no side effects at this time)
TSH - 2.3 (0.4-5.5 uIU/mL)

2/23/2006 (On Propecia, no side effects at this time)
TSH - 2.9 (0.4-5.5 uIU/mL)

6/7/2007 (On Propecia, around the time my side effects began)
TSH - 2.3 (0.4-5.5 uIU/mL)

So it would be great to hear feedback from Mew or any other experienced members. Also, I am trying to treat the problem with supplements at this time, so if anyone has any recommendations in that area, it would definitely help me.

#2

The two areas I noticed, as you already have, are TSH being somewhat elevated, and SHBG/low Free T%.

Since SHBG binds to Testosterone, the higher it is the less Free T you will have available which is biologically active/available to the body. Supposedly, a drug called Danazol in low doses can lower SHBG, however it may also have surpressive actions on the HTPA. Shippen I believe may prescribe it in certain cases, but that is only what I have heard second hand.

In any case, your TSH seems to be much higher compared to years back and as others on here have noticed, hypothyroidism while on/after Finasteride seems to affect a fair number of us. Finally, your Estradiol was not the “ultrasensitive” test and this is generally considered unreliable… elevated estradiol/estrone/estriol can surpress overall Testosterone production, so you might want to get that re-tested using the ultrasensitive assay.

Natural supplement-wise I’m not sure what to suggest, others have mentioned kelp, iodine and sea salt for hypothyroidism, but I’m not an expert in this area and recommend you do your research. Otherwise, consider seeing the doctors most often mentioned on this site if you can afford it, and see what they suggest for treatment (TSH/SHBG or otherwise).

#3

TSH is higher because your body is telling itself to make more T4. It is out of range…The new accepted range is between .40-3.00 TSH. Free T3 should be at top of the range for optimal benefit. Conversion can be hindered if you AREN’T taking a good multivitamin.

Are you taking any multivitamins? This is also very important because a good multivitamin has B1, B2,B3, B6, B12, iron, iodine, selenium(very important for T4 to T3 conversion) and other vitamins that will help assist thyroid function.

Best luck to you…

#4

this high tsh is starting to become a pattern,looks like u have thyroid problems as well.

#5

Thanks Mew and everyone else for the feedback. I had been taking Nettle Root to increase my free testosterone because it binds to SHBG. But I just read on the forum today that it also inhibits 5a-reductase so I am going to try Avena Sativa instead.

As for multi-vitamins, I’ve been taking Centrum for years. I recently started taking “Thyroid Complex” from the Vitamin Shoppe, which includes:
B1, B2, B6, B12, Iodine (from kelp), Magnesium, Zinc, Selenium, Copper, Manganese, Molybdenum, and L-Tyrosine.

I also bought “Raw Thyroid” from Natural Sources which contains raw thyroid glandular concentrate. It seems to be similar to Armour Thyroid. I have not started taking this regularly yet because the Thyroid Complex might be enough to deal with with elevated TSH.

Also, thanks Mew for clarifying my estradiol test result. It will probably be a while before I can get the better test because I need to find a new doctor who would be willing to do that. For right now, I am taking DIM to keep my estrogen under control.

#6

I take thyroid complex as well…Good choice…However, I’m no where near cured…

Again, I believe our problems stem from pathyophysiological issues that are neurological. Everybody’s body is different, which can make things a bit complex…

#7

I had some further lab tests done for Dr. Irwig’s study. I also had my doctor order some Thyroid tests since my TSH was high in the past. These tests were done at LabCorp and my previous tests were done at Quest Diagnostics, so I can’t do a direct comparison.

The Reults are:
4/3/11
Testosterone Total - 554 (249-836 ng/dl)
Testosterone Free - 11.8 (8.7-25.1 pg/ml)

TSH - 5.700 (0.450 - 4.500 uIU/ml) HIGH
T4 free - 1.48 (0.82-1.77 ng/dl)

DHT - 36 (30-85 ng/dl)

So overall the results are pretty discouraging as it seems I’ve gone downhill from a year ago. My TSH is clearly too high and seems to be rising. But interestingly my free T4 seems fine. Can anyone explain this? My free testosterone and DHT are right around the bottom of the range, so this is clearly bad. Since my total testerone is not too bad, I am guessing that I probably have a high level of SHBG which accounts for my low free testosterone. But I didn’t have that tested this time.

If anyone has any other observations, I would like to hear them.

#8

Elevated TSH points to hypothyroidism. Did your doc have anything to say about these results?

E2 and SHBG would be good to know, as well as 3-adiol G.

#9

I have not been back to see my doctor yet but he did add a few notes to my lab reports. He said that my DHT and testosterone are “normal” and my TSH is “slightly elevated” and there is a good chance it will return to normal.

Given that my TSH has been elevated for at least a year now and is increasing, I don’t see much chance of it returning to normal on it’s own. As for my testosterone and DHT, I don’t consider being at the bottom of the range normal for a 32 year old. But it was my general practitioner who ordered the tests, so I didn’t expect much insight from him.

#10

Here are the results from the second round of lab tests I had done for Dr. Irwig’s study. Interestingly, my TSH and DHT levels look significantly better in this test, and my testosterone was improved. But I did not feel any better than usual the day I had the tests done.

6/28/11
Testosterone Total - 592 (249-836 ng/dl)
Testosterone Free - 13.6 (8.7-25.1 pg/ml)

TSH - 3.760 (0.450 - 4.500 uIU/ml) HIGH
T4 free - 1.45 (0.82-1.77 ng/dl)

DHT - 52 (30-85 ng/dl)

#11

Here are the results of the two fertility tests I had done for Dr. Irwig’s study. I did not have a doctor give me an analysis of the results, but everything looks pretty much normal. The semen volume is slightly below range in the first test, but is within range on the second test.

5/5/11
Volume - 1.4 (>=1.5ml)
Concentration x 10^6/ml - 49 (>20x10^6/ml)
% Motile - 78 (>=50%)
Progression - 2 (2+ to 4)
pH - 7.6 (>=7.2)
Viscosity - Normal
% Normal Morphology - 13 (>=4%)
Round Cells x 10^6/ml - 2.3 (<=3.0x10^6/ml)
Total Motile Sperm x 10^6 - 54 (>8)

7/21/11
Volume - 2.6 (>=1.5ml)
Concentration x 10^6/ml - 59 (>20x10^6/ml)
% Motile - 69 (>=50%)
Progression - 2 (2+ to 4)
pH - 7.4 (>=7.2)
Viscosity - Normal
% Normal Morphology - 4 (>=4%)
Round Cells x 10^6/ml - 2.7 (<=3.0x10^6/ml)
Total Motile Sperm x 10^6 - 106 (>8)

#12

Were the times of these tests different? I also have had high TSH… Even higher then yours, 6.24 to be exact… Armour thyroid didnt do much for me… I’m going to start T3 and see how that works for me… Id imagine that it will give me some needed benefit… I also have high thyroid antibodies, which is something you should have gotten done as well, along with Reverse T3… I suspect t3 will help me a bit, but nothing substantial… Ill let you know how I feel on it…My free t is also mid range slightly low as well…

#13

Your body is attacking your thyroid. You should not have any anti-bodies at all. Your level is 19.

Free testosterone is low, but SHBG is semi-decent. This could mean that your albumin is high.

DHT is also low.

You also need to get these tests to see a bigger picture.

Free T3 (not T3 uptake)
Reverse T3
Cortisol 24 hour urinary

#14

I forgot to include my free T3 value from my last lab.

For the sake of completeness, here are all of my thyroid related values from 6/28/11
TSH - 3.760 (0.450 - 4.500 uIU/ml)
T4 free - 1.45 (0.82-1.77 ng/dl)
T3 free - 3.4 (2.0-4.4 pg/ml)

#15

I went to see Dr. Irwig today and showed him all of my lab results. He said that nothing in my lab results explains my problems. I asked him about my TSH, and he stated that it indicated subclinical hypothyroidism, but it was not high enough that he would recommend medication since my T3 and T4 were normal. I also asked him about the thyroid antibodies test, and he said that it was normal to have some antibodies and that my level of antibodies was not something to be concerned about.

I asked him what he thought about trying TRT. He stated that based on his survey, almost no PFS sufferers improved with TRT, and if they did improve it was only temporary. He also considered my testosterone level to be normal and did not think TRT would be beneficial to me. He said that the only medication that he thought would be worth trying is direct DHT supplementation, but unfortunately that is not available in the United States (at least not legally). So I am not going to be taking any medications for right now.

#16

ask him to test 24 hour urinary cortisol and rt3

#17

Yeah, because you haven’t tested E2. Furthermore, the last time you tested it (15 months ago), you wrote the result as:
Estradiol - <50 (<=54 pg/mL)
I’m not sure but it looks like the lab performed a “female estradiol” test. You must test male estradiol (sensitive test), which would look more like 14.7 (12-40).

#18

I decided to see one of the top thyroid doctors in my area since I’ve had an elevated TSH based on my lab results in the past.

He had me get some preliminary tests done to start out with before starting any new medication. Here were the initial results:

12/28/12 (Before taking any medication)
Total Testosterone - 667 (348 - 1197 ng/dL)
SHBG - 42.5 (16.5 - 55.9 nmol/L)
Calculated Free Testosterone - 120 pg/ml

TSH - 4.080 (0.450 - 4.500 uIU/mL)
T3 Free - 3.7 (2.0 - 4.4 pg/mL)
Reverse T3 - 17.6 (9.2 - 24.1 ng/dL)

Vitamin D, 25-Hydroxy - 74.3 (30.0 - 100.0 ng/mL)
Fibrinogen Activity - 243 (193 - 423 mg/dL)
Ferritin, Serum - 81 (30 - 400 ng/mL)
Magnesium, RBC - 5.3 (4.2 - 6.8 mg/dL)

It showed that my TSH was in the high range. My total testosterone was higher than in the past probably due to taking DHEA. My Vitamin D level looked good (I supplement 10,000 IU per day).

He put me on Armour Thyroid, starting at half a grain (30 mg). After several weeks I tried to bump it up to 1 grain but this gave me terrible insomnia, so after giving it a try for a couple weeks I went back back down to half a grain. I stayed at this level for several more weeks before getting my follow up lab work done. Here were the new results:

2/7/13 (On Armour Thyroid)
TSH - 1.760 (0.450 - 4.500 uIU/mL)
T3 Free - 3.6 (2.0 - 4.4 pg/mL)

My TSH went down a lot to well within range. Interestingly, my free T3 stayed the same. The results of taking the medication is that I have more energy and feel better when doing athletics. It did not help any of my other symptoms.