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Thyroid question. Tsh - 2.79. Low vitamin D. Testosterone…

Thyroid question. Tsh - 2.79...
Thyroid question. Tsh - 2.79. Low vitamin D. Testosterone 669.I’m still struggling with symptoms. I just had a visit with the endocrinologist and they seem to think it’s mental. I go on and off of feeling good to feeling a bit bad.
Still feel fatigued and have some issues with erections as I did not have before prior. Am an athletic guy. 29 years old. Good lipid panel as of November 2017.
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Answered in 12 minutes by:
3/20/2018
Richard Han
Richard Han, Board Certified MD
Category: Endocrinology
Satisfied Customers: 964
Experience: Physican with over 15 years experience
Verified

Hello my name is***** am a board-certified physician with over 15 years of clinical experience and I am happy to help you. I'm sorry to hear about your current struggle. Can you tell me please do you have any chronic medical conditions or take any medications regularly? Have you been having any changes in appetite or energy level lately? Any difficulty falling asleep or staying asleep? Any major life changes recently such as a geographic move, relationship break up, death of a friend or family, stress from work or school?

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Customer reply replied 1 month ago
Hi. So I was diagnosed with hypothyroid ism in October of 2017. Tsh was 7.83. We started levothyroxine and took up to 75 mcg to get thyroid level to 2.79. I recently switched to actual brand synthroid as a family relative did say to me that synthroid is better absorbent.I stopped taking a multi vitamin and only take vitamin D, B complex vitamin and magnesium 250 mg.

My apologies for the delayed response. I became side tracked in my office. I'm glad to hear that the thyroid condition has been adequately addressed. Your current TSH and testosterone levels are both within the normal range. The symptoms you are having do not appear to be related to your thyroid gland or hormone levels. The endocrinologist essentially believes that his/her work is done, and it is possible that your fatigue, issues with erections and on/off feeling of good and bad may be psychological and/or emotional. Depression can certainly cause all of the above, as I was alluding to in my series of questions above. If you believe that might be a possibility, I would encourage you to seek help in the form of therapy/counselling as well as antidepressant medication. You can talk with your primary care provider and/or a psychiatrist. Is there anything else I can help you with, or any specific questions I can answer for you?

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Customer reply replied 1 month ago
HMm well first of all I don’t feel depressed. Never struggled with depression. I felt great before hypo thyroid symptoms came to play.
Customer reply replied 1 month ago
I’ve been reading about t4 to T3. Why don’t doctors or endos test T3
Customer reply replied 1 month ago
Also can I take OTC medicines like a 12 hour relief pseudofed ?
I’m glad to hear that you do not feel or believe you are depressed. So long as th TSH and T4 are normal, T3 is virtually always normal. T4 is converted to T3 peripherally in the body tissues, independent of the thyroid gland so it isn’t routinely checked. That being said you can certainly request your physician add it on to your current lab panel. If it was recent, there may still be some of your blood specimen available on hold in the lab and it would only take a phone call from your doctor to have it checked as a test add on.
Yes, you can safely take OTC decongestants like Sudafed (pseudoephedrine).
Anything else I can help with?
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Customer reply replied 1 month ago
Is there anything that could be underlying? Any foods I shouldn’t be eating?
Customer reply replied 1 month ago
My T4 was normal when my TSh was high in November. I haven’t had a recheck of my T4 once my tsh normalized.My vitamin D was low so I take 2-5,000 IUS per day. Could that have an effect on my erection issues?They are testing cortisol and adrenals as well.
Since your TSH has normalized, no need to recheck your T4 technically since it was never even low. Low vitamin D can cause some of your symptoms too so it’s good to take the supplement you are taking. Sounds like your doctor is being very thorough in checking cortisol and adrenal steroid hormones too, since they can affect the symptoms you’re having too. No need to avoid any particular foods, just continue a well balanced healthy diet. All in all I’d say you’re receiving excellent medical care already.
Any other questions I can address for you?
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Customer reply replied 1 month ago
Actually it’s not my primary care that ordered these tests. My Endo did. If I didn’t push for my thyroid and vitamin levels to be checked back in the fall , idk if I’d find out. But that’s a different story.
Customer reply replied 1 month ago
My concern is things haven’t return to normal. My pressure was 100/70. Lipids, sugars and metabolic were all good.
Customer reply replied 1 month ago
Honestly I think all my blood work was great minus vitamin d. Tsh is now normal. Not sure if I’d function better off a lower number under 2.0?
Is it true that it’s better to be on brand name synthroid and not generic? I just switched a week ago to the brand name for better absorption.
No need to have a lower TSH, within the normal range is where you want to be, raising your Synthroid dose would not provide any further benefit and would likely cause adverse side effects. For some patients, yes, using the branded drug over the generic can be better. Now that you are euthyroid you could consider with your endocrinologist, after a certain time period of staying within the range of normal, switching back to a generic in the interests of cost reduction, to see if you remain euthyroid.
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Customer reply replied 1 month ago
Shouldn’t my symptoms resolve after being normal? Should I add a multi vitamin back to my regime?
I’m getting erections as I am in a relationship but sex is not the same. I don’t wake up with them. When I get them they’re not long lasting as before the hypo thyroidism. I tried explaining this to the Endo. And I didn’t get much resolution. He did a physical exam and said everything felt normal.Is it possible or common that symptoms take a while to resolve?
Customer reply replied 1 month ago
As I add, before hypothyroid , I had a 5-6 day workout routine, avid tennis and basketball player after work leagues, and a very high sex drive to satisfy my girlfriend. I know my body has not returned to normal. I may have had one or two nights that I’ve had in that time frame sexually since February 20th (when I returned to normal) but I haven’t seen consistency.
I understand your concern. You can certainly add back vitamins to your intake, particularly B complex ones that are helpful in terms of restoring energy. It is still very possible that you just need more time since you’ve only been back to euthyroid status for about a month and from the sound of it we’re likely clinically hypothyroid for a time period much longer than that. Think of your condition similar to adrenal fatigue, but thyroid. It would take at least as long a time period back to normal and maybe even longer in comparisons to the time you were hypothyroid. But have hope, you are well in your way toward recovery.
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Customer reply replied 1 month ago
WHats an average time frame it takes it takes patients to fully recover after being in euthyroid ?
Difficult to say. It depends on how long you were hypothyroid. If we assume you were hypothyroid for 4 months, then I would say about 4-6 months to retune to normal. Any other questions?
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Customer reply replied 1 month ago
what if I was hypothyroid for 2 years?
Customer reply replied 1 month ago
Could I really lose another year off my life feeling like this

Probably not, but it still may take some time as your body re-adjusts to having an normally active thyroid. Certainly more than 1 month as it has been so far. I would have high hopes, in my opinion, now that you are on the correct Synthroid dose with good lab values, it's just a matter of time.

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Customer reply replied 1 month ago
What scares me is that I was a 4.4 tsh with no symptoms in 2011 and labs were not repeated yearly until my symptoms took a toll on me last summer.- August 2017.
Customer reply replied 1 month ago
I’m also doing some research on foods to eat and cut out. IT says peanuts and peanut butter.
That I should include more vitamin B, a, d, e, selenium , zinc and iodine in a multi vitamin ? Or the amino acid tyrosine.Do you recommend a specific multi vitamin that contains these?

You can try MegaMen by GNC. It has everything you listed above, except tyrosine. GNC also has a separate L-tyrosine 500mg supplement you can take with it.

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Customer reply replied 1 month ago
I used to take that and I quit. I’m not sure if the fillers are too much.I’ve never used this site before. Should I consult with my doctor first ?Is there anything I should eliminate from my diet?

I do not believe you need to eliminate anything from your diet unless you find a correlation between intake and stomach upset. When it comes to OTC vitamins, as long as you use them as directed on the packaging, and in your case none are marketed as having "thyroid supplement like effects" you should be able to safely use them, however if you have any concerns it never hurts to consult your physician first.

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Customer reply replied 1 month ago
COUld the largenine and vitamins in mega min and tyrosine maybe improve my energy and erections back to normal ?
Customer reply replied 1 month ago
Does the thyroid medicine deplete any of your vitamin levels? That is a huge question I have.

The MegaMen vitamins and supplements could improve your energy level, particular because of the B complex vitamins, but probably not affect erections. There is another OTC supplement known as yohimbe that may help in terms of both energy levels and erections. It is relatively safe but can interact with some medications such as blood thinners, blood pressure and anti-seizure meds, but not to my knowledge with thryoid medication. Best to ask you endocrinologist. Synthroid does not deplete any vitamin levels in any way.

I've enjoyed our interaction but now need to bring this conversation to a close. If you feel that I've been helpful and informative as your expert through this series of questions, I would kindly ask that you accept these many answers and favorably leave a 5 star review. To continue with any further questions, I would also request that you open a new question and request me personally if you like. Thank you and have a great evening.

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Customer reply replied 28 days ago
Could there be something underlying in regards ***** *****? I don’t think I show signs of heart disease or anything. Could it just be the thyroid or vitamin D?I thought l Argenine could help
Probably not from the vitamin D but could be a residual effect of being hypothyroid, which should get better over time now that you’re euthyroid. L-arginine is purported to help with erections because it gets metabolized into nitric oxide which can help Dialer blood vessels, but taken alone in studies didn’t show much improvement. However, results were better when l-arginine was combined with yohimbine.
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Customer reply replied 28 days ago
Yeah my issue is I haven’t had an erection in over a week. And I know my body. And it’s defintely not back to normal.My Endo called with my test results and all are good. But told me to give it until May if I’m not feeling better which I’m not sure what they do.
I’ve never had depression or anxiety issues so I’m kinda sick of people telling me it could be that.
Customer reply replied 28 days ago
when you say these symptoms “should “ get better. I’ve been on the thyroid medicine since October 3,2017. I feel like I’ve lost a year of my life being myself. And it’s extremely frustrating that I’m in the normal range but I’m no where near the same.
Customer reply replied 28 days ago
I have consistent headaches too in the front of my head. Not sure if it’s sinus related or not.
Customer reply replied 28 days ago
my Endo said not to be concerned about not waking up with erections....which I’m confused Bc before I had symptoms I did almost daily or would wake up In the middle of the night with one. And I didn’t need stimulation to get them. I had a high functioning energy level and sex drive.
Customer reply replied 27 days ago
Anyone going to assist? Or shall I ask for a refund?
Customer reply replied 27 days ago
Anyone assisting?
Customer reply replied 27 days ago
Is there could be anything underlying outside of the thyroid issues that I should have checked? Any other symptoms I should be looking for? Should my tsh be under a 2.0 ?
DocPhilMD
DocPhilMD, Internist
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Satisfied Customers: 58,697
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Hello. Thank you for your patience. I am so sorry for the long wait, but I have been busy taking care of patients and have just now come online. Would you like my help with your question today?
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Customer reply replied 26 days ago
please. Have you evaluated what I’ve stated above?
Customer reply replied 26 days ago
I’ve been euthyroid now for a month. I’ve switched from generic levothyroxine to brand name synthroid about 10 days ago Bc I still have symptoms of no energy , brain fog, headaches and lack of erections. I’m a former athlete who before hypo thyroid, was energetic , had a very high sex drive and was sharp. I’m a supply chain manager and am excellent at my job.I just want to get back to normal again and I don’t feel it. I’ve never struggled with depression or stress.
The only thing that has frustrated me was not feeling right with hypothyroid ism.

Have you had T3 checked?

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Customer reply replied 26 days ago
NO my doctors say it’s unecessary because my free T4 was 1.21. I asked about it and they said no reason to test. Is that accurate?

I often will add a low dose of cytomel to synthroid or levothyroxine to help when people still have symptoms

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Customer reply replied 26 days ago
What is cytomel? I don’t mean to be rude but you have to provide details. I’m not familiar with medical terms.

Yes, this is a form of T3 that you can take

like synthroid but T3 instead of T4

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Customer reply replied 26 days ago
Is my doctor correct in T3 is normal if T4 is a 1.21 with tsh being 2.79?
Customer reply replied 26 days ago
Or should I request a full lab of thyroid testing. T4-t3

No he is not correct

you need a full thyroid panel

I sincerely ***** ***** I have helped you, and that I have earned my 5 star rating today.

Please remember to rate my service by selecting the 5 stars at the top of the screen ( rating me now does not close your question).

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Customer reply replied 26 days ago
Can I ask...is there any thing I can take OTc to supplement better T3 function? Why is T3 controversial ?And next thing I’d like to ask: is it normal that symptoms can take a while to subside? Like for instance could it be that Bc I was hypo thyroid for a while that my body could still be adjusting to new tsh ?

T3 isn't controversial

I think it is more laziness honestly

there are no supplements I am aware of

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Customer reply replied 26 days ago
How rare is it for T3 to be low? What is the exact test I should ask for?
Customer reply replied 26 days ago
how long does it take for t3 medicine to resolve symptoms?

it is not that rare

I see it all the time

Ask for a free T3 level

It takes 4-6 weeks

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Customer reply replied 26 days ago
Will they give me a test after I’ve asked?
Customer reply replied 26 days ago
My next question is what if my T3 is normal ?

1)I hope so but I can't be sure

2)then you should look at other issues like vitamin deficiencies and adrenal gland issues

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Customer reply replied 26 days ago
Bc I’ve felt okay some days then I seem to regress. I can’t get strong erections like I’ve used to. Im 29.
Customer reply replied 26 days ago
I’ve had adrenal, testosterone and cortisol performed. They came back fine.

Ok

sleep study

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Customer reply replied 26 days ago
I’ve had vitamin B12 and Vitiman D checked. B12 was normal. Vitamin d was low but recent check I was at a 40 as I’m supplementing about 4,000 iu a day o

sleep study?

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Customer reply replied 26 days ago
What about that

have you had one?

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Customer reply replied 26 days ago
Why wouldn’t doctors order a full thyroid panel ? They’re not drawing the blood.
Customer reply replied 26 days ago
My endocrinologist doesn’t believe in T3 either.
Customer reply replied 26 days ago
no I have not had a sleep study.

I don't know why they wouldn't order it

I have no idea

I would recommend a sleep study in that case

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Customer reply replied 26 days ago
I’m getting soft erecgions. No 100%. Im exercising 3-4 days a week but I just feel exhausted. I don’t wake up with them often. And I’m in a relationship. Whenever I attempt sex with my girlfriend it doesn’t last long and it’s killing me. Doctors won’t listen to me.
Customer reply replied 26 days ago
Can you explain why I need a sleep study? I’m not a medical professional. I’m detailed and need an explanation.

Think about how important sleep is. It is 1/3 of your life

If you aren't getting adequate sleep it affects EVERYTHING

or if your sleep is disrupted

A sleep study will help determine if you have obstructive or central sleep apnea

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Customer reply replied 26 days ago
I don’t have a hard time sleeping. I sleep 7-10 hours s night. Pending which night it is during the week. I sleep in on Sundays til about 9 am.

Yes, but it may not be adequate sleep or your REM sleep might be disrupted for a variety of reasons

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Customer reply replied 26 days ago
Do fit bits measure REM sleep? I get about 2-4 rem per night on that

No, not accurately

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Customer reply replied 26 days ago
Is it possible I just need more time to adjust or do I sound like a patient who needs T3?

I think you need T3

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Customer reply replied 26 days ago
How should I ask? They weren’t a believer last time.
Is there anything potentially underlying that could be causing this outside a sleep study?

Nothing that you haven't had tested

I would just be honest and sincere

tell him that you are very concerned and would like the test

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Customer reply replied 26 days ago
Will insurances cover that test if you have hypo

Yes, they should

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Customer reply replied 26 days ago
IS it dangerous for them to prescribe me T3 hormone without testing for T3?
Customer reply replied 26 days ago
Or is it recommended to have a tsh lower than 2.0?
Customer reply replied 26 days ago
What is reverse T3? And are there side effects to cytomel?
Customer reply replied 26 days ago
my final questions are I currently take a multi vitamin - GNC mega man. Is that ok?And is there a certain diet plan I should follow? Maybe get with a nutritionist for hypothyroid?

1)yes it is dangerous

2)TSH around 1.0 is ideal

3)I find reverse T3 to be of little value. Side effects are same as synthroid

4)GNC multivitamin is fine but probably not necessary

5)get the book eat to live by joel fuhrman. That is the best diet

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Customer reply replied 26 days ago
Should I ask to have my dose of synthroid upped from 75 mcg to 100 then? I’ve been on 75 since January 5th.How would I take T3 if it’s needed?I’m getting worried because I don’t think I’ll ever feel normal again. My girl friend is patient but I can tell she isn’t happy about how I act
I thought those were your final questions. ;)
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No I would get T3 tested and go from there. A low dose of cytomel works wonders. You take it with the synthetic T4 as normal
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Customer reply replied 26 days ago
I know I’m sorry. I don’t get more than 10 minutes with these docs at my appointments.Should I eventually feel better? I was a 6 day a week workout warrior and highly functional sexually active male with my girl friend of 2 years. I want my life back.
I'm hoping for you man. I truly am. No one can predict the future. But I hope so.
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Customer reply replied 26 days ago
Have you seen thyroid patients never feel the same again ?
I have unfortunately
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Customer reply replied 26 days ago
https://drhagmeyer.com/thyroid-treatments/Are these the tests they should be ordering?

I don't think so because they don't really help with treatment

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Customer reply replied 26 days ago
I also would like to pick your brain. If my test came back negative for Hashimoto, my ultra sound was normal , yet when I was diagnosed, I had a 7.8 tsh. What could have caused it?Is there some nutritional deficiencies I could also have checked like selenium zinc iodine and vitamin a?And is there anything I can do to improve my erections or is that something T3 would have to play a part?
Customer reply replied 26 days ago
have you ever seen patients not return to normal after hypothyroidism?

The antibodies probably just haven't shown up yet

they will

I don't believe in nutritional deficiencies causing this. You are eating a standard western diet high in vitamins and taking a vitamin so unlikely.

I'm not sure about the erections. It could be a part of the T3. Or the hypothyroid. So yes.

Yes, I have seen them return to normal

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Customer reply replied 26 days ago
Will my erections return?

I hope so my friend

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Customer reply replied 25 days ago
55357;�
Customer reply replied 25 days ago
I switched from the generic levothyroxine to brand synthroid. I read that that should be better not worse for me? I don’t know

It depends on who you ask

I have seen it help and not help

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Customer reply replied 25 days ago
Like I have headaches and am just feeling run down
Customer reply replied 25 days ago
Are the chances high I’ll never get my energy and sex drive back? I’m really nervous :(

Part of the issue is you have to stop obsessing over it my friend.

Try to push through and make the best of it until you can get the follow up testing

the more anxiety you have the worse it will get

I sincerely ***** ***** I have helped you, and that I have earned my 5 star rating today.

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Customer reply replied 25 days ago
I know but it’s hard. I’ve been feeling this way since June/July of 2017 so it’s becoming quite frustrating that a year of my life has been affected.Just think when these doctors just say you should be feeling fine and you don’t and continuously have to wait

I don't agree you should be feeling fine

if you don't feel normal then your doctors need to keep looking or think outside the box

If you were my patient, I would be doing that

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Customer reply replied 25 days ago
I rated you 5 stars and the endocrinologist office will call me back tomorrow

ok great!

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Customer reply replied 25 days ago
THANK you. I’ll have to be more forward of how I want to make this work.

You have to take the bull by the horns

squeaky well gets the grease

etc etc

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Customer reply replied 25 days ago
Is there anything underlying besides T3 I should have checked for erection issues and fatigue? And my frontal headache.

was testosterone checked?

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Customer reply replied 25 days ago
Yessir. 669
Customer reply replied 25 days ago
My one question would be is we had a water main break a year ago and I wasn’t notified and drank water. Could I just have some toxicity of copper, lead or mercury or chlorine in my blood? I’m phishing here but I’m not sure.

No I don't think so.

You could have blood tests done

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Customer reply replied 25 days ago
Guessing I’d have other symptoms?
I’m thinking my headache could be a sinus infection as my eyes are tearing and it’s painful but that wouldn’t cause issues with my erections right? My back teeth are extremely sensitive. I’m not sure

No I don't think that would be related

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Customer reply replied 25 days ago
Thank you. The only other thing I can think of is heart disease. Could thyroid issues cause heart disease? I never had an issue with blood pressure or cholestoral. I’m. Not sure what the If dental issues are related to it? I just went to the dentist and everything was fine.....Could I have that and not know it or are there symptoms?

would you mind accepting additional services?

we can continue as long as you like

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Customer reply replied 25 days ago
No I don’t have the money for that.

We're really not supposed to keep the questions open forever

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Customer reply replied 23 days ago
They ordered a free T4 -T3 test.
But they also asked me to go to my primary to see if it could be something else underlying. My concerns are I feel light headed during cardiovascular vascular exercises fatigue and sexual dysfunction. And some headaches near the sinuses and bloating.I hope it’s nothjng regarding the heart. If you’d like to shed an opinion great. But if you can’t. I understand.
Customer reply replied 7 days ago
Hey. My T 4 to T3 came back normal. I still feel 50/50. Is that Normal?
Customer reply replied 7 days ago
Erections and fitness /energy level is not where it is and I have frontal headaches.What vitamin deficiancies should I look for
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Medical Degree, Former Assistant Professor at School of Medicine at Yale University

DrRussMD

DrRussMD

Board Certified Physician

51,786 satisfied customers

Internal Medicine--practice all of internal medicine, all ages, family, health, prevention, complementary medicine, etc.

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Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

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