UK NHS doctors & low T diagnosis

[Guest guest]

Hi..this is my first post here,hope you can give me some guidance...I'm

in the UK & because of low funds restricted to working with NHS docs.

My names Andy,45 years old..diagnosed with ME/CFS 15 years ago then

pretty much abandoned by my docs..had the usual gamut of tests & had the

usual NHS docs response..everything is in the " normal range " there's

nothing wrong,we'll label you with CFS & forget you.

I have always had low energy,low libido,almost no night time

erections,low life drive..from my mid 20's on everything worsened,I took

days to recover from physical activity,I'd feel shaky,spacy,brain

fogged,anxious..as I reached my late 20's I was a complete physical

wreck,zero energy,virtually no libido or night time erections,completely

intolerant to exercise,felt cold all the time,low basal temp,low

metabolic temps,anxiety attacks,extreme muscle weakness,weight

gain,night sweats & sore hard nipples,dry skin/hair,almost every

hypothyroid/adrenal insufficiency symptom.

It reached the point last year where I felt as though I was going to

die..I was so weak that I could barely move,I could sleep 18 hours a day

& still have no energy,any physical activity left my muscles burning &

aching for days afterward,brain fog became so bad I couldn't remember

the day of the week,libido reached an all time low..no erections at

all,no night time wood,my testicles & penis look as though they are in

permanent cold weather mode they are so shrunken.

I have long suspected hormonal issues..thyroid/adrenal/low T as the root

cause of all my problems but kept getting told my tests where

normal..you have CFS,there's nothing we can do.

October last year I had a couple of tests performed by Genova

Diagnostics,results below....

Adrenal Stress Profile

Sample 1 8.4 Range 12-22 nmol/L

Sample 2 3.6 Range 5.0-9.0 nmol/L

Sample 3 1.0 Range 3.0-7.0 nmol/L

Sample 4 0.1 Range 1.0-3.0 nmol/L

Total Daily Cortisol 13.3 Range 21-41

DHEA-Cortisol Ratio 4.21(High) Range 1-4

24HR URINE T3 T4

T3 787 Range 592-1850 pmol/24h - according to Hertoghe (The Hormone

Solution..page 80) T3 should be over 1500 pnmol/24h

T4 859 Range 347-1994 pmol/24h - according to Hertoghe T4 should be

over 1800 pnmol/24h

These tests confirmed my suspicion that my adrenals/thyroid where far

from optimal,add in low basal & metabolic temps with virtually all

Hypothyroid & adrenal insufficiency symptoms I was pretty confidant to

self diagnose & self treat..NHS GP was not interested in looking at the

the

test results so I had no option but to self treat.

I started HC in October,metabolic temps stabilized at 27.5mg dosed 10

7.5 5 5 four hours apart last dose before bed,felt less fatigued/less

brain

fogged,less shaky...two weeks later started NDT (Naturethroid) at 0.25

grains,slowly increased at STTM recommended rate...Initial results where

promising then I hit problems at 2 grains,hyper type

symptoms,anxious,shaky,muscle weakness,short of breath..my resting pulse

stayed in the

low 60's & temperature didn't rise so seemed most likely it was an

intolerance issue not true hyper.

Stopped taking NDT about seven weeks ago...I continued on HC 27.5mg &

the recommended thyroid/adrenal support vits/mins..I had the following

tests performed 20th March to try & find why I was intolerant to thyroid

meds.

FERRITIN 33 Range 20-288 Think low ferritin is a major reason why

I couldn't raise NDT..asked GP for a full iron panel he only tested

ferritin.

B12 565 Range 150-650

FOLATE 615 Range 183-584

THYROID FUNCTION TEST

TSH 1.21 Range 0.3-5.6

Free T4 8.4 Range 7.8-14.4

As the TFT was performed one month after stopping NDT I don't know how

accurate the results are..I'm guessing TSH is probably still

suppressed below my normal baseline level..T4 from NDT is probably

exhausted but with TSH possibly still suppressed I'm guessing the result

is not completely accurate,although T4 at the bottom of range certainly

reflects my low temps & Hypo symptoms.

SERUM MAGNESIUM 0.89 Range 0.74-1.0

ELECTROLYTES

SODIUM 145 Range 133-145

POTASSIUM 3.8 Range 3.6-5.2

FBC

WBC 5.9 Range 4.0-11.0

RBC 5.35 Range 4.5-5.5

HB 16.4 Range 13.0-17.0

HAEMATOCRIT 0.495 Range 0.400-0.500

Now the big question...Testosterone,my GP was very reluctant to test

T..looking at the following result I'm glad he did.

SERUM TESTOSTERONE 12.7 nmol/L Range 6-27 How does 12.7 look to you

for a 45 year old guy..looking in the files section here 12.7

seems very low & would only be considered " normal " for a geriatric male

over 80

years old..it certainly feels that way.

Does 12.7 serum T point to low T as an issue necessitating further

investigation,particularly with zero libido/no night time

erections?..I'm seeing

my GP next week & need to go armed with enough info to get all the

necessary tests..so any guys in the UK here what tests did you manage to

get

from your GP & how low where your test results before the NHS treated

treated you for low T.

As I'm having to work with NHS docs can you please recommend the tests

required for low T diagnosis & if there is a problem enable me to find

out if it's primary or secondary.

If anyone can point me to any studies showing that a 12.7 serum T is too

low for someone my age it would be very helpful,I have a feeling my docs

going to say my T is in range therefore normal..if I can present studies

showing otherwise it might help in getting the required tests performed.

Hope you can point me in the right direction,I'm more convinced than

ever that hormone imbalance/insufficiency are the root cause of most if

not all

my health problems.

Thanks for your time..any guidance you can give will be very much

appreciated.

Andy

[Guest guest]

Hi Andy and Welcome,

You were right to go on HC meds and feeling hyper on NT meds even STTM is sets

it levels to high for some people. How fast did you go up on your NT meds.

When I was going up on Armour the old kind it took me about a yr. to get leveled

off.

I started on 45 mgs and went up every 2 weeks only 15 mgs if I did more it

stressed my Adrenals or Cortisol levels so when I got up to 90 mgs or one and a

half grains. I held this for 8 weeks then did labs if I still was looking low

and felt hypo I went up 15 more mgs. and head this 8 more weeks.

I ended up on 4 grains going by what the people at STTM said and I was there Mod

for Men's Only Thyroid.

My Free T4 was all ways on the low side 1.1 and my Free T3 as post mid range

near the top of the range. I was walking around on the hyper side. When Armour

was pulled by the FDA I could not get it. So I went on 150 mcgs of T4 and took

5mcgs of T3 3x's/day. I feel dam good on this and my Free T3 is mid range.

Your Ferritin is low you need Iron pills mine was very low and as it turns out I

need Iron pills for life. I take my Iron with Vit. C and I take supplements to

help with my Thyroid meds.

Biotics Bio-D-Mulsion Forte Vit. D 2000 IU's per drop I am doing 10 drops a day.

Solary Super Bio C 2 x’s/day 1000 mgs. Total.

Iodoral Iodine 1 tab / day 12.5 mgs.

B-12 (Brain) Methylcobalamin - 5000 mcg lozenges. 3x’s/week.

I am taking 800 mcg. Folacal for low Folate RBC

BioCitrate Selenium - 200 mcg 1x’s / day morning.

Krill Oil capliques 1,000 mgs. 2 with food morning mercola.com

I take this for Iron.

Ferrous Fumarate Iron pills 324 mgs 1x/day

Your Testosterone levels in my unit is 365 that of a man 80 to 100 yrs old there

are no studies showing when to put men on TRT unless they are below the normal

range. Yet any dam good Dr. knows your to low by how your feeling.

And you need to test your Estraidol levels if your above 75 pmol/l you need to

take something to bring this down.

Men that can't get there Dr. to treat this take this.

http://www.iherb.com/Enzymatic-Therapy-Pure-Rip-with-DIM-60-Tablets/12814?at=0

In this link is shows levels by age in your units and mine.

http://www.mens-hormonal-health.com/normal-testosterone-levels-in-men.html

If you can't get A Dr. to treat you see a privet one.

Co-Moderator

Phil

> From: <gomjabbar666@...>

> Subject: UK NHS doctors & low T diagnosis

>

> Date: Saturday, April 16, 2011, 4:54 AM

> Hi..this is my first post here,hope

> you can give me some guidance...I'm

> in the UK & because of low funds restricted to working

> with NHS docs.

>

> My names Andy,45 years old..diagnosed with ME/CFS 15 years

> ago then

> pretty much abandoned by my docs..had the usual gamut of

> tests & had the

> usual NHS docs response..everything is in the " normal

> range " there's

> nothing wrong,we'll label you with CFS & forget you.

>

> I have always had low energy,low libido,almost no night

> time

> erections,low life drive..from my mid 20's on everything

> worsened,I took

> days to recover from physical activity,I'd feel

> shaky,spacy,brain

> fogged,anxious..as I reached my late 20's I was a complete

> physical

> wreck,zero energy,virtually no libido or night time

> erections,completely

> intolerant to exercise,felt cold all the time,low basal

> temp,low

> metabolic temps,anxiety attacks,extreme muscle

> weakness,weight

> gain,night sweats & sore hard nipples,dry

> skin/hair,almost every

> hypothyroid/adrenal insufficiency symptom.

>

> It reached the point last year where I felt as though I was

> going to

> die..I was so weak that I could barely move,I could sleep

> 18 hours a day

> & still have no energy,any physical activity left my

> muscles burning &

> aching for days afterward,brain fog became so bad I

> couldn't remember

> the day of the week,libido reached an all time low..no

> erections at

> all,no night time wood,my testicles & penis look as

> though they are in

> permanent cold weather mode they are so shrunken.

>

> I have long suspected hormonal issues..thyroid/adrenal/low

> T as the root

> cause of all my problems but kept getting told my tests

> where

> normal..you have CFS,there's nothing we can do.

>

> October last year I had a couple of tests performed by

> Genova

> Diagnostics,results below....

>

> Adrenal Stress Profile

>

> Sample 1 8.4 Range 12-22 nmol/L

> Sample 2  3.6  Range 5.0-9.0 nmol/L

>

> Sample 3  1.0  Range 3.0-7.0 nmol/L

>

> Sample 4  0.1  Range 1.0-3.0 nmol/L

>

> Total Daily Cortisol 13.3 Range 21-41

>

> DHEA-Cortisol Ratio 4.21(High) Range 1-4

>

>

> 24HR URINE T3 T4

> T3 787  Range 592-1850 pmol/24h - according to

> Hertoghe (The Hormone

> Solution..page 80) T3 should be over 1500 pnmol/24h

>

> T4 859  Range 347-1994 pmol/24h - according to

> Hertoghe T4 should be

> over 1800 pnmol/24h

>

> These tests confirmed my suspicion that my adrenals/thyroid

> where far

> from optimal,add in low basal & metabolic temps with

> virtually all

> Hypothyroid & adrenal insufficiency symptoms I was

> pretty confidant to

> self diagnose & self treat..NHS GP was not interested

> in looking at the

> the

> test results so I had no option but to self treat.

>

> I started HC in October,metabolic temps stabilized at

> 27.5mg dosed 10

> 7.5 5 5 four hours apart last dose before bed,felt less

> fatigued/less

> brain

> fogged,less shaky...two weeks later started NDT

> (Naturethroid) at 0.25

> grains,slowly increased at STTM recommended rate...Initial

> results where

> promising then I hit problems at 2 grains,hyper type

> symptoms,anxious,shaky,muscle weakness,short of breath..my

> resting pulse

> stayed in the

> low 60's & temperature didn't rise so seemed most

> likely it was an

> intolerance issue not true hyper.

>

> Stopped taking NDT about seven weeks ago...I continued on

> HC 27.5mg &

> the recommended thyroid/adrenal support vits/mins..I had

> the following

> tests performed 20th March to try & find why I was

> intolerant to thyroid

> meds.

>

>

> FERRITIN  33  Range  20-288   

> Think low ferritin is a  major reason why

> I couldn't raise NDT..asked GP for a full iron panel he

> only tested

> ferritin.

>

> B12  565  Range  150-650

>

> FOLATE  615  Range  183-584

>

>

> THYROID FUNCTION TEST

>

> TSH  1.21  Range  0.3-5.6

>

> Free T4  8.4  Range  7.8-14.4

>

> As the TFT was performed one month after stopping NDT I

> don't know how

> accurate the results are..I'm guessing TSH is probably

> still

> suppressed below my normal baseline level..T4 from NDT is

> probably

> exhausted but with TSH possibly still suppressed I'm

> guessing the result

> is not completely accurate,although T4 at the bottom of

> range certainly

> reflects my low temps & Hypo symptoms.

>

> SERUM MAGNESIUM  0.89  Range  0.74-1.0

>

>

> ELECTROLYTES

>

> SODIUM  145  Range  133-145

>

> POTASSIUM  3.8  Range  3.6-5.2

>

> FBC

>

> WBC  5.9  Range  4.0-11.0

>

> RBC  5.35  Range  4.5-5.5

>

> HB  16.4  Range  13.0-17.0

>

> HAEMATOCRIT  0.495  Range  0.400-0.500

>

>

> Now the big question...Testosterone,my GP was very

> reluctant to test

> T..looking at the following result I'm glad he did.

>

> SERUM TESTOSTERONE   12.7 nmol/L 

> Range  6-27  How does 12.7 look to you

> for a 45 year old guy..looking in the files section here

> 12.7

> seems very low & would only be considered " normal " for

> a geriatric male

> over 80

> years old..it certainly feels that way.

>

> Does 12.7 serum T point to low T as an issue necessitating

> further

> investigation,particularly with zero libido/no night time

> erections?..I'm seeing

> my GP next week & need to go armed with enough info to

> get all the

> necessary tests..so any guys in the UK here what tests did

> you manage to

> get

> from your GP & how low where your test results before

> the NHS treated

> treated you for low T.

>

> As I'm having to work with NHS docs can you please

> recommend the tests

> required for low T diagnosis & if there is a problem

> enable me to find

> out if it's primary or secondary.

>

> If anyone can point me to any studies showing that a 12.7

> serum T is too

> low for someone my age it would be very helpful,I have a

> feeling my docs

> going to say my T is in range therefore normal..if I can

> present studies

> showing otherwise it might help in getting the required

> tests performed.

>

> Hope you can point me in the right direction,I'm more

> convinced than

> ever that hormone imbalance/insufficiency are the root

> cause of most if

> not all

> my health problems.

>

> Thanks for your time..any guidance you can give will be

> very much

> appreciated.

>

> Andy

>

>

>

>

>

>

>

>

>

[Guest guest]

Hi Phil..thanks for the welcome & your response.

I took three months reaching 2 grains NDT,that's when I started to experience

intolerance issues..as the intolerance issues worsened I decided to stop NDT &

have further tests to find the problem..I have been vegetarian almost thirty

years so suspected low iron as a possible problem,my ferritin level of 33

confirmed my suspicion..I am taking 50mg Iron Bisglycinate 2x daily with 2 grams

Vit C to raise my iron & will look at retesting in a couple of months time.

I gave myself a couple of weeks head start on iron before restarting NDT..I

restarted a week ago at 0.25 grains,felt so hypo after 4 days raised to 0.5

grains dosed 0.25 in the morning 0.25 mid afternoon,I'll hold there for 14 days

then try raising 0.25..when I reach 1 grain I'll probably hold for a month then

try raising 0.25 every 2 weeks till I reach 1.5 grains & hold again..I'll raise

far slower than STTM recommendations this time,allowing my iron reserves to

build & adrenals time to compensate for the additional load.

I take the following supps daily...

Natures Answer D3 drops-started 5 weeks ago,first 2 weeks at 24,000iu daily then

dropped to 8,000iu daily.

Magnesium Oil-decided to add this to my supps stack a few weeks ago,I had always

had problems taking D3,fatigue/headaches/feeling toxic this was even at low RDA

doses..since adding Mag Oil I now have no problems with D3,I had forgotten how

important magnesium is to D.

Zinc Gluconate 25mg

Selenium as Se-methylselenocysteine 200mcg

Vit A as palmitate 5000iu

Jarrow B Right-I have always been intolerant to B vits,can only take a quarter

capsule daily.

Jarrow methyl B12 1000mcg-started after my test results showed B12 could be

higher particularly as the UK B12 upper reference range is quite conservative.

Pantothenic acid 50mg

PABA 25mg with morning & mid day HC

I also use hemp oil & himalayan salt on my food & use raw hemp protein powder in

green smoothies.

I'm really hoping my docs receptive to my T being low,my experience with NHS

GP's is that they pay more attention to figures on a piece of paper than the

patient sitting in front of them,if the results fall within range then

everything is fine regardless of symptoms..I've printed out the AACE chart & T

levels by age studies in the files section,hopefully they will persuade my GP to

look beyond reference ranges.

I intend asking for the following tests..

Total T

Free T - not sure if free is available on the NHS?

SHBG - if I can't get free T tested are Total & SHBG tests enough

to calculate Free T?

E2 Estradiol - Don't think the sensitive test is available in the UK so guessing

they'll use the female test..is that ok?

LH & FSH

Prolactin

DHT

DHEA

Progesterone - worth testing at this stage?

IGF-1 - worth testing at this stage?

Any other tests you'd add?

What is the likelihood that as my thyroid & adrenals hopefully optimize my T

will rise enough to lessen all my symptoms..also with sore hard nipples & zero

libido I'm guessing I have an estrogen dominance issue,is it possible to raise T

enough through lowering E2 & optimizing thyroid/adrenals or is it likely that

I'm going to have to resort to TRT?

If my E2 levels are high is DIM better than low dose Arimidex if not on TRT?

Thanks for your time..

Andy

>

> Hi Andy and Welcome,

>

> You were right to go on HC meds and feeling hyper on NT meds even STTM is

sets it levels to high for some people. How fast did you go up on your NT meds.

When I was going up on Armour the old kind it took me about a yr. to get leveled

off.

>

> I started on 45 mgs and went up every 2 weeks only 15 mgs if I did more it

stressed my Adrenals or Cortisol levels so when I got up to 90 mgs or one and a

half grains. I held this for 8 weeks then did labs if I still was looking low

and felt hypo I went up 15 more mgs. and head this 8 more weeks.

>

> I ended up on 4 grains going by what the people at STTM said and I was there

Mod for Men's Only Thyroid.

>

> My Free T4 was all ways on the low side 1.1 and my Free T3 as post mid range

near the top of the range. I was walking around on the hyper side. When Armour

was pulled by the FDA I could not get it. So I went on 150 mcgs of T4 and took

5mcgs of T3 3x's/day. I feel dam good on this and my Free T3 is mid range.

>

> Your Ferritin is low you need Iron pills mine was very low and as it turns out

I need Iron pills for life. I take my Iron with Vit. C and I take supplements

to help with my Thyroid meds.

>

> Biotics Bio-D-Mulsion Forte Vit. D 2000 IU's per drop I am doing 10 drops a

day.

> Solary Super Bio C 2 x’s/day 1000 mgs. Total.

> Iodoral Iodine 1 tab / day 12.5 mgs.

> B-12 (Brain) Methylcobalamin - 5000 mcg lozenges. 3x’s/week.

> I am taking 800 mcg. Folacal for low Folate RBC

> BioCitrate Selenium - 200 mcg 1x’s / day morning.

> Krill Oil capliques 1,000 mgs. 2 with food morning mercola.com

>

> I take this for Iron.

> Ferrous Fumarate Iron pills 324 mgs 1x/day

>

> Your Testosterone levels in my unit is 365 that of a man 80 to 100 yrs old

there are no studies showing when to put men on TRT unless they are below the

normal range. Yet any dam good Dr. knows your to low by how your feeling.

>

> And you need to test your Estraidol levels if your above 75 pmol/l you need to

take something to bring this down.

> Men that can't get there Dr. to treat this take this.

> http://www.iherb.com/Enzymatic-Therapy-Pure-Rip-with-DIM-60-Tablets/12814?at=0

> In this link is shows levels by age in your units and mine.

> http://www.mens-hormonal-health.com/normal-testosterone-levels-in-men.html

> If you can't get A Dr. to treat you see a privet one.

> Co-Moderator

> Phil