Hormonal Imbalance and what to do next

[ShinyJabberwocky]

So I was telling my endo on a regular checkup that I wanted to eliminate some health concerns because I've had digestive, cardiovascular, neurological, and muscular issues for a few years with no apparent cause. I asked if he had ever done a hormone panel on me and he started asking questions about my erection and sexual drive and I said they were fine but I really wanted the test. So I got my test results back today and I'm curious what sort of symptoms these numbers could produce.

Testosterone was 251 and flagged as low.
Cortisol was 26 and flagged as high.
Prolactin--can't remember what the actual number was, but it was flagged as high
ALT (SGPT)--can't remember the number for this one either, but it was flagged as high

My problems range from high blood pressure/palpitations, fatigue, muscle weakness, excessive belly fat, problems sleeping, dizziness/lightheadedness, anxiety, stomach easily bloated and distubed...those are the main ones. I've been to cardiologists, gastroenterologists, urologists and a few others in between and no one can find anything wrong. Could these hormonal imbalances be causing any of my issues that I'm suffering from?

[gimel]

I would not rule out any thyroid issues just yet.  You have lots of symptoms that relate to hypothyroidism.  Low testosterone and high prolactin are sometimes related to being hypo.  Not sure what to make of the ALT result.

You did not list the reference ranges for FT4 and FT3, but if I assume them to be what we see very often, then your Free T3 would only be around the middle of its range, which is too low for many hypo patients.  So, I suggest that at your earliest opportunity, you should request to be tested for Free T3 and Free T4 again, along with Reverse T3.   Since hypo patients are frequently too low in the range for Vitamin D, B12, and ferritin, I also suggest testing for those.  The reason I suggest Reverse T3 is that the ratio of Free T3 to Reverse T3  is reported to be the best measure of tissue thyroid levels, which can be different than serum levels.

These additional tests should give a much clearer picture of your status.  

[ShinyJabberwocky]

I don't believe it to be anything with my thyroid though. Years before I knew I had thyroid cancer--and years after with multiple medication adjuastments--I've had the same types of symptoms. I think the only reason why my blood pressure dropped slightly after having my thyroid and the cancer removed was piece of mind.

I originally started on .150 levothyroxine and am currently at .200, and the only difference I can feel is that at .150, I was getting headaches in the afternoon and feeling more fatigued than I usually do.

And I'm not necessarily convinced that my hormone levels would warrant the problems I've been having, but I know that chronically high cortisol levels can be detrimental to your health. I'm not really the kind of guy to stress out over things either, so I can't see why my cortisol would be so high.

My endo asked me to come back for another blood test to see if the numbers are the same, but either way I think about it, I'm screwed. If the tests come back the same, that means there's either something wrong with my testicles or pituitary gland. If the test results come back as normal, then I'm back to square one with figuring out what the hell is wrong with me.

[gimel]

And your testosterone was low and cortisol was high, but I only focused on thyroid for the moment because of the symptoms.  You didn't mention your thyroid med and dosage, but apparently it is sufficient to get your Free T4 near the high end, but your Free T3 is only around the midpoint of its range (I am assuming, since no range was posted).  

Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  Yes, your TSH is suppressed, but may need to be suppressed even further by the addition of some T3 to your meds.  There are numerous members here, myself included, that have TSH levels at .05 or lower, in order to get Free T3 and Free T4 high enough to relieve symptoms.  Scientific studies  have also shown that suppressed TSH occurs frequently when hypo patients take enough thyroid meds to relieve symptoms.  That doesn't mean that you become hyper, unless you also have hyper symptoms due to excessive levels of Free T3 and free T4, which you do not have.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

[ShinyJabberwocky]

Oh and my Prolactin was 15.6 (normal high is 15.2) and my ALT was 54 (normal high is 44).

[ShinyJabberwocky]

Thyroid tests are fine, but that's because I don't have one anymore...lol. I had papillary thyroid cancer and had a total thyroidectomy in 2011. No sign of the cancer since, and my numbers are below. The Endo said he wants to keep me more hyper than hypo to make sure the thyroid doesn't try and grow back any of the cancer.

Free T4 - 1.35
Free T3 - 3.23
TSH - .226

Even when my thyroid was removed and I was on synthroid, my symptoms didn't change. The only thing that did was my BP dropped slightly...maybe a few points on average.

[gimel]

A number of your symptoms are sometimes related to hypothyroidism.  Have your thyroid hormone levels been tested?  The best tests would be Free T3 and Free T4 (not the same as Total T3 and Total T4).  Please post any thyroid related tests and their reference ranges that you have.