Aa
how do I help my husband?
I couldn't find quite the right place to put this--so I thought I's start here since my husband has only half a a thyroid. He had a huge nodule, you could see it poking out the front of his neck, 18 years ago. they couldn't rule out cancer, so they removed half his thyroid--no cancer, but he was put on suppression therapy. He was told his 1/2 thyroid would kick in if he quit taking medication, but they wanted to suppress it to keep any more nodules from growing.
The doc who put him on suppression therapy retired, and over the years, various docs have checked his thyroid levels--and i think they have been treating him as hypothyroid instead of suppression.
He tried to go off his levothyroxine a couple of years ago--and thought he was doing fine---but I noticed his face was swelling up--he wouldn't believe me--my son-in-law had also noticed it. He finally went in and got checked--and his thyroid tested low---but I am almost positive no one remembers that he was supposed to be on suppression therapy.
Over the last 6 years or so he has become more and more irritable and becomes angry at the drop of a hat. He uses obcenities and yells horrible things at me. He started throwing things to scare me, he pretty much ignores the kids, he comes home from work, showers, eats his dinner in bed, and stays in bed the rest of the night watching TV until late---then gets up with just enough time to dress and eat breakfast and leave. He wakes up every morning with anxiety and he is battling depression.
He developed a hydrocele several years ago and had two failed surgeries to repair it. It slowly was getting bigger over this last year, so he finally opted to have the testicle removed. They tested his testosterone levels and SHBG levels before the surgery.
His testosterone came back only 6 points obove the bottom of the "lab normal" value---but the doc said he could not legally put him on testosterone until it dropped below the reference range because it is an anabolic steroid. The doc told him to take 25 mgs DHEA twice a day.
My husband used to be very active, always working on something or building or repairing things. He was also quite lean--I was always impressed with the fact that he didn't have a belly clear up to almost age 50, when so many younger men had bellies.
My husband very rarely does anything except lay in bed and watch TV and eat junk. He has developed quite a belly, which used to seem at leat more firm, but now it is getting softer and looks bigger. He has a little bit of what look like "man boobs"---maybe that is just the extra weight--but the funny thing, is that he is not putting weight on all over. He weighs about 20 lbs more than he used to--and this has only been in the last 5-6 years that these big changes have come on.
He has always been a yeller--but now he is angry and yelling at the drop of a hat. We have a son with some problems who is almost 24 and living at home. He came home drunk last night--my husband was in a good mood and went down to talk to him about some money issues (he wouldn't have tried to talk to him if he knew he was drinking). My son started yelling--and my husband went beserk and had my son pushed up against the couch and was choking him--I think he realized what he was doing fairly quickly and stopped. My son, who has anger issues, just kept swearing and trying to goad my husband into hitting him---he was being rough with the furniture and telling my husband to get a knife and cut him and kept on swearing--my husband finally hit him in the jaw.
My husband came upstairs and woke me up, he was pretty shook up about the whole thing---he hated what he had done and he was nervous about what our son might do--he has a thing for knives.
My son is in counseling.
I am sure that my husband has symptoms of low testosterone--irritability, anger, depression, anxiety, weight gain in the belly and chest. I don't know what to do or who to see to try and get him some help. I wish the doctor would look at him as a person and at his symptoms instead of the ink numbers on the lab report---which were getting pretty low.
Should he have all of his hormones tested instead of just testosterone and SHBG? The urologist mentioned something about estrogen being too high if his testosterone is low. I am wondering if looking at the levels of all of his hormones would give a better picture.
Can anyone help me?
The doc who put him on suppression therapy retired, and over the years, various docs have checked his thyroid levels--and i think they have been treating him as hypothyroid instead of suppression.
He tried to go off his levothyroxine a couple of years ago--and thought he was doing fine---but I noticed his face was swelling up--he wouldn't believe me--my son-in-law had also noticed it. He finally went in and got checked--and his thyroid tested low---but I am almost positive no one remembers that he was supposed to be on suppression therapy.
Over the last 6 years or so he has become more and more irritable and becomes angry at the drop of a hat. He uses obcenities and yells horrible things at me. He started throwing things to scare me, he pretty much ignores the kids, he comes home from work, showers, eats his dinner in bed, and stays in bed the rest of the night watching TV until late---then gets up with just enough time to dress and eat breakfast and leave. He wakes up every morning with anxiety and he is battling depression.
He developed a hydrocele several years ago and had two failed surgeries to repair it. It slowly was getting bigger over this last year, so he finally opted to have the testicle removed. They tested his testosterone levels and SHBG levels before the surgery.
His testosterone came back only 6 points obove the bottom of the "lab normal" value---but the doc said he could not legally put him on testosterone until it dropped below the reference range because it is an anabolic steroid. The doc told him to take 25 mgs DHEA twice a day.
My husband used to be very active, always working on something or building or repairing things. He was also quite lean--I was always impressed with the fact that he didn't have a belly clear up to almost age 50, when so many younger men had bellies.
My husband very rarely does anything except lay in bed and watch TV and eat junk. He has developed quite a belly, which used to seem at leat more firm, but now it is getting softer and looks bigger. He has a little bit of what look like "man boobs"---maybe that is just the extra weight--but the funny thing, is that he is not putting weight on all over. He weighs about 20 lbs more than he used to--and this has only been in the last 5-6 years that these big changes have come on.
He has always been a yeller--but now he is angry and yelling at the drop of a hat. We have a son with some problems who is almost 24 and living at home. He came home drunk last night--my husband was in a good mood and went down to talk to him about some money issues (he wouldn't have tried to talk to him if he knew he was drinking). My son started yelling--and my husband went beserk and had my son pushed up against the couch and was choking him--I think he realized what he was doing fairly quickly and stopped. My son, who has anger issues, just kept swearing and trying to goad my husband into hitting him---he was being rough with the furniture and telling my husband to get a knife and cut him and kept on swearing--my husband finally hit him in the jaw.
My husband came upstairs and woke me up, he was pretty shook up about the whole thing---he hated what he had done and he was nervous about what our son might do--he has a thing for knives.
My son is in counseling.
I am sure that my husband has symptoms of low testosterone--irritability, anger, depression, anxiety, weight gain in the belly and chest. I don't know what to do or who to see to try and get him some help. I wish the doctor would look at him as a person and at his symptoms instead of the ink numbers on the lab report---which were getting pretty low.
Should he have all of his hormones tested instead of just testosterone and SHBG? The urologist mentioned something about estrogen being too high if his testosterone is low. I am wondering if looking at the levels of all of his hormones would give a better picture.
Can anyone help me?
COMMUNITY LEADER
Can you post the actual lab results, along with reference ranges, so we can see what they were? If your doctor didn't give you a copy, s/he is required, by law, to provide one upon request.
You should always make sure you get a copy of all blood work and other tests and keep them for your records.
Is your husband still on the 2 grains of NP?
You should always make sure you get a copy of all blood work and other tests and keep them for your records.
Is your husband still on the 2 grains of NP?
Well good luck, I'm that things will improve for both you. If thyroid and testosterone were both low, that would explain a lot.
PS: vis hashimoto's was his TSH elevated? or 'normal' with low T4/T3?
PS: vis hashimoto's was his TSH elevated? or 'normal' with low T4/T3?
hubby's testosterone came back low--he will be giving himself testosterone shots every week now. Also looks like he has hashimoto's. Hopefully this will explain the majopr changes we have seen in him.
thank you! both of you.
I have central hypothyroidism, I was lucky that before I had carpal tunnel surgery, my orthoped felt like my FT4 was too low---even though it was in the normal range---it was low normal---.89. Nobody seemed to notice that my TSH was also .89---but they did get me to an endocrinologist quickly so I could get my surgery done (doc wanted to make sure thyroid was not a contributing factor--it wasn't)
the endo was the first person to ever test my FT3---I had been on suppression therapy for 10 years, and then a psych pulled me off to see what my thyroid would do on it's own---obviously by that time the pituitary problems were starting to show up. My endo also hit all the major glands, too--and several things were too low. I was also diagnosed with secondary adrenal insufficiency--I struggle daily to feel ok.
I ended up with a different endo who pulled me off everything without running any proper testing of his own--and refuse to do any testing when I asked--I knew my testosterone was dropping.
Fast forward to a new doc who tested everything again (not an endo, just a doctor who specialized in balancing the endocrine system) This doc does not go by lab values, he goes by values for optimal health. My testosterone was not flagged low--but it was at the low end and lower than he wanted---he was able to put me on testosterone without any problem---and no one went after him for breaking the law.
I flew across the US to see this doctor, and he has had two major illnesses, so he is not even able to run test that I need done, now---so he is not an option for my husband.
My GI wants me to see and endocrinologist---so I suppose I had better get my husband to go with me---I'm just so wary of endocrinologists because they are particularly bad about not keeping up with the most recent information--and so many of them are stuck on the TSH--I'm at least fortunate in that area because TSH is never reliable with a pituitary problem.
Gibbon 1--can you direct me to any information that says it is alright to treat very low testosterone that is still "within lab ranges"
I can see that my husband has so many symptoms of low testosterone--I know that some people think some of these things can be normal---but i have read that a man's testosterone should really be near where it was when he was in his 20s or 30s--because that is when he was most likely in optimal health. I have also read about the health problems low T can cause---besides the psychological problems and sex problems (I dared say it!!)
I'm actually most concerned about the psychological problems and health problems---since we've both been low, the sex problems haven't been a major problem for us. (fortunately)
I have central hypothyroidism, I was lucky that before I had carpal tunnel surgery, my orthoped felt like my FT4 was too low---even though it was in the normal range---it was low normal---.89. Nobody seemed to notice that my TSH was also .89---but they did get me to an endocrinologist quickly so I could get my surgery done (doc wanted to make sure thyroid was not a contributing factor--it wasn't)
the endo was the first person to ever test my FT3---I had been on suppression therapy for 10 years, and then a psych pulled me off to see what my thyroid would do on it's own---obviously by that time the pituitary problems were starting to show up. My endo also hit all the major glands, too--and several things were too low. I was also diagnosed with secondary adrenal insufficiency--I struggle daily to feel ok.
I ended up with a different endo who pulled me off everything without running any proper testing of his own--and refuse to do any testing when I asked--I knew my testosterone was dropping.
Fast forward to a new doc who tested everything again (not an endo, just a doctor who specialized in balancing the endocrine system) This doc does not go by lab values, he goes by values for optimal health. My testosterone was not flagged low--but it was at the low end and lower than he wanted---he was able to put me on testosterone without any problem---and no one went after him for breaking the law.
I flew across the US to see this doctor, and he has had two major illnesses, so he is not even able to run test that I need done, now---so he is not an option for my husband.
My GI wants me to see and endocrinologist---so I suppose I had better get my husband to go with me---I'm just so wary of endocrinologists because they are particularly bad about not keeping up with the most recent information--and so many of them are stuck on the TSH--I'm at least fortunate in that area because TSH is never reliable with a pituitary problem.
Gibbon 1--can you direct me to any information that says it is alright to treat very low testosterone that is still "within lab ranges"
I can see that my husband has so many symptoms of low testosterone--I know that some people think some of these things can be normal---but i have read that a man's testosterone should really be near where it was when he was in his 20s or 30s--because that is when he was most likely in optimal health. I have also read about the health problems low T can cause---besides the psychological problems and sex problems (I dared say it!!)
I'm actually most concerned about the psychological problems and health problems---since we've both been low, the sex problems haven't been a major problem for us. (fortunately)
"Should he have all of his hormones tested instead of just testosterone and SHBG? The urologist mentioned something about estrogen being too high if his testosterone is low. I am wondering if looking at the levels of all of his hormones would give a better picture."
Generally yes, you need an endocrinologist to take an active stance in getting to the bottom of what's going on. And not just jump on the first thing. It would be bad for the doctor to prescribe testosterone replacement when low testosterone is symptom of something else.
I think I remember (it's been ten years) that my endocrinologist hit all the major glands. Cortisol, Growth Hormone, Thyroid, and I don't remember what all. I also remember my doctor asking pointedly about booze and pot smoking.
Generally yes, you need an endocrinologist to take an active stance in getting to the bottom of what's going on. And not just jump on the first thing. It would be bad for the doctor to prescribe testosterone replacement when low testosterone is symptom of something else.
I think I remember (it's been ten years) that my endocrinologist hit all the major glands. Cortisol, Growth Hormone, Thyroid, and I don't remember what all. I also remember my doctor asking pointedly about booze and pot smoking.
Thanks for the additional info. I had a feeling I was probably missing a few tests that would be valuable additional info.
"His testosterone came back only 6 points obove the bottom of the "lab normal" value---but the doc said he could not legally put him on testosterone until it dropped below the reference range because it is an anabolic steroid."
I'm terribly sorry but that is totally (insert french word of your choice).
From personal experience I know this is simply not correct. And unfortunately I also know from experience that many doctors have a mental block when it comes to hypogonadism (low testosterone) and will just outright refuse to treat it. I think the attitude is 'my dog does fine without his testicles, so you're obviously fine.' But consistently low levels are a problem and need to be treated. It's simple malpractice not to.
Testosterone is an important hormone and there are a lot of metabolic processes that are dependent on it. Not to mention psychological effects that no one talks about. (Or the other thing no one talks about in polite company) Frankly, it's a terrible life to live like that. Your husband deserves better and you deserve better.
One problem is testosterone levels vary over a daily cycle, high in the morning, low in the evening, and will often drop temporarily for all sorts of reasons like stress or a bad nights sleep. Levels also vary depending on age and health. So the lab ranges for testosterone tend to be very wide. Which makes interpreting labs tricky. The endocrinologist needs to run multiple tests to make very sure that it's not a temporary problem.
My personal advice is to find an endocrinologist that will take this seriously and do not stop until you find one. Really do not give up unless he can show you that your husbands levels of mid-range normal or high.
In general your husband needs his total and free testosterone levels checked, along with his FSH (Follicle-stimulating hormone) and LH (Luteinizing hormone) levels. FSH and LH are pituitary hormones. If LH and FSH levels are high, then primary hypothyroidism. (most likely because your husbands previous surgery) If these are low or _normal_ then it's central (pituitary related) hypothyroidism, and a work up needs to be done to rule out a pituitary tumor (rare but more more common than people think)
PS: When I was first diagnosed I was embarrassed to tell anyone. And then I decided, no I'm going to tell everyone, because this condition is common and it's truly awful.
Good luck.
I'm terribly sorry but that is totally (insert french word of your choice).
From personal experience I know this is simply not correct. And unfortunately I also know from experience that many doctors have a mental block when it comes to hypogonadism (low testosterone) and will just outright refuse to treat it. I think the attitude is 'my dog does fine without his testicles, so you're obviously fine.' But consistently low levels are a problem and need to be treated. It's simple malpractice not to.
Testosterone is an important hormone and there are a lot of metabolic processes that are dependent on it. Not to mention psychological effects that no one talks about. (Or the other thing no one talks about in polite company) Frankly, it's a terrible life to live like that. Your husband deserves better and you deserve better.
One problem is testosterone levels vary over a daily cycle, high in the morning, low in the evening, and will often drop temporarily for all sorts of reasons like stress or a bad nights sleep. Levels also vary depending on age and health. So the lab ranges for testosterone tend to be very wide. Which makes interpreting labs tricky. The endocrinologist needs to run multiple tests to make very sure that it's not a temporary problem.
My personal advice is to find an endocrinologist that will take this seriously and do not stop until you find one. Really do not give up unless he can show you that your husbands levels of mid-range normal or high.
In general your husband needs his total and free testosterone levels checked, along with his FSH (Follicle-stimulating hormone) and LH (Luteinizing hormone) levels. FSH and LH are pituitary hormones. If LH and FSH levels are high, then primary hypothyroidism. (most likely because your husbands previous surgery) If these are low or _normal_ then it's central (pituitary related) hypothyroidism, and a work up needs to be done to rule out a pituitary tumor (rare but more more common than people think)
PS: When I was first diagnosed I was embarrassed to tell anyone. And then I decided, no I'm going to tell everyone, because this condition is common and it's truly awful.
Good luck.
It would be very helpful if you can get the test results from the time he was put on thyroid meds, and maybe the last couple of year's test results. For this round I suggest that along with the FT3 and FT4 and TSH you should also request Reverse T3, just to be sure about that. Also, since hypo patients are often too low in the ranges for Vitamin D, B12, and ferritin, I would also ask for those.
Additional tests that would be advisable are a 24 hour saliva (or urine) test for cortisol. Also test for free testosterone. Calcium levels should be checked.
All these results should provide some good insight into what is going on with him. When available, if you want to post results and reference ranges shown on the lab report, members will be glad to help interpret and advise further.
Additional tests that would be advisable are a 24 hour saliva (or urine) test for cortisol. Also test for free testosterone. Calcium levels should be checked.
All these results should provide some good insight into what is going on with him. When available, if you want to post results and reference ranges shown on the lab report, members will be glad to help interpret and advise further.
I have never seen any of his thyroid labs---his thyroid problems started long before I discovered it was good to get copies of everything. I am going to get copies from when he was originally put on thyroid suppression therapy.
I can probably get copies of his yearly tests over the last 10 years or so--I'm pretty sure they stopped the suppression therapy and started putting hypothyroid as his diagnosis instead---the original doctor retired.
He is taking 2 grains of NP thyroid right now and he needs to have blood work done.
I want then to run a TSH, FT4, FT3, and both antibodies--anything else I should specifically ask for as long as they are doing blood work? should I ask them to go ahead and test his hormones? If so, which ones?
We have a doctor that is pretty good about running whatever tests we ask..
I can probably get copies of his yearly tests over the last 10 years or so--I'm pretty sure they stopped the suppression therapy and started putting hypothyroid as his diagnosis instead---the original doctor retired.
He is taking 2 grains of NP thyroid right now and he needs to have blood work done.
I want then to run a TSH, FT4, FT3, and both antibodies--anything else I should specifically ask for as long as they are doing blood work? should I ask them to go ahead and test his hormones? If so, which ones?
We have a doctor that is pretty good about running whatever tests we ask..
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