Increased TSH and low Testosterone

[RMBJR]

My husband is a 37 year old male that has been treated for Hashimoto's disease for about 10 years.  He has had screenings on and off to monitor a cyst/tumor he has located on his thyroid and has had cancer marker screenings a couple of times over the years.

Approximately one year ago, blood results showed that his testosterone levels were around 230.  He was prescribed Androgel in larger doses than are typically prescribed which actually resulted in a reduction of his testosterone levels, down to 150.  This prompted the dr. to order testosterone injections (every two weeks) in addition to the Androgel therapy.  After months of therapy, his levels actually did increase to the 500 range about 3 months ago, however treatment has remained the same and levels are again falling, back to 291 as of 2 weeks ago.  In addition, although his TSH levels fluctuate every few months, they are again on the rise.  

He is a fit person, goes to the gym every day and eats well.  He is often lethargic, and has a temperament that is  impatient and he is easily aggrevated.  Since August of last year, he has been under the care of both his family physician and an Endocrinologist.  He has had an MRI to rule out a problem with his pituitary gland.  He is a contractor and is generally out in the sun 8-10 hours daily however he was recently told that his Vitamin D were drastically low and he began taking a Vitamin D supplement daily.  

My husband was also diagnosed with a mitochondrial myopathy approximately 9 years ago and underwent a muscle biospy because he had CPK levels in the 1200 range, he currently undergoes no treatment for this.  

We are looking for any help in asking the appropriate questions of our doctors to determine a course of action moving forward and educate ourselves on possible causes and treatments.  Thank you in advance for any information you can provide.

MaryAnn

[ThyroidHunter]

MaryAnn,

One experience I've had, of many misdiagnosis', was Hashimoto's, when I really had Graves disease, but the tumors (now 9) were causing the white blood cells to attack my gland on a regular basis. It took old fashioned sulpha drugs to get that stopped, and it is somewhat recurrant. The point is, the Hashimoto's diagnosis may not be correct and should be seen by another endo for a second opionion.

Some questions that immediately came to mind despite a very detailed post:

1. Is the vitamin D deficiency caused by another type of metabolic disorder?
2. Has he gotten more sensitive to the sun?
3. How are his bowel movements, very frequent? Urination? same question
4. How is he being treated for hashi's
5. What are his current blood levels of Free T-3 and Free T-4? Have they changed since the last test?
6. It is very uncommon for men with either hashimoto's or Graves to have low testoterone. Mine is off the chart which interferes with my beta blockers. Has he been prescribed a beta blocker ever?
7. Are there any anti-depressant meds involved? Should they be?

A layman's thoughts who has no medical experience, just a life of thyroid disease. Best in Health.

ThyroidHunter

[gimel]

It is good that they found out about the low Vitamin D.  He needs to take enough supplemental D3 to get the level substantially above the low limit of the range.  Also, if he looks through this listing of typical hypo symptoms, does he have any of the 26 typical hypo symptoms?  

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html


Since he also has Hashi's, I'd like to see his thyroid test results and their reference ranges shown on the lab report.  The reason is that so many people with Hashi's are improperly tested and treated, with resultant lingering hypo symptoms and their effects on other body functions.  I think you might get some good info from these links.

http://anabolicminds.com/forum/male-anti-aging/52522-hypothyroidism-low-testosterone.html

http://thyroid.about.com/b/2006/05/21/men-are-you-struggling-with-low-testosterone.htm

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.  Symptom relief should be all important, not just test results.  This is a good link to read about clinical treatment.

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

Please post his thyroid test results and their reference ranges shown on the lab report and members will be glad to help assess the adequacy of his testing and treatment.