Questions about hypo condition in men, should I get blood test?

[Franklin_T_McWiggamshire]

Over the last 10 years or so I have noticed several problems and started to wonder if I could have a thyroid problem. The main things I have noticed is weight gain, hard to lose weight, constipation or irregularity, memory loss, fatigue or weakness, Irritability, Depression, hair loss (might just be male pattern baldness). And a few other symptoms from what I read on-line but these are the main ones I noticed. Out of these the main ones are fatigue and weight problems.

Me:
Male
33 YO
260 lbs

Some history of the problems I noticed.

Weight:
I started gaining weight around 19, getting married and working at a desk didn't help but went up to about 293. I eat pretty healthy for the most and have never been a gorge eater but still had some eating habit issues every now and then. Almost 3 years ago I got serious and started working out a lot more and watched my calories more. About 3000 calories a day should have been my maintenance level at that time so I ate around 1800-2200 (depexercisen exersize level for the day) a day and worked out a good 1-2 hours a day 5 or 6 days a week. Work outs were walking some running and low weight weight lifting. Doing this I lost about .5 - 1 lbs a week, to me this seems very low, about 35 lbs total.

I leveled off for over a year and ended up gaining 15 lbs back eating well under my maintenance level 90% of the time and then last July I started a low carb diet, in 10 months excluding water weight I lost about 13 lbs. During this time I didn't exercise as much but I really watched the carbs and calories and ate around 1800 - 2000 a day plus some light exercising a few times a week due to a injury I was trying to nurse. According to everything I have read about nutrition and losing weight I should have lost a lot more weight. The only thing that may have interfered is once a week I would eat carbs but even then almost never went above my maintenance level in calories.


Fatigue:
I have dealt with tiredness and fatigue for many years, even when I am well rested I regularly am tired through texhaustednd feel exausted physically and a lot of times mentally. I have sleep apnea and have been on a machine for about 8 years, it has helped some but I still have a very hard time getting up regardless of how much or little sleep I get and feel fatigued through the day, not every day but moreprobablyan not, probalby 5 out of 7.


Bowls:
I have had problems with constipation for a long time, even with drinking a lot of wpro-bioticing a good probiotic and fiber a few times a week I am lucky to go once a day and go 2-3 days without going a few times a month.


Mental:
I have a hard time memorizing things and short term memory, focus, I have gotten used to using a lot of sticky notes and reminders on my phone but seems like it has been a problem for a while. Irritability over small things some times, some times I feel ticked off for no apparent reason, some depression, anxiety. MOstly I feel these last few things some times with no apparent reason triggering it.

[flyingfool]

If you were trying the Atkins low carb diet.  From what I've read it is critically important to stay in ketosis. And eating too many carbs even for a single day can kick you out of ketosis and thus you will not lose weight like you would think.  It takes several days or more to get back into ketosis after even one day of too many carbs. So eating too many carbs once a week could keep you almost totally out of ketosis.

Gimel is right.  It is worth getting tested for low thyroid.

many people find that they need their Free T4 in the MIDDLE of the range AND (that means in addition to) they need their Free T3 to be in the UPPER 1/3 of the range.

Do NOT let a Dr tell you simply because you are "within the normal range" that you are fine.  Also absolutely do NOT settle for just being tested for TSH.  TSH is a screening tool at best and not a very good one at that.  It is TOTALLY unacceptable to be used to adjust medication.

[gimel]

I think that using a copy of the letter is best.  That way you make sure all the important points are covered and it makes sure the doctor understands the type of testing and treatment you are looking for.

If you are trying to determine if the doctor is a good prospect before making an appointment, I have done that numerous times by calling the office and mentioning that before making an appointment I needed to ask a nurse two questions.  That usually always works to get a nurse on the phone.  Then I ask the two questions I mentioned above about clinical treatment, and also about T3 meds.  

[Franklin_T_McWiggamshire]

Great thank you very much for the info.

Do you generally give the doctor a copy of the letter you posted above or just ask if they give T3 type medication?

[gimel]

Sending a Private Message with some info on a doctor for you to consider.

[Franklin_T_McWiggamshire]

I live in the Louisville, KY area. Also Indianapolis or Cincinnatti isn't too far away.

Thanks,

[gimel]

It does not have to be an Endo.  Many of them have the "Immaculate TSH Belief" and only want to use TSH to diagnose and treat a hypo patient.  That is very wrong.  Others use "Reference Range Endocrinology", by which they will tell you that a thyroid test that falls anywhere within the range is adequate.  That is also wrong.

You just need a good thyroid doctor, who will treat clinically, as described in the link I gave you.  You can pretty much tell about a doctor by asking if he is willing to treat a hypothyroid patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  The second question should be if the doctor is willing to prescribe T3 type meds.  If either answer is no, then keep looking.

If you will tell us your location, a member may be able to recommend a good thyroid doctor based on personal experience.

[Franklin_T_McWiggamshire]

Thanks for the reply. Should I just go to a endocrinologist or a famility doctor?

About 5 or 6 years ago my wife was diagnosed with thyroid cancer so we have a few good contacts for Doctors in the area.

[gimel]

With those symptoms you definitely need to be tested for the possibility of hypothyroidism.  The most important tests for your to request would be Free T3, Free T4, Reverse T3, and the TSH test they always run.  Note that the Frees are not the same as Total T3 and Total T4.  If the doctor resists these tests and makes excuses that they are not really necessary, just insist on it and don't take no for an answer.  Free T3 largely regulates metabolism and many other body functions.  Scientific studies have also shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.  

While at the doctor's it wold also be a good idea to test for Vitamin D, B12, zinc, and selenium.  Many hypothyroid patients are also low in these areas.  

I should also say that a good thyroid doctor will treat  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.  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 from a distance.  The letter is then sent to the PCP of the patient to help guide treatment.

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

So it would be a good idea to find out if your doctor is willing to treat clinically as described in the letter.  If not, then you will need to find a good thyroid doctor that will do so.