Thyroid and bloat

[6'4Incel]

I'm basically perma bloated, have shitty skin with rosacea like look, have perma cold hand and feet, super dry skin, and some light hair loss since some times. I got blood test, my TSH was 8.96 at the max, T4/T3 where normal, thyroid antibody where negative, my endocrino and doctor (in france) tell me those level are bad but not bad enought to get T4 prescribed. What should i do? Could i have other issue like low T that i should get tested or it's most likely thyroid related?

tagging people i saw talking of thyroid
@HairVolume
@PrimalPlasty

 

[PSL Center]

I'm basically perma bloated, have shitty skin with rosacea like look, have perma cold hand and feet, super dry skin, and some light hair loss since some times. I got blood test, my TSH was 8.96 at the max, T4/T3 where normal, thyroid antibody where negative, my endocrino and doctor (in france) tell me those level are bad but not bad enought to get T4 prescribed. What should i do? Could i have other issue like low T that i should get tested or it's most likely thyroid related?

tagging people i saw talking of thyroid
@HairVolume
@PrimalPlasty

what's your diet?

 

[Arwin12]

the cure is 6 sets of gooning ( till failure) 8 days a week thank me later

 

[6'4Incel]

what's your diet?

I’ve been eating whole food and counting my calorie and macro for multiple year so basically close to perfection

 

[Deleted member 71669]

I am in the medical field are you able to give me your actual results so i can give u more specific advice

 

[6'4Incel]

I am in the medical field are you able to give me your actual results so i can give u more specific advice

 

[PrimalPlasty]

I'm basically perma bloated, have shitty skin with rosacea like look, have perma cold hand and feet, super dry skin, and some light hair loss since some times. I got blood test, my TSH was 8.96 at the max, T4/T3 where normal, thyroid antibody where negative, my endocrino and doctor (in france) tell me those level are bad but not bad enought to get T4 prescribed. What should i do? Could i have other issue like low T that i should get tested or it's most likely thyroid related?

tagging people i saw talking of thyroid
@HairVolume
@PrimalPlasty

whats ur body temperature at morning, after breakfast and mid day, this is important information

 

[6'4Incel]

whats ur body temperature at morning, after breakfast and mid day, this is important information

Idk at mid day but around 36-36.5 when i wake up and i feel hotter after eating

 

[Deleted member 71669]

you have subclinical hypothyroidism as suggested by your elevated TSH and normal ft4. Its a controversial field of medicine still if subclinical hypotyhroid should be treated or not. However if you are symptomatic then you should be treated.

• Retest TSH, free T4, free T3,
• Check estradiol total testosterone, free testosterone, SHBG, prolactin and cortisol to rule out other causes like low T or adrenal issues
• Iron status (ferritin, transferrin saturation) can affect T3 conversion too
• Zinc, selenium, vitamin D, and iodine, folate
• Check FBC, LFTs

Your symptoms do align with hypothyroidism although not all of them are textbook. I would start with those tests but also request the doctor to refer you somewhere to check your smyptoms.

Dont let them gaslight you and say you are fine even when you have symptoms

 

[6'4Incel]

you have subclinical hypothyroidism as suggested by your elevated TSH and normal ft4. Its a controversial field of medicine still if subclinical hypotyhroid should be treated or not. However if you are symptomatic then you should be treated.

• Retest TSH, free T4, free T3,
• Check estradiol total testosterone, free testosterone, SHBG, prolactin and cortisol to rule out other causes like low T or adrenal issues
• Iron status (ferritin, transferrin saturation) can affect T3 conversion too
• Zinc, selenium, vitamin D, and iodine, folate
• Check FBC, LFTs

Your symptoms do align with hypothyroidism although not all of them are textbook. I would start with those tests but also request the doctor to refer you somewhere to check your smyptoms.

Dont let them gaslight you and say you are fine even when you have symptoms

My endo prescribed me FBC, LFT, Cortisol and ACTH, idk if he will prescibe T, SHBG and prolactin. Unless you say you have ED they won’t prescibe you this in france and i don’t have ED, maybe i should lie to him idk

 

[Deleted member 71669]

My endo prescribed me FBC, LFT, Cortisol and ACTH, idk if he will prescibe T, SHBG and prolactin. Unless you say you have ED they won’t prescibe you this in france and i don’t have ED, maybe i should lie to him idk

is france public healthcare? thats probably why they are being stingy with their tests.
ask for estradiol at least - it can influence the water retentiuon alot. the other tests seem good.

 

[6'4Incel]

is france public healthcare? thats probably why they are being stingy with their tests.
ask for estradiol at least - it can influence the water retentiuon alot. the other tests seem good.
also can you put the thumbs on my posts pls

Yeah it’s public healthcare, i try to ask for everything next time i see my endo

 

[HairVolume]

I'm basically perma bloated, have shitty skin with rosacea like look, have perma cold hand and feet, super dry skin, and some light hair loss since some times. I got blood test, my TSH was 8.96 at the max, T4/T3 where normal, thyroid antibody where negative, my endocrino and doctor (in france) tell me those level are bad but not bad enought to get T4 prescribed. What should i do? Could i have other issue like low T that i should get tested or it's most likely thyroid related?

tagging people i saw talking of thyroid
@HairVolume
@PrimalPlasty

You are subclinicaly hypo. Transition from the euthyroid state to subclinical and eventually overt hypothyroidism usually progresses slowly over decades.

In your stage, the functional capacity of the thyroid gland is sometimes enough to compensate, and sometimes it isn't. In your case, you can see that FT3 (the active thyroid hormone) is above mid-range (about 63%), which is an expected compensatory mechanism from raised TSH levels. But you do report symptoms so clearly the compensation isn't enough.

Before you decide to treat, try to find out why your TSH is so high. Check both TPOAb and TGAb. Do an ultrasound of your thyroid gland. Iodine deficiency is possible too.

If you decide to treat, then use both T3+T4. Yes I know the guidelines suggest LT4 monotherapy but these are outdated now. In fact, T4-only causes worse long-term health outcomes compared to combination or untreated. I can post a link to this study soon.

 

[HairVolume]

Idk at mid day but around 36-36.5 when i wake up and i feel hotter after eating

I'm not surprised. When you are well over six feet, you usually tend to run colder probably indicating thyroid deficiency. In fact, the reason you're so tall could be due to minor deficiency at puberty. Thyroid hormone plays a part in causing bone growth centers to close normally. That's just a guess . Instead, it could be your parents are tall too

 

[CopingHard]

What does your bloat look like, proportionally all over the face or more so in the nasolabial area?

 

[6'4Incel]

What does your bloat look like, proportionally all over the face or more so in the nasolabial area?

nasolabial af tbh it ruin my face

 

[6'4Incel]

You are subclinicaly hypo. Transition from the euthyroid state to subclinical and eventually overt hypothyroidism usually progresses slowly over decades.

In your stage, the functional capacity of the thyroid gland is sometimes enough to compensate, and sometimes it isn't. In your case, you can see that FT3 (the active thyroid hormone) is above mid-range (about 63%), which is an expected compensatory mechanism from raised TSH levels. But you do report symptoms so clearly the compensation isn't enough.

Before you decide to treat, try to find out why your TSH is so high. Check both TPOAb and TGAb. Do an ultrasound of your thyroid gland. Iodine deficiency is possible too.

If you decide to treat, then use both T3+T4. Yes I know the guidelines suggest LT4 monotherapy but these are outdated now. In fact, T4-only causes worse long-term health outcomes compared to combination or untreated. I can post a link to this study soon.

yeah if you could post the study, for thyroid antibodies they are negative / really low so it's not hashimoto, i'm doing thyroid ultrasound soon, i don't think it's iodine deficiency i live in develop country and eat whole food

 

[6'4Incel]

also i'm like 12% bf atm and been cutting for some time (carbs are really low) so it's not bloat related to high bf% / high carbs intake

 

[HairVolume]

yeah if you could post the study, for thyroid antibodies they are negative / really low so it's not hashimoto, i'm doing thyroid ultrasound soon, i don't think it's iodine deficiency i live in develop country and eat whole food

If it's iodine deficiency or drug side-effect then it's reversible.
Anything else on this list, you will need treatment.
Ultrasound is a good idea.
Find root cause first before anyhting else

 

[6'4Incel]

Just came back from the endocrino with the ultrasound he said i have hashimoto but i don't have any thyroid antibodies somehow. So he said we check in 3 month again and if everything is the same he will prescribe me T4, i'm tired of waiting it's been more than 6 month tho so i'm gonna self medicate prob and will get prescribed later, thinking of going with 50µg

 

[HairVolume]

Just came back from the endocrino with the ultrasound he said i have hashimoto but i don't have any thyroid antibodies somehow. So he said we check in 3 month again and if everything is the same he will prescribe me T4, i'm tired of waiting it's been more than 6 month tho so i'm gonna self medicate prob and will get prescribed later, thinking of going with 50µg

Good job

I would actually start at a dose closer to your bodyweight (like 62.5, 75 or 87.5 mcg). Smaller doses of T4 than this during subclinical stages can make your symptoms worse.

Like I said before, in these early stages when Tsh<10 and ft4 is normal, your thyroid uses something called TSH-T3 shunt, which basically boils down to "accelerate t4-t3 conversion rate". You first need to replace this shunt by providing enough T4 substrate. Usually this is around 1mcg/kg T4. This will bring TSH=1 or 2. Your symptoms (and FT3) will stay the same.

From there, as you keep increasing t4 closer to full replacement dose (around 1.6 mcg/kg), you should start to see symptoms improve, temperature increase, heart rate increase, reduced facial bloat, weight loss etc etc., depending on which tissues lacked t3. If you're still hypo, then just add t3 directly.