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Suggest Treatment For Dizziness And Weight Gain After Discontinuing Steroids Along With Hypothyroidism

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Posted on Sat, 31 Jan 2015
Question: Hello,



My english is not very good, but ok...



I am 29 years old, male, 1.84m high and 91 kg ( 6 feet and 200 lbs).



So, I took anabolic steroids 5 years ago, for 14 months, and than i stopped because i had some healthy issues, and this were high pulse and dizzines.



After i stopped i had hair loss and accumulate some body fat , but not too much, mostly over my six-pack and now i have a little belly..this was normal, but same dizzines.



Went to allot of doctors and all said i'm ok, they didn't find any problems.



Now i went to endocrinologist and found this problems :



1. Thyroid is a little inflamated (left 4,5ml and right 7ml) , tsh was 8,5 ( normal 0,4-4) but after 1 month of euthyrox 0,25mcg was 2,7. Ft3, Ft4, Anti-tgo, etc all normal.



2. Because i have low libido and i feel weak and of course dizzy all day, i took this tests:



Testosterone : 1,75 ng/ml - 6,07 nmol/L ( normal range 3,30-8.05 ng/ml) - so this is low.

LH - 1,86 UI/L ( normal 1,7 - 8,6 UI/L) - low too

Estrogen : 15 pg/mL ( normal 7,63 - 42,6 pg/ML) - ok

GH - 0,05 ( normal 0.05 - 3 ) - this is VERY low

IGF-1 - 226,6ng/ml ( normal 93-250) - this is ok, so for me seems very weird because GH is LOW.

Free Testosterone - 8,11 pg/ml ( normal at my age - 4,5 - 42 pg/ml)

ACTH - 22,4pg/ml ( normal 7,2 - 63,3)

Serotonin seric : 209 ug/ml ( normal 40-200)

Cortisol: 28 ug/dl ( normal 6.2 - 19.4) - so this is HIGH

FSH : 3.99 ui/L ( normal 1.5 - 12.4 )

Porlactine: 4.39 ng/ml ( normal 4.04 - 15.2)





All my other analises are ok, and trust me i made them all.



So now i have to take xanax so i feel a little better every day, like this : morning 0,25 , lunch 0,25 and evening 0,5 .



I feel so weak almost all day, but i found that tribulus terestis makes me feel better and also muscular tonus and that give me the mood for GYM, because feeling dizzy and weak i have no place in the gym and i really want to go back regular on exercise.



Interesting is also that i have good muscle mass and strength.



So do i have a GH deficiency or not? Because i know that this thing are conected GH-LH-Testosterone, but i also understood that is is there a GHD also IGF-1 should be low...



I also have a very high metabolism , i eat 6-7 times a day, good food, quality protein ...maybe this can explain the good look, and in 1 year i gained 2 kg and exactly 2 cm more body fat arround the waist( belly) , everything else was messured and they are all exactly the same , by cm.



Errection for example is ok, but doesn't stay more that 5s if not stimulated... but sex is ok, problem is after sex i feel very weak/tired and it takes at least 4-5 days to feel the need for sex again.



So, no one can tell me where is the problem? Why am i dizzy all day? What's with this stupid anexiety i feel and some time depresion, but this i believe is caused by the problems i have , because is very frustrating for me that i'm not feeling ok and can't find the problem.



Sometimes i feel a burnheart sensation in the left side of the heart, but went to bets cardiologist and said all is ok there, even made the effort test and was ok. If i want i can run for 4-5 km... but next day i'm waisted... so recovery it's very hard. Interesting is also the fact that i have good strenght and resistance, but sometimes when i take the stairs feels like 1km run ...



This dizzines is not when i move, or turn head quickly ( cheked also spine, head RMN, ears, all are ok), it's just there... all day, and when i'm hungry i became very dizzy if i don't eat ( also glucose levels are ok 80-85 when i'm hungry , 90-100max after eating) .



Somebody find the source of this problems please... is there a GHD or not? Or what is it then... :)



Thanks in advance!
doctor
Answered by Dr. Binu Parameswaran Pillai (12 hours later)
Brief Answer:
No GHD

Detailed Answer:
Good day,
Noted your concern.
You do not have GHD. A random GH has no value and IGF-1 is more reliable. Since that is normal, please do not worry.

You have subclinical hypothyroidism and you have been started on Euthyrox . It has improved as well.

Your had used anabolic steroids ( probably testosterone derivatives) for body building and hence your LH and Testosterone levels are low. You have to wait for few more months and repeat the tests. PLEASE DO NOT TAKE FURTHER TESTOSTERONE INJECTIONS OR TABLETS. if the testosterone level doesn't im,prove after few months, we need further tests.

YOPU DO NOT HAVE GROWTH HORMONE DEFICIENCY. Please ask further if you have any doubts
Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (6 hours later)
Hello,

Anabolic steroids i used 5 years ago, nothing since.

Testosterone levels in this past years were always between 1,5 - 4 ,4(that was maximum) .
LH levels were after the steroids : 0,007 , and in this past years were between 1.4 - 3 ( that was maximum, this was when testosterone was higher too) .

Now i'm taking euthyrox 25mcg a day , tsh is now 2,4, rest are normal. But i'm not feeling good at all.

For example this day:

I wake up, i heard a little pulse in my right ear, i took euthyrox and 30min later i took breakfast. After breakfast i took 0,25 xanax. I had libido for sex, but as soon as erection was up, it was going to orgasm, if i stopped, than errection was going away quickly.
I'm feeling very dizzy, i have tension 150/83 and pulse 95, my head feels very hard and i feel also very very tired, and in the same the i'm very agitated.
I'm so dizzy i feel like i'm drunk when i walk...
I also feel a little burnheart in the left/up side of heart.
I also feel a neck tightness and it also feels like an itch, in the thyroid arrea.
I also feel a dry mouth, thirsty...but i drinked enough water.


So this is how it is...for today.
Sometimes i feel every day hungry, even if i eat very good, after 30min-1 hour i feel very hungry, somethimes this fake hungry sensation goes away, and somethimes it doesn't ...

What should i do? It's very hard to live like this... but i have to solve the problem :)
doctor
Answered by Dr. Binu Parameswaran Pillai (5 hours later)
Brief Answer:
XANAX

Detailed Answer:
Dear,
I really can't beleive that you are taking such a dose of Xanax daily and still able to type this question. XANAX ofcourse will make you drowsy and tired. I would advice to try reducing it to once at night only. This may improve many of your symptoms including sexual symptoms. Who have prescribed you this dose??

If you take testosterone injections, your Pituitary LH/FSH system gets shut down and that cause low LH and testosterne levels. It will also cause low sperm count. Once you stop Testosterone, usually, it takes 5-6 months to recover partially and it may take even longer for full recovery. In your case, it is showing a recovery tendency. Please relax. It will improve gradually.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (1 hour later)
1. Yes, but i also had this simptmos when i didn't took xanax in the past, anyway it's a month now since i'm taking xanax , 0,25 morning - 0,25 lunch - 0,5 at night, so that's 1mg/day. I'd like to remove it but i think i have to drop it gradually, so how do you advice me to do ?

My family doctor prescribed it for anexiety / panic attacs said would help, maybe for first 2 weeks but now i don't think so.

2. I know that this happens when you take anabolic steroids, i also used steroids 10 years ago, but just for 3 months, full recovery was in 2-3 months maximum, last time i used for 1,5 years so i'm thinking maybe pituitary recovered but not at "full power" ... but now it's 5 years i'm clean.

3. What do you thinks it's the cause for my thyroid problem? ( steroids, stress ( i worked 24/7 at one point i had ~800 employes starting from 0) , smoking, ... ) ?

4. How does smoking affect my problems ?

5. I also made research and find out that for my thyroid problem i should avoid gluten, sugar, etc.
I also found supplements that help such as : omega 3-6-9 ,gingko biloba ,spirulina ,Evening Primrose Oil, Noni Lichid, Mega q Protect ( http://calivita.eu/products/FL0091/ ) , ASHWAGANDHA, NATURE-THYROID ( http://www.inhousepharmacy.vu/p-417-nature-throid-tablets-65mg.aspx ) , AMIX GuggulLean ( http://www.amix-nutrition.com/products/47/guggullean ) , ALGE KEMP , Now- Thyroid Energy ( http://www.nowfoods.com/Thyroid-Energy-90-veg-capsules.htm ).

Thanks for your answers, i appreciate your help.

I'm asking allot of questions here so if i need to pay more just tell me, no problem.
doctor
Answered by Dr. Binu Parameswaran Pillai (10 hours later)
Brief Answer:
Smoking too bad

Detailed Answer:
Good day,
No extra payments required.

Xanax is Alprazolam which we prescribe for less than 2 weeks. Otherwise it can cause addiction. You must consider meeting a psychiatrist and get the panic disorder addressed by him. He may stop XANAX and give you a better drug to deal with anxiety/panic episodes.

Your Testosterone seems to be recovering. But please remember that Testosterone levels will not be accurate when you are stressed. You must recheck Testosterone levels on empty stomach between 7 to 9 am. This is the best time to check Testosterone. Besides, I noted that your free testosterone level is very normal. Not to worry.

SMOKING is a killer and affect Thyroid, Testosterone levels . IT SURELY WORSEN ANXIETY.

To determine what has caused thyroid issues, you may need to do a test called as " Anti TPO antibody test". Stress surely affect the thyroid functions in a negative way.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (5 hours later)
Hello again,

Those are ok. All thyroid analises are ok in this moment.

Anti TPO : <10 UI/ml ( normal <35)

During past years i have made more blood tests, all they could find was that TSH 8,5 that decreased after 1 month of euthyrox 25 mcg at 2,4.

I believe that tsh level was than 8,5 because i had intense stress , i say this because i took euthyrox still after tsh was ok ~ 2 , and i checked it every 3 months, and was ok 2- 2.5 XXXXXXX , so one month i had a big stress so it went to 6,2 , and after that decreased to 2.5-3 again in two months , and every day i took in the morning euthyrox 25.
doctor
Answered by Dr. Binu Parameswaran Pillai (6 hours later)
Brief Answer:
May stop and watch

Detailed Answer:
Okay,
Anti TPO < 10 rule out auto immunity. STress can push TSH on both ways. TSH can go up or down in stressful situations. Most commonly we see TSH to go down. ( which is called as sick euthyroid syndrome).

In your case,as anti TPO is negative, you may stop Euthyrox for 6 weeks and recheck TSH and Free T4 after that. If the TSH goes up again, then you may need long term ( possibly lifelong) treatment.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (38 minutes later)
Hello,

Already done that.

I had TSH 8,5 in february 2013, so i took euthyrox 25 , and after 1 month was 2,5, and i continued with it, after that i checked it at every 2 months, and results were always between 2,3 - 3,2 , in february 2014 i had a big stress and it was 6,2, after that in march 2014 was 3,7 and in april when i felt very bad , and was 3,9.

And than, i stoped taking euthyrox and i had it checked every month to see if it goes up again. So, in april with euthyrox was 3,9, from 1 may 2014 i stopped taking it, and in 1.06.2014 after one month without euthyrox TSH was 4 , than in july wa 3,9 , in august was 4,1 and in october 2014 was the same, 4,1, and in november same 4. ( normal range here is 0,4 - 4) .

So in november when i went to endocrinologist said it's notok because it's 4 because is at it's limit and i should take euthyrox again, so i did, and now i have it 2,3.

But i feel the same even if it 2,3 or 4 ... anyway doctor said i'm not feeling that bad because of the thyroid.

So what is it than since i cheked them all? :)

I'm thinking since thyroid it's inflamated maybe it's bothers blood vessel arround it and cause circulatory problems in my brain.

How else can be explained the pulse i hear in my right ear somethimes since i have MRI done to my head and it's ok, i also checked ear/inner ear inluding audiogram and it's ok, and i also checked my heart + blood vessels and they are all OK....

I'm very dizzy almoust all the time, i have no pain, but i have simptoms as i wrote up ( very tired, and in the same the i'm very agitated.
I'm so dizzy i feel like i'm drunk when i walk...
I also feel a little burnheart in the left/up side of heart.
I also feel a neck tightness and it also feels like an itch, in the thyroid arrea.)

This simptoms i have with or without euthyrox, with or without xanax ...

So what is it than?

I also want to know if you can tell me how can i reduce inflamation of thyroid and what cause it.

And one last question, from where it's that neck tightness were is the thyroid.

I wait for answer.

Thank you very much.
doctor
Answered by Dr. Binu Parameswaran Pillai (10 hours later)
Brief Answer:
Psychology consultation

Detailed Answer:
Thank you for the reply.
I wouldn't agree with your old endocrinologist. If the TSH was just 4, I would rather observe it.
Since you are stressed and as you have done extensive investigation with out any positive result, I would advice to meet a psychologist and psychiatrist who can help you to overcome the symptoms. Besides, it is a very good idea to practice Yoga and stretching exercise to overcome the stress

It is worthwhile to do an 8 AM serum cortisol and a repeat 8 AM fasting Testosterone
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (6 hours later)
Hello again,

I practice yoga and meditation, it helps.

I'd like to know the answer for this if you can, please :

1. From where it's that neck tightness were is the thyroid?

2. Can you tell me how can i reduce inflamation of thyroid and what cause it? Could the thyroid be inflamed from smoking?

3. How does affect me the fact that thyroid is inflamated since blood test are normal?

Thanks.
doctor
Answered by Dr. Binu Parameswaran Pillai (20 hours later)
Brief Answer:
Inflammation in thyroid

Detailed Answer:
I had explained earlier that the neck tightness can be due to inflammation from smoking or an infection. Usually this settles with time. If the pain is more, we may have to use anti inflammatory medicines or steroids for couple of weeks.

Blood tests are abnormal only during the initial part of inflammation and then it settles. But in the future, inflammed gland may not work properly and you may develop hypothyroidism
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (2 hours later)
Hello,

How can i find out if it's an infection, what tests are there to be done ?


Does anabolic steroids affect thyroid? I mean in normal case if it's not inflamated.
doctor
Answered by Dr. Binu Parameswaran Pillai (21 hours later)
Brief Answer:
CBC, ESR

Detailed Answer:
If you do a CBC, and ESR, it may show evidence of infection. ESR will be usually high in infections.

Steroids doesn't affect Thyroid in a bad way. YOU MUST PLEASE CONSIDER STOPPING SMOKING.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (2 days later)
Hello,

I think quit smoking is a must.

I have CBC done over the years, mostly are ok but some a little over the limit.

ESR was in 2009 when problems started 2 ( normal 2-10) , and than in 2012 it was 13 , and in 2013 it was 9 , and last i have was in april 2014 and than it was 5.

So, what do you think?
doctor
Answered by Dr. Binu Parameswaran Pillai (19 hours later)
Brief Answer:
Not so high

Detailed Answer:
Yes, Quiting smoking is surely a very good idea. Your ESR trend is not bad. Please do not get too worried about it. Doctors do not consider ESR to be high unless it is more than 20 persistently.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

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Suggest Treatment For Dizziness And Weight Gain After Discontinuing Steroids Along With Hypothyroidism

Brief Answer: No GHD Detailed Answer: Good day, Noted your concern. You do not have GHD. A random GH has no value and IGF-1 is more reliable. Since that is normal, please do not worry. You have subclinical hypothyroidism and you have been started on Euthyrox . It has improved as well. Your had used anabolic steroids ( probably testosterone derivatives) for body building and hence your LH and Testosterone levels are low. You have to wait for few more months and repeat the tests. PLEASE DO NOT TAKE FURTHER TESTOSTERONE INJECTIONS OR TABLETS. if the testosterone level doesn't im,prove after few months, we need further tests. YOPU DO NOT HAVE GROWTH HORMONE DEFICIENCY. Please ask further if you have any doubts Regards Binu