Hello Elaine,

Firstly, I want to thank you for your years of service to our community. In 2008, I was diagnosed with graves disease and immediately given RAI by an Endo who provided no options. GD runs in my family. You helped me get back on my feet and I am now stable on desiccated thyroid, healthy diet and exercise. My Son, 27, has been suffering greatly for the last couple of years. He is (was) a happy young man full of vitality. An athlete, who does not smoke, drink, and lives a healthy active lifestyle. He has been plagued with extreme fatigue and his quality of life has taken a nose dive. He no longer has the energy to go out with friends, socialize, exercise, play sports and says he almost nods off at the wheel while driving home from work each day. He sleeps right after work 6 pm and sometimes doesn't wake up until the following morning 6 am. I was struck when he told me that because that's exactly how I lived for 6 years (in a hypo state) before I was diagnosed with graves. For 6 years my TRab and other labs kept coming back normal but I could barely function I was so exhausted all the time. I feel he may have graves too but his blood results don't make sense to me. I want to be proactive and help him before his GP sends him to an Endo and he's given RAI. I would love your thoughts on his labs please.

Oct 25, 2023
TSH: 4.08 (0.20 - 6.50)
Free T3: 6.6 (3.0 - 6.5)
DHEA: 6.9 (4.3 - 13.4)
Random Testosterone: 11.1 (8.0 - 35.0)

Nov 13, 2023
TSH: 1.79 (0.20 - 6.50)
Free T3: 5.9 ((3.0 - 6.5)
DHEA: 8.2 (4.3 - 13.4)
Random Testosterone: 9.7 (8.0 - 35.0)
Luteinizing Hormone (LH): 7.3 (less than < 12.0)
Prolactin: 7.5 (less than < 21.0)

His doctor prescribed 200 mg transdermal testosterone cream and 30 mg DHEA capsules. He is reluctant to start the medicine and has not started them yet. He has not taken any of the prescribed meds before, between, or after the above blood tests.

Kindest regards,
Jeannie

Hi Jeannie,
His testosterone level looks fine and testosterone feeds prostate cancer so it's wise to be cautious. Same with DHEA. His level looks fine.
The recommended range for TSH is 0.3-3.0 so he may have been in a hypothyroid phase in October but November labs show improvement. With Graves' disease the hypothyroid phase can move into hyper but my daughter had a hypo phase that resolved and she's never become hyperthyroid.
A good idea would be to have a CBC and a complete biochemical profile to see if there are any medical causes for his fatigue. It's good you're watching out for him. Best, Elaine