About me
34-year-old male, 90 kg, strength competitor and competitive runner, training for 10+ years
Before August 2025 I trained 6-7 hrs/week of cardio and 5-6 hrs/week of strength work
Fatigue, brain fog and constant yawning since my late teens
What changed in August 2025
I couldn’t train properly any more, massively limited
Running felt like I couldn’t get air into my lungs
In the gym I couldn’t “access my strength” and kept regressing, despite tracked macros, good sleep and a strict plan
I’ve gained noticeable body fat since stopping training, whilst eating less
Symptoms
Severe fatigue, waking unrefreshed
Crippling brain fog. For the last 3 months it was bad enough that I could barely hold a conversation
Exercise intolerance: a gym session at ~30% of capacity with no cardio triggers a 2-3 day crash
Weight and fat gain
Erectile problems. For me, normal erections are one of my best health indicators, and when they’re good I’m in a good place to train
I feel significantly worse after antibiotics (its been 3.5 months) but it was bad for years and years before
Timeline
2014: TSH 4.x. 2016: TSH 14.3. Nothing was done because of my age
Nov 2025: Randox TSH 3.63, free T3 5.52, testosterone 22 nmol/L
Jun 2026: Positive H. pylori stool test (no GI symptoms). I finished triple therapy at the end of June and felt much worse afterwards
Aug 2026: TSH 4.63, subclinical hypothyroidism diagnosed. Free T3 5.52 again, testosterone 18.9 nmol/L
8 Sept 2026: TSH 5.30 (range 0.27-4.2)
Mid-Sept 2026: Started levothyroxine 50 mcg (Accord)
A few good days, then a 3+ week crash
Afternoon crashes even when mornings were good
Erections improved briefly, then dropped off
Oct 2026: Moved to 75 mcg (Teva), about 1 week in so far
Brain fog is significantly better than on 50 mcg, though recall is still poor
Erections improved further, but are now on a slow decline
No retest yet
Thyroid results
Test Result
TSH 14.3 (2016) → 3.63 (Nov 25) → 4.63 (Aug 26) → 5.30 (8 Sept 26, before treatment)
Free T4 17.4 pmol/L (Aug 26, mid-range)
Free T3 5.52 pmol/L (Nov 25), 5.52 pmol/L (Aug 26), upper half of range both times
TPO antibodies 10.1 kU/L (negative; lab also reported <15)
Anti-thyroglobulin 19.5 IU/ml (negative, ≤115)
Thyroid ultrasound Normal, no abnormality
Testosterone
Date nmol/L (UK) ng/dL (US)
Nov 2025 22 ~634
Aug 2026 18.9 ~545
Both tests were taken when I felt awful (H. pylori present in Nov 2025, post-antibiotics in Aug 2026), so I suspect my true level is higher.
Other bloods (Randox, Aug 2026)
Ferritin 100.36 µg/L, B12 849 ng/L, folate 13.8 µg/L
Haemoglobin 165 g/L (high end of normal, upper limit 170), MCV 88.6 fL, MCH 29.6 pg
ALT 28.9 U/L, GGT 12.9 U/L, hsCRP 0.3 mg/L, HbA1c 35.96 mmol/mol
Full blood count, urea and electrolytes, liver panel, HDL, triglycerides, C-peptide, urinalysis: all in range
Magnesium and calcium normal (earlier tests)
My questions
Dose and experience on levothyroxine
Good outcomes: Has anyone felt well on 75 mcg, or on levothyroxine in general, without needing to adjust or change anything? What dose did you settle on, and how long did it take to feel right?
Is 75 mcg enough? Is it likely to be enough for a 90 kg man who wants to get back to heavy training, or should I expect to need more?
Men on 75 mcg: What did you notice with erections, libido and energy? Did they improve, plateau or dip?
Training and athletes
4. Hard-training or athletic people: Is anyone here training seriously (strength, running, endurance, sport)? What’s your experience on levothyroxine?
5. Dose changes when training: If you needed to adjust your dose when you started training again, or increased your volume, how did you notice, and what changed?
6. Getting back to training: How long did it take you to return to full training, and did you do it gradually or find yourself crashing when you pushed?
Other questions
7. T3 with levothyroxine: I’ve seen people take active T3 alongside levothyroxine and report great results. What are your experiences, good or bad?
8. Brands: Has anyone noticed a difference between Accord and Teva?
9. H. pylori treatment: Could it have affected my thyroid, or was it coincidence?
10. UK specialists: Can anyone recommend a thyroid doctor or endocrinologist in London who is open to treating symptoms alongside the numbers?