[demografx]

PRONOBIS, thank you for your patience! Bureaucracies like this can be maddening. But you're making great progress.

After this, maybe we should email them every hour until they wake up []

[demografx]

TREATMENT UPDATE

Today is Day One and I feel teriffic! Yesterday was not great. It seems I can't completely escape Day Zero, but my horrible OLD Days 1, 2, and 3, seem to be mostly gone!

More bloodwork and endo visit in about 10 days. I have now been in treatment and reporting to you all  for about 7 months.

[demografx]

JOHN, more exciting news! I have Craisins, cranberry raisins, wonder if they would work? My wife buys and eats them all the time, maybe I'll steal some.

[martin88]

Since I know this forum I tried to be more attentive to what happens during an orgasm. I realized that exactly during the few seconds of the release, not after or before, there is something strange happening: it's a sudden big fatigue in the legs exactly like in pois, but more intense than in POIS. This fatigue is more obvious if you stand up while having an orgasm which is rarely happening but it's how I realized that.

I recover from this very intense fatigue 5-10 seconds after release.
Is there really a chemical substance like hormones, neurotransmitters, prolactin or oxytocin able to act so quickly to produce such an intensity of fatigue?  I'm not sure.
 
To be a so quick reaction it seems like it's more a temporary lack of electrical power in the nerves and then after it's becoming hormonal when the time comes to recover from this..

According to documents on the web, potassium and sodium are involved in the production of electricity, and the adrenal gland produce and release hormone that maintain sodium and potassium levels. Just a theory! I don't know what to think about this  [] 

Electricity and nerves:
http://www.spc.cc.tx.us/biology/lsimpson/Biol2401/Lecture%20Notes/NervI.pdf

 

[demografx]

Martin, very interesting description and theory. Maybe one day all these pieces will be put together.

[hardasnails1973]

Hi my name is hardasnails1973 currently I am in school working on my degree of naturopathic medicine.  While studying for my ND I also work at hormone clinic in the united state that deals with complex issues of fatigue and also sexual dysfunction as a medical consultant to the MD.  The number one thing that I see when people walk into the clinic is that they present symptoms, but there ranges are in "normal range " according to the DR.  What is normal for some one is not normal for another person.  When dealing with fatigue we focus on the whole endocrine system, life style, nutrition, physical and emotional well being, as well as past child hood tramas.  When looking at this issue in the past we think that it is a combination of unresolved past trama or unresolved stress dealing with emotional repression.  We tend to look at the physiology of the brain and also the interactions of all hormonal and immune systems.  I was refered to this board by a client of mine that we are working to help rebalance his system.  One can search under my name and will see over 7 years of post dealing with issue related to fatigue and sexual dysfunction.  I am here to offer a helping hand into helping you resolve these issues or point you in the proper direction. 
Be well and remember there is always hope so never give up.  I have seen people from around the world and if here is any improvement in ones quality of life then that encouragement. POIS is a very unique disorder that has many different aspects which all need to be explored.  90% of the Dr do not know how to read lab work properly.  When properly interpret and levels are restored amazingly people lives start to turnaround.  Drs are just lazy and are looking to stick up on some antidepressant when the real cause was something totally unrelated in the first place.

[hardasnails1973]

From looking at your blood test results you are severely hypothyroid which could be making your POIS worse then it really is. Your ferritin levels are below optimal levels in order to make dopamine production.  When ferritin levels go below 100 this can cause mitochondrial dysfunction and alterations in hormone signaling.  This is why DR's are idiots when it comes to reading lab work. I can read labs in 2-3 minutes come up with a protocol in less then 10 with clinical improvement.  Your vegan lifestlye is at the root cause to alot of your issues because with out fat you will not absorb your DHEA.  Dhea is a fat soluable vitamin and needs to be taken with some kind of oil or fatty food. I have seen several vegans as clients and in the end they ended up self castrating them selves and shutting down there own thyroid and endocrine system because lack of cholesterol in the diet.  Remember times have changed its not the same as it was 50 years ago and 9 time out of 10 most vegans do not know how to mix foods to prevent your minerals from being assimulated properly.  SOme times we are our own worst enemies.

I just got my test results:

                     Result:      Range:
Free Tesosterone:    9.3          7.2-24.0

Testosterone Serum    474         241-827

DHEA-Sulfate          141         70-310
(I take 50-75Mg. DHEA/day

EStradiol             29           0-53


Creatinine            .74          .76-1.27
(I have a vegetarian diet which would lower this.)

It seems everything is awfully normal in your blood tests .
Was it "in pois" ?


I did my tests and went to the MD's office to have the results but they don't have all.
Here is what I have:
From hospital lab, release friday evening, testing monday morning.

Cortisol : 533 (138-690)
prolactin : 9.3 (2.7-16.9)
TSH : 4.4 (0.4-4.5)
Glucose fasting 5.5 (3.9-5.5)
HDL cholesterol 0.97 (1.04-1.29)
Creatinine 83 (55-110)
calcium 2.41 (2.12-2.62)
lymphocytes 39.7 (25-45)
ferritin 80 (15-350)

I didn't wake up very early just before the test, but it's rare, so maybe my cortisol is too high otherwise. TSH and glucose in the high limit. Nothing to explain why I'm so tired..

I made sure I was in POIS(what we do for science), although sypmptoms were less severe and prolonged than in the past.  I was taking DHEA and Tribulus Terestis so they may have actually elevated my Testosterone level into the range. 
Unfortunately I don't have any previous Testosterone test to refer back to ,except saliva(several years ago) which was mormal but maybe not that accurate.
My Chloresterol was normal but HDL was low.  Hormones like Testosterone need chloresterol to be produced.

[girlwind]

Hi my name is hardasnails1973 currently I am in school working on my degree of naturopathic medicine.  While studying for my ND I also
work at hormone clinic in the united state that deals with complex issues of fatigue and also sexual dysfunction as a medical consultant to
the MD.  The number one thing that I see when people walk into the clinic is that they present symptoms, but there ranges are in "normal
range " according to the DR.  What is normal for some one is not normal for another person.  When dealing with fatigue we focus on the
whole endocrine system, life style, nutrition, physical and emotional well being, as well as past child hood traumas. We tend to look at the
physiology of the brain and also the interactions of all hormonal and immune systems. 

90% of the Dr do not know how to read lab work properly.  When properly interpret and levels are restored amazingly people lives start to
turnaround.  Drs are just lazy and are looking to stick up on some antidepressant when the real cause was something totally unrelated in
the first place.

Yes! Yes! And Yes!  Hardasnails-- I am so happy to see your post. You are right up my alley in your thinking. I have
sent you a PM and I'm hoping to learn more from you about what you know about the hormonal issues. I have learned
A LOT about this over the past year, but still have a long way to go. I'm eager to know more!

[hardasnails1973]

I am starting to find that alot of people are getting optimal levels of testosteorne,e2 levels but still are not feeling right. Many of these people have other hormonal imbalances such as cortisol, thyroid, or neurotransmitters. With the ability now to check the what is going on in the brain it makes it much easier to finally put the finally pieces of the puzzle together for many people that have been dealing with this issue for along time. One of the biggest factors that has been over looked for the longest time is the hormone signaling which is not due to the amount of hormone but how the body is responding to it at the tissue level. This factor is more important then how much is one taking. One of the factors that can affect this is ferritin. Ferritin is a 2 edge sword. Too much can cause tissue destruction and not enough will cause hormones not to respond at the receptor sites. The optimal levels for proper hormone signaling has been shown to between 135-200. When levels start to exceed above 300 then this could be red flag for hemochromatosis even though one is still with in the range. Anything < 100 ferritin can cause problems with low ATP production as well as decrease in dopamine signaling as well, hormone response. Our goal is to get people up to 150 ferritin +/- 35. How this number was determine was looking at people that had normal healthy hormone level from over 200 patients to come up with a mean average excluding people with hormonal, thyroid problems or people following conditions of Fibro or CFS. These people with CFS and FM tend to have low ferritin levels <60 which can impede mitochondrion functioning. A person can have optimal thyroid levels but if ferritin levels are low that person will exhibit low thyroid symptoms because of deficiency at the tissue level.

When looking at a person one needs to take in
1) psychological history
2) recreation drug abuse
3) hormonal imbalance
4) current lifestyles
5) nutrition habits
6) sleep patterns
7) motives to why they are there (some people will use Dr's as an excuse not to get better) "Oh I went to the best HRT dr and he could not help me" These people need attention all the time and can use their illness as way to get sympathy.
Current daily stress - work, relationships, financial obligiation

The success of over wellness is to HRT combined with proper lifestyle, and nutrient dense eating patterns. Finding the road blocks are the biggest challenge to a medical practioner.
When dealing with people with HRT the objective is to identify the root of the cause for people that at younger age <26-29 (depending on case). For people that are over 30 then TRT should be explored while properly balancing cortisol then thyroid issues. Many times given TRT has resulted in reduced thyroid function which dr's 80% of the time do not monitor because they do not know the interaction of specific hormones. GH or GHRT is initiated after all the other hormones are in check. In many instances not all igf-1 will rebalance it self when thyroid , cortisol, insulin, dhea, testoserone are properly balanced.
Again this is age dependent and case specific.

[hardasnails1973]

Yes I know you had it because I was the one that discovered it. As I told you before I will go after the cause of the issue and not just the symptoms. Personally IMO correcting the hemochromatosis will not resolved your low T issues, but one can give it a try for 2-3 months and see if levels return. If not then do not screw around trying to "jumpstart" it and wasting precious time which you have spent many years wondering what was wrong with you.
If you were 10 years younger then i said try clomid, but not at your age. Every case is dependent and most logical scenerio would be to treat the hemochromatosis (get levels down to <50) then start TRT along with what I already recommended you. Once on TRT then monitor thyroid. In your case starting TRT may resolve your thyroid issues since your rt3 were high. Most likely due to iron binding zinc reducing your T levels. Zinc is needed to help reduce rt3 as well as selenium which can.

When dealing with hemochromatosis it takes priority over all things as Dr Mariano nicely pointed out just how destructive it is and how it has been over looked. When dealing with hemotologist they always error on the side of caution as keeping ferritin levels <50. The reason these occurs because ferritin can build at rapid rate in an individual at any given time. Every ones saturation ability is different so just as a safety blanket they set these standards for every one. In the past I have found articles that use high dosages of milk thistle for hemochromatosis, but also found other ones that counterdict it. So the jury is still out. It may not be the iron build up but due to low vitamin A and E, molybednum one can not metabolize ferritin properly. Iodine has also been known to lower ferritin levels as well. Yes and one of strength 77 friends was also identified as having this same disorder at the age of 17, but when further investigated it was found that this was self induced through dietary habits. Oats contain 40% of iron RDA this is one serving in a specific brand. He was eating 12 servings of this a day along with 1 lbs of red meat. It was not the meat doing the damage but more so the fortifed oat meal and also iron in multivitamin was the culprit. He was like "great I have to give blood for rest of my life" I just started laughing and said "NA you lucked out"

newbielink:http://www.lef.org/protocols/metabol...matosis_01.htm [nonactive]
newbielink:http://www.squidoo.com/hemochromatosis [nonactive]

[hardasnails1973]

When interpreting thyroid function, it is very important to obtain a Total T4.
T4 is about 98 percent of circulating thyroid hormone.

If one is treated with T3 (Liothyronine, Triiodotyronine), then Total T3 will also be important to determine what is occurring.

Thus a more complete thyroid panel would include:
Free T4, TSH
Free T3
Total T3
Total T4

One reason total values are important is that the free levels are influenced by the availability of the various thyroid binding proteins - such as albumin, thyroid binding globulin, and transthyretin.

These binding proteins are influenced by other factors, such as:
Albumin - hydration, general nutrition
Thyroid binding globulin - estrogen signaling strength
Transthyretin - vitamin A signaling strength (since it not only binds T3 preferentially but also vitamin A)

The binding protein levels are not accounted for by the free levels of T3 or T4. Thus when other factors come into play, they will directly interfere with or complicate interpretation.

Additionally, you have weakly bound versus strongly bound interactions with the binding proteins - just as Albumin vs. SHBG have weak vs. strong binding to testosterone. (This is why total testosterone is the best measure overall of testosterone signaling strength.)

Total T4 can be used as a ceiling for how much T4 can be given. Similarly with T3.

Free T4 is not a sensitive indicator of total thyroid signaling strength.

Free T3 is one indicator of total thyroid signaling strength, but I would also take into account Total T4 since thyroid can also be converted within certain cells to T3 prior to use.

Using Free T3 without a total T4 (and Total T3 if needed) to determine thyroid hormone dosing is like flying blind in fog. There is no indication of the endpoint. It would be like using Free Testosterone to determine how much testosterone to give.

In addition to lab tests, it would be important to also try to establish physical markers as targets when doing thyroid replacement therapy. This would include reduction or correction of signs of thyroid hormone deficiency. When one can establish physical markers/signs to determine thyroid dosing, it can be as sensitive or as good as lab tests. This is how physicians did it prior to the development of lab tests.

Combining both physical exam and lab testing would be ideal though patients may not have the means for frequent lab testing. Thus the choice of labs needs to be tailored to the patient and their circumstances.

Winter is a particularly stressful time. One factor is colder weather which forces an increase in sympathetic nervous system activity. This may lead to a reduction in serotonin signaling. This then may result in a reduction in thyroid hormone production. Additionally, the stress resulting from cold weather may result in adrenal fatigue, which would result in a reduction in T4 to T3 conversion. Lower vitamin D levels - as it is used up from fat stores in darker light - also may result in a reduction in serotonin signaling, resulting in a reduction in thyroid hormone production. Stress may also result in zinc loss, impairing thyroid hormone production. Stress also increase insulin resistance, leading to a renal loss of iodine, possibly impairing thyroid hormone production.
Assuming the nervous system is working well enough (a huge assumption) to:
1. monitor thyroid hormone signaling well
2. produce TSH well
then certain doses of thyroid hormone replacement do not necessarily result in a lower TSH.

There are many factors involved. For example:

1. Does the additional exogenous thyroid hormone lead to suppression of thyroid hormone production such that there is more or equivalent loss of thyroid hormone than addition of thyroid hormone? This lead to TSH remaining the same or going higher.

2. Does the additional thyroid hormone lead to stress on the adrenal glands and adrenal fatigue? Or is there already adrenal fatigue, which can be worsened by the addition of thyroid hormone? If so, then thyroid hormone activation from T4 to T3 is impaired. This would increase TSH or break even and keep TSH the same.

3. Does the additional thyroid hormone trigger metabolic signaling pathways such that thyroid binding hormones are increased? This would lead to the same or lower free thyroid levels. TSH would then either remain the same or increase.

4. etc. etc.

Note that one alternative way to do thyroid hormone replacement is to deal directly with the hormone levels, forgetting about TSH. TSH varies much between people and actual thyroid hormone levels and it makes a huge assumption that the nervous system is functioning well enough to appropriately monitor thyroid levels and appropriately produce TSH (despite aging, for example). Thus TSH in many people (such as those with metabolic illnesses, heart disease, diabetes, mental illness, etc.) is not a good measure of thyroid function. This method is analogous to doing testosterone replacement. Who determines testosterone level based on LH or FSH? Hardly any one. It is easier to dose testosterone based on total level than by monitoring LH and FSH levels. With thyroid, Free T3 is actually a useful tool, unlike Free Testosterone (which reflects SHBG which is determined by a multitude of hormone signals). When combined with Total T4, Total T3, and Free T4, and the patient's signs and symptoms, this is all that is needed. TSH in this case is not needed

[hardasnails1973]

Speculation (in reality the situation is even more complex and I continue to research the matter):
1. Testosterone can increase dopamine levels in the brain.
2. Increasing dopamine levels may reduce serotonin levels - since their production is inversely related.
3. Serotonin help reduce perceived stress and helps reduce anxiety symptoms.
4. Reduction in serotonin level may increase the likelihood of perceived stress and anxiety.
5. Increased perceived stress and anxiety may cause the brain to increase Adrenocorticotropic Hormone (ACTH) release.
6. The ACTH signal is received by the adrenal glands, which in turn starts the stress response (including increasing cortisol, norepinephrine, epinephrine production, among the 50 hormones produced by the adrenals).
7. Increased perceived stress may activate the sympathetic nervous system, which then increases output of norepinephrine from the brain as part of the fight-or-flight reaction.
8. Increased testosterone may also lead to aromatization of testosterone to estradiol/estrone (estrogens).
9. Estrogens have multiple effects including behavioral effects such as increasing anxiety, irritability, hyperactivity and aggression.
10. Estrogen increases the expression of receptors and other associated proteins for neurotransmitters including serotonin, norepinephrine, and dopamine.
11. Reduction in serotonin level from increased dopamine levels may affect thyroid hormone conversion in the liver from T4 to T3 via the cytochrome P450 2D6 enzyme.
12. Reduction in active thyroid hormone may destabilize mood - perhaps contribute to anxiety, hyperactivity
13. Estrogen itself may compete with thyroid hormone at the thyroid hormone receptor site - creating a virtual hypothyroid state - perhaps also contributing to anxiety - despite normal thyroid hormone levels.
14. Remeron's mechanism of action includes increasing serotonin release, increasing norepinephrine release (at higher doses), and by blocking histamine receptors (accounting for sleepiness and weight gain at lower doses).
15. Remeron, in my experience, does not work well to reduce anxiety.
16. Increased norepinephrine levels from Remeron makes a person more likely to have anxiety when norepinephrine is further increased and serotonin decreased - from other causes - such as those written above.
17. The higher the dose of Remeron, the higher the increase in norepinephrine, the higher the likelihood of anxiety.
18. One of testosterone's functions is to reduce stress by reducing ACTH production from the brain and by directly reducing adrenal gland hormone production (i.e. reducing cortisol production).
19. Should the adrenal gland, from long term exposure to anabolic steriods, become tolerant to the effects of testosterone, testosterone may not be able to reduce stress and anxiety.
20. Adrenal insufficiency may occur from long term anabolic steriod use - where the adrenals cannot make adequate cortisol and other hormones as needed when stressed to handle stress.
21. Adrenal insufficiency/fatigue results in intolerance of stress, fatigue, chronic sleepiness, irritability, anxiety.
22. Tolerance to testosterone's effects in the brain may occur with long term anabolic steriod use.
23. Testosterone usually has a calming effect. This may not occur if tolerance occurs to testosterone.
24. With adrenal fatigue, progesterone levels are reduced.
25. Progesterone is being shunted to create more cortisol in adrenal fatigue.
26. Progesterone has a mood stabilizing, calming, antidepressant, sleep-promoting effects through several mechanisms of action.
27. Progesterone increases seroronin, norepinephrine, GABA, dopamine activity in the brain. Progesterone blocks NMDA Glutamate receptors. Progesterone promotes myelination of nerves to improve signal transmission. Progesterone increases Estrogen receptor sensitivity. Progesterone promotes thyroid hormone activity.
28. Low progesterone levels may lead to increased anxiety, insomnia, tension, and mood instability.
29. Low testosterone levels and high cortisol levels (as a result), may lead to insulin resistance.
30. Insulin resistance not only predisposes one to diabetes, it impairs neuron signal transmission, and directly reduces testosterone production.
31. Insulin resistance may increase the likelihood of mood instability, anxiety, depression.
32. A serotonin-reuptake inhibitor (a group of medications with many members) increases serotonin more specifically than other effects.
33. Increasing serotonin has a calming effect.
33. Increasing serotonin excessively, however, causes a reduction in dopamine production.
34. Excessive serotonin, and subsequent reduction in dopamine causes a motor movement disorder called akathisia.
35. Akathisia has symptoms including anxiety, panic attacks, insomnia, irritability, restlessness, hyperactivity, agitation (to the point of suicide attempts by some people).
36. When attempting to balance or optimize the effects of one hormone/neurotransmitter, one may have to balance or optmize the effects of others to obtain the desired state. Testosterone, Estrogen, Progesterone, Cortisol, Insulin, Thyroid Hormone, Dihydrotestosterone, the metabolites of progesterone, Norepinephrine, Epinephrine, Serotonin, Dopamine, GABA (gamma amino butyric acid), Glutamate, Histamine, etc. are highly interlinked in their effects - with the endpoint of allowing a person to maintain balance between health and the stress the person faces.

[Counterpoints]

Welcome hardasnails!

I'm interested in whether you have encountered people with POIS, what the symptoms were in particular, and what the assessment was.  You've given a lot of (unsourced and speculative) information about hormones, but I'm not seeing how this specifically connects to POIS.  Can you give us some ideas about what you think might cause POIS, explain why, and refer us to peer-reviewed scientific journals that would substantiate your ideas?  This could help us develop new POIS theories, and help us present them in a credible manner to researchers.

Thanks!

[Counterpoints]

From looking at your blood test results you are severely hypothyroid which could be making your POIS worse then it really is.

Don't you mean hyperthyroid?  (I assume you're referring to Martin's results here).

Your vegan lifestlye is at the root cause to alot of your issues because with out fat you will not absorb your DHEA.  Dhea is a fat soluable vitamin and needs to be taken with some kind of oil or fatty food. I have seen several vegans as clients and in the end they ended up self castrating them selves and shutting down there own thyroid and endocrine system because lack of cholesterol in the diet.  Remember times have changed its not the same as it was 50 years ago and 9 time out of 10 most vegans do not know how to mix foods to prevent your minerals from being assimulated properly.  SOme times we are our own worst enemies.

You are responding to results from two different people, as one person.  Also, "Finally" said he is vegetarian (not vegan?), and I don't think Martin has mentioned whether he is or isn't. 

[demografx]

hardasnails1973, welcome.

From looking at your blood test results you are severely...

1. Please refrain from individual medical diagnosis "over the Internet". I consider it, in the very least, highly unprofessional, without having seen a patient in your office. I have personally witnessed disastrous results coming from sight-unseen medical diagnosis and recommendations via the Web.

Most state medical boards consider cybermedicine unethical unless the physician rendering treatment has already established a traditional face-to-face relationship with the patient.
http://www.aaos.org/news/bulletin/oct07/managing2.asp

2. While your intent seems altruistic, it can be easily construed as advertising for your services, which is expressly prohibited.

Showing similar proficiency with medical language, we have had a naturopath advertise his services here, through his "patient."

3. What is your specific experience with POIS? Not just sexual dysfunction and fatigue. What have you actually studied about POIS? Have you consulted with POIS researchers?

From your suburban Pennsylvania location, it doesn't seem likely that you would have had opportunity to see many "patients" with POIS.

We have had some - not all - questionable interactions with naturopaths and their aficionados, but we remain open to the field, especially with MD-ND's who can provide a well-rounded perspective of both worlds, and also from "hard as nails" factually-based premises, especially from empirical, scientifically based documentation and rigorous study, which we have already initiated.

This forum is designed for POIS sufferers, so I won't type the standard welcome, which includes some helpful pointers for sufferers, but you seem to know more about POIS than we do collectively, including many world class researchers.

I do apologize if this comes across as overly negative, but you frankly have come across, as others before you, in a mighty aggressive manner (your first 2 very long posts, including your medical diagnosis of a forum member, all in less than 3 minutes!)...and with many of your supposed "answers" to POIS that we have all been struggling to find, with, as yet, no definitive proof one way or another.

[GoingCrazy]

I believe I'm in the same boat as John21 now.  Today I O'd and experienced no POIS symptoms.  To make myself a believer I did it 2 more subsequent times and I am still experiencing no POIS symptoms.  I followed his plan for eating yogurt, I've been doing it for 2 weeks now, and just recently I ordered Threelac.  I've took about 7-8 packets of threelac up to date and all I can say is I feel like I finally beat POIS.  Usually I am in POIS immediately after orgasm... I just hope this feeling lasts.


*** make that 4 times...lol

[Limejuice]

Goingcrazy, what type of yogurt are you eatting?

[GoingCrazy]

Stonyfield, probably any brand with active yogurt cultures would help.

[martin88]

From looking at your blood test results you are severely hypothyroid which could be making your POIS worse then it really is.

Don't you mean hyperthyroid?  (I assume you're referring to Martin's results here).

Your vegan lifestlye is at the root cause to alot of your issues because with out fat you will not absorb your DHEA.  Dhea is a fat soluable vitamin and needs to be taken with some kind of oil or fatty food. I have seen several vegans as clients and in the end they ended up self castrating them selves and shutting down there own thyroid and endocrine system because lack of cholesterol in the diet.  Remember times have changed its not the same as it was 50 years ago and 9 time out of 10 most vegans do not know how to mix foods to prevent your minerals from being assimulated properly.  SOme times we are our own worst enemies.

You are responding to results from two different people, as one person.  Also, "Finally" said he is vegetarian (not vegan?), and I don't think Martin has mentioned whether he is or isn't. 

Exact Counterpoints, I'm not vegetarian or vegan so this can't explain why ferritin is a bit low (but still in the range..) It could be also a lack of vitamin C in my case.

TSH value alone is not enough to make a diagnostic of low thyroid. However elevated levels suggest a sluggish thyroid (the body produce more TSH to keep normal T3 and T4.).

I have other TSH tests results :
2003:TSH 1.8(range 0.45-4.65)(out of POIS)
2004:TSH 1.17mUI/l(range 0.45-4.65)
2005:TSH was 2.2mU/l(range 0.40-4.50)
I remember I had also a result 3.1 but I can't find when.

On this page they're talking about 23 patients diagnosed with severe hypothyroidism, with TSH > 50mU/l ! http://cat.inist.fr/?aModele=afficheN&cpsidt=16915473

[demografx]

I believe I'm in the same boat as John21 now.  Today I O'd and experienced no POIS symptoms.  To make myself a believer I did it 2 more subsequent times and I am still experiencing no POIS symptoms.  I followed his plan for eating yogurt, I've been doing it for 2 weeks now, and just recently I ordered Threelac.  I've took about 7-8 packets of threelac up to date and all I can say is I feel like I finally beat POIS.  Usually I am in POIS immediately after orgasm... I just hope this feeling lasts.

*** make that 4 times...lol

Good luck! Very glad that you're realistic about it!