Yeah that’s what is so strange about it. My free t4 and t3 always seem to come back very normal and midrange. I have gotten antibodies tested multiple times and it always comes back negative. I could get rt3 tested. That’s what has always been so strange about my high tsh. Tsh of 6 is completely abnormal but I’m not sure what’s causing it.
I’ll bet rT3 is causing a lot of your problems that TRT won’t fix. rT3 is like anti gravity, it will annihilate good fT3 levels. Your hypothalamus is increasing TSH in the hopes your thyroid pumps out more fT3, expect it is. High rT3 is the answer.
So you would still recommend trt while also trying to figure what is going on with my thyroid?
A proper functioning thyroid will complement TRT, their a team and a great team feels good. It’s like buying a sports car and putting cheap tires on it, it won’t perform it’s best.
Bump
Those labs were with or without thyroid meds?
fT3 was mid-range and should support good body temperatures.
Should be >= 97.7 when you wake up and reach 98.6 mid-afternoon
fT3 is the only active thyroid hormone. There is no receptor for T4. T4 is a reservoir for T4–>T3 conversion. fT3 is part of the body’s temperature control loop, controlling your energy and metabolic rate.
Standard recommendation:
self inject 50mg T twice a week, subq not IM, #29 1/2" 0.5ml insulin syringe
250 iu hCG subq EOD, above syringe or #31 5/16"
0.5mg anastrozole at time of injections
Some are anastrozole over-responders who need to take 1/8th mg twice a week.
E2 management needs steady doses of T and anastrozole. You mostly can’t be making dose changes based simply how you feel one day VS the next.
I might be able to provide better response, but I am confused by time line and lack of labs along the way and/or format of lab data.
When fT3 is good with low body temperatures we suspect elevated rT3 and stress issues.
You have not discussed if you had been using iodized salt - history of that please.
In the future, put lab data in list format with ranges, please not inside prose.
What iodine supplement?
Have you been getting selenium in vitamin pills?
What estrogen problems did hCG create?
Labs to validate that?
Thyroid meds made you feel hyper?
Did you see high body temperatures?
You were jittery or like too much caffeine?
Sleep affected?
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
KSman is simply a regular member on this site. Nothing more other than highly active.
I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re Thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab numbers and ranges.
The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.
Yeah I’m sorry about everything being jumbled like that. My most recent labs that I posted above were from last week. I have been on a 6 month hiatus from all medications and supplements to see if I can heal naturally. I was on thyroid medication during the summer months of last year but while they did make me feel better my body temps starting creeping up to a consistent 99.5. I could still sleep and function just fine it just made me feel very sped up in a strange way. It was much different than i caffeine feeling. I quit the thyroid meds over 6 months ago. My recent labs above show that my tsh has slowly came back up. I don’t have low body temps and my iodine intake is great, so that’s why my high TSH is strange.
Would you recommend trying out trt for my sub par test levels and very Low DHT? Also what can cause my iron levels to be as high as they are like that on my recent labwork above? Thank you for your help KSman.
Also my Dhea-S is very high but I have heard that is normal for a guy my age. Does this signify a stress issue because of my high tsh and Dhea-S?
DHEA is an adrenal hormone and not directly part of any regulating process. No relation to stress. Adrenal fatigue can lower DHEA.
DHT is from FT–>DHT and it just happens, no control process, if LH is low, DHT will be too. So testing DHT is sort of pointless when dealing with low T.
Serum iron changes with recent meals and should not be acted on by itself.
UIBC is low, blood has a lot of iron at that time.
Ferritin is not high.
Hematocrit is fine.
RBC is fine
Hemoglobin is fine.
I do not see an iron problem.
Avoid iron fortified:
- vitamins
- flour
- mixes
- pasta
- flour
- rice
- read the labels
Some diseases can increase iron levels.
Larger doses of iodine do increase TSH and then TSH lab results are not actionable and should be mostly ignored.
Can TRT work for me although my test levels are in the 400s? If it can improve the way I feel then I’m all for it. Feeling like an old man and a fraction of my former self is wearing me down. It’s hard to explain to people how you feel when you look fine on the outside. Whether it’s treating my thyroid or testosterone something has to happen fast. My urologist has said he might recommend it.
Update. Urologist called me and told me that he looked over my labs and while my testosterone was low for my age at 450, and my tsh was slightly high at 5 that It does not warrant treatment. He said to come back in 6 months for more labs and that we should just keep an eye on it. What do you guys think? Go through with trt with my other doc or wait it out?
Your thyroid must be addressed asap. In 6 months you can have nodules
I’m slightly concerned I might be developing some. My thyroid feels sore and enlarged occasionally. My anti-aging doctor is the only person who has wanted to put me on trt and thyroid hormones. Every endo and urologist I have seen just pushes me out the door. I’m contemplating just trusting my anti-aging doc and doing everything he says.
Didn’t read up. But get thyroid labs.
Tsh
Free t3
Free t4
Reverse t3
Thyroid antibodies
You can do one thing at a time. Fix thyroid first after 4-6 weeks retake all labs. then start trt which you will probably still need.
Just an update in case anyone else is still following this. I saw my general practitioner regarding my iron levels, and he wanted me to get a liver ultrasound and genetic testing to see if my iron levels could be hereditary. He told me that if indeed I do have hemotomachrosis that it could be the cause of my low sex hormones. I’ll keep this thread updated on the results. I’ve still been suffering bad sexual issues with a test level at 470. Just letting everyone know that it wouldn’t hurt to get your iron levels checked before looking into TRT.