Labs:
TSH was 2.1 and my free T3 was a bit below the top quarter of the reference range and free T4 wasn’t quite in the upper half of the reference range. I ran iodine + selenium supplementation which jacked my TSH up for a while (normal). It has since started coming back down and the supplementation has improved my free T4 
Started with Defy and ran with those drugs. I wouldn’t say that my symptoms have improved though. I think the most obvious would be morning wood daily and frequent daily erections + a libido change. Not any different.
Sounds like I won’t have another appointment for like 3 weeks, which kind of pisses me off, they could be more proactive with scheduling existing patients. Got another weeks supply of these meds then I’m out.
Observations. That Free Test, wowza! Estradiol (sensitive) is higher than it should be, probably need more anastrozole if I continue clomid. Prolactin is too low, maybe I could cut that dose in half. I had a previous TPO Antibodies test that came back negative so no autoimmune problems with the thyroid. Then there is reverse T3:
Iodine fixed free T4, but reverse T3 seems to be blocking free T3. Why is this high? I’m not sure, but there is no way in hell that this could be responsible for having whacked my testosterone levels and driven up prolactin, for the past 5-7 years or so as I suspect.
Lifestyle wise, I’m not stressed at work, haven’t been cutting weight, and am not overtraining. I drink one night a week and probably have one or two nights a week where I don’t sleep optimally (trouble falling/staying asleep), which I don’t think is too abnormal. Beyond that, I can’t see how lifestyle would be an issue.
Dr. Saya said my liver function, metabolic panel, and lipid panels were great. I’ve never used other meds. I do get tonsil stones occasionally which could cause inflammation theoretically, although I never get sore throats and have never had tonsillitis.
My DHEA-S looks good. I had an 8am cortisol test a few months ago and that came in right at the top of the reference range where it should. Adrenals look good from that perspective, not that a single cortisol test is the be all end all.
Maybe I need to use more selenium and get ferritin, b6, b12, and zinc tests (started using vitamin D a few months ago).
At the end of the day though, I’ve likely had testosterone issues for 5-7 years. High prolactin from low thyroid function makes sense since I don’t have a prolactinoma or renal failure. And then low thyroid function from a lack of micronutrients, which is where this all stems from? Seems a little far fetched to me. Will obviously have to see what happens at the follow up, but that is what I’ve come up with now on my own.
Thanks