I was given 160mg on day 1 at the clinic. So 40ish mg of that is still hanging around in my system at this point. Thinking that probably dropped my SHBG quite a bit as my free T % went from 1.5% to 2.3%. Will probably stay the course for another 4 weeks and then get more labs.
Well, I was about ready to post on here yesterday about feeling decent and having a pretty good day. Then about 2pm I had a full blown panic attack. I used to have these when I was younger and still struggle with anxiety but have not have a full blown attack in 15 years. Luckily, I have some propranolol I use for public speaking events. It helped with the physical symtpoms as I can deal with the mental pretty well on my own. Then woke up at 1am with another full blown attack happening. Took some propranolol and fell back asleep a few hours later.
Assuming, this is just my body balancing out all the hormones including my stress hormones which I am sensitive too. Thinking I may slightly lower my dose (15 vs 18) and go subq. Hopefully those few days of transitioning to subq will let this all settle down. Wondering if I should go even lower, like 10-12mg. I dont want to overreact though and cause other issues by dropping my dose to fast.
Panic attacks are no joke for me and could make this whole thing problematic if they continue. Propranolol really helps keep the physical symptoms from turning into a run away train. I know beta blockers decrease testosterone effects as they block certain receptors. Going to keep using if needed but hoping I dont have too.
Thryoid panel came back today. Everything is in the reference range but low end of normal. Need to do more reading at stop the thyroid madness. Curious if there are any opinions on my current thyroid labs and how much these may change over the next 4-8 weeks. Fatigue has been one of my major symptoms so just wondering if thyroid is worth looking into as I stabilize with TRT. I am currently 3 weeks into my TRT treatment.
Typically top 25% of the range for ft3 and rt3 under 15 is where people feel best.
You are def on the low end thyroid wise
I am a little confused how to think about correcting it. Is it like low T where getting optimal requires medication? Or what is the process for getting optimal naturally? Currently take iodine and selenium daily but that is about it for thyroid.
Your Free T3 is low and Reverse T3 on the higher end, fT3/rT3 ratios are too high. You need T3 only medicine because you have a conversion disorder.
A few questions about fixing this
- Do you just straight to T3 medication or is there a way to fix not converting enough?
- Should my FT3 continue to decline as I get further into TRT?
- Would you wait until stable on a TRT dose or start T3 medication now?
If you knew what was causing the conversion disorder, then you would have implemented a plan to address it. It can be tricky figuring it out. The demand on your thyroid is greater on TRT, so I expect everything to be forced to work harder, my TSH pre-TRT was .6ā>.9 on TRT.
TRT canāt work if Free T3 is low, the higher Free T3, the more effective TRT will be. You canāt play the TRT game if you donāt have enough Free T3.
I donāt expect good results with these thyroid numbers.
So I found a much better local doctor finally. Think this one is really going to be good for the long term. He was onboard for cytomel and metformin additions to my TRT. Able to get a normal script for Test-C and fill at my own pharmacy.
Now, where my question comes in. He wants to start at 5mcg of cytomel once per day and then evaluate in a few months or so.
- With that low of a dosage can I expect any real benefits over time?
- Will the introduction of exogenous T3 shutdown my own T4 to T3 conversion? Could this low does put me in a worse situation?
This is one of those things that you just have to find out the old fashion way, try it and see what happens.
This is hard to say, but this isnāt a concern, thyroid levels bounce back quickly after stopping thyroid medicine.
I guess I was more thinking that 5mcg could reduce my own production enough to put me even lower than where I already am. Basically, could I end up with lower free T3 by taking this low dose of Cytomel?
Well if the dose is too low, then you call your doctor and tell him you feel like you got hit by a truck.
~ 4 month update. Thoughts, feedback, or comments are appreciated.
Just thought I would post my latest labs, feelings, and other changes. Had a pretty big panel drawn a few weeks ago. Feeling ok but I canāt shake the anxiety and heart palpitations. Not sure what is causing them but excercise really brings it on. Pulse sits at 130 bpm or so during even light lifting and stays above 100 for a decent time afterwards. When the palpitations begin they sort of take my breath away and bring on additional anxiety. This has really impacted my exercise level and ability to change body comp during all this.
Have increased daily calorie count to 2700 and moved away from Keto. Eating roughly 40% carbs, 30% protein, and 30% fat. Weight has gone from 185 at the start to 194.
Some other thoughts:
(1) IGF-1 has really increased. I guess this is a good thing?
(2) Free T3 has rising quite a bit. Again, good I guess but could that be the cause of anxiety?
(3)Reverse T3 has dropped a good amount
(4) Lipids have improved dramatically. I am thinking this is due to the change in estrogen, allowing me to better metabolize and process cholesterol overall.
(5) Taking 50mg Pregnenolone daily
(6) Taking 25mg DHEA daily. My numbers seem slightly low though.
(7) Taking 4000iu Vitamin D EOD. Numbers suggest I need to bump that up
*TRT start date was 8/6
I had very fast heart rates on pregnenolone, I couldnāt wait for it to wear off. Your estrogen is slightly high, if these are trough numbers you may be peaking estrogen higher and this can contribute to anxiety.
I donāt think everyone needs testosterone at the top of the ranges, FT is above ranges and is probably responsible for estrogen being over the ranges.