The one omission that is unforgivable is not testing prolactin. However, with a clear MRI, doc may have concluded that there was no need for that. But we do see some oddly elevated prolactin cases where nothing is obviously wrong on a MRI.
TSH=2.6: Should be closer to TSH=1.0, 2.6 is trouble and may be a result of not using iodized salt. fT4 did look OK a bit above mid-range. fT3 is the active hormone and was not tested.
Please self-eval overall thyroid function via last paragraph in this post.
You may be feeling cold easily.
Might have generalized hair thinning. - not a male pattern baldness issue
Your outer eyebrows may be spare.
Many with great TRT TT, FT and E2 numbers will feel crappy with thyroid issues that are all ‘lab normal’.
Doctors never ask about iodine intake.
If you are not getting enough iodine, what about others in your home?
Low thyroid function lowers: energy, temperature, libido and mood affecting every cell, tissue, organ system and brain.
Did you ever take any prohormones or gear?
Ever used a hair loss drug? - 5-alpha reductase inhibitor
When stopping a SERM, it is very important to slowly taper off. Stopping suddenly can ruin chances of your HPTA taking over. Some guys do simply have unexplained and unfixable secondary hypogonadism. You can review the HPTA restart sticky to see some of the considerations. Few doctors understand what you can understand after reading that. HPTA restarts are not that successful. But we have had some good successes.
You can test LH/FSH while on Clomid to see what is going on.
You can do TRT: T+clomid+anastrozole and enjoy the benefits of good hormone levels and fully protect your fertility. You can also then reduce Clomid dose to get lower drug loads while maintaining useful but lower LH/FSH levels. Or maintain current Clomid dose with lower T dosing.
How do you feel?
How is libido?
How is energy and initiative?
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.