I think you should hold off on TRT and try thyroid meds. I know you tried armour but, you haven’t taken it long enough to see the effects. It takes a while for your body to adjust to more T4, sometimes a month or more. T3 on the other hand will be pretty much immediate. You should feel the effects of T3 after the first dose if it is a high enough dose to increase t3 within the cells. You might want to consider having rt3 checked, just to see how your t4 → T3 conversion is.
I know your thryoid labs appear normal however even with t3 at an ideal level this does not mean that it is at an ideal level at the cellular level. I myself have a similar issue to yours so just adding my 2 cents from my research.
Edit:
[quote]hozer wrote:
And since all of my symptoms are testosterone related (I have nearly every one), I figured it would be best to go at that angle first.
[/quote]
Low T symptoms and hypo symptoms are often very similar. Many people thinking they have low t, are actually in fact hypo.
Thanks for your input and I hear what you are saying. But the very low total T value of 220 isn’t going anywhere with thyroid meds. And while there is certainly an overlap in symptoms, only TRT has the potential to treat all of them (especially the ED/libido related). So rolling all of that in, (and that my thyroid lab data isn’t too bad), I think TRT would be the place to start. It is not say that I should ignore the lower body temp and low FT4, but I still see TRT as the logical first step. I don’t want to complicate things too much and I don’t have a whole lot of time for experimentation. I really need to start feeling better soon.
If T3 is mid range or higher and body temps are low, do rT3 labs to see if rT3 is blocking fT3 from entering your cells. If rT3 is elevated, T4 meds can make that worse. See issues in the thyroid basics sticky re; rT3, adrenal fatigue, Wilson’s book, stress, infections, starvation diets etc.
With these showing ranges: [which see different than typical]
FSH, 7.04, mI U/mL, 1.27-19.26
LH, 3.52 ml U/mL, 1.24-8.62
FSH should be allowing for higher T levels than you are getting. So I still think that your testes are a weak link. But I still do not understand if the testes could be like that from thyroid issues. So it does make sense to focus first on thyroid issues and note that TRT with thyroid problems can make some guys feel worse.
I got wilsons book. He had 3 tests in there and I passed all of them. My temps arent erratic and cortisol seems to be normal(ish). I added adrenal supps a few weeks back and no improvement.
The problem with thyroid meds is what to take and what dose? Last time I asked, there wasn’t a good answer so I went to a thyroid forum. They seemed to think thyroid wasn’t a big issue and they didn’t care much about temps. I got the impression they were fairly knowledgable. But even then, what would be the measurable metric since lab data seems to be pretty good.
Is it worth at least doing trt for 6 weeks and just see how it goes? At least I know the protocol. With thyroid I seem like I’m shooting in the dark.
From what i have read, RT3 is a great tool but ultimately body temps are the greatest diagnostic tool for thyroid IMO. I have read two different dosing strategies for thyroid all which utilize t3. But you might be fine dosing t4. Keep in mind when taking t4 it takes a month or more before levels start to increase. Taking it for only a week will not get you the results you want.
The two different t3 dosing strategies I have read about are Wilson’s temperature syndrome and circadian t3 method. I just started the circadian t3 method, he has a book I read which outlines protocols. Might be worth a look or I can provide some more info. I think most people are in the dark when it comes to thyroid medication and dosing. Patience and tracking symptoms are the two greatest tools when attempting to medicate.
As a guy close to your age I can relate with your problems/frustration. Personally I am holding out for TRT as an extreme last resort. I think fixing the thyroid should be a priority.
Out of curiosity have you been checked for Lyme disease?
Regarding body temps, I just don’t know. I looked into Wilson’s temperature syndrome as well. At first it made sense, but I am not sure now. It is considered “alternative” and the people on the thyroid forums, whom seem knowledgable, don’t seem to recognize it or care much about body temps. Why isn’t there more discussion about body temps on the forums outside of this one? His book doesn’t seem to have a lot of reviews either. There just isn’t a whole lot of info and that is bothersome. I don’t see the evidence for going on thyroid replacemet therapy just to increase body temps. I am not saying it isn’t the right thing to do, just that there isn’t much info out for this particular alternative treatment.
No check for Lyme disease, but I am willing to check anything that should be done. If nothing else, it eliminates that as a possibility. I want to hold off on TRT as well. I hear ya there.
I have been on Armour thyroid for a few months. I am up to 1.5 grains a day, which is a decent dose. But during this time, I have not noticed any increase in basal temperature. I still max out at 98.1F during the day and am usually around 97.7F the rest of the day.
sorry can’t help answer your questions with Thyroid…Is everything good with your liver and kidneys, are you a diabetic?
Are you still on TRT? if so did it help take care of the other symptoms…I would also think that Testosterone could play a role in body temp, but I could be wrong.
Not on TRT. I was only on it for less than a week and wanted to try harder to find the root cause.
If temps have not improved, thyroid labs look good, no apparent improvement of symptoms from thyroid med, should it just be stopped? But why are the temps low? Could that just be normal for me? Are we putting too much stock into temps?
From an test several months back:
Reverse T3, 13.8, (9.2-24.1)
Based on this experiment, my free T3 is getting close to max range. No improvements in general feeling, temps, or testosterone. It would seem that thyroid levels are fine and this would not be related to anything. So I plan on tapering off and discontinuing. Any comments about this?
Some further detail. I stopped drinking alcohol, have been eating good (lean meats and veggies, good fats), exercising regularly. I also tried ZMA and increased/monitored Vit-D 25-OH levels.
I had a few more testosterone tests along the way (about every month). I was showing a moderate increase and was in the mid 300’s. A test last month got to 420. At that point, I had hope that perhaps the thyroid medication/Vit-D/ZMA adjustments may allow me to hold off on TRT. But something happened about a week ago (the only change being that I started lifting heavier weights) and I have been feeling tired and having low grade headaches. My most recent test showed I am at 290. So I feel like the changes I made are not going to cut it.
So my thought is to increase Vit-D levels a bit more (currently at 50ng/ml) and go to 75ng/ml. I am going to take it a bit easy on the weights. I am going to regularly use ZMA and continue to eat good. I will taper off on the thyroid meds. For a few more months, I will collect more lab data and see if there is any improvement. If there is no significant improvement, then I will finally bite the bullet and go for TRT.
Is there any issue with FT4 being relatively low? Previous tests have been 0.94 and 0.84. Thyroid meds have not really affected FT4 and slightly increase FT3.
Also, my brother is a year younger and is at 290 testosterone. So could the root cause of this simply be genetics and not necessarily any other underlying issue?
Genetics could be a factor. But don’t consider that a non-issue. Any observations re your father? Does your brother have low body temperatures? Brother uses iodized salt?
Any early congestive heart failure in your blood line?
Your lack of response to thyroid meds is unusual.
With TRT, your response to training may be very different. Try to have some proteins and sugars on board when you start your training. Try a protein shake before you go to the gym. If you have one there it will not have enough time to be available. Keep hydrated. When training muscles, you can feel weak and/or hungry from the recovery and growth demands of the muscles.
Were you experiencing a tenancy for muscle cramps before ZMA and now reduced?
Have I discussed CoQ10 before? T3 regulated mitochondrial activity and controls body temperature via that mechanism. CoQ10 is made in the liver. Statin drugs can impede that production. Mitochondria make ATP, the universal currency of energy inside the cells. That process does not work properly if CoQ10 is inadequate and there are not enough anti-oxidants on-board. You could try 50mg ubiquinol, note spelling, a highly bio-available form of CoQ10. This would be another science experiment for you.
Low T4, fT4 suggests low iodine or poor thyroid function. T4 is the reservoir for T4–>T3 production.
I suspect my father suffered from low T starting about the same age as my brother and I. That is not confirmed, but based on mood and body type, it would seemingly be possible.
My brother had a normal temp, but I only have one data point for that.
No heart related problems in the blood lines. My grandfather died of heart disease, but he was in this late 80’s.
Yeah, I do all of those things for training already. I am hoping that on TRT everything will change! Otherwise, things are gonna suck.
No muscle cramps or anything. I just took the ZMA in hopes of better sleep and improved testosterone.
I have been taking CoQ10 for general health purposes, but it has been random. I can try again though.
Should I be concerned about low T4 and what can I do about it? I took the thyroid meds and T3 was nearing max, so increased thryoid meds wouldn’t seem to be the solution (I was taking desicated thyroid). I think the synthetic thyroid is different though. If thyroid production is poor, why didn’t the meds help? And why have my FT3 numbers been good, even before thyroid meds? So that part is rather confusing.
It keeps coming back to why adequate fT3 and low body temps exist together. I was wondering if CoQ10 could be the weak link. There could be other things which is potentially a huge number of health conditions which are beyond hormone tinkering. I would still like to see how your body responds to higher thyroid meds. You should feel warm, agitated or jittery at some point and that would define your upper limit and you would want to approach that with caution. Avoid higher levels in the PM as your sleep might be disturbed. So its other issues or an abnormal thyroid requirement which then could involve many different issues. I would like to see rT3 repeated as we should not be chasing our tails if a lab result is not right. There are also some people who seem to have lower body temperatures, assuming that a cause is not there. Hard to know what to do with that. But if you feel symptoms of hypothyroid, that means something. What signs of hypo do you have now? Low body temps, sparse outer eyebrows, thyroid enlarged, feel cold easily, dry skin etc
I will take the CoQ10 regularly and see what happens.
I can try increasing the thyroid meds. I did not notice any odd side effects while on them.
After about a month or so, can retest rT3. I want to get back to a steady state.
Yeah, maybe I just have “normal” low body temps. I don’t have any other symptoms of hypothyroid (other than fatigue). Most of my symptoms are consistent with low T.
My DHEA was good and saliva test indicate cortisol is normal. So that was odd. I noticed that if I take ZMA, I tend to sleep better. I am noticing a connection between how I sleep and how I feel. Perhaps I have not been getting good quality sleep? My sleep patterns are odd because of my relaxed work schedule. I typically sleep 4-5 hrs at night and about 3-4 hours during the day. I have shortness of breath and mild headaches sometimes. On days that I get better sleep (recently monitoring it with iPhone app) I tend to feel better. Nothing conclusive, but something to think about.
I can’t even describe what a difference a good night (and consistently) sleep makes for me. I make sure I get 7.5 hours minimum now.
If slack on sleep, esp. few nights in a row I am tired, cranky, less driven, crave junk food etc… On TRT and good sleep I feel great.
I’ve done following to improve sleep:
-turn all the lights off, even the blinking one from your tv and what not. Aids in melatonin production
-hot shower before bed, very relaxing
-no cell, ipad, or any computer use an hour before you want to fall asleep
-Audiobooks! You can have your room pitch black while listening. Books also distract your mind from daily worries and anxiety which are sleep killers.
Get 8+ hours a night for few weeks and I bet you’ll feel much better.
No improvement from taking CoQ10 or increased thyroid meds so far.
Is body temperature really that important? I am usually about 97.6F and get up to about 98.1F max about 3 days of the week.
Looking back, I have had problems making it through a full day without being fatigued. When I was 20 at my first real job, I got home and went to bed for 1-2 hours each day. I have not been able to get through a full day since. I have just found ways around it and didn’t think it was that big of a deal. But I should have have decent testosterone back then, especially since I went bald in my late 20’s. I think the issue I have had since being 20 is not becoming a real problem when combined with low T.