First of all, wait with the thyroid medication until you have your cortisol test back.
If you need some adrenal support like ACE or HC then start using that while slowly starting with T3-only.
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| TSH | S | 1.75 | µIU/ml | 0,27 - 4,20 | ECLIA |
|---|---|---|---|---|---|
| Free Т4 (fT4) | S | 14.28 | ng/l | 9,30 - 17 | ECLIA |
| Free T3 (fT3) | S | 2.96 | ng/l | 2 - 4,40 | ECLIA |
| ТАТ (Tg Ат) | S | 10 | IU/ml | 0 - 115 | ECLIA |
| A-TPO (MAT) | S | 5 | IU/ml | 0 - 34 | ECLIA |
| Reverse T3 | S | pg/ml | 90 - 215 | RIA | |
| LH | S | 3.62 | IU/L | 1,70 - 8,60 | ECLIA |
| FSH | S | 1.58 | IU/L | 1,5 - 12,40 | ECLIA |
| Prolactin | S | 168.9 | mIU/L | 84,80 - 318 | ECLIA |
| Estradiol | S | 25.64 | ng/L | 7,63 - 42,60 | ECLIA |
| Progesteron | S | 0.2 | ng/ml | 0,05 - 0,15 | ECLIA |
| 17-ОН-Progesterone | S | 1.367 | ng/ml | 0,20 - 2,30 | ELISA |
| Dihydrotestosteron (DHT) | S | 417 | ng/l | 219 - 1140 | RIA |
| Total Testosterone | S | 19.52 | nmol/l | 9,90 - 27,80 | ECLIA |
| Total Testosterone US Units | S | 562.53 | ng/dl | 285 - 801.15 | ECLIA |
| Free Testosterone Calculated | C | 8.8 | ng/dl | ||
| Albumin | S | 46.7 | g/l | 35 - 52 | PHOT |
| SHBG | S | 50.65 | nmol/l | 18,30 - 54,10 | ECLIA |
| DHEA-s | S | 10.85 | µmol/l | 4,34 - 12,20 | ECLIA |
| ACTH | EP* | 18.15 | ng/l | 7,20 - 63,30 | ECLIA |
| Cortisol (morning) | S | 466.2 | nmol/l | 133 - 537 | ECLIA |
| Insulin (fasting) | S | 4.62 | mU/L | Оптимални ст.: < 10.0 | ECLIA |
| Growth Hormone(STH) | S | 0.43 | ng/ml | 0,03 - 2,47 | ECLIA |
| IGF I | S | 254.3 | ng/ml | 83 - 246 | CLIA |
| PSA | S | 0.491 | ng/ml | 0,010 - 1,400 | ECLIA |
| free-PSA | S | 0.27 | ng/ml | ECLIA | |
| ratio FPSA/PSA | - | * | % | ||
| Prabability for finding prostate carcinome - * % Calculated according to the TPSA value in interval from 4.00 to 10 ng/ml | |||||
| Total Cholesterol (Chol.) | S | 4.06 | mmol/l | 3,5 - 5,20 | PHOT |
| HDL- Cholesterol (HDL-C) | S | 1.43 | mmol/l | > 1.5 | PHOT |
| LDL- Cholesterol (LDL-C) | S | 2.67 | mmol/l | 0 - 3,35 | PHOT |
| Trigliceridi (Tg) | S | 0.75 | mmol/l | 0 - 1,70 | PHOT |
| Glucose | S | 4.89 | mmol/l | 2,80 - 6,10 | HK |
| Total Protein | S | 71.8 | g/l | 64 - 83 | PHOT |
| Bilirubin, Total | S | 26 | µmol/l | 0 - 21 | PHOT |
| Bilirubin, direct (конюгиран) | S | 7.9 | µmol/l | 0 - 8,5 | PHOT |
| Uric acid | U | 1973 | umol/l | 2200 - 5475 | PHOT |
| Creatinine | S | 89 | µmol/l | 62 - 106 | Jaffe |
| СРК | S | 177 | IU/l | 0 - 190 | IFCC |
| Na + | S | 136 | mmol/l | 136 - 145 | ISE |
| Cl - | S | 98 | mmol/l | 98 - 107 | ISE |
| Calcium | S | 2.32 | mmol/l | 2,15 - 2,5 | CPC |
| Magnesium (Mg) | S | 0.84 | mmol/l | 0,66 - 1,07 | PHOT |
| Iron | S | 17.7 | µmol/l | 7,20 - 27,70 | |
| Ferritin | S | 280.4 | µg/L | 30 - 400 | ECLIA |
| Zinc in Serum | S | 17.1 | µmol/L | 9 - 18 | AAS |
| Copper, total in serum | S | 889 | µg/L | 560 - 1110 | PHOT |
| HbA1с - гликиран хемоглобин | EB | TINIA | |||
| according to DCCT | - | 4.72 | % | 4,80 - 5,90 | |
| according to IFCC | - | 28.09 | mmol/mol | 29 - 42 | |
| eAG (calc. mean glucose) | 4.91 | mmol/l | |||
| CRP - quantative measurement | S | <1 | mg/l | < 5.0 | TURB |
RT3 still pending, the test was taken on 06th of November…
You got a pretty clear case of hypothyroidism.
Your FT4 conversion to FT3 is really shitty and I would assume without being able to see your RT3 that it is actually high due to you having high FT4 but low FT3.
And I can guarantee you that this is main thing that is stressing your adrenal glands.
Also you iron is too low (want 32-34) and your ferritin is way too high (so you have some kind of inflammation, do you know why?)
I can already say that TRT will not be enough for you but I believe that starting TRT while.you fix your hypothyroid, inflammation and iron is exactly what you need.
It is a bit debatable whether FT3 of 2.9 is so bad, but it looks a bit below optimal, yes.
I tried taking T3 but from that quickly got into hyper symptoms, only on 12.5 mcg. In fact Im taking now microdse of it, 3.25mcg
If you ask me about inflammation… I have not idea nor how to find it out. Everybody is talking about inflammation, but how do you specify and isolate that thing?
I will discuss all that with the doctor.
What makes you believe TRT will be positive on me based on these labs? Also do you think I should start supplementing iron, maybe TRT will further deplete it? But with this high ferritin isn’t it harmful?
@kemosi - what time of day do you inject (AM or PM)?
I don’t often see people talk about injection time, only frequency.
When I started trt 2 years ago, I injected in the AM. Once I built to enough half lives and the T started working, I also found I had too much energy/felt amped at night and had trouble sleeping.
I realized I could “feel” the T working about 12-16 hours after my injection, which would explain this issue for me… So, I switched to injecting at night, before bed so I could reap the benefits of the T kicking in during the day instead and it’s been great. No issues hitting the pillow and sleeping now.
Interested to hear what time of day you inject.
With that high FT4, you should at least have 3.6+ in FT3 and it becomes even worse when you most likely have a high RT3 which blocks the little FT3 you have. We want everything optimal.
The way I see it, I was happy when I saw that my hormones was shit since I knew that I can have a huge improvement with my life when it comes to mood, energy, sex drive and etc. It would be much worse imo if all your lab works came out perfect and you had no idea how to feel better.
Looking at your negative symptoms when you tried even just a small dose of T3 tells me that you 100% have an underactive adrenal glands that needs support in order to handle the thyroid medication. The best would be for you to do the 4 point SALIVA cortisol test in order to see if you only need a little support (ACE) or if it is more severe and that you need hydrocortisone. (This is what I used and I got all the “hyper” symptoms when I was on a too low hydrocortisone dose, but that went away as soon as I increased my dose). If you have a good doctor than he will understand how important it is to use ACE or HC when trying to fix the thyroid.
You can read more here why people can’t tolerate T3 and NDT:
Inflammation is a bit tricky, and I can only recommend you to read this page to see if you could possibly find why you have such high inflammation. Once again a good doctor should be able to help you find the culprit behind your high inflammation.
Because optimal hormones will make you into the best possible version of yourself and that goes for all hormones and vitamins.
And finally, I would not start supplementing with iron until you find out why you have the inflammation in the first place and then fixes it.
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@kratom_dumper
Thanks. In fact I’ve read the book STTM, I have it hardcopy and I know T3 treatment should not work when there are adrenal issues. But here comes this very shady concept of adrenal fatigue that a lot of even progressive doctor don’t agree with. To be honest I dont believe I need more cortisol, maybe I somehow need to regulate it’s timing. Hope testosterone can do that.
So the way I see it I need to fix thyroid, but cannot fix thyroid until I fix adrenals so I can hope testosterone will fix adrenals(as other things as well) 
Here are my last saliva cortisol tests:
| Cortisol, morning 08:00 | sal | 13.13 | nmol/l | 0 - 24,10 | ECLIA |
|---|---|---|---|---|---|
| Cortisol, noon 11:45 | sal | 9.42 | nmol/l | 0 - 9,65 | ECLIA |
| Cortisol, afternoon 16:45 | sal | 2.73 | nmol/l | 0 - 9,65 | ECLIA |
| Cortisol, night 23:45 | sal | 2.98 | nmol/l | 0 - 11,30 | ECLIA |
Here are one and a half year ago:
| Cortisol, morning 6-10 ч. | sal | 28.61 | nmol/l | 0 - 24.10 | ECLIA |
|---|---|---|---|---|---|
| Cortisol, afternoon 16-20 ч. | sal | 0.92 | nmol/l | 0 - 9.65 | ECLIA |
| Cortisol, night 23:30-0:30 ч. | sal | 2.59 | nmol/l | 0 - 11.30 | ECLIA |
You will say that this year’s morning cortisol is low, but last summer it seems high, and I struggled with the same symptoms and issues back then. I think If I take another test it will show different results from those two
On Wednesday evenings , like 19.30 and on Sunday afternoons around 13.00.
I will try your method and will inject before bed. Thanks. I thought the peak would be after 36 hours though.
Are those really the correct references ranges for your cortisol?
It makes zero sense that your night cortisol reference range would be higher than the noon or afternoon.
But if those references ranges are correct than you obviously have too little cortisol throughout the day, except in the noon, but you definitely don’t have too much cortisol that is for sure. I believe you might even need hydrocortisone to get your adrenal glands working as properly as they should.
And look, you did the ACTH test which clearly showed you are on the lower end of cortisol.
I mean it is up to you what you decide to do but adding in testosterone will not help your adrenal glands until you have fixed your hypothyroidism, it will only put more stress on them.
How do I know this?
Because I did the exact same thing, in which I had a bunch of different symptoms and lowish testosterone, and I decided to only use TRT which worked out great in the beginning but after pushing myself from the energy I got from the TRT, I crashed so hard that I started developing some serious low cortisol symptoms I had never had before like passing out every time I quickly stood up, soul crushing fatigue, suddenly developed extreme allergy, and etc.
And once I started taking hydrocortisone all of those symptoms that I had constantly for months just went away.
I am not trying to scary you or tell you that this will happen to you but I will tell you that this can happen if you push yourself by taking a lot of testosterone while not fixing your adrenal glands and thyroid hormones.
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I’m not suggesting my injection time could with for everyone, more just to be aware of injection time and when you have those issues.
Do you notice sleep issues only on specific nights or is it every night?
Maybe instead of e3.5 days, you do e3 days, but just at night and see how that goes? I don’t think you’ll see much difference between an e3.5 and e3 protocol tbh.
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@kratom_dumper
Hope I do not need hydrocortisone This will make the game a bit complicated, will ask doc specifically about adrenals and low cortisol.
How reliable is the saliva cortisol and then why is morning serum cortisol high?
I thought morning ACTH could be relatively low because morning serum cortisol is high
No need to worry about using hydrocortisone, for me it has zero side-effects since it is a natural hormone just like testosterone and it is not something you need to be on for life like TRT, most only need a couple of months at most.
One problem you have now is that you can only handle a small dose of T3 due to having low cortisol, but using too low T3 will just make your adrenal glands even more stressed since you shutdown the natural production of T3 in your thyroid so you actually become even more hypothyroid. So either use T3 at the correct dose (something like 60-100 mcg) with adrenal support or don’t use it at all until you start using the adrenal support.
Saliva cortisol is the most reliable measurement for testing cortisol, especially since you do it 4 different times of a day.
You want cortisol at the top of the range in the morning like you almost had 1.5 years ago but as you can see now, your adrenals are not working as efficient anymore probably due to your hypothyroidism and your high inflammation.
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@kratom_dumper Do you think 3mcg of T3 is reducing the activity of the thyroid temporarily?
Yeah, there is no point in using such a low dose.
Please let me know if you want what the doctor says. I am curious to hear.
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Yep this is pretty much me too.
I felt good for couple of weeks but now i am short of breath from mild things, constant fatigue etc. T won’t fix your adrenals. For instance I have had no problems with my sleep before TRT. I think it messed up my adrenals further , causing insomnia… This is the most obvious sign… Add hypothyroidism to the picture and you are doomed.
Only the night before the next injection my sleep is a little better.
When i was on 100mg a week , this wasn’t the case. But my FT was so low with that protocol
, i have had to increase it. To be honest i don’t feel better with my current 150mg a week (75mgx2) protocol and besides i have got worse sleep too. But i am a complicated case. My adrenals and thyroids probably playing a big role in this.
This thread got long suddenly and I skipped ahead, so I may be off here. Did you say that you are getting RLS? That’s related to dopamine issues (in a few things that I read), and possibly B12/folate/iron issues. If an increase of T brings on RLS, that would make sense, as an increase of T brings an increase in carecholamines (at least if you were low T before). Magnesium Glycinate or 5-HTP might help, but mostly it will likely be a time thing.
Yeah, that is why I always recommend guys with hypothyroidism to fix that and your adrenal glands before adding in the TRT. Some people doen’t even need TRT after they fixed their hypothyroidism.
On the other hand I know one guy who had low cortisol as well and it was fixed after he started TRT. I guess everything is very individual.
By the way why if my cortisol is low my DHEA-S is relatively high?