No one in this forum has ever been banned for posts in this forum that I am aware of.
Most docs do not understand the things in the stickies. If I have so many thousands of words in the stickies, why should I be repeating myself and spoon feeding fractions of that in each guys thread? I don’t get paid to do any of this and I am not part of T-Nation, I am just another guy here. If things are unpolished, that is what you get.
Normal is a statistical term that that captures most of a sample group in three standard deviations. Docs mostly think that normal means an OK state of health [very wrong]. [A few lab ranges were adjusted to be health ranges such as glucose and cholesterol.] TSH ranges from 0.5 to 5.5 in most labs. So a range of 11:1 is all healthy[wrong]. Thyroid expert doctors have tried to fixed the lab ranges but nothing gets done and docs keep their heads in the sands of lab ranges. T3 and T4 labs are hormones bound to thyroid binding globulin, T3+TBG and T4+TBG. But it is the free thyroid hormones that are active, fT3 and fT4. It is fT3 that needs to get into the cells to regulate mitochondria which produce ATP, the universal currency of energy in cells. Thyroid activity thus regulates overall metabolic rate and body temperature as the normal set point [goal]. So you can have thyroid labs that are normal in vast lab ranges where you don’t feel well and body temperatures are low, so a thermometer cuts through all of the crap and provides a measure of your metabolic rate; and how much fT3 is getting inside your cells. fT3 lab levels can be great, but rT3 can block fT3 at the T3 receptors in you cell walls then you have functional hypothyroidism with symptoms. If T, FT and E2 levels are good, one can still have weight problems, lower libido, brain fog and many of the symptoms of hypogonadism, because these two conditions share many symptoms. And to make matters worse, we see many guys here with both issues. Some guys have really bad thyroid issues and their doctors see the lab results in range and then pronounce that there thyroid if fine. Perhaps many can manage to function with such thyroid problems if their testosterone and estrogen levels are good. But we do seem to see such a strong association of testosterone and thyroid problems that one can easily be thinking that one might be causing the other. But when we see that someone has not been using iodized salt for a long time, it is easy to conclude that low T levels did not lead to their avoidance of iodized salt, so the reverse has merit. And we have seen some younger guys with pronounced thyroid problems go on Rx thyroid meds and their LH/FSH and T levels normalized. So there is a thyroid link to secondary hypogonadism. So we have these societal problems with education about iodine, lab ranges that mislead doctors and doctors who are mostly lack deductive reasoning skills and critical thinking. But another layer of problems exist when doctors take action on thyroid lab numbers; I have not seen a single report here from a guy who has had his doctor ask about iodine. The result is that doctors can put people on a life time of Rx thyroid medication when there is a simple iodine deficiency.
In your case, your thyroid levels might be optimal. But you need to look to know.
Most are faced with doctors who are ignorant of many things and don’t really care. The advice here, that many accept, is that they need to stop been passive and start managing some aspects of their own health care. Many come here with horror stories about their heath care. If your experiences are perfect, why are you needing anything? Most guys who find this forum are here because they were not getting proper medical care. Many who are here who start to understand the broader issues cannot get their doctors to do the right thing or cannot find a doctor who is not an idiot. We see that endo’s and uro’s can be really idiotic and when we see involvement with those specialists of incompetence, we suggest that guys read the finding a TRT doc sticky. And when guys are caught up in a state run health system, things are often an order of magnitude worse.
I used to go through all of the basics and explanations with every new guys thread, and took on many cases with intense PM traffic or emails. As you can guess, after a few years that was a burn out. So I started writing stickies so I could point guys written material. When I find someone who is new here, they need to be directed to the stickies. Some individuals seem to have attention issues and need to be reminded to respond to requests to read the materials and to respond to specific questions that are part of what gets done here that is diagnostics [problem solving].
In your case, your symptoms and decent T and E2 labs could be explained by low thyroid function. From that, one needs waking and mid-afternoon body temperatures, history of long time consumption/non-consumption of iodized salt or vitamins listing iodine and labs. Optimal thyroid levels are near TSH=1.0 and fT3 and fT4 that are mid range or a bit higher. Sometimes we have guys that have these optimal levels or higher fT3 with low body temperatures; enough fT3 in the blood but not the cells. In those cases we look to rT3 that blocks fT3 at the T3 receptors and ask about the factors that lead to elevated rT3; stress, illnesses, inflammation, over training, extreme diets/starvation etc.
What goes on here is way more comprehensive than all but a small segment of doctors. When I and many others see a guy reporting that his doctor state that something is normal, our bullshit alarms go off.
I can go on an on, the above is thyroid centric but the theme repeats with many other issues. You also should be aware that the high TSH levels from iodine deficiency can lead to enlarges thyroid glands then lumps that product thyroid hormones outside of the TSH control loop and these can lead to cancer. So iodine deficiency leads to hypothyroidism that can progress to hyperthyroidism [high TSH] and some of those cases lead to cancer.
Related: We know from histories of guys here that low thyroid function is strongly associated with low absorption of transdermal T [creams/gels]. So poor absorption of transdermal T is a symptom of hypothyroidism and we act on that. So there may be a progression of iodine deficiency to low T to inability to respond to transdermal T and again, totally off the radar of the broad medical community.
[I have not stated anything here that is not in the stickies.]
I have read a stack of books on male hormone centric books, sexuality, thyroid books and adrenal fatigue as well as other medical/heath/nutrient reading. I have studies drug interactions and done a huge amount of research driven by health conditions, lab results, and symptoms presented in individual case threads. [I also understand female hormone issues, but few threads here on that.]
If I speak with authority, it is from understanding and conviction. I also get directive because I can’t take the time to spoon feed and micromanage every case that I get involved with.
