You need to post all your labs, I couldn’t tell you much with what you’ve given. By bi-weekly is that twice weekly or once every 2 weeks?
Your thyroid concerns are enough to raise red flags, it’s no wonder you feel no better. TRT requires optimal thyroid levels period. If Reverse T3 is high it would negate most of your Free T3. Need to check if there is GI bleed? If so it would explain where your testosterone is going, literally right in the toilet.
TPO 55 klU/ L. Range <=34.99
TSH 6.34 ml U/L Range 0.35-5.0
Free T4 1.3 pmol/L Range 12-22
T3 1.3 nmol/L Range 1.0-2.7
Free T3 3.4 pmol/L Range 3.4-5.9
Thyroglobulin ab <20 kl U/L Range <=40.99
Vit D 157 nmol /L Range 76-250 ideal
Vit B12 742 pmol/L Range >220
Reverse T3 was previously checked and fine
Your levels are low because your doctor is incompetent, 200mg every 2 weeks doesn’t work. It’s clear your working with an incompetent doctor, most doctors out there will not be able to help you because thyroid and TRT matters requires an A lister, average won’t cut it as thyroid is very complex for most people to grasp. Your SHBG determines how well you hold onto your testosterone, if SHBG is low which I strongly believe, you will need to inject testosterone every other day or perhaps everyday.
Your TSH suggests your SHBG is low, hypothyroidism cause SHBG to lower. You really wanting to take your doctors work that reverse T3 is fine? Is this the same doctor that put you on one injection every 2 weeks? You need to educate yourself because your thyroid is a real mess and most doctors are complete morons when it comes to thyroid matters.
Something has to explain your high TSH, you mention no thyroid medication, what is your doctor doing about your high TSH? Your pituitary gland is sending signals to your thyroid by raising TSH, your thyroid isn’t responding. TSH will continue to raise until the thyroid is destroyed.
A TSH of 6.34 is insane, what’s more insane is your doctor says it’s fine. Your massively hypothyroid and Reverse T3 needs to be less than 15 ng/dL, lower if Free T3 is borderline low. Your doctor just doesn’t know what their doing. You need to say goodbye to this doctor!
Blood test results for TPO antibodies are positive in 95% of patients with chronic lymphocytic thyroiditis, also known as Hashimoto’s disease, and in 50% to 80% of patients with Graves’ disease. Patients with high levels of TPO antibodies are at risk for future thyroid dysfunction.
I’m not on thyroid treatment. My doc says it’s mayne borderline and may treat down the road. I’m trying to get educated but he can be a typical let it pass kinda doc.
Reverse T3 was 12.2 ng/dL ( range 9.2-24.1)
In looking at my records, my DHEA has always been low too. Last result was 0.7 unol/L ( range 1.2-8.98)
Finding a good doctor may be a bit of a task. I agree with both of you that my primary care doc know nothing about this crap. Access to lab work without a doc requisition is also hard. I can cross the border and pay out of pocket for that to monitor as we live just an hour from Detroit MI. Unfortunately, we are in Ontario and while health care might be free getting the right one is difficult. Most docs are full and too busy to take the time needed in complex situations and it’s not easy to just goto a new one. Perhaps a referral to an endocrinologist might be a good idea given the hormonal mess I’m in although I’m sure they can be misinformed as well. I can get access to NDTH to treat the thyroid but I know there is some controversy in using those hormones. Plus self treating could backfire.
I felt better st first. Initially it was 400mg monthly and I felt great for a few days then nothing and had sore nipples. Convinced him to let the nurse change it to every 2 weeks. Likely trying to cut down on nurse time with injections. Not sure we have TRT specialist in Ontario. Perhaps and Endo? Reverse T3 in reply below to systemlord.
Whenever a GP takes the either starts a patient on thyroid or TRT it always ends badly for the patient, would you take your car to an airline mechanic? You need a hormone doctor and not a garden variety doctor, they usually always screw it up because it’s not their specialty. You got the flu, pneumonia go to your GP because that’s what they do.
TSH is pointing to a serious thyroid problem and doctor is ignoring it because he/she is in over their head. Your antibodies are attacking your thyroid, just because antibodies is midrange doesn’t mean nothing is happening. Doctor should have at least referred you to an endo, but then the GP would lose out of a patient and $$$. Good hormones do exists in your area, you need to keep looking.
At least you know you feel better with testosterone, therefore you will be fine with the correct dosing schedule. The high dose will increase E2. If you cannot find any help you could go with your own source, get your usual injection through your doctor, but decrease the dose (doubt he’d object to that) and then take the weekly, or biweekly, dose on your own.
You’ll still have access to some labs through the system. A monthly injection schedule is awful and twice monthly is only slightly less so.