Need Advice on Thyroid Panel and Elevated CBC

Pharma TRT
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35m, 190lb, currently 6 weeks into a 12 weeks cut til after the new year.
TRT since Feb 2019.
Live in Denver, CO, so CBC has always been elevated due to elevation.
Used to lift 5 days week, but started doing bodyweight corrective exercises (FRC) to increase range of motion so I can start lifting again by 2020. Bodybuilding mostly now, used to do CrossFit and oly exclusively.
Always felt lethargic which pushed me to abuse stimulants, whether pharm, nootropic, or the reg coffee/tea. Always went out of control and caused sleep issues and irritability.

Recently started iodine replenishment therapy (as of 3 days), started at 15mg, then tried 50mg, now exclusively doing 25mg for the next month of Dec. This has seemed to helped tremendously. But I am worried about these labs.

2019-11-15T07:00:00Z
TSH (0.45-4.5 uIU/mL) 3.31
FT4 (0.82-1.77 ug/dL) 1.12
FT3 (2.0-4.4 pg/mL) 2.8
RT3 (9.2-24.1 ng/dL) 18.9
Thyroglobulin Antibody (0.0-0.9 IU/mL) <1.0
TPO (0-34 IU/mL) 14

Pre-TRT TSH (0.45-4.5 uIU/mL):
2018-02-05T07:00:00Z 2.2
2019-02-05T07:00:00Z 1.79

Post-TRT with Defy (although I’ve been on TRT since Feb, Defy was the only ones to test TSH):
2019-08-07T06:00:00Z 2.69
2019-10-25T06:00:00Z 2.81
2019-11-15T07:00:00Z 3.31

The Nov 15th reading is pre-Iodine treatment with elevated iodized salt intake.
I’m kinda freaked out that my TSH level is so high and I had been having lethargy, libido issues, and shit sleep for the last 4 months.

Since these labs were drawn, I have also reduced my weekly dose of 150mg to 112mg, subQ daily shots. I’ve since abandoned HCG as there was a possible pharmacy recall on a batch of HCG and I have not been taking AIs to treat high E2 symptoms prior to this.

I want to note that I feel great after reducing my dose and going to daily shots. I feel even better as I’m supplementing with iodine now, as is my wife. Both our libidos are up and we have way more energy throughout the day, and substantially less brain fog.

If anyone can help interpret these labs, I’d greatly appreciate it. TIA.

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TSH is way high.
FT4 is ok.
FT3 is low.
RT3 is a bit high.
Antibody is good assuming 0.

I’d want to check Total T3 and see how that looks, but other than TSH, your levels are not way off optimal thyroid. I’d keep an eye on them as you adjust with the dailies protocol. Maybe someone with more Thyroid experience can help out too.

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Thanks @marcus007.

I’m going to assume supplementing with iodine/selenium (brazil nuts) for the next month is going to help thyroid function.
The elevating TSH reading is the most worrisome.
My lipids have all came back looking great from what the PA has said. So there’s that.

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Do that and please report the results. I have similar thyroid levels and also am exploring my options to ultimately reach optimal thyroid levels.

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I was able to reduce my rT3 by diet and exercise alone while on a daily protocol, it went from 22.6->17 in only a couple of weeks. I even got an increase in SHBG and had never seen it higher at any time before in any prior testing even pre-TRT.

T4 testing is useful, this is the total thyroid hormone produced by the thyroid gland before it converts to the other free hormones.

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May I ask your diet? I’m on the standard cooked meats, non-processed food, low sugar, vegetables, fruits diet.

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@marcus007, I’ve been on iodine for 3 days (Day 1 ~15mg, Day 2 ~50mg, Day 3 ~25mg).

I started IR because my morning temps were low 96’s the last week and steadily staying high 96 mid-afternoon into the evening. That and brain fog, lethargy, and general malaise.

The last few days morning temps have rising up to high 96’s into the low 97’s. Mid afternoon yesterday was right around low 98’s while not doing anything and watching some TV. I have 2 more hours until I take todays temps, tho. So I’ll report or edit this post afterwards.

So far I’ve felt the best on Day 1 and 3 (huge jolt, like drinking a pot of coffee, but sustainable), Day 2 felt like I was overloaded which caused me to crash mid-morning. So I’m going to stick to the 25mg levels and eat some brazil nuts with my already high protein, moderate fat, currently low carb diet.

I’ve noticed when I get half way into a cut, my lethargy goes up and I end up drinking more caffeinated tea/coffee (sparingly). It doesn’t feel like I have to abuse it to stay awake like before, tho.

Hope this is helpful for others out there.

Edit: To your response @marcus007, mine is similar. Mostly whole foods, high lean protein, dairy and nuts for fat, potatoes and rice. I’ll have a cheat meal or two throughout the week.

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@systemlord my SHBG (16.5-55.9 nmol/L) actually went from 55 pre-TRT down to 35 (Aug 2019) to 28 (Oct 2019). I wonder if it went down since doing daily.

I may start running soon and doing some kettlebell work for a workout.

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Be glad it went down because your FT wouldn’t have increase had it not come down.

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High doses of iodine will increase TSH levels… Mine increased to 4.2 and now it’s 1.18…
Also i felt absolutely nothing from IR… In what way it made you better?

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I don’t think iodine treatment will be enough for you.

Do you have iron values or 4 point saliva cortisol?

I would recommend you start with a T3-only medication in order to lower your RT3 to 8-10 and then fix the cause behind the high RT3 before adding in T4.

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I’ve felt amazing. Mostly energetic, nil brain fog, and libido is fantastic. My wife said she felt the same throughout the last 3 days.

Like ferritin? I have not gotten iron or cortisol done. Money is tight and the thyroid lab costed a bunch out of pocket. I may go see my primary to see if I can offset the cost through insurance though. I’ll also discuss thyroid treatment with them as well. Thanks for the info.

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Just wanted to update evening temps, kinda late from mid-day, but better late than never.
97.7. 98.1, 98.2F

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Yes, ferritin is one of the four. Iron labs, do you have any test samples?

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Here’s the breakdown of all my labs since 2018 and on.