New Poster with Thyroid Issues

Pharma / TRT Testosterone Replacement
1

Hi

I am 47 and have had thyroid issues for many years. I have been fairly balanced for the last 4 years, but i still get low moments of energy in the week. It is ALWAYS much worse as the autumn comes along and i am feeling a little more unbalanced at the moment.

I have always wondered if low testosterone could be an issue because i had an undescended testicle. Aged 9 i had the operation. So i am sure i only have one healthy working testicle. My sperm production is damaged as i have very high FSH and sperm production has been a problem as i am making about 15-20m sperm per ML. The norm is 60m. We have had a baby girl five years ago via IVF treatment, so all is good here.

I just wondered if anyone on here can help me understand the relationship of thyroid with testosterone. I understand how thyroid and cortisol/DHEA work together, but does testosterone impact as much on the thyroid as say low cortisol ?

I last had some testosterone tests done in january of this year and it showed my SHBG has gone up quite a lot and based on the results i am low in overall testosterone (even though my testosterone level is mid point). Here are the results:

D.H.E.A. SULPHATE 6.790 umol/L 0.44 - 13.40

FOLLICLE STIM. HORMONE 12.3 IU/L 1.50 - 12.40

LUTEINISING HORMONE 6.41 IU/L 1.70 - 8.60

TESTOSTERONE 15.6 nmol/L 7.60 - 31.40

SEX HORMONE BINDING GLOB 47.5 nmol/L 16.00 - 55.00

FREE ANDROGEN INDEX 32.84 Ratio 24.00 - 104.00

These bloods were done feb 2017 on a general body screen.

Oestradiol 83 (28-156 pmol/l)

Testosterone 15 (8-31 pmol/l)

Albumin 46 (35-50)

My thyroid labs are TSH 1 and FT4 22 (10-22). I take 125 T4.

I don’t have any erection issues and my sex drive is ok. It fairly strong, but i do notice it is less compared to the teenage years (sure this is the same for most people with the law of diminishing returns etc).

I am 5ft 9 and weight 175. I am not carrying much fat and have a flattish stomach. So i am in shape, but i don’t work out. I do building work for a job and play football and squash.

I am due to see a testosterone doctor in a weeks time to get some new blood tests and discuss my situation.

2

Your testosterone is while isn’t terrible, but your elevated SHBG is making things worse. SHBG binds up your testosterone and regulates free testosterone and when elevated negatively effects your free testosterone.

There’s no way in hell you will get TRT in europe with those numbers unless free testosterone is measured low. Our thyroid hormones are lower in autumn when compared with the warmer months, the same thing is seen in bottlenose dolphins.

You may be skirting the edge of the therapeutic range for thyroid hormones in the summer months and when autumn comes you are dipping low enough in thyroid hormones that you are experiencing symptoms which suggests you are underdosed or aren’t converting Free T4–> Free T3 properly in which you may need a combination of T4 and T3 treatment.

Amazing your doctor isn’t testing for Free T3, you cannot effectively treat thyroid and not test for Free T3. Most of the time doctors know very little and are only following guidelines which are outdated.

Normally we expect to see testosterone higher with LH higher, I suspect you may not be responding good enough to LH stimulation and that one testicle is doing the job of two and it isn’t enough.

1 Like
3

Thanks for the reply.

I am pretty experienced with the thyroid side of things and i convert well and don’t need any T3. I have used it before, but over time i found i needed less and less T3. So now i am using just T4.

This summer i discovered a few new things and basically was doing better than in previous years on slightly LESS T4. I found 112.5 T4 was great for me and i was using progesterone on alternate days. So only 1.5mg per day effectively.

Roll forward to autumn and things suddenly go downhill. I am sure it is due to lower cortisol production, but i cannot prove it. So currently i am feeling a bit low in energy, but i don’t think more thyroid is helping out.

Its a bit of a mystery, hence maybe a testosterone connection. My last labs from January this year showed a surprise high SHBG.

I just wonder if to MUCH T4 could bump up the SHBG and i may actually need less T4 again (even though you would expect the opposite in the winter).

My latest thyroid labs on 112.5 T4 showed TSH had come up from 0.3 to 1 (previously on 125 T4) but the FT4 had also jumped from 19 to 22. You would really expect a drop in the Ft4 and not a jump.

FSH is always super high and i have confirmed low sperm production.

They will not test FT3 in the UK unless they are pushed. But over the years i have had many tests and FT3 is always good.

I am struggling to find out on the net how testosterone and thyroid interact as i am sure these interactions are key for some people. I have seen higher thyroid will push up testosterone, but can lower testosterone availability affect the thyroid in some way ?

ps. i am experiencing a really strange heart burn sensation in this area at the moment and my blood pressure has increased a bit.

4

My thyroid number only slightly increase after starting TRT. As we age SHBG can increase and diet plays a big part, thyroid medicine can increase SHBG. You really want T4 midrange and Free T3 midrange or slightly higher and believe and are having to compensate for more T4 medicine do to the lack of T3 medicine.

If you lower the T4 medicine and Free T3 become lower, then you may need T3+T4 medicine. Higher thyroid will not increase testosterone, thyroid and testosterone are two separate matters and we don’t tweak one to increase the other.

Your at an age where testosterone is expected to be on the decline, we start losing 1% of our testosterones after the age of 30 and continues to further decline until we are elderly.

I would check out balancemyhormones in Dorset.

I had high blood pressure when my testosterone was low, it could also be too much thyroid medicine.

5

Are you in the UK ?

BMH are based in London i think based on their website.

Yes the NHS care is disgusting. I just manage my own conditions with minimal input from the NHS. I get my T4 on the NHS, but never go see them if i can help it.

I have recently increased my T4 back to 125 from the 112.5 and this maybe why i am getting some issues. I am going to back down again and see how i get on, but i upped noticing i was getting some tiredness in the afternoons and this is typical for this time of the year.

Autumn time always brings adjustments i think.

6

I’m in the USA so my options are plentiful. I get TRT through insurance and my endocrinologist lets me decided on dosages and I have Defy Medical balance my levels, even in the USA endocrinologists are useless for TRT.

The NHS or VA are the worst for healthcare. Theses reference ranges for testosterone and thyroid are set up to make it difficult to get treatment approved, going private moves the goal posts higher and all of a sudden a guy with a total testosterone of 450 can get TRT where under insurance or state healthcare he cannot.