On The Right Path?

Pharma TRT
81

So today I went to yet another doctor who tells me that RT3 means nothing and me levels are “within range”. So guess I am going to have to try to do this myself so I would appreciate any guidance on how to titrate up the dosage and what my ultimate goal would be (it seems like most are able to clear their RT3 on 50-75mcg) and then I’m assuming I would need to taper off as well?

Below are the results from my most recent blood work (2/5/2018 @ 8:49am - Fasted) and my 4x Saliva Cortisol test…

Thyroid
TSH 1.280 uIU/mL 0.450-4.500
Thyroxine (T4) 7.8 ug/dL 4.5-12.0
Triiodothyronine,Free,Serum 3.7 pg/mL 2.0-4.4
T4,Free(Direct) 1…39 ng/dL 0…82-1.77
Reverse T3, Serum 26.2 High ng/dL 9.2-24.1

Iron and TIBC
Iron Bind.Cap…(TIBC) 308 ug/dL 250-450
UIBC 202 ug/dL 111-343
Iron Saturation 34 % 15-55
Ferritin, Serum 83 ng/mL 30-400

CBC
Glucose, Serum 97 mg/dL 65-99
Uric Acid, Serum 4.3 mg/dL 3.7-8.6
BUN 9 mg/dL 6-24
Creatinine, Serum 1…02 mg/dL 0.76-1.27
eGFR If NonAfricn Am 91 mL/min/1.73 >59
eGFR If Africn Am 105 mL/min/1…73 >59
BUN/Creatinine Ratio 9 9-20
Sodium, Serum 139 mmol/L 134-144
Potassium, Serum 4.5 mmol/L 3…5-5…2
Chloride, Serum 99 mmol/L 96-106
Carbon Dioxide, Total 25 mmol/L 18-29
Calcium, Serum 9.5 mg/dL 8.7-10.2
Phosphorus, Serum 3.2 mg/dL 2.5-4…5
Protein, Total, Serum 6.7 g/dL 6…0-8…5
Albumin, Serum 4…6 g/dL 3…5-5.5
Globulin, Total 2.1 g/dL 1.5-4.5
A/G Ratio 2.2 1.2-2.2
Bilirubin, Total 0.4 mg/dL 0.0-1.2
Alkaline Phosphatase, S 51 IU/L 39-117
LDH 147 IU/L 121-224
AST (SGOT) 24 IU/L 0-40
ALT (SGPT) 37 IU/L 0-44
Iron, Serum 106 ug/dL 38-169
Cholesterol, Total 256 High mg/dL 100-199
Triglycerides 117 mg/dL 0-149
HDL Cholesterol 73 mg/dL >39
VLDL Cholesterol Cal 23 mg/dL 5-40
LDL Cholesterol Calc 160 High mg/dL 0-99
T. Chol/HDL Ratio 3.5 ratio units 0…0-5.0
Estimated CHD Risk 0.6 times avg. 0.0-1…0
WBC 6.0 x10E3/uL 3…4-10.8
RBC 4.82 x10E6/uL 4.14-5.80
Hemoglobin 14.4 g/dL 13.0-17.7
Hematocrit 42.9 % 37.5-51.0
MCV 89 fL 79-97
MCH 29…9 pg 26.6-33.0
MCHC 33.6 g/dL 31.5-35…7
RDW 12.4 % 12.3-15.4
Platelets 256 x10E3/uL 150-379
Neutrophils 60 % Not Estab.
Lymphs 26 % Not Estab.
Monocytes 9 % Not Estab.
Eos 4 % Not Estab…
Basos 1 % Not Estab.
Immature Cells
Neutrophils (Absolute) 3.6 x10E3/uL 1…4-7…0
Lymphs (Absolute) 1.6 x10E3/uL 0.7-3.1
Monocytes(Absolute) 0.5 x10E3/uL 0…1-0.9
Eos (Absolute) 0.2 x10E3/uL 0.0-0.4
Baso (Absolute) 0.0 x10E3
Immature Granulocytes 0 % Not Estab.
Immature Grans (Abs) 0.0 x10E3/uL 0.0-0.1

4x Saliva Cortisol Results
Cortisol Morning - 18 nmol/L (optimal range 18-35) (ref. Interval 5.1-40)
Cortisol Noon - 1.7 nmol/L (optimal range 6.0-12) (ref. Interval 2.1-16)
Cortisol Evening - 3.3 nmol/L (optimal range 2.0-5…0) (ref. Interval 1.5-8.0)
Cortisol Night - 1.1 nmol/L (optimal range 1.0-4.0) (ref. interval 0.33-7.0)
DHEA - 197 pg/mL (ref… Interval 137-336)

Secretory IgA 118 μg/mL (ref. Interval 75-330)

82

Ferritin=80 is considered adequate for T4–>T3 conversion.

Your fT3 is above midrange, some kind of adjustment for rT3.

Find a compounding pharmacy in your area/region and ask for a referral for a doctor who deals with rT3 and TRT.

Thyroid is really too complex for most doctors. In a few hours you can know more about the issues than they do.

Read Wilson’s book. You need to deal with the stresses that have created/contributed to this.

DHEA is another adrenal hormone and AM cortisol seems low. I do not understand why your lab results are all nmol/L etc.

The adrenals make progesterone and then progesterone–>cortisol. Some can increase cortisol with progesterone cream. Amazon and others sell “KAL” brand progesterone cream that can be helpful.

83

Just to say I’m following this with interest. Similar to my story albeit I’m younger and having no luck from doctors. I’m almost certain the thyroid is the problem not the testosterone- and it is quite possible the thyroid has caused the testosterone to reduce. My t level dropped 300ng in 4 years and I had all the symptoms with a great t level of 750 but a TSH of 2.54.

Am self medicating thyroid with a combination of t4 and t3 at the moment and what I have noticed is when the t3 wears off, around 8 hours after dosage, my heart starts to palpitate and heart rate rises. Can’t understand why but it seems like my body wants more t3.

84

Some get panic attacks that we have seen resolved here with iodine or thyroid meds. Related to your heart rate?

85

I will look into the KAL cream. Another forum wanted to put me on oral hydrocortisone but I really don’t want to do that.

[quote=“KSman, post:84, topic:236973, full:true”]
Some get panic attacks that we have seen resolved here with iodine or thyroid meds. Related to your heart rate?[/quote]

Really? My anxiety has been up over the past few months as well as my heart rate so hopefully getting my thyroid functioning properly will fix it.

Would iodine not work for me since I just have elevated RT3 / hypothyroid symptoms?

86

doesn’t seem to be panic related, I just randomly noticed it happens a the same time every day which corresponds purely to t3 wearing off. Tried dosing at different times and sure enough the palpitations came approx 8 hours later. Maybe that means my body feels under threat when the hormone that it is low in starts disappearing from the bloodstream again? Only 5 days into thyroid meds so far. Did notice quite a few night time erections last couple of nights which is unusual for me in recent years.

87

@KSman I don’t think you ever mentioned if I can try Lugol’s or Idoral in my particular situation (functioning thyroid with RT3 stuck elevated due to a chronic infection / on antibiotics 6-8mo) or if I should wait until I receive my Cynomel? Based on what I have read I cannot tell if the iodine could make me go “hyperthyroid” since my thyroid already creates ample T3/T4? I have both Lugol’s and Idoral on-hand but didn’t know if maybe I should just wait the couple of weeks to get the Cynomel. Thank you.