On TRT, Should I Get Pituitary and Thyroid Checked?

I get treated at the V.A. and around 4 months ago, I was diagnosed with secondary hypogonadism.
I do have a history of T.B.I.s, and I believe I read somewhere in one of the TRT threads that you should get your other hormones checked.
I mentioned this to my P.C.M. and flat out refused. Apparently, I have had my thyroid checked, but he won’t check anything else.
Am I remembering incorrectly? Should I leave well enough alone?
If I am right, does anyone know of any research, or articles that would establish precedent to back up my stance that I should get these labs done?

What were the thyroid results? “Good” or “ok” from a doc means nothing these days. What were the numbers?

Are you having any symptoms that would make you suspect issues?

The VA for hormonal treatments is notoriously bad at thing related to testosterone and thyroid matters. The VA is no better than the sick care system in treating hormonal problems, unless you have really good private insurance or work for a really good company with top rate insurance for its employees, the doctors you have access to will be extremely limited in hormonal knowledge.

The sick care definition of normal thyroid status is very wide and broad covering a large range, the problem with this is the ranges need to be narrowed because a lot of people have symptoms with thyroid levels “in range” and because levels are in range, treatment is denied and the symptoms are completely ignored and it becomes a game of numbers all to deny medical treatment and save on healthcare costs.

You should seek answers by going to Discount Labs are ordering and paying for your own labs and if treatment is needed, I expect the VA to deny treatment until such time your levels are well below the threshold at which point symptoms are encountered.

You should post all labs including reference ranges, if you don’t at least have TSH, fT4, fT3 rT3 and antibody testing which I seriously doubt you do, then you don’t have a complete picture of how your thyroid is performing. TSH in range is no guarantee that free thyroid hormone as are sufficient, especially if there are conversion disorders.

The sick care system (VA) is not going to optimise your state of health, they only need to keep you from dying, you want optimal testosterone and thyroid hormones, be prepare to pay for it out of pocket.

I sure hope your doctors tested more than just testosterone, low growth hormone is common in TBI patients. You would want to test IGF-1 to check growth hormone status as it’s more reliable than testing growth hormone.

Thanks for the replies, both of you.
I just checked my records, and the last time my thyroid was checked, it was just normal TSH, and it was over a year ago.

Date/Time Collected: 12 Sep 2018 @ 1529 Collected
TSH 1.40 uIU/mL (0.358-3.74)

I was aware of the low growth hormone, but when I mentioned it to the Doc, he shot me down. That’s why I was asking if anyone knew of any studies or scientific articles they could point me in the direction of.
If not, do I just need to get the thyroid labs mentioned above, and IGF-1?

No growth hormone testing with prior TBI, your doctors comes across like a uncaring robot and is not qualified enough to be treating you.

You have to bring your doctor a study to prove he should order a growth hormone test for someone with a TBI, ridiculous. I’m afraid your doctor won’t know how to interpret the labs results, if you confirm results are less than stellar through your own testing, find someone more competent because he’ll just blow you off as before.

Prevalence of hypopituitarism and growth hormone deficiency in adults long‐term after severe traumatic brain injury

Effect of Growth Hormone Replacement Therapy on Cognition after Traumatic Brain Injury

Post-traumatic hypopituitarism, and specifically growth hormone deficiency (GHD), has been found in a large percentage of individuals with chronic moderate to severe TBI. Presently, there are no published treatment studies of hormone replacement in this population. In this study, 83 subjects with chronic TBI were screened for hypopituitarism. Forty-two subjects were found to have either GHD or GH insufficiency (GHI), of which 23 agreed to be randomized to either a year of GH replacement or placebo. All subjects completed the study with no untoward side effects from treatment. A battery of neuropsychological tests and functional measures were administered before and after treatment.

The findings of this pilot study provide preliminary evidence suggesting that some of the cognitive impairments observed in persons who are GHD/GHI after TBI may be partially reversible with appropriate GH replacement therapy.

TSH only testing, you can’t get anymore old school than this. When doctors check T status, they normally check LH which is the stimulating hormone, but they don’t stop there because they need to see how much testosterone the testicles are producing.

It’s no different with thyroid testing, you have the stimulating hormone TSH, but he didn’t check the hormones in the same way he did when he checked LH and testosterone.

The odds are your thyroids is perfectly fine, I would worry more about IGF-1.