Usually a mixture of T3 & T4 medicine unless Reverse T3 is elevated >15 ng/dL, then T3 only medicine. You will not be able to dial-in your TRT protocol until thyroid hormones are optimal.
Flying out to see Dr Nichols in Tennessee on Thursday. Wish me luck, fellas!
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Very curious to see what he prescribes for you and what your experience is like in general. I’ve considered working with Dr. Nichols. Please keep me updated.
Dr. Nichols will optimize you, normal isn’t good enough for him.
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Had my visit with Dr Nichols yesterday and I was SUPER impressed. The entire experience was just night and day versus my experience at the local TRT mill. The dude is just insanely knowledgeable and caring. One of those top 1% doctors. The trip to Tennessee was a slight financial stretch right now (trying to get our house painted this summer to the tune of $12k), but I already feel like it was worth every penny.
So I was really struggling before I went. Feeling at just about the lowest point I’ve ever been at. I was actually having some suicidal thoughts this past week.
He saw 3 distinct reasons for it.
First was the HCG. He pointed out that it side effects that are exactly what I was experiencing, with fatigue, headaches, and mental health issues.
Second was that my T levels were all over the place. I’ll see if I can get the latest labs to post here in a bit. But the HCG was causing my T to fluctuate wildly.
Third was my thyroid. He said it wasn’t terrible, but far from optimal, and definitely fit the symptoms that I was describing.
So here’s what he did:
- Took me off of the HCG
- Switched me to the cream. Twice a day. Two clicks each time. He said that if you’re injecting, he wants to see ED/SQ. But he feels that for ED, the cream is so much more convenient, and just as efficacious in his experience.
- Got me on pregnenolone, DHEA, and melatonin for supplements
- Put me on Armour Thyroid
Initial results? I picked up all of the meds right there in Tennessee on my way back to the airport, and popped half an Armour Thyroid as he had instructed. Within 30 minutes I felt a difference. Not feeling anywhere near “optimal” yet, but the mental anguish and shit that I’ve been going through was immediately reduced by like 90%. Total game changer.
Looking forward to the results over the coming weeks and months.
Picked up some other interesting bits from him too. For example, he doesn’t even believe in testing E2 in men. He’s seen E2 over 100 and he doesn’t believe that it has any effect on 90% of dudes on TRT.
Due to his theories on Type 3 hypogonadism, he also likes to see total test in the 1500 - 1800 range, with free test over 40 or 50.
Fascinating shit and such a different take.
Like I said, not feeling 100% yet, but feeling well enough now to actually start hitting the gym and whatnot.
Looking forward to keeping you guys updated on my progress.
If anyone is not happy with their own provider, Nichols costs about 50% more than my TRT mill, but I just can’t say enough good about the whole experience so far, and I’d highly recommend a trip to Tennessee. Some states have a reciprocal licensing agreement with Tennessee now, so you don’t even have to travel there, and can just do it all via telemedicine.
Big thanks to @enackers for turning me on to Nichols.
Let me know if anyone has any questions about the experience so far!
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Very cool and best of luck with him
Dr Nichols is the best in the business. He never blocks E2 because he is up to date with the literature. We have guys in our group with E2 at 120 and they’re essentially boners with legs. Blocking/managing E2 was taken from the bodybuilding community and has ZERO to do with TRT. If your current doc states you need an AI, do yourself a favor and change doctors.
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I want to be a boner with legs
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Oh yeah, another interesting thing was his approach to high SHBG. The TRT mill wanted to give me Danazole, and the prevailing bro science on the forum is “inject one massive dose a week” and that will somehow lower SHBG.
Nichol’s approach? Get your Total T high enough and it’ll spill over. Another reason that he runs some guys at really high T levels.
Danazole is an androgen, it has the same effect as a really high T level, but without aromatisation. The prevailing theory virtually everywhere is that SHBG rises in response prolonged low test levels, and drop in response to high levels. Usually. A bigger once a week shot results in more free T, overcoming the SHBG number. Frequent smaller shots get eaten up by the SHBG. It’s not rocket science.
listen to your doctor not hardartery as he is still in the stone ages with regard to TRT
This paragraph is complete Bro Science nonsense
I am not actually disagreeing with his doctor. If you were literate you would know that.
Which part did you have trouble understanding? Do I need to spell it out in little jpeg block letters for you?
you never want to lower SHBG and when you give daily testosterone injections you give it in a dose that overcomes the SHBG (if high) and raise the free testosterone level. One does not need to measure SHBG to optimize a man. You just need to follow the free testosterone levels. Its that simple. Low SHBG is associated with increased morbidity and mortality. It is an independent predictor of the metabolic syndrome and insulin resistance.
Everything is true within a confine. Relatively higher SHBG is associated with longevity. So is lower test levels in some studies. An SHBG of 60+ is not a good thing, and there are guys on here with that and higher. Nothing is as simple as following one level of a hormone. Ever. Anecdotally I know for a fact that higher free T did not result in better anything for me. Where I’m at has been the best so far, and it is not my highest free T.
And, generally speaking, most guys here are going to calculate their free T using their SHBG, so it is kind of important to measure it for that use.
Yup hes a great doc I had the same experience with thyroid and visiting him. Im glad you finally saw the doc.
SHBG just isn’t as big an issue with the cream. Maybe the injections, but on cream you just don’t have as much interference. I don’t know why, but I see it over and over again.
Again, not a fucking clue who you’re talking to. Not even in the slightest.
I never claimed to know who you are. I don’t actually care. I know that you are an idiot, so that’s as much as I need to know. The only intelligent post that you have made was regarding depression.
This is not a “new” approach. Crisler was another who touted this method (“just throw more t at it”).
But it does not always work for everyone, and when it doesn’t, you need to consider other options.
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