Thyroid Advice with TRT?

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@anon18050987

I was giving you a different perspective based on relevant experience.

Can I understand what relevant experience you’re referring to? Just to know who I am talking to (a doctor, an endocrinology student, someone passionate about the subject ecc).

I’m not on thyroid meds, I did a trial 3 years ago with Euthyrox monotherapy before TRT and felt horrible. I still remember the body aches I was getting and the inability to recover from trainings.
Ditched it in the trash and started TRT.

My TSH has been creeping up during the past months and this paired up with the cognitive function decline I’m experiencing, despite the proper amount of androgens in the body. I basically match all the cognitive sides associated with hypothyroidism.
What would you do then if a patient was coming to you, with everything else in check, but with symptoms of hypothyroidism? Would you shrug your shoulders and say you are perfectly fine, there’s nothing I can do for you.
This reminds of the docs that were telling me that a total T of 300/400 ng/dL is perfectly normal and that androgens are not an issue.

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@anon18050987

Note the words above I put in bold. Everyone thinks they are rare (I am guilty myself). Hence, my SWAG estimate of 1-5%.

Didn’t say I feel I’m rare, quite the opposite actually.
But you’re extrapolating what you want from that quote.
They wrote: “The potential for dichotomy between serum thyroid hormone levels and intracellular action is dramatically illustrated in reports of individuals with rare mutations in the MCT8 transporter”.

It doesn’t mean it doesn’t happen to average Joe, it means it can happen to a less degree to normal people and it has been reported anecdotally many times, but it is clearly obvious in people with the Allan-Herndon-Dudley syndrome.

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@anon18050987

My relevant experience on these medications and my knowledge of the subject. I am a simple anonymous stranger on the internet.

I notice feedback on here that agrees with what the poster wants to do is always much more welcomed than throwing a wrench in said plans, but I figured i would give you a different perspective.

I wish you the best and hope things work out for you.

Wait, I’m in the same position as you. No medical degree in anything medical related, but just passionate about the subject and I had to drag myself out of the hole incompetent doctors threw me in. So I want to listen to all the opinions and I understand your positions.

We had Ksman and phisiiolojic in the past that played doctor and messed up people, so you need to accept the fact that people don’t take what you say as the Gospel, but rather want to have a conversation about it.

And as I said, I was following the same exact school of thoughts you;re preaching (and still do to a certain degree), but following ranges just left me symptomatic and made me waste 2 years and a half on TRT.

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@anon18050987

I understand the need to feel better, so I wish you the best on your journey. I felt compelled to share with you as I have been down this road (you may have a very different outcome) and I think the advice that gets shared on here to run up your TT and fT3 levels (without expecting a risk with the reward) is irresponsible.

Ignorant people I can understand giving this advice after reading some internet articles, but there’s MDs out there giving people supra levels of Test and shooting their fT3 above range.

I understand your concerns and as I said I agreed with your view in the past, but let’s say you were having your testosterone numbers great on paper, but you were symptomatic like me when in range. You go slightly above range (i’m not talking about 2000 ng/dL of T and a free T of 50) and you start seeing symptoms fading away. What would you do? Contemplating a piece of paper telling you how good your numbers are for the rest of your life and feel junk, or have a couple of values marked in red on your blood work and finally starting feeling normal?

I agree with you that TRT is overly prescribed and I’m one of the few with a clear diagnosis of secondary hypogonadism at age 27, being basically unable to function. I’ve tried everything to restart my HPTA before committing to TRT for life, so I can’t say I’ve left anything untried.
And I eventually experienced on a 3 years journey that I feel ok when I cross the “normal range” in terms of androgens and estrogens levels.
Would you consider me irresponsible? Are you able to guarantee that I’m doing harm to myself?

Regarding thyroid, I’m not willing to go above range at all. Just trying to bring both T4 and T3 higher to see if it solves cognitive issues. It’s a trial. If it doesn’t, the thyroid is not the issue and I’ll keep looking for a possible cause.

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@anon18050987

Without clinical experience I think a lot of us thinkers can get in our head we’ve got something that perhaps we do not. Again, not referring to you specifically, maybe just me.

I don’t know how you would make up brain fog, inability to focus/concentrate and forgetfulness, while they weren’t here 12/18 months ago.

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@anon18050987

Note Testosterone controlled by HPG which is coupled with HPTA.

Sorry, I didn’t get what you’re trying to say.

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I thought HPG (Hypothalamus, Pituitary, Gonads) was interchangeable with HPTA (Hypothalamus, Pituitary, Testicles).

Out of curiosity, are you taking testosterone or anything else at the moment?

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I always knew they used the same acronym for both:

Hypothalamic-Pituitary-Testicular Axis

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Yeah I agree with you that HPG should be used, but HPTA is still used on several papers to indicate the hypothalamus, pituitary and testicles axis, so I keep using it without thinking much about it.

[highpull]

@appassionato

The dose above seems to be the equivalent of 2.5 grains for T3 and almost 4 grains for T4. Too much as a staring dose?

It would seem so.

[enackers]

Let me just mention a few things because some folks make this topic way too complicated for no reason. They make it sound like you will end up with an autoimmune disorder or end up in cardiac arrest if you take thyroid meds. Some people are too smart for their own good, they are well read, but they have zero experience / or have actual tested their bullshit with real people. This kind of advice keeps people feeling like shit for eternity and you mentioned this with your last doctor and trt.

RT3 at 13 is high. There is a website out there called stop the thyroid madness. Just go there and see what folks say about high reverse t3. Not some guy pulling bullshit articles and other shit from the web and trying to over complicate your path to health.

You want it below 5 and even closer to 1. I saw someone else suggest its totally fine and i cannot verbally emphasize how horrible that advice is. i don’t understand why some people think they are so smart compared to doctors who do this for a living. Im not a doctor, but my doctor specializes in hormones for men and woman. He knows his shit and his credentials surpass the keyboard warrior credentials above. He has actual decade of experience with men and woman and thyroid therapy. Ive learned everything from him and im sure he’d back this up.

When you have high rt3 like my wife did you want to hit it head on by lowering that rt3 if its due to diet or whatever else that causes it. Don’t wait for this to resolve and start a t3 only protocol If symptoms are bad enough. Like fatigue… bad fatigue. Hair thinning. Metabolism.

If rt3 is high and the rest of your thyroid labs look excellent, i would just work on lowering rt3 through whatever means necessary. No need to get on thyroid meds for life. They are expensive.

My wife was eating low carb diet and she started to eat carbs and went on a normal diet. She went from the exact same rt3 of 13 down to 6 and since then she has been on armour thyroid. This took 3 months.

She was on t3 at the start but it didn’t make a damn difference for her because the doctor was giving her 5mcg 1 a day. I convineced him t give it to her 3 times a day. still didnt do shit. She took her first armour thyroid 2 grain tablet and it was a night and day difference.

Synethic thyroid meds suck ass. Get dessicated and enjoy.I tried it and many others have as well. Dont waste your time.

End of day if a man is on trt and he still has fatigue, metabolism and other symptoms, that man should test thyroid. If thyroid labs do not show ft3 top of range, t4 mid range, that man should run a trial of thyroid. Slowly increase until symptoms resolve. If symptoms do not resolve, thyroid is not the answer.

If ft3 is well below 50% of the range start with 2 grains like i did. If its neither great nor horrible start with 1 grain. The worst that can happen is you feel like you drank a few cups of coffee for a few hours and you can lower your dose. If you decide to start with a smaller dose i would just cut the pill in half and see if that works. After a few days you will stabilize and realize if that dose works for you.

One last thing. Due to the half life of t3 and dessicated thyroid meds, you will want to take it twice a day or 8 hours apart. 6 am and 2pm.

This is how I was taught thyroid therapy from my doctor and the exact same steps my wife, my friends and I have followed.

Get as big a dose as you can from the doctor. Otherwise you might end up waiting 3 months to feel better. You want control over your dosing and need to increase without having to call the doctor and ask for more. If you can.

Goood luck. dont waste your time with fear mongering and guys who want to make it harder than it is. hormone therapy is very simple. supplement until symptoms resolve.

Im taking 2 grains twice a day. Its been almost 2 years. I feel fine. I race bikes, do intervals, life weights and sleep. I dont and never have had any of the symptoms of high thyroid levels. Although my levels are just a tad bit over the lab range. Some folks on here would tell me i am going to ruin my health or have a CV event. Guess what. … it hasn’t happened.

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@enackers

End of day if a man is on trt and he still has fatigue, metabolism and other symptoms, that man should test thyroid. If thyroid labs do not show ft3 top of range, t4 mid range, and low rt3, that man should run a trial of thyroid. Slowly increase until symptoms resolve. If symptoms do not resolve, thyroid is not the answer

That summaries what I’m trying to do. Thanks.

I’ve ordered pharma grade compounded NDT, each tablet is the equivalent of 1 grain. I will do thyroid labs on Thursday and post it here.
What was your wife starting dose? 2 grains together in the AM? Or 1 in the AM and one in the early PM?
Would you start a man on 2 grains as well and tirate up if necessary?

You mentioned also you wouldn’t want to be on thyroid meds forever, but I consider NDT almost like a supplement. What’s your thyroid protocol now?

I’m eating my carbs (rice, potatoes, fruit, vegetables and whole grain bread). I love carbs and I’ve learned it the hard way when I tried a keto diet years ago. My thyroid didn’t like it all. What would you do if fT3 goes top of the range, fT4 mid range but rT3 still above 10?

Last thing. Are you followed by Dr. Nichols?

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Sorry I saw you responded to some of the questions already in the previous post.

[enackers]

Glad to hear it brother and yes doctor Nichols is my guy.

My wife takes it twice a day so a total of 4 like me. She needs it and her labs are perfect. Without it she feels horrible. Even on 1 grain twice a day she feels blah.

Start at 1 and take that for several days. You should notice a benefit quickly . If not go to 1.5 then 2 twice a day. It’s hard to explain the feeli when it works. I would say it felt like the clouds lifted and the sun started to shine. My brain was awake and the fatigue from hell dissipated within hours. Symptoms just vanish.

Don’t take thyroid just to take it if you don’t have the symptoms though. Otherwise take it as needed and find the fastest route to finding a dose that works for you without wasting your time.

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@enackers

Start at 1 and take that for several days. You should notice a benefit quickly . If not go to 1.5 then 2 twice a day. It’s hard to explain the feeli when it works. I would say it felt like the clouds lifted and the sun started to shine. My brain was awake and the fatigue from hell dissipated within hours. Symptoms just vanish.

The reason I’m trying it is because my cognitive function has been declining in the past months rapidly and you described it perfectly. I feel tired upon waking, then I have breakfast and go workout with heavy weights and I resurrect. Then I crash again after lunch and wake up again around 5-6 in the evening.
I’ve lost the enthusiasm on doing things too. I just feel ok with working out and working for my own business. I find all the rest boring.
Now, it could be thyroid or not, but my thyroid numbers went worse and worse and I started feeling like that.

I’ll keep you posted.

[enackers]

Yes really … really

I literally said nothing out of the ordinary. Tell me what exactly did you not understand.

[enackers]

If you are talking about the rt3 comment. I removed that. He knows what I’m saying although I made an error.

[enackers]

I had the fatigue where I slept 10-12 hours, and I could sleep more. I just couldn’t focus and nothing worked to wake me up.

Keep us posted. You are being Smart and stick to the basics as you have.