So at my April appointment my doc said that he hasn’t been liking what he’s seeing while tracking my thyroid. So he put me on T4 and T3. Like mentioned here, my doc says that TRT puts a greater demand on your metabolism and therefore, thyroid. In fact he says thyroid is more important than testosterone (if you had to list them in order of importance). So he kinda insisted on me going with the T4 and T3.
So the last labs before going on the meds looked like this:
TSH 1.6 (uIU/mL 0.27-4.20)
T4 (free) 1.7 (ng/dL 0.9-2.1)
T3 (total) 99 (ng/dL 80-200)
After being on 50mcg T4 and 15mcg T3 per day for 3 months, they now look like this:
TSH 1.1 (uIU/mL 0.27-4.20)
T4 (free) 1.8 (ng/dL 0.9-2.1)
T3 (total) 158 (ng/dL 80-200)
Thoughts? I was a little surprised to see that I still have a good TSH number. I had assumed that would drop off to nothing.
Also the blood was drawn about 3 hours after taking the meds, so the T3 and T4 numbers are likely peaking…I’m guessing I could take those numbers a little higher…at least the T3? I’m guessing he’ll tell me to add an additional 5mcg to the 15mcg T3 I’m already taking…whaddya think?
Hmm, thyroid more important than testosterone? That’s like saying your heart is more important than your lungs, kidney or liver. If any fail, you’re dead, it’s just a different process.
I think a key element is missing, and that is free T3. That is what is really working. Reverse T3 would be nice to know too. Maybe antibodies. Were you having hypothyroid signs or symptoms?
It does not appear your meds are doing much. A TSH of 1.6 is not bad at all and, yes, typically you see it bottom out when thyroid medication is added. Are you noticing any difference with it?
As for TRT putting greater “demand” on metabolism, I’m not sure what that means. Maybe indirectly? You feel better and have more energy, so you are more active? Having more sex? Putting “demand” on the genitals? It would be interesting to know what he means in that regard.
The doc just meant that for overall recovery and feeling better, thyroid is where it’s at.
Yeah I will ask for free T3 for next labs. As far as how I’m feeling, I didn’t notice anything at all for a couple months, and then lately I’m actually feeling more tired and drained than normal, despite getting plenty of sleep.
Something interesting…right before getting on the thyroid meds I had experimented with the carnivore diet for about a month (it has zero carbs). I didn’t do it to lose weight, in fact I really didn’t have excess weight to lose. However I lost ten pounds. Right about the time I started the thyroid meds, the experiment was over and I went back to carbs, so I fully expected to gain my weight back…but I haven’t. I have attributed this to the thyroid meds, but of course can’t be sure. And looking at my numbers, it wouldn’t seem to be the case.
Were you having any symptoms when the doctor “didn’t like” what was happening with your thyroid?
After starting TRT, my TSH went from 1.2 to 2.5 or 2.2 , it was consistent in the 2’s for about a year, but recently I had it checked and it went back to 1.6.
Maybe my backlog of “fixes” is done and my thyroid is back to running normally. Not sure. Thyroid is not really my subject.
I never had any negative symptoms though. Just increased TSH…
I’m surprise you doctor put you on thyroid medicine with the labs you’ve got, you should know where your Free T3 and Reverse T3 are before treatment begins.
Doc loved my thyroid numbers and said to keep the dose where it’s at. He said that to see someone achieve T3 at 160 is absolutely optimal. However, I will be getting a free-T3 test for next labs.
fT3 is the only active hormone. T4 is simply a reservoir for fT4–>fT3. There is no receptor for T4
You are better off checking your oral body temperature when you wake up and mid-afternoon to eval thyroid function status. See below re temperatures.
Fast acting T3 makes fT3 labs sort of sketchy. In USA time release T3 is a compounding pharmacy only medication. I take 25mcg per day.
If one has elevated rT3, that blocks some fT3 action and with ample fT3 body temperatures can be low. In that case, taking T4 simply increases fT4–>rT3. Thyroid is more complex than TRT. If TRT hormones are perfect, one can have most of the same symptoms of low-T if thyroid function is poor. Thyroid lab normals are mostly useless, one has to seek optimal. fT3 should be mid-range or a bit higher.
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
KSman is simply a regular member on this site. Nothing more other than highly active.
I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.
The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.
I asked my doc exactly that…in fact I mentioned that my labs were taken within a couple hours of my taking the medication. I asked about fast acting vs time-release. He said that once it’s steadily in your system, it wouldn’t have mattered when I took the labs. He said that I could have skipped the next 3 days of meds and still taken the labs and it would have shown the same numbers.