Really appreciate your input here! The thing is, I am on TRT with HCG and still feel like garbage. My libido is in the toilet, I have ED (and zero sensitivity), cold extremities (that come and go), cold intolerance, dry skin on my face/scalp, and digestive issues. All of this started when I got an injury that caused a varicocele around 12 years ago, resulting in progressive testicular atrophy and feeling cold constantly. I also developed food allergies at the same time, which I never had prior.
Initially I put everything down to low testosterone (which was also showing up on lab work), but my thyroid shifted a lot as well. I was lucky that before I got this injury, I had labs done a month or so earlier that (by chance) had thyroid. All that was done was Free T4 which was:
TSH: 0.63 mu/l
Free T4: 15.8 pmol/l ( 9 - 24 )
One doctor I spoke to said with total/free t4 levels like that (as they are currently) I have acute subclinical hypothyroidism, which may be causing my issues.
Even going on Proviron, has done nothing to improve my symptoms which make me think thyroid is the issue. The other factor is constantly feeling cold all the time and needing heaters, etc.
The thing that pushed me away from hypo, was the fact I never had serious fatigue or memory issues. This is more than likely because my Free T3 was good and my body was compensating with progesterone (which has some similar properties to thyroid in some respects and boosts it), along with adrenaline. Even the slightest “shock” gets my heart racing like crazy, which never happened prior…
The coldness sounds like thyroid but because thyroid is so general it is hard to really confirm unless bloods help out. This is why a trial is a great idea if bloods are not indicative but symptoms scream out.
First some info and more info from you:
have you taken your waking temp in the morning without moving out of bed. If it is low this indicates low thyroid according to the grandfather of thyroid docs Broda Barnes.
He wants a temp over 36.6C.
From my own data a temp lower than 36.3C indicates the metabolism is running to slow.
Before t4 I was around 35.9C on waking.
Read about temps/ thyroid/ broda barnes
have you had thyroid anti bodies checked?
In hashimotos the thyroid levels go up and down and a patient really has it tough getting balanced. So any auto immune issues in the family?
did your injury involve any damage to the head? Have you ruled out pituitary damaged to your signalling systems eg tsh, tsh, lh
have you been diagnosed with low stomach acid, so contributing to poor digestion. This is a common complaint for low thyroid patients often
I hear many issues with nth over the years. Supply is just not as accurate as synthetic production. I am just so pleased I never found nth any different to t4.
There has been talk on the uk thyroid forum about thyroid-s but I do not follow this issue as it is not relevant to my own treatment.
Your point about not wanting to take t4 because it will eventually shut down your own system is true of all hormones in excess. Do you think nth will act any differently?
No head tramua, the issue started due to a testicular injury that caused a varicocele. After this point everything went downhill, a few theories exist that the testicles have thyroid receptors and are part of the thyroid feedback loop, so any damage could down regulate the hpta-axis. It makes sense, because sperm requires specific temp to function properly. Varicocele obviously causes overheating, which “may” explain the down regulation that happens.
In relation to antibodies, nothing like this, all are zero on labs. Pituitary is also fine with no issues at all.
Regarding stomach acid, nothing like that either. Though, one doctor mentioned that I might have low stomach acid due to b9 being low (or something like that).
This was my level before the injury (roughly 10-12 years ago), so I have a feeling that getting back to this will (hopefully) put me back to normal. But who knows…
My level now is 9.3966, which may explain these issues for sure. I am getting new labs done this week, so hopefully that will give an ever clearer idea. In relation to LH/FSH, I am on TRT currently so they are zero.
This study really opens my eyes to a lot of things…
Specifically this line:
“There were no significant differences in serum levels of FT3, E2 and TT between ED patients with SCH and the controls with euthyroidism (all P>0.05, Table-IV), while the serum concentrations of TSH and PRL were significantly higher, and FT4 was significantly decreased in ED males with SCH than euthyroidism controls (all P<0.05, Table-IV).”
This is literally exactly what happened to me…so free T4 is the culprit behind the libido/ED issues…
I frequently have a waking temperature less than this. My thyroid has not proved to have any issues and I NEVER feel cold, even when I’m in Canada in January and it’s -22C outside. I put zero stock in that idea, based on experience.
You keep ignoring the definition of subclinical hypothyroidism
‚Subclinical hypothyroidism (SCH) is defined as mild thyroid function failure and diagnosed by elevated thyroid stimulating hormone (TSH) with normal free thyroxine (FT4) concentration.‘
Basically it’s defined by a TSH of greater 5ish, normal fT3/4 and only mild to no clinical symptoms. Treatment of which does in most cases not improve quality of life.
You don’t meet a single criteria of subclinical hypothyroidism.
TSH is perfect, fT4 is ok and fT3 is also spot on.
Lowish fT4 with normal fT3 is seen very often in men on TRT as the enzyme responsible for the conversion is stimulated by T. I have exactly the same labs pre and post initiation of TRT and my thyroid is fine.
You can’t make a comparison between pre and post varicocele on the basis of a single lab each and draw firm conclusions. Thyroid hormones vary widely.
I am not saying that your health problems are all in your head, by no means, but I think regarding your thyroid you a chasing a ghost.
Ft4 of 9 is low. You really need to trial some t4.
Kemosi
Rt3 is not as important as many seem to worry about. If you are on huge doses of t4 and have big rt3 figures that is obviously not a good place to be.
WHY is rt3 high is the bigger issue to solve. Often it is cortisol related.
The T3 protocol boys and girls will have you believe rt3 will disappear once you get on a high enough level of T3. I just don’t buy this from my own experience. I mean how many weeks do i need to feel crap as i ramp slowly from 55mcg to 90mcg T3. This was done in the summer of 2010 i think. I was in a terrible state.
The body is designed to work in balance and this is the aim and this applies to the whole system. I am sure testosterone usage will affect thyroid uptake and hence thyroid production. I am hoping to see this in my bloods as time goes on.
All hormone balancing is complicated. What works for you may not work for others. There are general treatments which work for most people, but you do get the extremes. The T3 only guys and girls represent the extremes.
Paul Robinson in the UK was ill for many many years taking T4 only. Eventually he worked out T3 was better for him. He did this via an understanding GP who supported his own small experiments and was collecting urine samples to measure cortisol production. He has an engineering background and so this helped him work logically through all the scenarios affecting his health.
Eventually he realised even a tiny bit of t4 added to his T3 crashed his adrenal system. So he has been on T3 for many years and regained full health. He developed the early morning T3 dosing routine and has written books about this. He does consultations on the net i think.
So is he a normal thyroid patient ? No way, he is on the extreme. He still hasn’t worked out why he gets this damging reaction to T4 but he feels it is cortisol related and maybe missing some enzymes at DNA level. His body just dumps cortisol with T4 in the system. I think T4 is more heavy on cortisol uptake than T3. I think NTH also gave him the same reaction because all this is is T4/T3 combined.
My advice for all thyroid patients is to TRY the easiest solutions first which work for the majority and then go for the alternatives. It is really very simple to do. Adding in and removing a hormone will give you very good clear data on what effects your body. It isn’t rocket science.
My waking temp is usually good, but i notice if i drop below 36.3C then this helps highlight all is not so good, but i never do temps anymore as i am no longer sub hypothyroid.
It is a rough diagnostic tool and not a gold standard. I find it amazing that someone would discount a doctor who has seen thousands of patients and noticed this specific issue pop up. I am sure he had many high temp patients who were ill, but generally the rule worked out ok.
This is the old med school approach, but in the last 10 yrs patients have been able to bang on this door and show they are deficient in thyroid hormone. Slowly sub optimal thyroid functioning is gaining more traction.
What country are you based in ??
In germany and Japan a TSH greater than 2.5 is treatable.
In this document they talk about what has changed in thyroid treatment in the last 10 yrs and was published in 2013. They are saying TSH needs to come down to 2.5.
In the UK you wouldn’t get looked at if TSH was under 10. In the last 20 yrs this has come down to 4.5 officially, but still the old ways stick around and many docs won’t help you with a TSH of 9, for example.
So with the greatest of respect what you are doing is perpetuating old and damaging protocols onto the general population. You are completely wrong about this topic and on a forum like this it should be highlighted.
If you need thyroid hormones you will react well pretty much straight away. The hit of the much needed T4 will change something in your system. What happens weeks after can be a bit more rocky as the body readjusts to new levels and they need tweaking over time. This is why a trial is the best way to go.
I wasn’t in any way talking about a valid TSH reference range. I was referencing to the values @anon8512651 posted. Keeping in mind the well described induction of T3 to T4 conversion by exogenous T there is no evidence that would point towards a diagnosis of subclinical hypothyroidism. fT3 is the active hormone and controls TSH release by the pituitary via a feedback mechanism.
Yes there is an ongoing discussion about the TSH reference range in particular. But the proposed limit of 2.5 is so far a recommendation by a single society on the basis of a new, more sensitive and specific TSH assay. If this limit was applied to the current standard TSH assay than about a quarter of the population would be considered hypothyroid. The basic idea of lowering the ref range is to identify subjects that will develop clinical hypothyroidism as early as possible. It doesn’t mean that these subjects are already hypothyroid when a single TSH value was higher than 2.5. TSH varies widely over time in a single subject.
No, the upper TSH reference range in Germany using the current standard assay is not 2.5. It’s around 4 depending on the assay used.
Subclinical hypothyroidism defined as TSH higher 5ish with fT3 and fT4 in range is associated in men with low T values. While the latest metaanalysis did not show any benefits in treating this condition with thyroid hormones, a experimental treatment in men with low T is indicated.
Let me put it another way, would you treat low testosterone based on LH/FSH solely? No, you would look at free testosterone and the metabolites of that and treat accordingly. So based on that logic, why are we using a (brain) peptide to treat thyroid disorders?
It’s also worth noting that TSH can be widely inaccurate in situations of adrenal failure and/or nervous system disorders.
Similarly, TSH can be thrown off with elevated rt3, which is the case for me.