Agreed !
Our situations sound very similar, my progesterone is naturally high. Do you have any insight into that? My theory is that in subclinical hypothyroidism, more progesterone is created to facilitate thyroid function.
Did you have ED/libido issues when this all started for you btw?
It’s actually scary how similar our situations are, my situation started 12-13 years ago and I have struggled with it for many years. My main symptoms have been cold intolerance, dry/pale skin (as you say), low (non-existent) libido, ED/sensitivity issues, weight gain around mid section, etc. I also had skin thinning, dandruff and a few other things pop up. The elevated progesterone hasn’t been fun, because it’s been castrating me slowly (effectively) by blocking DHT/E2 which were already low prior to TRT.
What were your labs like prior to thyroid treatment?
I found Ray Peats Progest E oil to be great and used 6mg per day. It really helped the thyroid work better in 2013 when i started on it.
It is funny how we are all similar, but we all have small differences. It just shows you how subtle the hormone system is.
So the one thing i have never had an issue with is erections and libido. Both have always been strong. Now i will admit libido has been lower at times because of feeling crappy and low energy, but generally it has been good. Now my dad started to get erection issues when he was in his late 40’s. He is 79 now and i don’t think it is an issue anymore.
Is low libido/erection problem connected to low oestrogen ? I think my oestrogen has always been mid range.
Before i started thyroid my bloods were:
Age 21 having problems, TSH = 2.4 and FT4 14
Age 36/7 just before i started self treatment, TSH 3.7 and Ft4 12.
I never had an FT3 done, apart from when on thyroid treatment.
Not sure about the progesterone. Do you have good hair then?
If you have higher progesterone, is the oestrogen to low ? I wonder if you could up the oestrogen somehow. I remember speaking to one guy from the UK a few yrs back and his issue was low oestrogen. It really was a killer for him. I think he ended up with some kidney or liver issues and this was the route of his problems.
How is your diet ? Could this be contributing to the issue ? My knowledge on food intake is not that good.
Even when you had issues, you still had higher ft4 than me! So for 100% you are right, my issue is rooted in crappy ft4 levels. Which explains why you still had a good libido and no ED issues, because your ft4 was noticeably higher than mine.
I strongly believe that once thyroid and testosterone is balanced, progesterone won’t be as high because it won’t be required any more. The reason it’s high is due to struggling thyroid (my theory) and will probably come back down once everything is back in check.
@marsaday and @johann77
I really want to hear what you’ll say for my case because @marsaday literally just stopped me from going T3 only route.
Ok so this is what i want to ask you… I actually have 5 different RT3 lab results as below ;
June 132.0 pg/mL
July 205.7 pg/ml
September 160.0 pg/ml
October 167.0 pg/ml
November 139 pg/ml
Range 90 - 215
With all these thyroid tests my average FT3 is 2.94 pg/ml (2.04-4.40 pg/mL). My T3 is always below the range. My T4 is always low or barely in range.
Below is my latest results from October ;
T4 - 5.93 ug/dL 5.13-14.1 ug/dL
Free T4 - 1.25 ng/dL 0.93-1.71 ng/dL
T3 - *72 ng/dL 83-200 ng/dL
Free T3 - 3.11 pg/mL 2.04-4.40 pg/mL
TSH - 1.18 uIU/mL 0.27-4.20 uIU/mL
TPO - < 9 IU/mL < 34 IU/mL
Anti-Thyroglobulin ANTIBODY - <10 IU/mL < 115 IU/mL
3 questions :
- How come my RT3 show marginally different values every month ?
- Since i have high RT3 despite so having so little/below the range T4 , does that mean if i’ve had higher T4 i would have extremely high RT3?
- My TSH was always above 2.8 pre-TRT but after TRT somehow my TSH is close to 1.1 now yet no big change on my thyroid levels… Why is that?
Your ft4 is actually at a good level. Anything above 15.2 pmol/L is good, and you are at 16.0900. Based on the research I have done the standard is around 15 (worldwide based on data), so you are definitely not “low”.
What symptoms are you experiencing?
Your Free T3 is low though, and could be more optimal for you to feel a lot better. I can understand why looking into T3 would be an option.
1.25 ng/dL is the highest my FT4 has been… Usually it is around 1.12-1.16.
Wasn’t aware it was a good level. Well i guess it’s good despite having so little T4.
And i wonder what would my RT3 be with higher T4. This is why hesitate to go T4 only or NDT.
My T3 is also always below the range and my T4 is very low.
Well first off i can’t seem to benefit fully from TRT… I still have fatigue , still feel tired despite sleeping 8-9 hours and lazy to get out from bed… Dry skin , thinning hair , mood issues… I can go on… TRT decreased these symptoms to a degree but i am no where close to feeling well and energized.
Did you ever get TBG tested? Looks like partial TBG deficiency.
Did you get a thyroid scan?
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Thanks @johann77 for sharing that info about thyroid.
I have a question, to make sure I’m understanding this statement correctly -
“Thyroid gland disorders are associated with alterations in sex steroid metabolism. Early studies observed that hypothyroidism was associated with an increased metabolic clearance rate of T and E2”
On most of my early on in TRT blood tests (while on 120-140mg a week) my TT levels were between 590-620ish.
Upon further investigation, we found out I was hypothyroid and my Dr prescribed 90mg Armour Thyroid.
Fast forward - I hadn’t changed my dose (maybe small variations due to over draw) and had a blood test over the summer, about 5 months after starting the Armour Thyroid and my TT jumped from the 590-620 range up to 1192.
I was perplexed as to how my numbers jumped so much, but if I’m reading that statement correctly, does that mean as I’ve improved my thyroid, I’m not clearing the testosterone and estrogen from my system as fast as I was before taking Armour?
Any info is appreciated.
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Do you have SHBG levels of both periods, before and during thyroid hormone substitution?
The range in the UK is 10-24 for FT4. So 14 and 12 is close to the bottom.
@johann77 - Before thyroid meds, my SHBG ranged between 31-38. My most recent blood work after 5 months on Armour has my SHBG at 27.
I thought insulin had a direct impact on SHBG. Less insulin = more SHBG and vice versa.
When I had higher SHBG, I was intermittent fasting. When I had lower SHBG, I wasn’t intermittent fasting and just thought my higher SHBG was a result of fasting.
Do thyroid meds also have an impact on SHBG?
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RT3 and TSH do bounce around a fair bit. Ft4 is usually more steady. Ft3 can fluctuate and is probably corresponded to RT3 a fair bit.
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You don’t have high RT3, you are in range on every reading. Why are people fixated on RT3. It is not that relevant. Only if you are well over range may you need to take it into account.
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Testosterone is supposed to improve conversion. If this happens you will see FT3 staying the same, but FT4 will be used up a lot more (greater conversion and use of the T4).
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Looking at your bloods the one thing which jumps out is Total T4 and Total T3. They are very low. Free T4 is ok’ish, as is Ft3.
Again i would be looking to trial some T4 first and then see how you feel get on for 4 weeks. T4 all the way for me. Do this first before trying the T3
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General question @marsaday - I inject 42mg EOD and was taking 90mg armour. These numbers are me on 90mg armour thyroid. What would you make of them?
I wasn’t feeling the relief I expected, maybe a little more energy, so we upped my dose to 150mg a day. I feel more energy for sure, but curious your thoughts.
90mcg armour = 1 1/2 grains = 54mcg T4 and 13.5mcg T3
150mcg armour = 2 1/2 grains = 90mcg T4 and 22.5mcg T3
On any NTH FT4 is always low to mid range, very rarley will it be high in range.
Ft3 is usually higher in range.
So your Ft4 is fairy typical, but Ft3 could be higher.
If you feel more energy on the higher dose great. However, you must wait 4-6 weeks on this dose to really access how it is working out. It is very common for thyroid increases to work really good for a week or two and then it cancels out a little. It can be 3 steps forwards, 2 steps back until you get to the correct level.
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Thank you. I’m coming up on 4 weeks on my increased dose. I was planning on getting new bloods a week from Wednesday to see where I am. Maybe I’ll push it out to December.
If you are at 4 weeks this is usually enough time to retest. You still feel good so this is a good sign.
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