23, Low Free T, Possible Thyroid Issue

Pharma / TRT Testosterone Replacement
1

Hi guys, I’m new to the forums. I have low free T and have seen a couple of docs, but haven’t started TRT yet. I read the stickies.

age : 23
height : 6 ft tall / 183cm
waist : 31.9 inches / 81cm
weight : 153 lbs / 70kg

HAIR
I display a decent beard, but it’s not very dense. I have very little hair on my upper body, but much more on my legs

WHERE I CARRY FAT
I carry some fat around my hips and lower belly, but I’m still rather slim overall.

SYMPTOMS / HEALTH CONDITION
Was diagnosed with depression 3 years ago, but low mood, apathy, social anxiety and social withdrawal have been ongoing problems since childhood. I have a hard time concentrating on anything, and my short term memory is bad. I feel sluggish, mentally slow and I sleep 10-12 hours a day whenever I can as I feel tired on a daily basis. When I talk to someone or try to listen to a professor giving a lecture, I donâ??t seem to absorb the information and can’t focus.

I’ve had troubles maintaining erections ever since I was around 17 or so.

To top it off I also feel physically weak.

HISTORY OF MEDICATIONS & OTC DRUGS
I’ve taken antidepressants - citalopram, Cymbalta, Wellbutrin, moclobemide ,Valdoxan, and Marsilid, an irreversible MAOI. I’ve also taken Abilify & Solian (atypical antipsychotics) at low doses. I’ve swallowed all of these within a period of 2 years, not spending more than 2-4 months on any given med. I haven’t taken psychiatric meds for a year now, but my penis still feels numb, as if it was some residual side effect from the antidepressants.

I’ve also taken Armour Thyroid for 2 months (60mg for one month, 120mg for the next month) to see if it helped with my depression, although I was not clinically diagnosed with hypothyroidism. It initially improved my mood, but then the latter went back to baseline after a week and I developed an even harder time focusing on various tasks in general, and my erectile dysfunction got worse. I quit taking the med 6 months ago, but my cognitive and erectile abilities still aren’t back to where they were - and these were bad to begin with! - which worries me enormously. The thyroid labs are shown below.

I am currently on DHEA(100mg) & pregnenolone(200mg) every day, and it’s been 4 months. I also take a cheap multivitamin, some magnesium, vitamin D (5000 IU) and omega 3.

DIET
Some variation of the paleo diet. I mostly eat fish, meat, eggs, green veggies, rice, potatoes & sweet potatoes. No starvation diet or anything of the sort. I do not restrict salt.

TRAINING
I barely train. I walk every day, and occasionally workout with bodyweight exercises (twice a week at most). Back when I used to go to the gym 3 years ago, my recovery time was awfully long and my lack of drive caused me to give up.

MORNING WOOD
I’ve never had morning wood, even as a teen.

TEMPERATURE
After waking up: 96.6
Afternoon: 97.7

These temperatures were taken orally. According to the sticky there’s a problem.

LAB RESULTS

Thyroid hormones 26/03/2014 (before taking Armour Thyroid hormones)
TSH 2.42 (0.3 - 5.6)
fT3 2.90 (2.5 - 3.90)
fT4 7.9 (6.1 - 11.2)

Thyroid hormones 27/11/2014 (5 months after quitting Armour)
TSH 1.78 (0.3 - 5.6)
fT3 3.29 (2.5 - 3.90)
fT4 8.4 (6.1 - 11.2)

Testosterone and other hormones 25/07/2014 (2 weeks after quitting Armour)
Free T 6.4 (8.9 - 42.5) pg/ml
Bioavailable T 1.05 (1.00 - 3.70)
Total T 453 (300 - 1100)
FSH 1.2 (1.5 - 15)
LH 3.4 (1 - 9)
Estradiol 24 (< 20 - 48)
Cortisol (8AM) 12.6 (6.7 - 22.6)
Cortisol (4PM) 7.7 (7 - 17)
Free Cortisol (24h) 25 (20 - 50)
ACTH 18.6 (5 - 60)
DHT 0.26 (0.33 - 1.20)
Pregnenolone sulfate 23 (40 - 120)
DHEA-S 1766 (2110 - 4920)

Testosterone and other hormones 27/11/2014
Bioavailable T 1.14 (1.00 - 3.70)
Total T 486 (175 - 780)
FSH 1.4 (1.5 - 15)
LH 3.7 (1 - 9)
Estradiol 32 (< 20 - 48)
DHT 0.32 (0.33 - 1.20)
DHEA-S 2090 (2110 - 4920)
PSA 0.42 (< 4)
Prolactine 7 (2.6 - 13.1)

As you can see, my total T isn’t as much of a problem as my Free or bioavailable T.

MRI scan in November 2014 revealed no tumor, but my pituitary gland apparently displays a slightly convex shape from the frontal view. According to my last endocrinologist it means it’s under-active.

He wanted to start me on 125mg T enanthate per month all in one injection, which is moronic. He also told me monitoring estradiol was useless during TRT, so I nexted the idiot.

I’ve been seeing another doc, an anti-aging specialist. He’s the one who put me on DHEA and Pregnenolone 4 months ago in the hopes that it would boost my T, since I’m deficient in both Preg’ & DHEA. I’m seeing him again in February, and if my Free T hasn’t augmented he wants to put me on testosterone. He seems to be a fan of gels instead of injections, idk if he’d allow me to self-inject twice a week. He also seems to dislike HCG but maybe there’s some room for a bit of convincing…

While the stickies on this forum mention that T injections are the way to go, I’ve heard the internet-famous Dr Crisler prefers to start with Androgel. If there are no absorption issues with my skin, I’d be better off going for the gels, wouldn’t I?

I’m ready to hear any advice you guys have to give vis-a-vis my situation. Here are a couple questions:

If my Free T is low but my Total T normal, does that mean I’m going to have to take a big amount of T to compensate for the SHBG and actually feel the effects of T?

If my tendency to be apathetic and socially withdrawn dates back to my childhood, would that mean that these symptoms aren’t linked to testosterone?

Do you think I screwed myself up completely by trying out thyroid hormones for 2 months (I think I went for too high of a dose)? I’m desperate to achieve better mental clarity, I literally feel like an 80 year old in body and mind.

Thanks!

1 Like
2

Nice post.

I wouldn’t worry much about your previous use of thyroid medications. Unlike the adrenals/testes etc, your thyroid actually doesn’t shut off. Many people use T3 to clear RT3 and then cycle down and have positive results. The thyroid is very resilient.

You should have your SHBG levels checked. Wondering if everything is being bound, I am having similar issues, my SHBG is thorugh the roof but, all my other levels look decent(except FT).

Your adrenals seem to be ok, but with your morning temps def. a thyroid issue going on. I would be more keen on trying T3 instead of any type of TRT program (at least at first to rule that out).

3

Have you been using iodized salt forever or?

You are very estrogen dominant at last labs. So TRT may require anastrozole.

Your E2=32 might be from DHEA as some guys seem to freely convert to E2. Suggest 25 or 50mg DHEA.

Can you post cholesterol [might be low], CBC, hematocrit, AST, ALT ?

Have your testes been examined for vascular abnormalities?

You need to also be resolving your thyroid problems.

We often see that guys with hypothyroidism cannot absorb transdermal testosterone.

Androgel is very expensive. If you don’t have the cash, you need to inject.

You should get a sperm test. If you are not sterile, you will need hCG with your TRT to preserver fertility.

You could try 12.5mg nolvadex and test LH/FSH, TT, FT and E2 after 4 weeks. This will tell us a lot about your HPTA. If levels are good, you could try an HPTA restart and if that fails, try hCG monotherapy. Otherwise you will need T+AI+hCG.

4

[quote]KSman wrote:
Have you been using iodized salt forever or?

You are very estrogen dominant at last labs. So TRT may require anastrozole.

Your E2=32 might be from DHEA as some guys seem to freely convert to E2. Suggest 25 or 50mg DHEA.

Can you post cholesterol [might be low], CBC, hematocrit, AST, ALT ?

Have your testes been examined for vascular abnormalities?

You need to also be resolving your thyroid problems.

We often see that guys with hypothyroidism cannot absorb transdermal testosterone.

Androgel is very expensive. If you don’t have the cash, you need to inject.

You should get a sperm test. If you are not sterile, you will need hCG with your TRT to preserver fertility.

You could try 12.5mg nolvadex and test LH/FSH, TT, FT and E2 after 4 weeks. This will tell us a lot about your HPTA. If levels are good, you could try an HPTA restart and if that fails, try hCG monotherapy. Otherwise you will need T+AI+hCG.[/quote]
Thank you for your observations.

The salt I’ve used is regular sea salt; so it’s low in iodine if I remember your sticky. I will buy some iodine and proceed to an IR to see if it boosts my temperature, I’ve got nothing to lose.

In my next lab measurements, in less than a month, it’ll be clear whether DHEA is boosting my E2 or not. I’ll stop taking it at that moment, or reduce the dose.

I don’t have any recent cholesterol, CBC, hematocrit, ALS, ALT measurements. The last time they got checked was 2 years ago, and everything came back normal.

My testes have never been examined to see if there was an abnormality.

What would the nolvadex tell us exactly? btw I forgot to mention it in my first post, but I did a GnRH/LHRH stimulation test: they measure LH & FSH, inject an amp of GnRH and then remeasure my LH & FSH at frequent intervals over 90 minutes.

My FSH went from 1.2 to 1.9 (1.5 - 12.4)

and my LH went from 2.6 to 14.8 (1.7 - 8.6)

5

[quote]MUthrows94 wrote:
Nice post.

I wouldn’t worry much about your previous use of thyroid medications. Unlike the adrenals/testes etc, your thyroid actually doesn’t shut off. Many people use T3 to clear RT3 and then cycle down and have positive results. The thyroid is very resilient.

You should have your SHBG levels checked. Wondering if everything is being bound, I am having similar issues, my SHBG is thorugh the roof but, all my other levels look decent(except FT).

Your adrenals seem to be ok, but with your morning temps def. a thyroid issue going on. I would be more keen on trying T3 instead of any type of TRT program (at least at first to rule that out).
[/quote]
I’ll check my SHBG on my next blood analysis. Perhaps also rT3 to see where I stand.

I’m wary of getting on thyroid hormones again, since the last time I took these, my state worsened and I have yet to recover although I discontinued 6 months ago. It wasn’t pure T3 though, Armour is a mix of 80% T4, 20% T3.

6

I bought some Iodoral on Amazon, been taking 50mg/day for 2 weeks now. My IR is pretty much complete.

I had a metallic taste in my mouth the first couple days, like the sticky warned.

My temperature readings haven’t improved, I never get above 98 during the day.

Nonetheless, I’ve been feeling a slight sense of well-being during the last couple days. Could be a placebo effect, or maybe the iodine is doing some good. I’ll have to wait it out and see if the effects are prolonged.

My ability to focus and process things intellectually is still very much less-than-optimal.

7

[quote]KSman wrote:
Your E2=32 might be from DHEA as some guys seem to freely convert to E2. Suggest 25 or 50mg DHEA.

Can you post cholesterol [might be low], CBC, hematocrit, AST, ALT ?

You could try 12.5mg nolvadex and test LH/FSH, TT, FT and E2 after 4 weeks. This will tell us a lot about your HPTA. If levels are good, you could try an HPTA restart and if that fails, try hCG monotherapy. Otherwise you will need T+AI+hCG.[/quote]

Here are my new labs. I don’t have cholesterol, but with all the bacon, eggs, and red meat that I’m eating, I’ll be damned if my cholesterol is low.

hematocrit 45.2 (40 - 54)
AST 22 (<50)
ALT 20 (<50)

Total Testosterone 487 (175 - 781)
Free T 11.5 (8.9 - 42.5)
FSH 1.2 (1.3 - 19.2)
LH 2.9 (1.2 - 8.6)
Estradiol 43 (<20 - 47)
DHEA sulfate 3550 (2110 - 4920)
DHT 0.41 (0.33 - 1.20)
Pregnenolone sulfate 73 (40 - 120)
PSA 0.30 (<4)

To sum up, after these couple months of DHEA & Pregnenolone supplementation, my free T has increased and is now barely in the normal range, while my estradiol is getting to the top of the normal range.

I cannot get my hands on Nolvadex, since no doc would give it to me, and I’d prefer to avoid buying meds off the internet to do some bro-science.

Concerning my thyroid, my temperature readings aren’t bad lately: I’m reaching 98.24 in the afternoon.

Should my doc still prescribe me TRT with these free T readings? They still look low to me, although technically in the normal range.

8

I thing that your DHEA is driving E2 too high. Stop for 3-4 days then take half that or even less. High E2 is reducing LH/FSH and T levels.

9

[quote]KSman wrote:
I thing that your DHEA is driving E2 too high. Stop for 3-4 days then take half that or even less. High E2 is reducing LH/FSH and T levels.[/quote]
Yes, I’ve stopped taking the DHEA. Back when my estradiol was 24 in my first labs, my LH & FSH were still low though.

Do you think I should hop on TRT based on the labs so far?

10

You could try 12.5mg nolvadex and test LH/FSH, TT, FT and E2 after 4 weeks. This will tell us a lot about your HPTA. If levels are good, you could try an HPTA restart and if that fails, try hCG monotherapy. Otherwise you will need T+AI+hCG.

I did a GnRH/LHRH stimulation test: they measure LH & FSH, inject an amp of GnRH and then remeasure my LH & FSH at frequent intervals over 90 minutes.

My FSH went from 1.2 to 1.9 (1.5 - 12.4)

and my LH went from 2.6 to 14.8 (1.7 - 8.6)

At your age, try the HPTA restart. With the years ahead of you, jumping on TRT without first trying the restart does not make sense. At your age, hCG monotherapy might be possible as well as your TRT. With your low body temps [thyroid], you might not absorb transdermal TRT. Please read the stickies again so you are well informed.

11

I got my thyroid tested again, including rT3, to understand if it could explain low body temps and sluggish cognitive function. I had completed the Iodine Replenishment more than 2 months ago.

TSH 0.95 (0.34 - 5.6)
FT4 8.8 (6.1 - 11.2)
FT3 3.26 ng/L (2.5 - 3.9) or 5 pmol/L
rT3 0.26 ug/L (0.09 - 0.35) or 0.40 nmol/L

According to stopthethyroidmadness FT3/rT3 ratio calculator, I have a ratio of 12.5, while the optimal ratio is 20+.

I guess it could mean my symptoms are hypothyroid symptoms, induced by the rT3? Can someone knowledgeable about the thyroid jump in and help me out?