T Nation

25 Year Old - Should I Jump Fully Into TRT or Try Thyroid First?

Has anyone treated their low T from using thyroid, DHEA? I just had my consult with Defy & the Dr. wants to put me on DHEA, dessicated thyroid (as well as TRT). I’m hesitant to jump into the TRT @ 25 but I think im going to do it. (Protocol is 80mg 2x/week & 500IU HCG w/ shots) . Just didn’t know if fixing my thyroid would fix this - my TSH has always been good but Free T3 low. FWIW been trying to raise test for 2.5 years - tried clomid & came off only to come back about 100 pts higher on my test than before with the same free. I have always had very high SHBG. My T levels (multiple blood tests) off clomid are basically between 270-330 with free being below the range.

October( off clomid, out of gym for 7 months & stressed highly because of it):
Total T 322 NG/DL 270-1070
SHBG 57.6 NMOL/L 17.3-65.8
Free T 41.3 PG/ML 48.2-169.6
Bio T 114 NG/DL 113.1-397.7
Estradiol 23.8 PG/ML 0.0-39.8
LH 3.8 mIU/ML 1.5-9.3
FSH 1.1 mIU/ML 1.4-18.1

November (1 month on 25mg eod clomid):
Albumin 4.8 ng/dl 3.5-5
Total T 938 ng/dl 270-1070
SHBG 78.9 NMOL/L 17.3-65.8
Free T 113.5 PG/ML 48.2-169.6
Bio T 295.5 NG/DL 113.1-397.7
LH 3.7 miU/ML
Estradiol 26.2 PG/ML 0.0-39.8

Main thyroid problems I had were always extreme sensitivity to the cold, constipation, easy fat gain & lowered metabolic rate. Recently, I had development of myofascial trigger points that took me out of the gym for 7 months & still somewhat affect me.
|TSH, High Sensitivity|2.095 uIU/ML|.35-5.5 |
|Free T3|237.5 PG/DL|230-420 |
|Free T4|1.14 Ng/dl|.80-1.8|
Antibodies all negative

Clomid raises me to 900-1300 but w/ high SHBG. I do feel better on clomid(morning wood 95% of the time), but its fleeting at times in terms of libido & mood. I have been having some vision issues when transitioning to different lights & after exertion(exercise). Additionally, my muscle recovery & level of pain are not at levels that I want them to do be at. I suffered from chronic muscle pain & tore a bicep. I’ve always had a hard time putting on muscle & I look like I don’t lift despite being highly educated in bodybuilding science. I’m not overweight as im 6’0 160 lbs - been trying everything under the sun the past 2.5 years. Initial tests of hormones revealed a 330 testosterone level (w/ free being below range) during a period of no stress (summer) and everything optimized.

Doc gave me the option of going all in with everything or trying the conservative approach with the thyroid, DHEA & stinging nettle root. I have ordered the entire treatment but don’t know what I should do! I’m tempted to come off the clomid & see if the thyroid/dhea/stinging nettle correct my low T.

TRT - 80mg E3.5D
HCG - 500IU w/ TRT
DHEA - 40mg/night
Stinging nettle - 500 mg/day
Dessicated thyroid - .5 grain for 1.5 weeks - work up to find sweet spot

Any inputs appreciated. I’m honestly 50/50 on what to do!

Didn’t know if anyone corrected hypothyroid and its impact on their low T!

It is confusing. Your numbers look good on clomid just no e2 numbers which is critical.

Eye issues are serious on clomid. You can lower dose further. May do just as good without eye issues.

When you introduce to much at once very hard to monitor what is helping and causing problems. First decide if going off clomid. Then stabilize/fix the thyroid. Then restest labs before considering trt. Imo.
Also lh stayed the same which is strange on clomid. It can vary greatly though during the day.

Edited! I just forgot to post it. Clomid barely raised my E2 (& LH). So I don’t know the issue. I might just stop the clomid when I get the thyroid/dhea/stinging nettle. The other issue with clomid is it raises my already high SHBG even higher + high liver values.

I really would not even take dhea without dhea-s lab. I would just work on thyroid.

I have a DHEA-S lab.

191.7 ug/dl range - 164.3-530.5 - Dr. said I should be up near 500.

The Dr. basically gave me the option of the conservative (everything but T+HCG) approach or the all-in approach & i’m conflicted. I ordered everything & it gets in on Thursday.

With shbg high You would need large weekly doses. Again thyroid affects almost everything. Shbg is made in liver. Once thyroid is right. Recheck all labs.

TRT actually lowers SHBG…

I edited my post. Also
The researchers believe that hypothyroidism is a cause of low levels of DHEA. Thyroid hormones may control the production of steroid hormones from the adrenal glands. … However, many of the symptoms of hypothyroidism may be a result of the low DHEA levels, including depression, muscle weakness and fatigue. From https://www.livestrong.com/article/540018-low-dhea-hypothyroidism/

Another thinkg. When I was on clomid my thyroid slowed down too. Not sure why. I am doing my labs in a couple of weeks. Been on injections since 12/18.

My thyroid is always in the range its in. I’ve had it tested a lot the past 3 years & TSH is always between 1-2.5 & Free T3 always either below range or low but within!

The other thing is that normally being hypothyroid LOWERS SHBG & correcting it will raise SHBG - which would result in less free T in my case (especially off clomid)

It so complicated. Some days my basal body temp get to 98,6 others 98.0. Some days my hand feel cold some not. Maybe it’s the trt ups and downs

May 2016 I posted this in your first thread:
“Try the thyroid med and track body temperatures and how you feel. If body temperatures do not improve, or how you feel, that can be from rT3 effects.”

These are true:

  • Low thyroid function can lower sex hormones via lower LH/FSH.
  • Restoring thyroid levels can improve LH/FSH but often not sufficient.

If you are iodine deficient you should be avoiding a life time of thyroid meds from your doctor not understanding the role of iodine.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

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.

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I never ended up taking that medication but did take morning temps & use iodized salt + iodine from luogols. Didn’t do much. My morning temps are low (96-97) & have been for a very long time (I would estimate since sophomore year of college). I lost 80 pounds in 1 year & i haven’t been the same since regarding cold tolerance & metabolism - only worsening a little each year. I am starting on the dessicated thyroid tomorrow! Don’t know how much fixing the thyroid will/if it will cure my low T.

I am of the mind that, especially at a young age, TRT is a last resort. It is a big, BIG commitment and frankly it’s kind of a pain in the ass.


Hence why i’ve spent years & lots of $$ trying clomid, natural methods, diet changes, iodine. The only thing I haven’t tried is thyroid meds which i’ll get on now - I jsut don’t know if that will be enough improvement. Also - if it raises my SHBG - it will make it even harder for my testosterone.

Morning temp was 95.5 this AM - did 50mg iodine yesterday… WOW

Has anyone fixed their testosterone issues by improving thyroid?!

I don’t think you understand what is it play here, if you are hypothyroid and you start thyroid treatment your already high SHBG will become even higher, it won’t matter how much TT you have, it will never be enough.

My thyroid was/has always been perfect, when I was in low T land I also has sensitivity to cold weather that has more to do with blood circulation, testosterone affects the cardiovascular system.

When you’re low testosterone your circulatory system is subpar so blood supply is limited, that’s why your heart rates are increase, therefore you feel cold. The body is fighting to supply blood throughout your body.

Speaking of cold, everytime I lower my testosterone dose the sensitivity to cold returns for about a week, but never happens on a dosage increase as it makes me very hot. Clomid is a waste of time for high SHBG guys.

I do understand that about the thyroid treatment driving up SHBG. I’m just doing my due diligence & seeing if anyone has successfully treated thyroid/DHEA & fixed testosterone problems. I’m just apprehensive to jump into TRT for the rest of my life @ 25. I realize clomid isn’t a solution for me, hence why I stopped & sought out another Dr. & have paid a lot of money to ensure i have all the proper labs & saw a Dr. @ Defy who knows what hes talking about.

However - regarding the heart rate stuff - I have a very LOW heart rate - not high as you do.

Also tough how I don’t have all of the depression, fatigue & all that. Just mainly sexual, self-confidence, indecisiveness, chronic pain (trigger points) & inability to build muscle.