Thank you for your very detailed reply, KSMan. Below are my responses to your questions/requests.
"Do you and your family have a history of not using iodized salt? What is your history of that?"
My parents/grandparents grew up in and immigrated from a very poor, mountainous country with a known population-wide issue of goiter/iodine deficiency/thyroid issues. I was born here in the US though, and have lived here all my life. We have always used Morton Iodized Salt when cooking since I can remember (that iconic illustration of the girl with an umbrella is tough to forget), and have never shied away from using salt in general in our meals.
"fT3 is really what should be tested, it is what gets the job done"
I will request this test from my GP today.
"fT4 is above mid-range. Is range above correct?"
Yes, the range is correct...the test was performed by the University Of Washington Medical Center if that's of any use. All of my doctors are under the UW umbrella.
The UW standard range for fT4 is listed as 0.6 - 1.2 ng/dL, and I tested at 1.2ng / dL.
"Please read these stickies:
- advice for new guys
- things that damage your hormones
- protocol for injections
- finding a TRT doc "
"You need these labs:
fasting cholesterol [might be too low]"
I will request these labs from my GP today. My first testosterone injection is scheduled for Wednesday at 8am - most likely I won't get the lab orders for these tests approved until Wednesday (my GP is usually a 1-1.5 Business Day turnaround for my requests). Will the injection interfere with the usefulness of the data from these tests?
"drink water, don't be dehydrated"
I currently drink a minimum of 1 gallon of pure water every day. On warmer days, I take it up to 1.5 gallons. I don't drink any sodas (regular OR diet), and drink 3-4 cups of coffee with heavy cream a day.
"Also read the 'hormones and health' thread."
"Your starvation diets are wrong and elevated rT3 can be a result as well as epigenetic changes."
I should have elaborated on my current diet in my original post. I eat pretty much the same things every day (I don't get bored of food, and the Wellbutrin has seriously reduced the "reward" aspect of the food that I do eat). I track every single thing that goes into my mouth religiously on Myfitnesspal, and have been doing so since July 17th. Below is my usual day of eating.
2 oz roasted salted almonds (Blue Diamond Brand)
2 sticks Trader Joe's full-fat string cheese
2 cups of coffee with 4 tablespoons of heavy cream (no sweetener, always hated sweets)
*1 cup of coffee with 2 tablespoons of heavy cream
*Jimmy John's Big John Unwich with Provolone, Mayo, Onions, Lettuce, Dijon, Tomato, Oregano (I have this maybe 2x a week maximum - eating during the day makes me extremely tired, and I am currently working with my sleep doctor to totally eliminate naps to rationalize my sleep schedule and figure out if my continued exhaustion is a circadian rhythm problem, or something else entirely. No naps for the past 2 weeks, so been successful so far, but extremely tired and I usually can't risk eating because the urge to sleep/inability to be productive afterwards is so powerful).
*1 cup of coffee with 2 tablespoons heavy cream
*3 4oz servings of Chipotle Chicken OR Steak
*Extra large serving of Chipotle lettuce
*8-12 oz of Chipotle Pico De Gallo (Tomatoes + Onions + Cilantro)
*8 oz of Chipotle Guacamole (Avocado + Onions + Salt)
*EITHER 8 oz of Chipotle Sour Cream OR 6 oz of Ken's Creamy Caesar Dressing
My total calories per day hover in the ~2500-3000 range. The lowest it gets is usually 2300, and that's if I don't eat almonds / cheese or switch from the caesar dressing to sour cream, etc.
My net carbs per day hover in the 20-40g range, depending again on almond intake, gucamole intake, sour cream vs caesar dressing, etc.
My total protein per day hovers in the 140-170g range.
My total fat per day is almost always 200g+.
The exercise that I do (50-60 mins on the elliptical 5x a week) burns anywhere from 750 calories to 900 calories per session according to the machine (it asks for my weight and age, I assume it has some sort of algorithm that adjusts its estimates of calories burned based on that information). The variation in calories burned is due to variations in the length of my sessions + variations in resistance levels that I set the machine at.
Regarding my GP (he's the one running the TRT show for me), he seems receptive to alternative viewpoints, new information, etc. (he hasn't fought me in the least on all the tests I requested after the low total testosterone result). However, when I met with him last week, I mentioned Arimidex and doing injections at 100 mg/week instead of 200mg/every two weeks, and he resisted pretty strongly. I wasn't confident enough to challenge him then (and frankly was happy just to have someone willing to do injections) - do you have any tips on how to overcome his objections? Below is a summary of what he said to me.
*"We will necrotize your fat tissue and cause an abscess if we inject any more often than 1x every 2 weeks"
*"I only inject in the buttocks" (This is after I asked if we could do thigh injections)
*Why do you need that? We don't want to close that pathway (???? Lol)
*Of course your Estrogen will rise when we inject testosterone, that's to be expected (when I asked about the potential of feeling even worse than before with a post-T injection spike in E...mind you this is all before I got back my Estradiol test results)
*Well, what we'll do is inject every two weeks until your weight gets down to around 280, and then we'll take you off it and see how you do (When I asked what the plans for treatment were moving forwards, how we'll tweak stuff, regularly scheduled labs, etc.)
OK, I think I've bombarded you with enough information and questions for now. Again, I am truly very thankful for the time that you've put into helping me with all this. Time to request these labs and re-read the stickies you mentioned!