T Nation

32 Y/O Female. Low T3/Test?

Hi all,

Posting on behalf of my 32 year old fiance. She went to Defy over some concerns of irregular periods and to do some deeper digging. She was diagnosed with hypothyroidism, with low T3 specifically. The doctor mentioned that it is a result from an abnormality in the pituitary gland, which prevents it from making enough TSH to stimulate the thyroid.

He prescribed armor thyroid

He also mentioned she has low T at 1.2 and the doctor mentioned most women feel good at 3.0-5.0.

Does that seem correct? I can read mens lab work well, but struggling to confirm her results.

Testosterone, Serum 33 ng/dL 8-48
Free Testosterone(Direct) 1.2 pg/mL 0.0-4.2
T4,Free(Direct) 1.04 ng/dL 0.82-1.77
DHEA-Sulfate 209.0 ug/dL 84.8-378.0
TSH 1.160 uIU/mL 0.450-4.500
FSH 3.5 mIU/mL Luteal phase 1.7 - 7.7
Estradiol 179.0 pg/mL. Luteal phase 43.8 - 211.0
Insulin-Like Growth Factor I 251 ng/mL 84-281
Vitamin D, 25-Hydroxy 38.9 ng/mL 30.0-100.0
Progesterone 12.4 ng/mL Luteal phase 1.8 - 23.9
Thyroid Peroxidase (TPO) Ab <9 IU/mL 0-34
Triiodothyronine (T3), Free 2.9 pg/mL 2.0-4.4

Without writing a novel here, do you know if her Dr. would run a reverse T3 check? Reverse T3 looks like free T3, but the body cannot receive the correct signal, so the TSH stays a bit high, but nothing really gets done. Anyone that has compromised Thyroid usually has Testosterone issues. For ex:. Men with Thyroid issues (low T3) that use Test cream continue to have low Test numbers and usually start having E2 issues.

I am sure they would be open to it. My hope was just too get some extra eyes on the labs and confirm what she was told.

I will ask about it

Defy is pretty good at treating thyroid problems, depending on the doctor of coarse. Dr. Saya is very knowledgeable in both thyroid and low-T issues. Defy is one that is good at treating women hormonal problems.

There aren’t many places a women can go to for testosterone related problems, your options are limited. If you were to go to a regular healthcare provider, it’s not going to happen as you have probably already found out.

But do the values look low to you or warrant replacement therapy? I’m wary they’re pushing treatment on her. I go to defy for my trt, but I also know what I’m looking for. I was surprised that based on these levels they offered both try and thyroid meds. Really just looking to hear this forums insight. I generally trust them, but never can be too cautious

Nothing in these labs indicates treatment for anything. Is this what he made the diagnoses on?

Yes these were all ordered by defy and interpreted by defy

Would you describe her periods and any other symptoms for which she felt deeper digging was necessary?

She would spot for like a week before periods. Birth control pills changed her cycle a lot and she was concerned when it didn’t switch back after cessation.

I think she has reason to check but it’s hard for me to say if it was actually justified.

Oral contraceptives are the most common reason for younger women to spot between periods. How long was she on bc pills and how long has it been since she discontinued? Any other symptoms? Pain, etc.

Here is an important question: how is her libido? Sometimes, just mornings, just night time, not right now, I’m tired, or we’ve only got ten minutes, take me now! ?

Her libido is pretty bad. Not a ton of interest in the last six months

I am still doing some research here: Women are like Men in one sense; Testosterone drives arousal. It is not always just the level of Testosterone, it is the ratio of Testosterone to Estradiol. For example, even if a man has a “high” T level, if he also has a high “E2” level, arousal can be compromised. GTG. got to go right now.

So, she started testosterone, right? She has low free testosterone and reported poor libido, definitely not healthy for a 32 y/o fiancé.

Plus, thyroid will increase SHBG, which will decrease free test further. She’ll need to run the total pretty high to get a decent free T level.

Technically her ratio of free testosterone to total is 0.03xx, that is quite good, the low libido, spotting etc., is her Estradiol ratio to Testosterone is too high. How do you fix that a little at a time to not blow past the “happy spot”?
Her TSH and T3 are fairly balanced, but the real deal is “ranges” given for all of the tests she has had are based on thousands of peoples’ averages. The real question is what is normal for her specifically? Do you have any older testing results to compare the current numbers to? Resveratrol is a great aromitase inhibitor (stops conversion of Testosterone to Estradiol) leaving more T free. There are stronger AI’s but I cannot recommend them in open forums. They are commonly known as “research chemicals” and you will have to do your own research on them.

Technically, yes, but she has symptoms of low testosterone, and free testosterone will decline with thyroid treatment as SHBG elevates. I’d think about tripling her free test. As for her estradiol levels, those can, and usually do, change dramatically throughout the cycle.

Besides, higher estrogen levels promote vaginal lubrication and sexual desire. It’s thought that since testosterone enhances estrogen, that is the mechanism increasing libido, as much as the testosterone itself.

I’d be very surprised if her doctor did not give her testosterone with her Armour thyroid. She definitely does not need to block estradiol.

Estrogen does provide lubrication and arousal just like Google says. I am specifically talking Estradiol, not Estrogen.

Me too, estradiol is an estrogen, the most active form with the most benefits. I used them interchangeably. I don’t know about Google, but my guess is whatever you read was written for the general lay public and estrogen was used instead of estradiol.

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Actually I was being a smart ass, your earlier response was word for word Google, although I doubt you were copying Google for your answer.
I do not interchange estrogen for estradiol, my experiences appear to be different from yours at some level. When it comes to Men’s hormonal health in my experience, Estrogen and Estradiol although closely related are two very different animals. I have spent many years working with Men and their challenges, I have not been actively involved with Women’s health for a few years.

Interesting, in your experience with men, what differences do you see between estrogen and estradiol? When you refer to estrogen, do you mean to include estrone and estriol in that as well as estradiol?

Anyway, I’ve given estradiol to many women with sexual dysfunction, usually with testosterone. My point to the OP was that she needs estradiol and should not block it. She also needs testosterone and probably needs thyroid, assuming the doctor had the benefit of a consultation and examination which we don’t have. Hopefully, it will help. I’m still betting the oral contraceptives screwed with her periods, SHBG, and libido.