Been feeling like crapola for a while now. Sex drive down, tried/foggy, irritable and other stuff. Had full biometric done that came back and showed all normal. Then vitamin A/D/TSH all normal and test showed me at 325 total.
I go back in soon and believe that’s the issue. I know doc will want me to test again and all that but I am ready to get through this issue.
Any advice would be appreciated.
TSH is too high and the sick care reference ranges are not the same thing as the optimal healthy ranges. Your doctors should be comparing you with healthy people and not those with thyroid dysfunction, but this is where we are in this moment in time.
It’s not as if any thyroid hormones testing were ordered, TSH is a stimulating hormone, if you want to see the results of thyroid stimulation to gotta check the free thyroid hormones, fT4, fT3, rT3, thyroglobulin antibody and thyroid peroxidase antibody.
Though TSH remains the most commonly used endocrine test in clinical practice, the issue of an appropriate TSH, and to a lesser extent, free T4 and free T3 reference ranges is still under debate. First of all the distribution of TSH reference range is not normal, with median values (also depending on population iodine intake) usually between 1-1.5 mU/L.
There is also an argument that significant number of patients (up to 30%) with TSH above 3.0 mU/L have an occult autoimmune thyroid disease.
Testosterone levels aren’t normal, they may be within reference ranges for an 80 year old man, but they may not be normal for you. In fact your levels are on the bottom 5% and 10% meaning 90-95% of men on earth have higher testosterone across all age groups!
Your doctor didn’t test the free portion of testosterone, you know the stuff that’s bioavailable to all your tissues which you doctor failed to check because they don’t have enough education to be diagnosing you. At this point in time you’re not even being properly diagnosed and I don’t think your doctor is going to be much help.
You might have to seek private care for your hormonal issues because most doctors believe in range is normal, it is when you take into account their age, old men testosterone on the bottom of the ranges, young men at the top as you’ll see when taking from a sample of the population.
25-34 years of age 45 subjects 617 ng/dL
35-44 years 22 subjects of age 669 ng/dL
45-54 years of age 23 subjects 606 ng/dL
55-64 years of age 43 subjects 562 ng/dL
65- 74 years of age 47 subjects 524 ng/dL
75-84 years of age 48 subjects 471 ng/dL
85-100 years of age 21 subjects 376 ng/dL
According to Dr. Abraham Morgentaler who is an expert in testosterone at Harvard and has proven TRT doesn’t cause prostate cancer, who is a leader in the field of TRT, your doctor is wrong, the medical community is wrong and men will show benefit when FT levels are above 15 pg/mL (10.8-26.6). Normal FT is 2-3%, you want it towards the higher end.
Our medical system doesn’t care for low hormone levels whether it’s low thyroid or low testosterone and isn’t seen as a life threatening condition. Another problem is the line is fuzzy regarding natural and abnormal testosterone decline do to aging, normally testosterone starts declining 1% every year beyond 30 and upon old age levels are somewhere on the bottom of the reference ranges or in some cases below the reference ranges.
The problem is normal is very blurry at the moment and no one can agree on normal status. If you look at Dr. Abraham Morgentaler recommendations, they are vastly different from the other institutions recommendations.
Doctors prescribe based off various guidelines and recommendations. The endocrine society recommends TRT <300, ISSM TT < 350 ng/dL ICSM in 2015 also recommends TRT <300.
However the guidelines does state that TRT can be prescribed TT levels up to 345 ng/dL. You’ll also notice the guidelines don’t focus on what constitutes normal FT levels, in reality no one knows, only the reference ranges where the populations are scoring, but that in no way constitutes normal “healthy levels” for you. It only means we have outliers (like me) who can get by with very little testosterone without symptoms.
(1) Do nothing and continue feeling like dogshit.
(2) Go private for your TRT treatment and pay out of pocket.
(3) Find a doctor not worried about getting in trouble for prescribing TRT to someone with normal testosterone levels.
I was prescribed Clomid and stopped days in. That was probably the worst decision once I started to lean towards TRT. My Endo said it was better if we went that route. I stopped listening after he congratulated me for going from 270 to 318 in a 4 year span. So dont accept Clomid. I started therapy 4 weeks ago. Best decision ever. Im just starting to feel the change.