LH/FSH are not low enough to explain low-T. Problem then appears to be your testes. DHEA is suboptimal, but not low enough to suspect that DHEA-->T is rate limited by low DHEA. Low thyroid function affects all cells, tissues and organs in the body and testes might be slow because of this.
AM body temps are low. fT3 is below mid-range, but not by much. This situation is a bit gray. But I do suspect adrenal fatigue from over-training with low-T and low thyroid function where you have been overcoming your low energy with adrenalin. In the thyroid basics sticky, please find references to:
- over training - >>>>> YES <<<<<
- injury, surgery - no blows to head
- adrenal fatigue - suspected
- starvation diets
- Wilson's book <-- please read to see if it speaks to your experiences
TSH should be closer to 1.0
Please explain your history of using iodized salt, which may be an important issue for your wife and pregnancies.
* Not using iodine long term.
Eyebrows do not indicate long term low thyroid function.
Part of TSH elevation can be from rT3 also blocking what fT3 the hypothalamus can see.
Get back on iodized salt.
Also check wife's body temperatures. Hard to see what women's eyebrows look like. Does she feel cold easier now. Women need more iodine, gets stored in and is important for breast health and support of breast fed babies. Low iodine status also associated with miscarriages [and retardation when severe].
AM and PM body temps seem low. Please repeat for when you wake up and mid-afternoon. If temperatures are erratic, that can be an adrenal issue.
You could start TRT today and use hCG injections or [Clomid | Novadex] to maintain testes and fertility. Many guys here have had babies this way.
IGF-1 and GH: I think that you should address other issues and see if IGH-1 improves. Premature consideration given the costs. But more like $6000/year with correct pharmacy.
Self inject 50mg T twice a week
0.25mg anastrozole at time of injections, test in 3 weeks, adjust to get near E2=22pg/ml
12.5mg clomid EOD/E2D
Injected T is the gold standard.
After 3 weeks test LH/FSH to see where LH/FSH are. Do not want high, near where you are now.
For small doses of anastrozole, dissolve in dropper bottle 1mg/ml with vodka and dispense by volume or by the drop.
Warning: With the increased/restored metabolic demands of TRT, you may feel worse if thyroid problems do not allow your body to keep up.
Vitamin D3 is very important. Most need 5000iu per day. Needs vary by climate, sun exposure and skin tone/color.
Vit-D is mission critical for proper gene expression, affects everything.
You did not post cholesterol. Can be a problem if low [<180]. Cholesterol is the foundation for all of your
Also do labs:
AM cortisol - one hour after waking up
That is enough to choke on for one day!
Thank you for all of your effort and study behind your post.
Please read the stickies found here: https://forums.t-nation.com/t/about-the-t-replacement-category/38/2?u=ksman
- 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.