T Nation

37 YO, Is TRT the Next Step?


#1

Hello all,

Been doing lots of reading and research and figured it best to just ask…

I’m 37 and have been dealing with fatigue issues, low libedio, gradual weigh gain, etc over the past couple of years. Pri Dr diagnosed autoimmune thyroid issues and has finally gotten my levels straight there but the symptoms are the same. Asked him about testing testosterone levels and he ordered labs with the following stats… He says it looks normal to him?

Fairly active and decent diet but have def noticed a loss of a step or two…

-age: 37
-height: 6’4"
-waist: 38
-weight: 260
-describe body and facial hair: Not real hairy, thin and patchy facial hair
-describe where you carry fat and how changed: Belly/upper body - Gain around waistline past couple years, upwards of 30lbs.
-health conditions, symptoms: Good health, hypothyroidism(autoimmune) Fatigue, low libedo,
-Rx and OTC drugs: Levothyroxine 150MCG, b12 500mcg.
-lab results with ranges:
Chems:
Glucose: 86 (65-99)
BUN: 13 (6-20)
Creatinine: .95 (.76-1.27)
Sodium: 144 (134-144)
Potassium: 4.8 (3.5-5.2)
Chloride: 105 (96-106)
Calcium: 9.1 (8.7-10.2)
Protein, Total: 7.0 (6.0-8.5)
Albumin: 4.7 (3.5-5.5)
Globulin: 2.3 (1.5-4.5)
A/G Ratio: 2.0 (1.2-2.2)
Alkaline Phosphatase: 28 (39-177)
AST (SGOT): 30 (0-40)
ALT (SGPT): 47 (0-44)

LIPIDS:
Triglycerides: 47 (0-149)
Cholesterol: 147 (100-199)
HDL: 59 (39)
LDL: 100 (0-99)
VLDL: 9 (5-40)

Hematology:
WBC: 5.5 (3.4-10.8)
RBC: 5.06 (4.14-5.80)
Hemoglobin: 15.3 (12.6-17.7)
Hematocrit: 45.8 (37.5-51.0)
MCV: 91 (79-97)
MCH: 30.2 (26.6-33.0)
MCHC: 33.4 (31.5-35.7)
Neutrophils: 3.4 (1.4-7.0)
Lymphs: 1.4 (.7-3.1)
Monocytes: 0.4 (.1-.9)
Eos: 0.1 (0.0-0.4)
Basos: 0.0 (0.0-0.2)
Platelets: 212 (150-379)
RDW: 14.0 (12.3-15.4)

Thyroid:
T4 Free: 1.76 (.82-1.77)
TSH: 2.630 (0.450-4.5)

Endo:
Free Testosterone: 9.6 (8.7-25.1)
Testosterone, Serum: 277 (348-1197)
Triiodothyronine, free Serum: 3.7 (2.0-4.4)

-describe diet: High protein, low carb, and shoot for zero refines sugar.
-describe training: Walk/cardio 3 days/week, surf regularly, some weight training.
-testes ache, ever, with a fever? NO
-how have morning wood and nocturnal erections changed: Infrequent


#2

Please directly edit your above post to fix:
TT 9.6 (8.7-25.1) - please double check amount and range - reversed
FT 277 (348-1197) - please double check amount and range - reversed

Your labs suggest dehydration that can throw off results. Always drink water when fasting to maintain proper hydration.

T4 Free: 1.76 (.82-1.77)
TSH: 2.630 (0.450-4.5)
First of all, almost all doctors do not understand thyroid function.

TSH=2.6 means that you are hypo.
fT3 is the active hormone - not tested- and fT4 is not active.
fT4 is above range, normally would be good at midrange.
Concluding that you are one of many who have poor T4–>T3 conversion.
You need a T4+T3 medication, suggest desiccated thyroid product.
Some require T3 only meds.
Alternative is that rT3 is blocking fT3. rT3 can be high from adrenal stress/fatigue resulting from stress, starvation diets, illnesses, surgeries etc.

Check your overall thyroid function via last paragraph in this post.
Very important!

Please explain your use of iodized salt over the years and use of vitamins listing selenium which protects from processes that lead to thyroid auto-immune disease.

Part of your TRT workup should be:
TT 9.6 (8.7-25.1)
FT 277 (348-1197)
E2
LH/FSH
prolactin
fT3

Was ALT high from sore muscles?

Cholesterol is too low, 180 is ideal. If from diet, fix that. Some guys are simply low.

Do you take B-12 because of CBC results?


#3

Thanks!

The FT and TT are as listed above except for the word "lowL next to the number. Lab ranges are what LabCorp deems the normal range.

It’s odd the Dr omitted Ft3 this time for its normally in my resting for my Levothyroxine testing. It’s been right in the middle of the normal range the last 6-9 months.

I take the B12 as a recommendation from Dr due to possibility of deficiency with thyroid meds.

Besides the Levo and B12 I just take Fish Oil and a Multi (GNC Men’s sport) and green vibrance probiaotic veggie caps. All except B12 taken minimum of 4 hours after Levo.

Does dehydration cause TT and FT to shoe low?


#4

Good product!

Body temps will provide a measure of the balance of all thyroid factors.

If TSH is high with mid-range fT3 there is another problem, elevated rT3 and lower body temperature expected.

Often TSH needs to be pushed way below 1.0 with thyroid meds before hypo symptoms are eliminated. For normal guys, TSH=1.0 seems to be an optimal state.

Dehydration increases all labs that are concentration by volume. So FF and FT are slightly exaggerated.


#5

Feel pretty stupid here. Forgot the last lab on the report, which after looking up what you were saying is the fT3. Level added to first post…


#6

fT3= Triiodothyronine, free Serum: 3.7 (2.0-4.4)


#7

Body temps

Day 1 9pm 96.9
Day 2 7am 96.4
Day 2 10am 97.6
Day 2 2pm 98.4
Day 2 7pm 97.2
Day 2 11pm 97.1
Day 3 7am 97.3