T Nation

Bloodwork Advice for Potential TRT?

Just did a LabCorp hormone profile. I’m 5’11 and 285 pounds. Want to try clomid with an aromatase inhibitor. What do you all think?:

Testosterone Serum is 266
Free Testosterone (Direct) is 6.4
T4, Free (Direct) is 1.57
DHEA-Sulfate is 227.8
TSH is 4.250
Estradiol is 22.1
IGF-1 is 163
Triiodothyronine (T3), free is 3.3

I think you should get new bloodwork in 4-6 months after dropping 50+ pounds because your numbers will be different. That should be the first thing addressed before beginning a lifetime of medication.

Also, how old are you?

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Along with what Chris said, get that thyroid looked into.

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Your TSH is horrible and indicating hypothyroidism or an autoimmune disease, TSH should be <2.5. The reference ranges for TSH aren’t normal, don’t expect your so caller expert thyroid doctor to be educated in his/her own field of medicine, expect him/her to be practicing medicine the way it was taught to them in medical school decades ago. We’ve learn a few things since then.

If you eventually if you go on TRT I don’t expect good results with TSH that high, Reverse T3 may be the cause for elevated TSH.

The evidence for a narrower thyrotropin reference range

It has become clear that previously accepted reference ranges are no longer valid as a result of both the development of more highly sensitive TSH assays and the appreciation that reference populations previously considered normal were contaminated with individuals with various degrees of thyroid dysfunction that served to increase mean TSH levels for the group. Recent laboratory guidelines from the National Academy of Clinical Biochemistry indicate that more than 95% of normal individuals have TSH levels below 2.5 mU/liter.

Reference ranges for TSH and thyroid hormones

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

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Avoid if possible. Nasty stuff.

Edit: also second what Chris said.

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Yes I agree with you, and would like to do it this way. I’m 30 years old, been overweight my whole life, and wondering now if the thyroid thing systemlord mentioned has anything to do with it. Thanks.

This is very interesting to me, because I have so many of the symptoms of hypothyroidism like feeling cold all the time and struggling to lose weight. Do you think I would benefit from taking a Synthroid before looking into TRT? Thanks.

I was thinking of it to prevent gynecomastia, which I am prone to, but will reconsider. Thanks.

What are your symptoms and medical history?

Do you have any other lab results? Lipids, CMP, FSH, LH, prolactin, SHBG, reverse T3, VitD. If not, I would get those.

At 30 you’ll rebound quick. It’s obvious you’ve been inactive your pre and adult life. Start now and you’ll see fast changes. If you eat right , lose weight and bloods do not rebound. Then it’s time to see a doc. Until then trt isn’t a cure all of life style doesn’t change. That’s diet fitness and mental.

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It may be difficult for you to lose weight with thyroid issues. .

Check

TSH
Free t3
Free t4
Reverse t3
Total t3
Prolactin

A1c
Insulin
Metabolic panel - this includes glucose

You may need thyroid meds and if insulin resistance / pre diabetic - something like metformin. That will all help you lose weight along with diet and exercise. Than maybe you can get off those meds. And then see where your testosterone numbers land.

Right I wanted to add that If its super hard to wake up and get to the gym after fixing diet and lifestyle - then you might need thyroid at the least to get moving in the right direction. The body will adapt hopefully :slight_smile:

I wish ya luck.

Get some pre work out and kill it. Take before and keep taking pics every 30 days to keep your self motivated. Go to the other section of this site for training and get a good plan of action in regard to diet and workout plans.

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You need to treat both low T and thyroid together if you wish to see good results, otherwise you’ll be stepping on the gas and brake at the same time. You can’t increase metabolic rates without sufficient testosterone and you can metabolize testosterone with thyroid hormones.

No prob. List your current diet and any current exercise in a new thread over in the Beginners section and we can get you on the right track.

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