T Nation

Considering TRT, But I Have Thyroid Issue Questions


#1

I’m a 42 year old male in pretty good health, sort of. I weigh 213 lbs and 6’1" tall. I have been lifting for years on and off and have made some progress in size and strength, but not much and lately I have not been able to lean up no matter what. I eat a pretty good diet of about 2000-2300 calories of whole foods, plenty of protein, and plenty of good fats. I don’t eat processed foods nor milk. I usually stay on the lower side of carb on my eating plan. I exercise regularly with whole body weight lifting workouts 3 times a week. Cardio about 2 times a week. I do have a very sedentary job, however.
So, I’ve been thinking about Test replacement therapy for a while mainly because I have older friends that have made great changes in their lives and body composition on a TRT protocol. They feel great and are lean and strong and have all the confidence in the world. Just what I need and my wife agrees :slight_smile: I have done my research and I believe I am ready and I believe I will benefit from it tremendously as well. Specially for the feeling of wellbeing and confidence.

So I went to the doctor did lab work and she wanted to start me on 100mg a week of test cyp and 1mg of Arimidex. However, my blood work didn’t look so great with my thyroid and a couple of other things and maybe I should hold off the TRT until I figure this out first. First, my TSH was very high at 8.19 uIU/mL. My fT3 and fT4 were midrange, however, at 3.0 pg/mL and 0.96 ng/dL respectively. It thought they looked normal. But, my lab work also showed a TPO antibody of 97 IU/mL and a Thyroglobulin antibody of 2.2 IU/mL. My doctor said the word “Hashimotos” and that concerned me. However, she didn’t even scanned my thyroid or palpated it. All she did was prescribe Levothyroxine which I refused to take because I don’t see the point. That’s not going to help my issue if it is and autoimmune condition. That’s gonna just mask it. I may be wrong though. So now I am not sure what to do. For sure I’m not gonna start TRT. I don’t want to aggravate the condition.

I read the sticky on hypothyroidism and Iodine deficiency and now I have the question if doing the iodine replacement therapy would help me. Is there any other markers I need to check for to determine how to proceed next? Overall, I feel pretty good. I feel I don’t have the symptoms associated with hypothyroidism, but, I don’t seem to loose fat easily. Body temperature seems normal, but I will check it in the AM and PM, however, it is obvious I have something going on with my thyroid. I just don’t trust doctors and I want to find out on my own how to proceed. I also have deficiencies with B12 and vitamin D. One thing I didn’t get labs for was cortisol and to check for adrenal fatigue. I’m just more concerned about the antibodies.

What should I do next? I already started supplementing with B12, D3, Selenium, and some Kelp. Also a multi, fish oil, magnesium, and vitamin C. I read this helps protect the thyroid from antibodies attacking it.

I will appreciate any replies.
Thanks.


#2

Lab results/ranges:
TSH 8.190 Range 0.450-4.500 uIU/mL
fT3 3.0 Range 2.0-4.4 pg/mL
fT4 0.96 Range 0.82-1.77 ng/dL
TPO Ab 97 Range 0-34 IU/mL
Thyroglobulin Ab 2.2 Range 0-0.9 IU/mL
B12 371 Range 211-946 pg/mL
Vitamin D B4 29 Range 30-100 ng/mL

Still working on temperatures, but this morning was 97.8F upon waking up. Last night was 98.1F at around 8:30 PM


#3

What was your history of using iodized salt and your wife affected too?

Hashi’s probably from high TSH+Time and/or low selenium.
T4 production creates free radicals that enzymes bearing selenium clean up. With out that action, cells get damaged and immune system cleans up the mess and can then miscode normal thyroid cells as foreign. Anti-oxidants are helpful but insufficient if selenium is lacking. Try to get 200mcg selenium and start that 7-10 days before adding more iodine.

fT3 is a bit low, fT4 way below mid-range.

You may be magnesium deficient. Foot/leg cramps are then expected. How much magnesium are you taking.

How much iodine and selenium in your multi and how long have you been using that?

Try to get mid-afternoon body temperatures as well.


#4

Thank you for the response. Very interesting information about how the body can attack the thyroid because of nutrient deficiencies.
Looking back on salt consumption, we were following the common wisdom of not using too much salt and using sea salt or pink salt instead of iodized. I did change back about a year ago but from what I understand iodized salt doesn’t have much iodine. My wife hasn’t checked her thyroid, but she is going through some hormonal changes and having a hard time loosing weight too. She is blaming it on pre menopause. Who knows. I’m encouraging her to get her thyroid tested now.
As far as my supplements go, my multi has 150mcg of iodine per serving and I take a pill of Kelp which has 300mcg of iodine. The multi also has 250mcg of Selenium and I take an additional 200mcg. For magnesium, I started taking 300mg daily. For the extra Selenium and magnesium, I just started 2 days ago. For the multi, it has been about 2 months constantly. Before that it was just sparingly and inconsistently. As far as cramps, I don’t remember having any.
So I just took a mid afternoon temp and it is at 98.1F.
I have another appointment with my doctor tomorrow and most likely she wants me to take the Levothyroxine. What are your thoughts on it? How about natural desicated thyroid?

Thanks


#5

Levothyroxine works in many cases and is T4. But some do not convert T4–>T3 effectively. fT3 is the active hormone and then some can still be hypo. Desiccated thyroid fills that gap. You can try Levothyroxine and watch body temperatures and T3. In many cases, TSH needs to be pushed very low to get rid of hypo symptoms and many doctors will resist this seeing TSH as the only measure of things.

Your wife should check body temperatures before lab work.
If hypo there can be:

  • feeling cold easily
  • dry skin, but so many women have that aready
  • sparse outer eyebrows and many women have permanently altered eyebrows

I get hCG compounded with B12.

Do not take these with high fiber foods:

  • DHEA
  • fish oil and other EFA’s

Antacids reduce B12 absorption as well as minerals.

  • Vit-D3

#6

So should I go ahead and start on Levothyroxine? Wait until TSH is low and evaluate fT3 and fT4 again? At what point would be safe to go for the TRT?

Also, what could cause TSH to be high?

Thanks


#7

Should I continue with the supplement protocol I am currently using? Add the IR protocol to it?


#8

Body temps:
97.6 F upon waking
98.2 F mid afternoon
98.1 F late afternoon


#9

I had my thyroid surgically removed, and have a damaged pituitary gland so I have to take synthroid (levothyroxine) and T - so I understand your concerns.

I would like to address the thyroid concern.

I would push for an ultrasound of the thyroid gland. What your doctor says is correct on paper. Hashimoto is a common disease, but commonly found in women. Men do develop it but I would want to have an ultrasound to identify any abnormalities in the gland. If you have hashimoto or another thyroid problem that results in hypothyroidism (underactive), you will become tired, feel cold, and gain weight. The best corrective method is synthroid. No amount of vitamins will correct that. At a high level, there is nothing bad about synthroid (unless you take too much resulting in hyperthyroidism - overactive) which can be unpleasant. So once you have a solid diagnosis - you’re not putting anything bad into your body - and will fix a lot of stuff.

So push for additional tests first and foremost and if needed - take it.

Hope that helps.


#10

Thanks for sharing that information, sparky. I agree that the TSH is way too high and it concerns me. I do have the antibodies for Hashimotos and made changes to my lifestyle to include certain nutrients, heal my gut, and remove foods that trigger autoimmune responses, such as gluten. I did start taking the Synthroid as recommended by my doctor. But I just read the blogs on the “stop the thyroid madness” site, and wonder if using NDT are a better choice. I also increased my doses of B12 and D3 because they still are low. Supplementing also with ACV to increase my acids in the stomach. I understand hypothyroidism causes you to have low acid in the stomach. I will be coming back for more lab work in about a month and will post the results.


#11

Synthroid is a game of patience. If you’ve recently started taking it, don’t expect to feel better for at least 6 weeks, and if your TSH levels are still high - your synthroid will be increased.

If you want to try other options - as long as they are safe - go fir it.

TSH is a pretty consistent indicator that something is not right with your thyroid, and I am not sure if anything could help.

I think the madness happens in people fixated on squeezing out every single quick fix to get a great bod - I agree, taking Synthroid for that purpose is stupid. But your TSH levels are pretty much screaming “Hey - something is wrong here!”. Don’t ignore that because a thyroid imbalance is a bitch to recover from the longer you wait to correct it.

I hope this finds you well and feeling better.