T Nation

Drastically Inconsistent Results


#1

As a brief overview…I’ve been the exact same weight for the last 20+ years and have been on TRT for the last 2 years. I’ve always been naturally muscular and lean/toned. It was when I suddenly started losing muscle and gaining fat that I looked to TRT (aged 52 at the time).

TRT got me back to where I had always been. Nothing extra, and I wasn’t looking for extra.

So then, I was started off at 150mg T and 1.5mg anastrozole per week and that worked fine and levels were good (albeit high) at 1600 total T and 210 free T. My doc goes by results and not numbers, so he was happy with that.

I was happy with the results but experimented with lower doses, but they always ended up with me losing muscle again and putting on fat (diet, sleep, and exercise, is tip-top and consistent).

So I went back to 150mg T along with 1.5mg anastrozole (split into twice a week SQ). Everything went back to fine and dandy except for getting back my latest labs…

2500 ng/dl total T and 574 pg/ml free T.

I was in shock. And I don’t even feel any different. Still same weight etc…

I see my doc in a couple weeks to go through the latest labs but I’d like to get a head-start on what’s happening. How can my levels swing so wildly on the same dose? As an added complication, I had my doc test me for SHBG this time and I was very high at 63nmol/L.

I’m thinking this plays a role somehow…maybe it takes a large dose to overcome the SHBG, but once it’s overcome, the levels build dramatically? Maybe I need to micro-tune a correct dose? Maybe my SHBG levels are inconsistent?

Also, my next shot is later tonight. Should I skip this shot entirely or just reduce my dose?


#2

I forgot to mention…I gave blood twice recently at 500ml per visit…can this play a role in any of this?


#3

Your high SHBG dictates that you must inject large doses of testosterone and you will likely need supraphysiological doses to keep SHBG at bay. SHBG is still to high and might be the reason why you never got anything extra from TRT.

The most accurate way to get our FT is be using an SHBG calculator, take TT and SHBG will equal FT.

What you need is one large weekly dose, once SHBG comes down some so to will your TT and FT will increase. If you were natural I would say SHBG is overstating your TT numbers do to your FT being so low.

What does your thyroid numbers? Do you consume iodized salt? You may be iodine deficient, thyroid needs iodine to function. Check oral body temps and see our thyroid sticky. A lot of guys who come here have thyroid issues doctors seem to ignore do to these insane wide labs ranges, there are men and women in these ranges with hypothyroid symptoms.

fT3 is often ignored and is where the rubber meets the road as it’s the free thyroid hormone. It’s what FT is to TT.

http://www.issam.ch/freetesto.htm


#4

My last 2 thyroid labs were…

Sept 2017:

TSH 1.56 uIU/ml

T4 free 1.9 ng/dl

T3 total 131 ng/dl

April 2018:

TSH 1.6 uIU/dl

T4 free 1.7 ng/dl

T3 total 99 ng/dl

I should mention that I took a week’s worth of morning oral temps but they are recorded on my phone which broke the other day, but from what I recall, the average was the low 97’s…like 97.3 and such.

I also take one drop of lugol’s 2% once a week along with 200mg of selenium. So I believe that works out to 2.5mg/week.


#5

So @systemlord ,

Are you saying that in my case shooting once a week is better than twice a week? It blows my mind that my SHBG is still so high given my latest testosterone levels. I wish I had my SHBG tested long before this to compare…


#6

I just noticed I forgot to mention that I also do 250iu of hCG EOD. So that needs to be considered in the mix.

My latest E2 was 35 pg/ml…this will make my doc happy since he’s a life extension type doc, and he seems to like for your E2 to be higher than in the 20’s because he says there are lots of side benefits. Still, I’d like to get it back down at least in the 20’s. Tonight I shot a smaller dose but kept the anastroloze at 1.5mg/week…hopefully that’ll help reduce both the total T and E2 levels.


#7

Do not attempt to lower E2, your high SHBG is making most of it non-bioavailable, your free E2 is likely lower. You didn’t include ranges and are missing fT3, doctors should be checking free thyroid hormones.

Use a glass thermometer, your phone is expected to be way off, it’s a phone trying to be a thermometer.


#8

I’m sorry, I meant I wrote down my morning temps on my phone. They were actually measured with a pregnancy style thermometer that is accurate to 1/100th of a degree.

The thyroid ranges are:

TSH 1.6 uIU/dl (0.27 - 4.2)

T4 free 1.7 ng/dl (0.9 - 2.1)

T3 total 99 ng/d (80 - 200)

I’ll get him to check free T3 from now on.

As far as thyroid, I’ve always been one of those guys who’s always hot. I’m the first guy in the room to start sweating, and if it’s warm I’ll sweat in my sleep. Heavily. Yet I’ve noticed my whole life that I’m always under 98.6…I had always thought it was due to crap thermometers, but now I have a good one. Can an under-active thyroid actually cause you to feel hot?


#9

Feeling cold or having chills is associated with hypothyroidism. The system slow-down caused by an underactive thyroid means less energy is being burned by cells. That’s why people with hyperthyroidism sometimes feel too warm or sweat profusely.

fT3 is where the rubber meets the road, so checking T3 makes little sense as it’s not a free hormone. For me having high estrogen makes me feel warm.


#10

That’s what I thought, and is why couldn’t really make any sense of it all. According to my temps I’m hypo, yet my whole life I’m always freaking hot. Makes no sense. I’ve brought it up to various primary care docs over the years and they’ve just shrugged. I think I’ll bring it up with my life extension doc who seems to actually LIKE to solve problems.


#11

Feeling hot could also be hyperthyroidism do to increased metabolism, if fT3 is above ranges you would be considered hyperthyroid.


#12

I should mention that the difference from when I first started TRT at 150mg vs now at 150mg, is that originally it was once a week IM, and the recent results were at twice a week SQ.

I don’t think it could make THAT much of a difference (plus the hCG) but I thought I should mention that.

Either way, I have my appointment coming up in 2 weeks so I’ll update then…


#13

Low serotonin can also cause elevated body temperatures - especially hot flashes. It isn’t always thyroid.


#14

Okay, so I got back from my latest appointment yesterday…

I was surprised that my doc wasn’t shocked at my super high total and free T levels (posted in first post). He said that he sees levels that high in body builders all the time. I told him that I’m not a body builder, although I do train very hard in other endeavors. I told him that I had already lowered my dosage back to what used to get me to about 1500 total and 250ish free.

He said that recovering from hard training is more of a thyroid issue and not a testosterone one. He then told me that my current thyroid numbers were a mess.

TSH 1.6 uIU/dl (0.27 - 4.2)

T4 free 1.7 ng/dl (0.9 - 2.1)

T3 total 99 ng/d (80 - 200)

I mentioned that I take about 5mg of Lugol’s a week along with selenium, and he said he has yet to see anyone recover proper function of thyroid via that route. He put me on 15 mcg Liothyronine and 50 mcg Levothyroxine daily.

I have 2 questions…

  1. Do I continue to take iodine while on these meds?

  2. My labs from 4 months ago (when my testosterone numbers were lower) showed my T3 at 131 as opposed to the current 99. The 99 is what had him concerned, and what he wants raised. But I’m thinking that the current number may be an aberration due to the crazy T numbers I had during the latest labs. What if my natural numbers now creep back up to the 130’s and I’m taking these meds on top of it? Is there a concern? I’ve always been wary of messing too much with my thyroid or exciting it, because I’ve had a history of occasional heart arrhythmia.


#15

Not sure why he jumped on medicating your thyroid. Retake also get free t3 and reverse t3.


#16

I’ll ask him about that, thank you.

Also, I mentioned the high SHBG and he said that it increases with higher T numbers (feedback system) as opposed to getting lower with high T like has been mentioned on this forum. Who is right?


#17

Both are right. SHBG goes up when estrogen goes up. It goes down when testosterone goes up in presence of low androgens,IGF, and growth hormone.


High T, FSH, SHBG, Low E2 No Libido. My Lab Results
#18

Is it common to have high testosterone and low androgens?

Anyway, I’m on 3rd day of the thyroid meds and will update any noticeable changes. Does taking these meds down-regulate the thyroid in any permanent way? Also, I’m going to continue with the Lugol’s and possibly even bump it up a little to 7.5mg/week.