First TRT Bloods (+Thyroid Concerns)

Hey there T-nation! Long time UK lurker finally decided to make an account.
Background:
(Primary hypogonadism, On trt for 3 years, was self medicating until a couple of months ago)
Age 26
Height/Weight 5’9/155lbs
Lifestyle: Try to be as healthy as I can be, occasional drink, gym 3-4 times a week

Protocol: 40mg testE E3.5D, 200iU hCG EoD

TRT Bloods(After starting supervised therapy):
T 744 (ng/dL) (270-1,000)
E2 36 (pg/mL) (14-55)
SHBG 47.5 (nmol/l) (10-57)
Prolactin 275 (mU/L) (<450)
Haematocrit 0.505 (L/L) (0.45-0.52)

Thyroid:
TSH 4.04 (uIU/ml) (0.4-4.0)
FT4 1.39 (ng/dL) (0.7-1.9)
FT3 0.41 (ng/dL) (0.2-0.44)
T4 111.99 (nmol/l) (62-150)
T3 137 (ng/dL) (84-201)

All in all I feel quite good, slightly less energetic than my first years of self medication and have no problems with erections or libido. Somewhat started to struggle gaining strenght/muscle as compared to a couple of years ago too, also started to fall asleep during my meditation sessions(Which never used to happen before).

My testicles are still atrophied as hCG has been added to my protocol around 7 weeks ago. Are there any changes once they come back? (Particularly concerned about E2 further increasing)

I’ve read the thyroid sticky, there’s hardly any information on high TSH/normal T3,T4, my late afternoon temperatures average out at 98.2F. Does anyone have similar experiences? My diet was short on iodine the last 4-5 years so I’ve also added some supplementation and hope to re-test it in a month or two. My mother also has Hashimoto’s which is a hereditary concern I suppose.

Throw some ranges in there so we know those levels. What is your TRT protocol? I can’t speak to the hcg and time frame of your nuts coming back online. I do know that once they start producing again your E2 will probably increase as your T goes up but unless you are symptomatic there is no issue with higher E2.

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A TSH >3.0 indicates an autoimmune disease which vary by how far the auto immune disease has progressed.

You should have tested Reverse T3, otherwise you have no clue if some of that Free T3 is inactive do to elevated Reverse T3.

You must test Free T3 together with reverse T3.

You should also test antibodies, this test will show what’s going on regarding your thyroid gland.

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This is usually classifeid as subclinical hypothyroidism. TSH can fluctuate, (it’s not the Holy Grail for thyroid conditions) so I would not put all my faith in just one test.

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That’s the biggest concern I have as my mother has Hashimoto’s and autoimmune diseases tend to run in the family. I am doing a lighter version of iodine replenishment(From the forum sticky, around 6mgs a day) for the next 4-5 weeks(Deficiency is common in the UK) and re-testing (+rT3 +Antibodies)

-Edit(added iodine dose)

Protocol: 40mg testE E3.5D, 200iU hCG EoD

Added ranges(will edit the OP too)

T 744 (ng/dL) (270-1,000)
E2 36 (pg/mL) (14-55)
SHBG 47.5 (nmol/l) (10-57)
Prolactin 275 (mU/L) (<450)
Haematocrit 0.505 (L/L) (0.45-0.52)

Thyroid:
TSH 4.04 (uIU/ml) (0.4-4.0)
FT4 1.39 (ng/dL) (0.7-1.9)
FT3 0.41 (ng/dL) (0.2-0.44)
T4 111.99 (nmol/l) (62-150)
T3 137 (ng/dL) (84-201)

Like was said above you need to get a specialist involved with that TSH and your other numbers…somethings up it would seem. Personally I would hold off on the iodine supplementation. If you have underlying issues the iodine could make it worse.