[quote]KSman wrote:
When hypothyroid guys go on TRT, they can feel worse. With TSH=5.26, you were very hypo. So it looks like you are simply under-medicated. Are you missing doses?
Check your body temps as per the thyroid basics sticky and let body temps be your dosing guide.
You are taking T4 medication, but some need T3 as they are poor converters of T4–>T3.
This post needs thyroid panel labs.
I also noted:ACTH, Plasma 42 (6-50) 81%
Cortisol, AM 13 (4-22) 50%
ATCH can be up if the needle in your arm stressed you out and cortisol response to that can lag. That cortisol level is a bit low. Your thyroid function state might be part of this. Get good thyroid labs and body temperatures and see where adrenals go. You could try some KAL brand progesterone cream [which is 2%], amazon has it, also good for your ?wife? perhaps.
You need to be checking fT3, it is what gets the job done inside your cells, regulating body temps via mitochondrial metabolic rate.
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I have not yet tried the progesterone cream.
My morning temps were between 97.8 to 98 so I went up on Synthroid.
On 100mcg I was sweating a lot and I got so hot at night that I couldn’t sleep with even a sheet over me, so I backed down to 75mg earlier in the week.
Here are the lab results from LabCorp. Previous results were from Sonora Quest.
FT3: 3.5 (2-4.4) - 62%
FT4: 1.46 (0.82-1.77) - 67%
TSH: 2.53 (0.45-4.5) - 51%
ACTH: 50.1 (7.2-63.3) - 76%
Cortisol: 17.9 (6.2-19.4) - 88%
Serum Testosterone: 241 (348-1197) - -12% LOW
Free Testosterone: 30.7 (8.7-25.1) - 134% HIGH
Maybe I should have checked SHBG. I do not understand why Free T is now flagged high and serum T is flagged low at the same time. I am not on anything other than Synthroid. Except I started taking 100mcg Selenium about a week ago. I suspect this elevated Free T is a lab error because in all the tests to date (lots of tests), Free T has never been flagged high.
Some of the brain fog cleared up and I have more energy. But my muscles and joints still hurt and my short term / working memory hasn’t improved.
Last weekend was psychologically stressful so my cortisol was on the high end, but at least ACTH is looking better. I read the paper you talked about “Venepuncture causes rapid rise in plasma ACTH”. But I was stressed out at this lab draw (the phlebotomist was scary) so perhaps the Synthroid is helping to strengthen my adrenals.
But I’m now concerned about this HIGH/LOW free/serum testosterone problem. I’d like for my FT to be flagged HIGH, that’d be great, but I know it must have been either a lab error or some sort of problem going on.
I thought that thyroid hormone increases SHBG. If that’s the case, I must be really screwed up.
Should I retest?
I tried to post images of my labs. Is there a way to do that?
The differences in reference ranges for Free Testosterone (Sonora Quest) and Free DIRECT Testosterone (LabCorp) were confusing.
Sonora Quest range for free testosterone:
35-155 pg/mL
LabCorp range for free DIRECT testosterone:
8.7-25.1 pg/mL
I found a pubmed article on the different tests. “Free testosterone by direct and calculated measurement versus equilibrium dialysis in a clinical population”. It said “results support the clinical use of both RIA and cFT as measures of FT. Due to numerical differences, each test requires its own set of reference values.”