FT is actually quite low. With transdermals, there is a surge of T entering your system then its mostly over. FT has a short half life, so FT can peak and fall. The bio identical zealots like to day that is a natural pattern, I think not. In any case, because FT is changing, a lab can catch a peak or a trough and the result is major uncertainty.
Frequently self-injected T is the most cost effective T delivery and provides the most cost effective, steadiest and most consistent T levels. When T esters are injected in oil, the injections are slowly absorbed and as T ester molecules become mobile in your system, the ester groups are removed and you have a bio-identical T time release system, but the bio identical zealots can’t quite grasp that.
Your TRT may be inadequate. We do know that transdermal T absorption is poor with low thyroid function, which you should evaluate via last paragraph in this post. Low thyroid function can present almost all of the symptoms of low-T, even when TRT T levels are high.
So what was your lab timing?
If SHBG is elevated, there is more non bioavailable SHBG+T that inflates TT and then TT is misleading.
Men do not need added iron unless there is a pathology such as a GI bleed.
Humans hoard iron, men retain, fertile women do not. Try to avoid iron fortified vitamins, flour, rice, breads, breakfast cereals. Serum iron is quite variable depending on recent meals; I do not trust serum iron as a guide for change. Iron saturation does perhaps present a problem. In any case, HTC=47.5 does not indicate a problem. RBC, hemoglobin and ferritin might be useful.
Please post CBC.
Low thyroid function will absolutely rob your energy.
Also do lab: AM cortisol blood work and do 1 hour after waking.
And test SHBG which can add clarity in a case like this.
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.