T Nation

Help w/ Bloodwork: Thyroid, Adrenals, Anemia, etc

I’m a 35 yr old male, 5’9" height, 185lbs, 20%ish body fat. Had gyno surgery 10 yrs ago not related to AAS. I have read this site daily for a year. I’ve worked out for 10 years with some years harder than others.

Been on TRT for 8 months at 180mg/week, daily sub-q injections. As shown on the labs below I’m obviously lowering my dose. Going to try 120mg/week to see where that puts me and go from there. So yes I understand my test level is super high. My main concern is thyroid, adrenals, anemia, iron, etc.

My main reason for getting the blood work done is I have very little energy, drive, seem to get sick often, head is a little cloudy, and just don’t feel right. I felt exactly the same for years pre-trt so the high T levels aren’t the culprit for this. I’m sure bringing my current T dosage down will help to feel somewhat better but the main problems I’m having are something else. My T levels before TRT were at 500 and estrogen (non sensitive) was 48. I was put on TRT basically because I didn’t know any better at the time. I thought maybe even though I had a decent level that it could help with how I was feeling.

My father was recently diagnosed with hashimotos so it prompted me to think maybe I have something going on in the thyroid area.

I felt the best I ever felt when I did keto and intermediate fasting for about 3 months (this was before TRT) but I didn’t feel 100%. Not sure if that helps.

I take daily:
400mg magnesium glycinate (200mg morning/night)
5,000 Vitamin D
100 K2 (mk7)
3mg Boron
1200 Ashwagandha

Let me know what you see on the labs. I need to point out I was getting over a sinus infection at the time of the blood test.

I appreciate all of your help with this and I really value this website.

@charlie12 @systemlord @physiolojik

@NH_Watts @unreal24278 @hardartery @yubs @iron_yuppie @now_i_care @alldayeveryday @anon10035199 @Chris_Colucci @studhammer

Seems to me, the only real issue identified is prolactin. I wouldnt freak out over your T levels, just reduce your dose. High shouldnt be making you feel like shit, quite the opposite. You estradiol is high but not really in relation to your Test.

Just dont do anything reactionary. TRT is a slow moving game, make small changes not huge ones. Prolactin may be the cause of your symptoms. I dont know, maybe somebody like @unreal24278 will chime in.

How is your sleep? Do you or your partner snore? Have you had vitamin D levels tested? Have you had your Pregnenolone level tested? What do you take for supplementation? What do you do for exercise?

That being said I ran my T high for a bit and it didn’t feel as good as running it a bit lower so that is where I am at now. Although my free T was well over 10 times what yours is. I also introduced pregnenolone because my levels came back low and that can give you that tiredness along with head in the clouds.

Your reverse T3 is sky high. You are also kind of anemic. Your Iron binding capacity is high and your ferritin is low. So, I didn’t see a T3 number, but I’d say it’s reasonable that you have low or very low T3 factoring in that Reverse T3 number and you should supplement some iron and probably some folate (but take it easy with the folate).

Prolactin may come down some when you lower dose. Was lab taken when fasting? If so monitor glucose.

Rt3 can fluctuate. I would lower dose. Why the hell are you injecting daily? That’s so invasive.

You will probably do fine 2x a week

You can retake reverse t3 and prolactin v and whatever you like after about 6 weeks after you lower dose .

My prolactin was slightly elevated to when I went on trt. Dr told me no worries.

Btw are you taking anything else?

My sleep isn’t great. I wake up through the night at least 3 times. I’m in the bed 8 hours but wake up a lot. Sometimes I can’t go right back to sleep. I don’t snore but I do have nasal problems and wear breathing strips. I’ve always had allergies. Did not get vit D or pregnenolone tested unfortunately.

I take:
400mg magnesium glycinate (200mg morning/night)
5,000 Vitamin D - daily for past 3 months
100 K2 (mk7)
3mg Boron
1200 Ashwagandha

Lab was taken while fasted 12+ hours.

I was doing twice /week injections but found daily actually easier for me to not miss doses plus I do feel a bit better on daily vs e3.5 days.

I didn’t get T3 checked (accident) just Free T3 & RT3. What do you recommend for dosage on folate & iron?

What are my next steps with thyroid? I’m assuming go to an endo but what do you recommend I tell them so I don’t get put on the wrong medication? Armour/natural seem like a good option here?

Why do you wake up? Personally Id move all of your magnesium to night time supplementation.

What do you mean by nasal problems? Deviated septum? Have you had a sleep lab done? Why do you wear breathing strips? What happens if you don’t? Do you sleep in a completely dark room?

You need a full thyroid panel, including anti-bodies. Make sure it isn’t Graves or Plummer’s or something. My bet is you need Armour or something to boost your T3. it would be surprising if your T3 is high enough to overcome that reverse T3.
Just basic suuplementation. like 400 mcg of folate and try for chelated iron if you can find it. Don’t take the iron when you take calcium , zinc or copper, if you take those. They all use the same transport into your sysem so they should ideally be taken a few hours apart from each other.

I wake up every 2 to three hours I’m guessing. Usually I’ll have to piss. I’ve tried not drinking within 3 hours of sleep but it’s the same outcome. I sleep with a eye mask on in a dark room.
I’m not sure exactly what is wrong with my nasal passages but they get stopped up a lot, usually have a constant drip during the winter, and at night they just seem to close up sometimes from what I guess is allergies. It’s been that way my whole life. I have not had a sleep study but have looked into that in the past just haven’t done it. I’ve switched careers and with came a cut in pay for the short term so the sleep study has been put off. Living in NYC is rough when you aren’t ballin but I’m working on changing that.

Thyroid Peroxidase (TPO) Ab 19 IU/mL 0 - 34
Thyroglobulin Antibody <1.0 IU/mL 0.0 - 0.9
(not sure why it’s not an exact number instead of less than 1.0)

Does that help?

I was thinking my free T was high @ 35.8 8.7-25
Do you think that is low considering total T is 2000?
What do you think about SHBG @ 39.9 16.5-55.9? Would you consider mine very high and do you think lowering my dose significantly would likely raise it more?

My free T, with a total T of 1965, was over 400. I’m not sure which scenario is better to be honest.

Our local Endo has stated that SHBG can fluctuate by 500% throughout the day so not sure if that measurement is worth anything, though some members swear by it. Mine came in at 27 when tested but I only got it tested to satisfy @phil65. LOL

I do NOT think your SHBG is considerably high.

Im excited to hear you use a mask…I do too and I recommend it to anyone interested. Have you been to an ENT doctor regarding your nose? Sounds like a histamine issue if there is a reaction like that? Do you cover your pillows and mattress with HEPA covers? Mold, dust, and mites might be affecting you.

You should be able to get a sleep study covered by insurance (if you have it). Just talk to your PCP and tell them you think you have sleep issues and wake up all the time. They should order one.

Congrats on the new career! You’l be ballin in no time sir.

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Thanks man! You have convinced to go ahead and get the sleep study. I have insurance so I’m just going to do it. Same with the ENT. I would be willing to bet its a histamine issue.

If you are ok with posting it I’d love to know what dosage of test you are on currently and what level it has you at. How did you feel during the 6 weeks before you leveled out on the lower dose?

It’s amazing what sleep can do for a person.


I have yet to see anyone post blood test to prove this. In fact every blood test I have ever seen in over 5 years of being on these boards show SHGB doesn’t move more than about 10 points. I challenge anyone to post up their bloods and prove me wrong. Just because one doctor thinks it’s so does not make it so. Talk to ten different docs they will have 10 different explanations. Modern medicine is so weird that way. They just don’t have the answers and they are just too arrogant to admit it.

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@dextermorgan you are feeling like shit because your E2 and prolactin are over range. Your HCT is fine you are not anemic and you can keep your T dose where it is if you choose. You really need to get your hands on some anastrozole to get your E2 and prolactin in check before you start growing man boobs. Over range E2 and prolactin is how boys start to become girls and the reason you feel like shit. Take .5mg anastrozole for 2 weeks then cut back to .25mg/wk and you should be fine. Get your E2 in the low to mid 30’s and prolactin into single digits and watch your brain come out of that fog. Your libido will also pickup. High E2 is a real libido killer. Good Luck.

Oh if you don’t want to take anastrozole you could drop your weekly T dose to 100mg/wk. Most don’t need an AI at 100mg.

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If you wake up to pee, you aren’t getting REM sleep, BTW. When you actually get into deep sleep your body slows down the processes that result in urine. If you have to pee every few hours you’re not getting into that phase of sleep and you are not really resting. Your levels may fix themselves if you fix your sleep.
You could actually be anemic, but it is not the cause of your problems.

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Thank you for your insight! I was taking .25mg anastrozole every 3 days for a month or so and then .125 for a couple months but I was feeling horrible. I’m not sure if the anastrozole was helping cause how I felt but it was like I couldn’t get out of bed, I had absolutely zero energy, and felt like I had a hangover everyday. It kind of came in waves. Like for a full week I would feel like than then the next week would feel not as horrible but still bad and then it would hit again. I would explain to people it’s like what you would imagine someone on chemotherapy would feel mentally & physically. This was for months. It still happened after stopping anastrozole but I wasn’t sure if I had killed my estrogen and it was rebounding. Only the past few months have I felt a little better but still feel what anyone would classify as bad. It’s almost hard to put in words how bad it was.

I do have some gyno that has formed. I was thinking about trying Nolvadex to get rid of it. Any thoughts on that?

Only mini blood test will tell you where your E2 and TT are.
From what you are discribing you have something else wrong that is not hormone relate. Might be thyroid I am not sure.

When I have something weird going on I always drop back to 80mg/wk T cyp and nothing else.
I then wait and see what happens. I’ll even cut back or stop supplements, sarms and peptides I am on. Just give my whole body a break. Eat good, easy on the party drugs and drinking. It has always worked for me.

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