How Commonly Does TRT Unveil Thyroid Issues?

Just got my 3 month blood test results in, and the big red flag to me that I can’t explain is my TSH jumping to 3.5. It has in the past gone as high as 2.5 (including right before TRT) but is typically 1.5.

I’ve also had ongoing issues with fluctuating prolactin levels (which are higher yet now) and I’ve read that thyroid issues can cause it to bounce around.

I tried Ksman’s thyroid tests last year and from how I did it, seemed fine. So please (respectfully) hold the suggestions to do that. At this point, the numbers have spoken - really just wondering if this is a common thing. Yes, I do consume iodized salt, but not in any specific amount or frequency.

I talk to Dr Saya about this in a couple of weeks so not trying to do anything drastic yet and muck things up.

Its very common TRT to exposed hypothyroidism.

But on the other hand many people have reported of TSH initially and then to normalize at some point.

Prolactin is another strange animal regarding TRT. Most people claim that it is reduced from testosterone, but with some people seem to jump with not frequent enough injections. I guess it may have something to do with estrogen?(just guessing)

With thyroid you have only one important question. How much is your FT3?

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Hey man. Good question on the FT3. I may ask Defy if they’d recommend ordering a full thyroid panel now to save time. Probably after I ensure for a week that I’m getting enough iodized salt.

This isn’t the highest my prolactin has ever been but it’s definitely never consistent.

FT3 is the most important feature of your thyroid that many docs dont test. But I would suggest to have them all tested at once - TSH, FT4, FT3, Reverse T3, TAT, MAT. Yes, I know its expensive but thats how I test every time, otherwise I need to take the glass magical orb out…

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What?

Thyroid issues expose themselves with symptoms and testing.

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TRT masks thyroid issues and makes it even more difficult to determine the root cause of symptoms related to thyroid disorders

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I could see that normally. I feel a lot better. But this is hands down the highest my TSH has ever been.

Defy front desk is asking Dr Saya if more tests should be ordered.

Increased testosterone levels require all the body to work at higher rate. A slugish and unoptimal thyroid like most people have may not be able to keep up to. But its better first to optimize testosterone and then pay attention to thyroid optimization.

My thyroid is not optimal as well although in range and I feel some symptoms. Maybe will start taking armour thyroid at some point

You’re saying that TRT “exposes” hypo issues, which isn’t true.

Underlying issues are still there. Adding more T only aggrevates the issues. It doesn’t expose them.

Anyway, best to get blood work before going on TRT and afterwards to see what’s been affected.

Some are secondary hypogonadal, which should send the signal to get other hormones your pituitary conducts checked out.

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Ah basically what I meant…aggravates what’s already there. Let’s see how the extra bloodwork pans out.

Another thing to think about is that people who are looking into TRT think they don’t feel well, then if they go to a competent doctor and run the whole slew of tests, they find thyroid issues as well. This is what happened to me.

Found out most with thyroid was good, except RT3. It was really high, so I addressed it then.

That assumes that RT3 is low. You could have really good FT3, but in the presence of high RT3, it is not going to do much for you.

@mnben87 I doubt FT3 can be really good when RT3 is high. FT3 in range does not mean it is good. This hormone is like testosterone. In range means nothing

I can agree to that somewhat. My FT3 actually was pretty good (assuming top of range being good), but my RT3 was above range.

I think if you are top of range for something like Free Testosterone, you are probably okay. However, if you are bottom half, something to worry about even though you are in range.

@mnben87 Yes man, in range doesnt mean anything with testosterone and FT3 you really want to be at the top and with testosterone and this crazy top margin of 900 you sometimes need to be above the top. This range is based on a population with sick hormones.

I got interested in your case, how much was your FT3 with the ranges and your RT3? Can you find labs?

So before any treatment my labs were:
Thyroid:
FT3 - 3.7 pg/mL (2.0-4.4)
RT3 - 25.8 ng/dL (9.2-24.1)
TSH - 1.940 uiu/mL (.45-4.5)
FT4 - 1.57 ng/dL (.82-1.77)
Testosterone:
Total Test - 390 ng/dL (264-916)
Free Test - 10.8 pg/mL (8.7-25.1)
Other:
E2 - 24.1 pg/mL (8-35)
SHBG - 34 nmol/L (16.5-55.9)

I have other stuff too, but this is what I thought was applicable.

I do understand that the ranges have nothing to do with the measurement equipment. The equipment gets calibrated, so each brand is pretty consistent with each other.

The ranges have changed recently, and not due to equipment or lab techniques. TT used to have a range of 350-1100 ng/dL. Now it has a range of like 260-915 ng/dL. I speculate it has to do with insurance companies not wanting to pay for TRT.

@mnben87

Your Ft3 is not so bad, its just at the border of optimal. Mine for example now is 2.8

According to Dr. Abraham Morgentaler and expert in testosterone you will start to see benefit on TRT 15> pg/mL, so being at 10.8 and then there’s the testing methods used which is known to overestimate FT levels by 40%.

Things were never acceptable or remotely good.

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Ft3 looked good. It was the Rt3 that was not so good. If Rt3 is elevated it will negate good levels of Ft3.

@mnben87 How confident you are in this and where so you know it from? I ask, because a respected doctor told me RT3 is not so important if the FT3 value is good enough