TSH should be near 1.0
TSH probably elevated because you have not been using iodized salt. Thyroid hormones T3 and T4 contain 3 and 4 iodine atoms. Without iodine TSH increases trying to get the thyroid to work harder.
TSH is a control hormone.
The only active thyroid hormone is free T3, fT3.
fT3 comes from T4–>T3 conversion and T4 is a reservoir.
There is no receptor for T4
fT3 should be tested
T3 and T4 are inactive and most T4 and T3 are bound to binding globulins.
And reverse-T3, rT3 can interfere with T3 receptors blocking some fT3.
Confused yet? You can cut past all of that via oral body temperatures, see below.
Low thyroid function:
- depression and mood problems
- low energy
- brain fog
- low libido
- low body temperatures
- sparse outer eyebrows
- getting fat
— yes mostly the same as low T! You can have both.
Perhaps teste(s) can have vascular problems surgically repaired. But could easily be not enough.
You are not in USA, so this will be difficult to get managed properly.
During accident, was your head impacted? That can damage the pituitary and induce low LH/FSH aka secondary hypogonadism. LH/FSH labs can be useful.
Doctors will not think that T is low.
FT or Bio-T not tested. Sometimes TT is misleading.
With TT not low, docs may not see any point in testing further, you are “normal”.
How you feel is also largely affected by E2, estradiol, which opposes the effects of T in many ways. Higher E2 also reduces LH/FSH.
When young guys have problems like this, prolactin should be tested or as a follow up to lower LH/FSH numbers.
“Cheers” - UK - now its Europe…
We see a lot of iodine deficiency in UK as iodized salt is generally not available or promoted. But a few shops have it.
Clomid did not work. You cannot tell if problem was testes or pituitary. On clomid one can check to see increase in LH/FSH.
You will need a private doctor. NHS sucks.
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.
KSman is simply a regular member on this site. Nothing more other than highly active.
I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re Thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab numbers and ranges.
The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.