Labs. Need Your Wisdom for Newbie

Hi all -
I’m 59yo in pretty good shape, 5’10", 150#, 15%bf.
On thyroid replacement and considering T. Found a good doc that seems super knowledgeable and he’s been on T for almost 15 years.

All informed insights would be so appreciated and welcomed. Thank you!

Free T4 Index: 2.5 Range 1.4-3.8
Free T3: 3.1 Range 2.3-4.2
T4: 7.4 Range 4.9-10.5
T4 Free: 1.3 Range 0.8-1.8
Glucose: 91 Range 65-99
Insulin: 4.3 Range 2.0-19.6
Growth Hormone: 0.1 range < OR = 7.1
SHGB: 32 Range 22-77

Labs are:
HDL: 54 Range: >40
LDL: 122 Range: <100
Trigs: 79 Range: <150
Glucose: 91 Range: 65-99
Total Testosterone: 539 Range: 250-827
Free T Calculated: 81.3 Range 46-224

Estradiol (Male test): 30 Range <40
FSH: 3.2 Range: 1.6-8.0
LH: 3.7 Range: 1.5-9.3
DHEA S: 48 Range: 38-313
Free T3: 3.1 Range: 2-3.4.2
Free T4: 1.3 Range: .8-1.8
TSH: 2.09 Range: .4-4.5
Cortisol: 12.2 Range: 4.0-22.0
Prolactin: 6.2 Range: 2.0-18.0
Protein, Total: 6.0 Range: 6.1-8.1
Hematocrit: 45.0 Range: 38.5-50.0
PSA: 0.3 Range < or = 4.0
T4 Thyroxine: 7.4 Range: 4.9-10.5

Numbers look pretty good. What are your symptoms?

I bet, whatever you feel like, you would feel a whole lot better if you doubled, or tripled, your free testosterone. I’d look into taking DHEA as well.

@highpull Your comment is basically what my HRT Doc is saying. T + DHEA.

Your TSH is kinda high. You might ask him about this. I’ve always heard less than 1 is ideal.

Low energy, a little mental fog and some lack of motivation, which is not like me. No sexual symptoms. So given the numbers, I’m iffy on whether or not I should go down the TRT path, but really appreciate all input.

Would you expect his TSH to be high if he is on Thyroid Replacement meds?

See @highpull’s answer above. Especially since you appear to have a knowledgeable doc.

No, its the other way around. When T3 and T4 are too low then TSH increases to stimulates the thyroid gland to produce T3 and T4.

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@studhammer I’m not sure I understand your comment. My t3 and t4 were ‘normal’. We’re making a generic comment or one about my posted labs?

Right, he’s on thyroid, it just isn’t working very well.

Your thyroid is not optimal. TSH should bottom out and fT3 should approach 4.2. You should not feel tired.

It no wonder your considering TRT, you are underdosed on thyroid medicine, quite common for a lot of people because doctors that are lacking in knowledge are overly afraid of suppressing TSH, but that’s the point at which patients start feeling better.

Someone optimized on thyroid medicine, you would expect to see TSH suppressed to near zero or under 1.0. Healthy young men in their prime see TSH closer to 1.0 or lower.

I don’t see Reverse T3, Reverse T3 competes for the same receptor as Free T3, if elevated Free T3 is unable to soak into your cells. No SHBG testing either, this test is needed to figure out the best injection frequency for TRT, low SHBG means smaller multiple injections per week, higher SHBG and you can get away with 1-2 larger injections per week.

Thyroid is pretty complicated for most people to fully comprehend, far more complicated than TRT.

@systemlord you sound so knowledgeable about thyroid and I certainly don’t understand it. I’m currently taking 88mcg daily in the AM at least 30 min before food. Do you have any thoughts on synthetic vs Armour or compounded thyroid meds? It sounds like you think my dosage should be bigger? All input and any materials you can point me towards would be super appreciated. Thanks !

Everyone responds differently to certain types of thyroid meds, certain people do better on armour and others on NDT.

I take armour thyroid at 178 mcg. Works great

Hi All -
Just posted additional lab numbers in the original post to this thread. If anyone has time to take a look and comment, much appreciated.