T Nation

Low Free T3 and Low Test, What to Do?


I was wanting to get some of your guys expert opnions on the mess I find myself in. I recently have been dieting with Shelby Starnes and lost around 45lb on his regimen. I still did not look like I wanted to. I am 5'11'' and 185 lbs now and I still look fat (love handles and front stomach ect. This makes me extremely frustrated as I have been on a ketogenic diet for the past 4 months and doing 1 hr and 40 mins of cardio a day, lifting 3 times a week. He suggested I get my blood tested to see if I have hypothyroidism or maybe a underactive thryroid.

My free T3 came back as 1.6 and my testosterone came back as 177 L. Shelby told me to cut way back on cardio as we feel I would lose muscle as well. I am 22 and my levels should not be this low. I went to see an endocrinologist and he suspect i have a vericosil that may be causing the low t but he says my thyroid is normal. He thinks the weighloss may have lowered to this number. I dont agree with him because I have always had trouble with weight gain and weight loss ( I was 300lbs playing football in college...fat) I fear the endo will not give me the meds I need for either the thryoid or low T... I really want to lose the rest of this fat and finally have abs for the first time in my life lol. Ive done all this work and I feel so frustrated being forced to stop. I want to just go buy the meds myself maybe some T3 for the thy and nolva and HCG for the test. What do you guys think


My tsh was also considered normal


what was your TSH results?

TSH > 1 = possible problem
TSH > 2 = problem
TSH > 3 = serious problem

free T3 of 1.6 is horrible (assuming it is in pg/m units). It should be over 3.4 pg/ml.

read the stickies on blood tests and finding a good doctor. You need one.

You also need to check 8am Cortisol and Reverse T3 + Estradiol levels.

Don't jump into treatments until you know what is wrong and have the right tests to back it up - otherwise you will just prolong your suffering and lengethen the time it takes to find the right treatment protocol.


Are you using iodized salt? Iodine in your vitamins? Eating sea food? Note that there are no useful amounts of iodine in sea salt, lost in crystallization. You do not want to be treating an iodine deficiency with thyroid medications [you may still need those].

Check your waking body temperature before you get out of bed. Record this for a while.

Get and retain hard copies of your labs. Post results and ranges. NEVER accept "normal" from a doctor. You have to manage your own health care.

Read the stickies, you have a lot that you need to understand.

There are quite a few here with such problems at your age. And some who have such problems who have lost a lot of weight.

Please supply:

waist size= [how changed]
describe body hair and facial hair
when did you start and complete growth? sudden or steady?
changes to skin, hair, nails?
when do you think your T levels dropped?
any blows to the head prior to that? whiplash? concussions?
any reduction in peripheral vision?
testes ache, ever? -during a fever?
blows to the testes?
what drugs? - Rx and OTC -can change hormones
alcohol, weed?
what supplements?
take anything to 'burn fat'? ephedra?
steroids? ever?
prohormones? ever?
hair loss medications? ever?

You need to these labs at a minimum:
FT free testosterone
TT total testosterone
E2 estradiol

You should not self medicate as you need to know what is going on now by doing the lab work first.


Ok Here is the info requested from Ksman

-Age 22
-Height 5'11''
-Waist 32 inches
-Body Hair- really thick on head, normal on legs arms chest, pubic-no back hair-have never grown a full beard but it is enough to have to shave every couple weeks to not look trashy
-Growth- It was a steady growth, I was usually a little bit bigger and taller than most kids up until late highschool. I would say I stopped growing around 17 or 18.
-No change in nails and no hair falling out, no change in skin
-It is hard to say when my t levels dropped as I have always been overwieght and found near impossible when trying to lose weight- This weight loss was not steady coming from 300 about 2.5 yrs ago. At first I did not know anything about dieting so I would just eat 2 meals a day and run an extra mile after fball practice, somedays I would not eat at all. Throughout those two year it has been a graduall process of learning correcting my mistakes. Recently through some bb freinds I discoverd Shelbys services and decided to lose the rest of my fat so that I could start bodybuilding and then we hit this obstacle
-I did play football so a blow to the head might not be so ridiculous- The endo im seeing syas that the information so far points away from have to get a mri to check bllod flow to the pituitary.
-No loss in p vision
-no frequent testes ache
-no serious blows to testes
-no hormonal rx or OTC yet- only RX I take is adderal
-do not drink do not smoke weed
True Protien's Geranimo
Metamucil fiber (Keto Constipation)
Miralax (keto constipation)
Benadryl (for clen)
-Never taken steroids of any kind, never taken prohormones or hairloss drugs


FT- 2.29 ng/dl range 0.95-13.50 ng/dl
TT- 177 ng/dl range 280-1100 ng/dl
E2- 6.1 ng/dl range 7.6-42.6 ng/dl
TSH- 1.420 uIU/ml range 0.27-4.2 uUI/ml
ft3- 1.6 pg/ml range 1.8 -4.6 pg/ml
ft4- N/A

Cortisol 14.4

Range 8 am 6.2-19.4 ug/dl
6pm 2.3-12.3 ug/dl

going to see a urologist about a possible vericosil that could explain the lower testosterone but it doesnt explain the low thyroid.

BTW I really appreciate all the advice from you guys


Please edit the post above, use the lower right [edit] and add ranges to lab results.

How do you react to major stress?
Do you get cold easily?

Waist=32 does not seem to be a weight problem.

Please respond to iodine questions and do check body temps.


I included the ranges and also included the Cortisol

Iodine - I take a Multi Vit once a day contains 150 mcg of potassium iodine

Stress- It is hard to say- when something like that hits----I recently got laid off from work and I remember upon learning this I immediatley searched for other available positions in the company- I dont think I freak out but im not mellow yellow either- I though I lost one of my research papers that I had worked on for a long time and i was LIVID. So i guess im somewhere in between.

Yes I have noticed i get cold easy- but if i stand up or exercise it goes away- if i sit for extended periods of time (writing papers ect) I do get cold. At work siiting at a desk i was always cold during this summer.
Also during long cardio bouts ( 50 mins or more) I begin to get "cold Sweats"- it feels like my body stops sweating and I get cold- usually wears off afterward

I will check my temp in the morning

My waist is 32 but my lower back and lower stomach till have noticable excess fat. Even doning that much cardio with keto wasnt make that much difference. I was losing weight (around 2 lbs a week) but we were just not seeing the cut look that should have been showing up. Being this low in weight I only fear that further weightloss would be muscle.

Do you think it is soley my thyroid that is casuing this problem?or testosterone

Also throughout my diet I have tried mass gaining and while I do become very strong I gain no muscle.... The last time I tried mass gaining or offseason dieting I got extremely stronger ( +50 pounds to my squat) but almost no muscle was added the weight I gained went to fat around my midsection

Thnx again for ur help


again - Free T3 of 1.6 is horrible - as in major illness, upcoming total catastrophic shut down horrible.

do you have a complete list of your symptoms in bullet point format you can post?

Cortisol looks good assuming it was an 8am blood draw. was it?

with ft3 that low, it would seem to indicate a possible iodine, ferritin, selenium, and/or cortisol problem (but you seem to have plenty of Cortisol).

what was your RBC, Hemoglobin, and Hemacrit?

Did you test for D25-OH, Magnesium, B12, etc.?

with ft3 that low, my guess would be that your temp never goes above 98.0 during the day (and I wouldn't be surprised if it didn't go above 97).


RBC 4.53 4.2-6.0 M/ul
Hemoglobin 14.1 13.2-18.0 g/dl
Hemacrit 41.3 38.5-54.0 %

Ferritin- 183.7 30-400 ng/ml
D25-OH total 41 >30 ng/dl

If my temp does stay at that what does that mean.

I know i think it is horrible to but my endo is seems not to be concerned with my t3 being that low hes more worried about Testosterone- but i worry about both I want my t3 to be 3.1 to 4.6- So i can lose this last bit of fat and feel better-

I asked my endo what we were going to do about the low t3 he thinks it is just because of my diet ive been on---he say you have basically been starving your body and thats why it is that low so he wants to wait 6 to 8 weeks and take another blood test and see if it changes- I do not want to do this as even if it does change i feel i hav alway had this problem and i want to fix it- My mom also takes thy meds as she has hypo, her sister also as hypo- sister had thy removed- i am trying to get this corrected as soon as possible

also i have sort of put the diet on pause- but remaining in keto with lowering cardio- I am not losing any weight but my strength is draining still- I fear i cannot last much longer on while in this paused state- but i know if i get this fixed soon any weight i gain i will just have to lose again and so im stuck

I can post pics if needed

Thnx for the help again guys


Thonly symptoms that show to me are
- Tired often (could be the keto) but have been fatigued easily b4 keto
- cold often
- extremely slow weightloss- I was eating 1700-1800 kcals/ day +1hr and 40 min cardio and lifting 3 days a week just to keep regular weightloss of 2 lbs per week---but not getting cut just losing weight but remaining looking fat arounf midsection
-Constipation (mostly likely to keto diet)


Also the endo did another blood test his free t3 they took from me was 1.8---Thats the last peg in the normal range. I was pissed when i seemed not to be concerned with it


He* seemed not to be concerned with it


Hint: If you want to add something, you can edit an existing post, see the "edit" in red in the lower right hand corner?


This guy is seems to be a diaster waiting to happen because this is the second person that I have encountered that got screwed up. I just had a patient that was refered to us and when I was questioning him Shelly's name popped up. The patient was also one some extreme unbalanced diet as well trying to loose weigh. When i hear of 2 random people out of the blue mention some one name it really puts up red flags.

Any way Self medication is not the key, but geting proper hormone and nutritional evaluation by a proper doctor is. Since I have been working with people for over 15 years, I have them get manadatory blood test before and during different eating phases to make sure there is not undue stress to the body or having major thyroid issue. T-3 may not be the issue but rather excessive cortisol from starvation diet producing reverse t3 would be.

Competing at the national level bodybuilding my self in the past I see alot of women and guys get screwed up by people not under standing proper biocehmistry of the body. So best piece of advice would to examine why your levels are low and try to let your lifestyle, and eating patterns, with may be a few supplements allow the body to rebalance it self.


That is interesting... I still have about 10 or 15 lbs of fat to lose and i really want to do this before I level off back to a normal diet. I spoke with the urologist today and he okayd me to start a thyroid replacement therapy- this was a different specialist from the endo- I was talking with one of my friends dad who runs a anti aging clinic- he suggested a combo of t3/t4- The uro said this would help with energy levels but would it propel me to lose this last amount of weight?

The uro also seemed to think that maybe these might be just the level that my body is stuck with- the diet may have lowerded them a little but - i think i agree with him- my levels were always lower than normal-

with treatment how long do you think iit would take to return to normal-


would excessive cortisol prevent my fat loss?
Is my cortisol high?


You were asked about time of day for that cortisol lab. Low cortisol or low thyroid can slow down your metabolism and make one feel old and gain weight.

Are you feeling great? Maybe the fixation on fat loss is misappropriate right now. You make me wonder if you are really hearing what people have to say.


listen to Hard as nails. You need more tests before you jump into a treatment plan.

also before you start any thyroid treatment read stopthethyroidmadness.com/things-we-have-learned/ blog posts and read all of the links on the left.

low avg body temp = hypothyroidism (in most cases)
fluctuating body temps = hypoadrenal (low cortisol)


The time of day both labs were taken around 11am
and to answer your question, no I am not feeling great-
I know i may be fixated on fat loss, it has taken an enormous amount of dedication to get this far... and i feel im so close to my goal, but I am still open to the advice you guys have to offer

just to clarify, so you think the diet i have been on caused this?


Thnx PureChance i will read that right away.

And sorry if I seem like I am not understanding your advice- but this stuff is all new to me- I was hit with this info about a week ago and I have been researching eversince- It has been a miracle to find this out last tuesday and I have already got talk to an endo and a uro- I just want to figure this thing out and mabye improve my normal levels while im at it.