T Nation

Low Sex Drive (Thyroid Cancer)

I’m 34 and three years ago I got diagnosed with Thyroid Cancer so once they found that I had to get my Thyroid fully removed. I have been taking Thyroid medicine since but my sex drive has not been the same, I have been married for 10 years and it’s starting to effect my marriage. I have been to my doctor that monitors my Thyroid medication and he did blood work and my total t came back at 456 (249-836) and so he said everything looked fine. Please help on what to do next.

We need thyroid labs because doctors tend to get undermedicated, Free T3 should be at least midrange or higher, Reverse T3 <15 ng/dL. Your testosterone is not fine, it doesn’t seem like your doctor gets it, Free T was never tested, you know the free portion of testosterone circulating in the bloodstream.

Your SHBG binds sex hormones so you can have a guy with low SHBG and plenty of Free T, but have a guy with SHBG midrange and Free T below midrange. If your SHBG was midrange, I would expect Free T to be sub-optimal and this would help explain symptoms.

You need to seek out a TRT specialists and not some ordinary doctor, most GP’s and endocrinologists are inadequate and are ignorant in sex hormones. Going to an anti-aging doctors is recommended, they tend to be the leaders in TRT.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction.

Your testosterone is much lower than your peers, most men your age are scoring >600 ng/dL. You need to understand most doctors have zero knowledge and determine normal status fixating on reference ranges and have no real understanding in sex hormones or what is a normal testosterone level for a 33 year old.

What else have you had checked? What are your meds? Did you lose you parathyroid glands as well?

I haven’t had my Estrogen checked or anything else just Free T and my normal Thyroid blood work i get done.

My meds is just Levo .175

I honestly don’t know if I lost my Parathyroid gland but I’m pretty sure I didn’t

Yeah I was thinking the same thing, I will have to talk to my wife about this option since she’s not totally on board for this track.

I will still go to my Endo for the Thyroid though, correct?

You should have 4 parathyroid glands. They are normally the size of a grain of rice each, and are frequently removed with the thyroid accidentally as they exist right behind it. They should have checked your PTH (Parathyroid Hormone) levels to make sure. It is extremely irresponsible if they did not.

My advice is determined by how well you doctor is managing your hormones ~ thyroid labs. So far I’m not impressed with the testosterone panel.

Post the rest of your labs and then we can have a productive conversation.

Where are you located?

I’m in Tampa,FL. I currently go to Moffitt Cancer Center.

I know they test my Calcium levels every time and they’re in range, but I’m guessing this is not good enough?

What is “in range”. The range is fairly useless in regards to Calcium. You have Norman Parathyroid there in Wesley Chapel, he has a whole giant area at Tampa General. He also has an associated Thyroid center in house. They are better than Moffitt IMO.

Thanks I’ll check them out, do you think he could help with my Testosterone or is that something I need to handle elsewhere?

Your lucky, Defy Medical is in Tampa, FL and I joined their care almost a year ago. Dr. Saya is a leader in the field of TRT and thyroid treatment among other things.

He’s cocky and knows about zero regarding TRT, but he’s incredibly good with parathyroid and his partner is incredibly good with thyroid.

I know it’s different for everybody but what do you pay a month on average for the TRT and blood work?

It’s typically $1200-$2000 for TRT, on the lower end if no HCG. I pay closer to the lower end, but have been ordering more blood work because I always felt something was working against me and in April it came out of the woodwork in the form of vascular/edema problems and forced me off TRT for the short term.

$1200-2000 a month? I was thinking $120-$200

No yearly, sorry for not clarifying. You not just paying for the meds, but also the experience of the doctor.

LOL, okay.