Low T, Seemingly High TSH - 30 YO Help Needed

@KSman would you recommend dosing daily 12.5mg of Iodine and 200mcg of Selenium as a good starting point?

Edit: One other thing I wanted to throw out there, 2 years ago I moved to an area with fluoridated tap-water. I have read that fluoride can impact the thyroid negatively, possibly through disrupting iodine levels. Not to sound like a conspiracy theorist, but I thought I would mention it. I’ve switched to bottled water now for all purposes, just to be safe.

Anyone input on the proposed Iodine & Selenium doses? @KSman? I could break the Iodoral tabs in half if 12.5 is too aggressive to start…

Logs of recent temps, taken upon waking and in late afternoon:

AM - 97.4, PM - 98.3
AM - 97.2, PM - 98.4
AM - 97.3, PM - 98.2

Update — I saw an endocrinologist to investigate the possible Thyroid angle of my low Testosterone situation. He seemed dismissive of my Thyroid being an issue, because ‘TSH of 4.5 is still fairly normal’, but agreed to do full Thyroid panel blood work to get a clearer picture of the situation. He also ordered an MRI of my pituitary gland to rule out any tumors.

I’ll report back once I have the results of these tests.

Any thoughts / recommendations in the meantime are always welcome!

Floride levels in floridated water are typically not a problem.
Bromines seem to be a larger issue as these are in some citrus sport drinks, but getting phased out. Also as a dough conditioner in commercially produded bread. Oddly, idine was used for that, but some docs said that the iodine might be dangeous, so now it bromine and the doctors are silent.

Do not use reverse osmosis water for drinking, you need the minerals.

@KSman need your input

I started the Iodine IR with Iodoral, 12.5mg a day. I have now noticed two things… I seem to have more energy, I am experiencing discomfort in the area where my kidneys are. I’m on day three. I noticed when I skipped the Iodoral dose I did not have the pain in that area.

FYI my bloodwork has never indicated any kidney issues, and I haven’t felt this sensation before…

Could the iodine be stressing my kidneys? Is it a detox effect?

Please advise!

Iodine can kill your intestinal flora. I’d take a gas pill and see if that resolves your pain.

I will try having some Yogurt, as I believe that is a natural pro-biotic.

I tried taking 6mg vs 12mg today, still had the pain, although slightly less intense. I think I may stop for now, I’m worried it could be damaging tissue somewhere.

Aside from the pain, I am noticing that I go from mentally foggy to hyper alert… almost too alert… as if my mind is racing. It’s one extreme to the other.

Ultimately, I don’t know if I have Hashimoto’s (still waiting on bloodwork), so maybe best to sit tight till I figure that out first. I have heard Iodine can actually make things worse for people with Hashimoto’s…

sigh

Interesting and encouraging result.
Are you getting selenium too?

Digestive effects do look like a good guess. But not expected with 12mg.

So I halted my Iodine (Iodoral) experiment while I waited to receive full Thyroid panel results, as I didn’t want to just be super dosing Iodine while guessing that I was deficient.

I have continued to take 200mcg Selenium daily though.

Just got the following results from the Endo:

Pituitary MRI: Normal, no tumors or abnormalities detected

IGF-1 (LC/MS): 269 ng/mL (53-331)
Vitamin D25-OH: 72ng/mL (30-100)
Testosterone Free: 199 pg/mL (35 - 155)
Testosterone Total: 667 ng/mL (250 - 1100)
Ferritin: 144 ng/ mL (20-345)
FSH: < 0.7 (1.6 - 8.0)
LH: < 0.2 (1.5 - 9.3 mIU/mL)
Thyroid Peroxidase Antibodies: 1 ( < 9 IU/mL)
Hematocrit: 43.9% (38 - 50 %)
Prolactin: 6.9 ng/mL ( 2.0 - 18.0)
Iron: 84mcg/dL (50-180)

T3 Total: 86 (76-181)
T4 Free: 1.0 (0.8 - 1.8)
TSH: 1.4 (0.4 - 4.5)

Metabolic panel was totally normal – no kidney, liver, or diabetic issues.

Now, what really jumped out at me here is that my Thyroid TSH went from 4.5 to 1.4. The two consistent changes I have done during that time (2 months) is bring my Vitamin D3 levels up from 26 to 70 … and go on HRT (100mg / week). The Iodoral and Selenium I actually started AFTER I had this blood drawn, but before I got the results, so we can’t really say they are a part of this blood snapshot.

Could either of those things explain a TSH going from 4.5 to 1.4? How do the other Thyroid markers look?

See like to see TSH closer to 1.0 and T3, T4, fT3 fT4 should be close to mid range. Your T3 and fT3 are low. Keep track of your body temperatures and note if you start to feel more alert.

Vit-D25 very good.

TT could be better, but may be an effect of lower SHBG.

Hematocrit is low for those T levels and lower than pre-TRT.
Have you donated blood?
Suggest an occult blood test to look for evidence of a blood loss via GI bleed. Simple poop smear test. Must point out that ferritin and iron do not indicate a GI bleed. RBC should be strong with TRT.

How long were you on TRT for this lab work?

Missing lab work:
E2

No need to do these again: LH/FSH, prolactin

What was exact lab timing relative to injections?

@KSman KSMan I will try resuming the Iodoral IR regiment, now that it appears I do not have Hashimoto’s. Perhaps that will help get my TSH from 1.4 to 1.0 territory. I’ll continue dosing Selenium 200mcg.

Any thoughts on that TSH change from 4.5 to 1.4 though? It seems a pretty drastic reversal, could the TRT have caused that?

For this latest lab work I had been on TRT for 3 weeks.

I injected 100mg Test Cyp on a Monday and had the blood pulled on a Friday, so ~4 days or so with the lab timing.

I haven’t donated blood recently but because I am seeing two diff doctors (urologist, endo) they have each been ordering many tests, so leading up to this latest batch of blood work I had already given 12+ vials of blood that week… maybe it impacted the Hematocrit? RBC was 5.08 (ref, 4.2 - 5.8) for this latest labwork.

I really want to know my E2 now that I have started TRT… I have a lot of muscle mass but my bodyfat is 20% so I am worried about T >> E conversion. I have some Arimidex ordered from ADC since my doctors have been dragging their heels on it.

Biweekly dosing will help reduce T->E2.

I’m also around 20% BF and yes, my E2 increased to an intolerable level. Working on the BF levels at the moment.

Do you have any symptoms?

The big drop in TSH is interesting, but we do not know what that means.

Note that larger doses of iodine cause high TSH levels, a natural reflex. TSH labs are then misleading at best and you should be down to a maintenance dose for a few?several weeks before TSH labs are useful.

@gonadthebarbarian

I suspect an E2 increase because my first two weeks of TRT were amazing… tons of energy, positive mental state, rock hard erections, etc. Now… things are still better than they were prior to starting the TRT, but I feel a bit more emotional and my downstairs equipment isn’t quite as solid. Worried my body started converting that rise in T to E2.

I have been taking 50mg of Zinc Gluconate before bed to try and help with that while I wait for my Arimidex to arrive. What are you using now?

I’m working on the bodyfat % as well, just trying to do so gradually as I am a powerlifter and don’t want to ruin my strength.

@KSman

That is good to know about Iodine boosting TSH values. All my bloodwork posted so far has been pre-Iodine supplementation but I will keep that in mind for the future.

Plan now is to do your IR protocol. Going 6mg/day or a few days, then up to 12.5mg daily, and gradually work up to 50mg/day for 2 weeks.

My temps haven’t been great lately, even with the improvement in TSH value.
Averaging 97.8 @ afternoon.
There have been mornings I have woken up with 96.8…

Really hoping the IR yields some results here since it appears I do not have Hashimoto’s…

I’m doing:
12.5mg clomid
multivitamin
I just finished my 60 day course of one iodoral pill/day
vit d-3: 5000iu
dhea: 25mgs
arimidex: .5mg/week

Cutting sucks. I’m on day 4 or 5 of cutting out refined sugar and fructose. I’m like a fucking crack addict when I see cookies or other sugary goodies. I am losing the weight though, muscle seems to be sticking around so far. Strength is still decent. The higher T level really seems to be helping. In the past when I have cut down to 150lbs from 180lbs I still had fucking love handles and I lost all my gains. :frowning:

At least lost gains return quickly…

What are your morning and afternoon temps now, after that 60 day course? I just restarted IR with 12.5mg a day… so far feel OK but no change in temps yet.

I am following your lead with .5mg/week of Arimidex. Mine just arrived today, mixed it with Vodka so that each dose is .16mg and I will dose throughout the week to hit .5mg total.

How long did you start to notice a change from the Arimidex? I am hoping for my morning wood to return :cry:

And I feel ya on cutting… the whole time I had terrible T levels I still had great strength (600+ deadlift) but if I attempted to cut my body dropped strength and muscle very quickly.

EDIT: ~8 HRs after dosing that Arimidex (.16mg) my libido seems to be returning… can it work THAT fast?? I was expecting it to take a few days before I noticed an effect :open_mouth: Maybe I am a hyper responder?

Yes, I noticed in a day, but I took 1mg as my inital dose. Not good, I crashed out my E2 big time. I have a very obvious sign that my E2 is too high, my nipples itch so bad I want to burn them off with a hot poker. After recovering for a day, my nipples stopped itching.

Give it two days before you decide to adjust anything. The half life isn’t as long as clomid, so regimen changes can show up quick. Also realize that if you stop the AI for any reason, you MUST taper. Your body will make more aromatase in response to the blockage, if you go cold turkey, your E2 will crash.

I also tried .3mg/week, and it just wasn’t enough. Get yourself a quick method to dose accurately and you can adjust if needed.

Glad to hear you are doing better!

It has become a suspicion of mine that some of the “clomid side effects” are actually from not managing E2 levels. You have seen what a difference it can make…

edit: After my course of iodoral waking body temps are now in the normal range.

Thanks @gonadthebarbarian , you and KSMan have been super helpful!

I am going to stay the course with the Iodoral, body seems to be tolerating the daily 12.5mg dose well now. Your results are very encouraging.

I think my Arimidex dosing is accurate. I put 6mL of Vodka into a flash, then dropped a single 1mg Arimidex pill in there and let it dissolve. With an oral syringe I pull out 1mL at a time after shaking thoroughly … should be .16mg. Had morning wood for first time in a few weeks this morning, quality wasn’t 100%, but it’s a start in the right direction I am feeling optimistic… I will try dosing EOD and see how I feel over the next two weeks. Eventually I will pull some blood for E2… want to get close to KSMan’s ideal ‘22’ value.

HCG is another matter altogether… haven’t had any luck talking my Eurologist into that yet, but I am working on it.

Quick minor update lads…

Been dosing Iodoral @ 12.5mg daily (w/ 200mcg Selenium) for a couple weeks now, afternoon temps have not risen above 98.2 on average though. Going to go to 25mg daily and see what effect that has.

E2 control is very frustrating — it seems to be a moving target. I started with 0.16mg A-Dex EOD and that was a definite improvement from no AI, but still seemed to give inconsistent results with erections. I just recently ramped up to 0.25mg EOD but haven’t noticed any change yet. I wish Aromasin was cheaper, I’d like to give that a try… seems like it would be easier to tinker with too.

My next labs are on 7/1 so I will keep you all posted. My goal for next Urologist appointment is to get him to commit to giving me HCG. I want children some day and don’t feel comfortable doing TRT long-term without it.