You need to self inject T twice a week and take anastrozole at time of injections.
TT was strong, and FT was not. That suggests elevated SHBG creating more non-bioavailable SHBG+T that inflates TT so TT overstates your T status while decreasing FT.
Need time of day for cortisol. Should be near 8AM or 1 hour after waking up. AM cortisol=10 is borderline.
You have adrenal fatigue and as that progresses, cortisol could have been high from stress but after time the adrenals can produce lower amounts of cortisol.
You need to post oral body temperatures as suggested below. This is important. Note that two sets of temperature are needed.
In the thyroid basics sticky find references to: rT3, fT3, stress, adrenal fatigue and Wilsons’s Book ← read that.
With a thyroid issue like yours, we can see TRT making things worse as the increased/restored metabolic demands of T can outstrip the metabolic capacity of your body with low thyroid function and lower cortisol levels. There is no simple fix for adrenal fatigue. Taking T4 meds simply increases T4–>rT3. One needs to take T3 only meds to drive down TSH and T4 production. In USA get 25mcg time release T3 from compounding pharmacies.
Get SHBG tested. E2 management is important to influence SHBG levels. Get E2 under control for some weeks before testing SHBG.
Thyroid: We need your history of using iodized salt. Iodine is part of your thyroid hormones.
Magnesium labs: If you get foot or leg cramps or can tense and get a muscle to lock up, your are deficient. See “ZMA” product in this site’s Biotest store.
Never test serum DHEA, only test DHEA-S
We need:
age
height
waist size
weight
Ferritin=80 is considered adequate to support fT4–>fT4 conversion.
fT3 is the only active thyroid hormone, there is no receptor for T4
fT3 should be mid-range=3.2, so you are a bit low.
fT4 as adequate at mid-range
TSH is elevated because of two influences:
- inadequate iodine
- fT3 blocking fT3 at hypothalamus
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 number 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.