T Nation

Need Help Finding A Doc (NJ) - Will Travel


#1

I am not on TRT, however my testosterone is high. However I feel like SHIT.

Lab Work:
Total T: 861 ng/dL
Free T: 174.8 mg/mL ( HIGH -was out of range )
Tsh: 2.41 miU/L, which I know is high to alot of people!
T4 Free: 1.3 ng/dL

Symptoms: all most everything of low t…
Fatigue
No Morning Wood
Weak Erections
Low Libido
Muscle Weakness
Trouble maintaining 13-15% bodyfat
Feeling more down? not full on depression… ( more down because im so frustrated )

I have two theories:
I have high e2 or hypothyroidism

I’ve been to about 5 different endos- NO ONE will run more tests or attempt to treat as hypothyroidism.
This problem has been on-going about 3 years now and I can’t take it anymore!!
I’m willing to travel somewhat depending how far and how worth the drive will be! I need help unless I can self treat myself.


#2

You also need a full thyroid panel, thyroid issues can mimic low-T symptoms. You can gauge your thyroid by taking am and mid-afternoon temperatures with a mercury thermometer. You want a minimum of 97.3 upon waking and 98.6 mid-afternoon. You also need SHBG tested, if high or low could cause problems. If SHBG is low that would limit how much FT is active to be utilised by the body, therefore making it appear you have low-T with excellent T levels. High E2 could also render test useless and low E2 could make you feel like crap.


#3

Do you suggest I do these tests alone (as in order my own blood work online), and suppose I am hypo, what do I do if I can’t find a doc to treat it? Like I said, I can’t get a single doctor to order a full thyroid panel.


#4

If you were to get the test yourself online and the results were below range you could present the labs to your doctors possible forcing their hand in treating you, it would be more difficult to ignore blood work.

Here’s the tests you would need:

Testosterone, Free and Total
CBC specifically Hemoglobin/Hematocrit
Sex Hormone Binding Globulin
Estradiol Sensitive or Enhanced
Vitamin D, 25-Hydroxy
Prolactin
C-Reactive Protein Quant
Thyroid Panel
Basic Metabolic Panel
Prostate Specific Ag Serum


#5

So even if my free t is high, it’s possible that low shbg can counter act the effects?


#6

Elevated estradiol can render T useless (counter the effects) to the body’s tissue.


#7

fT3 is the active hormone and should be tested directly.

This thread is becoming your ‘case thread’ with an odd title.

You cannot do on-line labs in NJ or NY.

You must post lab ranges, edit your opening post directly and also add any other lab data that you have.

We need your history of using iodized salt and/or vitamins that list iodine.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

DO THIS!

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.


#8

I can get my own labs done by going over the bridge in PA. Im only 5 minutes from the bridge. I have not directly used iodized salt but im am assuming its in alot of food? I dont know much about it. I will edit & add screenshots of the lab work I had done.


#10

I added screenshots of all the bloodwork I have. Tomorrow I am getting my e2 checked. Also I had my vitamin d3 checked and should have the results for that tomorrow or tuesday.


#11

There is no iodized salt typically in:

  • processed foods
  • snack foods
  • fast food
  • restaurant meals
  • breads etc

You need to used iodized salt in your cooking and at your table.
A multi-vit with trace elements including 150mcg iodine and 200mcg selenium is a good idea.

Oral body temperatures please!
If temps are low, you are hypo. You do not treat an iodine deficiency with thyroid meds, you then need iodine. I have never seen a report of a doctor asking about iodine intake, they are blind.

SHBG may be low. Can be low for diabetics. Still need to know a lot more about you.

Get AM cortisol tested, at 8AM or 1 hour after waking up.

Endos seem to be mostly idiots, but almost all docs will ignore your numbers.

Young men do not need to test PSA.
T status is good, E2 cannot be driving LH/FSH down. Same for prolactin.

This “SHBG is needed to transport testosterone through the body” is wrong. SHBG+T is not bio-available and is metabolized in the liver. SHBG+T is tightly bound. SHBG+estrogens are not tightly bound and SHBG does move estrogens around.


#12

I will take my oral temp. tomorrow morning. How do I take a cortisol test? Order a lab for that also?


#13

And afternoon body temps.
AM cortisol is blood work.


#14

My oral temperature right now is 97.4


#15

Just had these tests done and my morning oral

temp was 95.8!!


#16

Temperatures taken in a clinic are rather useless.

fT3 is the active hormone and not tested.

Find 5,000iu Vit-D3, tiny oil based gel caps, take 25,000iu first five days then 5,000iu thereafter.

AM cortisol is OK, not great. Fixing thyroid status might help this.

TSH sucks. Read all of the thyroid basics sticky.


#17

I got my doctor to agree on ordering free t3 and tpo antibodies.


#18

Would you consider my t3 low?