T Nation

New to TRT with Hypothyroidism *updated labs 6/5*


#1

Hello,

I would appreciate some feed back and guidance. I just started TRT 2 weeks ago and have been on LEVO for 2 years at 100mcg.

I still feel my thyroid is not dialed in yet as I still have many symptoms.

please see my details below.

age: 40
height: 6’2
waist: 44"
weight: 315lbs
describe body and facial hair: body hair on legs, none on chest or back. Facial hair: able to grow a beard, not super thick
describe where you carry fat and how changed: mostly mid section (beer belly) (love handles)
health conditions, symptoms [history]: low energy, constant low grade haedache, brain fog, low sex drive, bad short term memory, itchy scalp, dry skin around nose and under ear lobes. unable to sleep through the night, tossing and turning. low motivation. sleep apnea, frequent urination( 2 times a night),
Rx and OTC drugs, any hair loss drugs or prostate drugs ever:
Phentermine HCI 30 MG capsule, 1 cap daily, started 5/30/17
T Cyp 200 MG/ML, 0.5 ml IM once a week, 2 injections so far
Citalopram 20 MG tablet, 1 tab daily, been using for 2 years
Levothyroxine 100 MCG, 1 tab daily, been on this dose for 1.5 years
CPAP Machine
ALL MEDS LISTED ABOVE

lab results with ranges:
Testosterone
DEC '16
Test 134/ngdL range:300-890ng/dL
Free 2.3% range: 1.6-2.9%
Test free Cal 30pg/mL range: 47-244pg/mL
SHBG 18nmol/L range:11-80nmoi/L

Testosterone
MARCH '17
Test 251/ng/dL range 300-890ng/dL
Free 2.4% range 1.6-2.9%
Test free Cal 61pg/mL range 47-244pg/mL
SHBG 16nmoI/L range 11-80nmoI/L
(these labs were take after being on CPAP machine)

Testosterone
May '17
Test 151ng/dL range 300-890ng/dL
Free 2.4% range 1.6 - 2.9%
Test Free Cal 36 pg/mL range 47-244pg/mL
SHBG 16 nmo/L range 11-80nmoI/L

DEC '16
FSH 1.7 mIU/mL range mlUmL
LH 3 mIU/mL range mlU/mL
PROLACTIN 7.9 ng/mL range 3.5 - 19.4 ng/mL
TSH 2.87 uIU/mL range 0.20 - 4.50 uIU/mL
CHOLESTEROL 179 mg/dL range 0-199 mg/dL
TRIGLYCERIDES 75 mg/dl range 4-149 mg/dL
HDL CHOL 41mg/dL range >39 mg/dl
CHOL/HDL ratio screen 4.4
LDL CHOL 123mg/dL range 19-130 mg/dL

describe diet High protein, low carb. been on this diet for a month now. Iodine salt with every meal.
describe training no training
testes ache, ever, with a fever? Twice a year and last for about a week, no fever.
how have morning wood and nocturnal erections changed still get more wood.

I have had a DRE, Sept '16
I have not been tested for thyroid autoimmune markers

ORAL BODY TEMP
6/2-6:00am wakeup- 96.3 and 95.8 ( tried 2 different spots in mouth)
8:30am-97.6
1:30pm 98.3


#2

I understand that you use a lot of iodized salt. But non-iodized salt comes in almost identical packaging. Please look at your salt container so we have an explicit result.

Check body temps on-going for a while.
Body temps can be low from thyroid problems that are not iodine related.

TSH=2.87 is a major problem.
Do you uses vitamins that list iodine and selenium?
Selenium deficiencies can lead to physical harm to the thyroid and auto-immune attack.

Labs:
TSH
fT3
fT4
rT3
thyroid auto-immune panel

Low SHBG can be a sign of diabetes.
Need labs for:

  • fasting glucose
  • A1C

HDL is low. Take:

  • fish oil
  • 25mg DHEA then test DHEA-S later to be a bit above mid-range
  • high potency B-complex multi-vit with trace elements including 150mcg iodine + 200mcg selenium
  • vitamin C 1000-2000mg per day
  • magnesium supplement, see ZMA in T-nations bio-test store
  • 5000iu Vit-D3, find tiny oil based capsules
  • Natural source Vit-E is any sign of elevated blood pressure

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

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.


#3

LABS 5/19

_Test 151 ng/dL RANGE 300-890nd/dL
Test free 2.4% RANGE 1.6%-2.9%
Test Calculation 36 pg/mL RANGE 47-244pg/mL
SHBG 16nmol/L RANGE 11-80 nmol/L


LABS 6/3

ALT 34 U/L RANGE 9-55U/L
AST 23 U/L RANGE 10-40U/L
_CHOLESTRO_L 192mg/dL RANGE 0-199mg/dL
TRIGLYCERIDES 65mg/dL RANGE 4-149mg/dL
HDL 42mg/dL RANGE >39MG/dL
CHOL/HDL RATIO SCREEN 4.6
LDL 137mg/dL RANGE 19-130mg/dL
Vit D 25ng/mL RANGE 20-80ng/mL
TSH 2.25 uIU/mL RANGE 0.30-4.50uIU/mL
T3 free, serum 2.7pg/mL RANGE 1.7-3.7pg/mL
T4 free 1.2ng/dL RANGE 0.7-1.5ng/dL
HEMOGLOBIN 14.4G/dL RANGE 13.4-17.5g/dL


LABS 6/5
Tes_t 490ng/dL RANGE 300-890ng/dL INCREASE FROM 5/19
Test Free 2.5% RANGE 1.6-2.9% INCREASE FROM 5/19

Test Free Calc 121pg/mL RANGE 47-244pg/mL-DECREASE 5/19
SHBG 18nmol/L RANGE 11-80 nmol/L _INCREASE FROM 5/19

ORAL TEMPS
6/2-6:00am wakeup- 96.3 and 95.8 ( tried 2 different spots in mouth)
8:30am-97.6
1:30pm 98.3
6/6-6am 96.8
830am 97.7
130pm 98.1
6/7
730am 97.5


#4

fT3 looks good at mid-range, but the range is different, so maybe fT3 is low and the ranges are simply different or absolute results are lower across the board. Body temps will tell.

Take 5000iu Vit-D3 every day, take 25,000 first 5 days. Find tiny oil based gel caps. Take Vit-D3, fish oil, DHEA with low fiber meals. High fiber reduces absorption.

Low triglycerides may be indicating extreme diet.


#6

UPDATE LABS FROM 6/5 ABOVE

I have only taken 2 shots of Test so far.

I still feel like crap most of the time. constant headaches, always tired, bad sleep, today i have tingling in my hands.


#7

Hi there.

Estradiol (E2) labs have not been posted. We have no idea where your estrogen level is and that would help a lot to know.

@KSman said:

Low SHBG can be a sign of diabetes.
Need labs for:

  • fasting glucose
  • A1C

Tingling hands could be another sign.

Depending where you live, you can order labs privately without having to see a doctor. Discountedlabs.com or privatemdlabs.com. Both use labcorp to draw the blood.


#8

thanks for the reply,

I have not has E2 done.

I will get on this ASAP.

I do have a Labcorp near by