I’m a 30 year old male with a number of low-T symptoms:
- Difficulty concentrating/brain fog
- Susceptibility to depression
- Difficulty gaining muscle
- Lack of interest
- Anxiety/easily overstimulated
- Low body temperature (typically 96.9 - 97.34F when waking)
Some of these, however, could be due to my thyroid as well as POTS/dysautonomia, which I also suffer from.
Saw an endo that supposedly specializes in TRT due to my low T symptoms/low-ish free T. He caught me off-guard when he suggested 50mg clomid EOD, which is something I wasn’t at all familiar with. Having done some reading since my appointment, however, I’m a bit confused, as clomid, while increasing total T, also tends to increase SHBG and E2? This strikes me as an odd approach given my already high normal E2 and high SHBG levels?
He also prescribed me a trial dose of thyroxine to see if this could fix my subclinical hypothyroidism. I’m a bit confused by this as well, and by what appears to be the general consensus on this forum with regards to any TSH level > 3. I understand 1 - 1.5 would be optimal, however, a fairly recent metanalysis found thyroxine to be of no benefit for the treatment of SCH? https://jamanetwork.com/journals/jama/article-abstract/2705188
What’s interesting is that since upping my iodine intake after my high TSH results in July, within 3 weeks my TSH dropped from 6.1 to 3.9. In the same time, my total test also increased from 503.5 to 654, despite only a slight increase in SHBG, resulting in my free test rising from 8.2 to 10.3. While a lot of my symptoms have improved during this time, they’re still not completely cured.
At the moment I’m kind of leaning towards upping my iodine slightly as well as supplementing Vit D (levels were a bit low), and then retesting in a month in the hopes that things will continue to improve without the need for drugs. Just wondering if anyone would do things differently in my place, and what to make of the clomid prescription? Surely TRT would be a better option for raising total T and lowering SHBG?