T Nation

Seeing Urologist Tomorrow Morning - Labs Inside


#1

I have been having symptoms of low T. I have posted before and the recommendation was to work on my thyroid (My TSH is high and LH is low). I have been doing so, by treating with iodine and other cofactors Iodine Treatment Protocol. I feel some slight improvements, body temperatures are up, more energy, less brain fog, slightly more libido. Slight improvement in erection ability.

I am unsure where to go from here. What should I tell my endo in regards the path I want to take. Will be seeing him at 8am tomorrow.

Question 1. Should i be trying to get on thyroid meds to further improve thyroid function?
Question 2. Has anyone boosted their LH by treating their thyroid? was not able to find much information on it.
Question 3. What course of action do you recommend i take?

T level of 9.4 nmol/L = 270 ng/dl
28 Y/O, 5"8, 150 Lbs

Tests from November 2017

Free Androgen Index: 67.1 Ref >=30
SHBG 14 nmol/L Ref: 10-55
Testosterone 9.4 nmol/L Ref 8-29
*-Note on sheet (total testosterone is reported with Free androgen index, free testosterone
and bio available testosterone)
-Previous results: Testosterone was 10.4 nmol/L (May 2017) and 7.2 nmol/L(Dec
2016)
LH: 3 IU/L Ref: 1-9
FSH: 2 IU/L Ref: 1-18
Cholesterol 4.88 mmol/L
HDL: 1.29 mmol/L
LDL Calculated: 3.21 mmol/L Ref 0-3.4

Thyroid
TSH: 3.65 mlU/L Ref 0.2-4 (Note* was above reference range at 4.7 mlU/L (December 2016) and 4.39 mlU/L (May 2017)
Free T3: 5.2 pmol/L Ref 3.5-6.5
Free T4 15.3 pmol/L Ref 10-25 pmol/L
Iodine Plasma: 0.35 umol/L Ref = 0.32 – 0.66
Selenium: 1.83 umol/L ref: 1.29-2.60
Zinc: 15.2 umol/L Ref 8-20
Thyroid Peroxidase Antibody: 11.9 klU/L Ref: 0-34 (May 2017)
Thyroglobulin: 13.6 ug/L Ref: 0-50 (May 2017)

Older Labs:

Cortisol: 322 nmol/L (May 2017)
Estradiol: 67 pmol/L Ref: 0-160 (Dec 2016)
Hematocrit: 0.51 L/L Ref: 0.40-0.54 (Dec 2016)
Glucose: 5.9 mmol/L Ref: 3.3-11 (Dec 2016)
Alanine Transaminase: 62 U/L Ref: 1-60 (high?) (Dec 2016)


#2

TSH increases in an attempt to get the thyroid to produce more free hormones, except fT3 hormone level is fine, rT3 is likely blocking good fT3 levels. SHBG is low which is likely caused by rT3 blocking fT3, SHBG should increase after thyroid treatment.

You can expect a poor response to TRT with thyroid issues, TRT requires optimal thyroid hormones. Once you start TRT you will need to keep a close eye on hematocrit, regular blood donations and or a phlebotomy every 12 weeks to control hematocrit.

Some guys start losing glucose control when testosterone is low, restoring testosterone will improve glucose control. Thyroid makes thyroid hormone, it’s a seperate system than your testosterone production, however increasing thyroid will increase SHBG levels making you hold on to your testosterone better instead of secreting it into your urine.

A lot of guys believe fixing thyroid somehow increases testosterone production, this is wrong.

It was so helpful of you to bold results on labs, thank you.


#3

@KSman any thoughts?


#4

That should have support good body temperatures. If not, we suspect elevated rT3 interfering with fT3 at T3 receptors. Have we covered that with concerns with stress, adrenal fatigue etc [see the sticky].

High recent doses of iodine can make TSH labs high then the result is not actionable.

Do not know range for cortisol or time of day. Can be part of rT3 and stress concerns.

Some -ve effects of TRT can be transient or TRT may disclose a weak link in thyroid or adrenals. E2 needs to be managed near E2=22pg/ml for most guys in terms of been optimal and high E2 can mess things up.