Am I right in thinking that my high-ish SHBG and high Albumin would account for my low-ish freeT? The liver tests are gonna be redone, but I think the results i’ve already got clear it up. High SHBG & Albumin = testes not working hard enough to create optimal free T = primary hypogonadism. Is that right? @ksman
Can anyone clear this up for me? I’ve got an appointment with a doc on Wednesday and I want to make sure i’ve got my head around it before I speak to him.
From what I understand high albumin and shbg would certainly decrease free t. But you’re also missing the point that lh and fsh are high, which means your pituitary is working overtime trying to stimulate the testes to produce testosterone but they are not working properly .
Also high prolactin can be from thyroid issues but you need ft3 tested.
Thanks for the reply Nathan.
Testes not responding to lh and fsh would still indicate primary hypogonadism?
I’m only used to dealing with the NHS, so going through a private company is a bit confusing for me. Optimale order labs and pass the results on to a private doctor to make a diagnosis. The labs Optimale order do not include fT3, only fT4. I can pay to have separate Thyroid labs done, but obviously the results won’t be available before my appointment tomorrow. Do you think the doc can still make a valid diagnosis with the info currently available?
I have started taking a thyroid multi vit as well as vit b complex and vit d3. Been taking them for around a week now but i’ve been working night shifts so haven’t been recording body temps as the results will likely be skewed.
Sorry yes it would still point to primary hypogonadism. You can’t make a proper diagnosis without ft3 and because your tsh and ft4 are in range I highly doubt nhs doctors will treat your thyroid issue even though they are obviously not optimal.
As for the iodine, if you are deficient ksman generally reccomends 50mg a day for 15 days if my maths is correct 
basically 750mg split into 50mg daily doses or 25mg a day if you have bad side effects. But you also need 200mcg of selenium a day.
My thyroid multi vit contains iodine and selenium. Gonna take that for 2 weeks, build my selenium up and then start taking iodoral to do an iodine replenishment. But thanks for work out the dosage for me, I couldn’t get my head around it.
After IR is 150mcg iodine and 200mcg selenium a good daily maintenance dose?
No problem man, that I’m not sure of but I’d imagine that would probably be fine especially if you eat other foods that contain iodine like dairy.
You’d be better off finding that out from ksman. There is a thread titled ksman is here where you can post a link to your thread to get his attention.
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He must be the busiest man on this forum!
Thanks for the replies Nathan, I appreciate it mate.
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Just spoke to Dr Savage. He wants to start me on Clomid at first, test bloods again in 6 weeks and see where we are.
Is that likely to help? He said Clomid works by increasing LH which in turn signals the testes to produce more T. My LH is already at a good level, will more LH do the trick?
Using a SERM with a clear case of primary hypogonadism seems a bit insane. Ask doc what he expect to happen in this situation.
Docs often use too much Clomid. Do not do 50mg/day, 25 might be OK. When doing labs try to get TT, FT, E2, LH/FSH. E2 could possibly get high. LH/FSH shows what pituitary is doing.
Do not go after T3 now. Too difficult and situation too transient.
Do the IR then drop to 0.5-1,0 mg/day.
Monitor body temperatures and note how you feel and mental clarity. Should be something even through the fog of low T.
Good call with the selenium pre-soak.
Remember the FSH:LH and high FSH connection to testicular cancer and when on TRT, test again and watch for LH–>zero and FSH that does not.
I guess he hopes my T level to rise due to increased LH. I don’t know if i’m as optimistic as he is.
Dr Savage is supposed to be one of the more respected TRT docs in the UK but he didn’t even mention my thyroid or ask about iodine. Being a bit foggy, I didn’t even think to bring it up.
Is doing IR likely to increase T? If that’s the case, should I be concerned about Clomid getting the credit from my T levels going up?
Just read that last post back, even I don’t know what I was asking there!
I do have a question though. If Clomid stimulates the pituitary to produce more LH but my LH levels are already good, is there a chance that making the pituitary work harder could stress it out?
Just had the paperwork through. They want to charge me £59/month for Clomid. Is it just me or is that really expensive?
I emailed OptiMale expressing my doubts over Clomid considering i’m already producing plenty of LH and FSH naturally. This was their reply
“Although you are producing LH naturally Clomid can still be effective at stimulating further testosterone production. It also improves fertility rather than reducing it and doesn’t inhibit your pituitary’s production of LH.
It may not work but we often see amazing increases in testosterone (sometimes more than Sustanon at 0.5ml a week!).”
So I guess i’m trying Clomid. Been prescribed 50mg EOD. I’m still on my Selenium pre-soak and will still be doing an IR. I’ll report back if/when things start changing.
I would use 25 EOD and increase after first blood test if needed.
I think they come in 50mg pills. I could break them in half, I guess. Any reason why you’d start low?
Mine also come in 50. As you said cut it in half. You can always increase the dosage if you feel like you should and your e2 is ok after 4 weeks. I got super sleepy on 25 EOD
Did you stay on Clomid or did you move on to trt? Trying to treat primary or secondary? Did the Clomid help?