T Nation

Thought Test was Low, but TSH was High

Hey fellas, 34 male here, I’ve been experiencing low T symptoms so I had bloodwork done and the doc told my my TSH is 9.09 and to see an endo. Also said my free test was good at 400’s and 500’s.
I thought I was going to be getting treated for TRT but it’s going a different route. I’m following up with endo but what’s your guys consensus on thyroid meds, are there better options? And is it true that testosterone (natural or exogenous) cannot metabolize properly and cause symptoms of low t?

With your tsh that high I would treat thyroid first.
Surprised no free t3 test. Also check thyroid antibodies.

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100% treat thyroid as there is for sure a problem there with a tsh that high. Free t3 is really what should be tested but the chances of them actually doing that are slim.

A lot of people like Armour for their thyroid med. Usually they’ll start you on t4 only though. It’s worth a shot first.

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Thanks guys, there’s more pages I just didn’t ge the chance to go through it all I’m going to check

We may be neighbors.
@longisland34

Small world bro! I’m in suffolk but work in nassau

We can exchange Dr recommendations if necessary

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Absolutely, I tried to message you

@charlie12 I did the bloods at restoration men’s health, I had an appt for Dr Rotman in Lynbrook thinking I needed TRT
But now after these labs restoration referred me to Dr Khalfin (endo) in syosset

Insane Dr Rotman is my Dr. And I’ve seen Dr Khalfin. He actually recommended her? I found her separately

Dr k is a bit of a drug Pusher. She gave me metformin for slight insulin resistance.
She actually does trt but I personally think she is not very experienced. She at one point had a pamphlet in the office about the 3 month injection for trt. I asked her about it and she said guys do well on that?? Wtf

Have her check am insulin, dhea s, am cortisol, thyroid antibodies and free t3. She is reasonable with doing tests you ask for.

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That’s crazy dude. actually restoration recommended the endo. I was planning to ditch restoration to see Rotman since I hear he’s the guy

Rotman has hcg in his office though I don’t take that.

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Thank you bro I will request all those on her bloods I appreciate it. I’m kind of bummed bc I had already accepted that I would have to treat myself for low T and that ain’t so bad since I’m a gym guy, but instead it’s this thyroid shit now that ain’t any fun Lol

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I would fix one thing at a time.
Am sure she will give you thyroid meds. She is even open to armour thyroid. Not sure what’s best.

Thyroid will take a couple months to stabilize.

Don’t rush to go on trt… You will never figure out what is causing what.

Btw am not a gym guy. But I am healthy concious.
Am 6’1 185 pounds. I do workouts at home.
Now that I got an injection in my elbow for golfers elbow I will try to build some type of bicep…lol
@longisland34

Also I saw you may be taking some designer drug… Not sure what impact that has on tsh. You may want to research…

Ill follow this thread.

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Your going to find that SHBG is probably elevated which is why Free T is closer to the bottom of the ranges and Total T closer to the top end of the ranges, they may be in the normal range, but that doesn’t mean you won’t have symptoms of low-T, something docs just don’t get.

Once you start thyroid medicine provided you have hypothyroidism, SHBG will increase and Free T will more than likely be lower. Your thyroid labs are inadequate, no active thyroid hormones were tested, your Free T3 is the active thyroid hormone (liver metabolism of T) and no thyroglobulin antibodies (TgAb) and peroxidase (TPO) antibodies.

Correct, but you probably already have high SHBG and thyroid medicine will make it worse by increasing it and lowering Free T even more in the process. IMO endo’s are the worst docs out there for treating thyroid and T related problems.

Nobody has an idea at which point a man will experience a testosterone deficiency, but Dr. Abraham Morgentaler suggests men at or below 15 pg/mL (reference ranges 10.8-26.5) are expected to show benefits on TRT.

Your doctor was taught “in range is normal”, but this is hogwash, the fact is nobody knows when you will experience low-T symptoms, not even your doctor. The numbers never tell the entire story, like how sensitive your androgen receptors are, men with less sensitive receptors will need more testosterone than a guy with more sensitive receptors.

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@systemlord
Which type of doctors would you suggest? Perhaps a urologist? This is all a little confusing to me but I’m going to educate myself

The problem is sick care, docs follow recommendations and guidelines and the endocrine society recommends TRT to men 300> and you are nowhere near that level and your Free T is “in range” so unless you find a knowledgeable doc who’s doesn’t care about getting in trouble for prescribing TRT to someone with normal levels, TRT isn’t going to happen for you.

You should be looking for a doc privately for your TRT.

I don’t need to go private. Ik your insurance is weak.
I live in a very populated area, you can find a Dr that knows their stuff.
My Dr gives me 200mg a week and I inject about 112.

@systemlord
Besides the endo, I’m keeping my appt with a more knowledgeable trt doctor and will consult with him as well. As Charlie said, I’ll ask for thyroid antibodies and t3
do you recommend any other things to test for?

@charlie12
I haven’t started the designer stuff yet, I was waiting for labs to come back and now this put a hold on everything. Not even sure ped’s would help me if my thyroid isn’t metabolizing test correctly yet