T Nation

Thyroid Help? Bloodwork

Have all the symptoms of low thyroid and low t. I’ve recently started trt and hcg, its been 3 full weeks on trt. I know its early but feel little better but overall symptoms are still there. Dr wanted to put me on thyroid meds from get go as he thought my free t3 was borderline low, i told him lets hold off for now and do one thing at time. Really so i could research it some more. Thoughts on thyroid numbers?

Total Test = 321 (264-916)
Free Test = 10 (8.7-25.1)
SHBG = 18.9 (16.5-55.9)
DHT = 26 (30-85)
DHEAs = 321 (138.5-475.2)

TSH = .956 (.45-4.5)
T4 Free = 1.28 (.82-1.77)
T3 Free = 3.2 (2.0-4.4)
Reverse T3 = 25.3 (9.2-24.1)
Thyroglobulin Antibody = <1 (0-.9)
Thyroid Peroxidase (TPO), AB = 9 (0-34)
Cortisol Saliva Test = All normal, and on low side

TRT protocol is 100mg/wk,split into 3 injections. 1000mg HCG split into 2 injections. I should note the bloodwork above is pre trt numbers. I will update bloods in 3 more weeks at 6 weeks total mark.

The Free T3 is the master thyroid hormone, it increase metabolism and while Free T3 may not look bad on its own, but having Reverse T3 elevated means a portion of your Free T3 is not making it into your cells because Reverse T3 is competing for the same receptor. I don’t see and estrogen testing, if we had a hint as to your estrogen levels, I could predict how this will turn out.

Interesting. Thanks for reply, I have several more bloods I didn’t include.

Estradiol sensitive = 23.4 (8-35)
Ferritin = 196 (30-400)
Iron = 93 (38-169)
Iron Saturation = 33% (15-55)
Iron Bind Cap TIBC = 280 (250-450)
UIBC = 187 (111-343)

How would I lower my reverse t3? Thanks for help.

thoughts, here is my e2 and iron labs?

All results of your tests very perfectly fine, reverse t3 is also fine, I feel give some time for TRT to show effects. While improvements like energy levels, libido and muscle strength come early. Mood and behavioural changes will take 6months to a year. If you still feel no changes after 2-3 months, bring you total testosterone levels 500 to 600 range

Your reverse T3 is high, above range high. I think that you ought to reconsider the T3 meds. You will probably benefit quite a bit from some T3.

Given your free T3 level, you would not want reverse T3 over 16, so yours is too high.

Thanks for reply, understood on it being high, but how does one go about lowering it? Or is only thyroid meds the solution?

Iron labs are optimal, ferritin stored iron is optimal (>70) supporting optimal thyroid function. Reverse T3 is elevated do to another reason, the cause could be numerous. In my case dietary changes and lifting weights lowered my Reverse T3 24->17 in only 6 weeks.

It was the improvements in insulin which had an impact on Reverse T3 and also increased SHBG 16->22. It was a domino effect that probably impacted other systems in a positive way.

One could theorize Reverse T3 was elevated do to low testosterone, testosterone and thyroid work in concert.

Your estrogen labs were good but I expect estrogen to be above range by doubling Total T, more frequent injection is needed if you want to avoid an AI.

You likely will not need high normal Total T levels, probably somewhere in the 500-600 ranges you will see Free T at the top of the reference ranges. The optimal Free T ranges is 20-26 pg/mL, the ranges of young 21 year old man which is what we should be using as our goal post.

Thanks for reply. I bet I’m in exact same boat as I’m 25% bf and just started working out again. Once I get that in check with diet Ill retest bloods and go from there.

Make sure you are eating enough. If you are dealing with excessive stress, work on that. Some medications can cause it, are you taking any rx drugs? Get enough iodine, selenium, zinc and iron in your diet, or supplement. Any inflammation? Maybe try an anti-inflammatory diet?