T Nation

Thyroid Numbers Seem Improved Since TRT

On a whim, I was at a different provider and had some thyroid tests run the other day. While the tests are not exactly the same ones I had run before, I was pretty surprised by how they seemed to be trending overall in comparison to those I had done five months ago, before TRT.

Old TSH: 4.08 (Range 0.27 - 4.20)
New TSH: 2.50 (Range 0.27 - 4.20)

Old Total T3: 0.84 (Range 0.80 - 2.00)
New Free T3: 3.3 (Range 2.3 - 4.4)

Old Total T4: 4.98 (Range 4.50 - 11.70)
New Free T4: 0.92 (Range 0.86-1.76)

Anyway, it wasn’t a total workup, but I just wanted something to look at, as my thyroid had not been tested since then. Also, I did not realize at the time that they were only running the “Free” of both hormones and not running them along with the totals. However, looking at where they fall in the reference range, I do think the numbers look more positive. I am curious as to what the cause might be. I have lost weight since then and have been exercising much more. I just wonder if the T or what the cause might be for what looks to be somewhat improved function.

Regardless, I still think that T4 is a bit concerning. I plan to get a full workup at my next visit with my primary physician and look at it more closely. As some others have mentioned to me, I do think the lower T4 may be hampering my weight loss a bit.

Anyway, I just thought I would throw them out there for input. Hope you guys are all doing well.

I’ve noticed a similar thing with myself. Obviously the endocrine system is very complex and I do believe that there is a relationship between testosterone and thyroid hormone that is not fully studied.

From my own experience, when I got on TRT I needed to lower my thyroid medication dose because I was starting to get hyperthyroid. I know a lot of people on the forums say TRT will be less effective if thyroid levels aren’t optimized, but I also believe the opposite is true as well.

The only thing you can directly compare is the TSH old and new, but the others are mixed up with T3 (inactive) and Free T3 (active). Tomorrow when you’re not testing TSH could be 4.0 for all you know, you just caught it at 2.50 on some random day.

As @galgenstrick stated the endocrine system is complex. TRT will demand more from everything.

Really? I was thinking that T3 was the total of active and inactive, but Free T3 was isolated to be only the active component. Is this wrong?

It’s a bit of a crap shoot, Free T3 is best for diagnosing hypothyroidism because all of it is free and you can see how much is making it into the cells.

You can’t determine how much is going into the cells testing for T3 because as you say it’s the total of active and inactive and doesn’t provide as useful information. Your T4 is low so your hormone pool (reservoir) to convert to these other thyroid hormones may be why TSH is at 4.0 on occasion.

I’m left wondering where your Free T3 is when T4 is bottomed out.

Yeah you really can’t get much from comparing old total vs new free tests. Totally different (though obviously related) values.

Your TSH has came down at least

My TSH came down to 1.28 after averaging around 2.75 prior to TRT yet there is no improvement on FT3… It’s still low-midrange.

What should i make of this?

Midrange is fine. It can fluctuate a bit. Keep an eye on it, get it check once a year or 6 months of your paranoid about it. I highly doubt thyroid drugs will make a noticeable change for you.

You see a reduction, I see a fluctuation. TSH fluctuates all the time.

1.28 is actually the average of my last lab results in the past 4 months… I NEVER got a TSH below 2.30 prior to TRT. I’ve had 4.1 , 3.11 , 2.75 etc. but never below 2.30.

Did you have rT3 tested as well?

There has been some thought that high rT3 reduces available T3 even though T3 numbers are fine. Not sure of this.

There is disagreement on that one. Rt3 “blocking” receptors is commonly stated as an issue, but others have posted that the affinity of rt3 for that receptor is like an order of magnitude less than it is for t3, so it doesn’t actually do a lot to block it in reality.

I hope I’m explaining that correctly.

That’s true. I’m new at this. I read that there’s a relationship between thyroid T3 levels and free Testosterone levels. There was some concern by my doc. that I might be a “slow/poor absorber” (on TRT therapy for hypogonadism) and recent labs showed very high rT3 levels but all other thyroid levels were in range. Though I have strong hypothyroid symptoms. (a drag) So, I thought maybe some of that might apply here for OP to look into.
As I’m a newbie, it’s all confusing and not sure if I got the dynamics of it correct. Likely not.

May be worth looking into. A trial of thyroid meds isn’t unheard of in that case imo. Depends on your symptoms and labs.

I have a new RX for cytomel to raise T3. Going to also ask for a RX for a DTE like NP Thyroid (T3 and T4 supplement).
Treat symptoms vs lab ranges seems to be the preferred thing here.
I’ve been dragging my butz around for the last 10 years and its taken a monster effort to excel consistently. I hope this works.
I have 2 good docs with open minds. Thank goodness.
OP: I hope this brings attention to your situation as well.