T Nation

TRT 1 Year Update


My favorite Endo @physioLojik

My endo started me at 25 mcg t4. Btw she thought my thyroid was perfectly fine. But she gave cause i wanted.
Recall labs below. Is the 25mcg going to shut me down? Or does it supplement my own t4 I make? And do you think I will need more t4?



My face has been dry and itchy. It appears the t4 meds are doing this since the dryness coincides with me starting t4. Anyone know if this is normal at the start of treatment? I started with 25 mcg

@physioLojik not many of us know about thyroid. Can you help please?

My eyebrows are flaking too.


@charlie12 hey man. That’s a super low dose of t4 so I would not assume that’s the cause. Remember though that when the thyroid increases in efficiency you can alter your sex hormones (ie estrogens and testosterone) and you might need to revisit your dosages. Can you remind me of what you’re using?


@physioLojik thanks. 2 months ago I switched to im and my estrogen starting running low. I was in 30s on 90mg a week split in 2 subq.

On IM I Went below 20 for a bit and last measured e2 was in the 20s. My joints are clicking in many places since switching to IM. No pain just clicking. Shoulders , wrists, knees. Even when I just turn over in bed. I am injecting 100 a week split in 2. Also Itching since on IM. Btw I switched to im because actually easier for me and figured that’s how t was designed to get injected. I can go back to subq. Just don’t understand this change.

Labs from 4 weeks ago. ( Prior to t4 and after 6-8 weeks after switched to IM) Estradiol eia assay was 23 and sensitive lcms was 29. See images below

No ai. NoHCG . Just a multi vitamin, daily Cialis , 300 mg allopurinol daily, 25 mcg synthroid. 5k D3 2x a week.

Ask Physiolojik Thread

I drew blood yesterday and got this test Estradiol Free, Equilibrium Dialysis, With Total Estradiol, HPLC/MS-MS (Endocrine Sciences

That’s from lab corp. Never ran free e. I think the results take a while. So am taking this test while my joints are clicking like crazy. In did this on trough. After test I did a sub q injection. I was doing im for past 2 months. Its funny I feel my clicking joints were much better yesterday all day.
Also took regular estradiol eia assay.


Lab update, after 2.5 months switching to IM and 50 mg 2x a week. prior was 45 mg 2x a week SUBQ, I felt fine b4 but wanted to try IM.

After switching to IM and hiring dose a bit to 100mg, HCT started climbing to 48-49. I also measured lower e2 initially after switching to IM. joints started clicking on im and still do but according to new lab e2 back up nicely.

Just took fresh labs 12/20.

hct - 45.6 went down nicely
hemoglobin 15.6 went down nicely
free t 17.6 (6.8-21.5)
total t could not get over phone
TSH 1.67 (one of my best - they were all over 2.0) probably due to starting t4
free t 4 1.16 (best measure since starting 25 mcg t4)
estradiol eclia 27.6
estradiol lcms 32
free e2 pending
shbg 25.5


Looks good @charlie12 . Sticking with IM ? How is libido and general mood ?


So are you feeling any better with this protocol Charlie? Have you noticed any changes in how you feel since starting the T4?


Looks good, how are you feeling?

I have allowed my E2 to go up, d/c AI. Joints feel better than they have in years.


I think I feel better on im.i also felt good before. But note when I switched to im i also upped my dose by 10 mg.

Am going to wait for the free e2 before I decide. But I might alternate between im and subq. When I started im my joints started clicking and I believe initially brought down my e2 . But as we always say you need to give it time and it e2 is back close to 30.

It appears my free t is best on 100 mg and IM. I get libido bursts on im that are fun.
Libido was good and it’s stillgood and wife can’t keep up. Thank God for palmela.

T4 Endo says takes 6 - 8 weeks to reach stable levels. It has only been 2 weeks. T4 has a 7 day 1/2 life so it’s still building. My walking up temps are about 97.2-97.3. Before was close to 97.0. And afternoon gets close to 98.3.

I stopped Cialis on Monday cause of a cardiac CT scan angiogram. Zero calcium score on all areas. Nice! They administered nitroglycerin to open stuff up. And Metropol to lower heart rate. It also lowered my blood pressure nicely. I would go on it but beta blockers are suppose to cause ED.
I stopped Cialis and still had firm erections in night and morning. I have started Cialis again. It helps my blood pressure.




First time posting and doing the free estradiol test

@physioLojik can you help on if this is good.
My joints are clicking moderately since starting IM in late September and upped dosage to 100mg from 90mg. No AI. No HCG. I do 2 Injections a week. Not sure if switching to im triggered the clicking. Why are most of my joints clicking when e2 Appears fine?

Btw everything else I feel very good.
Anyone is welcome to reply please.
@highpull @NH_Watts @bmbrady77 @unreal24278 @systemlord
Shbg on this test was 25.5


Remind me, no AI?


Correct. Just updated my post to state that for others.


Then I got nothin LOL :smiley:


@charlie12 stuff like this isn’t always hormonal. I think that’s the go to for most people here. Could be so many other things but your numbers look fine.


Thanks for taking the time to review. I appreciate it. :grinning:


Your numbers look good to me as well Charlie. Do you supplement omega 3? I have found that, especially as I get older, that the right amount of supplementation, particularly in things like omega 3’s, along with working out smarter (not overloading the joints and adjusting my techniques for making the muscles fail at a more manageable load), makes all the difference in the world for my joints.


Hard to say here. Doesn’t make sense as E2 is not low, but when using anastrozole mine was always in the 20s (20-28 both tests for anyone that wants to know) and since stopping anastrozole a few months ago E2 has been steadily raising, into the 40s and mid 50s. My joints feel much better, especially knees. Cholesterol down as well.


I do not take Omega 3. Cardiologist does not think Omega 3 is proven to help. Though an sure he was referring to cardio stuff.

Perhaps it helps inflammation but then again so does tumeric- which I do not take as well. I just don’t want to the take another supplement as it seems to much of anything is no good. I try to eat 2 servings of fish per week.

I don’t think it’s the extra free to doing it? The 100 a week and IM seem to have brought my free t to a beautiful 2.5 percent.
We will see if the clicking starts going away. It is a bit better

I’ve had high triglycerides most of my life. And unfavorable LDL and hdl but nothing crazy. Cholesterol always around 150.
Zero calcium and zero plaque on a CT angiogram just done.
Wife did CT same day and has up to 25 percent plaque and a moderate calcium score. Basically has been dx with Atherosclerosis.
They did a PET stress cardiac for wife as a follow up and blood flow is fine. So Dr changed her to crestor from zocor. With crestor and proper health measure should not see an increase in plaque. I actually read with crestor or lipitor and LDL 70 or below can actually decrease the plaque