TRT and Thyroid Relationship Questions

Hi everyone,
I appreciate your experience and thoughts.
I recently did my blood work with my doc friend, which recommends TRT for me.
He was going to prescribe cream test, HCG and Anastrozole. I haven’t been feeling the same for the past couple of years and have some of the Low T symptoms. I herniated my back lower disc sometime in 2015 doing crossfit and my workout routine has taken a hit. I workout avg 2-3 times per week, some weights and HIIT. I take a multivitamin and eat clean.
Now, I’m wondering if I should try a natural Test Boost path first such as increase Zinc, Vitamine E & C, Maca root, Ashwanganha, Cordyceps, Tongkat…what are your thoughts?

Bloodwork history:
6/29/2015 7am
T - 686 range (264 - 916)
FT - .476 nmol/L range
Prolactin 39 ng/mL High
Cholesterol Total - 138
HDL - 50
LDL - 68

6/3/2016 8am
T - 541 (264 - 916)
FT - .346 nmol/L
Prolactin 9.5 ng/mL Normal

6/22/2018 10am
T - 441 (264 - 916)
FT - 8.7 pg/mL (6.8 - 21.5)
DHEA 418.1 ug/dL (102.6 - 416.3)
E2 (Estradiol) 32.8 pg/mL (7.6 - 42.6)
SHBG 55.3 nmol/L (16.5 - 55.9)
LH - 10.6 mIU/mL (1.7 - 8.6)
FSH - 4.4 mIU/mL (1.5 - 12.4)
Prolactin 12.1 ng/mL Normal (4.0 - 15.2)
Cholesterol Total - 182
HDL - 47
LDL - 120

*My historical labs were ordered by my PCP and was based on my complaints in sexual function and they didn’t order some of the tests.

Some information that I forgot to include and found this template in a different post. :slight_smile:
age - 43
height - 6’2"
waist - 35 inches
weight - 210 lbs
describe body and facial hair - good facial hair, can’t grow a full beard. Body hair is good.
describe where you carry fat and how changed - Mainly around waist and thighs/butt
health conditions, symptoms [history] - Consider myself pretty healthy. I weight train 2-3 days a week. Stay active on weekends, but have a desk job. Lack of motivation Unable to make strength/muscle gains. Libido gone down. Get back muscle aches after lifting that take a couple days to subside.
Rx and OTC drugs - BCAAs, Multivitamin
describe training - weight training or HIIT about 45 min a day/ 2-3 days a week.
-testes ache, ever, with a fever? Nope
-how have morning wood and nocturnal erections changed - Morning wood at times. Nocturnal rarely.
Get about 7-6 hours of sleep during the week. Tired on the weekends and get a little more and usually an afternoon nap.

Anyone have thoughts?

There is obviously a downward trend here. 441 ng/dl is on the lower end but it’s your shbg that’s screwing everything up. You would definitely benefit from trt. I would skip the transdermal test and go straight to injections. With such high shbg you will certainly need one shot a week. If you and your doctor insist on the transdermal test you may want to look into using a derma roller. I’ve seen cases that increased their absorption rate by using a derma roller prior to application of transdermal test. Injections will certainly serve you better though. Talk to the doc about igf-1 testing as well and possibly sermoralin. Maybe that will help shore up some of these old injuries your nursing.

Thank you very much. Interesting the correlation between my injuries and my T drop. You know I never really put those two together, instead thought it was my changes in my workout and not working out as much. Straight to the shot, I’ll ask about that method.
Do you think just doing sermoralin would bump my test?
I appreciate it.

Sermorelin will not increase your testosterone, but it will help with joint issues related to age/degeneration.

I’m going to start taking my body temp, but I’m wondering if I need to request a lab from my doc for fT3 and fT4 or any other recommended tests based on these results?
TSH - 1.4 (.45 - 4.5)
T4 - 7.1 (4.5 - 12)
T3 uptake - 31 (24-39)
Free Thyroxine Index - 2.2 (1.2 - 4.9)

Also, I feel hot in the mornings and sweat for no reason during the day. I always attributed it to alcohol, but maybe alcohol is causing Thyroid issues. I’m still getting educated with KSMAN’s beginner’s guide.

When women hit menopause they get hot flashes do to their hormones being out of whack. High SHBG is a real problem and having TT levels below midrange is always a problem for high SHBG men. SHBG binds most of our testosterone, in your case it’s binding too much and bioavailable is low.

Also SHBG is overstating your T status inflating TT number to look better than it really is, if SHBG was significantly lower TT would be lower and free T higher which is what you want.

So testosterone production is low only being made to look good. Missing Free T3, Reverse T3 and female E2 panel for a man tells me your doctor likely doesn’t know how to play the TRT game. This doesn’t look good, I see it day in and day out. Cluelessness.

T3 uptake and Free Thyroxine Index are obsolete tests, this doctors is a little behind the times.

Gotcha. If we had free T3, reverse T3 and E2 panel then we might be dealing with a thyroid issue rather than hypogonadism?

Does anyone know a good doc in Sacramento area?

We are both in Cali, I’m with Defy Medical who offers telemedicine country wide. You will be hard pressed to find knowledgeable doctors anywhere in your area.

I reached out to Defy Med…they are cool folks and very easy to talk with. I will probably go with them! Thanks @systemlord

Question, I’ve taken Albuterol since I was a kid and I’m reading STTM…I think there might be a relationship between by albuterol and adrenals. It’s almost as if I take the inhaler in the morning just because I need a hit. Can I do stop using albuterol? but need to supplement with something else?