T Nation

TRT on the Cheap?


#1

I'm a 5'11" 215# 61 year-old with plenty of hair. Very active when I am active, and very sleepy when I'm not. I could take three naps a day, if you'd let me. Last year, it seems that something went click, and my energy and vitality took a big drop. I must have hit some sort of plateau, and I don't like it!

The doctor ordered some tests, the ones relevant to this forum are:

Total Testosterone 2.74 ng/ml Range 3.0 - 10
Free Testosterone 9.00 pg/ml Range 10 - 50
TSH 5.5 uUIml Range.3 - 5.0

The doctor started scribbling an address for a specialist, and I stopped him right there. I just don't have the money for another doctor and another set of tests. He said that probably some Synthroid and some Testosterone would perk me up, but he wasn't about to prescribe them for me. He did say that they wouldn't hurt me, so off I went to see what I could find.

The Thyroid was easy, and 25 mcg did warm me up quite a bit. I notice I'm grinding my teeth constantly, just like I used to to, and the Doc is happy with my TSH, so I guess that's under control for now.

I found two sources for transdermal T, LowTiyel gel, and AndroForte cream, both 50 mg.

The problem was a really bad swelling in my feet and legs with the T. I tried some 20 mg Lasix, and the Doc said that was what he would have picked too. It helped, but it didn't really fix the problem.

More tests, different lab:

TSH III 0.78 uIU/mL Range .27 - 4.20
Testosterone 192 ng/dL Range 280 - 800

This was off the Testosterone, because I didn't like having Flintstone feet.

Then I discovered your website, and learned about Estradiol and aromatization and started taking the T again. No doubt about it, this was causing my swelling. I took grape seed extract 2 100 mg capsules a day, and that helped. Then I tried DIM, and it worked well. At 50% full dose of T my ankles are back to normal.

I'd like to ask your advice at this point. Am I doing the right thing? Money is a big problem, and I have no insurance. I feel like excercising again. I have my morning wood back and feel more vital, but maybe this isn't the best for me long term? Any thoughts?


#2

I think if you feel better, if you can make it work financially, and if you can successfully manage the sides, it's worth doing -- and it's worth noting that some of the more subtle beneficial effects might not appear until you've been doing it continuously for a couple of months. I started TRT several months ago and it has made a huge life-changing difference. I would not want to stop now.

Something to ponder: You may be able to save some money by self-injecting Test E or T-Cyp. If you can get a doc to prescribe it and order 10 ml vials from one of the big (legit) online pharmacies it works out to about US$25-30 a month. Injections might also mitigate some of the E-related problems you've had with transdermals, and it is really not a big deal once you get the hang of it.


#3

Without more tests it is really hard to say what is going on. How were your two TSH tests so different? How much time passed between the two tests? What is "TSH III" and why does it have a different reference range than the standard TSH (typically 0.5-5.0 or thereabouts). I have a hard time believing your TSH could be that high and need such a small dose of Synthroid to be completely fixed, though I could be wrong.

TSH > 3 is a serious thyroid problem... your first test was above 5, which is, to put it mildly, not good. I need to understand the 2nd TSH test better. Your doc being "happy" with your TSH is not enough. Docs frequently are fine with bloodwork if it's in range - but that range is usually defined by what most people test at, NOT what is optimal or healthy. TSH around 1 is optimal for most people.

Also that initial TSH of 5.5 means there is a high probability you have an adrenal problem, get a cortisol test (8am blood draw) and I would be shocked if it was as high as it needs to be.

I know money is a concern, but without knowing some more blood work it is hard to know the best course of action long term. Sorry if I am being a Negative Nancy but it is important to be realistic about your health, and the reality here is that if you have underlying adrenal/thyroid issues you won't feel great for too long before something else goes wrong.


#4

The TSH values are so different because, from what I gathered, he was placed on replacement thyroxine from his doctor. The "TSH III" refers to TSH 3rd Generation. Same test.


#5

scj119, I don't think you are being a Negative Nancy at all! Your help is the reason I have posted to this group. I'm learning what the limits are, and what questions I should be asking for myself.

My two TSH tests were taken a little over a year apart, by two different labs; the first a lab in Mexico that I trust as much as any, and the second my Doctor's US lab. TSH III is their terminology, iIU/mL s/b uUImL, and my result of 5.5 was just outside their range of 0.3 - 5.0 FWIW. I'll look into that cortisol test.

B WS6, correct, the second test was after taking thyroxine for about a year. But it wasn't exactly from my doctor. He'd like to send me off to specialist Hell. I've already spent almost 600 bucks to get to this point, and I just don't have this kind of money to throw around. I've found that I feel more like myself when I take the thyroid, and from what I've been able to find thyroxine is fairly benign. My doc is okay with the amount and the results, and I am too if this is a far as it goes. If I'm making a mistake here, I hope you'll let me know.

Drexel, I think this is where I am heading, as soon as I find myself stable with the transdermals and the side effects. I think my doc may prescribe the T if I can show him success. If not, guess I'll just have to find a crook to prescribe it. The price of transdermals is eating me up.

Thanks for the input everyone, and please let me know If I am doing something dumb!


#6

The way your post was phrased I was imagining those tests being much closer together. The shady lab is also probably not reliable. Your lower TSH is good. I would say a cortisol test is necessary at some point because you need healthy adrenals for TRT to work. If you aren't feeling hypothyroid symptoms but want a simple (cheap) test you can do on your own, buy a cheap digital thermometer and take body temperature readings for a week. Measure when you wake up, and then 3/6/9 hours after waking. Don't measure within 20 minutes of eating/drinking or exercising.

Low body temps indicate hypothyroid. Body temps that vary widely from day to day indicate poor adrenals.


#7

I found out about my high TSH/low T on a routine test. It was a legitimate lab, but in Mexico. I try to save a buck whenever I can.

Yes, my temperature in the morning was low. I took it a few times first thing in the morning with a digital thermometer under my armpit, and didn't trust the readings because they we so low. I picked up some levothyroxin in Mexico, and it made me feel warmer, and I started grinding my teeth again, just like I have all my life. I feel more normal, and the doc likes my new test numbers.

I don't feel hot and cold on different days, in fact I'm barefoot and happy most of the time, so I hope that's a good sign for my adrenals too.

Thanks!


#8

How low is "low"?

"feel hot" and "feel cold" are not useful diagnostic tools, as PureChance scolded me in my thread haha. I never "felt cold" but my average body temps (at the 3/6/9 hours after waking) were 97.5, which is quite low. My waking temps averaged 96.5, which is also too low. Use a digital thermometer (I got 2 for like $5) under your tongue.