TRT with Hypothyroid?

Hey everyone I had a question about my trt and thyroid. I had my blood test done after a host of crazy anxiety, depression no libido I was in a dark place and it wasn’t good, all kinds of problem, my blood work came back and my tsh was 28 they immediately put me on levothyroxine, fast forward 3 months I had them check my testosterone and found this
Total test =300
Tsh .201 (they lowered my dose of levothyroxine)
Prolactin 10.0
Lh 6.3
Fsh 2.8
She never checked free test and said I was perfectly fine and sent me on my way.
Fast forward another 2 months I went to the urologist had my blood work done again.
Total Test 294
Free test 10.2
Estridol sensitive 12.0
The urologist started me on 200mg test cyp every 3rd week, but I split it up into 80mg a week with 3 shots a week.
Could all this have been caused by my thyroid?
I mean I haven’t had the best sex drive in the past 5 years, or could this just have been a shit storm of low test and crazy hypothyroid
I’m 33
205 5"8’
Eat somewhat health
Active constantly
Thanks everyone

You have autoimmune thyroiditis and treatment with thyroid hormones is what you need. There is a highly controversial discussion about the modality of treatment (T4 only vs T4+T3) as about 10 to 15% of T4 treated subjects dont experience symptom relief.

What exactly was yourprotocol of T4 therapy and how did you do 1 to 2 months into T4 therapy?

Thyroid disease if associated with low T but if I understood correctly T4 treatment did not improve T, so thats why you were put on TRT which is a reasonable thing to do.

How do you feel now and do you have labs already done? Splitting dose was a good idea.

They had me in 125mg everyday of levothyroxine from June to October then they bumped me down to 75mg everyday till present, I felt a tiny bit better but still had brain fog, no energy, anxiety short term memory was still terrible. I have been on trt with hcg for about a month and recently I have started to feel so much better I can actually remember things the brain fog is lifting anxiety is gone and my mood is so much better!
So basically even with the thyroid straightened out I’ll still be on trt?

I have appointments right after the new year so I will post as soon as my blood work comes back

Yep, you’re allowed to have more than one thing wrong.

Happy to hear you are so much better. I think you’re lucky, not sure a lot of urologists would have started testosterone, though the 200mg every three weeks is suspect. But, you already knew that. Good luck going forward. We’re men, no, or low, libido is not acceptable.

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100% agreed

I don’t usually see thyroid numbers this bad on these forums and I’ve been on T-Nation for years. The autoimmune disease (inflammation) probably affect your testosterone as well, your LH is ideal and testosterone low.

Your urologist probably isn’t the best choice to be meaning your TRT protocol being that he simply read the prescription label instead of drawing from knowledge and experience to guide your TRT protocol.

I was on this same 200mg every 3 week protocol and 5 days after my injection, my co-workers would comment on how much energy I had, then co-workers would ask if I was sick 5 days later because they could see the crash in energy levels.

It’s unreal that these protocols are still practiced in this day in age and in fact a randomized clinical trial “14 years ago” (!) proves these protocols are no good.

I was very surprised my urologist did that, but my endocrinologist sent me away and told me I was good to go. I found a new endocrinologist so maybe he will take over the trt.
Yeah I was shocked when the doctor called me, I was had a boat load of stress on my shoulders for months on end and I’m guessing that’s what triggered it. I completely agree about the urologist but now that I have the ball rolling I hope I can find a better doctor to get the ball rolling.

Also should I stay away from mk 677? Since I have the thyroid issue?

Did you not get FT4 tested when on 125mcg Levo?

My untreated thyroid numbers are just as bad, if not worse than yours. I’ve had Hashimoto’s all my life. I take 125mcg levothyroxine and that puts my FT3 and FT4 at pretty much optimal levels. My TSH also is around 0.1-1. It seems very odd that your doc would drop your Meds down by almost half without even looking at FT4.

Find a doc that will test TSH, FT3 and FT4. I’ve been able to convince most PCPs to test all of those. Endocrinologists seem to be more strict on what they will test. You also need to schedule an ultrasound, to make sure you don’t have any cancerous nodules.

When on meds, you’re shooting for a FT4 in the middle of the range, and a FT3 near the top of the range. TSH doesn’t matter. Start with levo only. Get your FT4 mid range and then check your FT3. If it’s not near the top you will need to add T3 into your prescription protocol. This can be compounded into your dose of T4, or you can try dialing in Armour thyroid.

I recommend getting separate meds for T4 and T3. That way you can split up the T3 dose as needed. since it has a very short half life, you will likely need to dose twice a day to feel the best.

When on T4 (levothyroxine), you need to take it fasted in the morning, absolutely do not take it with any multi vitamins or minerals. Don’t eat with 2 hours of taking the meds.

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This was my last blood work in October and she lowered my dose to 75, i have a appointment after the new year with a new endocrinologist, I was looking into the armour thyroid. I asked the Endo to do a ultrasound she told me it was unnecessary my thyroid feels fine.
Thank you for the explanation and things to look for.

That makes more sense now. I feel like your dose should have been lowered to 100mcg. But I will tell you hyperthyroid symptoms are much worse than hypo. So starting at 75mcg then stepping up makes sense too.

In regards to ultrasound. You need one. My thyroid has felt normal to all doctors, but I still have a 10mm benign nodule that is detected on ultrasound which I check regularly. Just because your doc can’t feel it, doesn’t mean anything.

I also forgot to mention vitamin D. If you can get that tested, it would help a lot. there is a link between low vitamin D levels in patients with Hashimoto’s.

Regardless, you’ll want to take 2000-5000iu of vitamin d3 per day. 5000 if you live up north or don’t get enough sunlight to exposed skin every day.

Do you take iodine and selenium? Deficiency is linked to Hypothyroidism and Hashismoto’s Thyroiditis.

Have you taken antibiotics? Chronic inflammation from the gut occurs when intestinal dysbiosis manifests post-antibiotic use.

This is actually not true. Iodine deficient regions of the world have a much lower risk for developing Hashimoto’s.

Selenium’s effects on Hashimoto’s thyroiditis has been shown to be inconclusive.

For someone with Hashimoto’s, I would recommend avoiding excess iodine. And if taking selenium, make sure to take it several hours after taking your thyroid medication.

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still controversially discussed topic. But i agree in the setting of Hashimotos I would stay away from excessive iodine.

I will make sure that I get a ultrasound done on my thyroid, thank you! My mother has nodules on her thyroid and I told the lady that and she basically didn’t care. 2 years ago I had low vitamin d and I was taking it for about a year then stopped. I don’t know why but I’ll get back on it. I have taken antibiotics probably once in 3 years. But that’s really good to know. I’m not sure about iodine or selenium but I will look into it just to see what’s up with it. Thank you everyone!
Just a quick question about mk 677 they say not to use it if you have hashimoto’s or a thyroid problem, I’m guess because of the antibodies attacking my thyroid?

Ultrasound is tomorrow. But I’m pretty sure my Endo is a idiot. I just had some blood work done…

Well he certainly has your t3/4 way up there.

I didn’t know you were taking biotin. Biotin will give false lab results. You want to stop taking it several days before a blood draw.

These results are 75mcg/day? But it looks like you’ve only been on that protocol for a couple months or so?