T Nation

Was on TRT, Gained Fat. Try Again? Thyroid Issue?


#1

Age: 27
Height: 180cm
Waist: don’t have measurements but pants size was from 32 (before) to 42+ (i wear pants that stretches easily…)
Weight: Before 140lbs. Current: 230lbs
Body/Facial Hair: Armpit and pubic area has hair. Anywhere else is almost hairless (arms, chest, legs, etc). No facial hair (my dad and brother both have a full beard and tons of body hair).
Describe where you carry fat and how changed: Most of my fat seems to store in my stomach and buttcheeks. I have stretch marks everywhere though from going 140lbs to 230lbs.
Health conditions, symptoms: Iron overload, hypogonadism, and may have subclinical hypothyoridsm.
Rx and OTC drugs, any hair loss drugs or prostate drugs ever: Nope
Lab results with ranges
TSH: 7.4 mIU/L Abnormal (general reference range 0.35 - 4.94)
T3 Free: 5.8 pmol/L Abnormal (general reference range 2.6 - 5.7)
T4 Free: 11 pmol/L Normal (general reference range 9 - 19)
Thyroid Peroxidase Antibody:
Value:< 10
Unit:IU/mL
Flag:Normal
Range:<=34
Testerone Level: 1.9 nmol/L (general reference range 8 - 32)
Describe diet: 95% home cooked foods. Only use salt/pepper/olive oil when I cook. Intake 2L daily of water. No sodas, coffees, etc. Consume 1500-2k calories. Most days, I consume about 1500 due to stationary job. Fish/eggs/chicken breast/rice/beef are my daily intake. Fruits/vegs: Mushroom/tomatoes/cantaloupe min twice a week.
Describe training: When I weighed 140lbs, I was in great shape, worked out 3-5 times a week and ate with almost the same diet. Currently doing none because even when exercising and having a calorie intake of 1500,2k, I will have no results. I feel like I need to fixed what’s inside of me before I can introduce external tools (exercise and diet)
Testes ache, ever, with a fever? No
How have morning wood and nocturnal erections changed: Have not had one in months (5 months+)

History with TRT
Was put on TRT 4 years ago due to low T that was caused by iron overload. After my first shot (100mg a month) it felt like someone flipped a switch in my head and my clarity and sense of well being was noticed. 2-4 weeks later, I gained 20lbs. Was told it will subside in 4-8 weeks. Continued TRT and weight increased an extra 10lbs. So 30lbs in total after 8 weeks. Over the course of a few years, my dosage was adjusted. First, 100mg a month, 200mg a month, 300mg a month, 150mg every 2 weeks, then 75mg once a week. The thing I noticed was that, the times where my weight never moved was when I stuck with a dosage but everytime the dosage was adjusted, my weight will increase. I’m not sure how to word it out but I’m certain that the testosterone has affected other hormones in my body where it’s suppose to increase lean muscle but did the opposite and gained fat. I’m not 100% knowledgeable and when I spoke with 3 endos, they all told me that TRT was suppose to help increase muscle and not gain fat and that I needed to improve on my diet and exercise… until I read their bio and their studies was general/diabetes endocrinology and after days and days of research and looking into other forums, I can safely say they were quacks and following the standard protocol of a typical endo.
And they said I may have subclinical hypothyroidism and taking thyorid medication may help (levothyroxine)
Right now, the decision relies on me if I want:

  1. go to back on TRT and re-challenge (currently off of TRT for 4 months and pretty sure it’s ganna be the same)
  2. go on thyroid medication
  3. go both TRT and thyroid medication
    I feel like taking the thyroid medication to see how it helps then going on TRT but after reading so many stickies/posts, I feel like this forum may be more knowledgeable then practicing doctors and I would like to know what I may/may not have and what steps I should take and if my plan on going on thyorid medication then TRT is correct or not. If someone can please help as I haven’t been enjoying life in a few years… Thanks!

#2

Do you have labs for Estradiol?

Have you determined if you are primary or secondary? FH / LSH labs?

Your TSH is high, have you supplemented iodine?


#3
  1. E2: 23.5

  2. Hypogonadotropic hypogonadism (secondary)

  3. Never had a FH/LSH lab test done

  4. No, have not supplemented iodine. I’ve asked if I should be taking iodine to the endos and they told me it might make my conidition worse.

I hope I was helpful


#4

Idiot doctors.

If you had not, have not, been using iodized salt, that may be a big factor in your problems.

Please follow these links, found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • thyroid basics explained – check oral body temperatures as suggested
  • finding a TRT doc

If you supplement iodine and do not have selenium in your multi-vits, there is a risk of problems with your thyroid.

Is thyroid enlarged, lumpy, sore, asymmetrical?
Get cold easily?
Generalized hair thinning?
Outer eyebrows sparse?

Your thyroid labs are sending a mixed signal and your docs do not know what to do.
I suspect that you might have elevated rT3 that blocks effects of fT3.
That involves adrenals and can be made worse by starvation diet attempts.

If you have elevated rT3, you cannot take T4 hormone because that will simply increase T4–>rT3.
You would need to take only T3

Please discuss:
stress in your life
stress events, crisis
illnesses, infections, inflammation
accidents, surgeries

Post what labs you can in list format with ranges.

TT
FT
E2
LH/FSH - too late now!
prolactin
CBC
hematocrit
iron labs and ferritin
AST/ALT
AM cortisol [ at 8AM please]
DHEA-S
IGF-1
fasting glucose
A1C
fasting cholesterol

Post labs and get docs to produce old lab data.
Post oral body temperatures.


#5

If you had not, have not, been using iodized salt, that may be a big factor in your problems.
Recently finished a pack of sea salt (not sure if it was iodized or not) but I have iodized sea salt around the house. Seems like I should start using it?

Thanks for all the available information that you posted up as I’m sure it has helped many people.

If you supplement iodine and do not have selenium in your multi-vits, there is a risk of problems with your thyroid.
I currently do not take supplements for iodine and selenium but should I start doing it to help fix my thyroid?
Is thyroid enlarged, lumpy, sore, asymmetrical? Thyroid looks normal, no lumps, no sores,
Get cold easily? This is a hard one to answer because I forgot to mention that, ever since going on TRT, I sweat way more then usual. When I have conversations with people, I sweat. If the room isn’t AC or have a breeze blowing, I’ll sweat. When I just wear a light sweater indoors, I sweat. It feels like my body that controls temparture had changed so I always tried to stay in cool places and prefered feeling cooled and it’s currently still snowing. Ever since coming off of TRT, I feel like I don’t feel I sweat as much but I still do. But overall, no, I don’t get cold easily or shiver from getting cold.
Generalized hair thinning? Hair thinning seems fine
Outer eyebrows sparse? Out eyebrows seems fine

If you have elevated rT3, you cannot take T4 hormone because that will simply increase T4–>rT3.
You would need to take only T3
So when you say I need to only take T3, what medication would that be? Cytomel or liothyronine? And completely forget about taking levothyroxine as it is t4 medication?

Please discuss:
stress in your life: I only have myself to worry about so I’m stress free. (not seeing anyone, mostly at home, mostly stationary unless I have to go groceries, bank, etc) Video games makes my life happy.
stress events, crisis None
illnesses, infections, inflammation Major thalassemia -> iron overload -> endocrine problems (from what I was told, fixing my iron overload MIGHT help reverse my endocrine problems but I might end up having low T which pretty much means, I still have endocrine problems)
accidents, surgeries None

TT (Not sure what test was done but it only said “Testosterone Test”)
1.9 nmol/L Abnormal (general reference range 8 - 32)
FT
E2 I remember it being 23.5 right in the normal range but I can’t find the lab result online for some reason.
LH/FSH - too late now!
LH: 1.7 IU/L Normal (general reference 1.1 - 8.8)
FSH: 2.3 IU/L Normal (general reference 1.4 - 13.6)
prolactin
N/A
CBC
Hemoglobin: 72 g/L Abnormal (general reference range 140 -180)
White Blood Cells: 5.4 Normal (general reference range 4 - 11)
Red Blood Count: 2.49 Abnormal (general reference range 4.5 - 6.5)
Hematocrit: 0.205 L/L Abnormal (general reference range 0.42 - 0.54)
You may wonder why my Hemoglobin is low and it’s due to Major Thalassemia. I go in for blood transfusions monthly which increases my hemoglobin back to normal but slowlys go back down and go back for another monthly transfusion and repeat. Due to having this many transfusions, I may have some bloodwork that might not look normal for someone without this condition.
hematocrit: 0.205 L/L Abnormal (general reference range 0.42 - 0.54)
iron labs and ferritin
Ferritin: 1197 ug/L Abnormal (general reference range 22 - 275)
AST/ALT
AST: 24 U/L Normal (general reference range 5 - 34)
ALT: 24 U/L Normal (general reference range 7 - 40)
AM cortisol [ at 8AM please]
N/A
DHEA-S
N/A
IGF-1
N/A
fasting glucose
5.1 mmol/L Normal (general reference range 3.8 - 6)
A1C
fasting cholesterol
Do not have fasting cholesterol but I have Cholesterol
2.28 mmol/L Normal ( don’t see a reference range)

Post oral body temperatures.
96.6 F (taken from ear, I do not currently own an oral device)
Post labs and get docs to produce old lab data.
I’ve tried my best with giving out all my current lab data and if I need to get the other lab data done, let me know which ones I’m missing and I’ll try to get them done to help figure out my situation. Also, I want to say thanks again for helping out and having information available, I’ll be looking at the stickies and other stuff.


#6

LH/FSH should be close to zero on TRT. Was this pre-TRT data?

Please get oral body temperatures.

TRT often increases RBC.

Get rT3 tested. If elevated, near of above high range, you need T3 medication to reduce rT3 and cannot take T4 medication.
See advice for new guys topic for definitions.

Yes, you need iodine. Get a good high potency B-complex multi-vit with trace elements, including iodine+selenium THAT HAS NO IRON.


#7

Just playing devils advocate here. If your diet and exercise routine did not change after starting TRT, then I don’t see how this weight gain is possible. If you fell off the workout wagon and started eating like crap then this makes logical sense. Which one was it?


#8

LH/FSH should be close to zero on TRT. Was this pre-TRT data?
LF/FSH was only tested once in 4 years and that was AFTER going off TRT.

Please get oral body temperatures.
Will be aiming for one.

TRT often increases RBC.
Yes, that would explain why my hemoglobin was low ever since coming off of TRT.

Get rT3 tested. If elevated, near of above high range, you need T3 medication to reduce rT3 and cannot take T4 medication.
See advice for new guys topic for definitions.
Alright, I will be getting this test in a few weeks.

Yes, you need iodine. Get a good high potency B-complex multi-vit with trace elements, including iodine+selenium THAT HAS NO IRON.

How much iodine do I need and selenium? I read online where iodine shouldn’t be taken over 500mcg but then there’s others like Alex Jones whos selling nascent iodine where he recommends 1950mcg a day. Is taking nascent iodine different then taking iodine and dosage wise?

Thanks a lot, this was very helpful.


#9

If your diet and exercise routine did not change after starting TRT, then I don’t see how this weight gain is possible.
My diet did not change and when I was on TRT, I’ve done multiple experiments in the past 4 years.
First experiment.
Exercising for 8 weeks straight including a strict diet, I did not even lose a single pound which was messed up. Doing HITT for 30-45mins 5x a week and strength training 2-4 times a week. Max calorie intaked was 2,000.
Results: 0lbs lost
Second experiment
Diet for 4 weeks. Ate only 1,000-1,500 (higher only when I was going out which was barely) calories for 4 weeks.
Result: Felt a bit weak but result ended up 0lbs lost.
Third experiment
Eat 2,500 - 3,000 calories for 1 week and see if I gain weight.
Results: It was very difficult eating 2,500 - 3,000 a day but result was that, I gained 5lbs-10lbs the first week and a half but over the next 2-4 weeks, it slowly went back down to 0 without doing any exercise and eating 1500-2k diet.

I’ve done a few more other experiment but these we’re the main ones.

Looking back at my experiments, I could say that I’ve tried EVERYTHING and the only time my weight changed was when my dosage for testosterone changed, right on the dot.


#10

So all the scenarios you just posted resulted in zero pounds lost. What were you doing when the pounds were going up? Nothing? I’m confused.


#11

When the pounds were going up, that whas when my dosage for testosterone was adjusted and I was only eating 1.5k-2k and doing 0 exercises.


#12

Ok dude. So you kept eating the same. But quit working out. That is your weight gain explained.


#13

Ok dude. So you kept eating the same. But quit working out. That is your weight gain explained.

Well I’m sure it’s more complicated then that.

But let’s say if that was the case. At the current weight of 5’8, 230lbs, in order for me to maintain weight I need to consume 2,391 calories on a daily biases, which I’m not, with little to no exercise.
http://www.calculator.net/calorie-calculator.html?ctype=standard&cage=27&csex=m&cheightfeet=5&cheightinch=8&cpound=230&cheightmeter=180&ckg=60&cactivity=1.2&printit=0&x=42&y=13

Ever since I came off of TRT (about 4 months ago), I was stuck at 230lbs. Eating more or less had little to no effect and just resulted back at exactly 230lbs.

Also, what would be the explanation for the given scenarios? For an average healthy person, they would’ve gotten results but I’ve gotten 0.

So it’s a lot more complicated then saying “diet and exercise” was the explanation, it has something to do with my body not working properly.

Thanks for trying to help out though.


#14

Thyroid function is a huge factor in weight loss/gain.