How important is TSH really?

[Vahevahe]

Hi guys its me Victor again,
Im 24 years old and my Testosterone is in the low 200's. My doctor at UCLA is currently canceling out the different possibilities (tumor, varicocele, etc) while looking for the root problem. I have a 24 hour urine analysis to check for possible kidney issues in process now. Im kind of beating the pavement on this one till my doctor figures it out. Could my Thyroid be causing these issues? I am on the fence on this because my UCLA doctor said that TSH is just a signal and it in itself does not warrant being on thyroid medication for the rest of my life. Other tests would need to be done like t3 and t4. Anyway Iv had my Tsh checked previously and it came back at 4.7 & 5.8 and the most recent one in which i was not on thyroid medication(UCLA doc took me off) was 3.2. This actually confuses me and gives some weight to her argument.


Here is my last lab of my Thyroid while being off of 50cmg Levothyroxine for 2 months

Tsh 3.2 mcIU/mL Range .3-4.7
Free T3, Automated 334 pg/dL Range 249-405
Free T4, Automated 1.1 mg/dl Range .8-1.6



Also i was researching the other day and it said Kick boxers had higher rates of hypogonadism due to testicle injury and possible pituitary injury due to trauma. I kick boxed for over 7 years , could this also cause low testosterone for someone of my age ?

[HRTstudent]

If you got kicked in the nuts a lot I could definitely see that playing a role. Let's face it, our nuts were probably not meant to like abused by that.

To say, without question, that it played NO role is, I believe, not reasonable. It is an avenue to consider.

As far as thyroid, all the measurements are important. Really though, a TSH of 3 is generally higher than anyone on this forum likes. We strive for optimal health though, and not just "no disease" which is what 98% of doctors out there aim for.

Here is what Dr Mariano had to say about Thyroid briefly...

A Total T4 is crucial to obtain since it gives me an idea of how much thyroid hormone a person may need. The other values only give me an idea of how the other systems interact with thyroid hormone. For example, if the brain is healthy enough to produce TSH, then TSH tells me how much of a thyroid hormone deficit it is running.

From a behavioral point of view (not an endocrinologist or internist point of view), my own observations as to the approximate lab criteria for suboptimal thyroid function (i.e. the hypothyroidism of mental illness) are:

Free T3 < 3.3
Total T4 < 8.0
TSH > 2.0

These reflect peripheral not brain levels of thyroid hormone. There can be a disparity since the brain and the rest of the body are separate compartments walled off by the blood brain barrier. Only a drastic maneuver such as a lumbar puncture and analysis of central nervous system fluid would tell the difference. In some illnesses, these values can be very different. The brain can be hypothyroid but the body can have enough. This can lead to persistent energy or mood problems and brain dysfunction through brain-related mechanisms.

In psychiatry, even if one isn’t hypothyroid, thyroid treatment can still be done to help improve mood. Under some circumstances, such as bipolar disorder, a hyperthyroid state stabilizes mood.

Generally, thyroid treatment is risky without adequate nutritional support and without consideration of nervous system-adrenal function and treatment of problems there if indicated. It isn’t something one does without medical supervision and monitoring.

He is a supposedly good doc. I've never seen him as a patient but I would if I lived closer to him. He's in California like you... might be worth getting an opinion from him. He would be on my very-short list of docs to see for improving quality of life.

But, what brought you to see a doc in the first place?

[bigboy67]

kicked in the nuts? You should look more into research done on getting kicked in the head, its been linked to low testosterone as well...

[TennTarheel]

Have you had your TPO checked for possible Hashimotos disease?

[Vahevahe]

I'm very lethargic, have difficulty concentrating, i fatigue very easily, depression, anxiety, sleep problems ,ed problems , severe lack of chest hair and gynecomastia .

Tenntarheel did you mean Thyroid Peroxidase Antibody ? if yes it was 9.5 IU/mL Range < or =20

[Bonaparte]

I don't get where you're coming from. Your thyroid levels are all in range, and you have low test and all the symptoms of hypogonadism. Yet you're worried about hypothyroidism rather than hypogonadism?

[Vahevahe]

Im trying to look for a cause of the low testosterone . A lot of the things that cause low testosterone have been ruled out for me so i am looking for a root cause of the low testosterone. I have heard that hypothyroidism can cause hypogonadism.

[Badidea]

I would be worried about both low t and higher than optimal tsh. Once I began to get my thyroid in check (hashimotos) my well being and stamina increased significantly even though I had been on trt for ~ 4 mos. it's all linked together and searching for improvements for all symptoms is the best route. Just my 2cents.

[TennTarheel]

I would be worried about both low t and higher than optimal tsh. Once I began to get my thyroid in check (hashimotos) my well being and stamina increased significantly even though I had been on trt for ~ 4 mos. it's all linked together and searching for improvements for all symptoms is the best route. Just my 2cents.

Badidea, what do you do for your Hashi's??

[Badidea]

100mg synthroid /ED and I have switched my diet to consist of foods that are anti inflammatory. Together they have lessened my symptoms.

[TennTarheel]

What type of symptoms did you have that differentiated themselves from Low T symptoms??

[HRTstudent]

Im trying to look for a cause of the low testosterone. A lot of the things that cause low testosterone have been ruled out for me so i am looking for a root cause of the low testosterone. I have heard that hypothyroidism can cause hypogonadism.

You can try improving it via nutrition and lifestyle.

In the mean time, you should get your LH, FSH, prolactin, estradiol (sensitive assay) and SHBG measured. These can help shed more light on what might be going on in your body as far as T goes.

[Badidea]

My energy levels, mental clarity and most importantly my bf%. I felt a ton better once I got my test over 1000 but until I began therapy for hashimotos I struggled to lose midsection fat and still had less than optimal stamina and mental sharpness. I've been on synthroid for ~ month. I've lost five pounds, 4 pack visible and I have energy and sharpness like when I was in my 20s.

[TennTarheel]

See, they think I have Hashi's but I haven't really had any weight issues as far as slow metabolism. If anything, my Low T keeps me from holding my lean mass I had. I mean I stay a little less lean than my avatar year round. So I'm still trying to figure this Hashimotos thing out. I'm not on any meds for it.

[Bonaparte]

Well, your thyroid is perfect, so that obviously isn't the issue.
No matter the cause (genetics, testicular trauma, etc), TRT is the answer.