New BW (Low free/total t3, normal free/total t4, normal tsh, + IGF-1)

[asiandudexxx]

Previous bloodwork showed low T (high SHBG, very low free T) and normal/low normal LH & FSH. Was seeking treatment for that and convinced my doctors to run other BW.

(11/30)
TSH - 1.16

(12/19)
Free T3 Index 63 (ref range 78-162)
T3-Uptake 1.0 (ref range 0.9-1.3 TBI)
T3, Total 63 ng/dL (ref range 85-185 ng/dL)

Free T3 Automated 201 pg/dL (249-405 pg/dL)

Reverse T3 26 ng/dL (ref range 11-32 ng/dL)

Free T4 Automated 1.2 ng/dL (ref range 0.8-1.6 ng/dL)
T4, Total 6.2 mcg/dL (ref range 4.9-11.4 mcg/dL)

IGF-1 191 ng/mL (ref range 83-456 ng/mL)

Could these numbers combined with my Low T be indicative of a pituitary problem? MRI was negative for tumors. Since hypothyroidism can cause hypogonadism, should I treat the thyroid first or both simultaneously?

My IGF-1 is right under the mean for my age and gender (24 year old male), would it be fruitful to get more tests to determine if a GH deficiency exists? From what I've read, even if my GH was also at the mean, I'd want to be at the upper percentile of my reference range for optimal health/well being anyways.

You guys have been a wealth of knowledge/help so far so thanks again!

[asiandudexxx]

Any opinions? My doc said he will most likely put me on Armour Thyroid but we will figure it out when I see him on the 3rd. Since everything is fine except t3, should I talk about adding cytomel alongside it in small doses?

[steroid.com 1]

I wouldn't say everything is fine; your RT3 is somewhat elevated at 25 and it would be much better at the lower end of the reference range.

Your Hypothalamus is under performing as you can see with the T3 assays = Hypothyroidism.

Note, Hypothyroidism will cause Hypogonadism and they share many of the same symptoms.

Cytomel (liothyronine sodium) may be a good add as well.

Keep us posted in this thread on your appt on the 3rd.

[asiandudexxx]

Thanks for the input gdevine!

So doc prescribed Armour + a little t3 starting monday. My hCG stim test is up on Wednesday and I take blood on Thursday. Good news is it looks my leydig cells are still functioning, but as mentioned in the hCG sticky, I believe my e2 shot up from the protocol (puffy/sensitive nipples, lots of water retention, excessively emotional, etc). But at least I have morning wood again for the first time in years so that's a good sign.

I wanted to ask if strength loss is normal when trying to find your optimal thyroid hormone dosage? I can't get my rx till Monday, so I was supplementing with Ar-r t3+clen (40 mcgs a day for extra insurance against muscle catabolism) until then. I started on 12/24 at 40 mcgs and kept adjusting the dose up and down based on symptoms. I'm finally settled at 60 mcgs spread out 3x a day and finally feel great, but my strength has gone down a lot since I started. Is it just a matter of adjusting my diet to my now normal metabolism? Could it just be because my free T is still low? (I have very high SHBG + aromatization).

[asiandudexxx]

So, just got my post-hCG stimulation test BW back. From the labs I think we can definitely rule out primary hypogonadism as a diagnosis.

1/07 (36 hours after 1000 iu hCG and 12 hours after another 500 iu hCG)

SHBG 110.1 nmol/L (ref range 20 - 49y: 16.5 - 55.9, >49y: 19.3 - 76.4) [Up from 59.4 nmol/L]
Testosterone ,Free 210.7 pg/mL (ref range Adult Males: 35.0-155.0 pg/mL) [From a low of 5.0 pg/mL]
Testosterone,Total 1735 ng/dL (ref range Adult Males>18 348-1197 ng/dL) [From a low of 63 ng/dL]
Estradiol 68 pg/mL (ref range Adult Male <41) [From a low of <12 pg/mL](NOT sensitive, will go to labcorp for ultrasensitive in the future)

DHEA-S 3580 ng/mL (ref range 1000-5500 ng/mL) [no before comparison]
17 - OH - Pregnenolone 210 ng/dL (ref range Adults 53-357)

The biggest problems are my e2 (which hopefully I can get an AI for) and my SHBG. But considering, this is pretty good news.

These next results may be skewed since I didn't refrain from taking thyroid meds prior to the BW (lab mixup where they tested for old stuff I didn't need), and was using t3 only for a bit to clear the rt3 and since it looked like I had a conversion issue to begin with. Have been on 1 1/2 grain Armour+ 10 mcg t3 since then. My BW prior to thyroid medication is in the original post.

T3, Total 289 ng/dL (ref range 85-185 ng/dL)

Free T3 Automated 866 pg/dL (ref range 249-405 pg/dL)
Reverse T3 6 ng/dL (ref range 11-32 ng/dL)
Free T4 Automated 0.7 ng/dL (ref range 0.8-1.6 ng/dL)
T4, Total 3.5 mcg/dL (ref range 4.9-11.4 mcg/dL)


TPO AB <5.0 IU/mL (ref range < or = 20 IU/mL)
TG AB <20 IU/mL (ref range <20 IU/mL)
IGF-1 279 ng/mL (ref range 83-456 ng/mL) [from 191 ng/mL]

Ferritin 167 ng/mL (ref range 24-336 ng/mL)
Iron 82 mcg/dL (ref range 23-202 mcg/dL)
Iron Binding Capacity 284 mcg/mL (ref range 240-520 mcg/mL)
% Saturation 29% (no ref range given)

Looks like I don't have hemochromatosis as I may have suspected (past labs had much higher numbers of Iron, IBC, but did not do ferritin)

[steroid.com 1]

Hmmmm...those testosterone levels are a tad bit high eh

[asiandudexxx]

Hmmmm...those testosterone levels are a tad bit high eh

Just too bad too. On the lower doses of hCG I didn't feel much (except for the increased e2 sides!) but at that last high dose I felt amazing. It's been over a week since my last hCG shot, so i'm starting to go back to "normal". Since I had a such a good response to the hCG stim, the doc ordered a clomid stim (50 mg ED for 3-4 weeks) to see if my pituitary is responding. The thing is, I don't have high hopes since initially my LH was low despite my very low e2. If my pituitary was functioning normally to begin with, the estrogen regulated negative feedback pathway should have been sufficiently inhibited, thus bringing LH up. Oh well, at least now we can medically verify it.

[asiandudexxx]

Also forgot to mention the doc rx'd .50 mg anastrozole e3d for 4 weeks to bring down e2+any new e2 that may happen if the clomid stim works. Not looking forward to the next 3-4 weeks if the clomid doesn't work/I experience sides. ED back already and starting to feel brain fog/tiredness.