Starting TRT while subclinical hypothyroid...Yay or Nay?

[RJslice]

Hey all,

I'm looking to start TRT but i was holding off till the anti-thyroid results came in because i was advised to fix my thyroid issue first before starting TRT as my thyroids would not be able to handle the youthful testosterone levels .
Well, my antibodies results came back and it says my hypothyroidism is not because of antibodies.

Where does that leave me now? Appreciate any advice.

Stats:

Age: 33
Height: 6'5
Weight: 264 lb
Body fat: %27

Hormones

Testosterone , total
216 (286 - 802) ng/dL

Testosterone, free
34.17 (34.51 - 107.78) pg/mL

Testosterone, bioavailable
138 (138 - 430) ng/dL

SHBG
16.0 (14.5 - 48.4) nmol/L

E2 (Estrogen)
32.6 (7.6 - 43.0) pg/mL

LH
4.0 (1.7 - 8.6) mIU/mL

FSH
3.5 (1.5 - 12.4) mIU/mL

Prolactin
16.7 (3.46 - 19.4) ng/mL

Cortisol (AM) (had sex a little less than 48 hours prior to testing)
8.30 (3.7 - 19.4) ug/dL

IGF-1
160.3 (150 - 350) ng/mL

Thyroid Panel

TSH
4.54 (0.27 - 4.20) uIU/mL

T3, free
3.6 (2.0 - 4.4) pg/mL

T4, free
1.24 (0.93 - 1.70) ng/dL

Anti-Tg
0.48 (0.00 - 4.11) IU/mL

Anti-TPO
0.00 (0.00 - 5.61) IU/mL

Lipid panel

Cholesterol
216.1 mg/dL

Desirable: <200
Borderline: 200 - 239
High risk: >240

HDL
32.7 mg/dL

Low: <130
High: >60

LDL
139.5 (<130) mg/dL

VLDL
27.90 (<40.0) mg/dL

Tg (Triglyceride)
219.5 (<200) mg/dL

CBC

HB (Hemoglobin)
12.5 (14 - 18) g/dL

Hematocrit
45.1 (42 - 50) %

RBC
4.79 (4.5 - 6.2) x10*6/uL

WBC
5.60 (5.0 - 10.0) x10*3/uL

WBC & diff / Lymphocyte
40.6 (20 - 40) %

MCH
26.0 (27 - 31) pg

MCHC
29.5 (32 - 36) g/dL

MCV
94.2 (80 - 95) fL

RDW
10.1 (2 - 20) %

Platelet count
250.0 (150 - 400) x10_3/uL

ESR
(up to 10) mm/hr

Clotting time
(2 - 6) mins

Bleeding time
(1 - 6) mins

CMP

-General

Glucose (fasting)
98 (65 - 99) mg/dL

Calcium
8.60 (8.40 - 10.2) mg/dL

-Liver

ALP
82.0 (40 - 130) U/L

ALT (SGBT)
40.2 (Up to 41) U/L

AST (SGOT)
24.9 (Up to 40) U/L

Bilirubin, total
0.80 (up to 1.1) mg/dL

Bilirubin, direct
0.20 (up to 0.25) mg/dL

Bilirubin, indirect
0.60 (0.1 - 0.75) mg/dL

-Kidney

Urea Nitrogen (BUN)
43.5 (<50) mg/dL

Creatinine
0.862 (<1.1) mg/dL

-Electrolytes

Potassium
4.60 (3.60 - 5.5) mmol/L

Sodium
141.0 (135.0 - 152.0) mmol/L

Chloride
99.0 (98.0 - 110.0) mmol/L

-Proteins

Albumin
4.40 (3.6 - 4.6) g/dL

Protein, total
7.30 (6.4 - 8.3) g/dL

[hammerheart]

Uhm... I had tT levels close to yours a couple of yrs ago, and was hypothyroid too. My endo at the time advised NOT to take thyroid hormone before TRT, and he was right on that one. Unfortunately, I was seeing another endo whom prescribed me levothyroxine. That resulted in the worst hypogonadal symptoms ever, anxiety, muscle loss, body hair falling, and dick feeling like it wasn't there.

Thyroid hormones accelerates sex hormones metabolism and excretion, and upregulate binding proteins, reducing the free quota available for tissues and brain. It's also true that thyroid dysfunction will compromise the benefits from TRT (I can personally vouch for that).

However, your fT levels look good compared to mine ( 8 pg/ml ), and your FT4/3 are great too, so I'd say your only slightly hypothyroid.

Imho you can start TRT safely before fixing thyroid. You won't need more than 50mcg of l-t4 which isn't a big dose, start with 25 right after commencing TRT then upgrade to 50 after two weeks.

Best of luck.

[RJslice]

Uhm... I had tT levels close to yours a couple of yrs ago, and was hypothyroid too. My endo at the time advised NOT to take thyroid hormone before TRT, and he was right on that one. Unfortunately, I was seeing another endo whom prescribed me levothyroxine. That resulted in the worst hypogonadal symptoms ever, anxiety, muscle loss, body hair falling, and dick feeling like it wasn't there.

Thyroid hormones accelerates sex hormones metabolism and excretion, and upregulate binding proteins, reducing the free quota available for tissues and brain. It's also true that thyroid dysfunction will compromise the benefits from TRT (I can personally vouch for that).

However, your fT levels look good compared to mine ( 8 pg/ml ), and your FT4/3 are great too, so I'd say your only slightly hypothyroid.

Imho you can start TRT safely before fixing thyroid. You won't need more than 50mcg of l-t4 which isn't a big dose, start with 25 right after commencing TRT then upgrade to 50 after two weeks.

Best of luck.

Need that in layman's terms buddy. Sounds like a catch 22

[hammerheart]

It means thyroid meds can worsen the low T symptoms by reducing test available, unless the hypothyroidism is causing low t, but judging by your bloods, you only have minor dysfunction and I don't think that's the case.

That's why I do suggest you start TRT first. Your thyroid will handle it just fine, but I also recommend you commence thyroid meds soon thereafter, for maximum benefits.