Gotta get this fixed...

[Brazensol]

Went to the doc a few months ago with the usual symptoms of low t. Tired, gaining weight but not eating any more than normal. low libido, etc,. Basically my give a damn was gone. No interest in much of anything including sex and my favorite hobbies. Got the following blood test results:

14 Mar 2012

Free Test.......40.1 pg/ml.....(35.0 - 155.0)
Total Test......231 ng/dl.......(250 - 1100)
TSH..............3.43 uIU/ml...(.34 - 4.82)
Vit D.............34................(18 - 72)

He put me on Androgel 1% (5 gram packets) once daily. Went from getting by to feeling worse. New blood tests
as follows:

6 Jun 2012

Free Test.....16.2 pg/ml
Total Test....108 ng/dl
Estradiol......20.6 pg/ml.....(7.6 - 42.6)
SHGB..........23 nmol/l.......(10 - 50)

I also had another testosterone lab as follows:

Testosterone.....0.83 ng/ml.....(2.1 - 8.0) But I do not know what this one was measuring exactly. Any thoughts?

I have also been reading up on thyroid and it seems my TSH lab result might indicate a "sluggish" thyroid. Again, any thoughts on this? I have been considering doing a iodine therapy for some time now and probably will go ahead and do it now.

Needless to say the Androgel 5 gram packets are not working for me so my doc ordered the 7.5 gram Androgel pump. I told him I wanted injections from day one but he says injections cause liver and prostate problems and also to stay far away from hcg. I have an appointment with my NEW doc on the 9th of July. At least he does injections but don't know about the hcg. He is supposed to be the doctor who orders all the "weird" blood tests (according to the nurses) so, to me anyway, it sounds like he wants to get to the root of the problem. Anyway that's my story in a nutshell.

[jdw999]

For a TRT, I don't think the dosage of test is enough to cause liver damage and didn't they disprove the prostate theory.

Anyway, welcome aboard. Some vets will be around soon and can give you some guidance.

Good luck, JD

[steroid.com 1]

Went to the doc a few months ago with the usual symptoms of low t. Tired, gaining weight but not eating any more than normal. low libido, etc,. Basically my give a damn was gone. No interest in much of anything including sex and my favorite hobbies. Got the following blood test results:

14 Mar 2012

Free Test.......40.1 pg/ml.....(35.0 - 155.0)
Total Test......231 ng/dl.......(250 - 1100)
TSH..............3.43 uIU/ml...(.34 - 4.82)
Vit D.............34................(18 - 72)

He put me on Androgel 1% (5 gram packets) once daily. Went from getting by to feeling worse. New blood tests
as follows:

6 Jun 2012

Free Test.....16.2 pg/ml
Total Test....108 ng/dl
Estradiol......20.6 pg/ml.....(7.6 - 42.6)
SHGB..........23 nmol/l.......(10 - 50)

I also had another testosterone lab as follows:

Testosterone.....0.83 ng/ml.....(2.1 - 8.0) But I do not know what this one was measuring exactly. Any thoughts?

I have also been reading up on thyroid and it seems my TSH lab result might indicate a "sluggish" thyroid. Again, any thoughts on this? I have been considering doing a iodine therapy for some time now and probably will go ahead and do it now.

Needless to say the Androgel 5 gram packets are not working for me so my doc ordered the 7.5 gram Androgel pump. I told him I wanted injections from day one but he says injections cause liver and prostate problems and also to stay far away from hcg. I have an appointment with my NEW doc on the 9th of July. At least he does injections but don't know about the hcg. He is supposed to be the doctor who orders all the "weird" blood tests (according to the nurses) so, to me anyway, it sounds like he wants to get to the root of the problem. Anyway that's my story in a nutshell.

Well you know that you have the wrong guy. Any "Doctor" that tells you injections causes liver and prostate problems doesn't have an F'n clue as to what he's saying! How in God's name doesn't an injection pose a problem with the liver when it bypasses it completely???

You have very elevated TSH levels and is probably a result of your Hypogonadism.

For Thyroid please get:

TSH
T4
T3
RT3
Thyroid Antibodies

See the sticky on how to find a TRT Doc there is a list of blood panels you need on your next pull.

Also, see the link to Dr. John Crisler's website and please print his paper on the use of hCG and take it to your next appointment but be sure to read and understand it so you can speak intelligently to this new Doc. Also, read the sticky at the top of the forum on hCG and what you should know.

Your serum levels are clinically low and you need to know why and with what you listed here very little assessment can be made.

Did you have LH tested? If so, please post.

[Brazensol]

Thanks for the quick responses!

Unfortunately I did not get LH or FSH checked. How long would I have to come off the gel to get these checked? I would like to know if I am primary or secondary. I don't think my new doc will have any problem running a thyroid panel so we can see what is going on there. I had heard that low thyroid can lead to low t but have not heard of it the other way around. Interesting. Do you think the thyroid will turn itself around once I get dialed in on the t injections? It would be nice to have one less thing to worry over.

I am already a member on Dr. Crisler's website. Lots of good info there as well as here. I've been to a few other sites but there seems to be a lot of crap going on at them so will stay on this one and Crisler's.

Any thoughts on that last testosterone lab result? Perhaps free % of t? It doesn't specify so I just don't know.

[kelkel]

Listen to GD. Get the full BW done with complete thyroid panel as listed above. Good to see your researching already. You've landed in a good place. Stick around and welcome!

[ecdysone]

Well you know that you have the wrong guy. Any "Doctor" that tells you injections causes liver and prostate problems doesn't have an F'n clue as to what he's saying! How in God's name doesn't an injection pose a problem with the liver when it bypasses it completely???

The theory is that the superphysiological test levels typically experienced with injections (and not with the gels/creams) are stressful on the liver - probably true, but generally not something we worry too much about - and of course, minimized if you do 2x per week SQ dosing.

But i'm in full agreement with all the rest.

[bass]

my liver enzymes always been on the high side, but now that i am on TRT its the lowest its been! one thing elevated my liver enzymes is anything oral whether its OTC meds or supplements, the worst one was the anavar. liver concern is only valid when injecting excessive amounts, like when i was blasting liver was getting hammered, but not within the protocol. for me at least.

[steroid.com 1]

We don't blast heavy amounts here so the liver should never be an issue at dosage rates at the physiologic level.

My enzymes are low as well except if it's been a weekend of boating and a ton of beer...than it shows up LOL!

[ecdysone]

my liver enzymes always been on the high side, but now that i am on TRT its the lowest its been! one thing elevated my liver enzymes is anything oral whether its OTC meds or supplements, the worst one was the anavar. liver concern is only valid when injecting excessive amounts, like when i was blasting liver was getting hammered, but not within the protocol. for me at least.

True, that.

What I am referring to, is if you do the "classical" 200-300 mg/ 2-3 weeks you will experience a very high spike that is hard on the liver.

WE have gone beyond that and have figured out that 2x per week is the solution.

However, you have to realize that 99% of the population doesn't read this board or even know what we are discussing. They basically go with the classical dosing or use gel/creams.

[bass]

True, that.

What I am referring to, is if you do the "classical" 200-300 mg/ 2-3 weeks you will experience a very high spike that is hard on the liver.

WE have gone beyond that and have figured out that 2x per week is the solution.

However, you have to realize that 99% of the population doesn't read this board or even know what we are discussing. They basically go with the classical dosing or use gel/creams.

exactly ECD! i knew what you were referring to, i just wanted to elaborate on it.

[Brazensol]

Did my first subQ testosterone cypionate injection today! It was a piece of cake.

[bass]

Did my first subQ testosterone cypionate injection today! It was a piece of cake.

its the only way to go!

[Brazensol]

Here are my latest labs (9 July 2012):

Free T 93.3 (35.0-155.0)
Total T 428 (250-1100)
T3 108 (80-200)
T4 0.62 (0.60-1.35)
TSH 7.55
Prolactin 10.6 (0-16)

Free T and Total T are both going up but this was after only one injection of 100 mgs. Labs were drawn Monday morning and injection was done the previous Thursday morning.

[Brazensol]

Another piece of information. I had my bodyfat tested in one of those air pod devices. Sadly it was higher than I expected measuring in @ 35%. Plan to have it down into the 20's by September.

[Brazensol]

Would supplementing with Lugos's 2% iodine have any affect on TSH levels? The reason I ask is I was supplementing 18.6 mgs/day of iodine before getting my second TSH lab. My first TSH lab were 3.43 (in March before Lugol's) and the second was 7.55 (9 July after using Lugol's for a few weeks). I know TSH is not the most reliable/accurate of tests but that seems like quite a jump in a relatively short time.

[steroid.com 1]

Brazensol - You are most likely in a state of Hypothyroidism and need to see a specialist right away.

Don't speculate or think about supplementing with Lugol's...find a specialist right away...I can't stress that enough.

There are pathological reasons why your TSH levels are so elevated and you need to be diagnosed by a trained Physician.

FT4 and FT3 are tanked and they should be in the upper third of the reference range.

More importantly your conversion from FT4 to FT3 (the most important) is in the shits.

Coupled that to your high TSH level and it says something is amiss!

Know: Hypothyroidism can and will cause Secondary hypogonadism and may be why you look like you do.

[Brazensol]

Latest bloodwork is back. Unfortunately after providing the doc with a list of labs to run (and him agreeing they all seemed reasonable to check) all I got was total T, free T, TSH, and free T4...

Total T 1420 (250 - 1100) ng/DL
Free T 434 (35 - 155) pg/mL
TSH .90 (0.34 - 4.82)
FT4 .71 (0.60 - 1.35) ng/DL

Didn't get SHBG or bioavailable T. Didn't get albumin so can't calculate bioavailable either.

Even though both my T labs that were tested are high libido is still not where I would like it to be. Same goes for energy level and general sense of well being. Good news is the weight is finally coming off so I think I am going in the right direction. Until 6 weeks ago it didn't matter what I did I could not lose an ounce. Have now dropped about 15 pounds and muscles seem to be responding to the workouts.

I think I will cut my T Cyp to 100 mgs/2xweek or maybe 50mgs/every three days. I see where my T4 is in range but definately on the low end. Will probably have a hard time convincing doc to increase armour dose since the almighty # TSH looks good... lol. I bet my T3 is low also. Will see if I can get the above tests redone along with SHBG, albumin, E2, T3 and RT3. Oh, and bioavailable T and vit D. Anyone see anything else include? Any other thoughts? Thanks dudes.

[Brazensol]

Any thoughts guys?

Also would it make a difference in t levels if I were breaking my T Cyp dose into to 30 mgs injections instead of one 60 mg injection? I find I get a bit tender at the injection site with one large single injection so I inject twice and this way I have no more tenderness. Would this allow a larger amount to get into my system?

[Brazensol]

Latest Labs - 12 October 2012:

Total T 505 (250 - 1100)
Bioavailable 187 (110 - 575)
Free T 90.9 No Range Given
SHGB 23 No Range Given
Albumin 4.5 (3.6 - 5.1)

TSH 0.45 (.34 - 4.82)
FT4 0.51 (0.60 - 1.35)
T3 118 (80 - 200)

Based on SHGB, Total T and Albumin I calculate my %free T as 12.3 ng/dL = 2.43 %. I can't find a reliable source for optimal %free T so does anyone know? Also according to the calculator my bioavailable T is 300 ng/dL which disagrees with my lab result of 187. Any ideas for the discrepancy? I've heard calculating bio-T is more accurate than the blood test but I don't really know...

AlsoT3 is low and T4 is even lower. Should I try synthetic T4 and T3? I don't think my doc will up my armour thyroid because of my "textbook" TSH number. (I hate that number).

Starting last night I am upping my T Cyp to 112mgs/week injecting half every 3.5 days. My last labs had my T (120 mgs/week) at very good levels (perhaps even high) but my symptoms still remain for the most part. At this point I am tending to think my thyroid is driving my symptoms more so than testosterone.

[TennTarheel]

What caused your TSH to drop back down so dramatically? Was it the Armour?

[Brazensol]

Yes. Unless the T has a role in it but I don't think it does. Boosting (correcting) thyroid can boost Testosterone but I don't think it works the other way.

[steroid.com 1]

Honestly, I think you may need a new Doc.

Your T4 and T3 are for shits and I'd also like to see Free T4 and T3 in addition to RT3 and antibodies.

Something is amiss.

[Brazensol]

I agree. Unfortunately, I'm stuck with this guy until early next year. One of the hazards of the retired military medical system. Looks like I will eventually go with one of the hrt online clinics... I just hate having to pay out of my own pocket for a service I earned through 23+ years of service. Sadly none of the military docs are really up to speed but he is the best one I have found so far.

[Brazensol]

Is 2.43% available free T a good percentage?

[labuski]

Is 2.43% available free T a good percentage?

Sure it is but percentages dont mean squat when your total is low.

[Brazensol]

True that. Do you know what the ranges are? I seem to remember reading 3.5% or so is about the best you can get but I don't know if I am remembering correctly.

[Renholder]

AlsoT3 is low and T4 is even lower. Should I try synthetic T4 and T3? I don't think my doc will up my armour thyroid because of my "textbook" TSH number. (I hate that number).

You are already on thyroid medication, right? Does not thyroid medications suppress TSH? A low TSH does not mean that your thyroid is optimal, if I understand correctly.

With a T4 that is below the range and a T3 that is low, your thyroid is obviously not where it should be right now.

Will your doctor let you try synthetic T4? I think you should give it a shot. Possibly a small dose T3 along with, but my understanding is that T4 is superior if you properly convert it to T3. Some need high doses though.

Mind you, this is my uneducated opinion.

[Brazensol]

You are already on thyroid medication, right? Does not thyroid medications suppress TSH? A low TSH does not mean that your thyroid is optimal, if I understand correctly.

With a T4 that is below the range and a T3 that is low, your thyroid is obviously not where it should be right now.

Will your doctor let you try synthetic T4? I think you should give it a shot. Possibly a small dose T3 along with, but my understanding is that T4 is superior if you properly convert it to T3. Some need high doses though.

Mind you, this is my uneducated opinion.

Yes I am currently on 60mgs/day of armour thyroid. This has brought my TSH down but as you can see it has not brought my T4 or T3 to optimal levels. Since armour is 80% T4, this leads me to believe I am not converting T4 to T3 very well and I do need to get tested for antibodies and RT3. He is willing to let me do synthecic T4/T3 (I actually had to talk him into the armour thyroid) which I may need to do if my RT3 is high. I would rather up my armour thyroid first but my doc is overly concerned it will cause my TSH to go to low even though my T3 is low... Based on my latest labs I don't think he will argue getting RT3 and antibodies tested. Before he thought he would just be to much information overload. Whatever that means.

[Renholder]

Yes I am currently on 60mgs/day of armour thyroid. This has brought my TSH down but as you can see it has not brought my T4 or T3 to optimal levels. Since armour is 80% T4, this leads me to believe I am not converting T4 to T3 very well and I do need to get tested for antibodies and RT3. He is willing to let me do synthecic T4/T3 (I actually had to talk him into the armour thyroid) which I may need to do if my RT3 is high. I would rather up my armour thyroid first but my doc is overly concerned it will cause my TSH to go to low even though my T3 is low... Based on my latest labs I don't think he will argue getting RT3 and antibodies tested. Before he thought he would just be to much information overload. Whatever that means.

Yeah, get the extra tests and see if they provide any new information. TSH is probably suppressed because of the Armour, but that is irrelevant when your T3/T4 is low, below range.

There are guys who need as much as 200 mcg of T4 to get good thyroid levels and a feeling of well-being, so it may simply be a matter of upping the dose. Your T4 is low, so it is not any wonder that your T3 is low as well. You may still be able to convert enough if you increase the T4 dosage.

But I`m only speculating here. This is not really my field, so take any advice on this from me with caution. Just saying what I would have done. Since you`re already using thyroid medications, it should not hurt you to experiment a little with different protocols and doses.