TRT and Levothyroxine

My endo has recommended a trial of TRT (Testogel patches) for low testosterone to run alongside thyroid treatment, however my usually helpful GP won't prescribe TRT as he feels the two shouldn't be treated at the same time. What's the view on this as to me it's absurd?

Also when I flagged up the high ferritin levels he said I must have had a cold when my bloods were taken which wasn't the case!

Recently upped my dose of Levo from 75mg to 100mg as persisting symptoms include low energy levels, painful joints, memory issues, head pressure, difficulty concentrating, brain fog, sleep disturbances and weight gain.

*Ferritin 524.8 30 - 400 ug/L

*TSH 3.37 0.27 - 4.20 mIU/L

T4 Total 95.8 64.5 - 142.0 nmol/L

Free T4 16.37 12 - 22 pmol/L

Free T3 4.26 3.1 - 6.8 pmol/L

*Anti-Thyroidperoxidase abs 372.5 <34 kIU/L

*Testosterone 6.11 nmol/L 7.60 - 31.40

*Free Androgen Index 19.12 Ratio 24.00 - 104.00

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5 Replies

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  • Porcelt,

    I would expect an endocrinologist to know better than a GP whether TRT could be prescribed alongside thyroid replacement. Menopausal hypothyroid women are prescribed HRT and thyroid replacement so I don't see why TRT shouldn't be prescribed. Perhaps your endo could speak to your GP?

    I'm not sure at what level a GP considers ferritin to be too high. My GP wasn't concerned about my ferritin being around 100 over range.

    Increasing Levothyroxine to 100mcg should raise FT4 and FT3 and bring down TSH.

    Painful joints can be due to vitD deficiency. Has yours been checked?

  • Hi Clutter,

    The endo wrote to my GP just over 6 weeks ago and said I should have blood tests in 6 weeks time and if my TSH was still high and my Testosterone was low that I should be trialled on treatment for both. At that time my GP agreed to a course of levo, as I had started self medicating anyway. Now he wants to know why the endo is changing my proposed course of treatment, which isn't the case, and in any event treatment should be either or rather than both. Will see if the endo can have a chat with my GP as you suggest and hopefully we can move things forward.

    Not sure if part of the problem may be due to seeing an endo privately and reverting back to a NHS GP for meds??

    Vit D levels have dropped recently despite taking 5000iu daily so have increased the dosage to 6000iu and will review when bloods are taken in 6 weeks time.

  • Porcelt,

    Ah, NHS GPs sometimes get a bit hacked off with private endos recommending drugs which make a dent in their drug budgets. I'm afraid the attitude is often that if the private endo thinks a therapy is important then the endo should write a private prescription. If your GP won't agree to prescribing TRT you should ask for referral to a NHS endocrinologist.

  • Think I'll need to have a chat with my GP as the endo works at a local NHS hospital 3 days a week and the only reason I went private was to save waiting for an appointment. Do you think it would be a major issue to switch to seeing the endo at the NHS hospital rather than privately or is that considered a no-no?

  • Porcelt,

    Some private endos will switch their private patients to their NHS clinics. If endo is working as an NHS endo at the local hospital your GP may not know whether you are seeing him/her privately or on NHS.

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