I've been on T3 20mcg and T4 75mcg daily for the past year, I started taking TRT (testosterone replacement therapy), initially I felt way better, but now I'm getting more tired and cold hands and feet than ever before. Is there any correlation between taking Testosterone while being hypothyroid? Before taking testosterone my blood tests were perfect, last blood test was as following and I didn't have any issues with cold feet or hands.
FT4 - 1.28 Range - 0.93-1.70
FT3 - 3.68 Range - 2.02-4.43
TSH - 1.42 Range - 0.27 - 4.20
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greg233
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How long have you been medicating? What is your nutritional status levels regarding Vit D, Vit B12, folate and iron? How much testosterone are you taking? Was it prescribed? How old are you?
Low testosterone is common in men with hypothyroidism and often levels restore to a natural level once thyroid hormones have been optimised for some time. All steroid hormones are bound to carrier proteins and most circulating testosterone is tied to SHBG, and a lesser extent to albumin (and then even lesser to several others). Therefore, only a little remains 'free' for use in a healthy scenario.
If you introduced the testosterone dose too quickly or too high, then SHBG risks also elevating and can bind too much thyroid hormone. When this happens you can end up with less ‘free’ of both testosterone and thyroid hormones than previous to medicating testosterone.
Albumin may raise too and is a carrier of thyroid hormone together with TBG (and to a lesser extent others) and this further risks binding too much hormone. All binding proteins are natural mediators for the total and free levels to allow only what is required. When we replace both thyroid and sex hormones with meds we have to be very careful not to exceed those ‘sweet spots’.
There are also connections of testosterone and thyroid hormone through deiodination enzyme (D1). The enzymes are responsible for activating or deactivating thyroid hormone and evidence the immense connection between the thyroid and sex hormones.
SlowDragon has offered great advice regarding all other hypo care and testing.
In a healthy situation higher levels of SHBG will result in lower levels of ‘free’ testosterone, and this is normal and will reverse by reducing total testosterone. This is like stage one problems and common.
Your scenario is another stage on and happens to those who take extra large testosterone amounts or continued mahoosive amounts that the body can’t deal with in a normal fashion. This is difficult to reverse and eventually results in the opposite happening to what testosterone should make happen, eg shrinking testicles, prostate enlargement, heart muscle damage, etc, and as you say SHBG plummets leaving even more 'free' to cause further damage.
The amount of 'free' required is tiny and in general testosterone will follow the levels of SHBG continually making minor adjustments to keep levels correct.
of course nobody is talking about taking extra large amounts of testosterone and that is not TRT. Most of us on TRT are simply trying to optimise levels, correct levels are actually protective to the heart, not damage it. Similarly with the prostate it is now shown that men with low testosterone are more prone to prostate cancer
On T3 most people when adequately treated will have very low or suppressed TSH
Most important results are ALWAYS Ft3 followed by Ft4
Many on Levo plus small dose T3 find they need BOTH Ft4 and Ft3 at least 60-70% through range
And OPTIMAL vitamin levels
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
Yes I recently added T to my HRT mix and it quickly affected my thyroid hormone levels (I am T3 only and free T3 increased) and I will be taking a lot less T than you. Suddenly I was unusually cold and have had to crack out some jumpers that have not been worn for years. I am going to leave it a while and test again to see if it settles.
Hi there this might help although I am still trying to find a correlation being being on TRT and a depletion of thyroid hormone activity - your levels look good - the weather is colder and your thyroid will struggle to keep up its activities to heat the body etc. Could you tell me what else you are taking as this might be causing the symptoms you are experiencing.
Those levels are pre T, I will be having blood tests this week so I will post them on Tuesday here. I'm only taking T3+T4 + Test Enanthate. I had some symptoms of high estrogen so I added some Proviron and the thyroid function returned within a few days I was a lot warmer, I stopped taking it as I just became too moody and irritable.
Hi Greg, I'm a 58 Y old male, live in Australia. For me TRT is great. I've been on it for about 7 years now. It helped me immensely. I was having real issues converting t4. I would get - crawly scalp, buzzing feet soles and fingers pads, breathless walking up stairs , getting fat on Levo, anxiety, dry eyes . I tried t3 , 4t combo's, NDT, nothing worked long term. I end up on a low t4 dosage levo with a tsh=+5 for 12 months. Went back onto NDT, struggled heaps. Couldn't seem to optimize from 30mg starter dose. Started taking trt and suddenly I could take a more NDT. Anxiety i had had, since being on t4 thyroid replace drugs lifted, easier to carry muscle, lost weight 107kg --> 90kg.
I semi competitively sail and ride dirt bikes (motor cycles) weekly. To do this at my age I have to train most days. lunch time jog or swim Mon to Friday. (plus work 8 hours) 30-40min weights on the back veranda each night. I don't think I could do without NDT and TRT.
With TRT, I'm super wary of feeding a cancer. Just had a PET scan to check prostate and the beauty of that is they do you whole body. Doing PSA every 6 months, keep copies of all my blood work and know my numbers. Drink lots of water, my kidneys have taken a flogging over the years with not drinking enough during all day competitions. Try and eat only grass feed meat, veggies and not allot of carbs. I'm a celiac too so no wheat products. Happy to talk in pm if you need.
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