TRT + Hypothyroidism Issue

[greg233]

Hello,

I've been on Thyroid meds for a few years, everything was stable until I started taking TRT along with the thyroid medication.

My latest labs are

FT3 - 3.42 pg/ml / Range 2.02-4.43

FT4 - 1.15 ng/dl /Range 0.93.170

TSH - 0.97 /Range 0.27-4.20

Testosterone - 480ng/ml / Range: - 249-839

Estradiol - 49.30pg/ml / Range: 7.60-42.60

SHBG - 26.4nmol/L / Range: 18.3 - 54.1

I am constantly cold and my hands and feet are freezing. Still trying to optimise the testosterone dose. Any ideas what I can do? Right now I'm taking Tirosint Sol (T4) 75mcg + Thybon (T3) 20mcg, upped it up to 30mcg but I don't feel any difference.

edit. I do have some NDT that I am willing to try but it's from Thailand, (Thyroid-S) the one with the 500 capsules. Not sure whether I should abandon my current T4+T3 protocol in order to try the NDT.

edit2, added lab ranges.

Thank you in advance.

[TiggerMe]

If you could add the ranges for people to see where you are with this, labs use varying ranges

[greg233 in reply to TiggerMe]

just added it, thanks

[TiggerMe in reply to greg233]

With results like this I'd say you need an increase in your T4 to start with and then retest in 6-8 weeks, when you adjust one hormone it has a knock on effect, your fT4 has dropped from 45% last test so already on the low side

Free T4 (fT4) 1.15 pmol/L (0.93 - 1.7) 28.6%

Free T3 (fT3) 3.42 pmol/L (2.02 - 4.43) 58.1%

[AKatieD]

Yes, started testosterone as part of HRT regime 6 weeks ago and suddenly feel the cold . It is quite odd as it was a family joke that Mum never gets cold (since being on thyroid treatment 10+ years ago). It is quite a novelty as suddenly I want to wear jumpers like everyone else!

My initial blood test suggested the Testosterone had put up my free T3 (I am on T3 only) when the coldness made me expect a fall, but will test again shortly just to confirm and then adjust.

[SlowDragon Administrator]

Was test done after 6-8 weeks on constant unchanging dose

Testing 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

FT4: 1.15 pmol/l (Range 0.93 - 1.7)

Ft4 only 28.57% through range

FT3: 3.42 pmol/l (Range 2.02 - 4.43)

Ft3 58.09% through range

When were vitamin D, folate, ferritin and B12 last tested

[greg233 in reply to SlowDragon]

6 months ago and they are all optimal