Thyroid labs help

[nothuman]

Generally, most will be symptom free with Free T4 1.4-1.8 ng/dL and with 5-15 mcg T3.


If that doesnt solve it, it's most likely something else causing the symptoms


Its a myth that RT3 blocks receptors, its basically inert. It's the smoke, not the fire. In illness, stress or inflammation states, the body will divert more T4 into RT3 instead of T3.


What are your main symptoms you suspect might be thyroid?

What do you think of the 100/12.5 T4/T3 dosing? I’ve been dealing with thyroid symptoms for 5 years on and off. Sometimes I’m better depending on my dosing but then when I make changes, things might go wrong.

 

[nothuman]

You've checked for auto immune disorders? You might never get your thyroid straightened out without having it removed.

My oldest brother has Addison disease(diagnosed as a teenager). In his late 20's, early 30's his thyroid wasn't working right, not sure all the details but he had to take a radiation pill to kill(or slow?) his thyroid. Same time my son was born and he wasn't allowed to hold him. Fast forward 14 years, his endocrinologist is still making adjustments to his thyroid medication. It has been reduced the last to times he's seen his doctor. I believe I read somewhere that the thyroid can actually recover for radiation treatment and start producing extra hormone again.

My middle brother, just a few weeks ago was diagnosed with Graves and hashimoto disease. Last year he went in for a physical, found he had low thyroid, started him on thyroid medication. Goes back for a check up and his thyroid numbers are off the charts high. They reduce his thyroid medication and his numbers still came back way too high. They discontinued medicine, ran more tests and found he had Graves and hashimoto. How do you treat a thyroid when you have to auto immune disorders and one causes hyperthyroidism and the other causes hypothyroidism?

Then there's me. I most definitely have thyroid issues. I have so many hypo symptoms. Last time I checked my thyroid, these were my numbers, tsh 2.7 (0.450-4.5), free t4 1.15 (0.82-1.77), free t3 4.8 (2.0-4.4). My symptoms get worse if my test levels are even marginally elevated. High test levels can cause excessive high free t3 causing the body to shutdown receptors causing hypothyroidism despite high free t3. Seems rare and with my brothers latest diagnoses, wonder if I don't actually have more going on than just testosterone levels. Being stuck never being able to run more than 80-100mg test/week seems to defeat the purpose of permanently shutting myself down, lol.

My brother tells me autoimmune disorders can be genetic...my mom has fibromyalgia, some classify it as autoimmune disorder. I should probably go get some bloodwork done.

Yes, many tests. No autoimmune issues at all fortunately. No antibodies or anything. I had low cortisol all throughout the day every time I tested and eventually treated myself with hydrocortisone.

I felt good for a while on 25-37.5mcg of T3 only and then it all went to shit the moment I tried to go up to 50mcg and then I never felt good again when I went back down to the old dose.

I’ve been playing around with the dosing ever since until I get back to how I felt before. It’s a struggle because I’ll think I figured it out and then a few days to a week later, I don’t feel good anymore.

 

[Crazy_jay]

Are you using HGH?

No. I have before, years ago, lethargy so bad, could barely function and that's with only a couple iu.

If I pin extra test, within a couple days, and if the dose is large enough(this varies depending on where my test levels are currently at) all within the same day I pin, lethargy will set in, bloat, water retention, reduced appetite, digestive issues, dry hair, dry hands, dry nails. I've tried coming off everything twice, both times, most issues went away but obviously I had crashed test and estrogen that comes with its own problems.

Unfortunately I have an addictive personality that crosses right into steroids use too. I don't run anything crazy but simply trying to get myself to drop down to say 80mg test/week for an extended period of time is very hard for me to cope with. I can say 125mg test is still too much but 150mg test only had my t levels mid 700s but free t was 1 point high. I'm working on being consistent with 80mg to prove or disprove its test and or thyroid related. If it don't help, at least my numbers will look good for a doctor to help me.

 

[Black Beard]

Yes, many tests. No autoimmune issues at all fortunately. No antibodies or anything. I had low cortisol all throughout the day every time I tested and eventually treated myself with hydrocortisone.

I felt good for a while on 25-37.5mcg of T3 only and then it all went to shit the moment I tried to go up to 50mcg and then I never felt good again when I went back down to the old dose.

I’ve been playing around with the dosing ever since until I get back to how I felt before. It’s a struggle because I’ll think I figured it out and then a few days to a week later, I don’t feel good anymore.

It's also possible you might feel better with a little more T4. Some tissues will not get enough T3 without enough T4 (They need to convert it themselves versus using it from the serum)


What are the exact symptoms that are bothering you? It may be something else entirely not thyroid related causing problems. A lot of things that seem like thyroid can be caused by many other things.


What is every single supplement and medication/hormone/drug that you take? You use HGH right? What time do you take it and what dosage?

(Something as simple as too much magnesium/vitamin D, low carb/keto diets, HGH useage, too little/too much estradiol, low ferritin, etc could be causing your issues.)


@Crazy_jay You ever donate blood? Have you looked at ferritin levels (this is an iron test). Your Free T3 is over range and Free T4 is on the lower side which is usually fine. You eat any low carb or keto diet? Have you ever tried test prop for TRT? (i use as little as 75 mg per week and feel awesome, very dry/hard/pumped, excellent mood, libido, etc)

 

[nothuman]

It's also possible you might feel better with a little more T4. Some tissues will not get enough T3 without enough T4 (They need to convert it themselves versus using it from the serum)


What are the exact symptoms that are bothering you? It may be something else entirely not thyroid related causing problems. A lot of things that seem like thyroid can be caused by many other things.


What is every single supplement and medication/hormone/drug that you take? You use HGH right? What time do you take it and what dosage?

(Something as simple as too much magnesium/vitamin D, low carb/keto diets, HGH useage, too little/too much estradiol, low ferritin, etc could be causing your issues.)


@Crazy_jay You ever donate blood? Have you looked at ferritin levels (this is an iron test). Your Free T3 is over range and Free T4 is on the lower side which is usually fine. You eat any low carb or keto diet? Have you ever tried test prop for TRT? (i use as little as 75 mg per week and feel awesome, very dry/hard/pumped, excellent mood, libido, etc)

10/10 brain fog when it’s at its worst. And fatigue. The symptoms change when I take the thyroid hormone so I don’t know how it could be anything else if I respond to taking those tabs. I’ve done hundreds of labs so if there’s anything else you can think of, I’ll tell my test result.

I tried going on and off meds/supplements before and no change except when the thyroid hormone is started/stopped/dose changed

 

[RandomMachine]

Hey, you might be one of the people who only needs T4. Many people wont need T3, and they will feel poorly on it. Optimal thyroid hormone levels will improve muscle function, too much and too little will decrease strength, endurance, explosiveness and recovery.

Use T4 only, every 4 weeks test FREE T4 , increase dose until you get into the optimal range 1.4-1.8 ng/dL. If you still have symptoms, add 5-10 mcg T3. (Must test Free T4 not total)



Thyroid hormones are analogous to coffee; there is a sweet spot, too little and no effect , too much and you willl feel like shit; stressed and anxious. (Both can work partially through beta receptors; adrenaline noradrenaline)

Appreciate the response.

As of now I'm on 100mcg of T4

Free T4
1.6
Range 0.8-1.8

Free T3
2.8
Range 2.3-4.2

TSH
0.03
Range: 0.40-4.50

At this point I wasn't sure if the low TSH is something I should be trying to correct. I was thinking it would pick back up some when I removed the T3.

 

[Black Beard]

10/10 brain fog when it’s at its worst. And fatigue. The symptoms change when I take the thyroid hormone so I don’t know how it could be anything else if I respond to taking those tabs. I’ve done hundreds of labs so if there’s anything else you can think of, I’ll tell my test result.

I tried going on and off meds/supplements before and no change except when the thyroid hormone is started/stopped/dose changed

You use GH daily? Ever try Mon/Wed/Fri?


You can try a bit more T4 and no T3 or less T3. Too much thyroid can also cause lower energy/brain fog.



@RandomMachine No reason to worry about the TSH. It's like worrying that your LH/FSH is suppressed on TRT. Makes zero sense.



More importantly how do you feel? Generally, you only need 0-10 mcg T3. Our thyroid only directly secretes about 6-8 mcg T3 per day. So anything over 10 mcg is supraphysiological.

 

[RandomMachine]

You use GH daily? Ever try Mon/Wed/Fri?


You can try a bit more T4 and no T3 or less T3. Too much thyroid can also cause lower energy/brain fog.



@RandomMachine No reason to worry about the TSH. It's like worrying that your LH/FSH is suppressed on TRT. Makes zero sense.



More importantly how do you feel? Generally, you only need 0-10 mcg T3. Our thyroid only directly secretes about 6-8 mcg T3 per day. So anything over 10 mcg is supraphysiological.

Yep, that definitely makes sense. What threw me off was seeing so many people claim to have normal TSH while on T4 or even T3 and T4.

Definitely not the case for me.

Other than that there isn't any reason for me to change anything at this point. It's easy to maintain and my values are improved from baseline.

 

[nothuman]

You use GH daily? Ever try Mon/Wed/Fri?


You can try a bit more T4 and no T3 or less T3. Too much thyroid can also cause lower energy/brain fog.



@RandomMachine No reason to worry about the TSH. It's like worrying that your LH/FSH is suppressed on TRT. Makes zero sense.



More importantly how do you feel? Generally, you only need 0-10 mcg T3. Our thyroid only directly secretes about 6-8 mcg T3 per day. So anything over 10 mcg is supraphysiological.

1iu HGH before bed but just added that in 2 months ago. In the past, I didn’t notice thyroid labs being different whether I was on it or not but maybe it makes a difference.

I got sucked into all the functional medicine thyroid for a while but I now realize they got a lot wrong. I never even considered trying T4 solo due to my rT3 issues but now I’m no longer convinced it’s not a useful test, when before I thought it meant everything.

I was listening to a podcast with an anonymous doctor who goes by “Hormones Demystified” who has a blog and he does a good job explaining in detail why some of those functional thyroid practices are false. You seem to echo the things he says.

Your thyroid knowledge is really strong so you are a godsend to this thread!

Another question: do you think the 5-15mcg T3 dose that accompanies T4 should be taken all at once in the morning or split in two doses?

 

[Black Beard]

1iu HGH before bed but just added that in 2 months ago. In the past, I didn’t notice thyroid labs being different whether I was on it or not but maybe it makes a difference.

I got sucked into all the functional medicine thyroid for a while but I now realize they got a lot wrong. I never even considered trying T4 solo due to my rT3 issues but now I’m no longer convinced it’s not a useful test, when before I thought it meant everything.

I was listening to a podcast with an anonymous doctor who goes by “Hormones Demystified” who has a blog and he does a good job explaining in detail why some of those functional thyroid practices are false. You seem to echo the things he says.

Your thyroid knowledge is really strong so you are a godsend to this thread!

Another question: do you think the 5-15mcg T3 dose that accompanies T4 should be taken all at once in the morning or split in two doses?

Yep, stop the thyroid madness is 90% bullshit. The only thing they got right is that T3 is important for many to feel their best. All their RT3, cortisol, iron ideas are horseshit. They have many men and women going hyperthyroid and wondering why they feel like shit, their answer is always ; low cortisol/iron, etc.


Thank you for the kind words. One of my hobbies is digesting research and reading papers. I have read probably tens of thousands of papers on thyroid, HGH, androgens, etc. I love physiology and i'm also a clinician who specializes in this stuff.


Generally, morning only works fine. Thyroid also has the "gene expression" effect like AAS, so the benefits are delayed and not completely tied to "serum levels". I have a paper that proves this too but also in my experience with patients. Sometimes taking T3 in the afternoon or evening can negatively affect sleep as well.

 

[RandomMachine]

Yep, stop the thyroid madness is 90% bullshit. The only thing they got right is that T3 is important for many to feel their best. All their RT3, cortisol, iron ideas are horseshit. They have many men and women going hyperthyroid and wondering why they feel like shit, their answer is always ; low cortisol/iron, etc.


Thank you for the kind words. One of my hobbies is digesting research and reading papers. I have read probably tens of thousands of papers on thyroid, HGH, androgens, etc. I love physiology and i'm also a clinician who specializes in this stuff.


Generally, morning only works fine. Thyroid also has the "gene expression" effect like AAS, so the benefits are delayed and not completely tied to "serum levels". I have a paper that proves this too but also in my experience with patients. Sometimes taking T3 in the afternoon or evening can negatively affect sleep as well.

Might as well ask because you seem knowledgeable and willing to offer advice.

You ever see anyone who has chronically low iron on TRT who also runs a few cycles per year?

For whatever reason mine is chronically low, even supplements haven't raised it.

Alkaline phosphatase is another thing that has been chronically low. No doctors seem to know or care about iron unless you have anemia. They have even less concern about the alkaline phosphatase.

I can provide more information if you have any theories.

 

[Black Beard]

Might as well ask because you seem knowledgeable and willing to offer advice.

You ever see anyone who has chronically low iron on TRT who also runs a few cycles per year?

For whatever reason mine is chronically low, even supplements haven't raised it.

Alkaline phosphatase is another thing that has been chronically low. No doctors seem to know or care about iron unless you have anemia. They have even less concern about the alkaline phosphatase.

I can provide more information if you have any theories.

Are you donating blood? or have in the past?

The doses of iron people use will not treat anemia. You often need very high doses for +8-12 weeks to restore ferritin/iron status if you are very anemic. It's best to use iron bisglycinate as ferrous sulfate (your generic iron supplement) will shred your insides at the doses and length of time you need to take them. Generally, takes 50-100 mg iron bisglycinate per day for 2-3 months.


What is your diet like? Vegan, keto, carnivore, anything like that? Are you usually in a deficit cutting a lot?

 

[nothuman]

Yep, stop the thyroid madness is 90% bullshit. The only thing they got right is that T3 is important for many to feel their best. All their RT3, cortisol, iron ideas are horseshit. They have many men and women going hyperthyroid and wondering why they feel like shit, their answer is always ; low cortisol/iron, etc.


Thank you for the kind words. One of my hobbies is digesting research and reading papers. I have read probably tens of thousands of papers on thyroid, HGH, androgens, etc. I love physiology and i'm also a clinician who specializes in this stuff.


Generally, morning only works fine. Thyroid also has the "gene expression" effect like AAS, so the benefits are delayed and not completely tied to "serum levels". I have a paper that proves this too but also in my experience with patients. Sometimes taking T3 in the afternoon or evening can negatively affect sleep as well.

yea I remained very symptomatic for a long time as a result of listening to their harmful bullshit because I didn’t know any better. They sound so positive of themselves too . It’s all anecdotal crap

Since you brought up cortisol and iron, do you think these have little impact on how well thyroid hormone will work? I know low iron needs to be raised since it creates a host of problems itself but how about cortisol?

 

[nothuman]

Might as well ask because you seem knowledgeable and willing to offer advice.

You ever see anyone who has chronically low iron on TRT who also runs a few cycles per year?

For whatever reason mine is chronically low, even supplements haven't raised it.

Alkaline phosphatase is another thing that has been chronically low. No doctors seem to know or care about iron unless you have anemia. They have even less concern about the alkaline phosphatase.

I can provide more information if you have any theories.

I also have low alkaline phosphate. No idea why either. Would love to hear an explanation but it’s been low for years no matter what I do.

 

[Crazy_jay]

@Crazy_jay You ever donate blood? Have you looked at ferritin levels (this is an iron test). Your Free T3 is over range and Free T4 is on the lower side which is usually fine. You eat any low carb or keto diet? Have you ever tried test prop for TRT? (i use as little as 75 mg per week and feel awesome, very dry/hard/pumped, excellent mood, libido, etc)

I used to donate blood but don't anymore because of iron deficiency. That was years ago and I recovered my ferritin levels.

It might not be my thyroid at all and is as simple as my body just does not handle test well. I want to avoid daily pinning and think my next goal is to split 80mg m/w/f. I have tried test u and the longer ester seemed to come with more problems.

 

[Black Beard]

yea I remained very symptomatic for a long time as a result of listening to their harmful bullshit because I didn’t know any better. They sound so positive of themselves too . It’s all anecdotal crap

Since you brought up cortisol and iron, do you think these have little impact on how well thyroid hormone will work? I know low iron needs to be raised since it creates a host of problems itself but how about cortisol?

It's more that if you have cortisol or iron issues, you won't feel well despite euthyroidism.


@Crazy_jay

You don't have to use prop daily. I have best results on 75 mg split MWF. Many don't "Feel TRT" unless they use prop. Just my experience. Something about the peak and the trough probably has something to do with it. Cyp and Enanthate tend to give very stable levels we don't see naturally. We don't need or want hyper stable levels of testosterone. It's not how we were designed to use it.

 

[nothuman]

Also @Black Beard , I weigh 202lbs when I wake up so according to the 1.6mcg x kg formula, I’m supposed to take 150mcg of T4.

My question is should I use less than that if I am also including 6.25-12.5mcg of T3 along with it?

Alternatively, should I also use less T4 since my TSH is already optimal (1.5) but I just need to raise my Free T3 (2.7) a little bit to feel right?

It’s tough go get an answer to these since they are such individualized questions

 

[Black Beard]

Also @Black Beard , I weigh 202lbs when I wake up so according to the 1.6mcg x kg formula, I’m supposed to take 150mcg of T4.

My question is should I use less than that if I am also including 6.25-12.5mcg of T3 along with it?

Alternatively, should I also use less T4 since my TSH is already optimal (1.5) but I just need to raise my Free T3 (2.7) a little bit to feel right?

It’s tough go get an answer to these since they are such individualized questions

Not necessarily, titrating T4 down when increasing T3 is just a cautionary step. Generally, most men need 100-200 mcg daily fasted to attain euthyroid status. Some will need 5-10 mcg T3 to achieve euthyroid status. (Taking T3 actually stimulates further T4 to T3 conversion in tissues).


Often times lipids and GFR will not improve in men who need more T4 or T3. Liver and kidney function is optimized in a euthyroid state, as well as mood, cognition/memory, etc.


Do NOT look at TSH. Do you look at LH/FSH when titrating TRT? TSH will lead you astray. Generally, euthyroid state will have you at <1 TSH, oftentimes highly suppressed (Like TRT).


TSH is exactly like LH/FSH, they are trophic pituitary peptide hormones that are just signals.

 

[RandomMachine]

Are you donating blood? or have in the past?

The doses of iron people use will not treat anemia. You often need very high doses for +8-12 weeks to restore ferritin/iron status if you are very anemic. It's best to use iron bisglycinate as ferrous sulfate (your generic iron supplement) will shred your insides at the doses and length of time you need to take them. Generally, takes 50-100 mg iron bisglycinate per day for 2-3 months.


What is your diet like? Vegan, keto, carnivore, anything like that? Are you usually in a deficit cutting a lot?

No blood donations.

Have had low iron/alkaline phosphatase at least since 2021 through various surpluses and deficits.

Had a lower and upper scope to check for bleeding. Nothing.

Eat a varied diet.

Beef
Chicken
Eggs
Egg whites

Sweet potatoes
Rice
Fruit

 

[Black Beard]

No blood donations.

Have had low iron/alkaline phosphatase at least since 2021 through various surpluses and deficits.

Had a lower and upper scope to check for bleeding. Nothing.

Eat a varied diet.

Beef
Chicken
Eggs
Egg whites

Sweet potatoes
Rice
Fruit

What supps, meds, hormones?