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Should I do TRT?

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I want to preface this by saying two things:
1) I was diagnosed with Graves disease recently. My thyroid panel was completely messed up but I have now gone on medication and my levels are fine last I checked. I have done multiple tests through out the years since 2013 (in my early 20s) and there was no indication of any thyroid issues.

2) From my uneducated observations what I have noticed about these tests (I have done about 4 of them) two things stand out. My total testosterone has ranged from the low 400s to the low 600s. Also, I have noticed that my LH and FSH levels have been chronically low but not clinically low......until the most recent test where my FSH was indeed 0.1 point below the lowest reference level.

Symptoms: Most of my symptoms are sexual and mood related.
-My libido is non-existent but at times I have the feintest yearning for sex. I thought it was in my head but down the road I noticed my ejaculate volume was EXTREMELY low to the point where it would be a tiny little drop. Like my libido it comes and goes but not to a healthy degree.
-I have experienced Erectile dysfunction numerous times. For no apparent reason.
-Mood is relatively stable but I feel extremely depersonalized and do have bouts of fatigue.
-Also I do feel fatigued a lot of the time. That could be the Graves disease but I never had any indication of a thyroid issue in the past.
-My Libido in my teenage years was through the roof and then one day, id say 21, it just vanished and never came back. I understand we age and things change but good lord is it supposed to be this abrupt?

Lifestyle
-I lift 4 times a week.
-My diet is highly regimented and I cover all my bases nutrition-wise. Been on the vertical diet for a while actually.
-Sleep is on point for the most part and stick to a pretty regular schedule.
- I am in school and that probably stresses me a lot more than I would like to admit
- The only substances that I abused growing up where cigarettes, stimulants and marijuana occasionally. Other than that I hardly drink and never do any other recreational drugs.

My current situation:
I mentioned this in my introductory thread but I have had a really hard time figuring out what the hell is wrong with me going through the medical system. I have been fit through out this entire process with very few lapses in my body weight. In my early 20s I was about 170lbs at 12% bodyfat and had the same testosterone levels that I do now with a much higher body fat percentage (low 400s). Sure im not clinically low but at the same time that sort of sucks for someone who lives practically like a monk and is relatively young. I begged a doctor at a walk-in to refer me to a mens clinic (Lawrence Komer) and by the grace of some higher being he gave it to me. The clinic has given me the green light to start TRT and they want to get me to the highest range possible. The question now is "if" I should start. The biggest reason I haven't started is because I want to have a kid with my girlfriend and I feel starting TRT would be absolutely irresponsible but at the same time i am "in" the system and getting back in will be a nightmare. Also I eventually wanted to get on TRT regardless by the age of 40. Why not? Im aging and want optimal levels into my older age.

The nurse practitioner told me we could start with HCG monotherapy and eventually get on TRT when we conceive. But what do you guys think about all this? Below are my values from my most recent test.
cjm1.PNGcjm2.PNGcjm3.PNGcjm4.PNG
 

Old RhynoS

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I am not seasoned at reading blood panels @Harley00 comes to mind as a very knowledgeable person for this.
What is your stress like In your life?
Your t levels , on paper , seem ok but that is irrelevant. You can have middle range levels and still be suffering from low t. It's about quality of life, not getting numbers right on paper. If you naturally sit high normal and things fall to normal then , for you , that's not good.
Have you looked into hcg? It may be enough to give your natural hormones a bump to wake them up.
How long have you had your thyroid under control, it can play with everything and may need time to really level off.
I don't think starting trt is irresponsible. It's your life after all, and I don't mean " it's my life I'll do what I want" I mean why go thru life feeling life less than a man when you don't have to.
I guess the question that will determine your best option is when do you want to have kids?
Now? Years down the road? Would starting trt and then coming off for the kids be an option for you? Have you been trying for them now?
I wish you the best in figuring this all out. Sorry I couldn't have been more helpful. I'm sure others will chime in.
 
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I am not seasoned at reading blood panels @Harley00 comes to mind as a very knowledgeable person for this.
What is your stress like In your life?
Your t levels , on paper , seem ok but that is irrelevant. You can have middle range levels and still be suffering from low t. It's about quality of life, not getting numbers right on paper. If you naturally sit high normal and things fall to normal then , for you , that's not good.
Have you looked into hcg? It may be enough to give your natural hormones a bump to wake them up.
How long have you had your thyroid under control, it can play with everything and may need time to really level off.
I don't think starting trt is irresponsible. It's your life after all, and I don't mean " it's my life I'll do what I want" I mean why go thru life feeling life less than a man when you don't have to.
I guess the question that will determine your best option is when do you want to have kids?
Now? Years down the road? Would starting trt and then coming off for the kids be an option for you? Have you been trying for them now?
I wish you the best in figuring this all out. Sorry I couldn't have been more helpful. I'm sure others will chime in.
Personally I would love to have more stable T levels and be able to pin point exactly at what level I feel best. I have looked extensively at the pros and cons and in my opinion none of the cons seem all that bad for what I could potentially get. I understand that TRT isn't some miracle therapy but if I can potentially absolve myself of certain issues while maintaining optimal levels I will be extremely happy. It's just that I have heard with normal-low levels you may not stand to gain much if at all but I just find it hard to believe in my case.

I have had my Thyroid under control just under a year now. We are playing around with my dosage for thyroid meds for another 6 months to see where Im at my best and will continue to monitor my thyroid panels every 2 months.

The biggest concern is fertility but once we conceive it's full steam ahead for me. And I will be trying to have kids ASAP just after school is finished in August (I'm in summer school). So basically starting in September. HCG seems like a good option and the nurse practitioner recommended we start with HCG monotherapy and eventually TRT when im ready to begin.
 

Old RhynoS

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It's not something you can out on paper. Going from an excuse of a man, no drive for life , no ambition, no desire, no will , depressed, etc to feeling like you're ready for battle, ready to take on life. That's where the paper diagnosis fails. If your normal spot is 800 and all the sudden you fall to 400, you're gonna feel that. Paper says you should feel good but you're putting out 1/2 what your body normally runs on. That's where doctors drop the ball.
I would persue the hcg as you're Dr suggested.
 

Harley00

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I would try hcg/combination with a bit of clomid or novaldex or rolaxfine. To pick up those natural numbers, the best combination is trial and error

The base markers are decent aside from fsh /lh


-What are your thryoid numbers, id like to see all the ones you have.
-Do you drink often, your b 12 is good, liver looks good, but your mcv is 92, indicating that your a drinker? , if thats the case that will show low levels of fsh/lh , were you trying to show low test levels to get trt?
- what is your iron levels
-ferritn is a bit high not high like in trouble high, but could be some inflammation going on. Im digging, and looking for signs of inflammation, list any issues you have (examples tooth infections? Or something like that,very well could be that your a smoker or were and levels haven't came back down .
- what is your acth
- like to see cortisol levels am and pm
-what are your dhea levels
- your progesterone levels.
- have you had zinc levels checked
- what is your magnesium levels.
-egfr (kidney markers how are they)
-do you have any other blood work, if so date it and add please old is fine i wanna see history and a pattern

I dont wanna give alot of info on Graves yet, till i see some numbers etc . But trt or raising your testosterone may have an effect on your thyroid. For me it rasied tsh and lowered my acth through a series of events i wont go into detail, iv done this in other threads, how it may effect you im not sure at the moment, it will depend on acth and cortisol. If you have Graves and high cortisol, trt gonna be a winner. If you have graves and low acth and low cortisol, then trt may make it worse.

As @Old RhynoS said hows your stress, stress is going to have the biggest impact hear on your luteinizing hormone.

At the moment i wanna give good advise but i wanna see more.




List of all your supplements that u take regularly.

Again hcg route along with clomid 3 times a week or rolaxfine,or novaldex on the side may very well be the answer for right now, that being said its gonna be trial and error hcg is going to effect crh and acth as well as all the other hormons.. its most definitely going to skew your current protocal for thyroid medication.

Also tell wjat your takimg current for thyroid meds.
Thnx
 
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I would try hcg/combination with a bit of clomid or novaldex or rolaxfine. To pick up those natural numbers, the best combination is trial and error

The base markers are decent aside from fsh /lh


-What are your thryoid numbers, id like to see all the ones you have.
-Do you drink often, your b 12 is good, liver looks good, but your mcv is 92, indicating that your a drinker? , if thats the case that will show low levels of fsh/lh , were you trying to show low test levels to get trt?
- what is your iron levels
-ferritn is a bit high not high like in trouble high, but could be some inflammation going on. Im digging, and looking for signs of inflammation, list any issues you have (examples tooth infections? Or something like that,very well could be that your a smoker or were and levels haven't came back down .
- what is your acth
- like to see cortisol levels am and pm
-what are your dhea levels
- your progesterone levels.
- have you had zinc levels checked
- what is your magnesium levels.
-egfr (kidney markers how are they)
-do you have any other blood work, if so date it and add please old is fine i wanna see history and a pattern

I dont wanna give alot of info on Graves yet, till i see some numbers etc . But trt or raising your testosterone may have an effect on your thyroid. For me it rasied tsh and lowered my acth through a series of events i wont go into detail, iv done this in other threads, how it may effect you im not sure at the moment, it will depend on acth and cortisol. If you have Graves and high cortisol, trt gonna be a winner. If you have graves and low acth and low cortisol, then trt may make it worse.

As @Old RhynoS said hows your stress, stress is going to have the biggest impact hear on your luteinizing hormone.

At the moment i wanna give good advise but i wanna see more.




List of all your supplements that u take regularly.

Again hcg route along with clomid 3 times a week or rolaxfine,or novaldex on the side may very well be the answer for right now, that being said its gonna be trial and error hcg is going to effect crh and acth as well as all the other hormons.. its most definitely going to skew your current protocal for thyroid medication.

Also tell wjat your takimg current for thyroid meds.
Thnx

My thyroid numbers that indicated hyperthyroidism were ---
TSH: 0.01 mIU/L
FREE T4: 23 pmol/L
FREE T3: 8.0 pmol/L

After treatment shortly after they were:
TSH: 2.43 mIU/L
FREE T4: 12 pmol/L
FREE T3: 3.9 pmol/L


The medication I am currently taking is: methimazole which I started in 2020 mid-year

List of supplements: All taken year round (with the exception of KSM-66 that I now have to discontinue.)
-
Opti-zinc: 30mg
- Creatine: 5 Grams
- Vitamin K2:100 micrograms
-Selenium: 200 Micrograms
-Vitamin D3: 5,000 i/u's
-Fishoil: 3-5 grams
-KSM-66 (discontinued usage because it isn't good for hyperthyroidism): 300mg
-Magnesium Bis-Glycinate: 400mgs

I actually hate drinking and don't drink often. Like one every two months I might have a beer or two OR potentially will get drunk but that's rare.

My MCV levels through out the years:
2014: 92
2015: 92.7
2020: 91 and of course the value on the most recent test this year.

I'll be honest and say I don't actually know what this means. No idea what MCV is responsible for or what a high MCV denotes. Im glad you brought it to my attention.

In 2020 my cortisol level in the AM was 237 nmol/L
Also DHEA-S was: 6.6 umol/L
The only Progesterone reading I have ever had was In 2015 and it was: 2.0 nmol/L

My FSH and LH have been chronically low through out the years how ever.

I want to asnwer what I can here but I will get around to scanning my other blood labs from 2014-2015 so you can see them in greater detail. Thank you so much for this it means a lot to me.
 

BigBen

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High mcv means there are a higher than normal percentage of recently matured or immature red blood cells in your blood. As they mature they shrink. High mcv means high median cell volume. ie higher percent of larger than average red blood cells, indicating a faster turnover of red blood cells. That may indicate a higher than normal turnover of red blood cells owing to loss or destruction of red blood cells. Or, it could just be your normal. Mine is always on the extreme high end of the range.
 

Harley00

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My thyroid numbers that indicated hyperthyroidism were ---
TSH: 0.01 mIU/L
FREE T4: 23 pmol/L
FREE T3: 8.0 pmol/L

After treatment shortly after they were:
TSH: 2.43 mIU/L
FREE T4: 12 pmol/L
FREE T3: 3.9 pmol/L


The medication I am currently taking is: methimazole which I started in 2020 mid-year

List of supplements: All taken year round (with the exception of KSM-66 that I now have to discontinue.)
-
Opti-zinc: 30mg
- Creatine: 5 Grams
- Vitamin K2:100 micrograms
-Selenium: 200 Micrograms
-Vitamin D3: 5,000 i/u's
-Fishoil: 3-5 grams
-KSM-66 (discontinued usage because it isn't good for hyperthyroidism): 300mg
-Magnesium Bis-Glycinate: 400mgs

I actually hate drinking and don't drink often. Like one every two months I might have a beer or two OR potentially will get drunk but that's rare.

My MCV levels through out the years:
2014: 92
2015: 92.7
2020: 91 and of course the value on the most recent test this year.

I'll be honest and say I don't actually know what this means. No idea what MCV is responsible for or what a high MCV denotes. Im glad you brought it to my attention.

In 2020 my cortisol level in the AM was 237 nmol/L
Also DHEA-S was: 6.6 umol/L
The only Progesterone reading I have ever had was In 2015 and it was: 2.0 nmol/L

My FSH and LH have been chronically low through out the years how ever.

I want to asnwer what I can here but I will get around to scanning my other blood labs from 2014-2015 so you can see them in greater detail. Thank you so much for this it means a lot to me.

Ok, i like that your organized, and have a good grasp on things already, so im going to try to get you to put some trust in what im going ro say, as much trust as you can on a body building fourm.

Take a deep breath. ..this journey will take awhile, it will be about attacking the right issue the root cause.

First mcv, can be used for lots of things, liver issues hypothyroidism, and flauctuating between hyper and hypo. Etc. Its a marker sometimes can identify an issue, dont need to get to into it , its just a starter marker to rasie questions. Theres alot of deeper things to say about it. But will always mean to look somewhwre else for the issue. Its just a identifying marker, dont focus on that its not the issue.

Im going to strongly go against what i suggested up top, step way back from hcg and trt for now. Just get it completely out of your head as it isnt why your having these issue. Your free t and total t are not bad , there low but not low due to you being old or what ever ,Its low due to an underlying issue thats causing your lh/fsh to be low. ... this is what we wanna no is it an auto immune disease, pituitary issues , genetic issues etc list goes on so long you wont see it.....and it could very well be u need trt or hcg to revive your lh... function.. but im betting not.

Fixing the lh by adding in hcg or trt will not fix your situation, what it will do is throw a big ass wrench into an existing problem and you will spend the next 3 years trying ro figure out what the hell went wrong, and back tracking everything you did and alaways think hcg or trt caused all these problems to be worse ....been there... done that... ill save u time .

Chances are its not even that u were hyper, because your not now....guess what.. your hypo now . So the numbers your gonna wanna be at or close to is mid to slightly above mid range ft4 so if top of reference range was 23 then 15
to 17 would be good.

I see that those labs had 23 ft4 and 8 ft3 thats a good indicator of hyper, but have you checked your anti bodies to confirm, tpo trab and tsi.

Where you should be .
Ft3 if top of the reference range was 6.5 then 5 5 to 6 would be great.

I understand your hyper or were but ither thats a genetic issue or self caused i do not no.

Tsh is really irrelevant but typical a bottom oit tsh indicates hyper as your an over producer of ft4 to ft3 . So your tsh dosn't have to work that hard. So the signal fron the pituitary, is most likely not sending alot of signals.....obviously it dosn't have too because your conversion is too good .

We are getting into complicated things, hypothalamus and hippocampus, pituitary. Signals etc... root causes is a most we have to find those before we add things.

A big question is if your were hyper and had low lh that makes sense, but now your not hyper and u still have low lh... i mean your hypo but we wanna see if correcting your thyroid increases your lh, if it dont then we need to know what will.

So....your a bit hypo now , now you can get an idea where u need to be., remember no meds 10 to 15 hrs before blood test . As this may throw your numbers off, this also means it could be showing you less ft3 ft4 then you are. Where as if you were truly hypo, thyroid meds could make you look too high if taken before test. This make sense? I dunno if your issue is genetic or what . Im also not familiar with that medication your using as i dont see hyper very often unless i cause it myself. And most are hypo over hyper that i see .

Ok. Lets move to a major root cause. That sometimes can be caused by a root cause... fak eh

Adrenal fatigue...known as low cortisol

Cortisol /Adrenocorticotropic hormone (acth) corticotropin-releasing-hormone (crh)

Cortisol can hugely effect lh fsh and every single hormone .

Blood test show bound and unbound cortisol so its not accurate at all. If your blood test comes back say 250, well you coukd still be 50 and wouldnt know it. Because of the bound and unbound...for instance if you were stressed that day your acth could produce cortisol and increse the circulating cortisol and show that you were 500 and u were really only 100 , blood work also increases cortisol.

You need a 24 hr cortisol saliva test and that is so very important to rule out. A blood test wont help. Doing a acth blood test will help though, but if your lh is low its possible your acth is low....due to a connection with you Corticotropin-releasing hormone. Or is it high.... and being over stimulated we dont know.

Also wanna add acth to every test to match with all the other test, it helps with figuring oout wjats going on.


Absolutely no adoptions 2 weeks before cortisol testing , noithing that effects cortisol, no caffine 2 days before, no food or drink 1 hr befoer each sample etc dont just get a kit and spit in the cup theres a procedure.

Dhea is low , but dont jump on dhea because it has major fluctuation its the see saw to cortisol but it changes so much dont even look at it yet , but its low. Still not gonna make the connection you need.

Ok your supps

Opti-zinc: 30mg yup good

- Creatine: 5 Grams dunno....hows your kidneys

- Vitamin K2:100 micrograms yup take with vit d

-Selenium: 200 Micrograms yup good but absolutely have to do blood work on it too much is very bad to low is bad it builds up suoer quick please check asap on next labs.

I gope your not taking iodine, pkease add that as well to blood test.

-Vitamin D3: 5,000 i/u's -yup great

-Fishoil: 3-5 grams- yup good

-KSM-66 (discontinued usage because it isn't good for hyperthyroidism): 300mg
Ok good its also nkt good if your cortisol is low already it can drive it lower.

-Magnesium Bis-Glycinate yup great

Im gonna end it hear or ill be all day lol but theres much more to discuss.

Definitely not going back to look for spelling errors there is probably a few , and im at work everyday all day lol
 
Last edited:

scotiaguy

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It's not something you can out on paper. Going from an excuse of a man, no drive for life , no ambition, no desire, no will , depressed, etc to feeling like you're ready for battle, ready to take on life. That's where the paper diagnosis fails. If your normal spot is 800 and all the sudden you fall to 400, you're gonna feel that. Paper says you should feel good but you're putting out 1/2 what your body normally runs on. That's where doctors drop the ball.
I would persue the hcg as you're Dr suggested.
couldn't agree anymore that's why having the right doctor is a world of a difference
 

Old RhynoS

Super Heavyweight
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Ok, i like that your organized, and have a good grasp on things already, so im going to try to get you to put some trust in what im going ro say, as much trust as you can on a body building fourm.

Take a deep breath. ..this journey will take awhile, it will be about attacking the right issue the root cause.

First mcv, can be used for lots of things, liver issues hypothyroidism, and flauctuating between hyper and hypo. Etc. Its a marker sometimes can identify an issue, dont need to get to into it , its just a starter marker to rasie questions. Theres alot of deeper things to say about it. But will always mean to look somewhwre else for the issue. Its just a identifying marker, dont focus on that its not the issue.

Im going to strongly go against what i suggested up top, step way back from hcg and trt for now. Just get it completely out of your head as it isnt why your having these issue. Your free t and total t are not bad , there low but not low due to you being old or what ever ,Its low due to an underlying issue thats causing your lh/fsh to be low. ... this is what we wanna no is it an auto immune disease, pituitary issues , genetic issues etc list goes on so long you wont see it.....and it could very well be u need trt or hcg to revive your lh... function.. but im betting not.

Fixing the lh by adding in hcg or trt will not fix your situation, what it will do is throw a big ass wrench into an existing problem and you will spend the next 3 years trying ro figure out what the hell went wrong, and back tracking everything you did and alaways think hcg or trt caused all these problems to be worse ....been there... done that... ill save u time .

Chances are its not even that u were hyper, because your not now....guess what.. your hypo now . So the numbers your gonna wanna be at or close to is mid to slightly above mid range ft4 so if top of reference range was 23 then 15 to 17 would be good.

Ft3 if top of the reference range was 6.5 then 5 5 to 6 would be great.

I understand your hyper or were but ither thats a genetic issue or self caused i do not no.

Tsh is really irrelevant but typical a bottom oit tsh indicates hyper as your an over producer of ft4 to ft3 . So your tsh dosn't have to work that hard. So the signal fron the pituitary, is most likely not sending alot of signals.....obviously it dosn't have too because your conversion is too good .

We are getting into complicated things, hypothalamus and hippocampus, pituitary. Signals etc... root causes is a mist we have to find those before we add things.

So your a bit hypo now , now you can get an idea where u need to be., remember no meds 10 to 15 hrs before blood test . As this may throw your numbers off, this also means it could be showing you less ft3 ft4 then you are. Where as if you were truly hypo, thyroid meds could make you look too high if taken before test. This make sense? I dunno if your issue is genetic or what . Im also not familiar with that medication your using as i dont see hyper very often unless i cause it myself. And most are hypo over hyper that i see .

Ok. Lets move to a major root cause. That sometimes can be caused by a root cause... fak eh

Cortisol /Adrenocorticotropic hormone (acth) corticotropin-releasing-hormone (crh)

Cortisol can hugely effect lh fsh and every single hormone .

Blood test show bound and unbound cortisol so its not accurate at all. If your blood test comes back say 250, well you coukd still be 50 and wouldnt know it. Because of the bound and unbound...for instance if you were stressed that day your acth could produce cortisol and increse the circulating cortisol and show that you were 500 and u were really only 100 , blood work also increases cortisol.

You need a 24 hr cortisol saliva test and that is so very important to rule out. A blood test wont help. Doing a acth blood test will help though, but if your lh is low its possible your acth is low....due to a connection with you Corticotropin-releasing hormone. Or is it high.... and being over stimulated we dont know.


Absolutely no adoptions 2 weeks before cortisol testing , noithing that effects cortisol, no caffine 2 days before, no food or drink 1 hr befoer each sample etc dont just get a kit and spit in the cup theres a procedure.

Dhea is low , but dont jump on dhea because it has major fluctuation its the see saw to cortisol but it changes so much dont even look at it yet , but its low. Still not gonna make the connection you need.

Ok your supps

Opti-zinc: 30mg yup good

- Creatine: 5 Grams dunno....hows your kidneys

- Vitamin K2:100 micrograms yup take with vit d

-Selenium: 200 Micrograms yup good but absolutely have to do blood work on it too much is very bad to low is bad it builds up suoer quick please check asap on next labs.

I gope your not taking iodine, pkease add that as well to blood test.

-Vitamin D3: 5,000 i/u's -yup great

-Fishoil: 3-5 grams- yup good

-KSM-66 (discontinued usage because it isn't good for hyperthyroidism): 300mg
Ok good its also nkt good if your cortisol is low already it can drive it lower.

-Magnesium Bis-Glycinate yup great

Im gonna end it hear or ill be all day lol but theres much more to discuss.

Definitely not going back to look for spelling errors there is probably a few , and im at work everyday all day lol
What did I tell ya @BurntToastLover 😉
 
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Ok, i like that your organized, and have a good grasp on things already, so im going to try to get you to put some trust in what im going ro say, as much trust as you can on a body building fourm.

Take a deep breath. ..this journey will take awhile, it will be about attacking the right issue the root cause.

First mcv, can be used for lots of things, liver issues hypothyroidism, and flauctuating between hyper and hypo. Etc. Its a marker sometimes can identify an issue, dont need to get to into it , its just a starter marker to rasie questions. Theres alot of deeper things to say about it. But will always mean to look somewhwre else for the issue. Its just a identifying marker, dont focus on that its not the issue.

Im going to strongly go against what i suggested up top, step way back from hcg and trt for now. Just get it completely out of your head as it isnt why your having these issue. Your free t and total t are not bad , there low but not low due to you being old or what ever ,Its low due to an underlying issue thats causing your lh/fsh to be low. ... this is what we wanna no is it an auto immune disease, pituitary issues , genetic issues etc list goes on so long you wont see it.....and it could very well be u need trt or hcg to revive your lh... function.. but im betting not.

Fixing the lh by adding in hcg or trt will not fix your situation, what it will do is throw a big ass wrench into an existing problem and you will spend the next 3 years trying ro figure out what the hell went wrong, and back tracking everything you did and alaways think hcg or trt caused all these problems to be worse ....been there... done that... ill save u time .

Chances are its not even that u were hyper, because your not now....guess what.. your hypo now . So the numbers your gonna wanna be at or close to is mid to slightly above mid range ft4 so if top of reference range was 23 then 15
to 17 would be good.

I see that those labs had 23 ft4 and 8 ft3 thats a good indicator of hyper, but have you checked your anti bodies to confirm, tpo trab and tsi.

Where you should be .
Ft3 if top of the reference range was 6.5 then 5 5 to 6 would be great.

I understand your hyper or were but ither thats a genetic issue or self caused i do not no.

Tsh is really irrelevant but typical a bottom oit tsh indicates hyper as your an over producer of ft4 to ft3 . So your tsh dosn't have to work that hard. So the signal fron the pituitary, is most likely not sending alot of signals.....obviously it dosn't have too because your conversion is too good .

We are getting into complicated things, hypothalamus and hippocampus, pituitary. Signals etc... root causes is a most we have to find those before we add things.

A big question is if your were hyper and had low lh that makes sense, but now your not hyper and u still have low lh... i mean your hypo but we wanna see if correcting your thyroid increases your lh, if it dont then we need to know what will.

So....your a bit hypo now , now you can get an idea where u need to be., remember no meds 10 to 15 hrs before blood test . As this may throw your numbers off, this also means it could be showing you less ft3 ft4 then you are. Where as if you were truly hypo, thyroid meds could make you look too high if taken before test. This make sense? I dunno if your issue is genetic or what . Im also not familiar with that medication your using as i dont see hyper very often unless i cause it myself. And most are hypo over hyper that i see .

Ok. Lets move to a major root cause. That sometimes can be caused by a root cause... fak eh

Adrenal fatigue...known as low cortisol

Cortisol /Adrenocorticotropic hormone (acth) corticotropin-releasing-hormone (crh)

Cortisol can hugely effect lh fsh and every single hormone .

Blood test show bound and unbound cortisol so its not accurate at all. If your blood test comes back say 250, well you coukd still be 50 and wouldnt know it. Because of the bound and unbound...for instance if you were stressed that day your acth could produce cortisol and increse the circulating cortisol and show that you were 500 and u were really only 100 , blood work also increases cortisol.

You need a 24 hr cortisol saliva test and that is so very important to rule out. A blood test wont help. Doing a acth blood test will help though, but if your lh is low its possible your acth is low....due to a connection with you Corticotropin-releasing hormone. Or is it high.... and being over stimulated we dont know.

Also wanna add acth to every test to match with all the other test, it helps with figuring oout wjats going on.


Absolutely no adoptions 2 weeks before cortisol testing , noithing that effects cortisol, no caffine 2 days before, no food or drink 1 hr befoer each sample etc dont just get a kit and spit in the cup theres a procedure.

Dhea is low , but dont jump on dhea because it has major fluctuation its the see saw to cortisol but it changes so much dont even look at it yet , but its low. Still not gonna make the connection you need.

Ok your supps

Opti-zinc: 30mg yup good

- Creatine: 5 Grams dunno....hows your kidneys

- Vitamin K2:100 micrograms yup take with vit d

-Selenium: 200 Micrograms yup good but absolutely have to do blood work on it too much is very bad to low is bad it builds up suoer quick please check asap on next labs.

I gope your not taking iodine, pkease add that as well to blood test.

-Vitamin D3: 5,000 i/u's -yup great

-Fishoil: 3-5 grams- yup good

-KSM-66 (discontinued usage because it isn't good for hyperthyroidism): 300mg
Ok good its also nkt good if your cortisol is low already it can drive it lower.

-Magnesium Bis-Glycinate yup great

Im gonna end it hear or ill be all day lol but theres much more to discuss.

Definitely not going back to look for spelling errors there is probably a few , and im at work everyday all day lol
Ok so im going to go down the line here as best as I can. Also Im going to upload my older tests so you can see in plain view what we are dealing with.

-So a saliva test for cortisol. Is this something that I can request from my doctor or is there a way I can do this on my own, privately? I will do what ever you think I need to do ASAP.

-Should I request an MRI for my pituitary gland? My doctor said he was slightly worried about my pituitary but said it was ultimately unnecessary because my FSH was only 0.1 points below the normal ranges and my LH was technically normal.

Below are literally all my blood tests done through out the years. :


I have done an anti-bodies test that came along with my last thyroid panel. The doctor didn't want to do it because he thought it was a forgone conclusion but I insisted so I can have closure that I indeed have Graves disease:
antibodies.PNG


Here is my test from 2014-15
millar1.PNG
millar2.PNGmillar3.PNG

Here is my test from 2013-14
aboujamra1.PNG
aboujamra2.PNG
aboujamra3.PNG

This is my test from last year
Hinchcliffe1.PNG
Hinchcliffe2.PNGHinch3.PNG
 

Harley00

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Cortisol saliva , 24 hr you shoukd be able to get that through your doc. Theres other options bit through your doc is best, it would probably be the dutch test. The zrt is the best but its in the states, they do ship , but u gotta ship back on ice and due to covid its faked .
Also add acth to blood work, ill prob write u a list of blood work , plus whatever your doc adds . Ill do that later though.

Your definitely going to need fresh labs for sure. Amd in your case every 3 months would be wise.

Pituitary tumor, i doupt because your prolactin isnt high, but that was 2015..... so redo prolactin, if its low then you would be safe in that department.

I would run some thryoid scans though see whats going on. Talk to your doctor about that. Goiters /noodles etc arent really my specially. And thryoid scans. But with graves its a good idea too check.

Any scans you can run , arent bad the more you cross off the better off you are.

Im a little concerned with the white blood cells being low, that can show an auto immune diesese which you have , but there can be others aswell.

I see there was a time you had pretty good testosterone, how long exactly have you known you had graves you must have had symptoms growing up? Did u fall , have an accident etc or have you always had this. Just looking for trigger points.

Also your hematocrit and hemoglobin seem to run high, this can be an issue for you on trt etc , and considering your already at top of reference range i can see issues. This also could mean you were dehydrated, and anyone who is hypo or hyper can sometimes have extreme pissing fits where you always have to pee. Dunno if thats u but that can easily cause dehydration.

You will need to get your thyroid under control and in range to see whats up.

We need fresh labs though honestly every 6weeks for labs till u dial in your thyroid, when u hit a wall like ill explain down below, then we can address it

Do you experience any heart palps at all? This could indicate cortisol issues or iron, but by the looks of your ferritin id say your good on iron , will add that to the blood list, dont worry ill write it all out later.

It looks like something happend last year. That's when it went to shit on, yoir Bilirubin was climbing as well, werid to see low ggt , im concerned with that as well, low ggt and rising Bilirubin indicates, a issue with bile flow causing that increse Bilirubin, now its not high...but i wanna see fresh results on ggt and Bilirubin. Your the opposite of fatty liver, and at that time liver enzymes looked good..aside from ggt. Were you trying keto diet ? Last year.

Im gonna hesd to bed im on nights but , ill stsrt a blood lab list for you, ill reach and add alot on there. But its important to do it all at onces see whats up. And id definitely like to see some cortisol tests . See how your graves is effecting your cortisol or vise versa.

You are hypo on those last labs but there still old id like to get you to those numbers i suggested, bjt again hypo is where my knowledge lays the most, but we can still work the numbers. Optimal is Optimal.

Iv also noticed a few times you were estrogen dominant, on your labs, thats a libido killer. If you had erection issues that would do it.Im not sure why exactly though, can be many things thyroid issues, liver issues making estrogen not clear fast enough. List goes on. Progesterone has been good and prolactin so thats good.

Your shbg is high as well so thats tieing up alot of that free testosterone, so will retest that, all these things helps because if you ever do go on trt it will help with the dialing in process, i belive you will have estrogen dominance so allowing less testosterone drops offs will be your friend, more frequent injections, that will also lower shbg and maybe pick that libido up.

Where gonna test for lupus as well thats a (ana) and (ena)


Will get this figured out even if its 1 thing at a time. Its still a guessing game without fresh good labs. Were definitely lookin at immune issues , thats why i always go back to cortisol for its inflammatory response. And bodys protection against stress.

If you have anymore symptoms then feel free to list. We also didnt get blood pressure readings from you. And i see your ac1 was good at that time , will re check your blood sugar as well. Now that your on the hypo scale instead off the speedy hyper scale u may have a higher ac1.
 
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Do you experience any heart palps at all?
I actually have but I will say that is is uncommon.

It looks like something happend last year. That's when it went to shit
So last year two things happened.
1) my girlfreind moved in (LOL)
2) I was on a massive dose of iodine...like MASSIVE... without realizing I had graves disease. I ate a can of mackerel a day, yogurt, eggs, iodized salt (tons of it), AND pure cranberry juice. I thought for what ever reason that I was always on the hypo side and not the hyper side so I decided to supplement my diet with more iodine. This is where my Thyroid levels basically went insane. I have been eating iodine rich foods for years but I have no clue how long Graves disease was in the picture. Last year my diet made it painfully apparent that I indeed have graves disease while the subsequent years it could have been exasperated but still flying under the radar somehow.

I have removed all sources of direct iodine aside from some probiotic yogurt to help with digestion.

Iv also noticed a few times you were estrogen dominant, on your labs, thats a libido killer.
The hilarity of this is that I initially thought I had estrogen dominance this whole time. That was why I began getting tested in the first place. I never thought I had an issue with testosterone because of my body composition and ability to build muscle but when low libido struck as hard as it did I thought

Thank you for this Harley it means the world to me.
 

Harley00

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I actually have but I will say that is is uncommon.


So last year two things happened.
1) my girlfreind moved in (LOL)
2) I was on a massive dose of iodine...like MASSIVE... without realizing I had graves disease. I ate a can of mackerel a day, yogurt, eggs, iodized salt (tons of it), AND pure cranberry juice. I thought for what ever reason that I was always on the hypo side and not the hyper side so I decided to supplement my diet with more iodine. This is where my Thyroid levels basically went insane. I have been eating iodine rich foods for years but I have no clue how long Graves disease was in the picture. Last year my diet made it painfully apparent that I indeed have graves disease while the subsequent years it could have been exasperated but still flying under the radar somehow.

I have removed all sources of direct iodine aside from some probiotic yogurt to help with digestion.


The hilarity of this is that I initially thought I had estrogen dominance this whole time. That was why I began getting tested in the first place. I never thought I had an issue with testosterone because of my body composition and ability to build muscle but when low libido struck as hard as it did I thought

Thank you for this Harley it means the world to me.
Dangers of taking to much iodine , mybguess is you caused this on ur own from iodine , thats why up top i said i hope your not taking iodine without blood work.

What im curious to no now , is since its possible it was self caused through overuse of iodine can you put it back into remission. That i dont know but i wanna belive its possible. Anti bodys can come down and sometimes go away.

The girlfriend, prob didnt give you graves lol , unless u picked her up on the streets and brought her home, then i may need to add different markers in to see what u have 🤣🤣

From now on don't take things unless you do blood work on it.
Vit d is about the safest, vit c even is pretty good unless you have hemochromatosis. Supplements for the most part are meant to be cycled , even too much zinc will deplete your copper but the 25mg a day 30 mg is generally good. Just to give u an idea, but iodine is leathal.

Fresh labs is what will do. So we can straightened this out.

Estrogen dominance can be from thyroid issues , liver issues etc and youve been all over the map, once you address the issues causing Estrogen dominance, it typically balances out. Finding that issue can take time.
 
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Dangers of taking to much iodine , mybguess is you caused this on ur own from iodine , thats why up top i said i hope your not taking iodine without blood work.

What im curious to no now , is since its possible it was self caused through overuse of iodine can you put it back into remission. That i dont know but i wanna belive its possible. Anti bodys can come down and sometimes go away.

The girlfriend, prob didnt give you graves lol , unless u picked her up on the streets and brought her home, then i may need to add different markers in to see what u have 🤣🤣

From now on don't take things unless you do blood work on it.
Vit d is about the safest, vit c even is pretty good unless you have hemochromatosis. Supplements for the most part are meant to be cycled , even too much zinc will deplete your copper but the 25mg a day 30 mg is generally good. Just to give u an idea, but iodine is leathal.

Fresh labs is what will do. So we can straightened this out.

Estrogen dominance can be from thyroid issues , liver issues etc and youve been all over the map, once you address the issues causing Estrogen dominance, it typically balances out. Finding that issue can take time.
Yea once I know what to test for I will request blood work immediately. Im just hoping my doctor doesnt give me a hard time. Im currently dealing with an endocrinologist for my Graves disease and will be seeing him in the next week I believe. The mens clinic I will be visiting at the end of August to give them an answer about HCG Monotherapy. Im hoping I can figure this out before then though.

I should also mention that I have done a thyroid scan and we did find some nodules but the doctor said that they aren't big enough to be worried about and that most people tend to have nodules in their thyroids.
 

Harley00

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@BurntToastLover
Iv included the labs below, for you and for others.

Wrote these at work, if i forget something ill tag u.

The most important thing is that if you have a non complying doctor, and someone who wont run labs, find another doctor. Endo/np you may need both. Np for hormones and endos for the rest as well as cortisol.

Find another doctor do not waste time with a shitty doctor i cant stress this enough....so very important.

Iv been there, and immediately left once i knew he wouldn't help me. All they wanna do is save money or say these teat aren't important.... this means your not important, the doctor works for you!!!

Hear are the labs, and labs youll be able to use forever so save these. Its a good idea to write these down and explian to your doctor waxh one and why you wanna run it.

Oh and no excercise 10 days prior to these tests. No weight lifting. Or running.

Alot of these shoukd be run every 3 months till you get recovered or stable, once a year will help no one.

immunoglobulin
IgG
IgM
IgA
Immunoglobulin g2
Do all sub classes g1 g2 g3 g4 see waht they have.

Alpha-fetoprotein (AFP) looking for testicle cancer, etc looking for reasons of low lh /fsh.

Ldh-Lactate dehydrogenase
is expressed on chromosome 12p, which is often amplified in testies cells. Ldh is less specific for testie cancer than HCG or AFP. However, elevated ldh levels are correlated to high tumer burden in seminoma and recurrence in NSGCT , i copied that from google becUse it was far better then me being able to explain it.lol.

Human chorionic gonadotropin (HCG)

fibrinogen
H pylori

Lupus markers.
Ana
Ena

Inflammation markers
Crp
Esr
Creatine kinase


Blood clot test good to Have.
D-Dimer
-Prothrombin

Liver markers
Ast
Alt
Ggt
Alp
Bilirubin

Shbg
Albumin

Kidney markers
Egfr
Cystatin c - filtration of Kidneys
Creatine

Full iron panel
Iron
Ferritin
Trans ferritin
Uibc
Tibc

Full thyroid panel need all a must.
Ft4
Ft3
Tsh
Rt3 (they may not have this one) iv yet to get this done labs bever come back. Can try.

Anti bodys wanna check these if you control them meaning get them lowerd if it shows progress then you may put hyperthyroidism into remission.
Tpo
Tgab
Trab
Tsi

Selenium
Iodine
Copper

Folate
B12
Magnesium
Zinc
Aldosterone
Homocysteine
Calcium
Phosphate


Blood markers for heavy metals
Mercury
Lead
Aluminum.

Full hormones panel
Prolactin
Pregnenolone
Progesterone
Estrogen
Testosterone
Dhea
Sensitive estradiol
Dht

Full cbc blood panel


Cortisol section panel
Cortisol am and pm
Acth
Cortisol saliva is best. For accuracy. Do all of them

Sodium
Potassium
Chloride.

Blood sugar panels. You never had issues with ur ac1 on your labs but i wanted to include everything for furture, the ac1 is fine for now and Fasting glucose
HbA1c
HOMA-IR
C-Peptide
Fasting Insulin
Fasting glucose


There's also things we didn't touch on , like the gut, having auto immune dieseses can kill the gut, especially since your floating into the hypothyroidism part now, thats if you are.

So signs of bloating after eating, bathroom breaks that come only after a few days , lots of burpes, constipation, acid reflux , heartburn more often , these can be good signs your gut is failing you, so another words leaky gut, this xan come and go as you dip further into hypo, and may come out of it, but if your in that state to long and you dont recognize it and can cause other issues.
If you experience these i like.

Collagen peptides
Nac only 500 if your taking Glutathione
Tudca
Glutathione
Glutamine after workouts
Probiotic, change out different brand each bottle
Dygestive enymes.

These are great and can help you in hypo states.
 
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Ok so what I did was put all of your recommendations on a word document which I will print out and request the doctor to write out a requisition for me.
blood work to be requested 2.PNG

I will call my MD and book an appointment ASAP. I also have an appointment with my endo in the coming week and he will run further bloodwork on my thyroid.

Here is the kicker. I have my appointment with the mens clinic at the end of august which is when I have to either give her the green light for HCG (and eventually TRT) or potentially push it to a further date. Do you think I will need more time to figure this out?

Edit: I have also tailored my diet for optimal digestion and without iodine (minus the yogurt). So far its been good but I have had issues with my digestion in the past.
 
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