New to board and have appointment with Defy in two weeks.

Thread starter #1
I am new to the board, but not new to TRT. I am going to be 38 in a month and have been on TRT from 04/2013 - 02/2018, so I have been completely off of TRT for past few months. The time I have been on TRT I have felt pretty decent, but not like a fresh 20 year old.

Here is some background that lead me on the path of TRT. My body type has been Ectomorph from a kid up until my mid 20's and now it seems I can put on fat by just looking at food. In January 2006 when I was 25 I lost my girlfriend in a car accident. Then a few months later I suffered from Testicular Torsion. So long story short I always thought me not feeling good was because I was depressed from losing my girlfriend, but as the years went on I felt like I dealt with her passing, but still wasn't feeling right. Long story short is I found a local doctor who tested me and was willing to treat me.

Now am mostly looking for a place who specializes in TRT because my other doc would never order a sensitive e2 test, but I did get him to order it in a couple of my labs. Also, I have been researching lately and I think he has overlooked my thyroid and he said everything looks fine back then, but after doing a lot of research lately it really looks like my RT3 is high and maybe that is why I have never felt great while on TRT. The protocal he had me on Test C 50mg 2x per/week, 250IU HCG 3x per week from 2013-2015. I felt pretty decent, but he switched me to Test C 40mg 2x per/week, 250IU HCG 3x per week(2015-Current) because the e2 was high and it wasn't even the sensitive test.

I also want to ask I have been having horrible joint pains through the years in my wrist, shoulders, ankles, left knee, and even my lower back. I have seen specialist for my knee and all the MRI scans look normal and did a couple PRP treatments and that didn't help. I had another specialist look at my lower back pain and all the scans look normal, so I ended up doing a epidural steroid injection in my facet joint and my pain was gone for a full month and i felt awesome, but the pain came back. The doc recommended I try the radio frequency ablation and that had zero effect on the pain. Would any of these above mention joint pain be related to having higher than normal RT3?

Here are a couple labs from over the years. Does anyone see anything from my current labs I should be asking them in my first consult?

Here is my labs from 2013 pre TRT with Thyroid labs:
pre01.jpg pre02.jpg pre03.jpg

Here are labs from 05-01-14 a year into trt with Thyroid:
TRT01.jpg TRT02.jpg TRT03.jpg

Here are current labs being off TRT for few months:
pg01.jpg pg02.jpg pg03.jpg pg04.jpg
 
Thread starter #2
Anyone have any input on my Thyroid labs?
Seems like all my previous labs show my FT3:RT3 is out of whack.
04-11-13 Labs: TSH = 1.78, FT3= 3.1, RT3 = 26.0, FT3 to RT3 Ratio= .119
05-01-14 Labs: TSH = 2.64, FT3= 2.9, RT3 = 20.0, FT3 to RT3 Ratio= .145
06-04-18 Labs: TSH = 3.08, FT3= 3.1, RT3 = 20.3, FT3 to RT3 Ratio= .152
 
#3
It would be kind of cool if you could first treat your thyroid and get your levels right, and then see what it does to your testosterone levels. I've been wondering what would happen to someone who has low testosterone and hypothyroidism, and took care of the thyroid.
 
#4
Reverse T3 needs to be under 15 ng/dL, any higher and T3 receptors are downregulated (partially disabled) when the body is under stress. I have perfect Free T3 and Free T4 and Reverse T3 22.4 ng/dL and have similar symptoms.

Your posted labs are impossible to see.
 
Thread starter #6
It would be kind of cool if you could first treat your thyroid and get your levels right, and then see what it does to your testosterone levels. I've been wondering what would happen to someone who has low testosterone and hypothyroidism, and took care of the thyroid.
I am surprised my Testosterone is about back where it was when I started TRT in 2013. I thought it was going to be super tanked being on TRT for 5 years. Looking at the LH number seems as if my signaling is still functioning. I am curious if I were to try to getting my Thyroid in check if that would budge my Testosterone back up.

Also to note being off TRT for last couple months I have been super tired through the day. I want to take naps all the time and when I wake up in the morning I feel like I barely got any sleep. Note sure if that is mostly Thyroid issues, the function of being off TRT, or combination of the two.
 
#7
You may have to self-pay for thyroid treatment with the current state of healthcare, insurance companies are strict and install barriers in your path to get stuff covered. As they say you're in the normal range, you're fine which couldn't be further from the truth.

However you were right to start TRT, thyroid treatment will raise SHBG and lower Free T.
 
#8
Also to note being off TRT for last couple months I have been super tired through the day. I want to take naps all the time and when I wake up in the morning I feel like I barely got any sleep. Note sure if that is mostly Thyroid issues, the function of being off TRT, or combination of the two.
Those symptoms can also be a strong indicator of sleep apnea. Try taking the Epworth Sleepiness test:

http://www.sleepapnea.org/wp-content/uploads/2017/02/ESS-PDF-1990-97.pdf
 
#9
I am surprised my Testosterone is about back where it was when I started TRT in 2013. I thought it was going to be super tanked being on TRT for 5 years. Looking at the LH number seems as if my signaling is still functioning. I am curious if I were to try to getting my Thyroid in check if that would budge my Testosterone back up.

Also to note being off TRT for last couple months I have been super tired through the day. I want to take naps all the time and when I wake up in the morning I feel like I barely got any sleep. Note sure if that is mostly Thyroid issues, the function of being off TRT, or combination of the two.
The symptoms for low testosterone and hypothyroidism are very similar, I'm right now trying to get my thyroid dialed in. I'm having Labs tomorrow.

can cytomel by itself be used to treat hypothyroidism

https://www.excelmale.com/showthread.php?14381-can-cytomel-by-itself-be-used-to-treat-hypothyroidism
 
Thread starter #10
I am going to give this a quick bump. Anyone have any suggestions of questions I should be asking when I have my consult with Defy on the 21st? My obvious questions will be about Thyroid. Do I need to ask for more test re: my Thyroid to see why its not performing up to par? Does anything else stand out on my labs that i should ask about?
 

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#11
Talk to them about raising your FT3, I'm unsure what they using to that these days whether it be NDT or Cytomel or something else. What you don't want to use is a T4 only product. I think guys do better on some blend of T3 and T4.

Your first appointment is going to be largely guided by them but if Thyroid is your main focus state that right up front and don't let it get pushed aside before your hour is up.
 
#12
When I look over your labs the two things that stick out mainly are, your high reverse T3 and low testosterone. Your reverse T3 to me looks too high but I am not a thyroid expert. With your low testosterone 304, I'll be interested to see where your estradiol levels go. I'm hoping when you improve your T, your E2 is still good. You look like an ideal candidate for testosterone replacement therapy but I wonder with that reverse T3. How good will you feel without that being addressed?
 
Thread starter #14
Had a good talk with Defy. Here is the plan they put me on:

40mg Testosterone Cypionate 3x per week(120 mg total per week)
HCG 250 IU 3x per week (750 IU total per week)
.125mg Anastrozole 2x per week (take only if start getting e2 symptoms)
Cytomel (Week 1: 5mcg per day, Week 2: 10mcg per day, Week 3 on 15mcg per day)
Then Blood work in 3 months see where i am at.
 
#15
Had a good talk with Defy. Here is the plan they put me on:

40mg Testosterone Cypionate 3x per week(120 mg total per week)
HCG 250 IU 3x per week (750 IU total per week)
.125mg Anastrozole 2x per week (take only if start getting e2 symptoms)
Cytomel (Week 1: 5mcg per day, Week 2: 10mcg per day, Week 3 on 15mcg per day)
Then Blood work in 3 months see where i am at.
My SHGB is 24.2 and your protocol is what i am running. except I have my HCG at 600/wk my call I'm suppost to be taking 900iu/wk
 
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