Thyroid treatment according to Neal Rouzier

[BillyJ03z]

I’m starting thyroid treatment. I have high tsh and my thyroid panel is coming with results in the coming days.

I am on trt and under supervision of a great doc.

I’m curious about my dose. I know you can feel jittery and have other sides if too much thyroid is taken. Is this a low dose and what should I expect? How will I know if it’s working.

I’ve been on trt for a while and haven’t felt much benefit. Still can’t sleep, wake up easily, fatigue, no focus and etc.

Is this a fairly normal dose ?

T438mcg T39mcg equals 60mg )1grain) 2 capsules daily

What were your Thyroid lab numbers? I have the exact same symptoms and I'm trying to figure this thing out.... I have felt meh for the most part since being on TRT other than strength but I have no energy, no focus, brain fog, sleep issues, up and down libido, have not been able to lose weight..... My FT4 is bottom 5% of range, my FT3 is top 80% of range, overall T4 total bottom 20% of range.. My RT3 was in range, no rt3 issues apparently... about 2 months ago my Doc finally started my on NDT Armour.. started at 15mg for 2 weeks, then 30 mg for another 2 weeks and during this time I lost 15lbs (242 to 227lbs) and started to feel a little bit better energy wise.. I bumped to 45mg for another 3 weeks and maintained weight loss hovering between 224 and 228 but kind of plateaued with energy feeling meh again.. I bumped to 1 grain still maintaining current weight but nothing else is improving... So Im not sure if my Thyroid was a little sluggish and the 15-30mg was all I needed and now the 45mg to 1grain is overkill initiating a negative feedback loop making me feel worse again... Thinking about dropping back to 15 or 30 mg.... Over the last 3 months I have reduced my Test from 200mg/wk to 100-120mg/wk injecting ED... but the weight loss didn't kick in until I started the Thyroid...

 

[Gman86]

What were your Thyroid lab numbers? I have the exact same symptoms and I'm trying to figure this thing out.... I have felt meh for the most part since being on TRT other than strength but I have no energy, no focus, brain fog, sleep issues, up and down libido, have not been able to lose weight..... My FT4 is bottom 5% of range, my FT3 is top 80% of range, overall T4 total bottom 20% of range.. My RT3 was in range, no rt3 issues apparently... about 2 months ago my Doc finally started my on NDT Armour.. started at 15mg for 2 weeks, then 30 mg for another 2 weeks and during this time I lost 15lbs (242 to 227lbs) and started to feel a little bit better energy wise.. I bumped to 45mg for another 3 weeks and maintained weight loss hovering between 224 and 228 but kind of plateaued with energy feeling meh again.. I bumped to 1 grain still maintaining current weight but nothing else is improving... So Im not sure if my Thyroid was a little sluggish and the 15-30mg was all I needed and now the 45mg to 1grain is overkill initiating a negative feedback loop making me feel worse again... Thinking about dropping back to 15 or 30 mg.... Over the last 3 months I have reduced my Test from 200mg/wk to 100-120mg/wk injecting ED... but the weight loss didn't kick in until I started the Thyroid...

My thyroid labs sound identical to yours!
T3 total - 83 (76-181)
T4 total - 5.6 (4.5-10.5)
Free T3 - 3.7 (2.3-4.2)
Free t4 - 0.9 (0.8-1.8)
Rt3 - 11 (8-25)
TSH - 0.73 (0.4-4.5)
Thyroglobulin antibodies - (<1)
Thyroid peroxidase antibodies -(1)

Glad NDT did at least a little something for you. No improvement in brain fog? That’s my main symptom. Idk if I would lower the NDT dose, as 1 grain is already a pretty low dose. I would first try splitting your doses up as much as possible throughout the day. You might just be getting too much T3 all at once. Do your labs look similar to mine?

Also, why did you lower your TRT dose so much? Do you think lowering that is having a negative effect?

 

[BillyJ03z]

My thyroid labs sound identical to yours!
T3 total - 83 (76-181)
T4 total - 5.6 (4.5-10.5)
Free T3 - 3.7 (2.3-4.2)
Free t4 - 0.9 (0.8-1.8)
Rt3 - 11 (8-25)
TSH - 0.73 (0.4-4.5)
Thyroglobulin antibodies - (<1)
Thyroid peroxidase antibodies -(1)

Glad NDT did at least a little something for you. No improvement in brain fog? That’s my main symptom. Idk if I would lower the NDT dose, as 1 grain is already a pretty low dose. I would first try splitting your doses up as much as possible throughout the day. You might just be getting too much T3 all at once. Do your labs look similar to mine?

Also, why did you lower your TRT dose so much? Do you think lowering that is having a negative effect?

Wow... I swear your lab numbers look exactly like mine... I mean exactly like mine...

I lowered my TRT dose because I have very low SHBG and I have researched that SHBG will decrease with exogenous Test and SHBG goes hand in hand with Thryoid, so the lower the SHBG the less effective thyroid is...( My pre TRT SHBG levels were in mids of range almost 25-35 pts higher than where it is now...) Also, I think it was overkill to my body with the T and the E, and I also think that the high Test was affecting my dopamine levels as not only do I have brain fog (which is scary to me because I am forgetting things I never forget and am slow at recalling things. that's not me) but I get no boost from caffeine/stims to help with workouts... I tried Adderall at different times and dosages (10mg, 20mg and 30mg ) and felt nothing.. so I know I have a dopamine issue... I had researched that high T levels/TRT can reduce dopamine sensitivity.... I do feel a little better since dropping my T dose about 40%..... but I am still suffering the brain fog, lack energy, lack of motivation, sleep issues, etc.. (I have had sleep test performed and I dont have apnea)...

 

[MikeXL]

I am suspect of anything Neil says

 

[Gman86]

Wow... I swear your lab numbers look exactly like mine... I mean exactly like mine...

I lowered my TRT dose because I have very low SHBG and I have researched that SHBG will decrease with exogenous Test and SHBG goes hand in hand with Thryoid, so the lower the SHBG the less effective thyroid is...( My pre TRT SHBG levels were in mids of range almost 25-35 pts higher than where it is now...) Also, I think it was overkill to my body with the T and the E, and I also think that the high Test was affecting my dopamine levels as not only do I have brain fog (which is scary to me because I am forgetting things I never forget and am slow at recalling things. that's not me) but I get no boost from caffeine/stims to help with workouts... I tried Adderall at different times and dosages (10mg, 20mg and 30mg ) and felt nothing.. so I know I have a dopamine issue... I had researched that high T levels/TRT can reduce dopamine sensitivity.... I do feel a little better since dropping my T dose about 40%..... but I am still suffering the brain fog, lack energy, lack of motivation, sleep issues, etc.. (I have had sleep test performed and I dont have apnea)...

Interesting, so the brain fog and poor memory are symptoms that only started once you began TRT? I had both symptoms before starting TRT, and TRT has done nothing for either symptom. TRT has given me other benefits, like with mood, strength, and lean body mass. Unfortunately I still have extreme brain fog, tired all the time, poor memory, difficulty concentrating, difficulty keeping off belly fat and don’t feel like I enjoy anything.

Starting NDT didn’t improve your brain fog at all?

 

[Vtail]

Interesting, so the brain fog and poor memory are symptoms that only started once you began TRT? I had both symptoms before starting TRT, and TRT has done nothing for either symptom. TRT has given me other benefits, like with mood, strength, and lean body mass. Unfortunately I still have extreme brain fog, tired all the time, poor memory, difficulty concentrating, difficulty keeping off belly fat and don’t feel like I enjoy anything.

Starting NDT didn’t improve your brain fog at all?

I started TRT this past December, primarily due to issues such as you describe (brain fog, low mental energy & poor focus). After about 3 weeks into TRT I experienced the "honeymoon period" which lasted for a couple of weeks. I felt great - Hi energy, good focus, no brain fog, sleeping well. I felt like I could accomplish anything again. Gradually the great feeling subsided and now I feel pretty much as I did before, maybe a little better. However I am encouraged by the honeymoon period - it tells me that it is possible to feel good again. I just need to figure out the right formula.

Since then I've increased my TRT dose by 20%, and later this week I have a consult about my Thyroid (all levels are within range except RT3, which is 23). I'm really hoping that getting my RT3 down helps - however I experienced the "honeymoon" with high RT3, so who knows . . . or maybe my thyroid levels were different earlier in the TRT process.

Since about 3 weeks after increasing my TRT dose, as the day progresses I start to feel a sensation of pressure in my head. Like my head is in a bubble. Nothing painful, just noticeable and seems to add to the brain fog. This is what I am currently fighting through. I go for my 6-week labs next week.

This TRT stuff really is a journey requiring lots of patience.

 

[Gman86]

I started TRT this past December, primarily due to issues such as you describe (brain fog, low mental energy & poor focus). After about 3 weeks into TRT I experienced the "honeymoon period" which lasted for a couple of weeks. I felt great - Hi energy, good focus, no brain fog, sleeping well. I felt like I could accomplish anything again. Gradually the great feeling subsided and now I feel pretty much as I did before, maybe a little better. However I am encouraged by the honeymoon period - it tells me that it is possible to feel good again. I just need to figure out the right formula.

Since then I've increased my TRT dose by 20%, and later this week I have a consult about my Thyroid (all levels are within range except RT3, which is 23). I'm really hoping that getting my RT3 down helps - however I experienced the "honeymoon" with high RT3, so who knows . . . or maybe my thyroid levels were different earlier in the TRT process.

Since about 3 weeks after increasing my TRT dose, as the day progresses I start to feel a sensation of pressure in my head. Like my head is in a bubble. Nothing painful, just noticeable and seems to add to the brain fog. This is what I am currently fighting through. I go for my 6-week labs next week.

This TRT stuff really is a journey requiring lots of patience.

Man I wish we knew what caused this “honeymoon phase”, so we would know what to do to get guys back in that zone. I never went through that period when starting TRT, but it sounds amazing! Lol.

Did you have high RT3 before stating TRT? I wonder if TRT throws off thyroid at all.

With you having your symptoms completely clear, while starting TRT, makes me think that the honeymoon phase for you had nothing to do with thyroid. It seems like testosterone completely cured them for you. I’m just wondering what caused all your symptoms to return. Your testosterone levels being higher at the beginning due to still having some endogenous testosterone in your system? High E2? Your natural pregnenolone levels being shut down from the exogenous testosterone? I’d love to know what is causing this is guys starting out.

 

[Vtail]

Man I wish we knew what caused this “honeymoon phase”, so we would know what to do to get guys back in that zone. I never went through that period when starting TRT, but it sounds amazing! Lol.

Did you have high RT3 before stating TRT? I wonder if TRT throws off thyroid at all.

I never had a Thyroid panel done previous to TRT. My primary doc and TRT doc never mentioned it, and I was not up to speed with any of this until starting TRT. Then after reading as much as I could find, and also many of the posts on this forum, I realized my TSH of 3.5 was an indication that I needed to dig deeper. I have since jettisoned those docs and will deal with Defy going forward for Thyroid and TRT.

 

[wsj357]

What were your Thyroid lab numbers? I have the exact same symptoms and I'm trying to figure this thing out.... I have felt meh for the most part since being on TRT other than strength but I have no energy, no focus, brain fog, sleep issues, up and down libido, have not been able to lose weight..... My FT4 is bottom 5% of range, my FT3 is top 80% of range, overall T4 total bottom 20% of range.. My RT3 was in range, no rt3 issues apparently... about 2 months ago my Doc finally started my on NDT Armour.. started at 15mg for 2 weeks, then 30 mg for another 2 weeks and during this time I lost 15lbs (242 to 227lbs) and started to feel a little bit better energy wise.. I bumped to 45mg for another 3 weeks and maintained weight loss hovering between 224 and 228 but kind of plateaued with energy feeling meh again.. I bumped to 1 grain still maintaining current weight but nothing else is improving... So Im not sure if my Thyroid was a little sluggish and the 15-30mg was all I needed and now the 45mg to 1grain is overkill initiating a negative feedback loop making me feel worse again... Thinking about dropping back to 15 or 30 mg.... Over the last 3 months I have reduced my Test from 200mg/wk to 100-120mg/wk injecting ED... but the weight loss didn't kick in until I started the Thyroid...

They took the wrong thyroid. New doc said he’ll get the right values in a few weeks.

You lowered your dose of T while messing with thyroid. One should not make changes to the only two feel good hormones a man has. One at a time. It could very well be that you are just having less free t and thyroids fine. After a month on the 1 grain you should take another blood panel and see where it lands you. You want to be at the upper end of the ranges not mid or low of optimizing.

 

[wsj357]

I

I started TRT this past December, primarily due to issues such as you describe (brain fog, low mental energy & poor focus). After about 3 weeks into TRT I experienced the "honeymoon period" which lasted for a couple of weeks. I felt great - Hi energy, good focus, no brain fog, sleeping well. I felt like I could accomplish anything again. Gradually the great feeling subsided and now I feel pretty much as I did before, maybe a little better. However I am encouraged by the honeymoon period - it tells me that it is possible to feel good again. I just need to figure out the right formula.

Since then I've increased my TRT dose by 20%, and later this week I have a consult about my Thyroid (all levels are within range except RT3, which is 23). I'm really hoping that getting my RT3 down helps - however I experienced the "honeymoon" with high RT3, so who knows . . . or maybe my thyroid levels were different earlier in the TRT process.

Since about 3 weeks after increasing my TRT dose, as the day progresses I start to feel a sensation of pressure in my head. Like my head is in a bubble. Nothing painful, just noticeable and seems to add to the brain fog. This is what I am currently fighting through. I go for my 6-week labs next week.

This TRT stuff really is a journey requiring lots of patience.

The honeymoon phase is when your body is still producing testasterone and your adding on top of it. This gives you higher levels. After a few weeks it stops producing naturally and your left with the injected T. Maybe Try raising it a bit. I hear you won’t get the honey moon phase back. People chase it and won’t happen. This doesn’t mean we should feel like shit

 

[wsj357]

Wow... I swear your lab numbers look exactly like mine... I mean exactly like mine...

I lowered my TRT dose because I have very low SHBG and I have researched that SHBG will decrease with exogenous Test and SHBG goes hand in hand with Thryoid, so the lower the SHBG the less effective thyroid is...( My pre TRT SHBG levels were in mids of range almost 25-35 pts higher than where it is now...) Also, I think it was overkill to my body with the T and the E, and I also think that the high Test was affecting my dopamine levels as not only do I have brain fog (which is scary to me because I am forgetting things I never forget and am slow at recalling things. that's not me) but I get no boost from caffeine/stims to help with workouts... I tried Adderall at different times and dosages (10mg, 20mg and 30mg ) and felt nothing.. so I know I have a dopamine issue... I had researched that high T levels/TRT can reduce dopamine sensitivity.... I do feel a little better since dropping my T dose about 40%..... but I am still suffering the brain fog, lack energy, lack of motivation, sleep issues, etc.. (I have had sleep test performed and I dont have apnea)...

Yup keep working on the dose. Dial it in.take Preg and dhea to support overall hormonal optimization. Melatonin as well.