Is high Reverse T3 a problem here? Labs included

So I'm about 6 months into TRT, and have currently been on HCG monotherapy for 4 weeks at 750iu MWF. These labs were taken friday, 48hrs after my last injection. I'm not as concerned with the T level right now because this is a trough and I've had higher levels with T. Cypionate injections without feeling better. I've got the standard set of symptoms plus a few. Fatigue, ED, Tinnitus, cold hands and feet. In addition when discussing thyroid I feel that I should add that I've always had to use a dandruff shampoo, I've got dark circle under my eyes, and my nails seem to be a bit brittle.

Iodine shouldn't be a problem anymore, I took a thyroid supplement for 3 months(discontinued 1 month before these labs), a multivitamin with iodine/selenium, and have been using iodized salt. TSH remains steady around 2.4-2.6, but my FT4 and FT3 levels have gone up over the course of supplementation. Reverse T3 is what concerns me.

TSH 2.47
FT4 1.48 0.82-1.77 ng/dL
FT3 4.4 2.00-4.40 pg/mL
RT3 23.8 9.20-24.1 ng/dL

FT3 and RT3 ratio is off, RT3 needs to be below 15, this is why TSH is climbing because RT3 is blocking FT3 from entering your cells. It's no wonder you gave up on TRT and switched to something else which will also fail you. Your thyroid is the weak link here, TRT attempts to restore metabolic rates that your thyroid can't match which makes some feel even worse.

It seems your pituitary is attempting to raise FT3 to compete with high RT3. Fatigue, ED, cold hands and feet is thyroid related. If it weren't for high RT3, you'd be closer to hyperthyroidism.

If you're truly injecting HCG 750 three times a week, that's a problem. Injecting more than 500iu at once is dumb as anything past 500iu is all estrogen and only bad stuff will happen.

Suggest you need a new doctor.

Agree with Systemlord. Your symptoms are high RT3 related. This is a very good explanation of high RT3 and a list of causes so, you can scroll down and see if any apply to you. Your Ferritin is good at 109 so its not iron related IMO.

https://www.restartmed.com/reverse-t3/

Keep us posted and good luck!

Systemlord said:

FT3 and RT3 ratio is off, RT3 needs to be below 15, this is why TSH is climbing because RT3 is blocking FT3 from entering your cells. It's no wonder you gave up on TRT and switched to something else which will also fail you. Your thyroid is the weak link here, TRT attempts to restore metabolic rates that your thyroid can't match which makes some feel even worse.

It seems your pituitary is attempting to raise FT3 to compete with high RT3. Fatigue, ED, cold hands and feet is thyroid related. If it weren't for high RT3, you'd be closer to hyperthyroidism.

If you're truly injecting HCG 750 three times a week, that's a problem. Injecting more than 500iu at once is dumb as anything past 500iu is all estrogen and only bad stuff will happen.

Suggest you need a new doctor.

Click to expand...

This confirms my suspicions, I'll start doing some research on elevated rt3 levels, thank you for the link 1Draw! So far it looks like I'll have to compile a list of labs to check for possible causes. I have some more labs coming in soon to check a handful of other things, one of which is ACTH and AM cortisol, which can provide insight if the elevated rt3 is caused by a cortisol issue. I've got a lot of work to do here, but it's nice to finally have found something that I can work on. Any further advice is welcome!

Regarding the HCG and dosage, I was concerned about all of the things you've mentioned Systemlord. However, I need to get good fertility results in order for my doctor to prescribe me HCG and Testosterone at the same time. This is my ultimate goal and I am only a couple months away from achieving this. I agree my current doctor is far from the best, but he is willing to prescribe, and prescribe generously so I always have extra on hand, which I will need due to the market dependent line of work i'm in.

My current T level with the HCG at 750iu x3/wk isn't too spectacular and I would imagine that I have some degree of primary hypogonadism as well as confirmed secondary. I've always had smaller testicles, so I really want to see the just how much I can make myself, and am upping my dosage to 1250iu x3wk. Estradiol conversion doesn't seem to be an issue for me coming in at 19.8pg/mL at the current dosage, and 21.9pg/mL when I was on 100mg of T. Cypionate per week with T levels at 500-600. As we can see, everybody is different.

Thank you for the reply!