Androgens make hyperthyroid worse?

[Vvs1]

Told my endocrinologist I had high reverse t3. He checked my gland with touching my neck while swallowing. Said he felt “something.”

Sometimes I’ll definitely feel hyperthyroid in short bouts, such as a half hour-of racing heartbeat, shaking hands, perspiration.

Im also having multiple improvements of androgen related symptoms, likely due to more androgens( better diet plus Vit D) or lowering RT3, and I have reading that androgens will suppress TBG-Thyroid Binding Globulin(like SHBG).

Im thinking that high reverse t3 is a result of normalizing high t4 rather than a t3 conversion issue, and androgens are further lowering TBG and increasing my free T3 or free T4.

Other than my reverse t3, my thyroid numbers are decent, including antibodies.

 

[Vince]

Told my endocrinologist I had high reverse t3. He checked my gland with touching my neck while swallowing. Said he felt “something.”

Sometimes I’ll definitely feel hyperthyroid in short bouts, such as a half hour-of racing heartbeat, shaking hands, perspiration.

Im also having multiple improvements of androgen related symptoms, likely due to more androgens( better diet plus Vit D) or lowering RT3, and I have reading that androgens will suppress TBG-Thyroid Binding Globulin(like SHBG).

Im thinking that high reverse t3 is a result of normalizing high t4 rather than a t3 conversion issue, and androgens are further lowering TBG and increasing my free T3 or free T4.

Other than my reverse t3, my thyroid numbers are decent, including antibodies.

Can you post all of your thyroid labs, along with the ranges.

 

[Vvs1]

Can you post all of your thyroid labs, along with the ranges.

Vince, this was from March of this year. Any specific lab suggestions? $250 is a lot for another panel.

Would Thyroid Binding Globulin be worth testing?

 

[Vince]

I have my thyroid labs done through advanced lipidology. They don't charge for labs. They only charge what the insurance pays.

Yes, you are really are pooling a lot of free T3. Does your doctor talk about lowing your reverse T3?

 

[Vvs1]

I have my thyroid labs done through advanced lipidology. They don't charge for labs. They only charge what the insurance pays.

Yes, you are really are pooling a lot of free T3. Does your doctor talk about lowing your reverse T3?

I tried 1 pill of T3 a day from Defy/Empower, I think 10mcg. RT3 went down to 23, but believe it pushed my shbg to 63 (usually high 50s).

The local endocrinologist wants to test regular T4 only, and treat with T4. I changed the subject because I was there mainly to get Natesto to help with high shbg. He prescribed Natesto, and I’m doing pre-lab work on Friday.

Im almost convinced thyroid hormones are causing the high shbg since estradiol is on the lower end/ taking t3 pushes shbg higher.

Im paying everything out of pocket after quitting work.

 

[Vince]

I tried 1 pill of T3 a day from Defy/Empower, I think 10mcg. RT3 went down to 23, but believe it pushed my shbg to 63 (usually high 50s).

The local endocrinologist wants to test regular T4 only, and treat with T4. I changed the subject because I was there mainly to get Natesto to help with high shbg. He prescribed Natesto, and I’m doing pre-lab work on Friday.

Im almost convinced thyroid hormones are causing the high shbg since estradiol is on the lower end/ taking t3 pushes shbg higher.

Im paying everything out of pocket after quitting work.

Supplementing with T4 and getting your TSH in range. Is the old way, most doctors know, that method doesn't work.

 

[jkozlow3]

Taking T3 can definitely increase SHBG. There's a known relationship there. Also, as you stated, TRT typically lowers SHBG for most men.

I have a different philosophy than many on thyroid treatment and I personally don't think most people need very much T3 - just a small amount is enough IMO (i.e. 5mcg/day added to your levothyroxine). This can be accomplished using natural desiccated thyroid (NDT) such as Armour/Nature-Thyroid (i.e. 1/4 or 1/2 grain added to your levothyroxine) or with synthetic T3 (i.e. you could cut your 10mcg pills in half with a pill splitter).

Having read more than just about any human on hypothyroidism treatment options, I'd recommend the books "Tired Thyroid" and the 2 thyroid books the late Dr. Kenneth Blanchard wrote (available on Amazon). He was a big fan of VERY TINY amounts of T3 being added to levothyroxine and said it worked wonders for most of his patients vs. taking levothyroxine alone.

I've been my own science experiment for a couple of years when it comes to treating my hypothyroidism and I tend to agree with Dr. Blanchard in that I've not personally found adding more T3 to be beneficial. Just a small amount (i.e. 1/4 - 1/2 grain of NDT) added to my Synthroid makes a huge difference. I can definitely notice a difference in how I feel every time I "experiment" with just going back to 100% Synthroid for a couple of months. Even if my blood work looks perfect (Free T4, Free T3, etc.), I don't feel as good on straight levothyroxine - even at higher than "normal" doses.

Everyone is different however - YMMV!

 

[apsjiml]

Told my endocrinologist I had high reverse t3. He checked my gland with touching my neck while swallowing. Said he felt “something.”

Sometimes I’ll definitely feel hyperthyroid in short bouts, such as a half hour-of racing heartbeat, shaking hands, perspiration.

Im also having multiple improvements of androgen related symptoms, likely due to more androgens( better diet plus Vit D) or lowering RT3, and I have reading that androgens will suppress TBG-Thyroid Binding Globulin(like SHBG).

Im thinking that high reverse t3 is a result of normalizing high t4 rather than a t3 conversion issue, and androgens are further lowering TBG and increasing my free T3 or free T4.

Other than my reverse t3, my thyroid numbers are decent, including antibodies.

You cannot be hyperthyroid with a free t3 in the normal range. Reverse t3 is made from t4, so if you want to have less reverse t3 you need less t4. Most people that do not have a conversion issue really do have a reverse t3 at the bottom of the range. Like my brothers was 8,9, 11 same as my dads but mine was 36 or more. So, reverse t3 most will tell you it is non thyroidal illness that causes that. The problem is when we are talking deiodinase (fancy term for enzymes responsible for t4 into the active hormone which is free t3) lower testosterone, lower growth hormone, lower iron all cause issues with thyroid conversion leading to higher reverse t3. There are also various genetic gene defects that cause this issue and a big one is ANY inflammation can cause lack of thyroid conversion, that could be back injury or hashimoto's or other autoimmune disorders , any inflammation of the body like that can cause a issue with thyroid conversion. One of the issues with the current essays is lack of sensitivity because rt3 and t3 look so similiar it can be difficult to tell them apart. I see when people take in less t4 (usually 50mcg or less ) and the rest t3 their free t3 levels go down when they get rt3 down . lc-ms/ms is suppose to be more sensitive but not always available. One last thing, If you have Hashimoto's with elevated antibodies, you should be looking into Low Dose Naltrexone to get those antibodies down. If you have not yet, you should be testing both Hashimoto's antibodies . Ldn actually lowers inflammation too.

 

[jkozlow3]

The problem is, there's no proof that reverse T3 is actually a problem. Some people have this idea that RT3 is a competitive inhibitor to the active T3 hormone (as in RT3 somehow blocks T3) but I have yet to see proof of this in any academic article.

Others have shot down this theory and said that RT3 is likely inert and does not compete with/block the active T3 hormone and is simply the body's way of dealing with excess levels of hormone (i.e. turning T4 into RT3 instead of T3 if the body believes there is already enough T3).

Who is right? That's the million dollar question!

 

[slicktop]

The problem is, there's no proof that reverse T3 is actually a problem. Some people have this idea that RT3 is a competitive inhibitor to the active T3 hormone (as in RT3 somehow blocks T3) but I have yet to see proof of this in any academic article.

Others have shot down this theory and said that RT3 is likely inert and does not compete with/block the active T3 hormone and is simply the body's way of dealing with excess levels of hormone (i.e. turning T4 into RT3 instead of T3 if the body believes there is already enough T3).

Who is right? That's the million dollar question!

here's something on the subject:
"The metabolic derivatives of rT3-diiodothyronines, and in particular 3, 5- diiodothyronine-are potent inhibitors of T4 to T3 conversion. rT3 itself can inhibit the calorigenic action of T4 and T3 in man."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1628409/pdf/archdisch00738-0034.pdf

 

[apsjiml]

The problem is, there's no proof that reverse T3 is actually a problem. Some people have this idea that RT3 is a competitive inhibitor to the active T3 hormone but I have yet to see proof of this in any academic article.

Others have acknowledged that RT3 is likely inert and does not compete with/block the active T3 hormone and is simply the body's way of dealing with excess levels of hormone (i.e. turning T4 into RT3 if the body believes there is already enough T3).

Who is right? That's the million dollar question!

We do know a few things, we know that children with elevated rt3 despite high thyroid levels from over replacement do not have hyperthyroid symptoms and high rt3 is why they think that. We also know that when studying older people, the ones that had high elevated rt3 above the range, were not as healthy with a lowered metabolism than the ones with a rt3 in the range. I will tell you my metabolism from going on t3 only compared to a ndt thyroid even with free t3 levels in the same range, my metabolism is WAY better now with a reverse t3 of 9 compared to 36 or 50 or way higher. I have seen this many times with others too. The sensitivity of the essays used unless it is lc-ms/ms the interference on free t3 essays is rt3 because they look so similar. We do know in animal studies that when given reverse t3 their metabolism lowered. So, what we need is more studies on this topic. https://adc.bmj.com/content/archdischild/59/1/30.full.pdf
https://www.holtorfmed.com/download..._Best_Measurement_of_Tissue_Thyroid_Level.pdf

 

[jkozlow3]

Thanks. I know there have been some studies showing HYPERthyroid patients having very elevated RT3 as well, so if RT3 is blocking the T3 receptors, it's certainly not doing it fully or enough to counteract their hyperthyroidism. I think there's a lot that the medical community still doesn't understand. Definitely more studies needed!

 

[apsjiml]

Taking T3 can definitely increase SHBG. There's a known relationship there. Also, as you stated, TRT typically lowers SHBG for most men.

I have a different philosophy than many on thyroid treatment and I personally don't think most people need very much T3 - just a small amount is enough IMO (i.e. 5mcg/day added to your levothyroxine). This can be accomplished using natural desiccated thyroid (NDT) such as Armour/Nature-Thyroid (i.e. 1/4 or 1/2 grain added to your levothyroxine) or with synthetic T3 (i.e. you could cut your 10mcg pills in half with a pill splitter).

Having read more than just about any human on hypothyroidism treatment options, I'd recommend the books "Tired Thyroid" and the 2 thyroid books the late Dr. Kenneth Blanchard wrote (available on Amazon). He was a big fan of VERY TINY amounts of T3 being added to levothyroxine and said it worked wonders for most of his patients vs. taking levothyroxine alone.

I've been my own science experiment for a couple of years when it comes to treating my hypothyroidism and I tend to agree with Dr. Blanchard in that I've not personally found adding more T3 to be beneficial. Just a small amount (i.e. 1/4 - 1/2 grain of NDT) added to my Synthroid makes a huge difference. I can definitely notice a difference in how I feel every time I "experiment" with just going back to 100% Synthroid for a couple of months. Even if my blood work looks perfect (Free T4, Free T3, etc.), I don't feel as good on straight levothyroxine - even at higher than "normal" doses.

Everyone is different however - YMMV!

t3 in normal ranges does exactly the same thing to shbg as a normal person with normal thyroid levels would do. t3 is just the active form. that is it. Hyperthyroidism (free t3 over the range) yes that could increase shbg quite a bit.
As far as how much t3 a person needs depends on their levels of free and total t3. The average healthy person has a free t3 in the upper portion of the range. 3.5 to 3.8 is the average. range of 2 to 4.2 t4 is ok if a person converts to t3. as t4 is mainly a storage hormone that has little biological activity .

 

[apsjiml]

Thanks. I know there have been some studies showing HYPERthyroid patients having very elevated RT3 as well, so if RT3 is blocking the T3 receptors, it's certainly not doing it fully or enough to counteract their hyperthyroidism. I think there's a lot that the medical community still doesn't understand. Definitely more studies needed!

The one thing I can say is people that have a high rt3 levels never feel well and they never have a good metabolism, no matter what their free t3 level is. I see it all the time, their doctors add in t3 on top of having a elevated rt3 and they never feel well. In my case, the endo would move my t3/t4 combo up and I would end up with low t3 low t4 and super high reverse t3 by the time I would get my free t3 just in a decent level I might as well take t3 because t4 was going into straight rt3. I have a deiodinase gene defect is why mine is like that.

 

[Vvs1]

You cannot be hyperthyroid with a free t3 in the normal range. Reverse t3 is made from t4, so if you want to have less reverse t3 you need less t4. Most people that do not have a conversion issue really do have a reverse t3 at the bottom of the range. Like my brothers was 8,9, 11 same as my dads but mine was 36 or more. So, reverse t3 most will tell you it is non thyroidal illness that causes that. The problem is when we are talking deiodinase (fancy term for enzymes responsible for t4 into the active hormone which is free t3) lower testosterone, lower growth hormone, lower iron all cause issues with thyroid conversion leading to higher reverse t3. There are also various genetic gene defects that cause this issue and a big one is ANY inflammation can cause lack of thyroid conversion, that could be back injury or hashimoto's or other autoimmune disorders , any inflammation of the body like that can cause a issue with thyroid conversion. One of the issues with the current essays is lack of sensitivity because rt3 and t3 look so similiar it can be difficult to tell them apart. I see when people take in less t4 (usually 50mcg or less ) and the rest t3 their free t3 levels go down when they get rt3 down . lc-ms/ms is suppose to be more sensitive but not always available. One last thing, If you have Hashimoto's with elevated antibodies, you should be looking into Low Dose Naltrexone to get those antibodies down. If you have not yet, you should be testing both Hashimoto's antibodies . Ldn actually lowers inflammation too.

Yes, not hyperthyroid based on free t3 only.

But if t3 is normal, and rt3 is high, there is a lot of t4 being converted, right.

Last time I checked salivary cortisol, it was low and not sure if that makes a difference.

 

[apsjiml]

Yes, not hyperthyroid based on free t3 only.

But if t3 is normal, and rt3 is high, there is a lot of t4 being converted, right.

Last time I checked salivary cortisol, it was low and not sure if that makes a difference.

IF it were me, I would want to know if your Secondary Hypogonadism, or primary Hypogonadism. I would also then want more evaluation on that cortisol, by testing am cortisol and acth serum. I would also want to know DHEA-s levels, IgF-1 . IF your secondary which is what I was, I also had low saliva cortisol, I ended up getting a Itt stim and glucagon stim for Growth hormone deficiency and sai (secondary adrenal insuficiency) I am Pan Hypo Pituitary as it turns out and I replace all those hormones. You will also need a MRI of the pituitary too

 

[Vvs1]

IF it were me, I would want to know if your Secondary Hypogonadism, or primary Hypogonadism. I would also then want more evaluation on that cortisol, by testing am cortisol and acth serum. I would also want to know DHEA-s levels, IgF-1 . IF your secondary which is what I was, I also had low saliva cortisol, I ended up getting a Itt stim and glucagon stim for Growth hormone deficiency and sai (secondary adrenal insuficiency) I am Pan Hypo Pituitary as it turns out and I replace all those hormones. You will also need a MRI of the pituitary too

LH and FSH are always normal. SHBG is high, so testosterone is normal on lab tests. DHEA is low, IGF is normal(180)

Dr Saya analyzed my cortisol
-Said morning was half of what it should be
-Said by noon it dropped really low
-Said evening was almost zero
No medicine besides DHEA/pregnenalone pills

I have never heard anything besides ACTH stimulation. It seems impossible to even find an endocrinologist that has any experience or knowledge to do what you recommended. And I’ve seen 4 of them.

 

[apsjiml]

LH and FSH are always normal. SHBG is high, so testosterone is normal on lab tests. DHEA is low, IGF is normal(180)

Dr Saya analyzed my cortisol
-Said morning was half of what it should be
-Said by noon it dropped really low
-Said evening was almost zero
No medicine besides DHEA/pregnenalone pills

I have never heard anything besides ACTH stimulation. It seems impossible to even find an endocrinologist that has any experience or knowledge to do what you recommended. And I’ve seen 4 of them.

When you say normal lh and fsh, were these at the top of the range or bottom of the range? lh and fsh in the am are typically in the upper part of the range for a average healthy guy with out any pituitary issues. For someone that has pituitary or hypothalamus issue, they may be in the normal range but typically towards the low end. When I see an elevated shbg the first thing I think of for reasons is low testosterone of course, shbg gene or iron overload. If it were me, I tell everyone to get a full iron panel with saturation and ferritin. If acth is 35 and below, with a lower am cortisol the acth stim is the wrong test for that. For SAI- secondary adrenal insufficiency, one would need a metyrapone stim test or the ITT stim test. If dhea was low as well (especially down to 50 and below) that is usually a part of SAI. If your SAI you need a stim test for growth hormone as well. For a person that has lower acth - to give someone acth -as you do in the acth stim test of course if your body produces adequate cortisol from that stimulation , that tells me that the issue is the pituitary or hypothalamus, not that all is . good. Often times I see SAI people pass the acth stim and fail the others. https://www.healio.com/endocrinolog...sleading-in-identifying-adrenal-insufficiency

 

[Vvs1]

When you say normal lh and fsh, were these at the top of the range or bottom of the range? lh and fsh in the am are typically in the upper part of the range for a average healthy guy with out any pituitary issues. For someone that has pituitary or hypothalamus issue, they may be in the normal range but typically towards the low end. When I see an elevated shbg the first thing I think of for reasons is low testosterone of course, shbg gene or iron overload. If it were me, I tell everyone to get a full iron panel with saturation and ferritin. If acth is 35 and below, with a lower am cortisol the acth stim is the wrong test for that. For SAI- secondary adrenal insufficiency, one would need a metyrapone stim test or the ITT stim test. If dhea was low as well (especially down to 50 and below) that is usually a part of SAI. If your SAI you need a stim test for growth hormone as well. For a person that has lower acth - to give someone acth -as you do in the acth stim test of course if your body produces adequate cortisol from that stimulation , that tells me that the issue is the pituitary or hypothalamus, not that all is . good. Often times I see SAI people pass the acth stim and fail the others. https://www.healio.com/endocrinology/adrenal/news/online/{65f6ec45-e7a6-45af-aaee-ae9f6d90edf0}/acth-testing-may-be-misleading-in-identifying-adrenal-insufficiency

FH and LSH are around 5-7. I have new labs coming soon.

SHBG was only 37 my first time testing, but has always been in the 50s ever since. On a vegan diet shbg was in the 80s.

I am retrying a low iron diet. I was feeling good on low iron, no red meat, and doing this “Root Cause” protocol that focuses on reducing unbound iron. I slipped up on cereal fortified with iron, or my body went back to this symptomatic state.
-I have had 2 iron tests, one had a high saturation, next one was in range.

 

[Vvs1]

When you say normal lh and fsh, were these at the top of the range or bottom of the range? lh and fsh in the am are typically in the upper part of the range for a average healthy guy with out any pituitary issues. For someone that has pituitary or hypothalamus issue, they may be in the normal range but typically towards the low end. When I see an elevated shbg the first thing I think of for reasons is low testosterone of course, shbg gene or iron overload. If it were me, I tell everyone to get a full iron panel with saturation and ferritin. If acth is 35 and below, with a lower am cortisol the acth stim is the wrong test for that. For SAI- secondary adrenal insufficiency, one would need a metyrapone stim test or the ITT stim test. If dhea was low as well (especially down to 50 and below) that is usually a part of SAI. If your SAI you need a stim test for growth hormone as well. For a person that has lower acth - to give someone acth -as you do in the acth stim test of course if your body produces adequate cortisol from that stimulation , that tells me that the issue is the pituitary or hypothalamus, not that all is . good. Often times I see SAI people pass the acth stim and fail the others. https://www.healio.com/endocrinology/adrenal/news/online/{65f6ec45-e7a6-45af-aaee-ae9f6d90edf0}/acth-testing-may-be-misleading-in-identifying-adrenal-insufficiency

ACTH was ran by a doctor years ago. My value was 12 on a range from 7-69, and this was drawn late-at 3pm.
Blood cortisol was 12, range of 2-23, drawn at the same time.

Saliva cortisol was done once, years after the above test. My 8am value was .300, upper range was .600, and by noon the number dropped ridiculously low- I’ll try to find the Labcorp results.