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I really think it's the same for me, i.e. I'd do better with T3 in the morning / afternoon.

Been thinking this over back and forth. I think the following theory makes sense: @Cataceous @Vince As we've seen in euthyroid subjects, the levels of T4 are relatively stable whereas TSH and T3 have a diurnal rhythm. FT3 following TSH by maybe 90 minutes, as if TSH is driving the T4 -> T3...

https://academic.oup.com/jcem/article/93/6/2300/2598837?fbclid=IwAR0K3DwjtcmQ0ITHtsceQmGNRmtdhAkGMkEvejicLnjWbUTxfmlIgpQsKLE This is somewhat interesting but doesn't leave me with a single theory. Apparently FT3 seems to follow TSH in a delayed fashion.

Hi guys, I've begun Levothyroxine treatment since last Friday, 50mcg a day, taken in the morning. I'm finding that it functions in a way that I didn't expect. I take it in the morning and around 10h later I'm awake like I haven't been for years. This is the effect I was hoping to get from...

What about your thyroid function? Is that fine?

And how was your protocol? Did the fatigue go away when you sorted the sleep and dropped the testosterone?

@Vince Two last questions: 1. What happens when you go too high with T4 and get too much rT3, just a return of the initial hypo symptoms? 2. Is T3 as poorly absorbed as T4? When you take it in the afternoon, does it have to be some time after/before a meal?

What are your sleep issues? Was there also fatigue/some other symptoms?

All of them? * Sensitivity to cold * Fatigue * Low libido * Weight gain * Reduced blood flow (??) * Dry skin * Depression * Slow thinking / movemens * Weakness (I wonder if there are more). What else? Why did you start TRT/are you still on it?

@Vince I think this article here is somewhat compelling for trialing Armour. Desiccated Thyroid Extract Compared With Levothyroxine in the Treatment of Hypothyroidism: A Randomized, Double-Blind, Crossover Study I will add quotes from it when I have the energy. But Armour or something...

That's really interesting to hear. We don't have a single lab in my country that measures rT3. So taking T4 almost harms you more than it helps you (?). I will definitely try to get the T3 prescription, I need to see if it helps. My GP is very conventional though.

How did you decide Armor and cytomel was for you, as opposed to Levothyroxine monotherapy? I am curious to try T3 along with the T4 but as you're probably well aware of it is hotly debated whether T3 is beneficial in any way. Where I'm from Levothyroxine (and equivalent) is pretty much the...

33% more sex, roughly. Masturbation hasn't changed. When did I start.. exactly 14 days ago. Things weren't "rock solid" before that, but there was a definite drop. Whether mental or otherwise. It is known to not increase prolactin unlike most antidepressants. And _possibly_ has less sexual...

Thanks Vince. I was wondering, can you educate me a bit on the difference between Levothyroxine and other possible preparations? I was quite surprised to see the following on Levothyroxine: "Levothyroxine is synthetic thyroxine (T4). Due to its prolonged half-life, levothyroxine steady-state...

What are you taking today & what are your symptoms?

Interesting, is there any way around that? Btw I know this sounds ridiculous, especially with Levothyroxine (T4) but I feel like I've felt a notable improvement today in mood and mental clarity. My thinking at work was much clearer. But this is day #1 of 50mcg.

Curious though, no food or drink? This might be less of a problem if I woke up earlier before work, but that's hard to do when the main thing you're battling is fatigue.

You mean I could be making too much T3? I do have some T3 numbers I can pull up.. There are several things though that point to hypothyroidism. One being immense sensitivity to cold. I was standing outside with a 70 year old this morning for a few moments and I was shivering and not him. This...

@Cataceous @Vince I had the doctor add TPO antibodies to the blood test. It came back raised, and then I got a Levothyroxine prescription. Working up to 50 mcg/daily. I am still curious to try T3 for various reasons, but I can also just keep measuring my FT4 and FT3 and see if this doesn't...

Interesting to hear. For the record I decided to try mirtazapine. If you read the literature you'll see that it lowers FT4 in favour of FT3. In fact, the more it does that the more likely it is to work for depression (according to one study). It's one of the few ADs that don't increase prolactin...

No sadly, just the FT4.

What about low FT4? When I measured my FT4 on Friday it was on the lower end of normal. And perhaps progesterone? Any input? @Vince @Cataceous

So my experience so far with TRT has been that morning wood is non-existent without anastrozole, and I can make it appear like clockwork when taking it. However for the past week or so I've been having trouble with erection quality and duration (when using it). Does anyone have any insight on...

If you're interested in some reading that I find fascinating (regarding FT4, FT3 and mood): SAGE Journals: Your gateway to world-class research journals Not trying to sell you on this particular drug, but rather that reading the results/discussion is interesting. Esp. the part where high FT4...

@JoeMatts Had another blood test drawn today where FT4 came back at 12.8 pmol/l (range 10.5 - 24.5). I've had two before with 15.1 and 15.8. I'm not too thrilled about how low it is but I'm also very hesitant to intervene with that.

Does that make a meaningful change for your testosterone levels?

So did you give up on TRT due to symptoms? Excess aromatisation/anxiety/irritability/depression/something else? How long did you give it before quitting and with what level of AI if any? Edit: Also you're aware that E2 suppresses T4 -> T3 conversion, and that inflammation suppresses the...

Was wondering because serotonin increases prolactin. However there exist antidepressants (that aren't SSRIs) that don't have that effect. But alright, very elevated still sounds like something to look into. Do you take an AI to control it/see a difference from taking an AI? And if you're intent...

How elevated is your prolactin? Not enough to check for an adenoma I guess? Interesting to hear. I would consider thyroid replacement myself, and/or low-dose hydrocortisone but it just sounds like a pain to titrate that and find an optimal dose. Looking at people on thyroid replacement they...

Interesting to hear, but do you not find that your FT3 and FT4 correlate with your total T3 and T4? If they don't then surely your TBG is varying a great deal?

Can you elaborate on the suppression you've experienced? Which markers have you been measuring? Would be interested to see your blood tests. My primary symptom was pronounced fatigue which testosterone does help with. I've been measuring cortisol as well as FT3 and FT4 for fun lately too.