TRT induced TGB deficiency leads to hypothyroid-like symptoms?

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Found something interesting in my research and was wondering if anyone is familiar with elevated testosterone leading to Thyroid Binding Globulin [TBG] deficiency? …Sometimes referred to Thyroxine Binding Globulin.

If there is not enough thyroid binding globulin, there can be too much free thyroid hormone available for cells. While this doesn’t sound like a problem, elevated free thyroid hormone shuts down receptor sites and can therefore cause hypothyroid symptoms, despite high free thyroid hormone levels. The most common cause of this is elevated testosterone in both men and women.
Sorry... I'm still new and can't link to sources yet...

I've been on HRT for both Low T and Hypothyroidism for nearly 6 years now. Before HRT I weighed over 400 pounds. I've since lost over 200 lbs and had to continually lower my Test Cyp dosage, as my T levels have shot up above normal due to the weight loss, while simultaneously needing to increase my thyroid med dosage to maintain similar effect, even though my T3 and T4 are both above normal now.

Could I have inadvertently re-created the same problem I've been trying to treat, but for different reasons? And once I get my T levels back down, will my TBG return to normal? [I sure hope so]

I found an old thread that touches on this and was hoping to get some further discussion going specifically about TBG deficiency. If you're interested and want to read the old thread, search this site for, "does testosterone replacement therapy cause hypothyroidism" ...I'll post a link later when I'm allowed.
 
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Defy Medical TRT clinic doctor
I am taking Arimidex. As for my Test Cyp dose; up until October, for the past couple years I'd been injecting 200mg a week broken up into two 100mg injections. In Feb I weighed 275 pounds and my T level was around 1250. But by Oct I'd dropped another 40 pounds and my T level shot up to *2600* on the same 100mg bi-weekly dose!

In Oct I dropped my dose down to 160mg a week. As of last week, my T is only down to 1600, so I'm dropping my dose again to 140mg a week and I'll test in a couple months.

For a reference; when I began TRT I weighed around 440lbs and was taking 240mg of Test Cyp a week. At that time my T level was in the 1100s.

I'm also taking 25mg of DHEA daily and 250iu of HCG about once every other week, down from 500iu 2x a week in the past... I'm trying to stretch out my last batch of HCG because it's been getting harder and harder to find.

P.S. Thanks for posting the link to the thread I was referring to.
 
Last edited:

CoastWatcher

Moderator
Yes, I am on Arimidex. As for my Test Cyp dose; up until October, for the past couple years I'd been injecting 200mg a week broken up into two 100mg injections. In Feb I weighed 275 pounds and my T level was around 1250. But by Oct I'd dropped another 40 pounds and my T level shot up to *2600* on the same 100mg bi-weekly dose!

At that time I dropped my dose down to 160mg a week. As of last week, my T is only down to 1600, so I'm dropping my dose again to 140mg a week and I'll test in a couple months.

For a reference; when I began TRT I weighed around 440lbs and was taking 240mg of Test Cyp a week. At that time my T level was in the 1100s.

I'm also taking 25mg of DHEA daily and 250iu of HCG about once every other week, down from 500iu 2x a week in the past... I'm trying to stretch out my last batch because it's been getting harder to find.

P.S. Thanks for posting the link to the thread I was referring to.

I don't believe you posted your e2 level or your Arimidex dose. Would you?
 
Latest E2 test was in Oct and my Estradiol Sensitive was 3. It's a bit on the low side for most however, I have none of the obvious low e symptoms. In fact, anytime I let it get higher, I start getting moody, anxious, my nipples get puffy, I retain fluid and my skin get's loose; I really notice it in my neck.
 
Last edited:

Vince

Super Moderator
As many as 35% of the population now have thyroid dysfunction in some form, an epidemic due to a number of factors that affect all of us, such as endocrine disruption from the industrial chemicals that surround us.

It means that thyroid dysfunction impairs weight control, energy, cholesterol values, blood pressure, skin and hair quality, and many other facets of health. If it doesn't now, it may in the future.
 
As many as 35% of the population now have thyroid dysfunction in some form, an epidemic due to a number of factors that affect all of us, such as endocrine disruption from the industrial chemicals that surround us.

It means that thyroid dysfunction impairs weight control, energy, cholesterol values, blood pressure, skin and hair quality, and many other facets of health. If it doesn't now, it may in the future.

You're absolutely right and it's a damn shame since most go un-diagnosed or are improperly treated. 13 years ago I lost a sister due to complications from hypothyroidism. In fact, she'd suffered her whole life with it, because she'd never been diagnosed. In retrospect it's obvious now. And just this past summer, my family lost a dear friend who was like a sister to me, due to complications from being improperly treated for hypothyroidism... I'd personally suffered for nearly 20 years before *I* found answers and I'm still struggling with it. It is indeed an epidemic.

This post from a Dr. on another site demonstrates just how much more complex it is than most of us realize. Frankly it makes my head spin:

Off the top of my head, there are several possible ways TRT can reduce thyroid hormone signaling, including the following:

1. Exogenous testosterone suppresses testicular testosterone production AND testicular thyroid releasing hormone (TRH) production. This reduces brain TSH production, lowering thyroid hormone production from the thyroid gland.

2. Exogenous testosterone may reduce liver production of thyroid binding globulin. This reduces the half-life of thyroid hormone. This leads to a reduction in available thyroid hormone.

3. Exogenous testosterone can lead to a simultaneous conversion of testosterone to estradiol. The increase in estradiol can increase liver production of thyroid binding globulin. This can lead to a reduction in free thyroid hormone levels (Free T3, Free T4). This then reduces thyroid signaling.

4. Exogenous HCG (human chorionic gonadotropin) not only increases testicular production of testosterone and sperm but also increases aromatase enzyme production. The increase in aromatase enzyme can then lead to an increase in estradiol production from testosterone. This (as noted above) can lead to a reduction in thyroid signaling.

5. Exogenous testosterone can suppress ACTH (adrenocorticotropic hormone) production from the brain. And it can directly suppress adrenal cortical activity, including cortisol production. This can then lead to an increase in norepinephrine production, then immune system inflammatory signaling. This can then shift thyroid metabolism so that T4 is converted to reverse T3 (the waste product pathway) instead of being converted to T3 (the active thyroid hormone). This can reduce both T4 levels and T3 levels, leading to a reduction in thyroid signaling.

When possible, I usually prefer to consider first optimizing thyroid signaling, adrenal function, immune system function, nervous system function, metabolism and nutrition, to allow a smoother transition to testosterone replacement therapy.

There are times when adding testosterone simultaneously while addressing the other systems is important to help break some positive feedback loops between systems that contribute to illness. For example, high insulin/insulin resistance/diabetes, obesity, inflammatory signaling, stress/norepinephrine signaling, and lower testosterone production can be involved in multiple positive feedback loops which can cause significant illness. Adding testosterone when it is low in such a person can help unravel the self-perpetuating signaling loops that keep a person ill.
__________________
Romeo B. Mariano, MD, physician, psychiatrist

Source site: http://www.definitivemind.com/forums/showthread.php?t=576

And for reference, now that I can post links, here's the source site from the quote in my first post above: 7 Thyroid Issues your Doc Likely Missed.

This *really* does need to be discussed more...
 
As many as 35% of the population now have thyroid dysfunction in some form, an epidemic due to a number of factors that affect all of us, such as endocrine disruption from the industrial chemicals that surround us.

It means that thyroid dysfunction impairs weight control, energy, cholesterol values, blood pressure, skin and hair quality, and many other facets of health. If it doesn't now, it may in the future.

You're absolutely right and it's a damn shame since most go un-diagnosed or are improperly treated. 13 years ago I lost a sister due to complications from hypothyroidism. In fact, she'd suffered her whole life with it, because she'd never been diagnosed. In retrospect it's obvious now. And just this past summer, my family lost a dear friend who was like a sister to me, due to complications from being improperly treated for hypothyroidism... I'd personally suffered for nearly 20 years before *I* found answers and I'm still struggling with it. It is indeed an epidemic.

This post from a Dr. on another site demonstrates just how much more complex it is than most of us realize. Frankly it makes my head spin:

Off the top of my head, there are several possible ways TRT can reduce thyroid hormone signaling, including the following:

1. Exogenous testosterone suppresses testicular testosterone production AND testicular thyroid releasing hormone (TRH) production. This reduces brain TSH production, lowering thyroid hormone production from the thyroid gland.

2. Exogenous testosterone may reduce liver production of thyroid binding globulin. This reduces the half-life of thyroid hormone. This leads to a reduction in available thyroid hormone.

3. Exogenous testosterone can lead to a simultaneous conversion of testosterone to estradiol. The increase in estradiol can increase liver production of thyroid binding globulin. This can lead to a reduction in free thyroid hormone levels (Free T3, Free T4). This then reduces thyroid signaling.

4. Exogenous HCG (human chorionic gonadotropin) not only increases testicular production of testosterone and sperm but also increases aromatase enzyme production. The increase in aromatase enzyme can then lead to an increase in estradiol production from testosterone. This (as noted above) can lead to a reduction in thyroid signaling.

5. Exogenous testosterone can suppress ACTH (adrenocorticotropic hormone) production from the brain. And it can directly suppress adrenal cortical activity, including cortisol production. This can then lead to an increase in norepinephrine production, then immune system inflammatory signaling. This can then shift thyroid metabolism so that T4 is converted to reverse T3 (the waste product pathway) instead of being converted to T3 (the active thyroid hormone). This can reduce both T4 levels and T3 levels, leading to a reduction in thyroid signaling.

When possible, I usually prefer to consider first optimizing thyroid signaling, adrenal function, immune system function, nervous system function, metabolism and nutrition, to allow a smoother transition to testosterone replacement therapy.

There are times when adding testosterone simultaneously while addressing the other systems is important to help break some positive feedback loops between systems that contribute to illness. For example, high insulin/insulin resistance/diabetes, obesity, inflammatory signaling, stress/norepinephrine signaling, and lower testosterone production can be involved in multiple positive feedback loops which can cause significant illness. Adding testosterone when it is low in such a person can help unravel the self-perpetuating signaling loops that keep a person ill.
__________________
Romeo B. Mariano, MD, physician, psychiatrist

Source site: http://www.definitivemind.com/forums/showthread.php?t=576

Personally, I still don't know the cause of my hypothyroidism and it's frustrating. But that's part of the reason why I'm here.

This really is a topic that needs greater discussion. Why it continually goes under the radar here in the US by patients and physicians alike, when it's so much more commonly understood in other parts of the world, is beyond me.

P.S.
For reference, now that I can post links, here's the source site from the quote in my first post above: 7 Thyroid Issues your Doc Likely Missed.
 
" testicular thyroid releasing hormone (TRH) production"

Wrong: thyroid releasing hormone

?? Not sure I understand.

And what about my original question? Given the T levels I've been experiencing, could I have lowered my TBG levels, thereby causing hypothyroid-like symptoms, requiring ever higher dosages of Nature Throid? And if so, would the TBG levels return to normal once my T levels are back in range?
 
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