Does Testosterone Replacement Affect the Thyroid?
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Nelson Vergel
Founder, ExcelMale.com
1- One study showed that the use of an androgen that does not get converted to estradiol affects the way the thyroid gland responds to thyroid releasing hormone (TRH):
"Fluoxymesterone, an androgen not converted to estrogen, caused a significant decrease in the TSH response to TRH in 11 men with primary hypogonadism [maximum change in TSH: before treatment, 11.3 ° 0.9 juU/ml (mean ° SE); 8.9 ° 1.0 after 2 weeks (P < 0.001); 8.2 ° 1.1 after6 weeks (P < 0.01)]. There was a significant fall in serum Thyroxine−binding globulin (TBG) (measured directly by RIA) without a change in the free T4 or free T3 index.
http://press.endocrine.org/doi/abs/10.1210/jcem-52-2-173
2- Another study looked at the effect of hCG (which raises T and E2):
After 3 months of hCG treatment, there was a marked rise in serum estradiol as well as testosterone. Serum T4 was reduced without a change in T3, T3 resin uptake, or TBG. Furthermore, there was no alteration in the TSH response to TRH.
The thyrotropin (TSH) profile in isolated gonadotropin deficiency: a model to evaluate the effect of sex steroids on TSH secretion - PubMed
3- This next study showed the effect of anabolic steroids on thyroid function. However, it does not mention if the were aromatizing anabolics or not. My opinion is that estradiol has a normalizing effect on thyroid function. Low E2 may be the cause for these results:
During the use of steroids significant decreases (P < 0.05 to 0.001) in the serum concentrations of thyroid stimulating hormone, thyroxine, triidothyronine, free thyroxine, and thyroid hormone-binding globulin (TBG) were found, whereas the value of triidothyronine uptake increased (P < 0.001). In relation to the changes in the thyroid function parameters measured, we suggest that the primary target of androgen action was TBG biosynthesis.
http://ajs.sagepub.com/content/15/4/357.short
4- This other study shows that increasing testosterone (using hCG in this case) can increase the conversion of T4 to T3 by reducing Thyroxine-binding globulin (TBG). I bet this is one of the reasons people lose fat and may also feel "hot" on TRT.
"Fluoxymesterone, an androgen not converted to estrogen, caused a significant decrease in the TSH response to TRH in 11 men with primary hypogonadism [maximum change in TSH: before treatment, 11.3 ° 0.9 juU/ml (mean ° SE); 8.9 ° 1.0 after 2 weeks (P < 0.001); 8.2 ° 1.1 after6 weeks (P < 0.01)]. There was a significant fall in serum Thyroxine−binding globulin (TBG) (measured directly by RIA) without a change in the free T4 or free T3 index.
http://press.endocrine.org/doi/abs/10.1210/jcem-52-2-173
2- Another study looked at the effect of hCG (which raises T and E2):
After 3 months of hCG treatment, there was a marked rise in serum estradiol as well as testosterone. Serum T4 was reduced without a change in T3, T3 resin uptake, or TBG. Furthermore, there was no alteration in the TSH response to TRH.
The thyrotropin (TSH) profile in isolated gonadotropin deficiency: a model to evaluate the effect of sex steroids on TSH secretion - PubMed
3- This next study showed the effect of anabolic steroids on thyroid function. However, it does not mention if the were aromatizing anabolics or not. My opinion is that estradiol has a normalizing effect on thyroid function. Low E2 may be the cause for these results:
During the use of steroids significant decreases (P < 0.05 to 0.001) in the serum concentrations of thyroid stimulating hormone, thyroxine, triidothyronine, free thyroxine, and thyroid hormone-binding globulin (TBG) were found, whereas the value of triidothyronine uptake increased (P < 0.001). In relation to the changes in the thyroid function parameters measured, we suggest that the primary target of androgen action was TBG biosynthesis.
http://ajs.sagepub.com/content/15/4/357.short
4- This other study shows that increasing testosterone (using hCG in this case) can increase the conversion of T4 to T3 by reducing Thyroxine-binding globulin (TBG). I bet this is one of the reasons people lose fat and may also feel "hot" on TRT.
Last edited:
I don't think that testosterone replacement therapy causes hypothyroidism. I DO think that many guys who go on TRT are subsequently more likely to be diagnosed with hypothyroidism that they already had. This is due to the fact that they're now more aware of and getting blood tests for various hormones, including thyroid. They're also now seeing doctors who are more aware of and more likely to test for and treat hormonal issues like hypothyroidism.
Many guys are probably walking around with subclinical hypothyroidism without realizing it. Once you start seeing a doc that understands TRT they'll likely also find and treat the hypothyroidism.
Many guys are probably walking around with subclinical hypothyroidism without realizing it. Once you start seeing a doc that understands TRT they'll likely also find and treat the hypothyroidism.
guitardaddy
New Member
I have never heard that but I have read that hypothryroidism can cause low T. Maybe people are looking at the coorelation but making the wrong cause and effect assumption?
Vince
Super Moderator
My TSH levels are good now. I believe it was from supplementing with too much iodine.
forrest_and_trees
New Member
The more I learn, the more I realize there are actually numerous causes for Hypothyroidism and Hypothyroid-like symptoms. I believe much of the problem is due to placing too many people in the same box.
http://www.definitivemind.com/forums/showthread.php?t=576
http://www.definitivemind.com/forums/showthread.php?t=576
Yes, testosterone replacement therapy does most definitely cause hypothyroidism in the long term.
We have done over 8 years of intensive research on this topic and this is definitely the case.
Most guys receiving TRT won't notice that their thyroid is slowing down because it is a very slow process.
The main reason that this is happening is because your testosterone levels are constantly high. In normal guys not receiving TRT, your testosterone levels cycle daily in response to waking up, excercise, eating, etc, which allows your thyroid to respond correctly.
There are a few ways for you to naturaly treat your trt induced hypothyroidism. Ice cold showers twice a day. Swimming in a ice cold sea. Holding onto ice packs when you go to bed. Getting plenty of sun.(without sunscreen) Lots of excercise.
Treating your hypothyroidism with T3 or T4 medication does not work. We are busy researching why this is the case.
I'm part of a team of researchers at a big university. I'm not allowed to disclose any other information right now.
Hope this helps a few guys.
We have done over 8 years of intensive research on this topic and this is definitely the case.
Most guys receiving TRT won't notice that their thyroid is slowing down because it is a very slow process.
The main reason that this is happening is because your testosterone levels are constantly high. In normal guys not receiving TRT, your testosterone levels cycle daily in response to waking up, excercise, eating, etc, which allows your thyroid to respond correctly.
There are a few ways for you to naturaly treat your trt induced hypothyroidism. Ice cold showers twice a day. Swimming in a ice cold sea. Holding onto ice packs when you go to bed. Getting plenty of sun.(without sunscreen) Lots of excercise.
Treating your hypothyroidism with T3 or T4 medication does not work. We are busy researching why this is the case.
I'm part of a team of researchers at a big university. I'm not allowed to disclose any other information right now.
Hope this helps a few guys.
CoastWatcher
Moderator
Chris - Start a new post, if you would, with some details on your test results and protocol. You'll generate some good discussion.
Singinhawk
Member
It seems like we are talking about people not taking thyroid meds.
I am interested in people who are on thyroid Meds and start TRT. It's well know that women who go on estrogen therapy have to increase their thyroid dose due to an increase in thyroid binding protein. Just the opposite on TRT. It seems to me, and I am not an expert, the the thyroid levels will look good on labs but the hormone is being bound and not able to be used. My speculation.
i have been on thyroid Meds, armour, for 25 years and did fine. When I started TRT I felt hyper and had to reduce my dose. As I stated in my initial post I read that in two thyroid books.
Thanks
I am interested in people who are on thyroid Meds and start TRT. It's well know that women who go on estrogen therapy have to increase their thyroid dose due to an increase in thyroid binding protein. Just the opposite on TRT. It seems to me, and I am not an expert, the the thyroid levels will look good on labs but the hormone is being bound and not able to be used. My speculation.
i have been on thyroid Meds, armour, for 25 years and did fine. When I started TRT I felt hyper and had to reduce my dose. As I stated in my initial post I read that in two thyroid books.
Thanks
Singinhawk
Member
I have also used 7 keto dhea for many years to avoid the estrogenic effects of regular DHEA. Anyone else
opinions please
opinions please
cyclingwolf
New Member
I've been on TRT since May of 2015. My previous doctors and I do not see eye to eye at all on any issue. And due to their idiocy I've been to a few different ones – that's another story.
A tad bit of past info – the 2 years before I started T, I went from cycling centuries and gym workouts to barely making it out of bed and to work when we found my T low. I suffered brain fog and memory problems, actually developed mild dyslexia with numbers, as well as weight gain, ED and no libido. If my wife hadn't been on me about not loving her and wanting me to ask my doctor about why I didn't want sex or have erections I may never have found out. And after the past 18 months of no warnings, misinformation, improper TRT, e2 management and hypo symptoms, I wish I never did or refused the therapy from the start.
Since starting TRT, I've had all the classic symptoms of hypothyroid, and these lab results look like hypo to me and all the research I've been able to do. But the last endo quack I saw said and I quote “T3, Ft3, Ft4 and T4 don't mean anything if TSH is in range”.
My first doctor didn't test anything else when TSH came back in the upper normal range. On the same labs we found T low and he started TRT. More labs would have been nice, but by all looks - Yes TRT drove me Hypo.
before TRT
Tsh - 2.26
3 months of TRT (August ‘15)(and different doctor)
Tsh - .86 (.45-2.5)
Ft3 - 2.89 (1.71-3.71)
Ft4 - .96 (.7-1.48)
T4 - 5.2 (4.87-11.72)
January of '16
Tsh - 1.76
Ft3 - 3.51
Ft4 - .83
T4 - .42
April '16 (didn't test anything else)
Tsh - 1.7
another doctor in November started me on HCG (and is currently helping me try to get off T, as pituitary mri results are negative)
December '16
Tsh - 1.16
Ft4 - 1.9
T4 - 5.8
TRT made me hypothyroid, thats the way it looks and has felt. I'll get more labs in 2 months and ill know for sure if everything straightens itself out. This is week three off of testosterone. I've got 2 weeks before i stop HCG and then its up to Serm's and my body to either come back or fail. My hopes are high as i have felt progressively better the past few weeks, which means HCG therapy has my body producing testosterone again or I'd have had a hard crash by now.
Anyway that's my story and labs. hope it helps someone or brings more thought into this kind of therapy.
A tad bit of past info – the 2 years before I started T, I went from cycling centuries and gym workouts to barely making it out of bed and to work when we found my T low. I suffered brain fog and memory problems, actually developed mild dyslexia with numbers, as well as weight gain, ED and no libido. If my wife hadn't been on me about not loving her and wanting me to ask my doctor about why I didn't want sex or have erections I may never have found out. And after the past 18 months of no warnings, misinformation, improper TRT, e2 management and hypo symptoms, I wish I never did or refused the therapy from the start.
Since starting TRT, I've had all the classic symptoms of hypothyroid, and these lab results look like hypo to me and all the research I've been able to do. But the last endo quack I saw said and I quote “T3, Ft3, Ft4 and T4 don't mean anything if TSH is in range”.
My first doctor didn't test anything else when TSH came back in the upper normal range. On the same labs we found T low and he started TRT. More labs would have been nice, but by all looks - Yes TRT drove me Hypo.
before TRT
Tsh - 2.26
3 months of TRT (August ‘15)(and different doctor)
Tsh - .86 (.45-2.5)
Ft3 - 2.89 (1.71-3.71)
Ft4 - .96 (.7-1.48)
T4 - 5.2 (4.87-11.72)
January of '16
Tsh - 1.76
Ft3 - 3.51
Ft4 - .83
T4 - .42
April '16 (didn't test anything else)
Tsh - 1.7
another doctor in November started me on HCG (and is currently helping me try to get off T, as pituitary mri results are negative)
December '16
Tsh - 1.16
Ft4 - 1.9
T4 - 5.8
TRT made me hypothyroid, thats the way it looks and has felt. I'll get more labs in 2 months and ill know for sure if everything straightens itself out. This is week three off of testosterone. I've got 2 weeks before i stop HCG and then its up to Serm's and my body to either come back or fail. My hopes are high as i have felt progressively better the past few weeks, which means HCG therapy has my body producing testosterone again or I'd have had a hard crash by now.
Anyway that's my story and labs. hope it helps someone or brings more thought into this kind of therapy.
Can you explain how you come to this conclusion with only TSH pre TRT?
Actually your december '16 labs look better than the 3 months on TRT labs. Your ranges look a bit strange: Do you have above range ft4 now? And in January you had almost top of the range ft3?
To me this sounds as if you might have been hypo even before you started TRT. What are the hypo symptoms you experienced during TRT?
cyclingwolf
New Member
1) Withonly TSH pre-treatment, it is my assumption that the others are normal. I thinkthis because looking at the lab results if I was hypo before treatment it wouldbe primary hypo (high range to high TSH and Low range to low T4 = underatcivethyroid). The next lab set is reverse Tsh and indicates secondary (pituitary)hypo. I would not think one would get better and the other get “sick”. TSH, as no lab proof/studies show, should not have been affected at all by TRT, but yet mine was. My mindsays there is something else going on. Admittedly I could be over thinkingthings but there it is. And agreed – I can't possibly know for sure with onlyTsh pre-TRT.
I am open to learning, and this sight has taught me a lot, but this is also a complex issue with many many variables. If GP's and Endo's don't understand it better than we do and aren't open to learning, then as it currently stands the low T man is stuck with high out of pocket expenses for Life/Wellness doctors who seem to know little more than the others or are rip off businesses praying on the man hoping for better. there are a few good ones out there but the knowledge is limited to those few who really want to research and help men Correctly. I have yet to find one in Alabama. I have so far found a urologist who is open to my suggestions, so long as I can medically back what i'm asking of him, which is as it should be.
2) Thelab ranges were from an independent lab my second doctor used, that has sincegone out of business. My new labs are with quest, but I haven't looked for anydifference in their ranges.
3) Symptoms during trt: lack ofmotivation or interest in work, life, hobbies I love; deceased sex drive; EDissues (mostly in maintaining); fatigue and tiredness (I'm good till a aboutlunch then I just don't have energy or mood for anything); my memory and mentalfog/confusion have actually gotten worse over the past 6-8 months, they nevergot better even after starting TRT; moodiness; anxiety; depression (been a lifelong battle with that so its not new, just not better); muscle weakness sometimes to the point I have trouble opening a bag of chips (in comparison at start of TRT I was benching 220 and leg pressing 780) now, 18 months later, my 50lb dumbbells weigh too much to bench.
I'm shure theres more but what is really interesting is all these symptoms are also symptoms of low T and Pregnenolone deficiency. Anyway if there is something specific i'm missing or that would help you help me, ask.
After starting trt my HDL decreased tobelow or just over low range and triglycerides skyrocketed and have stayed upperrange. Before TRT Tri stayed around 75 now it stays around 120, LDL stayedbetween 104-110 (0-99 labcorp range) now it stays 117-130. HDL stayed around 55(>39) now it stays bwtween 38-45. I don't know if that is significant, mydoctors didn't think so, but I've learned not to trust them so…
Which brings another thing I got mynew doctor to run more tests and as of December 23, pregnenolone is <10, dhea is 108, shbg 24,cortisol I forget but was low in range, testosterone 1017, and free test was 24.1, E2 22.
As far as FT4 as of December 9 yes it'sabove range with T4 in the low side of in range. This is after taking HCG 500iuEOD for 2 months. The endocrinologist said t3 didn't mean anything and wouldn'ttest it.
My next labs are in two weeks whenI'll be stopping Hcg, I'm gonna try to get him to add a thyroid panel. I'mhoping pregnenolone and dhea are up. The way I understand it if either/both arelow ALL hormone production suffers. Essentially I'm trying a restart but itwill most likely be serm maintained. And it might not work. At 35 I had mytestosterone checked as a possible cause of anger and depression issuesand it was 537.
At diagnosis my T was 383 on 2 tests4 weeks apart and my FT was 6 tested on the second lab. LH was 5.7 and FSH was3.9. every doctor I've seen so far says I'm secondary, and with no abnormalresults on MRI of pituitary, there is no reason to not try to resart, support or boost mynormal production. Also at the time of my diagnosis I have an epididymal cyst which I thought was getting bigger. compared to the ultrasound 2 years prior - at the time of my diagnosis my testes had already atrophied 20%, the cyst was the exact same size.
Interestingly, I was on thetestosterone diet, d-aparatic acid, TribulusTerrestris, Tongkat Ali, and Zinc during the time my initial tests were beingdone and I was diagnosed as low T.
Sorry for the length trying to be thorough but detailed and complete, and I don't do forums (aside from viewing info) so this is all new to me. Thanks for reading and any advice, info or teaching that may be offered.
I am open to learning, and this sight has taught me a lot, but this is also a complex issue with many many variables. If GP's and Endo's don't understand it better than we do and aren't open to learning, then as it currently stands the low T man is stuck with high out of pocket expenses for Life/Wellness doctors who seem to know little more than the others or are rip off businesses praying on the man hoping for better. there are a few good ones out there but the knowledge is limited to those few who really want to research and help men Correctly. I have yet to find one in Alabama. I have so far found a urologist who is open to my suggestions, so long as I can medically back what i'm asking of him, which is as it should be.
2) Thelab ranges were from an independent lab my second doctor used, that has sincegone out of business. My new labs are with quest, but I haven't looked for anydifference in their ranges.
3) Symptoms during trt: lack ofmotivation or interest in work, life, hobbies I love; deceased sex drive; EDissues (mostly in maintaining); fatigue and tiredness (I'm good till a aboutlunch then I just don't have energy or mood for anything); my memory and mentalfog/confusion have actually gotten worse over the past 6-8 months, they nevergot better even after starting TRT; moodiness; anxiety; depression (been a lifelong battle with that so its not new, just not better); muscle weakness sometimes to the point I have trouble opening a bag of chips (in comparison at start of TRT I was benching 220 and leg pressing 780) now, 18 months later, my 50lb dumbbells weigh too much to bench.
I'm shure theres more but what is really interesting is all these symptoms are also symptoms of low T and Pregnenolone deficiency. Anyway if there is something specific i'm missing or that would help you help me, ask.
After starting trt my HDL decreased tobelow or just over low range and triglycerides skyrocketed and have stayed upperrange. Before TRT Tri stayed around 75 now it stays around 120, LDL stayedbetween 104-110 (0-99 labcorp range) now it stays 117-130. HDL stayed around 55(>39) now it stays bwtween 38-45. I don't know if that is significant, mydoctors didn't think so, but I've learned not to trust them so…
Which brings another thing I got mynew doctor to run more tests and as of December 23, pregnenolone is <10, dhea is 108, shbg 24,cortisol I forget but was low in range, testosterone 1017, and free test was 24.1, E2 22.
As far as FT4 as of December 9 yes it'sabove range with T4 in the low side of in range. This is after taking HCG 500iuEOD for 2 months. The endocrinologist said t3 didn't mean anything and wouldn'ttest it.
My next labs are in two weeks whenI'll be stopping Hcg, I'm gonna try to get him to add a thyroid panel. I'mhoping pregnenolone and dhea are up. The way I understand it if either/both arelow ALL hormone production suffers. Essentially I'm trying a restart but itwill most likely be serm maintained. And it might not work. At 35 I had mytestosterone checked as a possible cause of anger and depression issuesand it was 537.
At diagnosis my T was 383 on 2 tests4 weeks apart and my FT was 6 tested on the second lab. LH was 5.7 and FSH was3.9. every doctor I've seen so far says I'm secondary, and with no abnormalresults on MRI of pituitary, there is no reason to not try to resart, support or boost mynormal production. Also at the time of my diagnosis I have an epididymal cyst which I thought was getting bigger. compared to the ultrasound 2 years prior - at the time of my diagnosis my testes had already atrophied 20%, the cyst was the exact same size.
Interestingly, I was on thetestosterone diet, d-aparatic acid, TribulusTerrestris, Tongkat Ali, and Zinc during the time my initial tests were beingdone and I was diagnosed as low T.
Sorry for the length trying to be thorough but detailed and complete, and I don't do forums (aside from viewing info) so this is all new to me. Thanks for reading and any advice, info or teaching that may be offered.
@cyclingwolf
You also need to check the reverse T3 (rT3), and both thyroid antibodies for a clearer picture (read: Stop the thyroid madness, 2nd edition).
I too suspect my thyroid was to blame for low energy (and all the usual hypo symptoms), as my rT3 was elevated (a form of hypothyroidism).
You also need to check the reverse T3 (rT3), and both thyroid antibodies for a clearer picture (read: Stop the thyroid madness, 2nd edition).
I too suspect my thyroid was to blame for low energy (and all the usual hypo symptoms), as my rT3 was elevated (a form of hypothyroidism).
Nelson Vergel
Founder, ExcelMale.com
Hello Mathew
I am interested in finding out more about your research. I will private message you. Thanks
Vince
Super Moderator
I really don't understand why higher levels of testosterone would affect thyroids. Will you post your studies, it sounds like you're making it up.
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