Euthyroid Sick Syndrome Advice

[BarryAllan]

Hey Guys,

First time poster on the forums, glad to be apart of the crew!

So here's the dilemma.

I've had a past history of steroid use and had my last cycle wrapped up since the beginning of 2016; I haven't been right since.

I started seeking help in 2017 and in 2018 i've seen dozens of Drs. being pulled in multiple directions yet still ending up no where.

After some time i realized that I've had low total and free t3. My highest total has been as low as 60 and as high as 81 for total, and 1.82 to 3.2 for free.

I've searched up what this means a while back and understand its called euthyroid sick syndrome. The problems resolve once you find the underlying condition. The issue is i haven't been able to find it, I've checked for inflammation, nutritional deficiencies, kidneys, the works. I've improved these individual circumstances to variable degrees but still haven't hit the nail on the head.

My current numbers are:
TSH 1.34 (0.40-4.50 mIU/L)
T4,FREE 1.1 (0.8-1.8 ng/dL)
T3,FREE 3.0 (2.3-4.2 pg/mL)
T3 REVERSE, LC/MS/MS 14 (8-25 ng/dL)
T3 REVERSE, LC/MS/MS 14 (8-25 ng/dL)

i suffer from low libido & ED, low mood, as well as fatigue and slight brain fog.

The only thing that worked for a bit was hgh because i know it helps t4-t3 conversion. in the beginning it did work from weeks 2-3 of supplementation i was feeling 60-70% thinking that i was finally going to recovery until it stopped working all together.

Fast forward and I'm on trt, my total test has always been high but free test always in the toilet. I feel better on trt but i still deal with ED & Low libido, plus i dont think ive fully dialed in my dosage yet.

With that being said, even when i blast cycle type dosages, i dont get any energy down there and its been seriously troubling. Drs. keep telling me that t3 can't have that much of an effect and that im probably depressed, or its in my head, etc etc but i think if i got my t3 levels up, then the problems would be resolved.

With no where else to seemingly turn, I've decided to start supplementing t3 only at a moderate dose of 10mcg until my next set of bloods mid September. I didn't want to take t3 but without any other leads on ESS, its my only option. This will be my first time adding them together, interesting to see how this works.

Anybody else take t3 only with trt? Besides increasing t3 numbers, did it make you feel any better? How long did it take for your numbers to get up? And is this a permanent addition or can i take it for a small period of time then hop off?

Thanks in advance!

 

[Systemlord]

I do not think your thyroid labs are terrible, your symptoms do not match up with your Free T3 levels, Free T3 is slightly below mid-range, but I do not think your Free T3 levels are the problem.

I see a lot of men previously abusing steroids complain of similar symptoms to what you describe, I think what you need is to dial-in your TRT protocol and get Free T up.

It's hard to answer if your condition is permanent, I've heard some recover and some do not.

 

[BarryAllan]

I do not think your thyroid labs are terrible, your symptoms do not match up with your Free T3 levels, Free T3 is slightly below mid-range, but I do not think your Free T3 levels are the problem.

I see a lot of men previously abusing steroids complain of similar symptoms to what you describe, I think what you need is to dial-in your TRT protocol and get Free T up.

It's hard to answer if your condition is permanent, I've heard some recover and some do not.

Free T was definitely up
Total T: 1366 (250-1100 ng/dL)
Free T 260 (35.0-155.0 pg/mL)
E2 sensitive 50

Things need to be dialed in of course, my first round of test was 125mg with 250iu hcg 3x a week and 12.5mg aromasin. I'm dropping the hcg and AI and will switch to Arimidex. I'm going to see how 100mg/wk without any of that puts me.

My total t3 is definitely a problem if i can't even get it up to triple digits, and i may have more free t3 available if my total increased.

Its crazy how 250mg of test doesn't do anything libido/erection wise but i assume it has to correlate with the t3 numbers. If my thyroid was on point i think everything would be alright.

I thought when i first found out my t3 was low that it would be a simple fix but nope, life can't be easy.

I'm taking thyroid supplements, will add in ferritin and the Vit A's and C's of the world to help thyroid numbers naturally first, i have plenty of t3 to use.

I'm even considering Bupropion and Buspar along the road too. My urologist suggested that I'm probably stressed & depressed which is causing my symptoms and ESS does list depression and stress as a symptom.

He said that he thinks i just need to dial in my test dosage, but if that were the case, i feel like it would've happened already. I was never into ancillaries like anavar, tren, etc. i just did test, no hcg or AI and was fine. But i can imagine if i add a shit ton of to an already-dysfunctional hpta system, that it wouldn't do any good.

My physician said above all else itll take time, and thats one thing i havent been good with. I know i tend to switch up to often and fallen victim to the "magic pill" formula or that one thing that'll fix anything.

Hopefully if i don't feel any better by September that my bloods will bring me one step closer to rectifying this issue.

 

[Mikeyp6679]

You've convinced yourself that you have a thyroid problem. I agree with everyone else, doesn't appear that way to me. Typically with Euthyroid you'd see Low FT3 and High RT3 i thought. What about SHBG? E2 could definitely come down. I'd focus on getting dialed in with trt but i wouldn't be changing too many variables at once. I am also struggling with the low libido despite the dialed in T/E2 so I understand the frustration.

Be careful playing with T3 hormones unsupervised when not needed. I am working through thyroid issues now (high rt3, low ft3) and finding the right dose of T3 has become a nightmare for me, even supervised. I started real low dose and essentially suppressed the negative feedback loop and the hypo symptoms have come with a vengeance, including weight gain!

 

[BarryAllan]

I wouldn't necessarily say I've convinced myself i might have a thyroid problem as opposed to seeing what I've read online.

I keep seeing total t3 should be in the upper range (ie 130-140 range:76-160) and free t3 in the upper range as well. \

My free t3 has always been on the lower always between 2.3-2.8 until these latest bloods. My free t3 was high at 3.2 whilst on hgh. My reverse t3 when i first tested it was 17 and now 14 which does fall below the <15 requirement that I've seen on restartmed.com and other sites. Plus at their worst, total t3 was 60 and free was 1.82.

Maybe getting these numbers up wouldnt make a difference, i can accept that, but what then?

i used to do 500mg of test no AI, no hcg and was fine. I do that now and i can't feel much libido wise. Maybe if i consistently did cycle dosages for an extended period of time id feel more as time went on, but that would be deleterious to my body and a temporary fix.

The fact that ive played around with various test dosages without any luck does seem to tell me that testosterone isnt the problem, or at least not the complete fix.

I'm ready to venture into the neurotransmitters. I'm still going to keep an eye on my test and estrogen levels and I'm trying to piece more hypotheses together.

But a dopamine issue after my steroid use and brief stints with mdma during my festival days make sense. Everytime i try a new substance that enhances libido, i get a short period of relief and then it fades. Happened with my first hcg shot last year, hgh, proviron, first round of trt.

I have wellbutrin coming in the mail. That may not be the medication that works for me but thats my starting point. I'm working with a very open minded dr so we'll see how far this goes.

 

[wondering]

That T4 could be a little higher. I have done better after adding a little Levothyroxine even though my blood tests didn't show much of a change in adding 25mcg. We can't be completely dependent on tests and not consider how we feel.

 

[BarryAllan]

That T4 could be a little higher. I have done better after adding a little Levothyroxine even though my blood tests didn't show much of a change in adding 25mcg. We can't be completely dependent on tests and not consider how we feel.

I agree. My t4 is usually 1.3-1.5 usually so its abnormal to see it at mid range this time.

I know for a fact my thyroid needs optimization, although i dont know if theres something else going on (because tsh is normal) or if i simply need to experiment with thyroid medication and how i feel over the next few months

 

[JimGainz]

Hi. As the other posters stated - it’s not your thyroid. You can’t go by total T3, Free T3 is what counts and yours are fine.

I am on TRT and take T3 (10 mcg daily) and noted no change in libido (my range is 3.3-3.9).

Your testosterone numbers look fine as well - although I may suggest getting your Estadiol down a tad).

Also, as a former steroid user from the 80s, I can tell you that coming off a cycle takes the body a long time to adjust. That, plus libido is a complex thing in itself - makes it hard to diagnose when all of your labs look good. You didn’t mention what you were taking - and when you came off. If taking something like Deca, you may have prolactin issues.

You need to come off everything and do a restart (HCG , then clomid) and there are a lot of posts on how to do this - to see where you end up natty and take it from there. I suspect things will resolve but it could take up to 4-6 months depending on the dose and duration of your cycle.

 

[Systemlord]

I keep seeing total t3 should be in the upper range (ie 130-140 range:76-160) and free t3 in the upper range as well.

I'm perfectly optimal with T3 <100 (Free T3 @3.6), T3 is better for diagnosing hyperthyroidism and is obsolete, Free T3 is best for diagnosing hypothyroidism. You symptoms are more than likely related to your past AAS usage and more than likely the cause of all you symptoms.

I believe you are so desperate to feel normal again you're latching onto any lab value that isn't optimal, it's likely going to take years to recover from steroid usage.

 

[BarryAllan]

Hi. As the other posters stated - it’s not your thyroid. You can’t go by total T3, Free T3 is what counts and yours are fine.

I am on TRT and take T3 (10 mcg daily) and noted no change in libido (my range is 3.3-3.9).

Your testosterone numbers look fine as well - although I may suggest getting your Estadiol down a tad).

Also, as a former steroid user from the 80s, I can tell you that coming off a cycle takes the body a long time to adjust. That, plus libido is a complex thing in itself - makes it hard to diagnose when all of your labs look good. You didn’t mention what you were taking - and when you came off. If taking something like Deca, you may have prolactin issues.

You need to come off everything and do a restart (HCG , then clomid) and there are a lot of posts on how to do this - to see where you end up natty and take it from there. I suspect things will resolve but it could take up to 4-6 months depending on the dose and duration of your cycle.

I've been dealing with this since i came off in 2016. My only history is superdrol 250 at 20 back to back to back and recovered despite not knowing this was a good idea.

I got hit by a car in 2014, couldn't work out for 6 months and jumped on test in spring 2015. I felt a little off after coming off and stupidly took the advice of a fellow roid user who suggested i hop back and do another reset. Nothing has been the same since.

I've done multiple hcg restarts. In fact before i even began trt, these were my levels.

Bloodwork 03/20/2018:
Total T 772 (249-836) ng/dl
Free T 173 (30-150) pg/ml
Bio Available T 451 (72-460) ng/dl
LH 4.2 (1.7-8.6) mIU/ml
FSH 1.2 (1.5-12.4) mIU/ml
Prolactin 8.6 (4.0-15.2) ng/ml
E2 21.45 (7.02-49.06) pg/ml
SHBG 30 (10-57) nmol/l

My estrodial has been as low as 15 and as high as its been now and no change. I shoot up 500mg of test in a week and it doesn't the same nor the way it should.

from Jan 2016 to Sept 2017 I didn't touch anything! No supplements no AAS no Sarms not a single thing. I left my body alone hoping to recovery it and never did.

I've done hcg, clomid, nolva, & hgh. All which worked for a short period of time after i first introduced them to my body after my long lay off. They'd always stop working, I'd have my ED & Libido issues return and i can't figure out what exactly is going on with my body that it won't allow me to sustain successful recovery.

I never took Deca. Did experiment with tren for 1 month on the lowest possible dosage.

I do have history of mdma use so im wondering if that, in conjunction with AAS has depleted or altered some neurotransmitters in the brain.

I would come off test, but i can't function with out it really. I get REALLY fatigued and no energy or motivation for anything at all. Trying to do my job without being on trt is nearly impossible, i can't think as quickly or as clearly.

I got a script for wellbutrin and will start tomorrow. Fingers crossed.

 

[BarryAllan]

I'm perfectly optimal with T3 <100 (Free T3 @3.6), T3 is better for diagnosing hyperthyroidism and is obsolete, Free T3 is best for diagnosing hypothyroidism. You symptoms are more than likely related to your past AAS usage and more than likely the cause of all you symptoms.

I believe you are so desperate to feel normal again you're latching onto any lab value that isn't optimal, it's likely going to take years to recover from steroid usage.

I obviously know my past AAS use has contributed to my condition, thats no secret.

I'm trying to figure out what exactly altered so i can actually fix it.

And whats optimal for you may not be optimal for me. My free t3 has been in the gutter many times with numbers like 1.82, 2.3, 2.8, etc. My total has literally been as low as 60 and the highest its been without thyroid meds is 81.

This is the first blood test ive had without thyroid meds that actually had my t3 hit 3.

I'm going to get the results of my saliva cortisol exam. Maybe i have supoptimal cortisol or a neurotransmitter issue, time will tell.

PS its already been 3 years approaching 4 so idk how many more years i have to go lol

 

[Kazman]

I don’t think anyone can say “it’s not your thyroid.” Everyone is different even if your lab values are fine.
Unless I missed it I didn’t see you mention anything about DHEA and pregnenolone? Have you tried that route? That would be one of the first things I would try.

 

[BarryAllan]

I don’t think anyone can say “it’s not your thyroid.” Everyone is different even if your lab values are fine.
Unless I missed it I didn’t see you mention anything about DHEA and pregnenolone? Have you tried that route? That would be one of the first things I would try.

DHEA SULFATE 392 (85-690 mcg/dL)
PREGNENOLONE,LC/MS/MS 62 (22-237 ng/dL)

I've been and currently am supplementing with Pregnenolone but i havent felt any change really.

 

[Kazman]

DHEA SULFATE 392 (85-690 mcg/dL)
PREGNENOLONE,LC/MS/MS 62 (22-237 ng/dL)

I've been and currently am supplementing with Pregnenolone but i havent felt any change really.

Have you supplemented with DHEA? I know on paper your numbers look fine but I personally don’t get any benefits unless I take them together.
How much pregnenolone are you taking?

 

[BarryAllan]

Yup I've taken DHEA a couple of times before, even in conjunction with pregnenolone but nothing. At least not yet.

I'm taking 100mg pregnenolone per day.

 

[JimGainz]

I've been dealing with this since i came off in 2016. My only history is superdrol 250 at 20 back to back to back and recovered despite not knowing this was a good idea.

I got hit by a car in 2014, couldn't work out for 6 months and jumped on test in spring 2015. I felt a little off after coming off and stupidly took the advice of a fellow roid user who suggested i hop back and do another reset. Nothing has been the same since.

I've done multiple hcg restarts. In fact before i even began trt, these were my levels.

Bloodwork 03/20/2018:
Total T 772 (249-836) ng/dl
Free T 173 (30-150) pg/ml
Bio Available T 451 (72-460) ng/dl
LH 4.2 (1.7-8.6) mIU/ml
FSH 1.2 (1.5-12.4) mIU/ml
Prolactin 8.6 (4.0-15.2) ng/ml
E2 21.45 (7.02-49.06) pg/ml
SHBG 30 (10-57) nmol/l

My estrodial has been as low as 15 and as high as its been now and no change. I shoot up 500mg of test in a week and it doesn't the same nor the way it should.

from Jan 2016 to Sept 2017 I didn't touch anything! No supplements no AAS no Sarms not a single thing. I left my body alone hoping to recovery it and never did.

I've done hcg, clomid, nolva, & hgh. All which worked for a short period of time after i first introduced them to my body after my long lay off. They'd always stop working, I'd have my ED & Libido issues return and i can't figure out what exactly is going on with my body that it won't allow me to sustain successful recovery.

I never took Deca. Did experiment with tren for 1 month on the lowest possible dosage.

I do have history of mdma use so im wondering if that, in conjunction with AAS has depleted or altered some neurotransmitters in the brain.

I would come off test, but i can't function with out it really. I get REALLY fatigued and no energy or motivation for anything at all. Trying to do my job without being on trt is nearly impossible, i can't think as quickly or as clearly.

I got a script for wellbutrin and will start tomorrow. Fingers crossed.

Your pre TRT numbers look good.
My thoughts are that the AAS and other drugs have tweaked some of the dopamine receptors. I had a very similar experience back in 1989/1990 - it took me a long time (about a year) to recover - I was perfectly fine after that. They put me on anti-depressants and it made things worse. My advise is to make an appointment with Defy and they can go through additional tests and discuss options. I would do this before starting Wellbutrin because you don’t want to have to deal with another variable.

 

[BarryAllan]

Your pre TRT numbers look good.
My thoughts are that the AAS and other drugs have tweaked some of the dopamine receptors. I had a very similar experience back in 1989/1990 - it took me a long time (about a year) to recover - I was perfectly fine after that. They put me on anti-depressants and it made things worse. My advise is to make an appointment with Defy and they can go through additional tests and discuss options. I would do this before starting Wellbutrin because you don’t want to have to deal with another variable.

I've already spent $20k plus easily since 2017 to aid in my recovery. I'm currently working with the anabolic doc Thomas O'Connor and he was $1750 for the year. Even if i wanted to work with Defy, my pockets aren't going to be able to handle it at the moment.

And dude i dont know what more or how many more additional tests i could have. Any ideas since i get bloodwork in september?

I'm going to be taking an atypical anti depressant in bupropion which is a dopamine reuptake inhibitor. Trust me i dont want anything to do with SSRI's and i pray i can avoid using any dopamine agonist since I'm aware of DAWS.

I hope wellbutrin works for my libido, but if it doesn't or if its short lived, i hope i feel more energetic, social and alive. I wanna pursue my passions and career to the fullest. That'll help my bank account and ill be able to enlist more help in the future. I'm willing to leave the country in order to solve this if i have to.

I think it has to be the brain. If i never took MDMA then my recovery might've already happened. i do regret my festival partying days even before i believed my brain was the problem.

I dont know what more i can do for my body but I'll always keep researching and keeping an eye out for any new findings.

But i hope its as simple as taking wellbutrin and i can move on with my life.

 

[Kazman]

Finding a Doc you can trust and following everything they tell you can be the best thing for you.
I know myself and others get impatient and try to mess with everything we can trying to fix our issues because we didn’t have faith in our current doctors. Good luck and keep us updated man!

 

[BarryAllan]

took awhile but the anabolic doc is somebody i trust for sure!

I really think neurotransmitters, in particular dopamine, is the issue.

All i have is my faith, i pray every night that this nightmare will come to an end.

Should wellbutrin or other drugs work, ill def report back with my experiences

and thank you!

 

[Joe Sixpack]

I've already spent $20k plus easily since 2017 to aid in my recovery. I'm currently working with the anabolic doc Thomas O'Connor and he was $1750 for the year. Even if i wanted to work with Defy, my pockets aren't going to be able to handle it at the moment.

And dude i dont know what more or how many more additional tests i could have. Any ideas since i get bloodwork in september?

I'm going to be taking an atypical anti depressant in bupropion which is a dopamine reuptake inhibitor. Trust me i dont want anything to do with SSRI's and i pray i can avoid using any dopamine agonist since I'm aware of DAWS.

I hope wellbutrin works for my libido, but if it doesn't or if its short lived, i hope i feel more energetic, social and alive. I wanna pursue my passions and career to the fullest. That'll help my bank account and ill be able to enlist more help in the future. I'm willing to leave the country in order to solve this if i have to.

I think it has to be the brain. If i never took MDMA then my recovery might've already happened. i do regret my festival partying days even before i believed my brain was the problem.

I dont know what more i can do for my body but I'll always keep researching and keeping an eye out for any new findings.

But i hope its as simple as taking wellbutrin and i can move on with my life.

I would NOT take that wellbutrin. It is not supposed to have as many sexual side FX as a typical SSRI. But I can tell you from experience that it is a boner killer. I didn't have erection or orgasm problems before I took that drug. Stay away. Fortunately the side FX were not permanent.

I would also advise that you will likely be better off using Armour thyroid than just T3 alone. Armour has T3 and T4. Armour tends to give you a smoother ride than T3 alone.