Many overfixate on testosterone -the thyroid is just as important

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Hormetheus

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I am a final year med student and have been replacing my hormones for multiple years. I post this because I want to raise awareness that it is not just testosterone. One thing I frequently notice, is that many males are really fixating on testosterone (e.g. whether adding HCG or different doses of anastrozole would make a difference, etc.), however upon asking them about their body temperature, blood pressure, pulse, and other signs and symptoms, it is often evident, that they are deficient in thyroid or adrenal hormones.

Frequently, after discovering low testosterone levels, many males go on TRT and feel somewhat better. Often, however, their energy levels (and other symptoms) do not improve as they wished. Many then tend to raise their dosage of testosterone -often repeatedly. Doing this, some symptoms improve (e.g. energy, mood) and therefore to them, it seems obvious that they were still deficient and simply have not raised their dosage high enough. But if thyroid or adrenal hormones are deficient, injecting all the testosterone in the world, will not make someone feel (or function) much better. For example, both libido and body hair are two things generally ascribed to testosterone. But if levels of thyroid hormones or cortisol are low, libido will be as well, even if testosterone levels are high. The same holds for body hair.

Unfortunately, the overreplacement of any hormone is tempting because it might ”feel good” and does often indeed improve some symptoms (esp. energy levels). However, the overreplacement of any of the major hormones (e.g. cortisol, thyroid hormones, testosterone) will almost always improve energy levels and mood, which will almost always improve symptoms. Therefore, every single one of the major hormones can be (ab)used as a stimulant and “masking-agent”. However, over the long run any form of overreplacement -whether intentional or not- carries more risks than benefits and likely comes with a tradeoff of health and longevity in the future for an increase in wellbeing and performance in the present.

Instead of over-replacing and abusing a single hormone in high and unphysiological doses, it would be much healthier, safer, more natural, and more effective to add one or more other hormones in small and physiological doses.

While treating adrenals can be dangerous if not done properly, treating thyroid hormones is quite safe and easy to do (comparably speaking) and for many males, it can make a world of a difference and bring them back alive -sometimes even more than TRT.

Thyroid hormones are the most prescribed medication on the planet. Despite there being millions of people with thyroid issues, the vast majority of them are not treated adequately (i.e. in 99% of people T4 monotherapy is used). This holds back millions of people from living far better lives and from contributing what they otherwise could. In my opinion, the therapy of choice should follow this order:

NDT > T3/T4 > T4 > T3

What about dosage?


dosages needed vary widely depending on patient needs, cortisol levels, ability to derive T3 by deiodination, thyroid sensitivity, IGF1 levels, and esp. the endogenous residual output by the individual's own thyroid gland.
  • T4: 50mcg-200mcg (average: 120mcg; once per day)
  • NDT: 1–2.5 grains (average: 1.5 grains; twice per day)
  • T3: 40–80mcg T3 (average: 60mcg T3; split into at least 3 daily doses)
A reasonable, generic protocol to start thyroid replacement is the following:

Principle: Starting with 25% of the presumed target dose and then gradually increasing the dosage over a 2 month period.

Implementation: Starting out with 0.25 grains of NDT (or 20–25% of the presumed target dose) → increase by 0.25 grains every 14 days until the average target dose of 1.25 or 1.5 grains/day is reached (about 0.25 grains less in the summer).

I wrote an article on how to properly replace thyroid hormones and because this post is already quite long and there are many other topics to delve into, if you are interested you can read more on some of these topics:

How To Replace Thyroid Hormones - An Ultimate Guide
  • Improving thyroid hormones naturally
  • Thyroid hormones require adequate levels of cortisol
  • A low-carb diet can impair thyroid status at multiple levels
  • Why T4 is not the therapy of choice
  • Temporary use of high-dose T3 can reverse thyroid resistance
  • Permanent treatment with T3-only?
  • Dosage
  • Timing
  • How to start therapy
  • Thyroid treatment in individuals with low levels of cortisol

I hope you find value in it. If you have any questions, feel free to leave your questions below!
 
Defy Medical TRT clinic doctor
How long would you suggest taking test or thyroid before switching up something else?

I think about trying thyroid for my high reverse t3 but my shbg is high and cortisol is low.
 
It's getting more common now. When you get your testosterone checked, they will also run a complete thyroid panel. Many of the same symptoms, low T and thyroid issues.
 
I agree 100%.
Starting TRT was really only the beginning for me.
Once I got the adrenals fully good to go and thyroid dialed the change was far greater than when I first got on testosterone.
If your thyroid/adrenals are out of whack, getting those treated as well is a complete game changer.
 
I wonder what symptoms you may feel as a result of thyroid problems ?
I have been on trt for almost 1.5 to 2 years now but didn’t check cholesterol or thyroid I will do that in my next test.

however my energy mood and pretty much everything is really good of course except for libido which i am sure many have issues with.
 
 
NDT did me little good. I would barely get free T4 to the lower end of the range and free T3 would be in excess of the upper range. Basically, NDT has too much T3 and not enough T4 for my condition (Hashimotos). TSH remained elevated as a result.

My best results came when we started on levothyroxine only until we got free T4 in range and then adding in liothyronine to bring free T3 in range and overcome reverse T3. I feel best when free T4 is in the middle-to-upper part of the range and free T3 is just slightly elevated above the upper range. That's the only way I can get TSH to <= 2.0.

Amazing what happened once we finally got me "there" - my TPO antibodies reduced in half (still slightly elevated) with no changes other than the medication (gluten free diet, etc.).

Never once thought about the half life of T3 though. This is definitely something to consider
 
Thanks for this information. In Germany L-Thyorxin is more public then NDT (what i understood is mixed T3/T4).
But i think you can first of all check TSH, T3, T4 and start trying to get the bloodmarkers in a better range by choosing the right food, living a healthy, sportive lifestyle and supplementing things like 7-keto, selen, jodit, l-tyrosin (or l-dopa), vitamin b complex, zinc, vitamin d3+k2.

What do you think about this?
 
I agree 100%.
Starting TRT was really only the beginning for me.
Once I got the adrenals fully good to go and thyroid dialed the change was far greater than when I first got on testosterone.
If your thyroid/adrenals are out of whack, getting those treated as well is a complete game changer.
What have you done to dial in your cortisol? Was it low or high ?
 
NDT did me little good. I would barely get free T4 to the lower end of the range and free T3 would be in excess of the upper range. Basically, NDT has too much T3 and not enough T4 for my condition (Hashimotos). TSH remained elevated as a result.

My best results came when we started on levothyroxine only until we got free T4 in range and then adding in liothyronine to bring free T3 in range and overcome reverse T3. I feel best when free T4 is in the middle-to-upper part of the range and free T3 is just slightly elevated above the upper range. That's the only way I can get TSH to <= 2.0.

Amazing what happened once we finally got me "there" - my TPO antibodies reduced in half (still slightly elevated) with no changes other than the medication (gluten free diet, etc.).

Never once thought about the half life of T3 though. This is definitely something to consider
I'm self treating with NDT(my doctors know about it). At 3 grains(180mg)in one dose. Busts my never ending depression, but because of weight gain, ED and the depression, the consensus of my doctors is hypothalamus/pituitary dysfunction(common in people with bipolar illness). I will continue to slowly titrate and do labs.
 
I'm self treating with NDT(my doctors know about it). At 3 grains(180mg)in one dose. Busts my never ending depression, but because of weight gain, ED and the depression, the consensus of my doctors is hypothalamus/pituitary dysfunction(common in people with bipolar illness). I will continue to slowly titrate and do labs.
Not sure I have much to back up this but I have noticed taking 30-60mg of zinc has helped my conversion for T4 to T3. It is crazy all the things that go into running the body! also noticed getting my fasting insulin under 5 has seemed to help with a lot of things. I would also run a RT3 to know where you stand!
 
Not sure I have much to back up this but I have noticed taking 30-60mg of zinc has helped my conversion for T4 to T3. It is crazy all the things that go into running the body! also noticed getting my fasting insulin under 5 has seemed to help with a lot of things. I would also run a RT3 to know where you stand!
I have noticed similar things from selenium and zinc! They are certainly underrated when it comes to thyroid function.
 
Mine was chronically low.
Primarly used Adrenal Cortex in very similar ways to the way it's outlined in Stop The Thyroid Madness.
I'm using tiny oral doses...less than the size of a pea...of OTC hydrocortisone ointment. Previously, I'd used large amounts,(15 to 25 mg topically), because of what I'd read on stopthethyrodmadness.com. Didn't do any salivary cortisol testing. Now, just taking it in a way similar to what was recommended by Dr. William McK Jefferies, 'The Safe Uses of Cortisol'; small doses, 3X daily. Already stopped using nose spray for chronic nasal congestion. Been living with chronic stress/C-PTSD after bipolar relapse 16 years ago. Age here is 70. Still trying to stop and reverse physical decline.
 
I tried TRT in 2017 (underarm roll-on), my testosterone increased but my energy level did not improve. In 2018, my cortisol and prolactin levels were checked. I had very low cortisol (adrenal glands) of 1.6 at 9 AM and high prolactin (pituitary gland) 22.4. It seems over the several years on Reyataz these numbers / glands were affected. When I switched to another HIV drug, my prolactin returned to mid normal range. My cortisol still low. I am on 5 mg hydrocortisone tablet twice a day. It seems that the hydrocortisone has helped my energy level and my testosterone level.
 
Beyond Testosterone Book by Nelson Vergel
HC helps a lot of people. In fact, it is able to bring many people back to life when thyroid and testosterone are not able to. If I were you, I would split the HC into 4x 2.5mg

Edit: However, I should add that cortisone acetate is much safer than HC, because of its interaction with HSD-II (it needs to be activated instead of inactivated)
 
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