Sexual Symptoms from High RT3?

[TRicker]

I've asked this in another thread, but wondered if others have experienced this with thyroid meds and high RT3.

My main question is, has anyone experienced sexual symptoms from high RT3? My main complaints are ED, lack of sensitivity, and severe delayed ejaculation. I've also had some recent fat gain despite dieting, which I attribute to the high RT3.
I know high RT3 can cause hypothyroid symptoms, and hypothyroidism can cause hypogonadism in natural men. But can high RT3 cause sexual symptoms in men on TRT? Or has anyone experienced any of these symptoms from thyroid medications themselves? I know @Anonymon experienced similar problems from T3 meds.


Thyroid Labs:
TSH: 1.7 (.45 - 4.5)
T4 Free: 1.36 (.82 - 1.77)
T3 Free: 3.5 (2 - 4.4)
Reverse T3: 25 (9.2 - 24.1)

Other Labs:
Total T: 600 (trough)
SHBG: 17 (low from TRT, it goes up when not on TRT)
E2 Sensitive: 25
Iron: 145 (Range 38-169)
TBIC: 318 (Range 250-450)
Ferritin: 110 (Range 30-400)
Prolactin: 7 (4-15)
Progesterone: .3 (0-.5)
Pregnenolone: <10 (Range Unknown)
Cortisol 4-Point Salivary Test: In range and close to optimal

I've tried 25mcg of T3 per day for two weeks, followed by 50mcg's per day for two weeks with no noticeable change. I went up to 75mcg's per day, but I felt jittery, nauseous, and had a rapid rate.
Perhaps I need to be on thyroid meds longer? I also don't want to become dependent on thyroid meds for life by trying to reduce RT3, unless it is necessary. I've also experimented with different test dosages, hcg/no hcg, ai/no ai, etc.

I still don't know what's causing the high RT3, and have had a 4-point saliva cortisol test with normal results (I definitely thought my cortisol would be sky high from stress, but it was normal and well within all ranges). My Doctor does not think the High RT3 is iron or ferritin related. He also stated that if it was inflammation related, my ferritin would be higher.

Any thoughts or input is appreciated!

 

[tareload]

RT3 seems to have taken on a religious or mythical status. Here's some info in case it may be of interest:

DESSICATED THYROID CONTINUES HAVING ZERO EFFECT ON TSH; ELEVATED FT3, NORMAL FT4

As I indicated in my post, I have already experimented with every possible combination, including adding T3 in various doses, over the last 10+ years. The only instance in that time frame I sufficiently suppressed was when I took T4 alone, go figure, but I wasn't able to maintain it for whatever...

www.excelmale.com

Cliff's Notes...it ain't the RT3.

 

[Vince]

To keep my reverse t3 below 15 I take tiromel. I’d buy tiromel 25mcg (T3) from India. It’s very easy to cut into quarters, that’s why I buy it. The cost is $42 for 100 tablets. Very reasonable.

 

[DixieWrecked]

@Vince I read your thyroid thread a long time ago and found it fascinating. It was a long time ago though. Did you have high reverse t3 and treated it with tiromel? If so what symptoms did you have? I know nowadays you are feeling great.

 

[Vince]

@Vince I read your thyroid thread a long time ago and found it fascinating. It was a long time ago though. Did you have high reverse t3 and treated it with tiromel? If so what symptoms did you have? I know nowadays you are feeling great.

The main reason I treated my thyroid was for good LDL levels. The thyroid does so many things for our body, energy, good libido, and good cholesterol panels. My may concern is always my health.

 

[DixieWrecked]

The main reason I treated my thyroid was for good LDL levels. The thyroid does so many things for our body, energy, good libido, and good cholesterol panels. My may concern is always my health.

Was you issue low T3 or elevated RT3?

 

[Vince]

Was you issue low T3 or elevated RT3?

Everything was in the low range. But my reverse t3 was high and I try to keep it below 15.

 

[Gman86]

Everything was in the low range. But my reverse t3 was high and I try to keep it below 15.

So u take 6.25mg of T3 everyday upon waking on an empty stomach?

No negative sides from taking it that u’ve noticed?

What was ur RT3 level prior to taking the T3? And where does it usually hover currently on the 6.25mg of T3/ day?

 

[Vince]

So u take 6.25mg of T3 everyday upon waking on an empty stomach?

No negative sides from taking it that u’ve noticed?

What was ur RT3 level prior to taking the T3? And where does it usually hover currently on the 6.25mg of T3/ day?

I take 90 mg. Of armor along with my 6.25 MCG of t3. I take another dose of t3 6.25 MCG on an empty stomach around 2:00 p.m. It took by reverse t3 of 25 now below 15. It changes some every lab I get. But it stays below. 15.

 

[Systemlord]

My main complaints are ED, lack of sensitivity, and severe delayed ejaculation.

I found only very frequent dosing restored my erections, orgasm quality as well as sensitivity. Dosing 1-2x weekly at any T level and everything was just meh.

What is your TRT protocol/injection frequency?

 

[TRicker]

What is your TRT protocol/injection frequency?

I've tried combos of 80mg-160mg of cypionate 1x,2x, and 3x per week, subq and IM, hcg or no hcg, ai and no ai. Right now I'm on 160mg per week (split mon/thur), and hcg.
I started TRT 8 years ago on the typical clinic protocol of 200mg/week, with hcg and ai, and I felt better than I do now.

Ever since I did my 5 month enclomiphene trial that ended last November, nothing is working. I think @Cataceous mentioned elsewhere that perhaps something changed in me from 5 months of enclomiphene, and things aren't working like they used to.

 

[Systemlord]

I've tried combos of 80mg-160mg of cypionate 1x,2x, and 3x per week, subq and IM, hcg or no hcg, ai and no ai. Right now I'm on 160mg per week (split mon/thur), and hcg.
I started TRT 8 years ago on the typical clinic protocol of 200mg/week, with hcg and ai, and I felt better than I do now.

Ever since I did my 5 month enclomiphene trial that ended last November, nothing is working. I think @Cataceous mentioned elsewhere that perhaps something changed in me from 5 months of enclomiphene, and things aren't working like they used to.

I think the reason you're still having problems is your dosages are too large. You really need to think about daily dosing, much smaller doses or at least Jatenzo @ 237 mg twice daily.

A new oral testosterone undecanoate therapy comes of age for the treatment of hypogonadal men​

 

[TRicker]

I think the reason you're still having problems is your dosages are too large

I've titrated down to 80mg/week in split doses, which didn't work out too well.
I've also looked into Jatenzo, but my insurance won't cover it, and is unaffordable without insurance.

 

[Vince]

Sexual dysfunction refers to any problem that affects your desire for or enjoyment of sex. In men, low thyroid levels can cause several different types of sexual dysfunction.

Some studies report that about 60% of men with hypothyroidism have low libido (sexual desire), erectile dysfunction, or delayed ejaculation. Premature ejaculation is much less common, affecting about 7% of men. Hypothyroidism has also been shown to affect semen quality and is associated with lower sperm count, form, and movement. These factors could potentially lower fertility.

https://www.goodrx.com/conditions/hypothyroidism/hypothyroidism-in-men-symptoms-causes-treatments

 

[DixieWrecked]

Sexual dysfunction refers to any problem that affects your desire for or enjoyment of sex. In men, low thyroid levels can cause several different types of sexual dysfunction.

Some studies report that about 60% of men with hypothyroidism have low libido (sexual desire), erectile dysfunction, or delayed ejaculation. Premature ejaculation is much less common, affecting about 7% of men. Hypothyroidism has also been shown to affect semen quality and is associated with lower sperm count, form, and movement. These factors could potentially lower fertility.

https://www.goodrx.com/conditions/hypothyroidism/hypothyroidism-in-men-symptoms-causes-treatments

Thanks for that good info. My thyroid panel looks like this....

Tsh: 2.23
RT3: 20.2
FT3: 3.6

Wonder if my RT3 is causing me problems

 

[Systemlord]

I've also looked into Jatenzo, but my insurance won't cover it, and is unaffordable without insurance.

I had treatment failure for 4 years on topicals and injections, my doctor gave me a medical exception that would get my insurance to cover it, otherwise insurance would have denied Jatenzo.

Have you contacted Jatenzo to see what assistance they can provide to make it more affordable?

 

[TRicker]

Some studies report that about 60% of men with hypothyroidism have low libido

Thanks Vince!
I guess the true question is: do my thyroid labs tell me that I need treatment?
I believe @DixieWrecked is asking the same question.
My endo says no, the primary is unsure, and the TRT clinic says "go ahead and try it"..LoL
The endo does not even test RT3 and they said it is irrelevant, which goes along with what @readalot was mentioning.

 

[tareload]

Thanks Vince!
I guess the true question is: do my thyroid labs tell me that I need treatment?
I believe @DixieWrecked is asking the same question.
My endo says no, the primary is unsure, and the TRT clinic says "go ahead and try it"..LoL
The endo does not even test RT3 and they said it is irrelevant, which goes along with what @readalot was mentioning.

Everyone keeps asking the question until they get the answer they want to hear. Great job asking around and reporting answers!

You will also get that story that Endocrinologists don't know what they are talking about.

Outside of inpatient care or euthyroid sick syndrome RT3 doesn't tell you anything. Your panel above looks great. I hope you get to the bottom of your symptoms.

Funny story... I have moved my RT3 from 28 to 5 (same ref range you posted above) in methodical steps with exogenous lipthyronine dosing in the past. Did not help my symptoms at all. Live and learn.

 

[sibuk]

This doctor deals with thyroid may be helpful?