Thinking about starting trt

[ivkonst2017]

Just curious as to why NOT to take the pill forms of vitamin b12?
I'll look into the other one and see if I can get it.
Yeah I do want to check the FT3 and FT4 but doctors here won't unless over 4.0 TSH, however maybe the clinic I went to will.
What was your T levels at again pre TRT? How has the TRT journey been so far any regrets (truthfully speaking) and has it resolved your symptoms?

First I think I want to try these T boosters a friend of mine is using, it took his T levels from 13.2 to 17.7nmol
He was using Tongkat Ali and Fadogia agrestis.
Might be worth a try. Maybe I can get my levels in the 18s or 19s lol. Could be wishful thinking, but seemed to work for my buddy.

Ive read data on Tongat Ali. It seems to help with lowering SHBG, but the effect is only temporarily. I think you are wasting time with t boosters but wont hurt to try them except wasting a bit of time.

Im very glad I started TRT. My SHBG was around 50 and total t moving from 13 to 19. Ive got issues and hard moments yes. Initially when I started the honeymoon was great but I had sleep issues. But the real hit came later when my levels on sub q injections that I started with dropped and I changed some protocols wasting months until I figured out sub q wasnt working any more for me amd I need to inject IM. Later I spend more time to find out only sustanon works for me. Now Im optimizing my thyroid.

But in the periods I was on sustanon despite everything else the quality of my life is way better. Im better at relationshops, at work and now Im thinking about starting some kind of business.

 

[Tgk_143]

Ive read data on Tongat Ali. It seems to help with lowering SHBG, but the effect is only temporarily. I think you are wasting time with t boosters but wont hurt to try them except wasting a bit of time.

Im very glad I started TRT. My SHBG was around 50 and total t moving from 13 to 19. Ive got issues and hard moments yes. Initially when I started the honeymoon was great but I had sleep issues. But the real hit came later when my levels on sub q injections that I started with dropped and I changed some protocols wasting months until I figured out sub q wasnt working any more for me amd I need to inject IM. Later I spend more time to find out only sustanon works for me. Now Im optimizing my thyroid.

But in the periods I was on sustanon despite everything else the quality of my life is way better. Im better at relationshops, at work and now Im thinking about starting some kind of business.

Thanks man I appreciate your honest feedback on your trt usage.
Maybe I'm getting this wrong or it could be something to do with your shbg when on trt, it seems like you've only improved your total test by 175ng/dl. I'm just surprised that would be enough to resolve symptoms. Maybe you could have benefited from T boosters as well as Boron to reduce shbg? But as you said it may only be temporary so I don't know lol.

How long have you been on trt? Have you considered compound creams? If I were to start I think I'd want to go with that first, If that wasn't going so well I'd probably do shallow IM as I've recently read people are loving it. Something to think about anyways I guess.

If I could get my levels near 18nmol with the test boosters I mentioned it wouldn't make much sense for me to go on trt would it?
That would be over 500ng/dl while you on trt are 548ng/dl. If of course it had lasting effects. Also i realize it's about symptom resolution as well. Dang This trt thing is complicated to say the least, lol.

 

[ivkonst2017]

Maybe I'm getting this wrong or it could be something to do with your shbg when on trt, it seems like you've only improved your total test by 175ng/dl

No, this was the zone in which my total t was moving pre TRT.

Now on TRT to feel optimal I maintain between 40 and 46nmol/l.

If I could get my levels near 18nmol with the test boosters I mentioned it wouldn't make much sense for me to go on trt would it?

Very unlikely this to cause enough difference.

Ive tried creams but they dont work well for me. I think the extra DHT caused me anxiety and even panic attacks.

If you ask me I would advise you to look at the thyroid before TRT. Maybe at the end you will need to fix both.

 

[Tgk_143]

No, this was the zone in which my total t was moving pre TRT.

Now on TRT to feel optimal I maintain between 40 and 46nmol/l.


Very unlikely this to cause enough difference.

Ive tried creams but they dont work well for me. I think the extra DHT caused me anxiety and even panic attacks.

If you ask me I would advise you to look at the thyroid before TRT. Maybe at the end you will need to fix both.

No, this was the zone in which my total t was moving pre TRT.

Now on TRT to feel optimal I maintain between 40 and 46nmol/l.


Very unlikely this to cause enough difference.

Ive tried creams but they dont work well for me. I think the extra DHT caused me anxiety and even panic attacks.

If you ask me I would advise you to look at the thyroid before TRT. Maybe at the end you will need to fix both.

Ok I see, that makes sense. So in your circumstance you have to be on the very high end if not more to resolve symptoms. Makes me wonder what your T was prior to having your symptoms that led to you taking trt.
I'd like to know what mine was before experiencing these symptoms would have had a better idea where I may need to be.
Well thats too bad you couldn't continue with the creams, hope I don't experience that issue if I decide to go with it.
But ya firstly ill look into the thyroid and if there is an issue try and fix that first and go from there.

 

[Systemlord]

Yeah I do want to check the FT3 and FT4 but doctors here won't unless over 4.0 TSH

It's a mistake to think thyroid hormones are sufficient just because TSH is in range. I've seen members with TSH levels <3.0 and have below range Free T3.

It boils down to how these doctors were trained.

 

[ivkonst2017]

Makes me wonder what your T was prior to having your symptoms that led to you taking trt

Ive also wondered, but I dont know.
And yet although many people think 46nmol/l is supraphysiological I dont agree to that. The reference ranges today are low because the average t levels of the general population have dropped significantly. When I walk on the street 90 percent of the men I see look overweight and soft. Thats the reference range we are looking at. I've seen bloodworks from 20 years ago where the range was up to 52nmol/l. Also often people that go to replacement need to take their levels higher to feel the same way as they would feel well on endogenous testosterone.

Well thats too bad you couldn't continue with the creams, hope I don't experience that issue if I decide to go with it.

Creams really dont work with anyone. Not everyone can handle elevated DHT. According to my practitioner issue would have guys with suboptimal progesterone. Also putting that cream 2 times a day and avoiding sex and sweating 2-3 hours after that seems a terrible overhead. 3 injections per week even IM are much better for me.

 

[ivkonst2017]

Yeah I do want to check the FT3 and FT4 but doctors here won't unless over 4.0 TSH, however maybe the clinic I went to will.

This speaks very poorly for these doctors and you cannot rely on them to fix your thyroid..Most managed care endocrinologists are INCOMPETENT in thyroid and TRT.

Even if they put you on thyroid treatment they will put you on levothyroxine(t4 monotherapy) which is GARBAGRE.

The only good types of thyroyd therapy include t4 and t3. There are two options - natural dessicated thyroid or synthetic t4/t3 combo. According to my practitioner NDT is handled better by most people escpecially some like me whose hormones are not outside the range. My FT3 was in the middle of the range and I had symptoms. The average doctor will tell you you are fine in that case.

Also when these doctors start treatment they wont dare to raise FT3 at the top of the range to optimize you because for some patients this means crashing TSH. They are affraid of that because they have been taught wrong.

The interesting thing with thyroid is some patients ot thyroid hormones wont shut down own production if they take both hormones. The chance to shut down reduces with NDT. However some need to get shut down and crash TSH to optimize FT3.

For NDT there are supplement forms that are as powerful as the pharmaceuticals. In USA this is the brand Ancestral Supplements. Here in Europe I take Nutriest from Estonia that was recommended to me. I havent yet done bloodwork but since Im taking it especially after I hit week 2 I have way more energy I even feel too stimulated on 1 grain only which means the supplement is high quality and contains the necessary thyroid hormones.

On thyroid you do blood work and evaluate symptoms on 6 weeks and raise the dose if necessary.

 

[Tgk_143]

It's a mistake to think thyroid hormones are sufficient just because TSH is in range. I've seen members with TSH levels <3.0 and have below range Free T3.

It boils down to how these doctors were trained.

Yeah I'm not sure why they would just rely on TSH if that's the case. Just so I know what are good ranges to be in when looking at T3 and T4 ?

 

[Tgk_143]

This speaks very poorly for these doctors and you cannot rely on them to fix your thyroid..Most managed care endocrinologists are INCOMPETENT in thyroid and TRT.

Even if they put you on thyroid treatment they will put you on levothyroxine(t4 monotherapy) which is GARBAGRE.

The only good types of thyroyd therapy include t4 and t3. There are two options - natural dessicated thyroid or synthetic t4/t3 combo. According to my practitioner NDT is handled better by most people escpecially some like me whose hormones are not outside the range. My FT3 was in the middle of the range and I had symptoms. The average doctor will tell you you are fine in that case.

Also when these doctors start treatment they wont dare to raise FT3 at the top of the range to optimize you because for some patients this means crashing TSH. They are affraid of that because they have been taught wrong.

The interesting thing with thyroid is some patients ot thyroid hormones wont shut down own production if they take both hormones. The chance to shut down reduces with NDT. However some need to get shut down and crash TSH to optimize FT3.

For NDT there are supplement forms that are as powerful as the pharmaceuticals. In USA this is the brand Ancestral Supplements. Here in Europe I take Nutriest from Estonia that was recommended to me. I havent yet done bloodwork but since Im taking it especially after I hit week 2 I have way more energy I even feel too stimulated on 1 grain only which means the supplement is high quality and contains the necessary thyroid hormones.

On thyroid you do blood work and evaluate symptoms on 6 weeks and raise the dose if necessary.

Thanks I really appreciate the info, I'll look into that NDT medication if there is something that needs to be done about thyroid, I'm assuming it's still a replacement therapy and has to be taken long term? What is your opinion on optimal level ranges for T3 and T4 ? It would be nice to see my energy improve, even though it's libido thats really tearing me apart lol.

 

[ivkonst2017]

Thanks I really appreciate the info, I'll look into that NDT medication if there is something that needs to be done about thyroid, I'm assuming it's still a replacement therapy and has to be taken long term? What is your opinion on optimal level ranges for T3 and T4 ? It would be nice to see my energy improve, even though it's libido thats really tearing me apart lol.

Yes this is a replacement therapy and even if it doeasnt shut you down should be taken long term. So thats why I said first to check the mineral deficiencies but with such TSH no doubt you have some form of hypothyroidism that is either with or without Hashimoto. However we dont know to what extend because the most important thyroid reading is unknown.

The optimal FT4 level is not clearly known and not so important as the optimal FT3 level which should be around top of the range. Yes some people may feel good with less, but its generally like testosterone - everyone needs different amount but if you have midrange values(not low) and have symptoms most likely you will benefit to some degree from raising it. Some guys or women on thyroud treatment even need to put the FT3 above the range to get full symptoms relief.

Libido can be either from thyroid or testosterone or both together. Its better in such cases to start fixing first what looks worse. So far in your case there is a good chance that is the thyroid but the data is very little.

 

[Tgk_143]

Yes this is a replacement therapy and even if it doeasnt shut you down should be taken long term. So thats why I said first to check the mineral deficiencies but with such TSH no doubt you have some form of hypothyroidism that is either with or without Hashimoto. However we dont know to what extend because the most important thyroid reading is unknown.

The optimal FT4 level is not clearly known and not so important as the optimal FT3 level which should be around top of the range. Yes some people may feel good with less, but its generally like testosterone - everyone needs different amount but if you have midrange values(not low) and have symptoms most likely you will benefit to some degree from raising it. Some guys or women on thyroud treatment even need to put the FT3 above the range to get full symptoms relief.

Libido can be either from thyroid or testosterone or both together. Its better in such cases to start fixing first what looks worse. So far in your case there is a good chance that is the thyroid but the data is very little.

You know I really wish doctors were more easy going about doing proper tests and weren't so damn ignorant about it. I asked my doctor today about running a test on my thyroid and he said there was no need for more tests and I shouldn't be concerned with those levels.

So I might have to pay for bloods myself again to get them checked, hopefully this Telemedicine clinic in Canada will do it. Looks like I got some searching around to do.

The thyroid medication is it in pill forms ?

Well if I can manage to get more blood tests done I will be sure to post them.

 

[ivkonst2017]

The thyroid medication is it in pill forms ?

all are in pills yes

 

[Tgk_143]

all are in pills yes

So I got my recent bloods back and i had free t3 drawn came out to 5.6pmol so seems not too bad. TT is 14.6nmol and FT is 278pmol. Dheas is 5.5umol
CRP was at 18mg/l ref range is <8 so it looks pretty darn high and I fasted for 13 hours and ate pretty healthy so not sure what that's about.

 

[ivkonst2017]

So I got my recent bloods back and i had free t3 drawn came out to 5.6pmol so seems not too bad. TT is 14.6nmol and FT is 278pmol. Dheas is 5.5umol
CRP was at 18mg/l ref range is <8 so it looks pretty darn high and I fasted for 13 hours and ate pretty healthy so not sure what that's about.

What is the range for FT3? There is no "not too bad there". Its like testosterone - if the value is not at the top of the range and specific symptoms are present optimization should be considered

CRP can be from many things. As a start what is your body composition and forget me that I dont remember your SHBG?

 

[Tgk_143]

What is the range for FT3? There is no "not too bad there". Its like testosterone - if the value is not at the top of the range and specific symptoms are present optimization should be considered

CRP can be from many things. As a start what is your body composition and forget me that I dont remember your SHBG?

The ref range for FT3 is 3.5-6.5pmol.
Ref range for Free T is 176-700pmol.

My body fat is around 18% the last time I checked was about 3 months ago. They never checked my shbg and I don't think they ever will they say it's not necessary so I don't know.

Ok so the CRP is nothing really to worry about than?

 

[ivkonst2017]

The ref range for FT3 is 3.5-6.5pmol.
Ref range for Free T is 176-700pmol.

My body fat is around 18% the last time I checked was about 3 months ago. They never checked my shbg and I don't think they ever will they say it's not necessary so I don't know.

Ok so the CRP is nothing really to worry about than?

CRP is important lf course and thats why I asked initially for SHBG and body fat level as a beginning. People with metabolic syndrom and obesity often have elevated CRP which seems is not your case. There are many factors that can be attributed to CRP. Its either some systemic inflation or something temporarily like a recent ilness.

The fact they dont want to test SHBG is a huge red flag. This is your most important hormone that can give big clues how to structure your protocol and what issues you may expect. Also its a good marker for metabolic health.

 

[Tgk_143]

CRP is important lf course and thats why I asked initially for SHBG and body fat level as a beginning. People with metabolic syndrom and obesity often have elevated CRP which seems is not your case. There are many factors that can be attributed to CRP. Its either some systemic inflation or something temporarily like a recent ilness.

The fact they dont want to test SHBG is a huge red flag. This is your most important hormone that can give big clues how to structure your protocol and what issues you may expect. Also its a good marker for metabolic health.

Yeah I figured it was a red flag too but I don't have many options if I want to start trt, so I've been going with a clinic that goes by Free Testosterone rather than total.
So I have a question about Free T, my recent blood test came back at 278pmol which correct me if I'm wrong is 21.5ng/dl and if that is the case than it seems like it's in a good range as I'm comparing to some people on trt that aren't even that high??
The ref range is 176-700pmol, I'm only about 100 points up from being under their "ranges" and I listened to a podcast saying a good range for Free T is from 25-30ng/dl.

I guess I should probably just give up on this trt idea hey?

 

[ivkonst2017]

Yeah I figured it was a red flag too but I don't have many options if I want to start trt, so I've been going with a clinic that goes by Free Testosterone rather than total.
So I have a question about Free T, my recent blood test came back at 278pmol which correct me if I'm wrong is 21.5ng/dl and if that is the case than it seems like it's in a good range as I'm comparing to some people on trt that aren't even that high??
The ref range is 176-700pmol, I'm only about 100 points up from being under their "ranges" and I listened to a podcast saying a good range for Free T is from 25-30ng/dl.

I guess I should probably just give up on this trt idea hey?

The testing methods of free on most places are very innacurate.
Having "normal" values of free or total t doesnt mean you wont respond positive to treatment, there are a lot of such examples.

Total t of 419 is pretty low in what Ive seen in most folks, we dont know your SHBG and we have some free t that we dont know how is measured. But knowing how the reference ranges are obtained this free t seems pretty low in the range, you said the range is up to 700, right?

 

[Tgk_143]

The testing methods of free on most places are very innacurate.
Having "normal" values of free or total t doesnt mean you wont respond positive to treatment, there are a lot of such examples.

Total t of 419 is pretty low in what Ive seen in most folks, we dont know your SHBG and we have some free t that we dont know how is measured. But knowing how the reference ranges are obtained this free t seems pretty low in the range, you said the range is up to 700, right?

Yup that's what doesn't make sense to me, the ref ranges are 175-700pmol and I'm sitting at 278.
While many people on trt, doing the conversion to ng/dl are lower than I am.

Could be the way the lab tests for it I'm not sure.

Supposedly my doctor wants to send me to an Endo but was kind of getting some mixed messages as in "well I already know what he's going to say so let me do some digging and I'll get back to ya" lol

 

[Tgk_143]

Good place for starting TRT

I thought so too, until I found out they don't test for TT at all, and they don't test shbg. I don't have much to work with here in alberta. Lol