Thyroid Issue or Simple Low T? What tests next?

[LakeGuy81]

Guys--36 y/o male here, I was on TRT last year for 6-8 months but discontinued because anxiety got high and libido didn't seem improved. I have MANY symptoms of hypothyroidism, including being cold overall at times, cold feet, low body temps, poor appetite but I don't lose weight. It seems my metabolism has really slowed down the past 3-4 years. I'm wondering if my thyroid could be causing me T numbers to be low in the first place? What tests should I be running to start looking into this angle? My GP put "normal thyroid" by lab results just a couple weeks ago but I've heard TSH should be closer to 1? Labs and test dates below, these labs go back 5 years and show my TSH appears to be getting higher overtime. The labs are partial, because not everything was pulled on each date. NT=Not Tested

 

[DragonBits]

Guys--36 y/o male here, I was on TRT last year for 6-8 months but discontinued because anxiety got high and libido didn't seem improved. I have MANY symptoms of hypothyroidism, including being cold overall at times, cold feet, low body temps, poor appetite but I don't lose weight. It seems my metabolism has really slowed down the past 3-4 years. I'm wondering if my thyroid could be causing me T numbers to be low in the first place? What tests should I be running to start looking into this angle? My GP put "normal thyroid" by lab results just a couple weeks ago but I've heard TSH should be closer to 1? Labs and test dates below, these labs go back 5 years and show my TSH appears to be getting higher overtime. The labs are partial, because not everything was pulled on each date. NT=Not Tested

To me the biggest item missing is estrogen and SHBG, if they were tested you should include them. High E2 could have been the cause of your symptoms when you were under TRT.

For sure your TT is on the low side.

Your TSH is climbing, but the T3/T4 hormones still look good, I would test thyroid antibodies. It could be a future problem is developing.

Thyroglobulin antibody (ATA) -
Thyroid Peroxidase antibody (TPO) -

 

[OMI100]

If you feel that you may have thyroid issues here are 2 links to some great info on thyroid testing and what basic set of labs to get:
http://www.tiredthyroid.com/what-labs.html
and
All Thyroid Tests + What They Mean & How to Interpret Them

 

[Vince Carter]

I would point to Reverse T3 notably omitted the last two sets of labs you had. Your FT3 is very good, I think 3.9 is the lab range so it would indicated to me that the T3 isn't making it in to your cells; pooling.
When you rerun labs:
TSH
FT3
FT4
Reverse T3
Antibodies