T3 / T4 Confusion

[permabulk]

Hey guys, looking for some insight on what direction my T3/T4 levels have my thyroid going. I've browsed some other threads here and I'm just really confused, apologies if I'm asking a stupid question.



Based on what I've read it sounds like I would be hypo? Currently on a bulk with a consistent caloric surplus and my weight doesn't budge at all. Happy to continue adding more calories, but if I'm hypo wouldn't that mean my metabolism is slow?

 

[mochul]

T3 uptake is useless. Test free t3
Hypo means your tsh should be high. You are in a good range so no you are not hypo.
Low t4 could be the result of high conversion to t3. Are you on hgh?

 

[permabulk]

T3 uptake is useless. Test free t3
Hypo means your tsh should be high. You are in a good range so no you are not hypo.
Low t4 could be the result of high conversion to t3. Are you on hgh?

Gotcha, thanks for this, I will add Free T3 to my next panel. Not on HGH, but should’ve included what I am running:

Test 800mg/wk
Deca 500mg/wk
Ment 25/mg day
Proviron 25mg/day

 

[Ghoul]

EDIT: "Central Hypothyroidism", ie, normal TSH low T4, is not covered in this treatment guide. Attaching another in a post below.



Rest of the guidance is here:

https://www.researchgate.net/profile/Md-Islam-661/publication/319347070_Hypothyroidism_-_A_New_View_On_An_Old_Disease/links/59d42e07aca2721f436ceac9/Hypothyroidism-A-New-View-On-An-Old-Disease.pdf

 

[Ghoul]

I'm going to preface this with: "If this were me I'd see a doctor first,". Based on those numbers, normal TSH and low T4, you have "Central Hypothyroidism", much rarer than "Primary Hypothyroidism", with numerous potentially serious causes, that should be evaluated. The other possibility is you're on something suppressing high TSH levels (that would normally indicate hypothyroidism) making it look normal, when, with low T4 TSH should be high.

If you're not going to see a doctor, in the spirit of harm reduction I'll say this. If nothing very serious is found, the usual treatment for this condition is T4 (levothyroxine) ONLY, without T3. Starting at a small dose, like 25mg/day, then recheck levels in a couple of weeks, and titrate up 25mg/day at a time until your T4 is in the upper 1/3 of the range.

Anyway, regardless of TSH, that T4 is hypothyroidism of one kind or another.

Like I said though, I'd get it checked out to eliminate any of the scary possibilities, but if you treat yourself, start with low dose T4 and keep getting levels checked a few weeks after each dose. Don't rush it and don't add T3, it could be very dangerous.

The diagnosis and management of central hypothyroidism in 2018 - PMC

Central hypothyrodism (CeH) is a hypothyroid state caused by an insufficient stimulation by thyrotropin (TSH) of an otherwise normal thyroid gland. Several advancements, including the recent publication of expert guidelines for CeH diagnosis and ...

pmc.ncbi.nlm.nih.gov

 

[permabulk]

View attachment 313508View attachment 313507

Rest of the guidance is here:

https://www.researchgate.net/profile/Md-Islam-661/publication/319347070_Hypothyroidism_-_A_New_View_On_An_Old_Disease/links/59d42e07aca2721f436ceac9/Hypothyroidism-A-New-View-On-An-Old-Disease.pdf

I'm going to preface this with: "If this were me I'd see a doctor first,". Based on those numbers, normal TSH and low T4, you have "Central Hypothyroidism", much rarer than "Primary Hypothyroidism", with numerous potentially serious causes, that should be evaluated. The other possibility is you're on something suppressing high TSH levels (that would normally indicate hypothyroidism) making it look normal, when, with low T4 TSH should be high.

If you're not going to see a doctor, in the spirit of harm reduction I'll say this. If nothing very serious is found, the usual treatment for this condition is T4 (levothyroxine) ONLY, without T3. Starting at a small dose, like 25mg/day, then recheck levels in a couple of weeks, and titrate up 25mg/day at a time until your T4 is in the upper 1/3 of the range.

Anyway, regardless of TSH, that T4 is hypothyroidism of one kind or another.

Like I said though, I'd get it checked out to eliminate any of the scary possibilities, but if you treat yourself, start with low dose T4 and keep getting levels checked a few weeks after each dose. Don't rush it and don't add T3, it could be very dangerous.

The diagnosis and management of central hypothyroidism in 2018 - PMC

Central hypothyrodism (CeH) is a hypothyroid state caused by an insufficient stimulation by thyrotropin (TSH) of an otherwise normal thyroid gland. Several advancements, including the recent publication of expert guidelines for CeH diagnosis and ...

pmc.ncbi.nlm.nih.gov

Really appreciate this info and you taking the time to break this down. I’m due for a GP visit soon so I will add this to my list.

I looked into central hypothyroidism and ironically I don’t have any of the symptoms listed. (Not doubting you, I know conditions can be totally asymptomatic) so I’m not going to rule it out based on that.

Aside from gear I don’t take any medication or have any other health conditions that I am aware of, so I’m really interested to find out what’s causing this.

Thanks again!

 

[Ghoul]

Really appreciate this info and you taking the time to break this down. I’m due for a GP visit soon so I will add this to my list.

I looked into central hypothyroidism and ironically I don’t have any of the symptoms listed. (Not doubting you, I know conditions can be totally asymptomatic) so I’m not going to rule it out based on that.

Aside from gear I don’t take any medication or have any other health conditions that I am aware of, so I’m really interested to find out what’s causing this.

Thanks again!

By all means doubt me, lol! I do, lol.

Like you said, it can be asymptomatic, and not much different from regular hypothyroidism, which is then treated with Levothyroxine like primary hypothyroidism would. But there are several low possibility, but serious things that should be eliminated first. You wouldn't want to mask things that might need to be addressed quickly with a "bandaid".

Whatever's going on, you've definitely discovered hypothyroidism, and once you're being properly treated for it I'm sure you're gong to feel much better, with a faster metabolism. Please keep us updated.

 

[Ghoul]

By the way, I would think carefully and have SOME symptoms related to hypothyroidism to report to the doctor(and as an explanation for getting the test done). Very often asymptomatic anything leads to a protracted period of doctors doing nothing.

 

[permabulk]

By the way, I would think carefully and have SOME symptoms related to hypothyroidism to report to the doctor(and as an explanation for getting the test done). Very often asymptomatic anything leads to a protracted period of doctors doing nothing.

Totally agree there, I’ll make sure to tell him I’m cold and tired all the time, LOL.

Also, one last thought I had and then I’ll stop speculating. Since I’m still finding it so hard to gain weight no matter how much I eat, I wonder if the gear is what has my metabolism cranked and if I were to be off it would come on faster due to the thyroid levels.

Anyway, just thinking out loud. I’ll keep the thread updated once I know more.