Discouraged with TRT continuation part 2

[Gunner@1911]

So with the continuing saga of whether or not to remain on TRT.
I just had a blood panel last week and this is what was ordered by my doc.
Testosterone, Free
Normal value 3.87-14.7 ng/dl
My value 19.6
Testosterone, total
Normal value 240-950 ng/dl
My value 525
Sex Hormone Bind GLB
Normal value 14-82 nmol/L
My value 19
TSH
Normal range .358-3.740 miU/L
My value 4.712 (This value has always been high my whole life)

I am doing 100mg cypionate once a week sub Q injections.

I realize this is limited information but I am self pay and uninsured so cost is very important.

Any opinions on what I have provided? I also had a complete Lipid panel and Metabolic panel done and everything there was within all limits.

Any advice is appreciated. Dave

 

[Systemlord]

Any opinions on what I have provided? I also had a complete Lipid panel and Metabolic panel done and everything there was within all limits.

Any advice is appreciated. Dave

Newcomers that aren’t familiar with your previous threads may not understand what is the problem?

I think you need to focus on what is causing the elevated TSH, it just can’t be ignored anymore.

Perhaps a trial of thyroid hormone therapy.

 

[davidandrade]

Systemlord is spot on. Your TSH seems a bit high. You should get a TPO antibody test to check for Hashimoto's Disease. You also want to check your Free T3 and Free T4 hormone levels and make sure they are at least in the middle of the normal range. Low thyroid levels can definitely make you feel crumby.

 

[Gunner@1911]

Newcomers that aren’t familiar with your previous threads may not understand what is the problem?

I think you need to focus on what is causing the elevated TSH, it just can’t be ignored anymore.

Perhaps a trial of thyroid hormone therapy.

Systemlord,
I have always been under the impression that if someone started thyroid hormone therapy it was a lifelong med that can't be stopped?
Am I incorrect on that?

 

[Systemlord]

I have always been under the impression that if someone started thyroid hormone therapy it was a lifelong med that can't be stopped?

You can stop any hormone therapy anytime you wish, you may not feel good though. If your thyroid isn’t getting the job done anymore, then it doesn’t matter.

 

[Gunner@1911]

You can stop any hormone therapy anytime you wish, you may not feel good though. If your thyroid isn’t getting the job done anymore, then it doesn’t matter.

Thank you for that info. I am incorrect in what I thought about it.
So basically there is no downside to a possible thyroid therapy IF my thyroid isn't doing its job now?

 

[Cataceous]

...
So basically there is no downside to a possible thyroid therapy IF my thyroid isn't doing its job now?

There's the little issue of longevity. Low-normal looks to be better.

There was a J-shaped association of FT4 with cardiovascular disease and mortality. Low concentrations of TSH were associated with a higher risk of all-cause mortality and cardiovascular disease mortality. The 20–40th percentiles of FT4 and the 60–80th percentiles of TSH could represent the optimal healthy ranges of thyroid function based on the risk of cardiovascular disease and mortality...​

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(23)00227-9/abstract

 

[RobRoy]

So with the continuing saga of whether or not to remain on TRT.
I just had a blood panel last week and this is what was ordered by my doc.
Testosterone, Free
Normal value 3.87-14.7 ng/dl
My value 19.6
Testosterone, total
Normal value 240-950 ng/dl
My value 525
Sex Hormone Bind GLB
Normal value 14-82 nmol/L
My value 19
TSH
Normal range .358-3.740 miU/L
My value 4.712 (This value has always been high my whole life)

I am doing 100mg cypionate once a week sub Q injections.

I realize this is limited information but I am self pay and uninsured so cost is very important.

Any opinions on what I have provided? I also had a complete Lipid panel and Metabolic panel done and everything there was within all limits.

Any advice is appreciated. Dave

Just a thought here, but since you obviously have no confidence in your present doctor, Have you ever thought of actually consulting with an expert in the field instead of trying to get advice from men on forms of which you know nothing about. Sounds like a really smart thing to do. If one of your family members gets cancer, are you going to go to a specialist or are you going to go to a forum for advice on how to get that cancer treated in the best possible way?

 

[Guided_by_Voices]

There's the little issue of longevity. Low-normal looks to be better.

There was a J-shaped association of FT4 with cardiovascular disease and mortality. Low concentrations of TSH were associated with a higher risk of all-cause mortality and cardiovascular disease mortality. The 20–40th percentiles of FT4 and the 60–80th percentiles of TSH could represent the optimal healthy ranges of thyroid function based on the risk of cardiovascular disease and mortality...​

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(23)00227-9/abstract

There was no discussion in the study about interaction with symptoms. I find it hard to believe that if supplementing thyroid relieved symptoms typical of low thyroid such as lethargy, excess fat, depression, CVD risk etc. that that wouldn't result in longer life, or at least a happier life of at least the same length. And/or perhaps TSH is indicative of something else. This doesn't seem like good evidence to discourage someone from experimenting.

 

[RobRoy]

There was no discussion in the study about interaction with symptoms. I find it hard to believe that if supplementing thyroid relieved symptoms typical of low thyroid such as lethargy, excess fat, depression, CVD risk etc. that that wouldn't result in longer life, or at least a happier life of at least the same length. And/or perhaps TSH is indicative of something else. This doesn't seem like good evidence to discourage someone from experimenting.

You are very insightful and presenting this study as what occurs when someone takes thyroid versus what occurs when you have a low TSH and high T4 at baseline is incorrect. A baseline observation cannot be extrapolated to what occurs when a person takes thyroid. What is going on with this baseline observation? Well it’s of course people with true hyperthyroidism. What happens when we actually give people thyroid and decrease their TSH and raise their free T3 well in no study did it cause increased morbidity or mortality. Thyroid has been used for over 100 years now. So what you have intuitively picked up on is the difference between a baseline observation and what happens when we actually give someone thyroid. Taking thyroid does not cause the same sequela as true hyperthyroidism because there’s an auto immune component that does the damage and hyperthyroidism that is not present when you take thyroid. This is a real problem with extrapolating the harm from baseline observations to what actually occurs when you take hormones like testosterone or thyroid.

 

[Gunner@1911]

Just a thought here, but since you obviously have no confidence in your present doctor, Have you ever thought of actually consulting with an expert in the field instead of trying to get advice from men on forms of which you know nothing about. Sounds like a really smart thing to do. If one of your family members gets cancer, are you going to go to a specialist or are you going to go to a forum for advice on how to get that cancer treated in the best possible way?

RobRoy,

Thank you for the response.

Just to be clear, I am in the process of finding another doc! As far as finding a specialist in my area? Quite simply its just not that simple since the nearest specialist from me is an hour and a half away! The other issue is Im self employed therefore self pay therefore cost is an issue!

I do not use these forums to diagnose my problems I use them to educate myself and see what has worked for other people to get ideas on a possible solution! This information helps me to go to my doc and get them thinking about a possible solution.

To answer your question about a family member getting cancer, You can be assured I would use every asset at my disposal to gain as much information as I had available and yes that would include forums of this type.

Any information good or bad is still educational!

If somehow my posts have irritated or offended you then I would respectfully request you just move on and ignore them.

 

[RobRoy]

RobRoy,

Thank you for the response.

Just to be clear, I am in the process of finding another doc! As far as finding a specialist in my area? Quite simply its just not that simple since the nearest specialist from me is an hour and a half away! The other issue is Im self employed therefore self pay therefore cost is an issue!

I do not use these forums to diagnose my problems I use them to educate myself and see what has worked for other people to get ideas on a possible solution! This information helps me to go to my doc and get them thinking about a possible solution.

To answer your question about a family member getting cancer, You can be assured I would use every asset at my disposal to gain as much information as I had available and yes that would include forums of this type.

Any information good or bad is still educational!

If somehow my posts have irritated or offended you then I would respectfully request you just move on and ignore them.

If You're serious about making your problem better then instead of spending time on a forum trying to educate yourself from the uneducated then maybe you should get a second job and hire an expert and then everything will be good. And there's no way in hell that you're gonna make me believe that if your Close family member such as a wife or child got cancer the first thing you're gonna do is go to a forum. No you're going to seek out the best care available no matter what the cost more than likely. You'll get a second job if it requires that to get their health taken care of. So you get out of all this what you're willing to put into it. You do realize that it's a significant minority of men that have problems on testosterone don't you? And the ones that all had problems are the ones that migrate to the forums. All of the problems could've been avoided if they would've gone to a specialist in the beginning. What you find is that many men want free advice and that is why they go to forums and the other issues that you see quite a bit of is that men are trying to treat non-testosterone related issues with testosterone. They are treating their underlying psychiatric disorders with hormones and it doesn't work out very well. It's not that they're crazy they have true mental health issues that need to be addressed and hormones are not going to fix it and they are the ones with most of the problems.
And lastly, "any information good or bad still educational" are you serious?

So why don't you just continue with your "continuing saga" instyread of taking some good advice

 

[Cataceous]

There was no discussion in the study about interaction with symptoms. I find it hard to believe that if supplementing thyroid relieved symptoms typical of low thyroid such as lethargy, excess fat, depression, CVD risk etc. that that wouldn't result in longer life, or at least a happier life of at least the same length. And/or perhaps TSH is indicative of something else. This doesn't seem like good evidence to discourage someone from experimenting.

There's a lot more than the one study supporting the premise that higher thyroid hormone levels reduce longevity. For example, I cited other studies here:

A recent large study by Collet et al. pooled individual data from 10 prospective cohort studies and concluded that endogenous subclinical hyperthyroidism is associated with increased risks of total and IHD mortality, and incident AF, with highest risks of IHD mortality and AF when TSH level is lower than 0.10 mIU/litre. [R]​

​

In this study, we found that people with low–normal thyroid function (i.e., highest tertile of TSH and lowest tertile of FT4 reference ranges) are expected to live more years with and without NCD than those with high–normal thyroid function (i.e., lowest tertile of TSH and highest tertile of FT4reference ranges). [R]​

​

An age-related subtle thyroid hypofunction appears to be related to human longevity. ...​

In conclusion, evidence from experimental studies clearly suggests that reduced [thyroid hormone] levels may prolong lifespan. [R]​

In this post @FunkOdyssey argues that animal models show the effect without any confounding effects of underlying dysfunction.

Moreover, it has been also shown that experimental hypothyroidism increased the lifespan of Wistar rats up to 28 months, while experimental hyperthyroidism reduced lifespan. ​

 

[RobRoy]

There's a lot more than the one study supporting the premise that higher thyroid hormone levels reduce longevity. For example, I cited other studies here:

A recent large study by Collet et al. pooled individual data from 10 prospective cohort studies and concluded that endogenous subclinical hyperthyroidism is associated with increased risks of total and IHD mortality, and incident AF, with highest risks of IHD mortality and AF when TSH level is lower than 0.10 mIU/litre. [R]​

​

In this study, we found that people with low–normal thyroid function (i.e., highest tertile of TSH and lowest tertile of FT4 reference ranges) are expected to live more years with and without NCD than those with high–normal thyroid function (i.e., lowest tertile of TSH and highest tertile of FT4reference ranges). [R]​

​

An age-related subtle thyroid hypofunction appears to be related to human longevity. ...​

In conclusion, evidence from experimental studies clearly suggests that reduced [thyroid hormone] levels may prolong lifespan. [R]​

In this post @FunkOdyssey argues that animal models show the effect without any confounding effects of underlying dysfunction.

Moreover, it has been also shown that experimental hypothyroidism increased the lifespan of Wistar rats up to 28 months, while experimental hyperthyroidism reduced lifespan. ​

These are baseline observations. You can't extrapolate what occurs at baseline to what occurs when you actually give someone thyroid and raise their thyroid levels and decrease their TSH level. So what we need is an interventional study. We need to give people thyroid and see if it decreases longevity. Well guess what it's been used for over 100 years and it's never been shown to do that in any study.
An example is that baseline observations show that women with her testosterone levels have an increased incidence of breast cancer. But yet we used testosterone to treat women with breast cancer. How can that be because by what you always produce which are based on observations that should make no sense. We should stay away from testosterone in women because based on observations show that testosterone is dangerous because women with breast cancer have high levels of testosterone. Well guess what it's not the testosterone it's the PCOS and insulin resistance that leads to the increased testosterone, and it's the PCOS and the insulin resistance that causes the increase in breast cancer. Testosterone gets blamed by those that don't know the difference between a baseline observation, and an interventional study. So how do we treat women with breast cancer. Well, we give them testosterone because it's a pop tonicinsulin resistance that leads to the increased testosterone, and it's the PCOS and the insulin resistance that causes the increase in breast cancer. Testosterone gets blamed by those that don't know the difference between a baseline observation, and an interventional study. So how do we treat women with breast cancer. Well, we give them testosterone because it's apoptotic to breast cancer cells. Rebecca Glaser does a lot of work in this area.
So what you really need to be producing our studies where we gave people thyroid, and it decreased their longevity. That's an interventional study. What you have produced has nothing to do with people taking thyroid. What do you have produced as part of the miss information that occurs on forms by people that have the dunning Kruger effect

 

[Cataceous]

...So what you really need to be producing our studies where we gave people thyroid, and it decreased their longevity. That's an interventional study. What you have produced has nothing to do with people taking thyroid. What do you have produced as part of the miss information that occurs on forms by people that have the dunning Kruger effect

The subject is thyroid hormones and the best you can do is some handwaving about testosterone and breast cancer? It's a roundabout way of saying that correlation doesn't establish causality. But you conveniently ignore the animal studies, which are interventional and support the premise. Also in @FunkOdyssey's references are likely mechanisms for the observed results. As usual you resort to childish insults to deflect attention from your lack of substance.

 

[Gunner@1911]

If You're serious about making your problem better then instead of spending time on a forum trying to educate yourself from the uneducated then maybe you should get a second job and hire an expert and then everything will be good. And there's no way in hell that you're gonna make me believe that if your Close family member such as a wife or child got cancer the first thing you're gonna do is go to a forum. No you're going to seek out the best care available no matter what the cost more than likely. You'll get a second job if it requires that to get their health taken care of. So you get out of all this what you're willing to put into it. You do realize that it's a significant minority of men that have problems on testosterone don't you? And the ones that all had problems are the ones that migrate to the forums. All of the problems could've been avoided if they would've gone to a specialist in the beginning. What you find is that many men want free advice and that is why they go to forums and the other issues that you see quite a bit of is that men are trying to treat non-testosterone related issues with testosterone. They are treating their underlying psychiatric disorders with hormones and it doesn't work out very well. It's not that they're crazy they have true mental health issues that need to be addressed and hormones are not going to fix it and they are the ones with most of the problems.
And lastly, "any information good or bad still educational" are you serious?

So why don't you just continue with your "continuing saga" instyread of taking some good advice

RobRoy,

Im not sure where you get that Im not serious about fixing my problem? Is my problem life threating? At this point it is not so I try to get as much information as I can from as many sources as I can, and yes that includes but is not limited forums. As I have stated previously finding doctors in my area that deal with this sort of thing is difficult.

The other issue that rather amazes me is you think you know my exact situation. With that being said it is not my job to convince you as to how I would handle any situation concerning my health or a family member, or even a close friend! I am not here to make you believe anything at all. I am here to talk to people that have had similar experiences and how they may have or not made their lives better. If in the process I can gain some education the way I see it thats a win!

I have spoken to many men that have or are currently on Testosterone and have had great results, then again I spoken to men that it didn't work out and they stopped taking it because it didn't provide results. Not once did I get the impression any of these men were treating with TRT because of any sort of psychiatric disorder. I guess my statement to that would be since there are so many on these forums that are doing it wrong and have these psychiatric disorders you speak of, then why are you here? Is it that your comments come from personal experiences? If so, Thank you for sharing! Please do not assume we are all like you, I have gotten some very good advice from people on this forum and because of that I could be educated when I went to the doctor.

As I stated previously if any of this offends or irritates then just scroll on by. You have stated your info and opinions and snide childish insults. I really have spent way more time then I should have with you so respectfully just move along. Your input has reached its usefulness.

 

[granger]

Systemlord is spot on. Your TSH seems a bit high. You should get a TPO antibody test to check for Hashimoto's Disease. You also want to check your Free T3 and Free T4 hormone levels and make sure they are at least in the middle of the normal range. Low thyroid levels can definitely make you feel crumby.

this right here man....

 

[Phil Goodman]

If You're serious about making your problem better then instead of spending time on a forum trying to educate yourself from the uneducated then maybe you should get a second job and hire an expert and then everything will be good. And there's no way in hell that you're gonna make me believe that if your Close family member such as a wife or child got cancer the first thing you're gonna do is go to a forum. No you're going to seek out the best care available no matter what the cost more than likely. You'll get a second job if it requires that to get their health taken care of. So you get out of all this what you're willing to put into it. You do realize that it's a significant minority of men that have problems on testosterone don't you? And the ones that all had problems are the ones that migrate to the forums. All of the problems could've been avoided if they would've gone to a specialist in the beginning. What you find is that many men want free advice and that is why they go to forums and the other issues that you see quite a bit of is that men are trying to treat non-testosterone related issues with testosterone. They are treating their underlying psychiatric disorders with hormones and it doesn't work out very well. It's not that they're crazy they have true mental health issues that need to be addressed and hormones are not going to fix it and they are the ones with most of the problems.
And lastly, "any information good or bad still educational" are you serious?

So why don't you just continue with your "continuing saga" instyread of taking some good advice

Lots of people on this forum are much more “educated” on the topic of hormone therapy than many doctors I’ve talked to about the topic. I’ve also seen many people benefit from discussions here(myself included) and seen tons of posters here try to help others. There has also been lots of anecdotal stories to help us all gain a better understanding of the complexities involved with hormone therapy. You don’t seem interested in the least with regard to helping though. All you seem to do is talk down to people and over-simplify things as if the entire process of replacing and balancing hormonal deficiencies is extremely simple. That kind of makes me wonder why you are here. As far as I can tell it’s either to talk down to people just for the sake of talking down to people, or maybe to try to make yourself feel smarter than you actually are.

 

[granger]

yes PLENTY of good things happen when you talk to more people.. sometimes they had the EXACT issue and spent years figuring it out so can pass on a possible solution. Drs of course cannot be a master at every single thing, and if know how healthcare operates advocating for yourself is prob the #1 thing above having a good Dr that will determine outcome, and even Drs who care will tell you this. educating yourself and learning how to speak DR will be the greatest help on any health journey.