Many overfixate on testosterone -the thyroid is just as important

[Match]

No caso de alto Anti-TPO, a Tireoide nao mais funciona? A solução de suplementar eternamente ou poderia reverter?

 

[Hormetheus]

I had to use google translator: In most cases once immune sensitization happened it wil be forever (however, with peaks and troughs in immune activity). Surprisingly though, many people are able to have replacement just be temporary

 

[Fortunate]

@Vince, I know you have benefited for years on thyroid treatment, so I thought I'd run some questions by you. I ran panels and per Defy, am a candidate for T3 treatment. Per my labs, I think I am borderline (have to do rT3 ratio calculation to justify treatment). In any case, I tried T3 for a bit and stopped. In fairness, I was also treating with cream, which in retrospect, was pushing my testosterone levels way over the top. So, I am not sure if the bad experience was T3, test, or both. I am considering stabilizing my test levels and trying T3 again. Questions:

• What did you labs look like prior to starting treatment?
• What subjective benefit did you notice once you started?
  • Along those lines, did you notice any benefit outside of energy/mental clarity?
• What objective benefit have you noticed
  • ie, have you seen improvements in other areas such as cholesterol, testosterone, etc.?

Thanks for sharing!

 

[Vince]

@Vince, I know you have benefited for years on thyroid treatment, so I thought I'd run some questions by you. I ran panels and per Defy, am a candidate for T3 treatment. Per my labs, I think I am borderline (have to do rT3 ratio calculation to justify treatment). In any case, I tried T3 for a bit and stopped. In fairness, I was also treating with cream, which in retrospect, was pushing my testosterone levels way over the top. So, I am not sure if the bad experience was T3, test, or both. I am considering stabilizing my test levels and trying T3 again. Questions:

• What did you labs look like prior to starting treatment?
• What subjective benefit did you notice once you started?
  • Along those lines, did you notice any benefit outside of energy/mental clarity?
• What objective benefit have you noticed
  • ie, have you seen improvements in other areas such as cholesterol, testosterone, etc.?

Thanks for sharing!

Yes my main goal for thyroid treatment, good LDL cholesterol. I've been on thyroid meds now for almost 10 years. I don't remember my original labs.

I go to a Lipidologist and get very thorough cholesterol panels.

 

[Fortunate]

Yes my main goal for thyroid treatment, good LDL cholesterol. I've been on thyroid meds now for almost 10 years. I don't remember my original labs.

I go to a Lipidologist and get very thorough cholesterol panels.

Can you speak to subjective benefits (example, traditionally, people associate thyroid with energy/mental clarity; did it help your libido? Mood? Did it facilitate your TRT goals?).

Thanks again.

 

[SSHSSA74]

I am a final year med student and have been replacing my hormones for multiple years. I post this because I want to raise awareness that it is not just testosterone. One thing I frequently notice, is that many males are really fixating on testosterone (e.g. whether adding HCG or different doses of anastrozole would make a difference, etc.), however upon asking them about their body temperature, blood pressure, pulse, and other signs and symptoms, it is often evident, that they are deficient in thyroid or adrenal hormones.

Frequently, after discovering low testosterone levels, many males go on TRT and feel somewhat better. Often, however, their energy levels (and other symptoms) do not improve as they wished. Many then tend to raise their dosage of testosterone -often repeatedly. Doing this, some symptoms improve (e.g. energy, mood) and therefore to them, it seems obvious that they were still deficient and simply have not raised their dosage high enough. But if thyroid or adrenal hormones are deficient, injecting all the testosterone in the world, will not make someone feel (or function) much better. For example, both libido and body hair are two things generally ascribed to testosterone. But if levels of thyroid hormones or cortisol are low, libido will be as well, even if testosterone levels are high. The same holds for body hair.

Unfortunately, the overreplacement of any hormone is tempting because it might ”feel good” and does often indeed improve some symptoms (esp. energy levels). However, the overreplacement of any of the major hormones (e.g. cortisol, thyroid hormones, testosterone) will almost always improve energy levels and mood, which will almost always improve symptoms. Therefore, every single one of the major hormones can be (ab)used as a stimulant and “masking-agent”. However, over the long run any form of overreplacement -whether intentional or not- carries more risks than benefits and likely comes with a tradeoff of health and longevity in the future for an increase in wellbeing and performance in the present.

Instead of over-replacing and abusing a single hormone in high and unphysiological doses, it would be much healthier, safer, more natural, and more effective to add one or more other hormones in small and physiological doses.

While treating adrenals can be dangerous if not done properly, treating thyroid hormones is quite safe and easy to do (comparably speaking) and for many males, it can make a world of a difference and bring them back alive -sometimes even more than TRT.

Thyroid hormones are the most prescribed medication on the planet. Despite there being millions of people with thyroid issues, the vast majority of them are not treated adequately (i.e. in 99% of people T4 monotherapy is used). This holds back millions of people from living far better lives and from contributing what they otherwise could. In my opinion, the therapy of choice should follow this order:

NDT > T3/T4 > T4 > T3

What about dosage?

dosages needed vary widely depending on patient needs, cortisol levels, ability to derive T3 by deiodination, thyroid sensitivity, IGF1 levels, and esp. the endogenous residual output by the individual's own thyroid gland.

• T4: 50mcg-200mcg (average: 120mcg; once per day)
• NDT: 1–2.5 grains (average: 1.5 grains; twice per day)
• T3: 40–80mcg T3 (average: 60mcg T3; split into at least 3 daily doses)

A reasonable, generic protocol to start thyroid replacement is the following:

Principle: Starting with 25% of the presumed target dose and then gradually increasing the dosage over a 2 month period.

Implementation: Starting out with 0.25 grains of NDT (or 20–25% of the presumed target dose) → increase by 0.25 grains every 14 days until the average target dose of 1.25 or 1.5 grains/day is reached (about 0.25 grains less in the summer).

I wrote an article on how to properly replace thyroid hormones and because this post is already quite long and there are many other topics to delve into, if you are interested you can read more on some of these topics:

How To Replace Thyroid Hormones - An Ultimate Guide

• Improving thyroid hormones naturally
• Thyroid hormones require adequate levels of cortisol
• A low-carb diet can impair thyroid status at multiple levels
• Why T4 is not the therapy of choice
• Temporary use of high-dose T3 can reverse thyroid resistance
• Permanent treatment with T3-only?
• Dosage
• Timing
• How to start therapy
• Thyroid treatment in individuals with low levels of cortisol

I hope you find value in it. If you have any questions, feel free to leave your questions below!

Great Post. I will be talking to my PA about thyroid and cortisol on my next visit. thank you!

 

[Vince]

Can you speak to subjective benefits (example, traditionally, people associate thyroid with energy/mental clarity; did it help your libido? Mood? Did it facilitate your TRT goals?).

Thanks again.

My libido has always been strong. I did fix my thyroid before I started trt. I believe at least for me, trt was more beneficial then thyroid meds.

 

[ivkonst2017]

Totally agree, and Im not a big fan if high doses as well, once I step over my sweet spot on anything I feel bad. Also I think its not just about replacing hormones, but optimising and fixing health issues like what Im trying to do regarding my NAFLD.

However one clarification:

in high and unphysiological doses,

The quotet statement is often abused by people who mistaken the physiological doses with the declined refence range that is the average of a very unhealthy population.

Also when one is on exogenous hormones often it is needed to achieve higher serum concentrations to get the same effect like if you were on endogenous production, at least for testosterone and FT3.

 

[Hormetheus]

Totally agree, and Im not a big fan if high doses as well, once I step over my sweet spot on anything I feel bad. Also I think its not just about replacing hormones, but optimising and fixing health issues like what Im trying to do regarding my NAFLD.

However one clarification:


The quotet statement is often abused by people who mistaken the physiological doses with the declined refence range that is the average of a very unhealthy population.

Also when one is on exogenous hormones often it is needed to achieve higher serum concentrations to get the same effect like if you were on endogenous production, at least for testosterone and FT3.

Yes, surely the effects of endogenous levels are different compared to the same results achieved via exogenous hormones

 

[Cataceous]

Yes, surely the effects of endogenous levels are different compared to the same results achieved via exogenous hormones

What level of scientific support is there for statements like this? Clearly it doesn't hold at the molecular level when bioidentical hormones are used. But intuitively the idea makes sense when you consider hormone levels being out of sync with normal feedback mechanisms.

 

[Hormetheus]

What level of scientific support is there for statements like this? Clearly it doesn't hold at the molecular level when bioidentical hormones are used. But intuitively the idea makes sense when you consider hormone levels being out of sync with normal feedback mechanisms.

Unfortunately not much. However, what we can say is that at the level of the hypothalamus the releasing hormones (e.g. GnRH, CRH, etc.) are also transmitted into the nervous system. Furthermore, various tissues have receptors for stimulating hormones (e.g. LH-receptors in the adrenal glands, TSH receptors on fibroblasts, etc.) and if there is suppression at the level of the hypothalamus these additional pathways are shut off which should result at least in a tiny measurable difference

 

[Cataceous]

... However, what we can say is that at the level of the hypothalamus the releasing hormones (e.g. GnRH, CRH, etc.) are also transmitted into the nervous system. Furthermore, various tissues have receptors for stimulating hormones (e.g. LH-receptors in the adrenal glands, TSH receptors on fibroblasts, etc.) and if there is suppression at the level of the hypothalamus these additional pathways are shut off which should result at least in a tiny measurable difference

You're preaching to the choir when it comes to concerns about HPTA suppression. It's this reasoning that leads me to try to restore a reasonable level of upstream activity under TRT—with kisspeptin, GnRH, enclomiphene and such. Although subjective and anecdotal, my results support the hypothesis that suppression isn't necessarily benign.

 

[Hormetheus]

You're preaching to the choir when it comes to concerns about HPTA suppression. It's this reasoning that leads me to try to restore a reasonable level of upstream activity under TRT—with kisspeptin, GnRH, enclomiphene and such. Although subjective and anecdotal, my results support the hypothesis that suppression isn't necess

Have you tried semaglutide (ozempic)? It also kickstart hypothalamic pathways - esp. if "damage" to hormonal axes was done by undernutrition/overtraining etc.

 

[Cataceous]

Have you tried semaglutide (ozempic)? It also kickstart hypothalamic pathways - esp. if "damage" to hormonal axes was done by undernutrition/overtraining etc.

I'm not familiar with semaglutide. I see that it's used to raise insulin and reduce blood sugar. A cursory search doesn't turn up much more information. It's noted that "Semaglutide directly accessed the ... hypothalamus but did not cross the blood-brain barrier;.."[R] Can you provide any references on its ability to "kickstart hypothalamic pathways"? I'd like to know more.

 

[Hormetheus]

I'm not familiar with semaglutide. I see that it's used to raise insulin and reduce blood sugar. A cursory search doesn't turn up much more information. It's noted that "Semaglutide directly accessed the ... hypothalamus but did not cross the blood-brain barrier;.."[R] Can you provide any references on its ability to "kickstart hypothalamic pathways"? I'd like to know more.

Well, it should not be too hard to find. Google "GLP-1 and LH/FSH" or "GLP-1 and POMC neurons". It actually does cross the blood brain barrier as there is a receptor for it. Furthermore, it can act on brain stem and hypothalamic areas at the circumventricular organs

 

[Cataceous]

... Google "GLP-1 and LH/FSH" ...

The first one that comes up doesn't sound promising:

In contrast to the animal literature, our data demonstrate that acute GLP-1 administration does not affect reproductive hormone secretion in healthy men.​

​

Effects of Glucagon-like Peptide-1 on the Reproductive Axis in Healthy Men

AbstractContext. Glucagon-like peptide-1 (GLP-1) potently reduces food intake and augments glucose-stimulated insulin secretion. Recent animal data suggest

academic.oup.com

 

[Hormetheus]

The first one that comes up doesn't sound promising:

In contrast to the animal literature, our data demonstrate that acute GLP-1 administration does not affect reproductive hormone secretion in healthy men.​

​

Effects of Glucagon-like Peptide-1 on the Reproductive Axis in Healthy Men

AbstractContext. Glucagon-like peptide-1 (GLP-1) potently reduces food intake and augments glucose-stimulated insulin secretion. Recent animal data suggest

academic.oup.com

I came off testosterone using semaglutide. My T levels doubled twice within 4 weeks. I am now somewhere in the 500s. A friend of mine had diet-induced low T. Using semaglutide without dietary changes his LH/FSH multiplied and T levels doubled.

Also, your study is exactly the problem: It does not affect it in HEALTHY men, whose reproductive axis is fully functioning. But in people with hypothalamic or pituitary forms of hypogonadism it does indeed help (esp. if dieting, stress, low body fat) are at the root cause

 

[M.J]

I came off testosterone using semaglutide. My T levels doubled twice within 4 weeks. I am now somewhere in the 500s. A friend of mine had diet-induced low T. Using semaglutide without dietary changes his LH/FSH multiplied and T levels doubled.

Also, your study is exactly the problem: It does not affect it in HEALTHY men, whose reproductive axis is fully functioning. But in people with hypothalamic or pituitary forms of hypogonadism it does indeed help (esp. if dieting, stress, low body fat) are at the root cause

So your saying semaglutide can actually increase T ? And it’s safe ???? Can you explain more. What if I have no issues in insulin and don’t have diabetes?

 

[Hormetheus]

So your saying semaglutide can actually increase T ? And it’s safe ???? Can you explain more. What if I have no issues in insulin and don’t have diabetes?

Given that your low T is of hypothalamic origin (mainly POMC-neurons mediated), then yes. Yes, it is far safer than almost all other drugs out there, as it is basically a benign hormone (acting on GPCR instead of nuclear receptors as do steroid hormones). Also, it is certainly worth a try and there is almost no risk to that other than the cost of getting the drug

 

[nodoctor]

How did the semaglutide turn out? About to try my own run with it monitoring blood sugar and such of course and starting out super low. I'm on a low 110/wk or so of cypionate and not much else right now for trt not cycling.