Many overfixate on testosterone -the thyroid is just as important

[Hormetheus]

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.

Best drug I have ever tried. Still on it and if possible I will never come off Hormones are back to normal (and much else improved)

 

[captain]

I went off TRT for 4 months at the same time I started Semaglutide. At the end of the 4 months my T was 253.

 

[Hormetheus]

I went off TRT for 4 months at the same time I started Semaglutide. At the end of the 4 months my T was 253.

It depends on whether your low T is due to lack of satiety signals or not. Yours obviously was not

 

[TRicker]

Best drug I have ever tried. Still on it and if possible I will never come off Hormones are back to normal (and much else improved)

My endo discussed possibly prescribing semaglutide, but I've read that there is a risk of thyroid tumors and/or thyroid cancer. I know you said you considered if very safe, so I was wondering if you have any insight on this?

 

[captain]

My Endo said the tumors was from a rare genetic disease. If you are not a mouse taking 200 times normal dose you should be fine.

 

[Hormetheus]

My endo discussed possibly prescribing semaglutide, but I've read that there is a risk of thyroid tumors and/or thyroid cancer. I know you said you considered if very safe, so I was wondering if you have any insight on this?

Yes it is incredibly safe. I describe my experience in detail in my new article The Simulated Refeed

 

[tareload]

Also, it is certainly worth a try and there is almost no risk to that other than the cost of getting the drug

Semaglutide Forum: Game Changer for Weight Loss

Mark A. Moyad, MD, MPH & Martin M. Miner, MD, discuss the potential benefits of semaglutide, a newly approved weight-loss drug. Semaglutide is a medication that has been approved by the FDA to treat type 2 diabetes and has also been approved for obesity management under the brand name Wegovy...

www.excelmale.com

From the references linked:

====

What is new and conclusions: Our findings showed disproportionality for thyroid cancer, medullary thyroid cancer and thyroid neoplasm in patients treated with GLP-1 analogues. We have found evidence from spontaneous reports that GLP-1 analogues are associated with thyroid cancer in patients with diabetes.
====

Conclusion​

Over the years, the use of GLP-1RAs has first been associated with several adverse events, which were later mostly nuanced or refuted. As one of the newer agents within the class, the safety of semaglutide—both the subcutaneous and oral formulation—has been scrutinized in the phase 3 programs and CVOTs. Compared with placebo and active comparator, semaglutide induces mostly mild and transient gastrointestinal disturbances, and increases the risk of cholelithiasis. However, no major safety concerns have arisen to date, although definitive conclusions for pancreatic cancer, thyroid cancer and DRP complications cannot be drawn at this point. When compared with the beneficial effects of these drugs on glucose metabolism, blood pressure, body weight and cardiovascular (and potentially even renal) endpoints, these agents have an overall beneficial risk/benefit-profile for treatment of patients with T2D.
====

 

[tareload]

Treating hypothyroidism is not always easy: When totreat subclinical hypothyroidism, TSH goals in theelderly, and alternatives to levothyroxine monotherapy

 

[tareload]

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)

You really should put a disclaimer on these bullet points. For those reading all this take your concerns to a board-certified endocrinologist and have him/her/they give their opinion of taking 40-80 mcg/day of liothyronine to address hypothyroidism.

Thyroid Advice with TRT?

Take this schematic to an Endo and ask him to review the various potential outcomes when a euthyroid patient does combination therapy or ends up going too high on the exogenous T3. I have tried my best to explain difficult concepts on here but this one I won’t expound on here (opportunity cost...

forums.t-nation.com

Ok, I see you have one on your website:

Fair enough.

 

[tareload]

Reverse T3 or perverse T3? Still puzzling after 40 years

Frontiers | Can Reverse T3 Assay Be Employed to Guide T4 vs. T4/T3 Therapy in Hypothyroidism?

Among the controversial issues surrounding combination T4/T3 therapy for hypothyroidism is the choice of the best biochemical parameter by which to monitor t...

www.frontiersin.org

 

[tareload]

Evidence for hormonal control of heart regenerative capacity during endothermy acquisition - PMC

Tissue regenerative potential displays striking divergence across phylogeny and ontogeny, but the underlying mechanisms remain enigmatic. Loss of mammalian cardiac regenerative potential correlates with cardiomyocyte cell-cycle arrest and ...

www.ncbi.nlm.nih.gov

Regenerating hearts by arresting development with hypothyroidism - PMC

A recent report by Hirose et al highlights the divergence in cardiac regenerative potential across phylogeny and mouse ontogeny. They provide a correlation between metabolic rate and cardiomyocyte ploidy across species, linking whole-body metabolic ...

www.ncbi.nlm.nih.gov

https://www.science.org/doi/10.1126/science.aax1006

 

[butter.bb]

I agree 100%.
Starting TRT was really only the beginning for me.
Once I got the adrenals fully good to go and thyroid dialed the change was far greater than when I first got on testosterone.
If your thyroid/adrenals are out of whack, getting those treated as well is a complete game changer.

Would you mind expanding on how you got your adrenals fully good to go? I’m having some troubles myself with adrenal insufficiencies

 

[Sean Mosher]

Well, without getting into the whole backfilling of the pathways argument, I fully believe that using hCG along with DHEA & Pregnenolone was critical. I experimented with using all 3 and then not and for me it's clear cut. Dosing is individualized so I'd be hesitant to give advice there.
Also, I enjoy the weightroom and lifting on the heavier side so I had to layoff that aspect for a bit.
And then honestly, just going by feel and paying attention to my body, I started to slowly add back in thyroid from there.
Thyroid/Iodine can be very hard on someone with adrenal insufficiency as was me so adding those back in can be tricky.

 

[Sean Mosher]

Would you mind expanding on how you got your adrenals fully good to go? I’m having some troubles myself with adrenal insufficiencies

If you have the ability to work with a quality doc here I'd highly suggest it as well.
Doing this on my own sucked lol!

 

[Charliebizz]

If you have the ability to work with a quality doc here I'd highly suggest it as well.
Doing this on my own sucked lol!

Did you have blatant thyroid labs ? Mine look good but have every damn hypo symptom except brittle nails

 

[Sean Mosher]

Nope.
I was "in range".
Simply have to try a therapeutic trial to see if your symptoms get resolved.
The only thing that was obviously out of whack for me was a fairly elevated RT3.

 

[Charliebizz]

Nope.
I was "in range".
Simply have to try a therapeutic trial to see if your symptoms get resolved.
The only thing that was obviously out of whack for me was a fairly elevated RT3.

My numbers look even better on trt but still feel bad.

 

[Sean Mosher]

Mine were similar.
I had to get that FreeT3 personally over 4.0 to start noticing a difference.
I think I"m around 4.6 or so currently

 

[TRicker]

The only thing that was obviously out of whack for me was a fairly elevated RT3.

I have the exact same situation going on, and have been discussing this on another thread. I have high RT3 (25), and all other thyroid labs looked good, however supplementing with T3 (all the way up to 50mcg's/day) had no impact on how I felt. Everything I've read states that high cortisol instead of low cortisol leads to high RT3.
When you stated you fixed your adrenals, did you lower your cortisol or raise it with hydrocortisone?

 

[butter.bb]

Well, without getting into the whole backfilling of the pathways argument, I fully believe that using hCG along with DHEA & Pregnenolone was critical. I experimented with using all 3 and then not and for me it's clear cut. Dosing is individualized so I'd be hesitant to give advice there.
Also, I enjoy the weightroom and lifting on the heavier side so I had to layoff that aspect for a bit.
And then honestly, just going by feel and paying attention to my body, I started to slowly add back in thyroid from there.
Thyroid/Iodine can be very hard on someone with adrenal insufficiency as was me so adding those back in can be tricky.

Good to know regarding the Iodine!

Ive been using HCG for years now on trt but I feel it’s not enough. I use 25mg preg cream every other day as too much seems to increase fatigue.
DHEA is on the lower end about 211.

Do you think oral or sublingual Preg works better for helping low cortisol? I. Struggling with daily low c and low aldosterone.