Testosterone and depression ..Dr. Mark Gordon

[Gman86]

Well that is a low dose of Lexapro. I am considering going back on since testosterone replacement therapy while it has helped my fatigue I still have situational anxiety and anticipatory anxiety which gives me physical symptoms. I don’t really want to go back on it but looking back at my calendar I was doing better for about six months while on the medicine. I just feel off. At a loss where to go at this point.

Have you looked into thyroid? I’ve been doing a bunch of research lately on it, and doctors are having great success treating people with depression and anxiety, with thyroid medication, even when those people present with “normal” labs.

Apparently it’s common now to even treat bipolar disorder with thyroid medication. One psychistrist reported an 80% success rate in regards to treating his bipolar patients with natural desiccated thyroid.

 

[jws1300]

Have you looked into thyroid? I’ve been doing a bunch of research lately on it, and doctors are having great success treating people with depression and anxiety, with thyroid medication, even when those people present with “normal” labs.

Apparently it’s common now to even treat bipolar disorder with thyroid medication. One psychistrist reported an 80% success rate in regards to treating his bipolar patients with natural desiccated thyroid.

I have had thyroid tested 3 times. TSH, T4free, and T3free is normal. Reverse t3 however is normal on the high side and ive heard some say it can cause anxiety/depression. My endo however says thats not the case. All of my issues started 3 yrs ago with a panic attack, then 2 more followed, ER visits, and now I do nothing like I used to. Think the panic disorder has depressed me bc I dont enjoy anything anymore. Looking back at my diary, the lexapro did help. Just waiting for miracle I guess before I pop the SSRI but maybe i just need it...hereditary or otherwise.

 

[Gman86]

I have had thyroid tested 3 times. TSH, T4free, and T3free is normal. Reverse t3 however is normal on the high side and ive heard some say it can cause anxiety/depression. My endo however says thats not the case. All of my issues started 3 yrs ago with a panic attack, then 2 more followed, ER visits, and now I do nothing like I used to. Think the panic disorder has depressed me bc I dont enjoy anything anymore. Looking back at my diary, the lexapro did help. Just waiting for miracle I guess before I pop the SSRI but maybe i just need it...hereditary or otherwise.

Reverse T3 should be under 15. If not, you’ll most likely feel like you have low T3, aka hypothyroid. What is your TSH, freeT3, Freet4 and reverse T3 levels?

Just remember, thyroid medication can help people with depression and anxiety, even when their labs look fine. So I wouldn’t rule it out.

 

[jws1300]

Reverse T3 should be under 15. If not, you’ll most likely feel like you have low T3, aka hypothyroid. What is your TSH, freeT3, Freet4 and reverse T3 levels?

Just remember, thyroid medication can help people with depression and anxiety, even when their labs look fine. So I wouldn’t rule it out.

TSH 0.85
T3free 3.3
T4free 1.2
RT3 23.4

 

[jws1300]

TSH 0.85
T3free 3.3
T4free 1.2
RT3 23.4

Have been supplementing with zinc and selenium but only a week so far. Was going to start back on lexapro tonight at 2.5mg. Just everything I do always comes back to the SSRI. I think maybe the anxiety always been there and at 38yrs old my body finally told me about it.

 

[Gman86]

Have been supplementing with zinc and selenium but only a week so far. Was going to start back on lexapro tonight at 2.5mg. Just everything I do always comes back to the SSRI. I think maybe the anxiety always been there and at 38yrs old my body finally told me about it.

Nah man, anxiety is just a symptom. You can absolutely get rid of it by figuring out the specific hormone imbalance that’s causing it. SSRI’s are for people that haven’t learned about hormones, or people that know about hormones, but are tired of trying to figure out the root cause and need immediate relief. Both situations, I greatly respect. I know how hard it is to spend the time learning about hormones, and how dealing with hormone imbalances on a daily basis feels like literal torture. So I don’t fault anyone for taking prescription medications, but 9/10 times you can either cure, or minimize greatly, anxiety/ depression by fixing the underlying hormone imbalance/ improving diet and exercising.

In your case, you are 100% hypothyroid. Your RT3 is very high. RT3 gets into the T3 receptors, and blocks actual T3 from binding to these receptors, which will give you all the symptoms of hypothyroidism. There is literally T3 receptors in every single cell of the body. The brain actually has the most T3 receptors out of anywhere else in the body. That’s why having optimal thyroid function is the most important thing you can do for your mental health. I’m not saying optimizing your thyroid will 100% rid you of your depression/ anxiety issues, but I can guarantee that it will help immensely, if not rid you of both all together.

 

[jws1300]

Nah man, anxiety is just a symptom. You can absolutely get rid of it by figuring out the specific hormone imbalance that’s causing it. SSRI’s are for people that haven’t learned about hormones, or people that know about hormones, but are tired of trying to figure out the root cause and need immediate relief. Both situations, I greatly respect. I know how hard it is to spend the time learning about hormones, and how dealing with hormone imbalances on a daily basis feels like literal torture. So I don’t fault anyone for taking prescription medications, but 9/10 times you can either cure, or minimize greatly, anxiety/ depression by fixing the underlying hormone imbalance/ improving diet and exercising.

In your case, you are 100% hypothyroid. Your RT3 is very high. RT3 gets into the T3 receptors, and blocks actual T3 from binding to these receptors, which will give you all the symptoms of hypothyroidism. There is literally T3 receptors in every single cell of the body. The brain actually has the most T3 receptors out of anywhere else in the body. That’s why having optimal thyroid function is the most important thing you can do for your mental health. I’m not saying optimizing your thyroid will 100% rid you of your depression/ anxiety issues, but I can guarantee that it will help immensely, if not rid you of both all together.

Thats where I'm at...I started back on lexapro last night. I have to function normally as I cant count on doctors straightening out my thyroid when they dont even think theres a problem. TRT didnt help much. Maintained levels that are in good ranges and its helped with fatigue but not the anxiety/panic. In fact its worse after injections for a couple days, and ive seen many guys with same issue.

I will absolutely still chase down this thyroid info. Rather not toss in another drug (cytomel) and not sure I can even get it Rx'd to me with "normal" labs. Maybe i'll continue the selenium and zinc as I've seen several doctors say it can lower Rt3 and then check bloods again in a month? Or maybe lexapro will lower cortisol and thyroid will get better?

 

[Gman86]

Thats where I'm at...I started back on lexapro last night. I have to function normally as I cant count on doctors straightening out my thyroid when they dont even think theres a problem. TRT didnt help much. Maintained levels that are in good ranges and its helped with fatigue but not the anxiety/panic. In fact its worse after injections for a couple days, and ive seen many guys with same issue.

I will absolutely still chase down this thyroid info. Rather not toss in another drug (cytomel) and not sure I can even get it Rx'd to me with "normal" labs. Maybe i'll continue the selenium and zinc as I've seen several doctors say it can lower Rt3 and then check bloods again in a month? Or maybe lexapro will lower cortisol and thyroid will get better?

Thyroid dysfunction literally effects every single function in the entire body, including every single function that low testosterone effects. So it’s impossible to feel good on TRT, when thyroid is still not functioning properly. Even though your Rt3 is in the “normal” range, it’s actually very high. It’s basically like having a testosterone level of 300, and your doctor saying that you shouldn’t be symptomatic because it’s within range still. Until you get your thyroid figured, out, you’ll never feel optimized on TRT, and sometimes TRT can make some of the symptoms worse. I’m in the same boat. TRT has helped some with mood, positive outlook, sleep and building muscle/ strength, but I feel like it’s made my brain fog even worse. After doing an insane amount of research on thyroid the past couple months, and now realizing low thyroid literally can mimic every single symptom of low testosterone, including low libido, ED, low energy, brain fog, inability to lose weight/ fat gain, tough time gaining muscle, depression, anxiety, apathy, moodiness, etc., I’m thinking thyroid dysfunction might of been an issue for me from the beginning. The thyroid is literally the “master gland” for a reason. For anything in your body to work properly, you need proper thyroid function. Including sex hormones. Without proper thyroid function, sex hormones are not able to be synthesized and utilized properly. So theoretically a dysfunctioning thyroid can be the cause for hypogonadism in a lot of cases.

But again, I don’t blame you for needing to start taking your SSRI again. I know what it’s like to need immediate relief. We all have lives that can’t be put on hold. I hope it at least improves some of your symptoms to make life more tolerable for you. But any doctor that doesn’t view your level of RT3 as a problem, is obviously not a doctor that knows what he’s doing. So if it’s possible, try to find a new one. I’m with Defy, and they’re amazing. $250 for the initial consultation, but after that, all you pay for is the meds, and a follow up every 6 months or so. I do the follow up with a nurse, so it’s only $50. Everything’s over the phone, so you can live anywhere in the United States. Just have to get a physical with your primary once a year and fax it to them. They’re literally the best. Super knowledgeable, extremely nice and understanding, and their customer service is beyond amazing.

If you want to learn more about the thyroid, just go to YouTube and checkout Dr. Westin Childs, Dr. Hotze, and Dr. Neil Rouzier. Within a couple months you’ll easily know more about the thyroid than your current doctor.

 

[jws1300]

Thyroid dysfunction literally effects every single function in the entire body, including every single function that low testosterone effects. So it’s impossible to feel good on TRT, when thyroid is still not functioning properly. Even though your Rt3 is in the “normal” range, it’s actually very high. It’s basically like having a testosterone level of 300, and your doctor saying that you shouldn’t be symptomatic because it’s within range still. Until you get your thyroid figured, out, you’ll never feel optimized on TRT, and sometimes TRT can make some of the symptoms worse. I’m in the same boat. TRT has helped some with mood, positive outlook, sleep and building muscle/ strength, but I feel like it’s made my brain fog even worse. After doing an insane amount of research on thyroid the past couple months, and now realizing low thyroid literally can mimic every single symptom of low testosterone, including low libido, ED, low energy, brain fog, inability to lose weight/ fat gain, tough time gaining muscle, depression, anxiety, apathy, moodiness, etc., I’m thinking thyroid dysfunction might of been an issue for me from the beginning. The thyroid is literally the “master gland” for a reason. For anything in your body to work properly, you need proper thyroid function. Including sex hormones. Without proper thyroid function, sex hormones are not able to be synthesized and utilized properly. So theoretically a dysfunctioning thyroid can be the cause for hypogonadism in a lot of cases.

But again, I don’t blame you for needing to start taking your SSRI again. I know what it’s like to need immediate relief. We all have lives that can’t be put on hold. I hope it at least improves some of your symptoms to make life more tolerable for you. But any doctor that doesn’t view your level of RT3 as a problem, is obviously not a doctor that knows what he’s doing. So if it’s possible, try to find a new one. I’m with Defy, and they’re amazing. $250 for the initial consultation, but after that, all you pay for is the meds, and a follow up every 6 months or so. I do the follow up with a nurse, so it’s only $50. Everything’s over the phone, so you can live anywhere in the United States. Just have to get a physical with your primary once a year and fax it to them. They’re literally the best. Super knowledgeable, extremely nice and understanding, and their customer service is beyond amazing.

If you want to learn more about the thyroid, just go to YouTube and checkout Dr. Westin Childs, Dr. Hotze, and Dr. Neil Rouzier. Within a couple months you’ll easily know more about the thyroid than your current doctor.

Thanks for the great info and the response. We share a lot of the same issues it sounds. The only test that was off was my total T, so I figured trt would be my savior without other meds; and fix my anxiety/panic/palpitations that came out of nowhere. Now i'm just a guy with anxiety AND small testicles... I guess the question now is, will the ssri help lower stress and in turn lower my rt3 maybe? Or should I continue the zinc/selenium to help as well, as i've read that can help with high rt3? My next task is to find a doctor who DOES think rt3 is a problem and see how they will treat it. If i stick with TRT, maybe i'll give defy a call...

 

[jws1300]

Thyroid dysfunction literally effects every single function in the entire body, including every single function that low testosterone effects. So it’s impossible to feel good on TRT, when thyroid is still not functioning properly. Even though your Rt3 is in the “normal” range, it’s actually very high. It’s basically like having a testosterone level of 300, and your doctor saying that you shouldn’t be symptomatic because it’s within range still. Until you get your thyroid figured, out, you’ll never feel optimized on TRT, and sometimes TRT can make some of the symptoms worse. I’m in the same boat. TRT has helped some with mood, positive outlook, sleep and building muscle/ strength, but I feel like it’s made my brain fog even worse. After doing an insane amount of research on thyroid the past couple months, and now realizing low thyroid literally can mimic every single symptom of low testosterone, including low libido, ED, low energy, brain fog, inability to lose weight/ fat gain, tough time gaining muscle, depression, anxiety, apathy, moodiness, etc., I’m thinking thyroid dysfunction might of been an issue for me from the beginning. The thyroid is literally the “master gland” for a reason. For anything in your body to work properly, you need proper thyroid function. Including sex hormones. Without proper thyroid function, sex hormones are not able to be synthesized and utilized properly. So theoretically a dysfunctioning thyroid can be the cause for hypogonadism in a lot of cases.

But again, I don’t blame you for needing to start taking your SSRI again. I know what it’s like to need immediate relief. We all have lives that can’t be put on hold. I hope it at least improves some of your symptoms to make life more tolerable for you. But any doctor that doesn’t view your level of RT3 as a problem, is obviously not a doctor that knows what he’s doing. So if it’s possible, try to find a new one. I’m with Defy, and they’re amazing. $250 for the initial consultation, but after that, all you pay for is the meds, and a follow up every 6 months or so. I do the follow up with a nurse, so it’s only $50. Everything’s over the phone, so you can live anywhere in the United States. Just have to get a physical with your primary once a year and fax it to them. They’re literally the best. Super knowledgeable, extremely nice and understanding, and their customer service is beyond amazing.

If you want to learn more about the thyroid, just go to YouTube and checkout Dr. Westin Childs, Dr. Hotze, and Dr. Neil Rouzier. Within a couple months you’ll easily know more about the thyroid than your current doctor.

Also this: If you’ve undergone standard thyroid tests, but are still experiencing hypothyroid symptoms such as cold hands/feet, dry skin, brittle nails, weight gain/difficulty losing weight, etc., it may be time to have a full thyroid panel ran, complete with rT3.

Wow, I know its cold out, but i have noticed lately that my damn hands and feet get cold sooo quickly. I used to be the one who didnt need gloves. My face has patches of dry skin on it that I have never had in the past as well...

 

[Gman86]

Also this: If you’ve undergone standard thyroid tests, but are still experiencing hypothyroid symptoms such as cold hands/feet, dry skin, brittle nails, weight gain/difficulty losing weight, etc., it may be time to have a full thyroid panel ran, complete with rT3.

Wow, I know its cold out, but i have noticed lately that my damn hands and feet get cold sooo quickly. I used to be the one who didnt need gloves. My face has patches of dry skin on it that I have never had in the past as well...

I’ve had my thyroid checked a ton of times. My numbers look identical to yours, but with normal RT3. I still have a lot of the symptoms though, especially very low basal temps. Usually around 96.1, which is a very obvious sign of low thyroid. Apparently it’s extremly common to have low thyroid function due to not enough T3 getting into the receptors on a cellular level. Apparently it’s extremely common for people to benefit from thyroid medication, even when labs are normal. I had no clue about this until recently. Here’s a video of a women explaining her experience with benefiting from thyroid medication, even when her labs were normal.

Here’s another video of Dr. Neil Rouzier explaining this phenomenon

And here’s Dr. Hotze’s opinion on the same concept

 

[Gman86]

Thanks for the great info and the response. We share a lot of the same issues it sounds. The only test that was off was my total T, so I figured trt would be my savior without other meds; and fix my anxiety/panic/palpitations that came out of nowhere. Now i'm just a guy with anxiety AND small testicles... I guess the question now is, will the ssri help lower stress and in turn lower my rt3 maybe? Or should I continue the zinc/selenium to help as well, as i've read that can help with high rt3? My next task is to find a doctor who DOES think rt3 is a problem and see how they will treat it. If i stick with TRT, maybe i'll give defy a call...

Don’t feel bad, I’ve had the same experience pretty much. Im thinking it’s due to me never fixing the underlying cause of my issues, which could of been my thyroid this whole time. I wouldn’t take zinc by itself. It depletes copper, and copper is extremely important. Way more important than most people think. I would just take dessicated beef liver capsules. They contain plenty of zinc and copper, in the perfect ratio Mother Nature intended. I would continue taking selenium. Around 200mcg/ day is a good dose. I get my selenium by eating 2-3 Brazil nuts per day. Also, stress reduction hasn’t helped my brain fog out at all. I thought it would. Hopefully it helps you though. But don’t get your hopes up. And hopefully the SSRI helps some of your symptoms. I would obviously still work on finding someone to treat your RT3. That way, you can work on the root cause of the issues, and eventually get off the SSRI, as it is not healthy to be on long term.

 

[jws1300]

Don’t feel bad, I’ve had the same experience pretty much. Im thinking it’s due to me never fixing the underlying cause of my issues, which could of been my thyroid this whole time. I wouldn’t take zinc by itself. It depletes copper, and copper is extremely important. Way more important than most people think. I would just take dessicated beef liver capsules. They contain plenty of zinc and copper, in the perfect ratio Mother Nature intended. I would continue taking selenium. Around 200mcg/ day is a good dose. I get my selenium by eating 2-3 Brazil nuts per day. Also, stress reduction hasn’t helped my brain fog out at all. I thought it would. Hopefully it helps you though. But don’t get your hopes up. And hopefully the SSRI helps some of your symptoms. I would obviously still work on finding someone to treat your RT3. That way, you can work on the root cause of the issues, and eventually get off the SSRI, as it is not healthy to be on long term.

All vids were great information, thanks. I'm going to log my waking temperature for the next week, and continue with the selenium (research more about the zinc), and check rt3 again in a month. I guess it might not hurt to ask for a small t3 dose either for a trial to see how I feel...

 

[Gman86]

All vids were great information, thanks. I'm going to log my waking temperature for the next week, and continue with the selenium (research more about the zinc), and check rt3 again in a month. I guess it might not hurt to ask for a small t3 dose either for a trial to see how I feel...

Anytime. Ya I keep a log of my daily temps. Every function of the body requires your body to be at an optimal temperature range. It’s a very overlooked part of health. Most guys haven’t learned how important it is yet. Also, your body temperature is a direct result of the energy in your cells. When they are operating poorly, they will put off less heat. An ideal body temperature tells you that your cells have all the energy that they need to function at optimum capacity.

And ya a low dose of T3 can’t hurt. It’s half life is short, so if you end up not liking it, once you stop your natural production will kick back in within a week. T3 from a compounding pharmacy is preferred, due to no fillers/ binders. Mainstream pharmaceutical T3 will have fillers and binders, which you can either react to, which will cause unwanted symptoms, and/ or the fillers and binders can inhibit absorption. So T3 from a compounding pharmacy is preferred, but if that’s not an option, brand named T3 should be ok. Most do well on it. Also, split up the dosage of T3 throughout the day to increase your success rate. You can only saturate your cells with T3 so much at one time.

 

[Vtail]

Thyroid dysfunction literally effects every single function in the entire body, including every single function that low testosterone effects. So it’s impossible to feel good on TRT, when thyroid is still not functioning properly. Even though your Rt3 is in the “normal” range, it’s actually very high. It’s basically like having a testosterone level of 300, and your doctor saying that you shouldn’t be symptomatic because it’s within range still. Until you get your thyroid figured, out, you’ll never feel optimized on TRT, and sometimes TRT can make some of the symptoms worse. I’m in the same boat. TRT has helped some with mood, positive outlook, sleep and building muscle/ strength, but I feel like it’s made my brain fog even worse. After doing an insane amount of research on thyroid the past couple months, and now realizing low thyroid literally can mimic every single symptom of low testosterone, including low libido, ED, low energy, brain fog, inability to lose weight/ fat gain, tough time gaining muscle, depression, anxiety, apathy, moodiness, etc., I’m thinking thyroid dysfunction might of been an issue for me from the beginning. The thyroid is literally the “master gland” for a reason. For anything in your body to work properly, you need proper thyroid function. Including sex hormones. Without proper thyroid function, sex hormones are not able to be synthesized and utilized properly. So theoretically a dysfunctioning thyroid can be the cause for hypogonadism in a lot of cases.

But again, I don’t blame you for needing to start taking your SSRI again. I know what it’s like to need immediate relief. We all have lives that can’t be put on hold. I hope it at least improves some of your symptoms to make life more tolerable for you. But any doctor that doesn’t view your level of RT3 as a problem, is obviously not a doctor that knows what he’s doing. So if it’s possible, try to find a new one. I’m with Defy, and they’re amazing. $250 for the initial consultation, but after that, all you pay for is the meds, and a follow up every 6 months or so. I do the follow up with a nurse, so it’s only $50. Everything’s over the phone, so you can live anywhere in the United States. Just have to get a physical with your primary once a year and fax it to them. They’re literally the best. Super knowledgeable, extremely nice and understanding, and their customer service is beyond amazing.

If you want to learn more about the thyroid, just go to YouTube and checkout Dr. Westin Childs, Dr. Hotze, and Dr. Neil Rouzier. Within a couple months you’ll easily know more about the thyroid than your current doctor.

I signed up with Defy and was waiting to schedule my initial consult after I got my 6 week Testosterone labs back. Based on what I've been reading on this forum lately, I had a full thyroid panel done and my Rt3 is at 23, right at the top of "normal". My FT3/RT3 ratio is 0.13 - which is too low. I seem to have some of the same issues you describe (my main issues are mental energy/focus and brain fog). Are you satisfied with Defy's knowledge of and treatment of Thyroid issues? I would love to use the same doc for both TRT and Thyroid.

 

[Gman86]

I signed up with Defy and was waiting to schedule my initial consult after I got my 6 week Testosterone labs back. Based on what I've been reading on this forum lately, I had a full thyroid panel done and my Rt3 is at 23, right at the top of "normal". My FT3/RT3 ratio is 0.13 - which is too low. I seem to have some of the same issues you describe (my main issues are mental energy/focus and brain fog). Are you satisfied with Defy's knowledge of and treatment of Thyroid issues? I would love to use the same doc for both TRT and Thyroid.

Ya 23 is way too high. According to the experts, anything 15 or over can cause symptoms of hypothyroidism. Obviously the higher the number, the worse the symptoms, I would imagine. My main issues are mental energy/ focus and brain fog as well, and I don’t even have a high RT3. I just have mid range T3, and most likely not enough T3 on a cellular level. So I’m sure you feel even worse considering whatever T3 you have can’t even get into the receptors, which is going to cause the same symptoms as someone with extremely low free T3 levels.

I can’t say yet how Defy is in regards to thyroid. I just had my labs done 2 days ago, and have to wait until I get them back to schedule an appointment to go over them and talk about possibly going on thyroid medication. But I’m not too worried, because Nurse Jill and Dr. Saya have both been amazing. They actually listen to you, and take what you say into consideration. I’m confident that regardless what my labs say, nurse Jill will allow me to at least do a trial run of desiccated thyroid, due to my extremely low basal temps, and other hypothyroid like symptoms. Especially considering my last set of labs had all my other hormones within a good range. I can’t speak for any of the other members of the medical staff at Defy, as I’ve only consulted with Dr. Saya initially, and Nurse Jill every single time after that.

 

[tjlab]

this happened to me, right 8 months into TRT, started to develop anxiety and BP going up, also I remember achieving an important goal in my life and not expressing any joy for it, at that time me and doc thought it was my elevated E2 causing anxiety increase BP, after that, things just got worse over the time, but I got to realize this not long time ago, in fact I need to talk to a Doc and focus on Pregnelonone and DHEA

How did you deal with blood pressure and anxiety issues?

 

[Gianluca]

How did you deal with blood pressure and anxiety issues?

We thought that was the result of my elevated e2, started small AI which seemed to care of them, but not for too long, I just started Pregnenolone RX two weeks a go, and Anxiety improved allot, BP is good now but Thyroid management and different trt protocol might play a role on it

 

[tjlab]

I found a new doctor and will be on 80mg try per week inject once weekly. What was your pregenolone dose? Are u testing labs for that?

 

[Gianluca]

I found a new doctor and will be on 80mg try per week inject once weekly. What was your pregenolone dose? Are u testing labs for that?

100mg, I just went for labwork last Thursday to check Pregnenolone/Progesterone/DHEA