Avatar universal

Low T in Women

I had posted this in the "woman's health" forum area and got no comments back at all. That area doesn't seem as active of a community as this one.  So I will re-post what I posted there related to my wife's hormone levels.

As far as thyroid she is being treated with Armour and just got bumped up to 180 mg (from 165).  her FT4 are BELOW range, her FT3 are about 25% to 50% of the range but the range is also wider than most ranges we see here.  We have been in discussion with the Dr to add in T4 medication but her symptoms are coming back and thus he raised the Armour again.  We will see how this settles out and then determine to again raise Armour or to start adding back in some T4 in about 4 to 6 weeks.

Here is the discusssion on the other sex hormone results.

My wife has low thyroid which she is being treated for. But over the last year, she has had her sex hormones tested.

Here are the test results.  All the tests were taken day 3 for the 1st two test and day 5 on the last test following the start of her period.

• Testosterone total was ZERO percent of range. (20 with a range of 20-73)
• Estradiol was 22% BELOW range (23 with range 56 - 204)
• Progesterone was 58.6% of range (0.42 with range 0.25 -0.54)

• Testosterone was essentially immeasurable (<20 with a range of 20-73) and therefore BELOW range.
• Estradiol Total was 27.2% of range (53 with range 19 –144)
• Progesterone was 24.1% of range (0.32 with range 0.25 -0.54)

• Testosterone was AGAIN essentially immeasurable (<20 with a range of 20-73) and therefore BELOW range.
• Estrogen Total was 25.8% of range (219 with a range 90 – 590)
• Progesterone was immeasurable (<0.25 with range 0.25 - 0.54)and therefore BELOW range

The estrogen it is a bit hard to tell what is going on as the actual hormone tested and the reference ranges changed a little bit. But seem to hover around 25% of the range.

Progesterone has decreased over time from 58% down to the most recent test where she is BELOW range.

I understand that early in the follicular phase the estrogen and Progesterone are at the lowest levels.  But that does not explain the consistent decrease of Progeesterone.  My wife if currently 45 years old so this could be a natural decline as she approaches menopause or is evidence she is in preimenopaus.

It is the testosterone that is of most concern. It remains at rock bottom or not even measurable BELOW range.  I have done some research of the top 10 symptoms of low T in women and she has about 7 or 8 of the ten symptoms.  THat being said, many of these symptoms are also parallel low Thyroid which we know she has and is being treated for.

However have any other women out there been diagnosed ith Low T?

If so have you been treated?  what worked?  How did you find a Dr to treat you?  And how do you feel now?

In my research I was shocked to learn that women have 10 times more testosterone in their blood than estrogen!  This would seem to indicate the critical and important nature and need for sufficient testosterone in women.

So far my wifes Dr. has been resistant to even consider doing anything about her low T condition.  Despite it being repeatedly tested low and her having symptoms consistent with low T.

This is VERY frustrating and any advice for help or where to go or who to call to find a good Dr would be much appreciated.

My wife is also a bit apprehensive or taking a "man's hormone" and since her Dr is not conmcerned about it she is not very motivated to do anything about it.  Even though it can help or may help her overall health.

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Avatar universal
I don't take any other prescription meds besides thyroid meds. I think my caloric intake  is about 2500 the most on a given day. I eat 3 meals a day, no snacks but eat if I'm hungry, and make sure to eat something before going to bed if my dinner is around 5 or earlier. I don't have much of an appetite,( never really did) food has never been a big thing for me. I eat to live, not live to eat.  I avoid sugar like the plague but sometimes I have something sweet, I have to stay gluten free otherwise is hell to pay. One important thing is about cortisol and progesterone, if cortisol is too high , progesterone will be low. Make sure your wife supplements with progesterone, in the last 2 weeks before her cycle. I do all the time,(21 days) on docs orders, but have a higher dose on last 14 days if needed. I feel so much better  since I do progesterone that extra week. If I take too much progesterone I get more water retention. Some people say is harmless to take too much, but you have to listen to your body.Smoky Mountain Naturals is one brand that I really liked for over the counter creams I used before going to the doctor, very inexpensive. You can get it on amazon or their website and they have DHEA too, 25 mgs, I would cut it in quarters before I got the one from the drs. office.  
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Avatar universal
My wife has been losing a lot of weight. At least for her.  Since Cugust 1st she has lost I think 23 pounds.

She also is REALLY stressed at work, and also has started taking on-line college courses that will continue for the until next winter.  Adding to her stress.

So I can just imagine that her cortisol levels have skyrocketed.  Which further make me wonder about the importance of DHEA.  And that DHEA is needed for Testosterone which we already know she is BELOW range in.

At the moment, the last thing I'm pretty sure my wife wants to hear or to have me put on to her already overflowing plate, is for her husband to harp on her about her hormone levels.  I'm pretty sure I will come out on the short end of that stick.  So I'm just trying to gather knowledge and biding my time to when I feel it is safe to enter those dangerous waters!
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1756321 tn?1547095325
That's good to hear about the gut issues. :)  I've only just started at the gym myself but I found I was using up more of my B12 (have autoimmune pernicious anaemia) and having various symptoms from unable to find the right word to fatigue so I've had to increase my B12 dosage.  I've read SHBG can also be increased by certain drugs such as phenytoin (anticonvulsant); anorexia nervosa; long term calorie restriction.
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Avatar universal
Hi, I have not experienced any gut issues so far and my stomach stay flat all day, and my skin around my abdomen looks "toned"  instead of puffy filled with water/mucin. Because of my fatigue I have not been able to work out in 3 weeks, not that I would see much improvement. They say when you exercise, have sex and loosing weight, would help with increasing testosterone naturally. It seems to be a rather vicious cycle, if you don't have energy you don't exercise, so on and so forth...In my case  4 yrs ago SHBG was still high, not over the top. I don't have any of the listed issues; while I do the hormone therapy, I don't  absorb well. I've always gone under not over in spite of getting higher dosages. I hope I might be closer to menopause.  
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1756321 tn?1547095325
I should of added that when I had my testosterone levels tested I was undereating due to a poor appetite but I was eating some fat to help with my testosterone production at least.
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1756321 tn?1547095325
Vino14, Glad to hear the proteolytic enzyme is working. What improvements have you noted?

I had my testosterone and SHBG tested back in March 2012 (was already treating my hypothyroidism).

Testosterone - 1.0 nmol/L (0.3 - 2.8)
SHBG - 18 nmol/L (18 - 114)

I had many reasons to be testosterone deficient back then - eating too much added sugar (this caused insulin resistance and chronically high insulin levels); zinc, vitamin D and magnesium deficiency; being overweight plus I wasn't doing any exercise/weight training either. But I also love my fat (cheese is my favourite! lol) and do intermittent fasting (a listed way to increase testosterone) so I was able to keep my testosterone in range.

SHBG can be decreased by hypothyroidism, high insulin levels, excessive testosterone administration, obesity, high cortisol, alcohol. SHBG can be elevated by high levels of estrogen, hyperthyroidism, excessive thyroxine administration, chronic liver disease such as chronic hepatitis and cirrhosis, fiber.  

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Avatar universal
Hi, you are so right about testosterone helping with bone loss, and there is a list quite long of benefits for the body.  I did find my doctor through a referral, and kept asking anyone I came in contact about him. Some had really nice things to say about him, some thought him to be too extreme. I needed someone that  was not stuck in the past. He is completely private, which I don't mind. He is a regular MD, that practices holistic medicine, functional medicine. He's in the same category as Mercola. I like that I don't have to tell him how to do his job or beg for labs. I'm imagining he came to those lab ranges based on how his patients feel best. Personally I didn't have issues when I was younger with eating sugary stuff. For my small frame 5'1, I would always be around 105 to 107 the most, and ate as many sweets  as I could. If I were at an event, I would always choose sweets over  real food. I was the women that ate anything and be skinny, and I enjoyed every minute of it. Never had issues with gut when all this eating out of wack was happening.  Since my thyroid problem was getting worse and didn't know about it, that's when gut issues started to bother me. I now weigh 130, but still look good, because I used to be so skinny back then. I feel perfect at 130lbs. Because of the increase in thyroid meds last month I was able to loose 5 lbs without doing anything extra. I think was mostly water/mucin. I avoid sugar and almost don't eat sweets at all, since I've added potassium foods to my diet. I simply don't crave it whatsoever, I would have never believed it was possible. I've added the proteolytic enzyme that Red_Star mentioned and I really like the effect.
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Avatar universal
you said:  "When I was in to see him first time in March my  total testosterone test was 20, he said that was like an 80 year old.

that is funny.  Since my wife is testing below 20.  They won't actually report a value the test report simply states "<20"  so what does that make my wife 100? or dead?  One thing I can say for sure is that her libido is dead!  but the lack of T also I have to believe is causiing other negative health effects as well.  Particularly the association of loss of bone density, muscle tone, weight loss, poor sleep, depressed mood etc.

also interesting you stated:  "My doctor says the T numbers for women should be between 70 to 130.

And that the top of the range my wife is listed at the very top of the range is 73! which is the very bottom of the range your Dr suggests is recommended.

How did you find your Dr?  Is he or does he recommend a certain professional organization or association that I could look up to find if there are similar affiliated Dr's in my area (South-Central Wisconsin).

There are a lot of quacks out there and if we go the out of pocket expense route, we really can't afford to churn through doctor after doctor until we find a good one.

We have gone to healthcheck USA.  In fact that was the ONLY way we could obtain the first Free T3 test.  And once we had that data to show how low her levles were did we finally have success to FINALLY convince the endo to prescribe T3.  He did so reluctantly and seemed "surprised" that the next time she felt so significantly better.  Dah!

I have not looked into them for the sex hormone testing. But maybe we will have to go that route yet.

I have not found eating specific times to be of any great value. In fact for losing weight I have found a later breakfast and skip lunch and then a larger dinner seems to be the best.  But I can't get too hungry either or I get really grouchy.

high carb and high sugar diet 9which is everything a "normal" american diet consists of is the exact recipie and perfect menu for Candidida bacteria. Which is the "bad" bacteria in the gut which over populates and causes the good bacteria to die back. Which results in leaky gut, which results in inflamation which results in all sorts of chronic diseased and aches and pains etc.  So eating probiotics, fermented foods etc and limiting the sugar and cabs does the opposite. Promotes the good bacterial growth and kill off the bad bacteria.

The connetion of the need for fats to promote testosterone is also fascinating.  As the so called "experts" continue to pound Americans to cut the fat and fat is bad, and eat low fat meals etc. Starving the body of what may be necessary fats for the body to make the proper hormone levels.  How many women are suffering from the symptoms of low T and they are continually tolld to eat low fat foods which further exacerbates the low T condition.  But they do not know it is low T because they are not even tested for it, and the ranges that a true healthy woman should have are NOT represented by the reference ranges?  vicious cycle.

Think about it.  The range is made up by 95% of the women who have been tested for testosterone.  Yet what women do you think gets recommended to be tested for testosterone?  Well the obvious answer to that is Dr's who suspect that testosterone is or may be a problem.  So now you take a population that is being tested, most or many of which are NOT normal or even sick. And then create a "normal" range based upon a nearly 100% population that is sick and NOT normal.

This is probably why your Dr recommends such a higher range for testosterone in women.

The exact same phenomena applies to thyroid. Which is why the "rule of thumb" to feel well is to be at or above 50% of the ranges.
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Avatar universal
Hi, interesting observation in your diet venture. One major thing that makes a huge difference for me is to eat on a regular schedule about 4 hours apart. We were in vacation in June and traveled from our area, Eastern WA all the way down to San Diego. It was just the two of us, kids stayed home. We ate out the whole time, I took some protein bars to have in case I got hungry, my husband only ate  a large late breakfast and an early dinner not much in between. I gained 2 lbs , and he gained 7 lbs. I lost all in one week, when we got back. He never did, and refuses still to go see my doctor for labs and a physical exam. Very stubborn this one!

The testosterone levels should be within that range all the time, my doctor said it should be at least 70, and it doesn't matter what day I do the lab work; yes for the E and P are ranges based on day of cycle.  I was wrong on an earlier post my labs ranges says 2.6 to 40.8 that's why he always crosses them.   If you check on line for hormone graphs, you'll be able to have a more visual of hormone fluctuation, you'll see the spike around ovulation time and flat line all the time for testosterone compared to the other 2. When I was in to see him first time in March my  total testosterone test was 20, he said that was like an 80 year old. In spite of all the adjustments so far I have never been stable, always fluctuating and SHBG is not adjusting, that should be around the middle of the range. If is too high or too low you have the same symptoms as of low T. On a men's forum someone mentioned that unstable thyroid problem drives up the SHBG, which in my case holds true. I'm  doing all the supplements that usually help with lowering SHBG,( boran and nettle root) and no budging so far. I followed a strict candida diet for the past month and used antifungals,  that was also mentioned on the list for things that drives up SHBG, since I've stopped those, I'll see what happens when I test in 2 weeks. You have to find a doctor that specializes in hormones, if the one she sees is not into that. The down side of doing the supplementation of the sex hormones is that you have to do tests to know how your levels are holding/or not holding up. So far my insurance (stupid Obama care) is been paying  really well for all the labs I've been doing. If they were not to pay and just benefitted from the adjustments on the bill, would still be affordable for me.
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Avatar universal
My wife and I and oldest 2 daughters recently went on the "Whole30" diet.  it is in essence the Paleo diet but a bit more stringent for the first 30 days.  Bottom line was that eat no processed foods, no refined sugars, no dairy.

It really means that you simply have to eat fresh fruits and Veggies, and non processed "clean" meats.

It also stresses coconut oil, avacados, nuts etc.

My wife who ALWAYS has struggled with her weight did nothing eles, that is she did NOT start excercising etc. Only the diet.  And in 30 days she lost 16 lbs and like 4 inches on her stomach and waist.  She continued more or less for another couple of weeks and is down over 21 lbs and lost an additional I think half to 3/4 inch from waist and stomach.  She averaged over about 4 lbs of weight loss a week.  Simply by eating fruits, veggies and clean meat.

This REALLY taught us the incredible power of the traditional American diet and the processed foods and hidden sugars in everything and just how impactful and terrible they are to our health.

This was further proved as we went away for the weekend and ate "normaly" and we BOTH gained weight.  Her from only the weekend gained a pound, i had a trip away for work and drank and ate outside of the whole 30 plan and I ended up gaining 3 lbs.

What I liked about whole30 was that we did NOT portion control.  That is when I was hungry, I simply ate compliant foods.  So it was NOT a starvation diet what so ever.

Many people look at the "do not eat" list and throw their hands up thinking that it is too restrictive. But if you look at it and basically think to yourself what you essentially CAN have in reasonable quantities is a LOT of food.  Just imagine what all the menu items you can make with fruits, veggies and meat.  (like ALL of them).

Of course any diet you can't fill yourself with soda, and cake and other sweets.  So nothing new here!

Thank you RedStar for that article.  Very interesting.  I see that the study was for men.  I wonder if the same effects are true for women as well????


The reference range for total T for my wife in Follicular phase was (20-73)

your Dr says 70-130 but is that for a particular phase of your cycle, or is that sort of an all encompassing range.  In any event what is most interesting is that the BOTTOM of your Dr's recommended range is essentially the very TOP of the range my wife lab was listed at.

i just checked and while progesterone and Estrogen list specific ranges for the various phases of a woman's cycle, for testosterone they do not.  I guess becuase they don't expect a woman to be tested for it.  Or if they do, that it must not fluctuate which would confirm vivo, your Dr's statement that testosterone is relatively stable or constant for a woman.

I also checke back and over a year ago, my wife's SHBG was listed at 39.8 (18.0-144).  So from this she would be at only 17.3% of the range, whatever that means.  This test was taken back in november of 2014 when her total T was listed at the very rock bottom of the range at 20.0.
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1756321 tn?1547095325
Yes indeed. My mother went on a low fat diet once and she developed serious depression. First and last time she did that!
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Avatar universal
Thanks for posting the importance of the right fats. I didn't think to mention that since my mind is not all there all the time. About 3 years ago completely changed my eating habits, and use all the good fats on a daily basis; I was happy to find out when I was tested,  my cholesterol and all the things pertaining to it was in perfect range, better than when eating the low fat crap. All our hormones are produced from cholesterol.(especially sex hormones)
It gets so expensive to eat good food, without all the chemicals in it.
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1756321 tn?1547095325
A good article on testosterone is Dietary Fat and Testosterone: Everything You Need to Know About Fats and Testosterone Production. I posted the entire article. :)

"Dietary Fats and Testosterone Production

There are two crucial factors to look for when focusing on dietary fat intake to optimize T.

1. The actual amount of dietary fat you eat is important. This should be pretty high, but there’s an upper limit from where things start going to the opposite direction.

2. The ratio between different types of fatty acids plays a crucial role. Not all of them are equally as effective, and one of the groups actually decreases testosterone.

I’m assuming that most of you already know the difference between fats, but for the sake of simplicity, these are the three types of fat you need to know:

Polyunsaturated fatty-acids (PUFAs) – omega fatty-acids (3,6,7,9), sunflower oil, canola oil, soybean oil, safflower oil, flaxseed oil, walnut oil, margarine, light spreads, etc.

Monounsaturated fatty-acids (MUFAs) – olive oil, almond oil, avocado oil, hazelnut oil, macadamia nut oil, peanut butter, etc.

Saturated fatty-acids (SFAs) – red meat, butter, coconut oil, palm oil, dark chocolate, egg yolks, cheese, whole milk, etc.

Here’s what science tells us about these fats and testosterone production:

a) In this study, the researchers tested several nutritional factors to see how they correlate with pre-exercise testosterone levels in healthy men. What they saw was that the diets high in saturated fat and the diets high in monounsaturated fat, significantly increased testosterone levels. Whereas the diets high in protein, or the diets high in polyunsaturated fats, both reduced testosterone levels in a pretty much dose dependent manner. The researchers also saw that the higher the dietary fat intake, the higher the testosterone (diet containing mixed fats).

b) The data of the study above is consistent with the results that are seen in vegan/vegetarian studies. Vegetarians eat lower amounts of dietary fat, and their PUFA/SFA ratio is higher than what is seen in most omnivores. That’s more than likely the main reason why vegans/vegetarians have noticeably lower testosterone levels than meat eaters do (study, study, study, study, study).

c) Several studies have also shown that when diets lower in total fat intake (~20%), are compared to diets higher in total fat intake (~40%). The higher fat intake groups always have more testosterone, and less SHBG in their blood serum (study, study, study)

d) In this study two elite ice hockey teams were put on different diets for a period of 7 months. The other team received a diet containing 40% fat and 45% carbs, whereas the other team ate a diet with 30% fat and 55% carbs (protein intake was identical). Both during and after the study, the researchers saw that the higher fat intake group had higher free testosterone levels, along with lower sex hormone binding globulin (SHBG) levels.

At this point it becomes quite obvious that you need to eat plenty of fat to increase testosterone levels, and that the types of fat you need to focus on are the saturated fats and monounsaturated fats. Whereas the consumption of polyunsaturated fats should be kept low.

Eating 35-40% of your daily calories from mostly SFAs and MUFAs would be my recommendation for optimal testosterone production. No more than that because you have to leave some room for carbohydrates and protein too.

“But what the heck? I’ve heard that saturated fat causes heart conditions?!”

Answer: Don’t fret over such nonsense. Recent research has shown multiple times that the correlation between dietary fat intake and cardiovascular disease risk is pretty much non-existant. Brett from the Art of Manliness actually has a post here, which shows how he ate a high-fat diet that doubled his testosterone levels, while his blood profile stayed optimal the whole time.


Eating a diet high in fat is a sure way to increase your baseline testosterone levels. In fact it’s one of the easiest ways to do so.

Research has also shown that the higher intake of saturated fats and monounsaturated fats leads to higher testosterone levels, whereas a higher intake of polyunsaturated fats leads to lower testosterone.

So not only does the amount of fat you eat matter, but also the type of fat.

Thank you for reading!"
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Avatar universal
Thanks again for your reply. I did have a reverse T3 test done  about a month ago and it looked ok, and the % between  reverse T3 and free T3 was lower than optimal,  my labs were still low,  in spite of meds for so many months. When we had labs done that's when the doctor mentioned resistance at the cellular level as a possibility. I had a thread started on that.(thyroid labs and questions)  My totals were low and especially free T3.  My main complains on Nature Throid being no energy of any kind, sleepy most of the time, feeling like a zombie pretty much.(a functional zombie) When we kept increasing the dose I would always feel more sleepy to the point I could barely drive to get home, and I would have to take a nap, the moment I got home. Libido never improved, luckly sex for me is more of a mental thing, 'cause if I waited for my body to want it, will never happen. All other bodily impairments have improved except for hair falling, but at least was still growing. In my above post the SHBG was 275 not the testosterone. My doctor says the  T numbers for women should be between 70 to 130, when using hormone creams and 150 to 300 for pellets( and for normal  functioning women) (the lab ranges shows 20-40, he always crosses over and writes 70-130, find that funny)  
The FSH stands for follicle stimulating hormone, is a hormone released by pituitary gland sending the signal to the ovaries to produce more estrogen, etc. Short story, if your body is not producing enough estrogen that number goes higher. I mentioned earlier he treats women as menopausal at FSH 20, regular doctors say 25. While perimenopausal that number fluctuates, but when things are off for me on day 3 is always  around 16 to 17 even with estrogen replacement. That's why it  got my dose high last time. For fertility purposes is best to test on 3 day of cycle. So my story is, I've been perimenopausal since age 33.5, at 35 first got tested and FSH was 18,( my current doctor wants it at 5 all the time, regardless of time of month) was not tested for estrogen, to my surprise I was tested for testosterone which was about 40 at that time, but was never explained anything just given a choice of birth control or anxiety meds. I chose the birth control pills, not knowing what perimenopausal was all about it. (the hormonal implications)  Since my thyroid condition was  not diagnosed, was affecting more of my body, one organ at a time until last November I  came to a complete stop. Nothing would work properly in my body, scary thing, and in top of it my husband was telling me that's how is when you get old! That was nothing wrong with me!  That's when I decided I have to seek the help of a doctor who knows about hormones, not hand me antidepressants. You may want to do some reading into pregnenolone. I started last year taking it on my own, I took 50mg for about 2 weeks until I felt was too much, (chest pain mainly), but for long term 10 mg a day is ok for women, men can take more.I was in perfect range when he tested me for it, and he said is ok to keep taking it.
It is very safe to take DHEA in the small 5Mg(micronized form)  few times a week, I was taking that,  way before going to the doctor and the same thing the facial hair is the only downside, and was doing that 3 times a week as well then. If you stop the meds for few days , facial hair stops growing.  I would forget to take it regularly, had I not taken any I would have been even lower in the test.(I was close to midrange, he wants it higher). That's what I don't understand about the "regular doctors", why are they so against testing for the right things? is almost like they don't want  people to feel good.

Make sure when she gets tested for testosterone to get Total T, Free T, % Free T, and SHBG(sex binding hormone globulin) . While is important to have Total T in the right range is crucial to have the Free T in the right range(the active hormone) and lower SHBG, like in my case with that high SHBG all my testosterone is bound and useless. In my case since I've never been optimal with my thyroid my SHBG is been getting higher with my increases in thyroid meds. Today was my first day on Synthroid and I didn't ask why, but I will at my next appointment, he has me taking 100mcg in the morning and 50mcg at 4(took mine at 3 today). I did really well until 1:30 pm, I literally had energy,felt very social and well mentally. By 2 pm I was falling into the sleepy routine, had a car appointment and almost fell asleep waiting, reading on my phone. I got home and slept for 2 hours.  I take my meds at 6:45, those hours of feeling good felt really nice to be able to move fast .(I do housecleaning) Have you looked into the healthcheckusa website for doing tests on your own. I have not used them, but here in my area prices seem quite affordable for me.  Better if your own insurance would not cover the labs and gave you a 20% discount. Your wife should consider herself lucky to have you advocating for her.  When I was feeling so bad, I could not even think straight, and in top of that having someone telling you is nothing wrong with you, even worse. Luckly for me I decided to ignore anyone and seek the help I needed so bad. Keep helping your wife.
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Avatar universal
Yes my wife was on T4 only medication fo r years.  UNDER medicated for years.  Then finally pursued and got increases in dosage but still only T4.

We then finally after several Dr's got an older Endo who after begging him, started her on T3 in addition to her T4.  And immediately started feeling better.  This dosage of T3 increased and each time she felt better.  About the time that she was I think getting close to optimized, this Endo retired.  And his replacement was a complete joke!  Remoeved all the T3 and my wife as we fully expected "crashed".  When she/we went back in, the endo would NOT believe it was the absence of the T3 etc and we just walked out of there and never even returned a call to that quack!

My wife then finally really got more serious into study of thyroid and read a book. It was a good book (Dr. Hoetz? or something)  and it really promoted Narual desicated thyroid.

She then switched primary care Dr's and this Dr was really good and actually took the time to listen to my wife.  And I went with her and had a huge list and a spreadsheet showing her dosing and symptoms all tied to blood labs and explinations etc.  He was impressed at our knowledge and the data etc.  

I personally thought my wife should go back onto the T3 and T3 combination as we had fairly recent results and blood labs and dosages that I thought was getting pretty close to optimizing her.  However my wife was hell bent on gonig to Armour.  And this Dr was willing to do that.  So this has been about 1.5 to 2 years now with iterations of bumping up her Armour dose.  But her Free T4 remains BELOW range.  So I have been advocating to add back in some T4 in addition to her Armour dose, but so far I have lost this battle.  My wife is now on 3 grains of Armour taking it in a split dose, in the morning and the 2nd dose about 3PM.

As far as medications I am a firm believer that there is no one perfect solution when it comes to thyroid.  Each person is so different, and what works for them is so different than another.  The important thing is that you obtain the correct balance between FT4 and FT3 that eliminates symptoms.  And then having the blood labs that then give you the target of where YOU need to stay in order to feel well.  But again this is more art than science. And the Dr's today are all about science and they have been brainwashed to believe that if the blood tests happen to come out within the "normal" range, then there is nothing wrong. Which is complete Bull.

Maybe my wife's labs were done with a differnt scale or something. As you say your total Testosterone was in the 275 while my wife is below 20.  So maybe your scale seems 10 times larger.  But your range is listed as (20-130) whereas for my wife's labs range is (20-73) which is the specific listing for the follicular phase as the lab reference range was broken down into the three phases of the menstural cycle.  The follicular being from the start of the period until I believe the definition is ovulation.  In the follicular phase the estrogen and progesterone is at the very lowest levels and rises closer to ovulation.  My wife was tested on day 3 and day 5 after starting so it would be expected to have the very lowest levels of progesterone during this early part of the follicular phase.  I have read nothing as to what the levels of testosterone do throughout the menstural cycle.  So it is interesting that you suggest that the levels of testosterone remain relatively unchanged which is very interesting.  And if true would further support the idea that something needs to be done to raise my wife's testosterone level!

With regard to your thyroid, have you been tested for Reverse T3 (RT3)?

This RT3 testing is somewhat controversial.  Some believe that RT3 is the mirror image of the Free T3 molecule. And that it "looks" so much like FT3 that the cells receptors will accept the RT3 thinking that it is in fact FT3. But as you probably know, RT3 is biologically inactive. So if there is a lot of RT3, then the cells become "plugged" and there is no vacancy (no room at the in) for the biologically active FT3.  So you are functionally and Hyupo at the cellular level, despite what would other wise look like from blood labs having sufficient FT3 levels.

Since RT3 is ONLY produced through the conversion process of T4 into T3, the idea to "clear" out the RT3 issue is to limit or completely eliminate to the extent possible T4.  This then shuts down the conversion process, and thus shuts down the production of RT3.  T his is HIGHLY controversial process as if on T3 only,  then as the cells "clear out" the RT3, you can switch from being Hypo to extremely HyPER very, very fast.  So if even considering this protocol, it is important to be VERY closely monitored and be very vigilent on knowing the very first signs of hyper and reducing or stopping taking T3 medication to keep from going Hyper.

I'm not saying that this is your probelem. But getting tested for RT3 may make some sense to rule it out if nothing else.

There is very little difference I don't think between Nature Thyroid and Armour. Both are natural dessicated thryroid medications derived from pig thyroid.  I'm sure the fillers and buffers etc are different. But that is really about it.

before going on synthroid or generic synthetic T4 only, you may want to get the RT3 test done.

When you say you are not getting anywhere with Nature thyroid, what exactly do you mean?   You could be one of those people who won't feel well until your FT4 levels are high enough despite your FT3 levels being OK.  This is the condition where I think my wife may be in relation to thyroid.

My wife has NOT been tested for free Testosterone or SHBG, or DHEA.

I am still very suspicious about my wife being low DHEA.  As that is the building block for all the sex hormones especially Testosterone as best as I've been able to research.  Also I think it would be MUCH easier to convince my wife's Dr to treat low DHEA than he seems to be willing to consider treating the low T.

For affordibility purposes I would obviously like to stay within our HMO insurance.  But at this point after years and years I have about had it and just want to get to an optimized condition and simply find a way to pay for it out of pocket if we have to!  

I do not know what FSH is, so I will have to learn more about that.  

In my wife's case, as she is 45 it complicates the situation a little as she is not yet in menopause but I suspect in preimenopaus.  So the Dr is less willing to do much with the "excuse" that she is in transition.

I say B.S.  She has had hormonal imbalances for 10 years or more so I just do not buy that argument for a second!  She has never had a libido even when she was in her 20's and first married, so I have to believe this has been a raging issue for a LONG time!  It is just that Dr's are unwilling to do the testing and find out a darn thing!
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Avatar universal
Hi, the testosterone level for women it only raises slightly during ovulation otherwise stays the same, including during cycle. I do understand your predicament and your wife's situation.  It is important to have referral if you decide to try a " functional medicine" doctor. I'm paying for mine all out of pocket,  I couldn't afford to have a regular doctor telling me nothing is wrong with me, when I feel like a zombie;  $84 for half an hour visit, I find it quite affordable.Normally I would go in once every 3 months, but because we're trying to figure out the thyroid situation, I go once a month and call in every week. I'll be starting Synthroid on Thursday and see how it goes, and Cytomel later if needed.  Had my labs done and my FSH was 7 which is better than before , Total T was around 115 which is ok , didn't look at free and %, but my SHBG was 275,( 20-130) so all my testosterone is blocked.  The reason I'm so determined to get this squared away because I know exactly what I'm missing.  When all was normal for me, I couldn't understand how a woman wouldn't be interested in sex, now experiencing the other side it makes  complete sense.  I also know it must be hard for you since your wife is not  pursuing this on her own. My husband is worse, he doesn't even want to go to the doctor, doesn't care for vitamins etc,. If he were to drop dead one day would not surprise me. I strongly believe the thyroid slows down the sex hormone  as a preserving mechanism. I'm a living example. Because of this resistance thing with the meds, I'm curious , has your wife tried other meds before Armour ?  I started with Armour, didn't do well, Nature Throid not getting anywhere.  I'm sacred at this point of all horror stories people say about Synthroid, but I have to try.
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Avatar universal
Yeah, I figure that if we cannot convince her current Dr to try replacement or at least further testing.  Then we are "stuck" with either doing nothing, or to go out of insurance system, and 100% out of pocket and trying to find a "good" hormone Dr.

however there are I know a lot of quacks out there who are more interesting and charging you for expensive tests and tons of supplements simply to make a LOT of money.  On the other hand, there are very good and qualified Dr's out there specializing in this.  So the trick is to find out which Dr is which.

The Maca root seemed to do nothing for her.  I can't remember saying she had other side effects like dizziness or anything. But seemed to do nothing but cost money so she stopped taking them after about two bottles (about 2 months) with no felt difference.

I have been here and reading and researching and studying Thyroid for several years.  And almost nowhere have I ever come across much of anything other than anecdotal story occasionally where any mention of thyroid interaction with sex hormones.  But that doesn't mean they don't interact. But it would seem with the thousands of people and many of them women that have come here, I can't recally hardly a single one who mentioned any testimonial about an interconnection.

I can also understand trying to not change three different medications at the same time, because if you felt better, or worse, you wouldn't be able to know which medication(s) that caused the change. So changing one thing at a time is a good general practice.

But after literally YEARS, multiple YEARS, at some point a person wants to "cut to the chase" and get somewhere already.

With hardly any effect of bumping of my wifes Armour dose the last few times, it really makes me wonder if the problem is not lying somewhere else. Which lead us to ask for the sex hormone tests.

The interesting thing is the symptoms of Low T in women virtually match identically the low thyroid symptom list.  So the difficulty is to convince the Dr. that her lasting symptoms may be low T and not Hypo thyroid is a touch argument to make.  And there is no gurantee that it is not BOTH.

All I know is that the tests show she is BELOW range.  As you can see above they won't even list the amount. It simply says less than 0.20 which is the botom of the range.  Thus saying that she was BELOW range.  The very first test was exactly 0.20 which is THE bottom of the range.

I realize that the timing of her cycle will have an effect of how much T there should be.  But three tests in a row ALL showing at or below range SHOULD mean something right?????  Not to mention that her symptoms match what a woman with low T would expect to experience.

It doesn't seem like rocket science to me.....

I'm pretty sure my wife has never had a testosterone driven life. As she has never had a libido, nor thinks much about it.  But how could she when she may have never had the biological fuel to sustain any thought or desire?

If you decide and want to go on vacation, you can make up your mind all you want. But if the car has no fuel in the tank, you ain't going anywhere despite your best of intentions!
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Avatar universal
Sorry I forgot to mention, I take a lot of supplements too. My kids make fun of my, they say I'm like a drug lord.
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Avatar universal
Thanks for your comment! I find it very disappointing when doctors don't test or suggest what to test for. In my case my husband doesn't care, but I want to feel the same like I used to be. I'll be 40 next month, I don't want to feel like my life is over. Many women don't pursue testosterone because don't know, and if the doctors don't mention testosterone as a test, that's the end of it. When I was looking for a doctor for my problems, I has asked all the women I knew. Only one mentioned him and the fact that he does  all the tests and knows how to treat with all hormones. All other women never mentioned testosterone as part of the equation.( 35 women all menopausal)  I completely trust my doctor on regards to the thyroid affecting the sex hormones. He's been practicing for over 26 years. A lot of the information he tells me is not available on line, no surprise!  If he doesn't figure it out for me I am completely doomed, he's one of the few in a 200 mile area. Looking back at my symptoms the thyroid ones were progressing for 16 years until the ovarian failure started 6 years ago. Also Adrenal Fatigue is one that interferes with thyroid meds and sex hormones not getting better, if you read on Dr. Lam website. I had the 4 times a day saliva test done in the beginning and was fine.  Funny thing is that when I get a thyroid increase things get better with sex hormones, lasts a week and back to square one again, because that's how long I feel ok with the thyroid meds. I'm taking a 5mg micronized DHEA.  I get it at his office very inexpensive. You can get it from  Pure Encapsulations. I don't tolerate it every day. I could never get used to maca powder, would make me dizzy. My labs on the thyroid are very low keeping in mind I've been taking the meds for 7 months. In the past month had the most increase, every week, or 2 depending how much of increase. I'm calling in every week, which is so wired, don't feel any different anymore.  I am very intrigued myself to see if more women reply. When I first discovered MH, I was curious if other women had the testosterone deficiency as well, while estrogen was really low for me, testosterone was almost non existent, and believe me I was testosterone "queen" in my day. There few posts from men asking the correlation between  hypothyroid and low T.  Good luck in finding more answers. One thing is for sure, I miss my testosterone driven life.
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Avatar universal
My wife is on Armour. She at the above sex hormone tests she was taking 165 mg which is 2.75 grains.

She has since been bumped up to 180mg = 3 grains.

Her FT4 is BELOW range and her FT3 is low in the range.  And the last blood test they did NOT test for FT3 which we are VERY upset about!  But her feet have been colder and she has been complaining about being cool in the car when the rest of us are hot, so a bump was definately needed.  She has brought up the idea of adding back in T4 medication to get the chronically below range FT4 levels up.  Maybe with the next dose change.

I'm not sure what type of interaction thyroid has with the other sex hormones.  I can't really find articles that really talks about this interaction, so it leads me to believe that the interaction is not all that great. And the bioidentical hormone therapy articles it would seem would all mention that thyroid imbalance should be taken care of FIRST if there was a great interconnection between thyroid and sex hormones.  So the silence is deafening if you know what I mean.

My wife has recently started taking some on-line college classes and is taking over some additional work at her job due to a co-worker out on maturnity leave. She is stressed out!  So I have little doubt that the last 2 weeks maybe 3 weeks her cortisol levels have shot up.

But the most recent blood labs were taken BEFORE this stress really set in.

I am leaning towards DHEA as first thing.  If it is low then holding off on Testosterone treatment would make sense to see what adding DHEA would do.

My wife has tried taking some over the counter (GNC) libido enhancers in the past. And she could not tolerate them.  Usually got the "shakes" and also almost immediately started breaking out in acne.  Tried it I think two or three times separated by weeks or months and had the same reaction each time and at least two different products.  I can't remember the name of them now.  But ended up throwing both of them away.  So I'm a bit dubious of over the counter herbal remedies.  I'm also concerned that likely these had DHEA in them.  Thus she like you may be way to sensitive to take DHEA even if she is low.

She has tried "Maca root" which is reported to help libido and other things and it did absolutelyl NOTHING.  So she stopped taking that.

My wife has been battling thyroid optimization for more than 10 years I think.  Many Dr's were hired and fired throughout this journey of misery.  All to start over and try to train them only to find they are a brick wall, On to the next Dr and on and on.  At oine point had a "good" endo, and he retired.  His replacement was a complete "ditz" and changed everything and my wife "crashed", and woudl not listen to my wife. So we fired her too!

This most recent Dr will at least listen to her and was the first to easily allow Armour.  And is willing to do the increases based upon what she is feeling. But even this has been over a year I think and she is still being bumped up and still has FT4 levels in the basement!  TSH is NOT suppressed at the moment (2.2) but has been suppressed on and off again.  But I take like zero credibility in TSH, especially at now 3 grains or Armour.  Yes she takes the Armour in two doses during the day and away from food and supplements.

She takes or did take a LOT of supplements including Vit D, and Selenium.  I think at least a common daily multivitamin.  But I'm not sure how much like Zinc and copper is in there per say.

It is only her/our proding to get the sex hormones tested that the Dr has agreed to test them.  The Dr seems to be resistant to want to do any sex hormone treatment.  Every time we mention it he seems to find an "excuse" as a reason to ignore it.  

He is, or seems to be a good Dr.  I think it is simply a matter that he is not experienced in sex hormone theapy and especially testosterone treatment in women.  So he is simply not comfortable with it so we are getting the "run around".  It is reminisant of what we have seen in the past with Dr's who know nothing about thyroid but keep giving excuses over how everything is "normal" while my wife feels like crap.

My wife is dealing with other issues as well and the testosterone thing is not very high up on her list.  She is pretty content at just getting and working on increasing her Thyroid at this point.  She doesn't think that a libido is anything much to care about.  But obviously I do, and the fact that testosterone plays a MUCH bigger health aspect in woman's health than I think she and most even realize.

The fact that normal levels of testosterone in woman's blood is TEN times more than the amount of estrogen.  Even with that long process Red_Star points out that it takes to make testosterone should indicate I think two things.

1) That testosterone is VERY important to woman's health
2) That Estrogen is amazingly powerful at extremely small amounts!

I am just trying to learn and see what other women have had for experience.  In particular I'm hopefully looking for a bunch of women who have been successfully treated and they can testify as to what the effects were in addition to libido.  As my wife will probably be more interested in those "other" benefits more so than her husband "pushing" for her to get testosterone treatment in order for her to obtain a libido.  That sales job is a bridge too far if you know what I mean!  She thinks I'm only out for THAT one reason, and that is not the case. Well not entirely the case anyhow ;)
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1756321 tn?1547095325
You could try a proteolytic enzyme supplement to see if that helps first.  Plenty of hickjacked threads on medhelp lol.
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Thanks for the info on proteolytic enzymes, so if I would take the said enzyme it might help?  If at 4 grains I don't have improvement I'll be switched to Synthroid/Cytomel.  When I get an increase I get sometime sleepier than before, after a week evens out to my usual sleepy routine. I don't have any sense of energy, mental alertness or anything to resemble being alive. My pulse is around 64 lucky if 70. I didn't mean to highjack flyingfool's post.  
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1756321 tn?1547095325
I was taking 3 grains of Armour and having major breathing issues and was back onto synthetic T4 (50mcg) quick smart! I actually have cellular thyroid issues but that is at the very least related to inflammatory cytokines. The issue with poor absorption of Armour however looks to be problems with absorption due to not enough proteolytic enzyme production (in my case I believe this was due to being hyperthyroid for a year).

Excerpts from the book: Thyroid Diseases: Clinical Fundamentals and Therapy by Fabrizio Monaco, Maria A. Satta, Brahm Shapiro, Luigi Troncone...

"There is some differences in the rate of absorption between animal and synthetic preparations. After a single oral dose of synthetic L-T4, the absorption is approximately 70 - 80%, 20 - 30% being recovered in the stool.  It is absorbed rapidly, mainly in the distal small bowel, reaching maximum plasma levels in 2 to 4 hours."

"Variability of absorption also occurs with desiccated thyroid, dependent on proteolytic enzymes of the gastrointestinal tract. Since desiccated thyroid and thyroglobulin preparations contains T4 and T3 incorporated into thyroglobulin, to release thyroid hormone the crude preparations must be hydrolyzed by gastrointestinal proteolytic enzymes, which indirectly influence the absorption of T4 and T3."
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1756321 tn?1547095325
Hmmm lol. Why am I not surprised.  It should be vitamin B5 and dietary fat make acetyl CoA. I'll post it again but with -- symbol.

vitamin B5 -- acetyl CoA -- dietary fat

acetyl CoA -- cholesterol -- circulating LDL's -- pregnenolone

pregnenolone -- progesterone -- cortisol / progesterone -- aldosterone

pregnenolone -- DHEA -- estrone -- estradiol -- estriol

DHEA -- testosterone

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