Here is an easy reference guide to see if your steroid panel (LH, testosterone, estrogen, DHT, etc.) is due to low thyroid hormones (hypothyroidism) or not.
Thyroid hormones include T4 and T3; the latter being the active hormone.
T3 promotes the release of LH and also stimulates the testes directly to produce testosterone.
Hypothyroid individuals usually have lower levels of testosterone than euthyroid peeps. But even if your T3 is normal, you might still have hypothyroid symptoms due to thyroid resistance.
Typical hypothyroid steroid panel
Here is the typical hypothyroid steroid panel.
- Low LH, but low-normal FSH. In euthyroidism, LH and FSH are usually the same. In hyperthyroidism, LH is usually much higher than FSH.
- Low total and especially free testosterone (R).
- Low DHT to testosterone ratio (T3 promotes DHT production)
- Normal estradiol despite low testosterone (thyroid optimizes T to E ratio)
- Low SHBG (even with low free testosterone) (R).
- Elevated prolactin (TRH, which stimulates TSH release, also promotes prolactin release).
- Low DHEA, DHEA-S and pregnenolone-sulfate (R).
- Less than a 10:1 ratio of DHEA-S to cortisol. TSH over 2uIU/L will start to increase cortisol (R).
Giving hypothyroid men T4 or NDT (natural desiccated thyroid) restores T4 and T3 levels which leads to higher LH, total and free testosterone, DHEA and DHT and lower prolactin. If your levels look more or less ok, look at the ratios.
How high is my:
- Estradiol to free testosterone ratio
- Prolactin to free testosterone ratio
- DHT to testosterone ratio
- DHEA-S to cortisol ratio
Additional signs of low T3 or T3 resistance
Low T3 or tissue resistance to T3 can lead to:
- Elevated cholesterol, triglycerides, LDL and lp(a) (a marker of oxidized cholesterol) and low HDL (R, R).
- High blood sugar as well as fasting insulin (R).
- Slightly elevated liver enzymes
- Lower levels of calcium and sodium and higher levels of magnesium and phosphorus. Thyroid hormone T3 promotes the release of calcium from the cells (thus increasing it in the blood) while taking up magnesium (thus reducing blood magnesium).
- QT intervals over 440 msec.
Lipids (cholesterol, LDL, HDL, etc.) are the easiest way to spot hypothyroidism. If cholesterol and LDL are a bit elevated and HDL a bit low, then low T3 is usually my first suspicion.
Check out this graph below for reference. The left column is euthyroid peeps, the middle is hypothyroid and the right is hyperthyroid individuals.
If you have low testosterone symptoms and you don’t know why then look at the other markers and ratios discussed in this article.
A good way to fix low T3 levels is to eat a nutrient-dense diet that contains all the micronutrients to support T3 production. Every single vitamin and mineral is required.
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