Welcome to Part 5 of our comprehensive hormone replacement therapy (HRT) series (click for index).
In Part 2 and 3, I shared the 2 primary hormone replacement therapy protocols I have used for the past decade.
In terms of thyroid hormone replacement, the results were -
(remember: the LOWER the number - the FASTER the TSH/metabolic rate)
#1 Cytomel (T3) 12.5mcg (everyday) = 0.7 mIU/L (FAST METABOLISM)
#2 Levothyroxine (T4) 50mcg (everyday) = 2.1 mIU/L (SLIGHTLY ABOVE-AVERAGE)
* Notable - my thyroid hormone is from a United States pharmacy, microgram to microgram, the stuff is WAY stronger than anything from an 'international pharmacy' or research chemical vendor. More on that later.
Let's discuss the thyroid hormone protocols, why I have come to prefer a normal metabolic rate to a faster metabolism and what I've learned along the way.
My Thoughts on Thyroid Replacement Therapy
(Is It Worth It?)
The T4 tablet is not a big deal, I have a prescription (it costs me about $12/month) and I've been taking some form of thyroid hormone for over 10 years, but it's something I wish wasn't necessary at this point in my life.
While I could stop taking thyroid hormone and my natural TSH levels would slowly return to normal (my thyroid is healthy, but sleeping), the process would likely take about 4 or 5 months.
(note: you can not "blow out your thyroid" or "give yourself thyroid cancer" from taking thyroid hormone, it will simply go to sleep)
During those 4 or 5 months, especially for the first 3, I would be sluggish, foggy and uninterested in doing anything but watching ESPN.
It sucks - back in 2009, I came off for a couple of weeks but decided it wasn't worth it.
I have businesses to run, places to go and better things to do than sit around depressed.
At the same time - I'm kind of stuck.
I need to take thyroid hormone or I'll eventually feel like crap.
So was it worth it?
I think so.
Back in 2005, I discovered how magical T3 could be.
My bodybuilder friend could eat 7000+ calories of total junk food and stay under 8% bodyfat.
Although I took far smaller amounts, so long as I am physically active (I'm really not these days), I can eat just about anything I want - as much as I want - and not get fat.
(without going completely overboard everyday obviously)
Even though I live nothing even close to the 'bodybuilding lifestyle' anymore, I always have the option to "up my dose" and burn fat with absolutely no added effort.
That's quite a luxury.
So why don't I speed up my metabolism anymore?
The same reason I don't live the bodybuilding lifestyle, the 'player lifestyle', or any other lifestyle I used to fully indulge - I simply have other goals and other plans.
While burning 3000-4000 calories a day with very little effort was a blast, the constant sweating, random bouts of irritability, huge meals and food bills simply doesn't fit my current lifestyle.
Still, despite the inconvenience of going to the pharmacy once a month and getting a blood test once a year to renew my prescription - it's largely been worth it.
That said, I only think that guys who are super serious about their long-term fitness goals consider using thyroid hormone to optimize their metabolism. You don't need thyroid hormone to get totally ripped and stay at an aesthetically-pleasing 8-10% BF.
If you have naturally low thyroid levels or hypothyroidism (just like if you have low testosterone), that's a totally different story.
Taking thyroid hormone may completely change your body and quality of life.
What I've Learned From Taking Thyroid Hormone for 10+ Years
Although thyroid hormone is probably the closet thing to a 'magic pill' for weight loss, it's not quite that simple.
#1 You ABSOLUTELY NEED To Get Blood Work Until You Find Your HRT Dose
Like testosterone replacement therapy, there will be a bit of a 'trial and error' period where you (and your physician) try to find which dosing protocol works best for you.
Despite my advice, many guys will be experimenting with thyroid hormone on their own and evaluating the results simply by "how they feel".
That's how I did for several years and there's way less margin for error with thyroid replacement therapy as compared to testosterone replacement therapy.
Here's what I mean -
If your testosterone replacement dose is too high and out of range - you might get some annoying side effects (face bloat, elevated estrogen, oily skin, etc.) until alter your dose. Chances are, you might not notice anything.
If your thyroid replacement dose is too high and out of range - you will feel like absolute crap and may cease to have a functional life. Even when you realize your dose is too high and abandon it, it will take about 7 to 10 days to feel normal again.
I've spent way too many days and nights on the floor in a pool of angry sweat waiting for my thyroid to slow down.
Like testosterone, but even moreso with thyroid hormone -
You absolutely need to get blood work.
This can't happen overnight though, you'll need to take T3 for ~4 weeks and T4 for ~6 weeks to see exactly where your TSH stands.
Just because a certain dose seems to work for someone on the Internet, it doesn't mean it's not going to make you feel completely insane.
For $59, you can see how fast your metabolism is -
#2 Not All Thyroid Hormone Is Created Equal - Or Even the Same Strength
(Get It From a USA Pharmacy If Possible, No Research Chems!)
I've used United States pharmacy-grade thyroid hormone, 'international pharmacy' thyroid hormone and 'research chemical' thyroid hormone.
Even at the EXACT SAME DOSE - the 3 vary considerably.
Real USA pharmacy thyroid hormone is way more powerful than the other two - that is why 12.5 mcg of T3 was more than enough for me.
12.5 mcg of USA Cytomel was equivalent to 50+ mcg of the popular "Grossman Cynomel" (no longer available) that we all took from MyMexicanDrugStore (Google it) back in the mid 2000's.
Taking 25 mcg of USA pharma-grade T3 from for a week gave me massive headaches that lasted 10 hours at a time. I literally could not function aside from repeatedly throwing books at the wall in complete anger.
Listen to me here -
Some people may have to take higher doses of the real stuff since their bodies won't process T3/T4 efficiently, but I'm just telling you that the prescription thyroid hormone from a US pharmacy vs. 'international pharmacy' is apples to oranges.
Do not play around with 'research chemical' liquid solutions, the dose (micrograms, basically invisible to the human eye) is way too small to accurately dose with an oral syringe. You will NEVER know how much you are taking (or not taking).
#3 T3 is Better for Fat Loss but T4 Makes Sense For Most People
You might be curious why bodybuilders only take T3 and don't simply take large doses of T4 for fat loss.
Unscientifically speaking -
T3 works better and faster to increase your metabolic rate. The half-life is 1 day.
T4 needs to convert to T3 and then to TSH. The half-life is 5-7 days.
But T4 has its advantages though.
You can miss a dose (or several doses) and your thyroid levels won't collapse.
While this wasn't an issue when I was serious about the gym, these days, I live in 2 places, travel frequently and I'm not always near my home pharmacy or doctor.
Compare my labs -
As you can see -
My metabolism will slow considerably if I miss consecutive T3 doses, but I can miss a week of T4 and still be in range.
#4 Doctors Want to Give You T4 (But Not T3)
(How to Get a Prescription for Thyroid Hormone - If You Need It...)
A lot of guys want to know how to get a prescription for thyroid hormone (namely, T3).
I'll tell you how I got my doctor (my former endocrinologist in Beverly Hills) to give it to me when I first moved to LA in 2008.
I simply told him the truth -
My thyroid is healthy and just sleeping.
I have been using an array of international and liquid 'research' solution T3 products for years, and I'm sick of how big of a difference there is.
(I brought in the exact stuff I was using)
I'd like start using real American T3 so I can stop this thyroid madness. I want to get my TSH between 0.7 and 1.0.
I will come in for blood work at 1, 3, 6 and 12 months to make sure everything is fine.
He said -
Okay. No problem.
I'll write you a prescription for it.
That's how I got my T3 prescription.
I've found that doctors are more likely (not less likely) to write you prescriptions for the stuff you want if you are fully knowledgable about the compound, the alternatives and mention that you WANT TO come back for blood work because it's important.
It also helps to hide any tattoos or huge muscles.
Bringing in any supporting clinical research, can only help too.
Don't show up baked or drunk.
"Playing dumb" (gosh golly, I didn't know that taking thyroid hormone would make my thyroid go to sleep, I thought it was a supplement...) won't be half as effective.
At the same time, finding a good doctor is a numbers game.
Some doctors are great, some are incompetent and should have their medical license revoked.
If you are going to do HRT - you should find a doctor that you like and can be open with. There's a lot of doctors out there that are legitimately interested in helping their patients and not just handing out antidepressants and "try a balanced diet" advice.
Most doctors want to give you T4 rather than T3 because of the longer half-life and other benefits I mentioned earlier.
Tell your doctor that you'd like to try T3 instead and you will come back for blood work.
I told the doctor that my sister takes T3 instead of T4 because it works better since our family doesn't process T4 as efficiently.
(this is actually true for my sister, but nothing stops you from saying it too)
If he forces you to take the T4, come back in month and complain that you feel fatigued and want to try T3.
Insist on it.
Thyroid hormone is not a controlled substance and getting a prescription for it isn't a big deal unless the doctor is super weird or simply doesn't care about you.
If all else fails (just find a new doctor), some guys do this -
Some guys take T4 for 3-4 weeks and then stop taking it for 2 weeks and get bloodwork -
Their thyroid levels will appear very low, they show the results to their doctor and once again insist that the T4 is not doing the job because your body doesn't convert T4 to TSH very well.
I'm not saying that is ethical. I'm just telling your how some otherwise responsible guys manipulate the results to get what they want.
Some doctors are going to require lab work (TSH) to cut you a first-time prescription for thyroid hormone. But not all.
(we talk a lot about TSH, but these other thyroid labs are important too; for simplicity purposes, I don't discuss them in-depth but you can see them on some of the bloodwork I provided, the basic $60 thyroid test above will check these)
Several guys (and girls) I know have been successful when they brought in "international" T3/T4 that they were taking and/or saying that they were previously prescribed thyroid hormone.
Just tell them that you will come back for blood work because you know it's super important.
#5 You Don't Actually Have Hypothyroidism Bro
(Most Fat People Don't Have Hormonal Deficiencies)
While hormones certainly can play a role in making and keeping people fat, hormonal imbalances or deficiencies are not the reason that most people are fat.
Most people are fat (or can't lose weight) simply because they consume significantly more calories than they burn.
They eat too much crap and they don't move their arms and legs enough.
They do this everyday.
That is why they are fat.
When I was a personal trainer in Beverly Hills, I immediately sent my clients to get their TSH tested. Only 2 in about 40 had a slow thyroid. Only 1 of the 2 actually had hypothyroidism.
(many elected to start using T3, even though they didn't actually need it; although I don't quite recommend this anymore, it was under the care of my personal anti-aging physician and most of my clients were 35+ and had a lot of money/resources)
My new friend, Alexander Cortes aka 'The Jesus', has trained 100's of people across the United States and he said the exact same thing -
I've been a personal trainer going on 7 years, and I've heard many times over from clients that they believe they have "low thyroid" I've always encouraged them to go get blood work done and get their thyroid levels checked.
Out of the hundreds of people I've worked with, only one time has a client been [actually] diagnosed with hypothyroidism.
While hypothyroidism can be a complex syndrome to diagnose and treat, the larger point is that vast majority of people have entirely normal thyroid function. And ironically, hypothyroidism is more likely to occur in people that have lost significant amounts of weight and have extremely low body fat. In fact, people that are overweight, are very unlikely to have low thyroid levels.
Follow him on Twitter -
Men that lift->confidence>women>sex All men should enjoy being strong https://t.co/yYF3sWehKU— Alexander J.A Cortes (@AJA_Cortes) October 10, 2015
Our point -
You probably don't have hypothyroidism (or even a slow thyroid), you just eat too much and don't move enough.
Fix that and you'll lose weight.
In fact -
Fix that and you'll fix almost all of your health and fitness problems.
The key is to not overeat and move your arms and legs more often!
Are There Any Thyroid Boosting Supplements That Work?
Unless you have nutritional deficiencies (specifically - iodine), which is VERY UNLIKELY unless you are following some weird diet or in a developing nation, a "thyroid supplement" is unlikely to help you.
At the same time, as I said on the topic of 'testosterone boosting supplements' - I'm out of the loop.
Maybe there is some new stuff out there that naturally increases TSH.
When I got off T3 for about 3 weeks in 2009 (in a silly attempt to restore my natural TSH), I took megadoses of "thyroid supplements" as part of my own little thyroid "PCT" treatment.
They didn't do a damn thing.
Should I Consider Taking Thyroid Hormone To Increase My Metabolism?
I feel like a big pharma TV commercial, but you should definitely discuss taking thyroid hormone with your doctor if your metabolism is on the slow side.
(and you've made the lifestyle changes: exercise 3-4 days a week with a healthful diet)
You shouldn't wait until you get diagnosed with hypothyroidism (and feel like complete crap all day) to act - especially if you are in your 20's and 30's and know that it's not "normal" to have a TSH level of a senior citizen.
What defines "slow side" is up for debate.
In my non-medical opinion - 'slow' is anything above 3.0 mIU/L.
Knowledgable, usually younger, doctors will say 3.5+ mIU/L and have adjusted their scales accordingly.
The American Medical Association still considers 'slow' to be 4.5+ mIU/L however.
I believe that optimal is .75 - 1.25 mIU/L.
I had fantastic gradual fat loss results when I kept mine at .7 mIU/L.
These days, for the reasons I explained, 2.0 - 2.25 mIU/L better fits my lifestyle.
Final Thoughts on Using Thyroid Hormone for Metabolic Enhancement
I think more guys can benefit from a TSH (thyroid) boost rather than an increase in testosterone.
It should be done under a physician's care though.
(No really - I actually mean this)
It's 2015, all the information you need to maximize your quality of life and human performance is available for free and it's literally a choice to live with a slow metabolism.
Even a small kick in metabolic rate will help you burn 500-1000 more calories without any change in diet or exercise. Over the course of a few months, this can absolutely do wonders for your body composition.
(or you can just pig out more...)
Unlike testosterone, I feel that thyroid hormone (even T4) may be worth taking even if your metabolic rate is "normal".
Still, the reality is, like testosterone levels, far too many guys read about T3 and start to believe their thyroid levels are low.
They probably aren't.
It doesn't mean you won't benefit from thyroid hormone - you might.
It just means that you NEED to get bloodwork and get your SPECIFIC NUMBERS to see where you stand.
Learn to read your bloodwork, show it to your doctor and post it in our forum if you aren't sure what to make of the results - we are here to help.
Our series on hormone replacement therapy continues here -
Non-medical questions and comments on in-depth subjects such as hormone replacement therapy are best left in our forum, blog comments have been disabled.