TSH moving on cutting cycle — context: down 18 lbs in 10 weeks

S
Joined 2026
36 posts
slow_loseMember
29d ago · 2216 views

Not sure if this is a peptide question, a caloric deficit question, or both, so posting here.

On tirz 5mg/week, 10 weeks in, down 18 lbs. Pulled thyroid labs.

Baseline:

  • TSH: 1.8 mIU/L
  • Free T4: 1.3 ng/dL
  • Free T3: 3.2 pg/mL

Week 10:

  • TSH: 3.1 mIU/L
  • Free T4: 1.2
  • Free T3: 2.7

TSH almost doubled, Free T3 dropped 16%. Still 'in range' but directionally this is the classic 'cutting phase thyroid suppression' shape.

Is this the GLP-1 or the deficit? And is a TSH of 3.1 something to act on or just ride out?

7 Replies

G
Joined 2026
32 posts
29d ago

That's the deficit, not the GLP-1. Prolonged caloric deficit + significant weight loss reliably nudges TSH up and pulls T3 down. It's the body's adaptive response — 'less fuel coming in, lower thyroid output'. Happens independent of any drug.

TSH 3.1 is nothing to act on. Free T4 is fine. It'll normalize within a few months of maintenance cals.

T
Joined 2026
44 posts
29d ago

Seconded. My TSH went 1.4 -> 2.9 during my biggest loss phase. Came back to 1.6 after 6 weeks of maintenance.

Tirze cycle
  • Tirzepatide · 5 mg · weekly · sub-Q
S
Joined 2026
36 posts
slow_loseMember
28d ago

I'm a little colder in the mornings than usual but otherwise feel good. Energy fine, mood fine.

C
Joined 2025
27 posts
cbc_cmpMember
28d ago

Free T3 is the meaningful one here and 3.2 -> 2.7 is a real drop (CV ~5-7%). But it's still well inside the reference range. Symptoms (temperature, bowel, energy) more than the number should drive any action.

GH axis test
  • Sermorelin · 300 mcg · pre-bed · sub-Q
  • Ipamorelin · 200 mcg · pre-bed · sub-Q
M
Joined 2026
31 posts
27d ago

Cold feet mid-cut is basically the body saying 'thank you for noticing, please eat'. Normal adaptation. Doesn't mean you need T3 or anything crazy.

D
Joined 2025
119 posts
dr_doubtRegular
26d ago

The 'do I need thyroid meds' bar on lab values alone is TSH >10 or Free T4 below range, generally. You're nowhere near either. Ride it out.

S
Joined 2026
36 posts
slow_loseMember
25d ago

Appreciated. Going to keep going and retest at maintenance after the cut ends.

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