TRT and Unexplained Muscle Loss

Hi Guys,

This is my first post here in this forum. It may be a little long winded, as I've inserted a letter explaining my history, but please bare wit h me..
Current Meds
Testosterone Cypionate - 40mg 2x per week (been doing IM in the delts)
HCG - 300 iu 2x per week (subq)
Nature-Throid NDT (3 grain per day)
Not currently taking Anastrozole, but previously on .25mg per week

Supplements:
Vit D 5000 iu
Fish Oil (now foods)
Multi Vitamin (now foods)
B12 5000mcg (jarrows sublingual)
Methyl Folate (jarrows) 400mcg
Iron - 25mg daily
DHEA 50mg daily



Here are my most recent labs from July of this year...

Total T 983 (348-1197)
Free T 15.5 (4.7-24.4)
E2 13.2 (25.8 -60.7) (sensitive)
SHBG 61 (10-80)
FT4 .91 (.93-1.7)
FT3 2.4 (2.0-4.4)
RT3 9.7 (8-24)
IGF 1 214 (110-337)
DHT 43 (30-85)
DHEAS 212 (160-449)
VIT D 54 (30-100)

Ferritin 45 10-400 ng/mL
Iron 91 65-175 μg/dL
Transferrin 249 163-364 mg/dL
Total Iron Binding Capacity 356 233-520 μg/dL
Transferrin Saturation (%) 26 20-50 %

CBC/CMP all within normal ranges




Im 31 years old, 5' 7" tall and currently 150lbs. Ive been very healthy and active all of my adult life, weight training and bodybuilding since I was a teenager and I've been on and off various forms of TRT since 2011 due to secondary hypogonadism of unknown cause.

The issue that I am having since March of this year, I have been experiencing an unexplained catabolic response to weight training, despite plenty of calories, and very good hormone levels due to being on TRT. My body weight even pre TRT was always around 165lbs. This past March, I was around 154lbs, since then my weight has very slowly declined down to around 149lbs. But this weight loss has not been due to caloric reduction or overtraining, and is not body fat loss, but muscle loss.

I've had great success with TRT in years prior, especially since when I began injections in 2013, which one main reason why this doesnt make sense to me at this point...

Side note, I was also diagnosed with subclinical hypothyroid by my ND when I originally went to see him about the TRT in 2013. I currently take Nature Throid NDT at 3 grains per day. I thought that the initial weight loss may have been from too much thyroid, but labs show differently...

Any guys out there who have lifted for any significant amount of time or have any bodybuilding background I hope can relate to me here, we seem to be more in tune with our bodies than many others, and this problem is truly very confusing to me.

I have been weight training since the age of 15 and always built muscle very easily as a natural. Now, even being on TRT and keeping my hormone levels at the top of the range, my body is remaining in a catabolic state for some unknown reason.

The past few months I had a digestive panel done to check for gluten sensitivity or allergies or parasites - it did come back positive for H. Pylori. I was treated for that in June with a triple AB, and confirmed that it was effective with a negative lab for H. Pylori about 6 weeks later.

I also had a phone consult with Dr. Crisler back in September about this problem. His thoughts were that it may somehow be related to thyroid, which are my thoughts as well. His advice was to slowly increase the NDT medication by 1.5grain every two weeks, as well as adding an iron supplement to get ferritin up. After doing both of these things for about 6 weeks or so, I can't say that I have seen any improvement, in fact I still seem to be losing muscle at about .25lbs per week despite eating well and continuing to weight train only 3 days per week.

I do feel that the answer to this lies somewhere with thyroid, as it cant possibly be testosterone related at this point. Even my current doctor, who is a very good Naturopath here in California has been stumped. If anyone here on this forum has any input at all it would mean a lot, as I've been battling this for several months now.

Any input from some of the more experienced people on this forum would be much appreciated, as I am seeking what action I need to take here, thanks guys

Your FT3, Ferratin, and E2 are too low. Your FT3 and FT4 shows that you are very hypo. Ferratin/Iron levels are very important for T4 to T3 conversion. Normal E2 levels are needed for the strength I beleive. Did you do the blood work while being on AI? I will let the rest on this forum respond about TRT.

yes the labs were performed while on anastrazole, I have since stopped taking it. Also, no thyroid meds were taken the day those labs were performed. Im going to have new labs done within the next couple weeks.

A lot of your free T is bound up with SHBG, 61 seems rather high. I was going to remark that 40mg/2x was rather low, then see your TT 983, but then the Free T is low(er/ish). Free T is the bio active available T for your body to use and it's bound up by SHBG, things get hard.
You're treating your Thyroid but those numbers, not knowing the exact history, is still a problem.

Please post your Thyroid Antibodies and TSH. If your TSH is very high or antibodies are fluctuating..this can be an issue. I suffer with similar issues..except I only lose weight when I cut carbs. I am 5'8" 185lbs now. I have gained 14lbs in 2 months on TRT. My test was very low..mostly because it is hereditary. My dad just started androgel and his total testosterone was 100. My family has a history of autoimmune disease. You may want to have some labs ran that check for autoimmune...example ANA, CRP.

I do have some concerns for you. First, I worked with and NMD in AZ for several years. They are great except when it comes to digestive issues. They mostly use stool tests and I assume that is where the H-Pylori was found to be positive? I also had this as positive, but EVERY GI doc found it to be negative per breath test and endoscopy? I was also treated with antibiotics..just as you were and of course it was eradicated. I really don't trust those stool tests too much. If they were accurate then ALL GI docs would use them, but NONE of the GI MD or DO use them. Seems very strange.

Your D3 could use a boost. I keep mine at 90. I use a sublingual formula. Has your methylation cycle been checked? The reason I ask is because I cannot take B12 or Folate.

I really don't know if any of this helps, but I hope you feel better soon.

Yes, I had 2 ANA labs done to check for auto immune, this was in April I believe. The first came back moderately positive, Ill have to check the exact reading when I get home, the second one which was repeated a couple weeks later was negative.
Also, my TSH is very low now due to being on thyroid medication for a couple years now. Ill have to check my records to see what it was prior to starting thyroid treatment.

If your TSH is too low you could be hyper..which will result in weight loss and many other symptoms.