Fatigue after long TRT

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PineTwigg

New Member
Hello everyone!

I'm a new member so bear with me. I'm a 34 year old male, with wife and one child. I have been on testosterone since 2012, I got a severe stress reaction which I never recovered from, at that time my doctor realized my testosterone was too low. I hade 5 mmol of total T at the time (normal reference > 12 nmol/L).

I got sent to a specialist endocrine Andrologist (2012), it's a center here in Sweden where they treat hormones in men.
They put me on Nebido shots for a couple of years, but I stopped 2014 for a year to conceive a child, it wasn't a good year. However it worked.

From there I continued but with testogel, I believed it gave me more consistent levels than Nebido and it has worked for me most part. At least it has helped me going. Last year I tried to get off it, the fatigue was excruciating, I got bed ridden at a point, so I started with testogel again in december 2017. But I got some really strange symptoms, and my GP don't know what to do, they have done ton of tests but all come back negative.

The Andrologist has taken a lot of blood test, I'm waiting for the answer, I will update the post with the results.

So to the symptoms: No morning wood, no sexual drive, prostatitis, Tietze Syndrome, chronic infection in the gum ( Even removed a tooth, didn't help), fatigue, need to sleep many hours, hard breathing, trouble with memory, dry eyes, sore throat, low resting pulse 55-60 while sleeping, high when I'm awake 90, got red face at night, weight gain, joint pain,

Feel stressed all the time, feels like my body is on high alert all the time for some reason, I get calmer when I stop TRT but then the fatigue take over.


Right now I'm tired of doctors telling me everything is all right, so I'm trying to take my health in my own hands.

So I'm glad for any input in the matter, I have been reading a lot on this forum but it's hard for me to grasp everything, I think I need guidance because I'm in a status quo.

I will update the post with my blood work, more will come next week.


Blood work:

Saliva cortisol:
Morning: 25
(ref 10 - 46 nmol/L)
Night: 2.8
(ref 3,2 - 15 nmol/L)

S-Prolakt 158 mIE/L
(ref < 279)
 
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Systemlord

Member
Welcome new member,

Definitely need lab work including ranges. I suspect thyroid issues, when one is on TRT and has low thyroid function, it creates an imbalance. TRT tries restores your metabolic rate and if you have an underactive thyroid it can make things worse as the two systems work together. Your location is a problem for anyone with hormones out of balance since the world is lagging behind in it's understanding or male hormones which has been ignored for so long, big pharma is to blame as it doesn't see hormone therapy as profitable.

You might also have low estrogen, I get inflamed dry eyes when estrogen is low.
 

PineTwigg

New Member
Thank you!

I have no swelling in joints, but they are aching. Yes I'm very often warm, get mood swings.

Estrogen, my endo forgot to put that in the blood work unfortunately. The high sensitive estradiol that I read about is not nothing I can do here i think, is serum estradiol enough?

We have free health care but I will order some new thyroid & estrogen from my own pocket, don't want to wait.
I can't find any blood test for Reverse T3

I plan to test:
TSH
T4 Free
T3 Free
Anti TPO
TRAK
Estradiol
Iron



From the Endo i'm waiting for:
TSH
Testosterone
Testosterone bio active
SHBG
ASAT
Cholesterol profile
PSA
Erythrocyte red blood cells
EVF
Hemoglobine
MCH
MCV
Leukocytes
Thrombocytes
HBA1C
Estradiol sensitive test

I hope I translated the labs correctly so you understand :)

Have I missed any test?

I ordered Progesterone cream to see if it helps me sleep better
 
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PineTwigg

New Member
Thanks! But I don't know if it's possible to send blood across the globe (From Sweden)

I'm on waiting list for my GP, it will take 2 months before I can see him. Because it's not considered urgent. But I will see if I can find a lab closer for reverse T3.
 

PineTwigg

New Member
Could I try low dose Anastrozole to see if I get any symptom relief? I have a box with 1mg tablets. But 1mg is maybe too much? My Endo has sent a sensitive test for Sensitive Estradiol.

I just wanted to add that the first 2-3 years of TRT I felt pretty good with Nebido injections, these symptoms have been sneaking up on me.

Reverse T3 can't be tested in Sweden unfortunately, they removed the test because they thought it was unreliable. I can pay about 200$ to send it to another country for analyze, but I will start with the regular tests I mention earlier for thyroid.
 

Vince

Super Moderator
I would skip the reverse T3, $200 is a lot, get your thyroid checked and like you said go from there.
 

Vince

Super Moderator
I really don't believe HCG is necessary and many members don't I use it. I'm one who likes to use HCG and I inject 500 IU every three and a half days.
 

PineTwigg

New Member
I can't edit my original post :( So this will be a mess, however I'll add my recent labs that has been coming in with new post's.

The only thing I can see is that T4 is at the low end but still in range, same with iron.

TSH 0.66
(Ref 0.4 - 4.0 mlE/L)

T3, Free 4.8
(Ref 3.3 - 6.0 pmol/L)

T4, Free 12
(Ref 10 - 22 pmol/L)

TPO-ak <28
(Ref < 60 kIE/L)

Ferritin 307
(Ref 20 - 375 &#956;g/L)

Iron 14
(Ref 9 - 34 &#956;mol/L)

Cortisol 628
(Ref 240 - 730 nmol/L)
 

PineTwigg

New Member
New labs

HbA1c 42
(ref 27-42)

B-eukocytes 5.8
(Ref 3,5 - 8,8)

B-Erythrocytes 5.1
(Ref 4,2 - 5,7)

B-Hb 153
(Ref 134 - 170)

B-EVF 0,47
(Ref 0,39 - 0,50)

Erc(B)-MCH 30
(Ref 27 - 33)

B-MCV 92
(Ref 82 - 98)

B-Platelets 223
(Ref 145 - 348)

P-Thyrotropin (TSH) 1.4
(Ref 0,4 - 4)

P-ASAT 0.26
(Ref 0,25 - 0,75)

P-Cholesterol 6,3
(Ref 3,3 - 6,9)

fP-Triglycerides 1.64
(Ref 0,45 - 2,6)

P-HDL 1.18
(Ref 0,8 - 2,1)

P-LDL 4.55
(Ref 1.4 - 4,7)

S-Testosterone Total 19
(Ref 5,7 - 26)

S-Prolactin 147
(Ref 60 - 260)

P-PSA total 1.6
(Ref <2,0)

S-SHBG 18
(Ref 15 - 95)
 
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