Boxer on TRT with persistent fatigue/brain fog - low-normal E2, mediocre free T, no gym battery

[skgproductions]

I’ve searched this forum and several others trying to find a situation that matches mine, but I haven’t found anything that really lines up, so I’m posting here hoping someone sees something obvious that I’m missing.
I’m a boxer with 15+ years of training. For the last 4 years I’ve been battling persistent fatigue, brain fog, poor recovery, and a complete lack of “battery” in the gym. I can wake up feeling somewhat okay, but once I train it feels like I have no gas in the tank.
I’ve been on a consistent TRT protocol since December:

Testosterone cypionate 250 mg/mL
75 mg every 4 days
I test labs on the 4th morning after pinning
Diet is clean
No alcohol/nicotine currently
No crazy supplement stack, just basic men’s health vitamins
I have been taking 50 mg DHEA since January because my DHEA-S has been chronically low for years. I’ve only recently gotten DHEA-S up to around 200.
Recently added iron bisglycinate: 25 mg morning + 25 mg night

Most recent labs, taken the 4th morning before injection:

Total T: 677 ng/dL
Free T: 75.1 pg/mL — highest I’ve managed to get it
Bioavailable T: 164.3 ng/dL
SHBG: 43 nmol/L
Albumin: 4.8 g/dL
Sensitive E2: 18 pg/mL
DHEA-S: 217 mcg/dL
Ferritin: 40 ng/mL
Hemoglobin: 16.0
Hematocrit: 48.1
WBC: 4.4
Eosinophils: 7.0%, absolute eosinophils within range

My E2 has been consistently low-normal, and I feel like it lines up with the dry/flat/no-recovery feeling. But even with TT at 677, my free T is only 75, and I cannot seem to get it much higher without feeling worse.

I recently tested a lot of other things because I started wondering if this was immune/histamine/mast-cell related. I tested autoimmune markers, inflammatory markers, tryptase, IgE, thyroid, iron, B12/folate, etc. Nothing major came back positive. IgE was only slightly high. CRP was normal. ANA, SSA/SSB, dsDNA, RF, RNP, Sm, Scl-70, complements, and tryptase were all normal/negative.

I also tried adding low-dose hCG recently:
125 IU once
250 IU once later that same week
Both times I became severely fatigued and felt worse, so I discontinued it.

I’ve had several primary care doctors who seemed out of touch with TRT. One prescribed an AI when my E2 was already low-normal, and that nearly wrecked me. I’ve tried researching this heavily, reading posts, looking at labs, comparing protocols, and I’m still crazy stuck and my battery has gotten worse and worse as I've continued this protocol.

What I’m trying to figure out:

-Has anyone had decent total T but free T stuck low/mediocre with SHBG in the 40s?

-Has anyone felt completely flat/exhausted with E2 around 18 even though total T looked okay?

-Did switching from every-4-day injections to smaller/more frequent injections help?

-Has anyone gotten severely fatigued from low-dose hCG?

-Could ferritin around 40 be enough to crush gym performance even with normal hemoglobin/hematocrit?

-Is there anything in these labs that screams “that’s your problem”?

I’m looking for pattern recognition from guys who have actually dealt with this.
At this point, I’m exhausted from feeling like something is clearly wrong while every standard test looks “normal.” Any serious insight is greatly, greatly appreciated.

 

[madman]

I’ve searched this forum and several others trying to find a situation that matches mine, but I haven’t found anything that really lines up, so I’m posting here hoping someone sees something obvious that I’m missing.
I’m a boxer with 15+ years of training. For the last 4 years I’ve been battling persistent fatigue, brain fog, poor recovery, and a complete lack of “battery” in the gym. I can wake up feeling somewhat okay, but once I train it feels like I have no gas in the tank.
I’ve been on a consistent TRT protocol since December:

Testosterone cypionate 250 mg/mL
75 mg every 4 days
I test labs on the 4th morning after pinning
Diet is clean
No alcohol/nicotine currently
No crazy supplement stack, just basic men’s health vitamins
I have been taking 50 mg DHEA since January because my DHEA-S has been chronically low for years. I’ve only recently gotten DHEA-S up to around 200.
Recently added iron bisglycinate: 25 mg morning + 25 mg night

Most recent labs, taken the 4th morning after injection:

Total T: 677 ng/dL
Free T: 75.1 pg/mL — highest I’ve managed to get it
Bioavailable T: 164.3 ng/dL
SHBG: 43 nmol/L
Albumin: 4.8 g/dL
Sensitive E2: 18 pg/mL
DHEA-S: 217 mcg/dL
Ferritin: 40 ng/mL
Hemoglobin: 16.0
Hematocrit: 48.1
WBC: 4.4
Eosinophils: 7.0%, absolute eosinophils within range

My E2 has been consistently low-normal, and I feel like it lines up with the dry/flat/no-recovery feeling. But even with TT at 677, my free T is only 75, and I cannot seem to get it much higher without feeling worse.

I recently tested a lot of other things because I started wondering if this was immune/histamine/mast-cell related. I tested autoimmune markers, inflammatory markers, tryptase, IgE, thyroid, iron, B12/folate, etc. Nothing major came back positive. IgE was only slightly high. CRP was normal. ANA, SSA/SSB, dsDNA, RF, RNP, Sm, Scl-70, complements, and tryptase were all normal/negative.

I also tried adding low-dose hCG recently:
125 IU once
250 IU once later that same week
Both times I became severely fatigued and felt worse, so I discontinued it.

I’ve had several primary care doctors who seemed out of touch with TRT. One prescribed an AI when my E2 was already low-normal, and that nearly wrecked me. I’ve tried researching this heavily, reading posts, looking at labs, comparing protocols, and I’m still crazy stuck and my battery has gotten worse and worse as I've continued this protocol.

What I’m trying to figure out:

-Has anyone had decent total T but free T stuck low/mediocre with SHBG in the 40s?

-Has anyone felt completely flat/exhausted with E2 around 18 even though total T looked okay?

-Did switching from every-4-day injections to smaller/more frequent injections help?

-Has anyone gotten severely fatigued from low-dose hCG?

-Could ferritin around 40 be enough to crush gym performance even with normal hemoglobin/hematocrit?

-Is there anything in these labs that screams “that’s your problem”?

I’m looking for pattern recognition from guys who have actually dealt with this.
At this point, I’m exhausted from feeling like something is clearly wrong while every standard test looks “normal.” Any serious insight is greatly, greatly appreciated.

Big Pharma TC comes in 100/200 mg/mL strength so are you sure your UGL gear is really 250 mg/mL?

Even then you always want to test at the true trough (lowest point) before your next injection which would be 4 days post-injection.

Downfall here is you tested after injecting.

You are injecting 75 mg TC (?) every 4 days so 131.25 mg T/week which is higher than the standard. starting dose 100 mg T/week.

S**t kicker here is although you are hitting a. robust trough TT 677 ng/dL seeing as you have highish SHBG 43 nmol/L your trough FT 7.5 ng/dL is not low but is sitting in what would be called the grey zone 5-7 ng/dL where some men may experience symptoms of low-T.

Your trough FT is far from robust and most men will easily do well with a trough FT 15-25 ng/dL or hitting the upper 1/3 rd.

Your trough FT is well under that and this is why your estradiol is not that high.

Yes your peak TT and more importantly FT and estradiol would be higher but nothing to brag about.

Keep in mind that although TT is important to know FT is what truly matters here as it is the active unbound fraction of T responsible for the positive effects.

What testing method was used for FT (direct IA (RIA/CLIA), calculated, Equilibrium Dialysis or Ultrafiltration)?

When posting labs always try to include the testing method/reference ranges especially for the most critical fraction free testosterone.

The only way to know where your FT truly sits would be testing using the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG.

Otherwise you would need to use/rely on the next best testing method the go to calculated linear law-of-mass action Vermeulen (cFTV) which will give a good approximation.

The easy fix here would be increasing your weekly dose of T seeing as you have highish SHBG you would need to hit a trough TT 800-1200 ng/dL in order to hit a healthy/high trough FT.

Driving up your TT will drive up FT and estradiol.

Another way too drive up estriol would be adding hCG which you have already tried using lower dose but never stayed on long enough to truly gauge how you would feel.

Even then before you make that move I would strongly recommend that you verify the strength of your T 250 mg/mL is legit.

Another big red flag that stands out here is your ferritin of 40 can easily be considered too low and may very well also be contributing to your symptoms.

Any dysfunction thyroid/adrenals can easily mimc low-T symptoms let alone the dreaded fatigue/lack of energy.

 

[FunkOdyssey]

75 mg every 4 days

Free T: 75.1 pg/mL

Something doesn't add up. How are you injecting? Needle length and injection site? Another subq casualty perhaps?

 

[skgproductions]

Big Pharma TC comes in 100/200 mg/mL strength so are you sure your UGL gear is really 250 mg/mL?

Even then you always want to test at the true trough (lowest point) before your next injection which would be 4 days post-injection.

Downfall here is you tested after injecting.

You are injecting 75 mg TC (?) every 4 days so 131.25 mg T/week which is higher than the standard. starting dose 100 mg T/week.

S**t kicker here is although you are hitting a. robust trough TT 677 ng/dL seeing as you have highish SHBG 43 nmol/L your trough FT 7.5 ng/dL is not low but is sitting in what would be called the grey zone 5-7 ng/dL where some men may experience symptoms of low-T.

Your trough FT is far from robust and most men will easily do well with a trough FT 15-25 ng/dL or hitting the upper 1/3 rd.

Your trough FT is well under that and this is why your estradiol is not that high.

Yes your peak TT and more importantly FT and estradiol would be higher but nothing to brag about.

Keep in mind that although TT is important to know FT is what truly matters here as it is the active unbound fraction of T responsible for the positive effects.

What testing method was used for FT (direct IA (RIA/CLIA), calculated, Equilibrium Dialysis or Ultrafiltration)?

When posting labs always try to include the testing method/reference ranges especially for the most critical fraction free testosterone.

The only way to know where your FT truly sits would be testing using the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG.

Otherwise you would need to use/rely on the next best testing method the go to calculated linear law-of-mass action Vermeulen (cFTV) which will give a good approximation.

The easy fix here would be increasing your weekly dose of T seeing as you have highish SHBG you would need to hit a trough TT 800-1200 ng/dL in order to hit a healthy/high trough FT.

Driving up your TT will drive up FT and estradiol.

Another way too drive up estriol would be adding hCG which you have already tried using lower dose but never stayed on long enough to truly gauge how you would feel.

Even then before you make that move I would strongly recommend that you verify the strength of your T 250 mg/mL is legit.

Another big red flag that stands out here is your ferritin of 40 can easily be considered too low and may very well also be contributing to your symptoms.

Any dysfunction thyroid/adrenals can easily mimc low-T symptoms let alone the dreaded fatigue/lack of energy.

Big Pharma TC comes in 100/200 mg/mL strength so are you sure your UGL gear is really 250 mg/mL?

Even then you always want to test at the true trough (lowest point) before your next injection which would be 4 days post-injection.

Downfall here is you tested after injecting.

You are injecting 75 mg TC (?) every 4 days so 131.25 mg T/week which is higher than the standard. starting dose 100 mg T/week.

S**t kicker here is although you are hitting a. robust trough TT 677 ng/dL seeing as you have highish SHBG 43 nmol/L your trough FT 7.5 ng/dL is not low but is sitting in what would be called the grey zone 5-7 ng/dL where some men may experience symptoms of low-T.

Your trough FT is far from robust and most men will easily do well with a trough FT 15-25 ng/dL or hitting the upper 1/3 rd.

Your trough FT is well under that and this is why your estradiol is not that high.

Yes your peak TT and more importantly FT and estradiol would be higher but nothing to brag about.

Keep in mind that although TT is important to know FT is what truly matters here as it is the active unbound fraction of T responsible for the positive effects.

What testing method was used for FT (direct IA (RIA/CLIA), calculated, Equilibrium Dialysis or Ultrafiltration)?

When posting labs always try to include the testing method/reference ranges especially for the most critical fraction free testosterone.

The only way to know where your FT truly sits would be testing using the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG.

Otherwise you would need to use/rely on the next best testing method the go to calculated linear law-of-mass action Vermeulen (cFTV) which will give a good approximation.

The easy fix here would be increasing your weekly dose of T seeing as you have highish SHBG you would need to hit a trough TT 800-1200 ng/dL in order to hit a healthy/high trough FT.

Driving up your TT will drive up FT and estradiol.

Another way too drive up estriol would be adding hCG which you have already tried using lower dose but never stayed on long enough to truly gauge how you would feel.

Even then before you make that move I would strongly recommend that you verify the strength of your T 250 mg/mL is legit.

Another big red flag that stands out here is your ferritin of 40 can easily be considered too low and may very well also be contributing to your symptoms.

Any dysfunction thyroid/adrenals can easily mimc low-T symptoms let alone the dreaded fatigue/lack of energy.

I need to clarify something from my original post: I test on the 4th morning before my next injection, not after injecting. So the labs I posted are intended to represent trough.

Also, I attempted to include my most recent thyroid panel. I tested TSH, free T3, free T4, total T3, total T4, and reverse T3. Everything came back looking good. This is probably the 4th time in the last year I’ve tested thyroid in some form, and nothing has stood out there.

One issue with my testosterone testing is that I have been using calculated free T, not equilibrium dialysis. I agree that I need to confirm with LC/MS total T and free T by equilibrium dialysis. My concern is that if anything, the more accurate testing may show my free T is even lower than what I’m seeing now.

For context, I’ve tested hormones a significant number of times over the last 4 years before ever reaching toward TRT. My free T has consistently lived around the 50–60 pg/mL range, which is why I feel like this may be something I’ve been chasing for years.

I did drift away from the physician-provided prescription and toward an online pharmacy. The vial label reads 250 mg/mL, but I understand the point that it may be worth verifying the strength/source.

I also recently started addressing the ferritin issue. Ferritin has dropped to around 40, so I started iron bisglycinate 50 mg on an empty stomach. I'm not sure how long that can take to restore but it isn't even "Low" from what I've read. I've also seen guys saying do not take iron, it could increase heart attack.

Over the last 3 years I’ve seen cardiology, pulmonology, endocrinology, multiple primary care doctors, and had enough bloodwork done to drown a city block. I only moved toward TRT at the start of last year after trying other routes first, including hCG, enclomiphene, and other attempts to get my own system working.

Since January, I’ve mostly tried to clear the noise and just run TRT consistently, along with DHEA because my DHEA-S has been chronically low and I’ve only recently gotten it up to around 200.

At this point I’ve tested thyroid repeatedly, mold, immune markers, autoimmune markers, histamine/mast-cell markers, inflammatory markers, iron, B12/folate, and ongoing hormones. Nothing has clearly explained the fatigue, brain fog, and lack of gym battery.

That’s why I’m posting here. I’ve basically run out of avenues I can think of, and I’m hoping people who live and breathe TRT optimization might recognize a pattern I’m missing.

 

[skgproductions]

Something doesn't add up. How are you injecting? Needle length and injection site? Another subq casualty perhaps?

I wish that would be the case.

IM in the Shoulder w 27g 1/2

 

[madman]

I need to clarify something from my original post: I test on the 4th morning before my next injection, not after injecting. So the labs I posted are intended to represent trough.

Also, I attempted to include my most recent thyroid panel. I tested TSH, free T3, free T4, total T3, total T4, and reverse T3. Everything came back looking good. This is probably the 4th time in the last year I’ve tested thyroid in some form, and nothing has stood out there.

One issue with my testosterone testing is that I have been using calculated free T, not equilibrium dialysis. I agree that I need to confirm with LC/MS total T and free T by equilibrium dialysis. My concern is that if anything, the more accurate testing may show my free T is even lower than what I’m seeing now.

For context, I’ve tested hormones a significant number of times over the last 4 years before ever reaching toward TRT. My free T has consistently lived around the 50–60 pg/mL range, which is why I feel like this may be something I’ve been chasing for years.

I did drift away from the physician-provided prescription and toward an online pharmacy. The vial label reads 250 mg/mL, but I understand the point that it may be worth verifying the strength/source.

I also recently started addressing the ferritin issue. Ferritin has dropped to around 40, so I started iron bisglycinate 50 mg on an empty stomach. I'm not sure how long that can take to restore but it isn't even "Low" from what I've read. I've also seen guys saying do not take iron, it could increase heart attack.

Over the last 3 years I’ve seen cardiology, pulmonology, endocrinology, multiple primary care doctors, and had enough bloodwork done to drown a city block. I only moved toward TRT at the start of last year after trying other routes first, including hCG, enclomiphene, and other attempts to get my own system working.

Since January, I’ve mostly tried to clear the noise and just run TRT consistently, along with DHEA because my DHEA-S has been chronically low and I’ve only recently gotten it up to around 200.

At this point I’ve tested thyroid repeatedly, mold, immune markers, autoimmune markers, histamine/mast-cell markers, inflammatory markers, iron, B12/folate, and ongoing hormones. Nothing has clearly explained the fatigue, brain fog, and lack of gym battery.

That’s why I’m posting here. I’ve basically run out of avenues I can think of, and I’m hoping people who live and breathe TRT optimization might recognize a pattern I’m missing.

Yes glad you fixed it as your original post stated that you injected after jabbing.

Not sure what lab you were using but if you had your FT calculated through Quest Diagnostics keep in mind they use a modified Vermeulen method otherwise your FT would be higher than 7.5 ng/dL.

If we use the go to calculated linear law-of-mass action and plug in your robust trough TT 677 ng/dL, highish SHBG 43 nmol/L and Albumin 4.8 g/dL then your trough cFTV 12.1 ng/dL would be descent and just under where a healthy young natty male would sit 13-15ng/dL

As I have stated numerous times on the forum over the years although it will give a good approximation it tends to overestimate slightly so chances are your trough FT would. be around 7-9 ng/dL if you had it tested using the most accurate assay the gold standard Equilibrium Dialysis.

Highly doubtful your. trough FT 7.5 ng/dL would be lower.

Even then if your true trough FT is 7-9 ng/dL it is too low!

Again once you verify the strength of your compounded TC (250 mg/mL) then your next move would be increasing your weekly dose which will increase your TT and more importantly drive up your FT and estradiol.

Yes your ferritin of 40 is not low but some menace experience symptoms when it falls >50.

Bottom line here is your trough FT is too low and seeing as you have highish SHBG you will need to hit a trough TT 800-1200 ng/dL in order to achieve. a healthy/high trough FT (15-25 ng/dL).

Thread 'What is the serum ferritin to diagnose iron deficiency?'

Dec 22, 2024

Robert Means Jr., MD

Robert Means Jr., MD

www.etsu.edu

Dr. Means joined the ETSU faculty in 2014 to serve as dean of the ETSU Quillen College of Medicine and continued as dean until 2018. He is board certified in internal medicine and hematology. He is internationally recognized for his research in hematology and brings his valued knowledge and experience to serve Northeast Tennessee and the surrounding regions. Dr. Means offers services to patients with non-malignant blood disorders including anemias, white blood cell diseases, platelet and coagulation/thrombosis...

• madman
• iron deficiency; anemia; ferritin
• Replies: 11
• Forum: Health & Wellness

 

[Forty2]

I'm a boxer with 15+ years of training.

Aren't boxers drug tested, like most other competitive athletes?

 

[FunkOdyssey]

Sleep and diet are major suspects we haven't touched on.

Do you have an oura ring, whoop strap or equivalent for sleep tracking? Ever tested for sleep apnea? Caffeine consumption?

You said your first is clean, but what do you eat specifically? What dietary changes have you tried over the years and what were the results?

What are these "basic men's health vitamins" that you take? How long have you been taking them?

 

[skgproductions]

Aren't boxers drug tested, like most other competitive athletes?

There in lies the real problem. Before this shit started 3+ years ago I was training 6 days a week, and that shortened to 4-5 days a week, and then 3-4 with restricted intensity. I've seen every specialist and did everything possible prior to considering trt. Peptides, all the fad supplements, all the fad diets, elimination diets, etc.
The last year and a half, since starting hrt, the decline has only gotten worse. I'm now to where I can maybe get 1-3 workouts a week and the intensity is so dialed back it's not even training. I have no ability to know if I'm going to wake up tomorrow feeling "okay" or if I'm going to continue just feeling like shit.

The last 3 years has been a struggle to even want to continue waking up.

The summary of this feeling is like, someone came into my house in the middle of the night, and took my entire life away. And I don't even get the satisfaction of know what, or who did it.

My entire life is, was, and will probably end with boxing.

I don't know anything else.

And its been taken away. I know all that is dramatic af. But desperation has applied for well over 3+ years.

But yes, testing is a thing.

 

[skgproductions]

Sleep and diet are major suspects we haven't touched on.

Do you have an oura ring, whoop strap or equivalent for sleep tracking? Ever tested for sleep apnea? Caffeine consumption?

You said your first is clean, but what do you eat specifically? What dietary changes have you tried over the years and what were the results?

What are these "basic men's health vitamins" that you take? How long have you been taking them?

As a matter of fact, I picked uo an sleep monitor ring a month ago to assist with diagnosing sleep apnea and compare vital signs with fitbit. I've used fitbits for roughly the better half of a decade to monitor hrv, rhr, etc.

Among the specialist I seen over the last few years I also had a sleep study done. The results showed mild to nothing at all.
The ring ive got shows no signs of episodes thus far.

Caffeine, only black coffee first thing in the morning.

The closest thing to describe my diet now is mild-moderate carbs, semi gluten free, with clean protein.

I pivot between just taking Rich Piana Liver & Organ one month and Opti Men Multivitamin. And dhea for the last 6 months.

An example of why I'm reaching out this way is, I did a light 10 minute bodyweight workout on Thursday followed by some corrective stretching, scapula control exercises. I hadn't worked out for an entire week before that. Just corrective stretching/breathing. I woke up yesterday with an HRV of 62(for me anything below 70 is "feel low/like shit" and don't train area). Felt nasty. So I didn't even go to work. I rested all day pretty much, did everything I could from home. Slept over 8 hours. Almost 2 hrs rem sleep, 1.5 of deep sleep.
I woke up this morning with an HRV of 45.
As if I spent the whole night awake drinking.

I'm so empty with this thing anymore. I don't know what to do

 

[Vince]

I’ve searched this forum and several others trying to find a situation that matches mine, but I haven’t found anything that really lines up, so I’m posting here hoping someone sees something obvious that I’m missing.
I’m a boxer with 15+ years of training. For the last 4 years I’ve been battling persistent fatigue, brain fog, poor recovery, and a complete lack of “battery” in the gym. I can wake up feeling somewhat okay, but once I train it feels like I have no gas in the tank.
I’ve been on a consistent TRT protocol since December:

Testosterone cypionate 250 mg/mL
75 mg every 4 days
I test labs on the 4th morning after pinning
Diet is clean
No alcohol/nicotine currently
No crazy supplement stack, just basic men’s health vitamins
I have been taking 50 mg DHEA since January because my DHEA-S has been chronically low for years. I’ve only recently gotten DHEA-S up to around 200.
Recently added iron bisglycinate: 25 mg morning + 25 mg night

Most recent labs, taken the 4th morning before injection:

Total T: 677 ng/dL
Free T: 75.1 pg/mL — highest I’ve managed to get it
Bioavailable T: 164.3 ng/dL
SHBG: 43 nmol/L
Albumin: 4.8 g/dL
Sensitive E2: 18 pg/mL
DHEA-S: 217 mcg/dL
Ferritin: 40 ng/mL
Hemoglobin: 16.0
Hematocrit: 48.1
WBC: 4.4
Eosinophils: 7.0%, absolute eosinophils within range

My E2 has been consistently low-normal, and I feel like it lines up with the dry/flat/no-recovery feeling. But even with TT at 677, my free T is only 75, and I cannot seem to get it much higher without feeling worse.

I recently tested a lot of other things because I started wondering if this was immune/histamine/mast-cell related. I tested autoimmune markers, inflammatory markers, tryptase, IgE, thyroid, iron, B12/folate, etc. Nothing major came back positive. IgE was only slightly high. CRP was normal. ANA, SSA/SSB, dsDNA, RF, RNP, Sm, Scl-70, complements, and tryptase were all normal/negative.

I also tried adding low-dose hCG recently:
125 IU once
250 IU once later that same week
Both times I became severely fatigued and felt worse, so I discontinued it.

I’ve had several primary care doctors who seemed out of touch with TRT. One prescribed an AI when my E2 was already low-normal, and that nearly wrecked me. I’ve tried researching this heavily, reading posts, looking at labs, comparing protocols, and I’m still crazy stuck and my battery has gotten worse and worse as I've continued this protocol.

What I’m trying to figure out:

-Has anyone had decent total T but free T stuck low/mediocre with SHBG in the 40s?

-Has anyone felt completely flat/exhausted with E2 around 18 even though total T looked okay?

-Did switching from every-4-day injections to smaller/more frequent injections help?

-Has anyone gotten severely fatigued from low-dose hCG?

-Could ferritin around 40 be enough to crush gym performance even with normal hemoglobin/hematocrit?

-Is there anything in these labs that screams “that’s your problem”?

I’m looking for pattern recognition from guys who have actually dealt with this.
At this point, I’m exhausted from feeling like something is clearly wrong while every standard test looks “normal.” Any serious insight is greatly, greatly appreciated.

My stepson was also an amateur /professional boxer. Have you ever had your magnesium levels check? It's one of the most important things you could add to your supplements. I believe everyone should be supplementing with magnesium. Also I would add in coq10 both will help you.

 

[Phil Goodman]

The boxing aspect makes me think that traumatic brain injury might be playing a huge role here. You say you’ve looked into all types of different studies, research, etc. so it’s quite possible you’ve already come across the approach of Mark Gordon. He has been very successful treating soldiers coming back with brain injuries and other issues so if you haven’t already done so, I’d recommend looking into how he approaches treatment.

https://www.lifeextension.com/magazine/2012/1/using-hormones-heal-traumatic-brain-injuries?srsltid=AfmBOopDc8SjHpmX6WZA7Y-JdTGQ3fMQ5HtkMOlPSzeOpy0z3sh5FaG0

For me personally, I can’t tolerate pregnenolone at all but he is a huge proponent of it. If you haven’t tried that yet it’s probably worth looking into. Good luck on your journey!