Extreme Tiredness after Meals

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Flexedup

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I have been experiencing rapid heart rate increase and extreme tiredness after meals that tend to disappear a few hours later. I am not on TRT but I did experiment with testosterone propionate, Clen and T3 over 10 years ago in college for a short stint. I used Tamoxifen for two weeks as PCT and never looked back. Fast forward to every subsequent year during my PCP physicals, I requested male hormone panels where they consistently showed my LH and FSH both sat at .9 (Low) while TT was 300, SHBG at 16, E2 at 25 (sensitive) and total estrogen serum at 220 (56-190 range). I was overweight my entire life that even caused puberty gyno due to poor lifestyle habits as a teen but before I discovered what the gym was. I endeavored on a weight loss journey and lost about 70lbs. I was 250lbs and went down to 180lbs stricly on diet and lifestyle changes. I experimented with testosterone propionate following that journey for size as I hit plateau I couldn't overcome.

Long story short, I began treatment with my local endocrinologist of clomid at 25mg a day for 3 months. The treatment was great in the beginning as it improved my libidio, sperm volume, sleep, energy, etc. I saw nothing but positives, but after stopping, is when the nightmares begin. I put on weight extremely fast, feel pounding heart, anxiety, extreme tiredness after meals, food coma, etc. I eat a relatively low carb, high protein diet and stay away from sugar as it makes all of the above much worse when consumed. Additionally, my entire mother's side of the family has some form of diabetes and I'm thinking I may be trending this territory. I took small dose Aromasin once to combat these symptoms thinking it was high E2 and granted, all of my symptoms tremendously subsided, however my libido, erections, pumps in the gym, endurance, etc. All went in the gutter. I performed another treatment of clomid with the same symptoms returning after stopping. The last treatment consisted of 25 mg of clomid + 10mg of Tamoxifen for two months with hard diet and excersise and I went from 280lbs to 240lbs in two months. I was doing and feeling great but the symptoms returned after stopping so I ran Aromasin for two weeks at 6.25mg taken EOD. It crushed my estrogen and testosterone. I lived a nightmare of crashed estrogen for 6 months from dry skin, dehydration, severe depression, joint pain, insomnia, etc. before I began feeling better. I was connected to a reputable organization to handle my care and I was placed on Tamoxifen 10mg EOD for 3 months to help expedite recovery again. I stopped this treatment this past Friday after performing FULL labs and still await the results but that pounding heart and extreme fatigue returned with a vengeance. I will share my labs upon receipt but did anyone live through something like this? Is it thyroid? Insulin resistance? Low T?

I would really love to not begin the TRT journey for life yet because I plan on having more children (God willing). I'm a low SHBG guy with a hereditary history of diabetes and obesity. I would do everything to not get diabetes, even if I can reverse it using TRT but I'm just not willing to make that leap yet.

My most recent labs off any SERMS are:

HDL = 42 mg/dl
LDL= 118 mg/dl
TT= 260 ng/dl
Free T = 16 pg/ml
Estradiol sensitive = 36 pg/ml
LH = 5.1 IU/L
FSH = 1.5 IU/L (low)
DHT = 16 ng/dl (low)
SHBG = 13 nmol/L (low)

These labs were performed 2 months ago before my Tamoxifen treatment. I'm waiting on new lab results. I'm 30 years old.

Thanks for reading.
 
Defy Medical TRT clinic doctor
I would do everything to not get diabetes
You’re already at high risk for type 2 diabetes with the low testosterone. DHT is low, this basically confirms Free T is low.
I would really love to not begin the TRT journey for life yet because I plan on having more children (God willing).
There are ways to deal with fertility for those on TRT, a restart using clomid and or HCG is the way it’s been done for some time now.

I would just go back on clomid and stay on, then later on when you’re done having children, start TRT.

You’re making the assumption you‘re fertile, why not find out and then start planning your next move.
 
Last edited:
= 260 ng/dl
Free T = 16 pg/ml
Estradiol sensitive = 36 pg/ml
LH = 5.1 IU/L
FSH = 1.5 IU/L (low)
DHT = 16 ng/dl (low)
SHBG = 13 nmol/L (low)
It would be helpful if you provided normal ranges for all labs, and testing methodology for the Free T. If Free T measured Direct Free T method, kindly ignore the results as this method is unreliable.

If so, then the calculated Free T would be more reliable.

The Tru-T calculator, recommended by the endocrine society, has your Free T at 9.39 ng/dL.
 
Last edited:
It would be helpful if you provided normal ranges for all labs, and testing methodology for the Free T. If Free T measured Direct Free T method, kindly ignore the results as this method is unreliable.

If so, then the calculated Free T would be more reliable.

The Tru-T calculator, recommended by the endocrine society, has your Free T at 9.39 ng/dL.
Thank you for your feedback SL. Always cherished your knowledge and participation. Here are the ranges as requested (apologies, but working from phone):

HDL >= 40
LDL below 100 optimal
TT 249-836
Free T 9.1-32.3
E2 11- 43
LH 1.7-8.6
FSH 1.5 - 12.4
SHBG 16.5 - 55
DHT 30-85

I'm aware of the alternatives of using HCG and SERMS for fertility. I really would like to make that leap at 40 if I make it instead and would love to push the envelope naturally. I did conceive my first son two years ago and plan to going for a few more. I worry about using HCG because of the estrogen and would rather ride TRT alone in the beginning before introducing it. Doing so from the start I fear having to use an AI which I swore I never will again after being down the road of crashed E2. The depression it caused was borderline suicidal for me and it hit me out of no where. I just need to defeat this sensation of a pounding heart and throbbing head and just feel stable. I no longer enjoy food because of how fatigued it immediately makes me. I may survive on peanuts until my labs result.
 
"I eat a relatively low carb, high protein diet and stay away from sugar as it makes all of the above much worse when consumed."

What percent is carbohydrate in your diet and what percent of that is sugar?
 
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I have similar symptoms after meals and eating sugars (even fruits or milk) exacerbates them. No guarantee that the cause is the same.

Until the cause is found, I would suggest you try digestive enzymes (I use AbsorbAid), since you may have exocrine pancreas insufficiency - the pancreas not releasing enough digestive enzymes. Before you get on the enzymes, you could test the level of stool elastase - it is a marker of pancreatic enzymes in the digestive tract.

To check for diabetes, test HbA1c.
 
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