I need help with lack of mental clarity

I'm currently experiencing something very similar to what the OP is describing, unfortunately I have yet to figure out the cause. Many have suggested this phenomenon results from a spike in E2 following an injection, but my experience dictates otherwise. Like OP I have tried differing injection frequency, I have also tried a myriad of different weekly T doses (ranging from 80mg-180mg) as well playing with anastrozole dosing/timing. I have also experienced the phenomenon of reduction of symptoms the longer I get from a shot. Recently, I have been treated for subclinical hypothyroidism and I am seeing some relief from my symptoms. Currently I don't believe my protocol is optimal or finalized, I believe once my dosage of thyroid gets squared away and balanced I may finally be free of the brain fog. As I look at OP's blood work I see that he may fall under the classification of subclinical hypothyroid as well. While OP falls into a decent range for TSH his Free T4/T3 seem to be on the lower end of things. Prior to treatment my Free T4/T3 fell into a very similar range with the OP, although my TSH was about 2UIU/ML higher. As I previously stated this has not been a miracle cure for me by any means but is solid progress in the right direction. Since starting thyroid medication the world around me has begun to get a bit clearer, my eyesight is no longer "clouded" (hard to explain, but it seems to come with the brain fog for me), my sense of smell and taste are improved and I'm having an easier time going to the bathroom (if you catch my drift lol). I'm still very "out of it", my working and long term memory can be spotty and the depression still lingers, but my outlook on my future is very hopeful. Hopefully this is helpful to you OP, hope you keep us updated!
 
In my opinion, poor sleep quality is the number cause of brain fog. Second is medication side effects. Third is low thyroid and/or low T.
 
I know for me and a few other guys taking testosterone replacement lowered my already low normal cortisol. Have you had your levels checked. I had tons of neurological symptoms from low cortisol. And testosterone mad them worse for me. It was also confirmed by lab work. However I was on testo only at the time so maybe the testosterone caused testicular atrophy and low lh preg,prog ect and lowered cortisol not sure. Dr Mariano also talks about for some with hpa dysregation aka "adrenal fatigue" just the higher levels of t can be detrimental to them.
 

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TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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