Over the last week i have felt out of sorts

[JayD]

Hi Guys

Over the last week i have felt out of sorts and are experiencing the following side effects, i believe it is possibly Testosterone related. I give myself my injection at 8am every morning and by around 1030-11am i am experiencing mild symptoms of Headache, nausea, anxiety, brain fog, trouble concentrating, heavy feeling eyes. This seems to subside by early evening but is still faintly in the background as if my body is telling me it is not happy.

I am going back on cabergoline as my Prolactin has gone up again. I don't believe these sides are from the Prolactin as have had it this high before without these systems I simply had a lower sex drive.

From your experience can you think of any reason this may be happening? is there anything else in the lab i could be testing for? Progesterone etc?(unfortunately we don't have testing for pregnenolone here in NZ)

I don't want to jump the gun so will give it another week to see where this goes.

Your thoughts

Latest bloods(last 3 months on 8mg subq everyday. Been on Testosterone for almost 12 months)

13/06/2023 11:29 am
_____________________________________________________________

Complete Blood Count

RBC 5.8 x10'12/L 4.0-5.8
Haemoglobin 167 g/L 125-170
PCV 0.51 L/L 0.40-0.54
MCV 88 fL 80-100
MCH 29 pg 27-32
Red Cell Width 12.4 % 11.5-14.5
Platelet Count 291 x10'9/L 150-400
WBC 5.7 x10'9/L 4.0-10.0
Neutrophil 2.5 x10'9/L 2.0-7.5
Lymphocyte 2.4 x10'9/L 1.2-3.5
Monocyte 0.5 x10'9/L 0.3-1.0
Eosinophil 0.2 x10'9/L 0.05-0.4
Basophil 0.1 x10'9/L 0.0-0.10
ImmGranulocyte 0.0 x10'9/L 0.0-0.25
Blood Film
Blood film not examined.
____________________________________________________________

13/06/2023 11:29 am
_____________________________________________________________

HbA1c

35 mmol/mol
***HbA1c measurements may be misleading in cases of haemoglobinopathy,
increased red cell turnover or post transfusion; amongst others.***
In the setting of diagnosis or CV risk screening, this result virtually
excludes diabetes. There is no need to repeat this test until scheduled
CVD risk assessment.
In the setting of confirmed diabetes, this result indicates excellent
control. There is increased risk of hypoglycaemia if on insulin/
sulphonylureas.
_____________________________________________________________

13/06/2023 11:29 am
_____________________________________________________________

Iron Studies

Ferritin 59 ug/L 30-500
_____________________________________________________________

13/06/2023 11:29 am
_____________________________________________________________

Haemolysis Level:

TRACE A
_____________________________________________________________

13/06/2023 11:29 am
_____________________________________________________________

Endocrine Studies

Testosterone 16.7 nmol/L 9.0-25.0
Testosterone: please note that reference range stated is for adults only.

Oestradiol 126 pmol/L
Male <190 pmol/L

Prolactin 705 mU/L H 65-400
Taken: 13Jun23 07:45 hrs
Causes of high prolactin include but are not limited to:
1. Physiological: Physical or psychological stress (including illness and
surgery).
2. Drug related: Psychotropics, Dopamine antagonists, Oestrogens (high dose
OCP), Antihypertensives(methyl dopa, reserpine, verapamil (not other calcium
channel blockers), opiates, cannabinoids, H2 antagonists, amphetamines.
3. Pathological: Pituitary/hypothalamic diseases e.g. pituitary tumours,
hypothyroidism, severe liver or renal impairment, PCOS, anorexia nervosa,
after seizures.
4. **Macroprolactin: a biologically inactive prolactin-immunoglobulin complex
which is cleared slowly from the plasma. IF THIS HAS NOT PREVIOUSLY BEEN
EXCLUDED, AND IS CLINICALLY RELEVANT, CONTACT THE LABORATORY TO ADD THIS TEST
(SAMPLE WILL BE HELD FOR 7 DAYS FROM COLLECTION DATE).

 

[Systemlord]

I give myself my injection at 8am every morning and by around 1030-11am i am experiencing mild symptoms of Headache, nausea, anxiety, brain fog, trouble concentrating, heavy feeling eyes.

From your experience can you think of any reason this may be happening?

Ferritin 59 ug/L 30-500

This ^^^^. All of those symptoms you have listed are typical low iron. I’ve actually had my ferritin levels this low, and I did have mild symptoms which didn’t go away until my ferritin Is 80> unless of course I miss a dose of iron. If I’m <80, these symptoms go on all day long.

So here’s how it works, you inject testosterone, which builds up to a peak, using iron along the way, iron stores are already in the early stages of depletion. Even now with my ferritin at 80>, if I miss a dose of iron, or I take a partial dose, and I take my Jatenzo, I’ll start feeling all of your symptoms around 10 am-12 pm.

 

[JayD]

This ^^^^. All of those symptoms you have listed are typical low iron. I’ve actually had my ferritin levels this low, and I did have mild symptoms which didn’t go away until my ferritin Is 80> unless of course I miss a dose of iron. If I’m <80, these symptoms go on all day long.

So here’s how it works, you inject testosterone, which builds up to a peak, using iron along the way, iron stores are already in the early stages of depletion. Even now with my ferritin at 80>, if I miss a dose of iron, or I take a partial dose, and I take my Jatenzo, I’ll start feeling all of your symptoms around 10 am-12 pm.

Thanks for this insight do you think I should start taking a daily iron supplement? My Ferritin before TRT was
189

i also forgot to add I have developed slight tinnitus in my left ear

 

[Systemlord]

Thanks for this insight do you think I should start taking a daily iron supplement? My Ferritin before TRT was
189

Yes, I do. Start on a low dose of iron.

 

[JayD]

Yes, I do. Start on a low dose of iron.

Is a low dose typically around 25mg per day?

And how long would it typically take to get my levels up to say 80 from 59?

I just read online some fella promoting a method of 70mgs 3 times a day for 3 days, that can bump your iron up 10 points? Is this safe?

 

[Systemlord]

I just read online some fella promoting a method of 70mgs 3 times a day for 3 days, that can bump your iron up 10 points? Is this safe?

Your hematocrit is already at the top of the ranges, so unless you’re okay with reducing your T dosage, start out low.

 

[JayD]

Yeah I hear ya. I have actually already reduced my dose from 10mg to 8mg for this very reason.

I intend to lower it now again to 7mg. I know from experience by adding prolactin back in, this gives a small boost to my total testosterone.

Hopefully 7mg is the sweet spot or im possibly done with TRT(No Jatenzo in NZ)

 

[sammmy]

Have you tried to skip a daily dose, to verify whether your symptoms are truly related to testosterone or you are having something else like an infection?

Your symptoms rising at 10:30am does not necessarily mean it is from the preceding testosterone injection. The body follows a daily cycle in everything, including immune and hormonal systems.

 

[JayD]

No I haven't. I guess this is something I could try

 

[Willyt]

i am experiencing mild symptoms of Headache, nausea, anxiety, brain fog, trouble concentrating, heavy feeling eyes. This seems to subside by early evening but is still faintly in the background as if my body is telling me it is not happy.

This accurately describes my Monday to Wednesday experience every work week lol

 

[JayD]

This accurately describes my Monday to Wednesday experience every work week lol

Haha lucky it's only 3 days

 

[Systemlord]

My Ferritin before TRT was
189

Iron Studies

Ferritin 59 ug/L 30-500
_______________________

This is a massive difference in ferritin pre-TRT and post-TRT, suggesting you’re operating way outside of what’s normal for you. I’ve read papers suggesting the thyroid gland needs a minimum ferritin of 70> to function optimally.

I’m going to quote Occam’s Razor, the simplest explanation is preferable to one that is more complex.

 

[JayD]

I completely agree. I just don't understand how this has happened on such a small dose of 8mg per day. My total T is also only 16(450).

I have now lowered my dose to 7mg per day, plus added in 25mg of bisglicinate iron supplement.

Will get bloods done in 6 weeks

 

[Systemlord]

I completely agree. I just don't understand how this has happened on such a small dose of 8mg per day.

Static hormones, equals very little peaks and valleys. When my testosterone declines every day, iron is spared. When testosterone peaks again, more iron is used up.

 

[JayD]

Static hormones, equals very little peaks and valleys. When my testosterone declines every day, iron is spared. When testosterone peaks again, more iron is used up.

Do you supplement with pregnenolone? I see a lot of guys that don't use HCG often supplement with 5-100mg per day.

Everytime I try to take it with 5/10/50mg it gives me a poor night's sleep along with just feeling out of sorts.

 

[Systemlord]

Do you supplement with pregnenolone?

I tried it once, and I had racing heart rates for several hours, the worst experience of my life! I can’t even handle a tiny amount of DHEA.

 

[JayD]

I tried it once, and I had racing heart rates for several hours, the worst experience of my life! I can’t even handle a tiny amount of DHEA.

Are you low in these hormones? Or were you just experiencing?

 

[Systemlord]

Are you low in these hormones? Or were you just experiencing?

No, I’m not. At the time I didn’t even know I had iron deficiency and was chasing my tail.

 

[JayD]

Have you tried to skip a daily dose, to verify whether your symptoms are truly related to testosterone or you are having something else like an infection?

Your symptoms rising at 10:30am does not necessarily mean it is from the preceding testosterone injection. The body follows a daily cycle in everything, including immune and hormonal systems.

So I skipped my dose today and feel good, just a dull headache which was transient.

I'm lowering my dose to 7mg, hopefully this resolves it.

 

[JayD]

I forgot to add, when I wake in the middle of the night for a pee, I have noticed in the mirror that the whites of my eyes are pink and feel irritated. So weird