Uncontrolled Type 2 Diabetes and Gastroparesis.

[Systemlord]

It would seem 6mg cypionate has crushed my potassium within 36 hours after restarting TRT. I felt fantastic for 34 hours, increased appetite, strong sense of smell, sore muscles, more energy and better sleep quality. Last night at work I felt something all too familiar, crushed potassium just like in April when more than one deficiency was discovered.

The potassium problem did cause my gut to become paralyzed causing other deficiencies. Pre-TRT potassium was on the high end of the ranges (4.8), after the first 6-8 months on TRT (4.8->4.0->3.8->3.6->3.3), I started having blood pressure problems which I now know was low potassium because labs show potassium lower and lower on every new lab test.

When my potassium gets down to 3.5, my heart has trouble beating and a feel bad long before potassium gets to 3.5. Days prior to restarting TRT, potassium was 4.6 (range 3.5-5.2) and 36 hours after two 6mg injections, potassium was crushed, teeth turned yellow again, muscle spasms in stomach, gut, legs and arms. I had burning sensations on skin, skin was also damaged from low potassium.

I've supplemented 800mg potassium today where the norm is 400mg, I feel good right after taking the potassium. I'm trying to understand what's going on here.

The enanthate doesn't affect my potassium to the same degree, it's a bit more mild so my next move should come as no surprise. The 7mg cypionate is devastating to potassium, the same 7mg enanthate doesn't affect potassium quite the same as cypionate.

Late 2018 I went from 7mg cypionate to 7mg enanthate which I felt better because potassium wasn't affected to the same degree. I can only imagine what T-cream would do to me shooting T high so quickly knowing what 6mg cypionate does to me.

It seems the more time passes, potassium is getting lower and lower, I wonder where it all stops.

Does anyone know why cypionate or even enanthate is crushing my potassium?

Maybe something else is going on that needs attention, maybe TRT is supercharging my kidneys excretion of potassium?

 

[madman]

It would seem 6mg cypionate has crushed my potassium within 36 hours after restarting TRT. I felt fantastic for 34 hours, increased appetite, strong sense of smell, sore muscles, more energy and better sleep quality. Last night at work I felt something all too familiar, crushed potassium just like in April when more than one deficiency was discovered.

The potassium problem did cause my gut to become paralyzed causing other deficiencies. Pre-TRT potassium was on the high end of the ranges (4.8), after the first 6-8 months on TRT (4.8->4.0->3.8->3.6->3.3), I started having blood pressure problems which I now know was low potassium because labs show potassium lower and lower on every new lab test.

When my potassium gets down to 3.5, my heart has trouble beating and a feel bad long before potassium gets to 3.5. Days prior to restarting TRT, potassium was 4.6 (range 3.5-5.2) and 36 hours after two 6mg injections, potassium was crushed, teeth turned yellow again, muscle spasms in stomach, gut, legs and arms. I had burning sensations on skin, skin was also damaged from low potassium.

I've supplemented 800mg potassium today where the norm is 400mg, I feel good right after taking the potassium, but it is short lived. I'm trying to understand what's going on here.

The enanthate doesn't affect my potassium to the same degree, it's a bit more mild so my next move should come as no surprise. The 7mg cypionate is devastating to potassium, the same 7mg enanthate doesn't affect potassium quite the same as cypionate.

Late 2018 I went from 7mg cypionate to 7mg enanthate which I felt better because potassium wasn't affected to the same degree. I can only imagine what T-cream would do to me shooting T high so quickly knowing what 6mg cypionate does to me.

Does anyone know why cypionate or even enanthate is crushing my potassium?

Maybe something else is going on that needs attention?

Should have absolutely nothing to do with using exogenous testosterone let alone what ester used.

If anything when on trt.....potassium is retained along with other electrolytes.



Depo-Testosterone (testosterone cypionate) leaflet:

ADVERSE REACTIONS
The following adverse reactions in the male have occurred with some androgens:

Endocrine and urogenital: Gynecomastia and excessive frequency and duration of penile erections. Oligospermia may occur at high dosages.

Skin and appendages: Hirsutism, male pattern of baldness, seborrhea, and acne.

Cardiovascular Disorders: myocardial infarction, stroke.

Fluid and electrolyte disturbances: Retention of sodium, chloride, water, potassium, calcium, and inorganic phosphates.

Gastrointestinal: Nausea, cholestatic jaundice, alterations in liver function tests, rarely hepatocellular neoplasms and peliosis hepatis (see WARNINGS).

Hematologic: Suppression of clotting factors II, V, VII, and X, bleeding in patients on concomitant anticoagulant therapy, and polycythemia.

Nervous system: Increased or decreased libido, headache, anxiety, depression, and generalized paresthesia.

Allergic: Hypersensitivity, including skin manifestations and anaphylactoid reactions.

Vascular disorders: Venous thromboembolism.

Special senses: Rare cases of central serous chorioretinopathy (CSCR).

Miscellaneous: Inflammation and pain at the site of intramuscular injection.

 

[Systemlord]

Fluid and electrolyte disturbances: Retention of sodium, chloride, water, potassium, calcium, and inorganic phosphates.

Thank you madman, I hope it's a simple as increasing the potassium supplement. I had tried the more natural approach adding in lots of potassium rich food and stopping the potassium supplements, 3-4 days later potassium founds its way to the bottom of the range just like now with the same symptoms.

It's clear I will more than likely have to supplement potassium for life. It wasn't easy increasing the potassium knowing it can stop your heart if it gets too high, but I figured if 400mg took me from 3.4->4.6 and that fact I was having symptoms as if I had stopped potassium supplements, another 400mg would get me to about the same 4.6 level.

It's safe to assume that I peak every 36 hours, I've always suspected as I can feel the peak and then to decline during the first 6 weeks which always occurs at around 8:30->9:30pm.

Are you aware of any medications that can help with this electrolyte imbalance, maybe something that will help my body hold onto potassium better without going overboard?

I just don't know how far this is going to go, I see the road ahead, just not the destination.

 

[fifty]

Could be potassium or some interrelationships between 100 other vitamins/minerals/hormones.

Trt...I say run away or try something like natesto or androgel.

 

[Systemlord]

Trt...I say run away or try something like natesto or androgel.

I think the whole problem is my body doesn't like steady levels as far as potassium is concerned. But remember naturally potassium would be below range is I wasn't supplenting. I think this was going to happen regardless of whether or not I needed TRT.

Stopping the Klonopin I believe caused these minerals to decline, this medicine slowed down metabolic processes, once I stopped the Konolpin, the minerals crashed then causing low testosterone.

My pre-TRT had iron at the bottom of the ranges, saturation below range, binding capacity at the top of the ranges. I need the fluctuations in levels so these minerals are not suppressed, but not too much that I'm symptomatic.

I didn't start having problems until going from twice weekly to EOD, daily has really brough out these mineral problems. I was on an EOD protocol and these symptoms I'm having now were less severe. I do remember when doing 18mg EOD, the feeling of low potassium, at the time I didn't know, but now I do because I've experienced it many times over.

I wonder how long we'll have to wait for something better than TRT in its current form. A chip implanted under the skin lasting up to 1 year varying levels throughout the day.

 

[Systemlord]

Should have absolutely nothing to do with using exogenous testosterone let alone what ester used.

Madman I agree with you, but what if the the shorter half-life is the key here. The enanthate has a slightly shorter half life than cypionate, what if the shorter half-life causes the peaks to be shorter lived sparing potassium enough to make the difference however small?

My experience is as I'm working my way towards the top of the peak, potassium is getting used up and when the levels start declining, potassium is spared. I think my levels are hitting the top of the peaks, then when working my way towards a trough, I start feeling better like I do right now.

About 30 minutes (12-1 a.m) ago I felt a little peak, not as high as earlier this evening because my metabolic rates are decreasing. I have had four separate low potassium episodes that disappear only to return within hours, rinse and repeat all day.

That might mean propionate would have a quicker, shorter lived peak sparing even more potassium. If enanthate fails to provide me with good results, I will try propionate.

 

[madman]

Madman I agree with you, but what if the the shorter half-life is the key here. The enanthate has a slightly shorter half life than cypionate, what if the shorter half-life causes the peaks to be shorter lived sparing potassium enough to make the difference however small?

My experience is as I'm working my way towards the top of the peak, potassium is getting used up and when the levels start declining, potassium is spared. I think my levels are hitting the top of the peaks, then when working my way towards a trough, I start feeling better like I do right now.

About 30 minutes (12-1 a.m) ago I felt a little peak, not as high as earlier this evening because my metabolic rates are decreasing. I have had four separate low potassium episodes that disappear only to return within hours, rinse and repeat all day.

That might mean propionate would have a quicker, shorter lived peak sparing even more potassium. If enanthate fails to provide me with good results, I will try propionate.

Forget about fretting over such.

Key here is getting enough through dietary sources as you should be aiming for 5000 mg/day.

If you have trouble obtaining sufficient amounts through diet than use supplementation.....mind you I would prefer dietary sources as you will be increasing your overall nutrient intake from a variety of sources as you should be concentrating on eating enough vegetables/fruits, beef/poultry/fish, beans/legumes, starchy tubers..

Mind you if following a low/lower carb based diet as I know you would like to lose weight than you will have to be more creative to make sure you meet your daily requirements and as I stated potassium is needed in higher amounts.

 

[madman]

Negative issues with taking potassium through supplementation will be discussed in the video.

 

[fifty]

Summary: eat spinach

 

[DragonBits]

@Systemlord

I doubt testosterone cypionate can directly be causing your potassium to "crash". Maybe, maybe indirectly it affects something else that is a problem and causes lower potassium.

You have had multiple mineral deficiencies, I would tend to look at something in common. Like gut biome or absorption issues, excretion issues.

My potassium levels are often above range, a month ago potassium measured 6.0 (3.5-5.2). I doubt it's anything about TRT, my potassium levels 50% of the time are above the top of the range, with or without TRT. Though 6.0 is the highest I have even seen it. A few days ago I retested comp metabolic panel, now my potassium is back to 4.9.

I have always been curious why my potassium levels are often high, but it never seems to get high enough to cause a problem nor does it stay high.

Since I am on nebido, I get a fairly rapid move up in testosterone after an injection then a very slow drop with no real fluctuations after the peak, just a gradual fall. Since you seem to be concerned about fluctuations, I felt it was worth mentioning.

 

[Systemlord]

Today I barely made it to my doctors appointment, I got out of my car and proceeded to walk into the building, sat down in the waiting room, then slid right out of the chair onto the floor and passed out. The doctor prescribed 5mg Glucotrol XL and glucose has decreased considerably in the last 45 minutes and is now below my typical morning glucose I've been getting on a regular basis even while on TRT.

My morning glucose has been 140 and after eating 270-330 and I would always feel like passing out. My glucose levels are not declining after eating and I'm creating ketones, so each meal with increase the glucose higher and higher. Back in april when I was on TRT and in the same situation, I lost 15 pounds in 5 days as I was having these GI symptoms caused by the high glucose levels as my body started using fat for energy since my gut was paralyzed and no nutrients were being absorbed.

My iron, vitamin C, potassium, vitamin D deficiency was caused by uncontrolled diabetes creating gastroparesis, the food would just sit there and not become absorbed causing gas and bloating. I want to ask a question, my doctor said TRT should have improved the glucose levels and improved all symptoms related to the uncontrolled diabetes that was causing the gastroparesis, but TRT seem to make everything worse.

I was out of it and didn't get the chance to ask the doctor, why did TRT not improve the uncontrolled diabetes making it worse?

 

[fifty]

Do you have these same problems not on trt? I know I’ve said this to you 10 times already but it seems like trt solves 1 problem but causes 5 others.

 

[Vman]

It would seem 6mg cypionate has crushed my potassium within 36 hours after restarting TRT. I felt fantastic for 34 hours, increased appetite, strong sense of smell, sore muscles, more energy and better sleep quality. Last night at work I felt something all too familiar, crushed potassium just like in April when more than one deficiency was discovered.

Sorry to hear your latest attempt at TRT did not work out well. You've definitely had a rough go of it for a long time.

My iron, vitamin C, potassium, vitamin D deficiency was caused by uncontrolled diabetes creating gastroparesis, the food would just sit there and not become absorbed causing gas and bloating. I want to ask a question, my doctor said TRT should have improved the glucose levels and improved all symptoms related to the uncontrolled diabetes that was causing the gastroparesis, but TRT seem to make everything worse.

I was out of it and didn't get the chance to ask the doctor, why did TRT not improve the uncontrolled diabetes making it worse?

This makes no sense at all. Curing diabetes is an often touted benefit of TRT.

Honestly, I would consider getting a really good nutritionist. They will sort out if you have any gut/GI/adrenal issues. I have a great one that works with a naturopath and is entirely virtual. PM me if you want their info.

 

[andrepohlann]

As far as I understand your potassium problems are caused by your diet. Maybe it helps: I tried carnivore diet 3 times, had to stop it after 6-8 weeks each time. The reason was high resting heart rate. Normally it is somewhere in the 60s it went up to 90s. It was caused by mineral depletion. Orange juice stopped the high rate every time. You cant solve your high blood sugar by low carb. You just cure the symptoms. Not even this seems to work. If I were you I would go for a higher carb diet, more fruits, milk (both high in minerals) and reduce my calorie intake. The lower calorie intake should reduce our bodyfat and therefor increase the ability of your pancreas to produce insulin AND your insulin sensitivity. Most of your carbs shuld come from fruitsuger or sucrose. The fructose part of it pass by the need for insulin.
Google Ray Peat. Excuse my english.

 

[Systemlord]

I naturally have an incredible energy and routinely shock those who underestimate me (6 ft, 235 lbs, thin frame/athletic with moderate muscle in legs), when natural T is optimal I have explosive strength and can have intense prolonged burst of energy that is sustainable for long periods of time. I would tear up obstacle courses with ease and great balance and agility.

I’m not terribly fatigue scoring TT 97-146 ng/dL these past 5 months, stamina is ok but declining a little bit the longer I’m off TRT. Erections have been very slowly declining as well. Only 6mg cypionate is enough to propel me into crazy energy. My joints are loose and pop when shifting body weight, muscle are soft.

I stopped TRT in April do to the deficiencies and in turned worsened my Type 2 diabetes which has caused gastroparesis dysfunction and my entire GI tract to experience poor absorption, dysfunction of the nerves that propel food through the GI tract. Restarting TRT only worsen everything because demand was increased on everything and I burned through what vitamin C I had quickly as my GI became more dysfunctional that it already is.

When I found I was deficient in vitamin C (=iron deficiency) I struggled with dosing and finally found the perfect dose which is 35mg, 60mg is too much and I must drink 3 ounces of orange juice (35mg) every day or else I become deficient pretty quick. When I re-started TRT my vitamin C was hovering on the bottom of the ranges as lab testing days earlier had confirmed.

Since August I had been taking 250mg vitamin C and even 65mg is too high, and have been drinking orange juice since I can't get vitamin C in 35mg doses and believe the OJ may have contributed to the rising glucose levels and a worsening of diabetes.

My typical diet is chicken, steak on occasion, spinach daily, carrots, asparagus, pepper jack cheese, chicken between bagels and eating out occasionally. I supplement potassium, vitamin C and vitamin D. If I stop the potassium, days later my potassium will be below range, teeth will turn yellow as the magnesium pulls calcium from my bones and teeth.

Restoring potassium be supplementing will see teeth white again within days. I’m assuming I need to eat small meals instead of large ones to keep glucose from rising.

 

[Systemlord]

I wanted to update my situation, in 2019 April I found multiple deficiencies and it was just down to a lack of essential vitamins (vitamin C) that caused all the problems, then I stopped TRT (big mistake) and months later my A1C started increasing (6.6-8.9) and diabetes worsened and this became my new problem.

Now every time I attempt to restart TRT, when I eat, my stomach/GI goes haywire and I get a lot of belching and gas, stomach burns on the inside and turns red on the outside as well as legs and feet. These episodes triggers urinary retention (glucose 240) and I can no longer sense an urge to urinate if I eat food, no problems when not eating.

So skipping meals or eating smaller meals has helped reduce these symptoms by 70%. It would also seem like my vitamin C intake needs to be increased 5 days after starting TRT because I encountered a deficiency again, 45mg off TRT is fine, on TRT requirements are higher.

I have been on TRT for a week and these symptoms are not as bad, my endo will nonetheless be treating the diabetes in 10 days to give me a better chance. He will first try medicine and if it gives me sides, then insulin therapy will be next. My A1C and glucose never really hinted at the true levels of insulin resistance.

My endo stated my insulin resistance is very high and my glucose levels are misleading as to the true extent of resistance. C-peptides are high and insulin is plentiful, I just can't use it.

My diet is spot on and cut out processed foods, eating only whole foods. I'm also exercising three times a week, plan to increase to 4-5 day when the energy permits.

 

[andrepohlann]

I still do not understand why you do not eat a Keto diet under these conditions. Are carbs so important for you?

 

[Systemlord]

I still do not understand why you do not eat a Keto diet under these conditions. Are carbs so important for you?

My device showed I have glucose at 80 when sleeping, it increase upon waking without eating, if I do keto will that not be good?

Also note off TRT there are no ketones in my blood, but on TRT there are within a short period of time. As for carbs being important for me, I don't know the answer to that question.

 

[MarcoFL]

I wanted to update my situation, in 2019 April I found multiple deficiencies and it was just down to a lack of essential vitamins (vitamin C) that caused all the problems, then I stopped TRT (big mistake) and months later my A1C started increasing (6.6-8.9) and diabetes worsened and this became my new problem.

Now every time I attempt to restart TRT, when I eat, my stomach/GI goes haywire and I get a lot of belching and gas, stomach burns on the inside and turns red on the outside as well as legs and feet. These episodes triggers urinary retention (glucose 240) and I can no longer sense an urge to urinate if I eat food, no problems when not eating.

So skipping meals or eating smaller meals has helped reduce these symptoms by 70%. It would also seem like my vitamin C intake needs to be increased 5 days after starting TRT because I encountered a deficiency again, 45mg off TRT is fine, on TRT requirements are higher.

I have been on TRT for a week and these symptoms are not as bad, my endo will nonetheless be treating the diabetes in 10 days to give me a better chance. He will first try medicine and if it gives me sides, then insulin therapy will be next. My A1C and glucose never really hinted at the true levels of insulin resistance.

My endo stated my insulin resistance is very high and my glucose levels are misleading as to the true extent of resistance. C-peptides are high and insulin is plentiful, I just can't use it.

My diet is spot on and cut out processed foods, eating only whole foods. I'm also exercising three times a week, plan to increase to 4-5 day when the energy permits.

I just went keto and glucose never goes above 80 now. Crazy to see how it works!

 

[Checkdis]

Keto diet ftw