I am 23 years old and starting experiencing symptoms of low T around age 17 or so; it was a gradual onset. By age 21 it had gotten so bad that I finally went in to get checked out by the doctor. At this point, these were my symptoms:
- slept 9-10 hrs/night yet was so tired I felt like I was in a waking coma
-brain fog, terrible memory
-freezing cold all the time
- libido was about a 0/10. Did not even notice pretty girls. Erections never occurred spontaneously. No morning wood
-worked out 3x/wk yet was gaining fat and losing muscle slowly but surely
-had lost interest in everything I used to enjoy. Had no joy left in life, really
-became so depressed that I struggled with very strong suicidal tendencies for the last 3-4 months before staring testosterone
Doc found T level of 280 ng/dL 1 year ago now and prescribed Test Cyp 120 mg/week (given bi-weekly). I soon felt markedly better than I had, but still lousy enough that I really didn’t have much joy in day to day life. Honestly, I still felt terrible; just less terrible than before. This doc referred me on to an endocrinologist for further treatment. I had reduced my Testosterone to 100 mg/week (50 bi weekly) at this point on my own because for whatever reason it improved my symptoms slightly.
The endo ordered a MRI to rule out pituitary tumor, which thankfully was negative. He also started me on Levothyroxine 50mcg/day for somewhat low thyroid levels, which warmed me up and ramped up my appetite but improved mood and energy only very slightly, which were the main concern. He next ordered a sleep study, which I just completed and am now waiting to consult with that doctor (a Pulmonologist) before seeing my endo again in 10 weeks. I and the pulmonologist are pretty darn sure I don’t have narcolepsy or sleep apnea; if there is actually a sleep cycle problem then it is something else.
I am 5’11", 160 lbs., about 7% body fat. I have more body hair than most. I eat a healthy diet and weight train 3x/wk, run about 15 miles per week. I take no other medications besides the Test Cyp and Levothyroxine. Of possible note is that I have Tourrette Syndrome, which I have had since a young child. It is not bad enough that medication is necessary, however.
Most current labs:
TT: 635 ng/dL (241-827)
FT: not tested
E2: not tested
Prolactin: 6.7 (2.10-17.7)
Cortisol: 12.7 ug/dL (5-23)
TSH 2.12 uIU/mL (0.3-4.0) *all thyroid levels are before starting Levothyroxine
Free T3: 2.9 pg/mL (2.0-4.4)
Free T4: 0.71 ng/dL (0.8-1.8)
PSA: not tested
FSH/LH: my only records reported only that they were “in normal range” before starting TRT 1 yr ago
As far as the whole TRT thing, I honestly still feel terrible, something just is not right. This has gone on for years now and I’m really starting to lose hope of ever feeling well again and actually enjoying being alive .Here’s what I’ve got going on right now:
I feel sleepy/groggy nearly all the time despite sleeping 8 hours per night. I wake up feeling not-well rested and stay feeling tired throughout the day, and I really crash by late afternoon. I really don’t enjoy much of anything anymore, though I make myself do social things and get out even though I don’t feel like being social. I feel about 50% better mood (and energy somewhat) when I’m around other people.
The biggest thing is that I feel just downright depressed and very sad for no apparent reason; my life is honestly good besides all this. I do feel strangely close to crying often when I never would have before, but no gyno or anything like that.
I notice girls mostly like works of art. I do have nocturnal erections now but morning erections I’m not sure; I don’t think I usually have them. I will have to take note. I have very low libido; I have no desire to masturbate. If I make myself, the erection is weak, it takes awhile to ejaculate, and ejaculation amount seems pretty low in volume to me. Testes never ache and they are not retracted up close to my body. After 6 months of TRT, I asked my endo if I needed HCG to maintain fertility. He measured my testicles and said they were exactly average size for my age; said it is expensive and that we won’t mess with it unless we have to. So we have not.
Lastly, and I think importantly, I always feel my worst 2-3 days after my injections. If I try a higher dosage, all the symptoms worsen together quite dramatically. All the symptoms seem to peak out and wane out together, but they are always there. If I give my whole weekly injection in one dose, all symptoms are much worse within 2-3 days, lasting 1-2 weeks before leveling out to where they normally are. At the same time, why should I feel markedly better (nearly 50% I would say) when around other people if it were an E2 problem?
- Could this simply be clinical depression??? Or does it sound hormonal?
- Is estradiol a big concern for someone like me? Is it very likely that with such a level of T (635 ng/dL), E2 will be excessively high?
- How essential are AIs and HcG for someone like me, and how expensive are they in the U.S.? If necessary, does anyone know of any literature that supports it that I could take to show my endo?
- What could I change right now so that I don’t have to live the next 2 1/2 months until my follow-up apptmnt) feeling absolutely terrible? Is it worth trying ing 3 injections per week and reducing to 80 mg/wk (as progressively higher T levels seem to make me feel worse?)
Thanks so much in advance, I really appreciate any advice anyone might be able to offer