T Nation

29/M Newly on TRT, Trying to Feel Better


#1

currently dosing 100mg weekly of cypionate via injection to quad. I am on week 6 I believe. I still have very bad brain fog, low energy, no motivation, trouble focusing. I believe some of it to be valium withdrawal, some of it stomach related(eating sugar/carbs gives me yeast/candida symptoms, tested positive through stool +4)

I get scared easily, i stay sick for very long periods of time, i constantly feel stressed and scared like something bad is happening, I cannot relax. Tiny movement will freak me out. My gut says adrenal issues but I don't know.

I've been taking vitamins recently, just a multi from ALIVE. Also I take lugols iodine, 3-5 drops in water with selenium 200mcg daily. I slow down on the iodine as sometimes I swear it makes my brainfog worse.

I just want more mental clarity, I want more energy. I want to be happy for myself and for my daughters and family. I have lots of trouble of work with my memory. I was hoping TRT would help this, it doesn't seem to be doing anything. My doctor isn't much help, I have to beg to get any tests done. and i'm not sure what to ask him to get tested, i'm trying to read the FAQs but this brain fog is a bitch right now. I have dry skin, very bad, Sensitivity to hot/cold, especially cold, i cannot stand it.

If I had my mental clarity back I wouldn't care, please give me advice on what to do from here?

-age : 29
-height : 5'10"
-waist : 30
-weight 140lbs

-describe body and facial hair body hair only in normal places, armpit, groin, legs. very little facial hair, little stubble on my chin for 4-5 years.

-describe where you carry fat and how changed: don't carry much fat, but if I have any it seems to be in mid section, although chest has gotten some of it. not my arms or legs.

-health conditions, symptoms [history] stomach issues, candiasis? parasites? I'm not sure...also valium addiction.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever : valium, 5 mg every 2-3 days.

-lab results with ranges :

SEX HORMONE BINDING GLOBULIN [13-110] nmol/L 21
LH [0.5-76.3] mIU/mL 2.6
Testosterone, Total [302-1096] ng/dL 200 L
TEST FR [47-244] pg/mL 48
TESTOSTERONE, % FREE [1.6-2.9] % 2.4
SEX HORMONE BINDING GLOBULIN [13-110] nmol/L 21
Auto Neutrophiils pct 56.1
Auto Neut Abs 2.0-7.3 K/MM3 5.2
Auto Lymph pct 35.5
Auto Lymph Abs 0.9-4.8 K/MM3 3.3
Auto Mono Pct 5.0
Auto Mono Abs 0.2-1.0 K/MM3 0.5
Auto Eos pct 2.5
Auto EOS Abs 0.0-0.4 K/MM3 0.2
Auto Baso pct 0.9
Auto Baso Abs 0.0-0.1 K/MM3 0.1

(3 weeks prior)
TEST TL 175.00-781 ng/dL 214.62
WBC 4.5-10.0 K/MM3 9.2
RBC 4.40-6.00 M/MM3 5.00
HGB 13.4-17.4 G/DL 14.5
HCT 38.9-51.5 % 42.8
Mean Corpuscular Volume 80-100 uM^3 86
Mean Corpuscular Hemoglobin 26.0-34.0 pg 29.0
Mean Corpuscular Hemoglobin Count 31.0-36.0 % 33.8
RDW 11.6-14.6 % 12.8
Platelets 150-400 K/MM3 195
MPV 7.2-11.1 uM^3 10.9

-describe diet [some create substantial damage with starvation diets]
usually late breakfast, or skipped until lunch, sometimes just coffe or pretzels/peanut butter. lunch is usually large sandwhich, or burrito/tacos someting close to work. Dinner varies, i'll have a protein shake with peanut butter/milk, 2 scoops protein, sometimes fruit. i'll eat chicken/rice/burritos whatever is in the house.

-describe training [some ruin there hormones by over training]
i don't currently train, no energy or motivation.

-testes ache, ever, with a fever?
not really, sometimes it feels weird but it's just like i'm very horny.

-how have morning wood and nocturnal erections changed
more frequent morning wood, much harder.


#2

This will be difficult as I am going to ask you to read some stuff.
I know that you are already reading, but here is the load.

Stickies to read:

  • advice for new guys
  • thyroid basics
  • protocol for injections

You are describing symptoms of hypothyroidism.
Please do these labs:
TSH
fT3
fT4 [PLEASE DO NOT TEST T3, T4, confirm with doctor first]
Check your body temperature when you first wake up. Ideal is 97.7-98, 97.3 and lower is a problem.
Also see if you can get to 98.6 in mid-afternoon
Are you using iodized salt? Check the container to verify. If not, you are iodine deficient.
If you are not using iodized salt, everyone in the house may be at risk, check temperatures. They take iodine drops?
If you have bromine contamination in your body, iodine can displace that and you excrete that. But during that time, you feel worse and might also have a nasty body/breath odor from the bromines. You can pick up bromines from some orange/citrus sodas or sports drinks. This is not a common issue. Are you exposed to chemicals at work?

So you inject 100mg T per week and T is low and LH=2.6?
On TRT , LH and FSH should go to ZERO
Its like you are not injecting anything.
Do these labs:
LH AND FSH *** should have been done before TRT ***, these should be ZERO on TRT
TT
FT
E2
prolactin
fasting glucose
A1C [useful detecting diabetes]
fasting cholesterol [might be low]
Vit-D25
DHEA-S
AM cortisol

You also sound like you might have adrenal fatigue. Please find references to that in the above two stickies, note references to cortisol, stress, adrenal fatigue, rT3 <–note, and Wilson’s book.
If body temperatures are low and FT is mid-range or higher, test rT3 [reverse T3]. rT3 stops fT3 from entering your cells.

We have seem some guys who are hyper metabolizers or excreters of T. They have typically needed 300mg T per week to get decent levels.

Many with significant thyroid problems can feel worse with TRT as the increased/restored metabolic demands of TRT cannot be managed with the thyroid issues.
Ditto with significant adrenal issues. Lab ‘AM cortisol’ is in list above.

Please read this more than once and revisit after reading stickies as you will then better understand.

T cyp vial is 200mg/ml and you inject 1/2ml?
Please inject 50mg twice per week

Useful:
Fish oil, nuts, flax seed meal/oil
5000iu vit-D3, find tiny 5000iu oil based caps, take 25,000 for first 7 days

Where are you located?


#3

I’ll try an read the stickies this weekend, usually I can focus a little better on the weekends.

All these tests were done before I started my TRT, i am getting more bloodwork done soon now that i’ve been on it.

yes I inject 1/2 ml every week. i’ll try and switch to 1/4 mg twice a week.

i’m located in portland, OR

So if my thyroid is messed up, (going to test temp in morning, do i need a special thermomter? I just have a basic digital one). Anyways, if it’s messed up, and testosterone makes it worse, what do i do? stop for now until my thyroid is fixed? i’ve been taking iodine. I use “REAL SALT” it’s sea salt, i think it has tiny bit of iodine, nothing added though.

i never drank orange/citrus or sports drinks a lot, only occasionlly. Also i am exposed to caulking at work, sometimes other chemicals. I work construction outside, well I used to, i’m in the office now.

I’m going to get those suggested blood tests done, i’m scheduling an appt tomorrow.

I’d like some mental clarity and energy soon, any tips?

Really take that much vitamin d for 7 days? ok, i’m starting now.


#4

Portland Oregon, not the sunshine capitol of the country, your Vit-D3 is now further limited by your office job. Some vit-d is 50,000 per capsule and in health studies, 300,000iu doses were used every 3 months. Your body stores vit-D3 and converts to an active hormone. The idea of 25,000iu is to boost your stores.

My wife switched to " real salt" a few years ago and I ending up with iodine deficiency [ID], low body temperatures and was feeling very low. My TRT levels were very good at the time, so I was feeling a pure thyroid issue. The packaging NOW states that it is not a source of dietary iodine on the front label. http://www.swansonvitamins.com/en_US/images/ItemImages_SW/images_Xl/RTC009_Xl.jpg
You can find my thread “KSman has a thyroid problem” where I described the problem and my iodine replenishment [IR].

Throw that real salt into the trash and get some basic iodized salt. Note that there are non-iodized salts side by side with iodized and the packaging is very similar, so look carefully. Your whole family is probably iodine deficient. Everyone else feels great? Your girls active or getting a but lazy? Everyone gets temperatures checked. Also note that iodine RDA is increased during pregnancy and nursing.

What pisses me off is that health food shops sell these “natural salts” and people get natural ID.

So its safe to conclude that you are iodine deficient, which is sort of a good situation, because IR can fix that, a drug free event.

Also see: https://en.wikipedia.org/wiki/Hypothyroidism#Signs_and_symptoms

It makes sense to address the IR and see where things go from there.

IT IS VERY IMPORTANT - that you have selenium in your diet from vitamins:
High potency B-complex multi-vit with trace elements, including iodine and selenium
Helpful: and/or Fish oil, flax seed oil/meal, nuts, vitamin C, natural source vit-E


#5

Hey thanks for the reply.

So I took my temp when I woke up today, it was 96.8, tried again and still was 96.7-96.9. I tried at 3pm and still low at 97.8. I thought it was broke so I had my girlfriend try, her temp is 98.6 while mine is 97.8-97.9.

I’ll get rid of real salt, get iodiEd. How much selenium? I take 2-300 MCG daily now. How much iodine should I be taking in? I take 3-4 drops of lugols 2% solution.

Anyways I’ll up the vitamin d. And I take a multi vitamin now with b vitamins in it.


#6

The selenium in a multi-vit that lists selenium, iodine and other trace elements will be good.

So do the thyroid labs and with rT3

In the thyroid basics sticky, review references to adrenal fatigue, stress and Wilson’s book.

So you are on the road now, knowing some of what you are dealing with.


#7

I actually have Dr Wilson’s adrenal fatigue book.

I asked my doctor to do reverse t3. He won’t do it cause he says its inaccurate. Time to find a new doc.