4 Years of TRT and Waking Up with Fatigue

Been waking up with fatigue everyday for 4 years so far. Not only that I recently had pneumonia type symptoms (couldn’t diagnose me with it) but was coughing up blood. My fatigue problems started exactly when when I started trt. I’m only 30 years old.

I don’t have labs but I’ve seen them at my endo’s office and he’s correct, everything looks as if in the normal range. I was thinking of just stopping trt but that made me feel even more ill as I’m diagnosed with KS.

What the hell should I do. I wake up feeling like I’m dead every morning for 4 years and it’s got so worse I completely stopped going out, can’t even clean my apartment (last 4 months), incredibly hard to workout.
Not only that, ground glass nodules where found in my lungs, but they are due to medications. The only medication I have taken for 4 years is TRT.

What do you expect us to comment on if you have no labs?

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Your doc thinks that normal lab ranges mean that everything is perfect. That is wrong. You should be seeking optimal.

Describe your TRT in detail, doses in [mg, iu] not volumes, timing

Your lethargy could be iodine deficiency if you have not been using iodized salt. If not, when did that happen?

Elevated E2 easily happens with TRT and that can affect energy, libido and mood. Are you bitchy, intolerant, moody, sensitive to sudden or loud noise? E2 is easily managed with ~1.0mg anastrozole per week with a target of E2=22pg/ml.

pneumonia can take months to get over

Suggested protocol:
50mg T cyp or eth, twice a week
0.5mg anastrozole at time of injections
250iu hCG EOD to preserve testes/fertility


  • TT
  • FT
  • E2
  • LH/FSH from before TRT, you cannot do this now
  • prolactin
  • CBC
  • hematocrit
  • fasting cholesterol
  • fasting glucose
  • AM Cortisol - at 8AM
  • Vit-D25 or just take 5,000iu every day, 25,000 for first five days
  • TSH
  • fT3
  • fT4
    What do these thing mean? - see the advice for new guys sticky.

You can easily check thyroid function by oral body temperature as per the thyroid basics sticky.

If there is a more serious thyroid problem, TRT can sometimes make it worse if the increased/restored metabolic demands of higher T levels cannot be supported because of lacking in the thyroid and/or adrenals.

Low Vit-D3 or low thyroid function may increase illnesses or make the illnesses more severe.

Your extrem fatigue could be from sleep apnia. It could be as simple as that. Beware of doctors, they tend to lack in optomising are healt. Have your doctor e-mail your blood work and post deme, it will give ksman the opportunity to give you the right tools to get you back on track.

Good luck

No it isn’t had a sleep study due to this fatigue and my AHI is 3.1 which is normal level. Mild is 5+. Some terrible doctors, after no sleep apnea problems on test and E2 levels at a normal range my family doctor gave up to help me. Now they are doing nothing and I still wake up like a zombie every day. Life is impossible.

Hi mentars, could be adrenal fatigue. Do you use pre workout ? Do you drink Cafeineted drinks? Are you still training ?

You need to post your blood work.
It’s the only way to go. We are there to give you a helping hand but it’s not possible with out blood work.