T Nation

8 Years TRT Recently Experiencing Joint Pain and Reduced Stamina


#1
  • Age - 42 (43 in march)
  • Height - 5’ 10.5"
  • waist - 33"
  • weight - 225
  • describe body and facial hair - prior to TRT, couldn’t grow any until I was around 30
  • describe where you carry fat and how changed - rear-end, but have always had trouble gaining weight
  • health conditions, symptoms [history] - In '08 when I got sick it was like hitting a wall. Falling asleep while eating, no concentration (foggy brain), body temp swings, no desire for sex or food, chronic diarrhea

Currently - aching joints, reduced sexual stamina but no ED, chronic diarrhea

  • Rx and OTC drugs, any hair loss drugs or prostate drugs ever - none used prior to TRT. Was a natural athlete from 92 to 08. After '09 - 200 mg Test Cyp E3.5D, 1mg Arimidex EOD (3 per week), 2Gr armour thyroid ED
  • lab results with ranges
    Before starting TRT/Armour
    Total Test - 85ng range 241-827
    Free Test - 2.4pg range 8.7-25.1
    LH - 1.1mIU range 1.5-9.3
    DHEA - 255ug range 120-520
    FSH - 3.2mIU range 1.4-18.1
    TSH - 7.810uIU range 0.450-4.500
    Estradiol - 32pg range 0-53
    Prolactin - 4.0ng range 2.1-17.7
    TPO - 44IU range 0-34
    AST - 70mg range 0-40
    ALT - 119mg range 0-55
    HDL - 83mg range 40-59
    LDL - 105mg range 0-99

Most recent labs from 3/22/16
Total Test - 1501ng range 348-1197
Free Test - 45.6pg range 6.8-21.5
T4 - 0.96ng range 0.61-1.76
® T3 - 19.1ng range 9.2-24.1
DHEA - 252ug range 102.6-416.3
TSH - 3.470uIU range 0.450-4.500
Estradiol - 23.8pg range 7.6-42.6
TPO - 11IU range 0-34
AST - 53mg range 0-40
ALT - 58mg range 0-55
HDL - 49mg range 40-59
LDL - 165mg range 0-99

  • describe diet - I eat pretty clean year round, but cycle my Marcos in the winter for bulk
  • describe training - typically a 2/3 split
  • testes ache, ever, with a fever - no sir
  • how have morning wood and nocturnal erections changed - no sir

#2

I have my semi-annual appointment coming up at the beginning of March (w/ bloodwork), and am looking for direct questions to go over with my Dr. He’s very open to discussion, and truly cares how I feel instead of what the numbers say. Took me a while to find him, but he’s been a good Dr and friend since '09.

The chronic diarrhea has never been solved…over 7 years without a solid #2, had upper and lower GI multiple times…no dice, so I’ll just live with that.

The concern I have is for the joints and loss of sexual stamina.
I personally think I need to lower my Cyp to 150mg or 100mg E3.5D, and lower the Arimidex to .5 EOD (3 per week). Thyroid can likely stay the same since its pretty stabile…maybe add some high Vit D for a while

thoughts?


#3

Wow all your TRT numbers aside, personally I would be most concerned about the chronic diarrhea. Gut health is among the most important things to be concerned with and you have a serious problem. How have you attempted to address it so far, and what have your doctors had to say and tested about it?


#4

had upper and lower GI twice…doctor actually said I had the healthiest colon he has seen. Tested for Celiac, Chohn’s, Colitis, and IBS…all negative. Had allergy tests twice, nothing. Stayed off all supps, dairy, wheat just in case…no changes. I wake up in the middle of the night to go! I’d say on average, on the can 8 times a day.

No weight loss, just all diarrhea. Heck corn goes through me in less than 4 hours :slight_smile:

Wife and I have talked about going to a Mayo Clinic, or maybe Johns Hopkins Hospital


#5

BTW - probably should be aware that we eat 90 organic…really hard to go 100%, but everything is grass fed, non-gmo, organic. No Mon-satan at our house - Heck we even drink raw milk instead of the fake crap in the store…lol


#6

How is your fiber intake? I assume you’ve tried various probiotics? Have you ever tried something serious like VSL #3 (probiotic) and Saccharomyces Boulardii?

Ever try to avoid gluten for a month?


#7

Fiber intake is awesome…Plenty of oats in the morning, rough greens in the evening. Tried all types of probiotics, to include pharmaceutical. grade. Gluten has been eliminated as a cause as well.


#8

Wow that’s crazy. You might want to try one of those alternative gut specialists (functional medicine?) as opposed to to the Mayo clinic etc…have your poop analyzed and maybe even get a fecal transplant or something.


#9

Try Calcium for the IBS. I have the exact same issue, have had all my life. Never been tested for much, but same thing Dr said on last colonoscopy. I have recently been able to regulate my IBS with calcium. I take a 1200mg softgel in the morning, and occasionally one at night, but not every night. It has given me my life back.


#10

Interesting @Jdeck,

What form of calcium is that and what’s the explanation for its action/success?


#11

Has anyone ever done a comprehensive blood screening to see if you have a vitamin deficiency? Chronic diarrhea and IBS, could be caused by a lack of vitamin D, A, E, K, Zinc, Iron or calcium. At the very least, the frequent bowel movements would make you more likely to have some form of vitamin deficiency since your body may not be absorbing the nutrients.

Also, when you say you gave up all the supplements as a test – does that include energy drinks, and things like Vitamin Water? I had frequent diarrhea episodes for years – until I figured out it had something to do with a combination of caffeine, and citric and malic acid that was in many of the beverages I consumed.

Lastly, I assume you were taking a good probiotic? This will help alleviate some of the symptoms as well as anything that helps reduce information such as fish oil, COQ10, etc.


#12

I have had my stool sample analysis completed…No dice. And seriously… Not having anyone’s crap put inside me!


#13

Interesting Jdeck…I haven’t tried a calcium supplement specificly. I’ll give that a try


#14

Jim,
Yes when I stopped taking supplements for the test I stopped all caffeine. I only drink coffee and water, so no energy drinks anyway. Remember that this isn’t IBS, since it never goes away.


#15

All , l appreciate the interest in my odd bowel movements, but honestly I came to the board regarding TRT… Anyone have thoughts/opinions on my case?


#16

If I read it right, you are taking 400mg T-Cyp a week. That makes it very difficult for me or anyone here to comment on your TRT protocol. Most of us here take 100-200 wk. You are doubling that dose and way above the norm on your bloods. I would tend to think your E2 could be out of wack, either low or high. You don’t have lab for that. If it were me I would half your dose for T and AI, and see where you land. Get E2 checked in next lab. Achy joints is a sign of low E2.

You should also be giving blood regularly. I’m sure your blood is thick as tar.


#17

Its a liqui-gel I just get from walmart 1200mg capsules. I read some about the calcium online for IBS, seems to work really well.


#18

I understand what you are saying about my levels. Not sure how the MD got the dosage that was decided on, but I know that he took how I felt into consideration more than the range. As you can see from my before levels, I was producing the same levels as my wife…lol… Compared her blood test to mine. Been on 400 a week for a really long time. Probably somewhere close to 5 years. However, just like all of you, I started out at 100 per week. Took for ever for my levels to come up and stabilize. Went through 4 separate Endo’s. Had my organs tested to include a brain scan on my pituitary gland for tumors. All were clean, but they are thinking that exposure to radiation has left me without the ability to regulate hormones. Have felt pretty good since '09, but in the last 6 months my joints and stamina have taken a turn.

Cut my T and AI to half dosage last Sunday. Left armour alone. That will give me three weeks on a half dose prior to blood work. Honestly, I could care less what dose I’m on as long as I feel normal.
Less is better for me if I feel good.

Never wanna feel like the rug got pulled out from under me again…I’m sure you guys can empathize with me there.


#19

Oh, and forgot to mention…No can do on giving blood. I used to donate regularly, however lately, I have done some traveling around the world, and can’t give blood due to areas I visited. Currently I’m out from a SE Asia trip in June


#20

OK – I’ll chime in on a few observations from looking at your latest bloods:

  • your total testosterone is too high, as you pointed out – so this indicates you need to lower the dose
  • however, your free testosterone is very low, considering the dose you were taking – which leads me to believe that your SHBG is very high - didn’t see labs on this bit that would explain a lot. There are a lot of different factors which cause this – and two which may be relevant to your case is too much thyroid replacement, as well as elevated liver enzyme’s. Regarding the former, it’s probably worth a conversation with your Endo. Your TSH prior to getting on the thyroid armor was extremely high. You may need a different type of medication to control that. As for the elevated liver enzymes – well, this could be the result of just taking so many meds – but I can personally attest to using a product called Liv52 (also called LiverCare in the states.). It dropped my values from slightly elevated to mid normal in about a month.
  • lastly, you mentioned you were going to supplement with vitamin D – and this is a great idea. In fact, you should have it tested, as well as B 12. For those of us with low thyroid – the B 12 is extremely important ( as vitamin D for normal bodily functions) and a lack in either of these – can produce a whole host of side effects.
  • One last thing – are you running anything else – like Clomid, SARMs, anabolics, pain meds or meds for depression / anxiety? Just curious – and I am only asking because these have also shown to affect people’s values on TRT.