T Nation

Chronic Fatigue Syndrome, So Doc Says

Hi all, new here. 34yo male. For over a year now my weight has been stuck at 200+ despite diet and exercise. Prior to to 2018 I was able to maintain a normal weight of 175-190, even getting down to a lean/ripped 168. I had no problem gaining and losing. However, for the past year or so I’ve been struggling to get the weight down and its not happening. I’ve also noted symptoms which include lack of concentration, decreased motivation, decreased libido, and I often feel sleepy and moody in the early evenings. My wife has commented that I hardly touch her anymore, and she has also noticed that my weight seems static despit diet and exercise.

I went to the Dr and explained this to him. He ordered a blood test and everything came back normal including thyroid function and B12. My T level came in at 374 ng/dl. After he reviewed my results he diagnosed me with Chronic Fatigue Syndrome and advised me to exercise, limit caffeine and seek counseling if needed.

I researched the symptoms of Chronic Fatigue Syndrome and they seem to include pretty sever e physical symptoms such as exhaustion and intolerance for exercise etc… none of which I am experiencing. Nonetheless, I took heed of his advice and cut back on caffeine and began to hit the gym harder. The sleepiness and lack of motivation have diminished a bit and I believe the caffeine reduction helped accomplish that. However, the other symptoms remain.

My question is, with a largely normal blood panel and a T level of 374 at 8am, couldn’t that explain why my mood and energy levels dip in the early evening? Since supposedly T levels are highest in the AM and decline as the day goes on, could my levels be falling below the normal range late in the day?

I would appreciate your input. Thanks.

That is not good, especially for a 34 y/o. Is it possible for you to post all of your lab results?

This is when you know there is a problem.

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The average 34 year old man scores in the 650-800 ranges, it’s time you locate someone who specializes in sex hormones ~ TRT otherwise you will continue to run into pretenders of medical skills which is what we have in your case.

Most doctors once graduate medical school opt out of optional education in sex hormones and is why you more than likely will NOT find a doctor that can hostently say he/she specializes in TRT under your insurance.

Free T is the free hormone circulating in the bloodstream and is where the rubber meets the road, Total T is bound to SHBG and not bioavailable. So if these tests were not done it would indicate your doctor does not specialize in this area of medicine.

Your body requires adequate levels of hematocrit, hemoglobin and red blood cells for your body to function, these tests should have been ordered. The truth is everyone will experience low testosterone at different ranges do everyone being biochemically unique, we all have different cut off points where we will experience low testosterone.

The problem is your insurance company will not approve you for TRT until you drop below 300 ng/dL, it doesn’t mean you’re not experiencing low testosterone, it means your insurance doesn’t want to pay for treatment in order to keep healthcare costs down.

Most members here either with the blessing of their GP or endocrinologist figured out their own TRT protocol while monitoring closely or have found someone that specilaizes in TRT in anti-aging or sports medicine which is what I did.

Men with low testosterone are at a disadvantage when it comes to losing weight. I can tell you I felt like I had metabolic syndrome when testosterone was in the 406 range or lower, I became fatigued very easily and losing weight was difficult if not impossible.

TRT can prevent and treat metabolic syndrome/obesity, diabetes, cardiovascular disease, heart disease, erectile dysfunction.

@ryanboz46,

Having trouble losing weight was something that led me to try TRT as well. Especially if it was never an issue before.

I would get retested. I have a friend that tested at 90 and then retested to 250 without changing anything.

Do you have any other medical conditions? Do you take medication of any kind? Have you had a vasectomy? I’m asking that last one because I have had one and a reversal and my friend above was another guy that had a vasectomy and a reversal for pain as well. Just curious.

Thanks for the responses. I will post my labs later today. No medical conditions, no medication, no vasectomy. Normal alcohol use, no smoking. I am an automotive technician and I’ve heard that T levels can be adversely affected by exposure to certain chemicals in my workplace.

Good point, testosterone levels are reportedly down as much as 25% in US males over the past three decades. Sperm counts too. Undoubtedly a lot of factors going on, but exposure to environmental toxins is likely one of them.

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Labs shown

Those tests are common of HMO’s, minimal of what you actually need for a proper diagnosis. You can’t diagnose of testosterone deficiency without SHBG and Free T, if your SHBG levels were high, that Total T value would see Free T below range.

TSH is ok, but no thyroid hormones were ever tested, very common of doctors who are operating in the dark. Let’s say you were diagnosed with low T, these doctors would have made you situation worse since the standard protocols are outdated and no good.

If 374 ng/dL is normal, then I’m mickey mouse because the studies show cardiovascular disease is associated with levels below 440 ng/dL. Do not play these sick care normal shell games, it’s just the insurance companies lowering the standards to 300 ng/dL to save on healthcare, this cutoff point wasn’t based off any studies, only cost saving measures, seek private care for your TRT immediately.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:

These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction.

“normal” doesn’t indicate optimal though, my height is considered “normal” despite it being on (barely) the 5th percentile for grown men, thus I was inelligable for treatment with growth hormone as a child (that and I was on the 25th percentile due to early puberty, I explained my concerns that precocious puberty would cause my ephysial plates to fuse sooner, however I wasn’t taken seriously until it was too late… At which point I was given anastrazole at 7mg/wk instead of GH… And it caused a lot of harm).

So a TT of 374 might be “normal” in the standard that it’s within the testosterone concentrations measured within 97.5 percent of the general populace, however normal doesn’t nessecarrily equate to optimal or healthy.

Insurance companies won’t treat T deficiency because insurance is a business in itself, as shady and fucked up as it is, if insurance companies treated all diseases its customers had they’d go bankrupt, thus systemlord is right in that it is probably better given you’re situation to go private, but it isn’t the fault of the doctors or insurance companies… Its business, and thats just how business works.

However I’d supplement with some vit D, boron, magnesium and zinc, potentially clean up diet and lifestyle and retest from there, as TRT may be avoidable.

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Yes, that is the way it is. Interestingly, the CEO of United Health Care made $35 million a few years ago, so it was good business for him.

Like not hitting your deductible for colonoscopies and mammograms, if insurance companies ever determine they will save money covering TRT, they will.

your Vitamin D lvls are VERY low. if i was you, would take 10k UI / day. for next 3 months. and try maintain above 70.
Your work environment could be a problem, you should test for heavy metal poisoning.
Also, increase good fats in your diet. like: extra virgin coconut oil, grass fed beef fat cuts. Oily fish and fish oil.

Great suggestion.

In the long run insurance companies will save money on healthcare approving TRT because we will need less services, we will be healthier versions of ourselves.

Other than broken bones or fevers, I rarely used my healthcare services in my 20’s when testosterone was optimal.

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He’s on the money and so is the next guy. Get help stop bothering with these dip stick of a doctor who see deathly low T and give you a diagnosis that makes no sense. .

Yah but that’s the deal…’pharma is more of a culprit then.

Sure because if insurance companies are saving money, big pharma is losing money and we know who doctors answer to, big pharma.

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Ok so insurance won’t pay unless they follow their rules and big pharma doesn’t want insurance making the patient population smaller…

How does big pharma get their claws into docs? I though it was illegal for them to give docs bonusss… at least in Texas I read about it being illegal.

Big pharma controls everything, big pharma dictates how doctors prescribe medicine and sets the standards and spends millions lobbying in Washington. Big pharma has lawyers waiting to attack private doctors who risk losing their license to practice medicine if they don’t comply.

There is a lot to lose if we start making everyone healthy, big pharma loses billions. No need for cardiovascular or heart disease medicine, TRT treats so many diseases it basically makes all these prescription drugs useless.

It’s already going to happen, after enough studies come to light, there’s no stopping it. All it takes is a couple of politicians with a family members who has become a victim of western medicine to force changes.

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My favorite big pharma story was when Joe Manchins daughter raised the price of her epi-pens 500% along with lobbying congress to successfully pass legislation to make them available in public places like schools subways etc…

I think they execute people in China when they do stuff like that.
That sort of grotesque profiteering is how our government works.

Manchin’s daughter, Heather Bresch makes 12 million a year for the company that has like 80% of the epi-pen market.

Disgusting.

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Thanks @systemlord system that makes sense. I knew they had their fingers in the pot but forgot about how with the lobbying and all.

I do not think a politician is powerful enough to make the change. It will take allot of congress senate and our reps to come together and change how they operate. Until then 2 politicians will fight against a 100 politicians who are in the pockets of big pharma. They have the power and financial means to keep their agenda ticking.

@bustofpallas I can understand turning a profit but ffs this was gouging and totally heartless and without character.

The guy could of kept the price low and simply allowed more folks access like you said and made more money. When the price drops you’ll see folks buying 3 or 4 instead of 1 or 2.

I spoke to a friend an hour ago who had to buy two epi pens and he spent 1200$. If they were 200$ a pop he could of bought 4. One for each car, moms purse, one at home. He would of still made a good amount of $$$$…

Bad business logic and outright greed is so prevelant in our country it’s truly sad.

My doc is giving me some cialis that runs a buck a pop in other countries. But for me it’s 1000% more.

Rant over.