T Nation

Current TRT/Issues and Scalp & Thyroid?

Age: 32
Height: 5’8"
Weight: 175 (up to 182 since starting
Waste: 32-34
i workout 4 times a week with weights and cardio in the morning. not really for body building but for general health.
Body Hair: hardly any. only genitals and had full head of hair. leg hairs grow and fall off but still not too much

health conditions: current medications before trt

  1. low dose oxycodone 5mg 3x a day (started this as Ive had major pain issues especially in the morning which felt like the flu or being hungover yet don’t drink.

I take a D3 supplement at 50,000 once a week then reduced to 10,000 everyday and now otc 2000
due to low d levels

  1. had extremely high ferritin levels back in 2011 and was brought back down to normal levels after 4-5 phlebotomy

  2. libido was on and off but gradually was zero. tried every anti depressant and got sick of them as they were doing more harm then good.

4; have done proH back in 2010 but stopped immediately due to sides

5 Test levels have fluctuated from >50 to 500 tt 500 was the highest and usually ranged in 200’s and below. also past have had appendix removed, tonsils gone. Havent had a cold or flu for over 10 years eyt I get these odd things that happen.

6 hard to lose fat and tend to get cold easily at random points in the days

These are some of my labs before trt

TT: 165
free: 45.9
FSH:9.5
Lh: 2.7
e2: 15
SHBG:12.7
TSH: 2.60
Total T3 102
Free T3 3.3
t4 1.0
Free t4: 5.4
TBG: 11.6
Thyroxine-binding globulin 12.4
anti tpO >10
anti tbG >20

These are just the labs I got over the phone unitl I receive them in the mail

current dosage on TRT is 200mg split 2x weekly but reducing
arimedex: as needed.
HCG: none yet) would like to prevent atrophy and children in the future

Here are some issues I’m having currently

  1. scalp breakout and hair thinning since starting but have had these before any trt treatment and went away on its own. Could DHT or something else be the issue or is it something else as I’ve had this before trt. I want to avoid fin or dut as that would seem counter productive to what I’m trying to achieve aside from long term effects of those meds.

2 gained about 10lb which is water but in the belly its really showing. Bothersome as I’ve been actively working out and no change in diet. I tried .25 of arimdex e3d but makes me feel like shit. I’m considering aromasin in place as I’m also worried about lipids as Ive had high numbers before.

Dhickey, was DR… willing to offer hcg when you went in?

3 It isnt until about day 3 after shot that I start to feel better but I guessing I still need some more time for my body to stabilize the increase in test. Possibly thinking about lowering dosage to 150mg per week and see if that helps with bloat and uneasiness.

  1. The doctor mentioned that hashi is a possibility but wants to try this and see how I react. I think I remember him saying i was scraping the bottom of the barrel with my thyroid and other tests but didnt want to start any treatments just yet. ( I will ask them for my labs tomorrow)

  2. did not get prescribed hcG as I was kind of in a fog when talking to him and briefly mentioned it but as I’m 32 I really would want to include that as part of treatment as I want another child in the future and also i’m starting to get some aches. He might scrpt it on our next visit. Otherwise i will have to go underground but again that’s something i’m having a tough time finding. (not sure but if anybody has a verified source I’d appreciate it.)

  3. still waking up very cold and in physical pain. docs still haven’t had a finger on that but i honestly can’t live like this continually using pain meds my whole life. weird thing is the worst pain is in the morning right out of bed and i feel like i either have a hangover or flu every single morning.

I’m also going to start this iodine plan to see if does explain some issues I have and possibly might be a thyroid issue.

I guess my biggest issue right now is my hair, scalp and bloat that’s depressing but will cutting my dose help this? why is it that i start to feel better on the 3rd day and feel like crap day after injection?

Kind of worried to try iodine as it can be counter productive if hashi is the case.

Update: bloat slightly going down. hair still inflamed and white pimples and thinning. Stomach pain has reduced but body ache is still severe in the morning and not as bad through out the day.

anything you see with Thyroid that could be an issue KSman? I made a new thread as the old one was mixed in with looking for a trt doc but since Ive found one I felt this thread would serve a better foundation for questions and answers.

“thyroid basics” sticky

  • iodine intake
  • body temperature
  • hair, skin, scalp, nails

blood pressure
current hematocrit
current hemoglobin

Did you try the reduced anastrozole dose for over-responders?

Are you using a dandruff shampoo?

What supplements are you taking?

You still need oxycodone after phlebotomy?

[quote]KSman wrote:
“thyroid basics” sticky

  • iodine intake
  • body temperature
  • hair, skin, scalp, nails

blood pressure
current hematocrit
current hemoglobin

Did you try the reduced anastrozole dose for over-responders?

Are you using a dandruff shampoo?

What supplements are you taking?

You still need oxycodone after phlebotomy?

[/quote]

not much for iodine intake but i did read the sticky. Just afraid it might make acne worse and doc might suspect hashi.

Hair: when not going through this damn scalp issue my hair is usually thick but kind of dry
skin: can get oily and mild breakours but had a lot when I was younger
nails: My lady thinks I have better looking nails then her except my toenails look like old potatoe chips, I have a unexplained split on my thumb nail but it just continues to grow that way
Scalp: right now feels like its pulsating and red spots with white pimples. Thinning as well. this has happened periodically through my life but after it cures it self then My hair grows back think and normal.

BP: was slightly elevated last check but otherwise normal at most doc visits
hemocrit 46.6
hemoglobin- 15.9
RBC 5.2
WBC 5.8

glucose always stayed in range but had some high numbers twice but those were done after eating.

I tried head/shoulders, Selsun , chacoal and none of those really helped. Only thing that helped before was Nizo 2% but now isnt working

Oxy is being tapered and this will actually be my last fill at 3x 5mg a day. Again these issues begun before low test and health issues. when every single nsaid that the doc scripted they finally put me on oxy… No Tylenol included so liver wasnt effected. The blood draws were done during the time I was on oxys. Still need them for pain but am actually going off of them myself as to see if it helps or caused any long term damage.

Not sure if I’m a over responder to arimedex but I try not to use them unless I feel I’m getting overly bloated or nipples start to itch. maybe .25 e4d or e3d.

I drink green or black tea occasionally and usually a P/W on days I lift but nothing to the point where it would cause adrenal fatigue.

I had hpylori and was cleared up with the usual meds. since being on TRT my stomach pains have decreased greatly but my body feels like its absolutely dead in the mornings. i guess the only thing I could think of comparing would be a hangover + rigamortis.

Will try taking temps tomorrow. I’m seriously at a loss as i’ve had a buttload of tests and mris but nothing adds up and keep getting pushed back and forth to different speacialists. been in therapy for about a year but do due to depression from being sick.(no hypochondriac lol) perfectly sound mind but my body doesnt work right. Only thing that hasn’t been done would be a pituitary mri so I’ll ask the endo monday on what she thinks.

Feel like crap in the AM? Do AM cortisol as early as you can manage on a bad day.

What is going on with supplements and diet?

If doctors have been failing, be open minded to other stuff.

Edit some lab ranges into your post above.

This makes sense? "
not much for iodine intake but i did read the sticky. Just afraid it might make acne worse and doc might suspect hashi.
"

[quote]KSman wrote:
Feel like crap in the AM? Do AM cortisol as early as you can manage on a bad day.

What is going on with supplements and diet?

If doctors have been failing, be open minded to other stuff.

Edit some lab ranges into your post above.

This makes sense? "
not much for iodine intake but i did read the sticky. Just afraid it might make acne worse and doc might suspect hashi.
"

[/quote]

I did an AM cortisal saliva test and it came back normal range.

diet is pretty good. Hardly any processed foods, protein healthy carbs usually and no multi as it seems not needed with my age and labs.

I’m trying to be open minded but doctors arent so once they get confused they push me off onto another doctor.

what i meant about the iodine test was that if i do have hashi (iodine) will possibly make things worse from what I read. If its hypothyroidism then I could try it. I guess i could try to test the waters out. It is known that excess iodine in the diet can trigger acne which at 32 i still get.

So from my blood work you don;t see anything abnormal?

This, “and it came back normal range” is bogus, post your labs with ranges. You do not know that normal only means that 95% of the population is in that range. There are big differences in QOL in that range. “normal” does not imply a good or optimal result, or indicate ‘healthy’.

Where are your body temperatures?

You come hear seeking help and are very dismissive of things that I want you to explore and consider. You go from doc to doc, how is that working for you? Try going with the flow here.

We do not work with saliva testing very often here, so we are not able to deal well with that.

You need to look for everything that I am asking. “Feel like crap in the AM? Do AM cortisol as early as you can manage on a bad day.” You should be looking for data that aligns with time of day symptoms.

I am concerned that you may be iodine deficient. You start talking about having too much iodine. You shut that down.

[quote]KSman wrote:
This, “and it came back normal range” is bogus, post your labs with ranges. You do not know that normal only means that 95% of the population is in that range. There are big differences in QOL in that range. “normal” does not imply a good or optimal result, or indicate ‘healthy’.

Where are your body temperatures?

You come hear seeking help and are very dismissive of things that I want you to explore and consider. You go from doc to doc, how is that working for you? Try going with the flow here.

We do not work with saliva testing very often here, so we are not able to deal well with that.

You need to look for everything that I am asking. “Feel like crap in the AM? Do AM cortisol as early as you can manage on a bad day.” You should be looking for data that aligns with time of day symptoms.

I am concerned that you may be iodine deficient. You start talking about having too much iodine. You shut that down.
[/quote]

ok first of all I’m not being dismissive and simply don’t have all the results as stated. the doctor only gave me an am cortisol test and would not give any other. dont have the means to spend money left and right as the bills are stacking up.

Salivary Cortisol 0800 Reference Range 0.09 - 1.55 ug/dL my results were 1.14 done first thing in the morning. I am will to explore and consider but again as stated if i have hashi then iodine would be counter productive. I dont have another meeting with him until mid april so this is all I have for now until I get the labs in the mail. also when you say do the tests on bad days, every morning is a bad day for me in regards to pain. Thanks!

The most issue as I stated is in the mornings and fatigue though out the day which is slighty getting better since on TRT but I simply ask from you what you thought from the labs I already posted. If that’s not satisfactory to you and I’m sorry but I guess I’ll have to wait until I get more labs. I didn’t say I wasn’t going to try the iodine method but was simply hesitant.

Ill get the body temps as soon as possible but I lose track of things as I have 2 very young children that I have to prioritize first. i respect your knowledge but please don’t jump to conclusions and assume I’m being dismissive as thats exactly what doctors do.

Opioids like oxycodone will cause low libido and sexual problems even when you are on TRT.

The reason you feel like crap in the morning is because overnight your levels of oxycodone fall and you start feeling the misery of opioid withdrawal.

Also, oxycodone, like all opioids, suppresses the body’s own testosterone production. Were you diagnosed with low T before or after starting to use oxy? If you were diagnosed after starting oxycodone, it is even possible that you don’t really have low T naturally.

[quote]seekonk wrote:
Also, oxycodone, like all opioids, suppresses the body’s own testosterone production. Were you diagnosed with low T before or after starting to use oxy? If you were diagnosed after starting oxycodone, it is even possible that you don’t really have low T naturally. [/quote]

I had low levels of T before opiads. the pain and issues began prior to the pain meds but I have thought of this as well so I tried not taking them when I woke up and the pain slowly started creeping up and leaving as the day went on. when I took them it just alleviated the joint issues faster. I talked to several doctors and at my dosage it shouldn’t cause more issues other then slight constipation which is helped with daily fiber.

I do think they suck to be honest as they have had some psychological effect but i will be off of them this month as I don’t want to be dependent on them as they were a temp fix.

Today i woke up and both my knees were in so much pain that i couldn’t walk up or down the stairs unless i kept my legs straight and now its not as bad. So far with TRT I noticed that i do have more energy and stomach issues have subsided to almost nothing but body aches are still there. I’m going to an endo on Monday to see if she will run a pit MRI and ferretin level check.

Do yourself a favor and go to a rheumatologist also. Pain and stiffness and malaise upon waking is a classic symptom of various inflammatory conditions such as rheumatoid arthritis or spondylitic disease. Counter to the common assumption, these conditions strike many young people, and they can be very well controlled nowadays.

I went down the blind alley of hormonal doctors for years before I was finally went to a rheumatologist and was diagnosed with ankylosing spondylitis.

[quote]seekonk wrote:
Do yourself a favor and go to a rheumatologist also. Pain and stiffness and malaise upon waking is a classic symptom of various inflammatory conditions such as rheumatoid arthritis or spondylitic disease. Counter to the common assumption, these conditions strike many young people, and they can be very well controlled nowadays.

I went down the blind alley of hormonal doctors for years before I was finally went to a rheumatologist and was diagnosed with ankylosing spondylitis. [/quote]

I tried that option and went through the tests and prednisone which basically caused anxiety and blood pressure issues with no change. They ruled it out due to the labs and referred me to see a endo again for low test.

hopefully the endo can give me some more insight and thyroid and adrenal tomorrow as I’m really frustrated given the circumstances of being on trt which was my last option

[quote]tc80 wrote:

[quote]seekonk wrote:
Do yourself a favor and go to a rheumatologist also. Pain and stiffness and malaise upon waking is a classic symptom of various inflammatory conditions such as rheumatoid arthritis or spondylitic disease. Counter to the common assumption, these conditions strike many young people, and they can be very well controlled nowadays.

I went down the blind alley of hormonal doctors for years before I was finally went to a rheumatologist and was diagnosed with ankylosing spondylitis. [/quote]

I tried that option and went through the tests and prednisone which basically caused anxiety and blood pressure issues with no change. They ruled it out due to the labs and referred me to see a endo again for low test. [/quote]

Okay, but…

Just so you know, while there are labs that can give circumstantial support for a diagnosis of, say, spondyloarthritis, reactive arthrits, etc., there are no labs that can rule these out. In fact, this category of diseases is sometimes also called seronegative arthritides precisely because the blood tests come up negative, so the diagnosis has to be made by a good clinician. In my case, my labs were all normal, yet I was eventually diagnosed with this based on other clinical evidence.

Did you see an actual rheumy or was it a regular doctor who did the workup and ran the labs?

OTOH, prednisone at the right dose would probably have made a difference after a few days if you did have one of these inflammatory conditions, so the fact that you didn’t would indeed be evidence against your having one, unless maybe the side effects caused you not to notice an improvement that was perhaps there. (By the way, prednisone is not used to treat these conditions long-term, precisely because of the side effects, some of which you experienced. There are other meds.)

Good luck. Hope you get to the bottom of this.

[quote]seekonk wrote:

[quote]tc80 wrote:

[quote]seekonk wrote:
Do yourself a favor and go to a rheumatologist also. Pain and stiffness and malaise upon waking is a classic symptom of various inflammatory conditions such as rheumatoid arthritis or spondylitic disease. Counter to the common assumption, these conditions strike many young people, and they can be very well controlled nowadays.

I went down the blind alley of hormonal doctors for years before I was finally went to a rheumatologist and was diagnosed with ankylosing spondylitis. [/quote]

I tried that option and went through the tests and prednisone which basically caused anxiety and blood pressure issues with no change. They ruled it out due to the labs and referred me to see a endo again for low test. [/quote]

Okay, but…

Just so you know, while there are labs that can give circumstantial support for a diagnosis of, say, spondyloarthritis, reactive arthrits, etc., there are no labs that can rule these out. In fact, this category of diseases is sometimes also called seronegative arthritides precisely because the blood tests come up negative, so the diagnosis has to be made by a good clinician. In my case, my labs were all normal, yet I was eventually diagnosed with this based on other clinical evidence.

Did you see an actual rheumy or was it a regular doctor who did the workup and ran the labs?

OTOH, prednisone at the right dose would probably have made a difference after a few days if you did have one of these inflammatory conditions, so the fact that you didn’t would indeed be evidence against your having one, unless maybe the side effects caused you not to notice an improvement that was perhaps there. (By the way, prednisone is not used to treat these conditions long-term, precisely because of the side effects, some of which you experienced. There are other meds.)

Good luck. Hope you get to the bottom of this.
[/quote]

It was an actual rheumatologist. 2 to be exact as one wanted a second opinion. They knew something was wrong as they seen it in my face and eyes. Those other conditions you stated could well be a possibility but it’s real hard finding a doctor that will think outside the box as most I’ve seen are either too busy and rush or rather not look at other alternatives because its either that or you are ok in there books.

I also had hpylori that wasnt treated until i wanted them to check it out and low and behold I had for god knows how long which in turn my GI thinks that is the cause for my current ulcers. go figure huh.

looking forward to seeing this endo tomorrow regarding my thyroid and other issues but also dreading what her response will be for my trt since the doctor I currently have understands my condition and low test levels and also doesnt go by text book protocols. she might be the type that sticks me on the gel or does shots every 2 weeks or 3 weeks and screw me up royally. i always wondered if 1 doctor can over rule another in terms of treatment.

another think i forgot to mention is i get these brown itchy patches on my legs that appear. cant really explain that but back to the derm for that issue… i wish i could just live a pain free life but i wont give up. final option will be going to the mayo clinic for a week and let them run the whole book on me.

temps i took today as well

8am 97.1

12pm 97.2

4pm 97.6

8pm 99.0 this was about 1 1/2 after working out.

Well came back from the endo and she was some 34 year old that honestly didnt seemed like she gave a shit. Told her I was on trt and the main reason I was there to see her was thyroid. Didnt do any type of physical check and wanted me to stop trt and wait another 2 months for labs. I told her I have labs from the trt doc faxed prior to starting trt and she reluctantly accepted. Its only been 3-4 week on trt. She took some labs today which consisted of TSH, T4 free, ferritin, anti thyroglobulin antibody and thyroid peroxidase antibody. not sure what the last 2 are as I don’t remember having those.

Then she asked if both my children were biological not once but 4 times. asked if I was sure. I was like wtf is going on. i’m listed as secondary not primary but low and behold I looked at my sheet and the other endo said I was primary but with no reason behind it. My TRT doc is in a different network and put me at secondary.

I’m really starting to hate these doctors!