body: fairly muscular but no beard(LIGHT mustache/chin hair), not much hair on arms/legs.
lifestyle: very active, sometimes train twice a day(not weights) but strenuous cardio
diet: lots of fresh vegetables / meats / pastas / fruits, no refined sugar/sea food
symptoms: fatigue, stress, low patience, low libido(no problems with ED), mood swings, irritable, lack of focus(fog), slow recovery(soreness). Keep in mind I have had these symptoms for quite a while, just never really thought they were symptoms(silly, but true).
Given the volume of physical activity and level of attention I have for my diet, I should look pretty lean and feel great, yet I am not. Thus the following:
1/6/16 - appt with my PCP regarding symptoms above, had no idea it was related to low T. He mentions potential thyroid issue along with pituitary/hypothalamus etc etc and gives me some paperwork to take to the blood lab(posted below). I go to the lab, get the bloodwork done head home to research this compulsively. Not happy, this seems like a very deep and dark rabbit hole.
Bloodwork comes back:
Sodium Level 141
Potassium Level 4.1
Chloride Level 106
Glucose Level 93
Creatine Level 1.610
eGFR African American 64
eGFR NON-African American 55
Calcium Level 8.8
Bilirubin total 2.7
Alkaline Phosphate 90
Protein total 7.2
Albumin Level 4.3
TSH 3rd generation 0.506
Sex Hormone binding globulin (SHBG) 30
Testosterone Total 230
Testosterone Free 43
Testosterone % Free 1.9
Lymphocytes Auto 25
Monocytes Auto 9
Eosinophils Auto 1
Basophils Auto 0
Abs Neutrophils 4,690
Immature Granulocytes 0
doc tells me I am secondary hypo and gives me a few treatment options. He reccomends the gel but my research showed the injections to the preferred treatment(that and I really didn't want to rub that crap on my body every day). I insist on home injections and he approves. Writes and rx for 1 x 1ml/200mg shot every 4 weeks.
My research at this point turns up quite a bit of conflicting information. I decide to go with my gut and inject .5ml IM instead of the prescribed 1ml/200mg(this was last monday). Tue-Thurs I felt great, or I should say normal. Almost all of the irritability went away, I felt an increase in patience, mood and energy. Also felt great cardiovascular performance(no increase in libido at this point). By thursday night I started to feel the effect wearing off, and by friday I was fully crashed(or at least my mind was). Monitoring my body temp the entire week(both oral/armpit) I noticed on average I am between 95.1-97.0, never really reaching 98 degrees. This along with the crash feelings(depression, irritibility, patience decrease and energy) and some other questions about dosage frequency, injection types I decide to make another appointment to see doc.
Trying my best to not come off as the know it all patient with a degree from google, I let doc know how I'm feeling and about the body temps, mood swings etc. Says its all normal but to contact him if I feel it gets out of hand. Asked about breaking up dosage(1ml/200mg/month) to .25ml per week instead. He didn't seem against the idea but also wasn't jumping on the bandwagon. The same for subq injections vs IM. He strikes me as a fairly open minded guy, just maybe not up to date on HRT. When I asked him about potential issues with estrogen and fertility he seemed confident in saying they would not be an issue(again, not out of arrogance but maybe ignorance?). By the end of the appointment he says he wants to increase my dosage from 1ml/200mg/monthly to 1ml/200mg bi-weekly(14 days). He tells me this is the maximum allowed dose and that we will be able to make any adjustments we need when we get the next blood work back in 6 weeks.
So here I am, still feeling like crap trying my best to monitor the situation and stay positive. I have a spreadsheet that I am updating hourly with everything from what I'm eating, to daily mood, sleep and energy feelings. Also keeping track of my weight(both morning and night), body temp and water intake.
Is this my body adapting to the recent influx of T? I mean as I sit and type this, I literally feel like sh!t, perhaps the only thing that lifts my mood is training. What gives?