T Nation

Extreme Fatigue

Thanks in advance for reading and hopefully shedding some light. Though I have suffered more than my share of health issues with regard to AAS, after a lengthy “lay-off” (except for GH), I started a pretty aggressive cycle 6 weeks ago. The length of the cycle at this point is immaterial, the sides (perhaps) are really horrid this go at it. I am fatigued beyond belief and frankly, scared. The fatigue is so bad that I cannot function, let alone continue to lift.

I should mention that I suffer with Polycythemia Vera… congenital, not secondary. I also have the Factor V Leiden deficiency (mutation). My JAK2 is negative… but otherwise diagnosed with Primary PV. Until now, my Hemocrit and Hemoglobin levels have been relatively normal for PV… just outside the higher end of the labs range.

My current symptoms include debilitating fatigue with shortness of breath (gasping at times) especially in the mornings. I do not have Sleep Apnea. I assume these symptoms are a result of the PV… and the aggravation by my AAS use. Oh, and btw… I was working out like a mad man, eating lots… yet very clean. 3500 calories low fat, high protein, lower carbs… all good carbs.

Cycle Components

500mg Test. Cyp. E3D
400mg Deca. E6D
200mg Mast. E3D

4iu HGH ED

2.5iu HCG E3D

Arimidex .25 ED

Here are my labs today:

Hemoglobin 22.8H (13.2-17.1 G/DL)
Hemocrit 60.1H (38.5-50%)
RDW 20.3H (11.0-15%)
Neutrophils, Absolute 10,800H (1500-7800 Cells/MCL)
WBC 11.3H (3.8- 10.8 Thous/MCL)

D-Dimer 1.1H (<1.0 MG/L)

All other bloods in range.

Hormones

IGF-1 372H (86-220 ng/ml)
FSH <0.7L (1.6 - 8.0) Male
LH <0.2L (1.5 -9.3)
Test. Total 2459H (241-827 NG/DL)
Estradiol* 50* (13-54)
B12 329 (200-1100)

Clearly I am Polycythemic now. The D-Dimer may be indicating a Clot somewhere… but my MD says not to be so concerned. I do take Lovenox to thin 2x day SC inj.

My estrogen is really high considering that I am taking Arimidex .25 ED.

In any event… I do need to bleed off some. But the fatigue is unbearable. Everything is exponentially difficult for me right now. I am getting gyno and lots of belly fat. With a totally clean diet and tons of lifting (until 10 days ago when I had to choose between lifting and work… energywise).

My prostate believe it or not is okay!!! No issues at this time!

Also, Liver funtion tests are all in range other than Bilirubin Direct is slightly elevated.

Thanks guys… any thougtful information is as always, greatly appreciated.

Regards,

Jet

You really need to avoid dehydration. Take some aspirin. You cannot work off calories now, so you need to reduce your calories. If some people are at risk for a heart attack or stroke on cycle, you are probably in the high risk group. Fish oil is also a blood thinner [never take before surgery]. Do you live alone? Will someone notice if you are struggling physically or acting strange?

What is your BP? Do not use stimulants.

That dose of adex is useless. It is a competitive drug that must be increased in proportion to your serum T levels. You need to take .6 - .75mg EOD.

Testing LH/FSH when on is really dumb.

You do not think that 4iu GH can increase blood cells?

How will you loose a pint of blood [per week]?

Nandrolone and testosterone increase hematocrit. Masteron does not seem to have a reputation for this in isolation, but its ability to increase FT may allow it to be an agent that increases hematocrit in a stack.

[quote]KSman wrote:
You really need to avoid dehydration. Take some aspirin. You cannot work off calories now, so you need to reduce your calories. If some people are at risk for a heart attack or stroke on cycle, you are probably in the high risk group. Fish oil is also a blood thinner [never take before surgery]. Do you live alone? Will someone notice if you are struggling physically or acting strange?

I am hydrating. I will start a low dose aspirin today. I use 12g of good Fish Oil, lots of Co-Q10 and R-ALA each day. I live alone.

What is your BP? Do not use stimulants.

BP was high. Started 40mg of Benicar a week ago. I drink coffee (a lot). No other stims.

That dose of adex is useless. It is a competitive drug that must be increased in proportion to your serum T levels. You need to take .6 - .75mg EOD.

I was thinking you would advize such, will start today.

Testing LH/FSH when on is really dumb.

I agree. Doc just wanted to prove to me I was “shut down”… well, of course I am.

You do not think that 4iu GH can increase blood cells?

Science says… yes.

How will you loose a pint of blood [per week]?

Was thinking a pint/week. I won’t do that myself. Need to find someone to bleed me.

Nandrolone and testosterone increase hematocrit. Masteron does not seem to have a reputation for this in isolation, but its ability to increase FT may allow it to be an agent that increases hematocrit in a stack.[/quote]

Thank you KS for taking the time. As always.

Jet

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Did the blood test check your phosphorus? Androgen therapy (which is usually , what… 100 mg a week? haha) can lower phosphorus, and one symptom of hypophosphatemia is lassitude and fatigue. Certainly 1600 mg of androgens a week could do some funny things to someones phosphorus.

[quote]bushidobadboy wrote:
OK I can relate to this. I call it ‘androgen poisoning’ though of course it isn’t that really, more a combo of too many AAS (I don’t know specifically why/how too many AAS cause fatigue, but partly due to excessive suppression of cortisol, adrenaline and DHEA/neuro-steroids I suspcet) and the sides they induce - insulin resistance in your case.

So, combined with excessive RBCs, leading to the breathing issues (don’t forget too, that adrenaline is a bronchiodilator and if you lack it then you may struggle to breathe).

I get this fatigue too, every time I fall into the trap of ‘more is better’ (and yes, I do repeat my mistakes, expecting theings to be different this time - the very definitiaon of stupidity). As I said to someone a few days ago: “steroids tend to put a spring in your step, but too many of them and you lose that spring and more”.

I suggest you drop the dose of the test (500mg/wk is fine), eliminate the deca - it will aggravate your PV more than the other things - and reduce the mast to 200mg/wk not 400.

The GH should be EOD to maintian natural secretion and minimise any possible exacerbation of your PV.

Yes, you need to remove some blood. I’ll leave it up to you to figure out how/who.

You should also reduce/eliminate coffee. It won’t provide you with much extra lift and for me is makes the breathlessness worse. It may dehydrate you, increasing your risk of clot/ischemic stroke. Coffe will also contribute to your insulin resistance - something that is already quite high I suspect, due to the elevated E.

BBB

EDIT: my own opinion on the breathlessness is this: Primarily that excess RBCs require more force/effort to be pushed through narrow lung capilleries. This may enlarge the right ventricle a bit, which may impinge upon the lungs. Add in the engorged liver (due to increased blood volume and increased glycogen uptake from the AAS and then whatever effect the GH has which may be quite significant IME) which further encroaches on lung space, and you have breathlessness issues.[/quote]

Thanks Bushy. It makes sense, the whole of it. I am going to knock back to basics immediately. I already upped the Arimidex to 1mg/day for a total of 5 days then to .5mg ed for 5 days then probably .25ed. Then BW to check the estrogen. I am wondering if the Lovenox (Brand Name) will help any. I am prescribed it because I am Factor V Leiden (deficient, mutated… ) but I am thinking it will thin the blood. I realize this won’t help to remove any RBC or volume, but thin until I can get bled off. Thoughts?

Time2jet,
My suggestion for you is to wait a full month after changing your arimidex dosage before getting b/w done. Anything less than that and you may get a false sense of security regarding your estrogen levels.
Longer is better, really.

[quote]KNB wrote:
Time2jet,
My suggestion for you is to wait a full month after changing your arimidex dosage before getting b/w done. Anything less than that and you may get a false sense of security regarding your estrogen levels.
Longer is better, really. [/quote]

Thanks KNB.

Mornings are brutal… with trying to get my breath. I skipped my last E3d injections of AAS Friday. Today, the next E3d is due, I am going to shoot just 300mg of test and stay on the 1xW schedule until ??? I cut the HGH back to eod at 5iu. Worked out some yesterday as I had a moment during the day when I had my breath and wasn’t terribly fatigued.

My doc is overwhelmed in his practice and maybe I didn’t impress upon him that this is closing in on a medical emergency. I can’t live like this. Brutal.

Call the office and ask that they schedule a series of phlebotomies ASAP.

http://www.healthscout.com/ency/1/000589trt.html

maybe i am just retarded…but wouldn’t ceasing ALL anabolics be the prudent thing to do RIGHT NOW

[quote]morepain wrote:
maybe i am just retarded…but wouldn’t ceasing ALL anabolics be the prudent thing to do RIGHT NOW [/quote]

I was thinking the same thing and/or go to the emergency of the closest hospital?

Follow-up.

On Monday evening I did end up presenting at emergency. Short of breath and with a maddening headache. I took my bw with me. Not once was I treated with anything but dignity. I was forethcoming about my AAS use and all supps./peps etc.

They treated the headache with 4mg of Dialudid IV every 2 hours. (Which, I gotta say… effs you up… but def. no headache left.

I was seen by the ER doc who persuaded me to be admitted (he understood my condition to be PV), my family doc (also a poker buddy… so no judging and great care) a cardiologist (found an earlier blockage from 3 years ago in a coronary artery (but not at the “widow-maker”) and an oncologist (he by far was the best). (Understood AAS and hormones as well as traditional medicine can). And finally a gastro… pancreatic enzymes were on the rise.

Treatment was phlebotomy. Four units out… "washed of RBC’s and 3 units back. I will continute once per week.

Spleen was enlarged moderatley, liver slightly… live enzymes were good, funtion test good.

Blood pressure was totally under control with Benecar and a diuretic. Actually, in a very healthy range.

I got home Friday afternood (yesterday) and still have shortness of breath… probably not something that subsides overnight as it’s root cause is hemoglobin, hemocrit.

As for the AAS… I was put on Armimidex 1mg ed. And told that we will start once/wk injections of test and eod of growth once the PV is under control and monitor.

Just and update.

Thanks guys for pointing me in the right direction… Bushy and KS… the docs agreed 100% with your assessment as to what was happening… bloods again confirmed.

Let you know how I am doing.

Regards,

Jet

Follow-up.

On Monday evening I did end up presenting at emergency. Short of breath and with a maddening headache. I took my bw with me. Not once was I treated with anything but dignity. I was forethcoming about my AAS use and all supps./peps etc.

They treated the headache with 4mg of Dialudid IV every 2 hours. (Which, I gotta say… effs you up… but def. no headache left.

I was seen by the ER doc who persuaded me to be admitted (he understood my condition to be PV), my family doc (also a poker buddy… so no judging and great care) a cardiologist (found an earlier blockage from 3 years ago in a coronary artery (but not at the “widow-maker”) and an oncologist (he by far was the best). (Understood AAS and hormones as well as traditional medicine can). And finally a gastro… pancreatic enzymes were on the rise.

Treatment was phlebotomy. Four units out… "washed of RBC’s and 3 units back. I will continute once per week.

Spleen was enlarged moderatley, liver slightly… live enzymes were good, funtion test good.

Blood pressure was totally under control with Benecar and a diuretic. Actually, in a very healthy range.

I got home Friday afternood (yesterday) and still have shortness of breath… probably not something that subsides overnight as it’s root cause is hemoglobin, hemocrit.

As for the AAS… I was put on Armimidex 1mg ed. And told that we will start once/wk injections of test and eod of growth once the PV is under control and monitor.

Just and update.

Thanks guys for pointing me in the right direction… Bushy and KS… the docs agreed 100% with your assessment as to what was happening… bloods again confirmed.

Let you know how I am doing.

Regards,

Jet

Your anastrozole needs will change with changes to T dosing. 1mg ED will probably take you to single digits and make you feel like crap. Who came up with that dose?

[quote]KSman wrote:
Your anastrozole needs will change with changes to T dosing. 1mg ED will probably take you to single digits and make you feel like crap. Who came up with that dose? [/quote]

Primary care physician. I am with you on this one… but not sure exactly what to do short of testing every couple of weeks. I was considering tapering back to .5 beginning Monday. Then perhaps to .25 the following week… until I can get a feel for it.

No test running right now, but had a significant amount of Deca over the last 6 weeks so I assume that is still floating around in there.

Thanks KS