T Nation

Fatigue with Low T


#1

Hello and great day to all. I’ve been struggling with low testosterone test since January 2017. Dr recommend compound testosterone cream 75 mg a day. I decided not to take it and in June 2017 was diagnosed with severe sleep apnea. I’ve been on cpap faithfully for 7 months . Testosterone has went from 200 to 343 in this time. I’m 37 ,276 lbs no fast food. Over weight . Very fatigue wondering if this could be from my testosterone? Next to no performance. I go for a second opinion this week and more blood work.

March 2018 blood work was. SHBG 32.7. prolactin 6.0. LH 4.2 FISH 3.9. ferritin 195. Estradiol 26. PSA 0.496. % of free testosterone 2.99. Testosterone free 10.26. Testosterone 343. Don’t want to start testosterone if I don’t have too. Can someone please recommend other test I may ask my doctor to order ? And do my past test results really point me in that direction or possible something other. Thanks .
Sodium- 139 range 136-145
Potassium- 4.1 range 3.5- 5.1
Chloride- 107 range 98-107
co2-26 range - 21-32
Glucose-75 range 74-106
Calcium- 9.0 range -8.5-10.1
Creatinine-0.86 range 0.67-1.17
Bun-15 range 7-18
Albumin- 4.1 range 3.5-5.0
Total protein- 7.2 range 6.4-8.2
Sgpt- (alt)- 28 range 16-61
Sgot-(ast) 14 range 15-37
Bilirubin- 0.4 range 0.2- 1.0
Alkaline phosphate-72 range 45-117
Ag ratio 1.3 to range 1.4-1.6
Bun/ creatine 17.4
Globulin serum 3.1
Anion gap 10.1
Estradiol 29 range 8-43
Shbg 32.6 range 16.5- 55.9
PSA - 0.496
Prolactin 6.0
Lh- 4.2 range 1.2-10.6
Fsh- 3.9 range 0.7-10.8
Ferritin 193 range 26- 378
Undescended testicle that was removed at childhood.
Diagnosed Hypogonadism


#2

We see guys with levels higher than your seeking TRT and seeing great results, typically when T levels get below 500 ng/dL we see minor depression symptoms in the mid 400’s and erection troubles below 350-400 range. You need to request injections, injectable testosterone is 100% absorbed, transdermal isn’t as effective.

We see plenty of guys here with elevated TSH indicating iodine deficiency, you also need to check thyroid as TRT demands a properly function thyroid. TSH beyond 2.5 is a problem, ranges are quite useless. Checking free thyroid hormones always shows a clear picture.

Your T is low on average given your age. Do not accept a doctor claiming your normal, most doctors fail at diagnosing hormone deficiency. Doctors learn about male hormones through experience, not medical school. This creates problem for us men often being told we are normal when we aren’t.

You need to include labs ranges.

TT
FT
E2
Prolactin
LH/FSH
CBC
hematocrit
TSH
fT3
rT3
fT4


#3

Yes, get everything else checked, but you’re likely going to need TRT. I started at age 59 with TT of 333 and very much wish I would have done so sooner. You may be good for a guy in his 80s.


#4

Thanks so much! I would like to also mention that my last cholesterol reading was 118 Again 1 yr ago. I will make sure all test u suggest are done on 2-14-2018 . Other symptoms have been , Joints ache , legs feet hurt, very seldom morning erection, very agitated ,mood swings. Doctor also perscribe Phentermine for weight lost, however I am not taking that either. I feel relieved and blessed to of found this site. Thank you


#5

Phentermine can cause psychosis, and heart failure. TRT is much safer, doctors are quick to hand out drugs that can kill you and slow to hand out a natural hormone that can transform your life.

Joint aches are from low E2.


#6

Thanks Systemlord, Will testosterone correct the E2? And from the posted results should mine be at a higher level? . I used the online testosterone caculator to get a conversion of my testosterone and the free stated 7.17ng/do (2.09%) and had a check mark for good. Can this be correct? Bioavailable testosterone 157ng/do (45.7%)


#7

We convert out E2 from testosterone (FT–>E2), E2 will rise with more testosterone.


#8

TRT will vastly improve your quality of life. But you cannot ignore adrenal or thyroid problems. Think of these as the three legs of the tripod of male health and vitality. Sometimes young men can fix their problems and avoid TRT.

Please directly edit your post and put the labs in list format and add the lab ranges. Look for pencil icon below your post.

Labs:
LH/FSH - both, cannot do after starting TRT
TSH
fT3
fT4
AM cortisol - at 8AM or 1 hour after waking up

You have low T. LH/FSH will show if the testes or pituitary are the problem.

What is compound testosterone? Injected with anastrozole in it? Nope, probably a T cream…

Many guys here have some degree of low thyroid function which robs one’s energy, mood and libido while leading to fat gain and lethargy. Please evaluate your overall thyroid function via oral body temperatures - see below.

And your thyroid needs iodine to work. Discuss your history of using iodized salt.

Transdermal T has highest potential for increased T–>E2, highest cost and lowest absorption. 10% absorbed at best and with thyroid problems can be very low or nil absorption.

Self-injected T is least cost.

We need:
age
weight
height
waist size
list health issues/concerns
list medications

Describe time line of how and when you felt your symptoms.

Now the fun part…


Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#9

Last test LH was 4.2 range 1.2- 10.6
FSH was 3.9 range 0.7-10.8 are those results worth saying it’s definitely coming from my testicle? I only have one. Compound testosterone is the cream.