T Nation

Help with TRT and Auto-Immune Disease.

Sorry for the great wall of text. Please bear with me, or you can skip to the “Testosterone” heading.

Background:
I am 33 years old, and I’ve had a chronic Auto-Immune Disease since I was about 20. (viral induced Reiter’s Syndrome). I saw many doctors that were absolutely useless.

It wasn’t until I was 27 and went to an infectious disease specialist that I was diagnosed and figured out how to treat my symptoms. I took Aleve for about a year, and eventually most of my arthritis symptoms subsided. I still have to use steroid cream (2% hydrocortisone) on my skin in various places, and .12% betamethasone valerate foam on my scalp to treat scalp psoriasis. I also have nail psoriasis, but not a lot has been effective for that.

I gained weight slowly over time due to poor diet and lack of exercise. I’m 5’10 with a narrow frame. At one point I weighed over 210lbs. I had little muscle mass and most of the fat was around my mid-section. I eventually decided to start eating right. Since I couldn’t really exercise, I wanted to stop compounding the problem. By diet alone, I dropped down to 155lbs. I felt good enough that I started doing light exercise, and gradually started doing more and more in the gym. I started eating more and lifting heavier weights. I’m back up to around 167lbs, with a lower body fat%. I still have more belly fat than I think I should.

Over time I have grown accustomed to feeling pretty bad. Granted, I feel slightly better now than I have my entire adult life, I still feel pretty crappy.

Testosterone:
I’ve known for over a year now that I’ve had low T. I was seeing an IM doctor just to get my other scripts, and I told him about some other problems I was having. He tested my T and it was low. He offered treatment options, but I didn’t take him up on it. I took some free samples and a script of Cialis instead.

My Low-T Symptoms:
Low Libido
Difficulty achieving and maintaining erections.
Difficulty reaching orgasm.
Don’t remember what it’s like having “morning wood”. It’s probably been 10 years.
Brain fog. Basically I can’t concentrate and have a poor memory.
Depression. I’m a pro at hiding it.
No motivation. I have absolutely zero motivation to do anything. I only do things because I have to.
Irritability. Borderline extreme.
Overly Emotional.

I started seeing a new doctor, whom I actually like. When I first saw him, he ran a huge panel of tests to get a big picture. He also noticed the low t (among various other things), and said I’d feel a lot better from treatment. I still didn’t take him up on it until a year later. He is very easy to work with, and I get the impression he will work with me. From what I’ve read form other people that’s a big deal.

So I finally took him up on treatment. I opted for the injections. He put me on .2 of 200 test cyp twice a week.

I received the first shot 2/21 in the office.

2/22 was amazing. It started when I woke up in the morning. I had a RAGING hard on. I wasn’t expecting to notice anything the very next day, but I can’t recall ever feeling so good. I was clear minded and didn’t have a ‘brain fog’. I was in the best mood I could ever hope for. I was motivated and energetic enough to start and finish a pretty big project I never would have started otherwise. Every single symptom of low t was GONE. Things happened that I didn’t even know to expect. WOW!!

2/23 I felt good overall (a little better than normal) but it wasn’t quite the same as the day before.

2/24 I was back to ‘normal’ and I was due for shot #2. It took me about 5 hours to purposely shove a needle into my thigh, but I managed to do it without issue.

2/25 I still felt pretty normal. Not good or greatâ?¦ not bad eitherâ?¦ just alright.

2/26 I felt awful. I was extremely irritable, depressed and emotional. I normally feel pretty crappy on a daily basis so I’m accustomed to “sucking it up” and dealing with it, but this was much more extreme than anything before. Worst day ever.

2/27 - not as bad as the day before. Still not normal, but it was more tolerable.

2/28 - I felt pretty decent again. Slightly better than normal. Shot #3

3/1 - still felt pretty good

3/2 - still feeling pretty good.

Okâ?¦. Soâ?¦. Why the extreme roller coaster at first? Why did the sexual effects disappear after 1 day and yet to return?

It seems like something is still off.

Picture is Hormone Panel Pre-TRT.

Be patient. I’ve been on the same dose of 25mg twice a week for 5 months and it’s still a rollercoaster.

I think being excited about taking testosterone makes people hypersensitive due to psychological reasons. There is definitely a lot of ups and downs as your body adjusts over MONTHS of time.

Starting T seems like it should be awesome. It isn’t. Hence the necessity of warning overexcited 20-somethings starting it unnecessarily. I don’t think anybody wants to be 26 and unable to get a boner just because they wanted big muscles for the summer.

You should not be on TRT. So many things you could have tried first. Knocking E2 and SHBG down a bit could have gotten you close to 20 on Free T. I would have tried Dermacrine and some DIM and/or Boron first. If the DIM and or Boron didn’t bring E2 down, you could have tried Aromasin. If your Free T was still low, an low dose SERM probably would have worked.

[quote]dhickey wrote:
You should not be on TRT. So many things you could have tried first. Knocking E2 and SHBG down a bit could have gotten you close to 20 on Free T. I would have tried Dermacrine and some DIM and/or Boron first. If the DIM and or Boron didn’t bring E2 down, you could have tried Aromasin. If your Free T was still low, an low dose SERM probably would have worked.[/quote]

Fair enough. I did start taking DHEA supplements at the beginning of the above tests (which does show an increase period over period), but did nothing for any symptoms. I also tried changes to my diet and a few other things without much luck. You’d think for a 33 year old guy that works out at least 3 times a week and eats clean, he wouldn’t have these issues. What can I say, viruses suck.

I just got tired of feeling like shit and wanted to try something more definitive. Right wrong or indifferent… When you’ve basically been a 90 year old man since the age of 20… life isn’t much worth living… and your patience can wear thin. At least I can be absolutely certain now that there is something very wrong with my natural hormones. Whether or not I’m making the problem worse, I guess we’ll see.

The day after that first injection reminded me of what it was like being young and healthy again. I honestly wasn’t expecting anything to happen so quickly. It almost seems like my natural T plus a dose of the ‘fake’ stuff made just the right combo for magic. Albeit, very short lived.

That initial roller coaster hasn’t came back… at least not that extreme… I feel a little bit better than normal. I’m not as irritable, not as emotional, not as depressed, and have a better sense of well being. Unfortunately all of the sexual symptoms haven’t improved very much aside from that first day. Right now I’m just looking to stay the course and see what the numbers have in store for me when I get re-checked.

Picture is a trend of my overall daily ‘status’ since starting injections.

It’s been about a month since my last update. Still on the same dose. Have not had updated blood work yet.

Everything has been consistently good. Not great… but good. Which is a far cry from where I started. I no longer feel menopausal, no depression, no irritability, able to think clearly, I’ve actually starting seeing improvement from time spent in the gym, I can consistently get it up without the help of Cialis (although reaching climax is still a bit of a challenge).

I think the worst thing so far is I’ve been getting deep rooted pimples in all kinds of random places that don’t pop… if I just leave them alone they go away in a few days. No big deal.

My only regret is not starting sooner. Looking forward to making a few minor adjustments after blood work and seeing if we can’t improve things a little more. I’m optimistic, for once. :slight_smile: