It has been a while since I visited this site. I suppose I have not felt my best. Thank you to all who have provided insights so far. I am still battling low energy levels and general fatigue. Sleep is decent, just never enough due to waking early every day around 4-5 am. I typically go to bed around 10-11 pm and generally do not have too much trouble falling asleep. For a few months now, I guess I would add muscle fatigue and soreness and what seems like slow muscle recovery to my list of ailments. To refresh, my exercise routine is riding my bike. Last year after starting on HRT, I felt good, could almost ride hard everyday, and was able to recover much faster. Fastest time on about a 12 mile ride was 42 minutes. This year, dropping back to a ride about every 3 days, my muscles stay sore, and I feel tired and not as strong, and I seem to be holding onto some water. My stomach seems bloated. The same bike ride takes me almost 8-10 minutes longer in spite of switching to smooth tires from knobby trail tires. Libido and erection quality is about the same - decent but could always be better.
My HRT med schedule up until recently was 60 mg t cyp e3d subq, 250 iu hcg eod subq, and 0.125 mg anastrozole e3d. Due to smallish testicular size, I tried a few months of 500 iu hcg, but dropped back to 250 per advice on this site/thread and lack of improvement with the higher dose. I will post all/new labs that are the result of this schedule at the end of this post.
Based on the new labs run back in mid-June, my new med protocol is 100 mg t cyp e3d, 150 iu hcg ed, and 0.25 mg anastrozole e3d. I have noticed some improvement in testicular size by doing hcg at a lower daily dose, but every day. No improvement thus far in energy levels, sleep pattern, and I still have muscle soreness and fatigue, and slower ride times. I am no longer taking Wellbutrin and I feel good about that. No noticeable change yet in libido or erection quality.
As refresher, I did try IR for a few weeks due to low morning body temps averaging around 96.9. There was no improvement in temps. I stopped all iodine for about two weeks prior to blood work. I did have quite a few thyroid and other labs run this time to try to pinpoint what is making me feel and perform so poorly. I seem to stay tired.
My doc wanted me to add 50 mg pregnenolone nightly just before bed. I'm cautious over this and started with 10 mg, now up to 20 mg for just a few days. No noticeable change in anything yet. I may continue to increase this slowly and monitor symptoms and side effects. Seems like some people can experience some heart palps if the dosage is too high. I also take 25 mg DHEA daily. Pregnenolone labs were 37 mg/dL and the labcorp range says <151 so I do not know if mine is low or not. I did also have 24 hour salivary cortisol test run. Due to my early waking which was especially bad on this day (3:30 am), I did my first saliva collection at 3:45 am. Then, 10:30 am, 3:30 pm, and 9:30 pm before bed. Results say normal and were 0.024, 0.124, 0.266, and 0.045 respectively. I had all other labs run on this same day with a blood draw at about 8 am.
I do not know how to interpret the cortisol test, but I believe they are the reason the doc added pregnenolone. I know cortisol is supposed to be highest in the morning, but my 3:45 am timing of the first one makes me think that it should be low then because I should be asleep! Any insights are welcomed. My highest reading was at 3:30 pm which seems whack too.
I won't write the results here, but a few things out of range, borderline, or that made me question them are high bun/creatinine ratio, high a/g ratio, high total cholesterol, high ldl cholesterol, maybe low iron binding cap (TIBC), low UIBC, high iron saturation, high DHEA sulphate, low prolactin, low reverse t3, high free t, low vitamin K1, and low ferritin. Some of these may be beneficial like the DHEA, but I don't know. Several of these like the iron ones I don't know enough about them to really spot a problem. Hoping some of you lab geeks are able to identify definite problems that I cannot.
I am not sure I agree with increasing my t cyp. Total t had dropped to 892 (348-1197), but free t is at 29 (6.8-21.5). I am worried that I have other issues like adrenal problems unrelated to this and that increasing the dose only cost me more money and could cause unwanted side effects. Opinions? I am about a month and a half into the new med schedule with no improvement in how I feel thus far.
That's about it for now. I look forward to anything anyone knows that may help. I am considering stopping all caffeine because of the cortisol labs. Possibly cutting way down on carbs to try to lose a few pounds. I am up about 10-15 lbs from last year.