I Feel Like I'm Dying After 12 Months of TRT. Something Else Isn't Right

oppenheimer · August 24, 2020, 5:02pm

Not trying to be dramatic, but I think TRT is a band-aid to a more serious endocrine disorder. Maybe it’s as simple as subclinical hypothyroid. I’m at my wits end.

I’m 33, never been laid, have been depressed and melancholy since about 13-14 when I first went to my doctor saying I felt tired and sick all the time after I ate food. I’ve also had excessive sweating, hyperhidrosis, since I was 5 or 6 years old.

There have been periods throughout my life when I’ve felt great, but it only lasted for a few days.

Maybe 6 months into TRT on 120mg/week I felt good. Great erections, felt energized, great sense of well being, was hungry. I went from 0 facial hair to facial hair, and more body hair growth and chest hair. So, I have androgen receptors, but I’ve been hypogonadal my entire life.

Now, after 12 months, I’m back to being tired all the time, mainly because I can’t sleep. I feel borderline psychotic staying up until 2-4 am waking up every hour. My body usually makes me wake up at 1-2 am and eat a shitload of food, mainly sugary food, before I can go to sleep.

I was pre-diabetic before I started with 126mg/dL glucose level, that has since normalized, and my lipids have as well. My TSH has gone down.

Something is F’ed with my adrenals or thyroid I swear.

I got giant ass stretch marks, sweat all the time, could never control my body temperature, tired all the time, big ass circles around my eyes.

I will try anything. My testosterone is suppressed because something is suppressing my hypothalamus, but I don’t know what it is.

I’d be embaressed if this is just subclinical hypothyroidism. All the women in my family have it, mother, grandmother, great grandmother. But my TSH was either normal or high normal.

spinup · August 24, 2020, 6:29pm

What are the details on the following?

diet
body comp (either height/weight or BF %)
physical activity

oppenheimer · August 24, 2020, 6:57pm

I used to run cross country and track and field in middle school / high school - I could run a 4 minute mile. I was extremely fit, but also extremely skinny. I started to feel depressed and sick all the time, so I dropped out of highschool, lost all my scholarships to top universities. Feeling like shit, coupled to throwing my life down the drain because I didn’t care because I wasn’t growing any facial hair or finishing puberty, I just started drinking and playing video games.

I grew up only eating healthy food, parents cooked good stuff all the time, rarely ever any soda or junk food in our house, and when I was running, I was a health nut.

6ft 3 inches, my heaviest I weighed 280 pounds at 32. I probably gained over 100 pounds in my twenties.

I’m now 6ft 3 inches, 220 pounds. I lost 60 pounds once testosterone was normalized.

I lift multiple times a week now. I tried lifting off and on during my twenties, I couldn’t lift shit, my joints killed, physical exertion made me nauseous. I felt sick all the time. If I ate anything, I’d feel ill. I was shitting blood for 5+ years. And…before anyone calls me a bitch, I’ve pushed myself during track and field and cross country to the point of vomiting, so I’m not afraid to push past pain.

On TRT, blood in stool went away within 48 hours. It was unreal. Also, that sick feeling went away as well. I don’t know if it was serotonin based or dumping syndrome or what.

I have friends who are heroin addicts and drink alcohol everyday and eat mcdonalds and they’re in better shape than I am with more body and facial hair. It aint just my diet.

I’d also add I quit drinking Jan 3rd 2019 and had a blood test while sober, still low T. So, it wasn’t alcohol making me hypogonadal either, I drank alcohol to cope, and because it gave me dopamine and made me feel not ill.

spinup · August 24, 2020, 7:06pm

Your complaints sound like a blood sugar and/or insulin response issue to me. My recommendation for addressing your primary complaint of lethargy and insomnia would be, instead of binging on sugar at 1am:

Start tracking macros and calories if you’re not already by weighing all food on a scale.
Figure TDEE and set daily caloric intake appropriately for goals.
Stop eating sugars and simple carbs, replacing carb sources with complex.
Shoot for at least 33/33/33 on macro percentages. You could bias this towards carbs and protein (15/35/50) if you want to lose fat more rapidly.
Constrain any stimulant use to before noon.
Get at least 30 minutes of LISS cardio daily.
Practice good sleep hygiene. Only sleep in your bedroom, no screens within two hours of bed, limit fluids before bed.

If you’re interested in exploring thyroid further, I would get a full thyroid panel pulled, including T4/rT3, T3/rT3, etc.

oppenheimer · August 24, 2020, 7:21pm

Yes, my blood sugar began to get out of control. This was fasted blood sugar at 8 am before food prior to TRT. I’d feel horrible until I ate some food, but then I’d normally pass out and fall asleep for a few hours, and wake up with a horrendous headache. These were my numbers prior to TRT for blood glucose.

Also - since being on TRT, I’ve had to drink like 4-5 coffees a day and I have a lip of dip in from morning to night. It’s like I can’t feel stimulants anymore but they’re the only thing keeping me awake. I know I should reduce nicotine and caffeine, and have heavily reduced coffees to 2 a day. However, I was using nicotine prior on TRT and never had this bad of insomnia.

oppenheimer · August 24, 2020, 7:31pm

I’d add that…diabetes, low SHBG, hyperhidrosis, hypogonadism, all symptoms of acromegaly or pseudoacromegaly. Starting at 5-6 years old…how the hell could a doctor miss diabetes in me?

el_nino_malefico · August 25, 2020, 12:07am

Well, sincerely, depression happens, some people are more predisposed to it and can have some chronic form since a young age, so that it could not be related to a specific underlying physical condition.

You already received a lot of good suggestions, so I want to only to add my personal view and questions:
Have you got some psychotherapy?
Have you ever tried meditation?
Do you know intermittent fasting?
Aerobic training is the gold standard of exercise for depression, but do not quit lifting to perform jogging, because recently has been noted that even weight training help with depression, so keep them balanced! Effectiveness of aerobic training seems to start at 20 minutes, and sessions between 20 and 40 minutes are the most effective. Personally, my standard is 2 days a week of aerobic 2 days a week of lifting, but I always try to get 3 + 3.
I like the suggestion on macros, and for me the most balanced approach is very similar and is to have the same ratio between protein and carbs, so more like 30f-35p-35c. I don’t like much the idea of counting calories if not really, really needed: it could be very stressful!
You do not need to have diabetes to have insulin issues! Remembering the this is an issue that compete to a doctor, there are some supplements that can help, like inositol, cinnamon and mulberry leaves.
Finally, since you are on TRT, you should check progesterone/allopregnanolone that can mediate some sides of TRT and considering pregnenolone supplementation with medical supervision.
You should also check DHEA at this point.
Caffeine should be contained to 2-3 cup a day and personally I stack it with theanine, and nevěře, never, nevere consume it after lunch, but only in the morning.

oppenheimer · August 25, 2020, 12:28am

I think it’s a pheochromocytoma. Pissing in a jug for 24 hours, will report back. The constant feeling of being on edge and thinking your going to die 24/7 that has been building for 30+ years I can’t take anymore.

I have every single one of those symptoms.

spinup · August 25, 2020, 2:00am

If you had pheochromocytoma for 30 years you would be dead already.

hardartery · August 25, 2020, 2:16am

I would ignore both of these pieces of advice. Cardio does sweet dick all for depression in some people, like me. Low test will cause an downchain problem with low E2, low serotonin, and low catecholamines. Joints hurt from lifting, good chance it’s the low E2. Depressed? Enter serotonin and catecholamines. You know what boosts dopamine and other catecholamines? Stimulants, like caffeine, and getting an endorphin rush from lifting heavy has a down chain positive effect on brain chemistry. I haven’t read the article that you linked yet, but I will give it a go and get back to you.

oppenheimer · August 25, 2020, 2:17am

Well I have essential hypertension, hyperlipidemia, hyperglycemia, went to the ER thought I was having a heart attack once. Had an abnormal rhythm and other stuff that fits.

Or with my luck, cancer.

oppenheimer · August 25, 2020, 2:20am

Yes, my estradiol when I was feeling achy and couldn’t even walk up stairs was, 7. My original T test was 171 ng/dL in the morning, fasted. So, it was only downhill from there the rest of the day.

hardartery · August 25, 2020, 2:22am

Totally makes sense. Low E2 is way worse than anything high E2 may be capable of (Or at least blamed for, LOL)
What are your levels and dose? Masteron is anecdotally implicated in lowering E2, if I recall correctly, so that should be factored into any protocol.

oppenheimer · August 25, 2020, 2:25am

My endocrinologist didn’t believe I could “feel” my hormones, but I sure as shit could. It’s like my body worked in cycles, sometimes I felt great, sometimes not so great. Mostly, not great.

I was having hot-flashes since I was 13. Doctors ignored me for 10+ years until I demanded my test saying I felt like a menopausal women. Oooo what do you know, hot flashes in men are associated with hot-flashes from low estrogen, hence low testosterone.

I’m on 140mg/week now. I think I’m too amped. Might go back to 120 or 100mg/week. Doc doesn’t believe in AI or hCG.

hardartery · August 25, 2020, 2:30am

It’s best to leave both the AI and HCG alone until you feel like the test is dialed in. One thing at a time, and you most likely do not need an AI. Most do not, no matter what they think initially. HCG is hit and miss. Good for fertility, but makes some guys feel like crap. One thing at a time. Get bloods at the current dose before changing if possible. It will matter later when you are deciding doses of stuff to know the numbers at a given protocol and dose.

oppenheimer · August 25, 2020, 3:04am

Yes 140mg/week I havn’t liked. I felt better on 120mg/week. 70mg every 3.5 days is when it all went to shit and I havn’t recovered from it. My free T went pretty high and my total estrogens were high on trough based on HPLC/MS/MS.

middleages · August 25, 2020, 3:39am

I swear this feels like a troll post, due to the constant list of symptoms and issues that keeps growing with every post. Depressed about not growing facial hair is troll material, but Ill give you the benefit of the doubt. You dont have a full understanding of TRT and how hormones work. If youre sensitive to T, then I will suggest lowering your dose back to a base level and work with that for a general sense of well being. Higher T levels could be key though. Stop eating sugar at 2am. Why are there sweets in the house to begin with? Stop lifting heavy and focus on lighter weight, higher reps. Do you have any life goals? Hobbies? A man without hobbies is man with no direction.

hardartery · August 25, 2020, 3:50am

The difference between 140mg/week and 70mg x twice a week is simply higher trough, but lower peak. You didn’t respond well to the numbers being more even. Obviously, you have something else going on as well. It could be complicated. I would go back to once a week if that felt better, and at a lower dose. Your free T is through the roof at even a low dose. Your glucose is high. What’s your A1C? Everyone likes to push cardio and light weights. Don’t listen to them. Find something you have to grind to lift and try give it all. Leave the gym a zombie, on heavy (For you) lifts and low reps and see how that does you. It resets my brain chemistry in a wonderful way, better than 120mg of Adderall hits, in my experience.

middleages · August 25, 2020, 4:28am

With sweets in his system, he wont get motivated to even start lifting the weights on to the bar. This guy is simply not the type yet. He should get a good baseline and start small. Then go big. Anyway, the sugar is a problem, and the medical issues are are another.

oppenheimer · August 25, 2020, 5:02am

Not trolling. Slowly losing my mind due to whatever is wrong the past 25 years. I shouldnt have dropped out of high school because I felt so sick. I shouldn’t have barely made it through college because I felt so tired. I get glimpses of energy and then weeks to months of feeling like my muscles are ripping off my bones.

I should have clarified, that fasting glucose was alongside the low T when I started. Since being on TRT all GI issues, hot flashes went away. Blood sugar is down to like 70s now so I regained insulin sensitivity.

I’ve read a lot of stories of people bordering on psychosis and every doctor telling them there is nothing wrong then they end up finding a tumor on their adrenals or somewhere else.