Hey I’m new here so I hope I’m posting in the right area but I was hoping I could get a little help reviewing my blood work and my Dr’s protocol.
Some background information struggled with very low energy since 14 years old, had some sleep issues such as sleep apnea but since cleared of it after losing weight. Got tested at 18 for low testosterone by a DR who thought it might be the cause of my chronic fatigue and came back at 9.8nmol/l he put me on Test C shots 200mg/2 weeks but I noticed no improvements and stopped the shots after 3 months because I wasn’t uncomfortable with it at such a young age.
Now 22 years old still suffering from chronic fatigue and have went down every route and tested for what seems to be every issue possible and all my blood work comes back completely healthy, on paper I should be the healthiest person yet still suffer from extremely low energy and mental fog , and a seemly inability to put on muscle even though I force myself to work out 5 times a week and have my diet very dialed in. Went to another doctor who ran my test levels and my bloods came back at
Testosterone total : 12.8nmol/l
Albumin Random U: < 3 mg/l
DHEAS: 17.4 umol/l
LH: 2.3 IU/l
FSH: 2 iu/l
My doctor put me on a testosterone compounded cream 100mg/g at 1g a day applied to bicep, he also found high Reverse t3 so put me on 5mcg of cytomel.
6 Weeks after no improvement I re did my bloods and my levels came back at
Total Test: 13.5nmol/l
Free Test: 235pmol/l
FSH: 2 iu/l
LH: 2.8 IU/l
After these results my doctor said it was because I was applying the cream to my bicep ( as directed ) and not my scrotum and to try scrotum application, personally I found the cream very annoying especially since I was told not to let anyone touch my arm, cant shower or sweat/ workout for 4 hours after application and asked to go on injections instead. I self injected and on my doctors advice split in into 50mg twice a week, so 100mg of Test C a week total.
I switched to injections and while I didnt notice any major changes I noticed a slight increase in strength and muscle mass over the 4 weeks, it felt like 2 years of working out finally started to get results which was nice as well and a little more mental clarity and a better mood, more calm but nothing major. I should mention I found myself sleeping much longer up to 12 hours. I re did bloods after 4 weeks and asked my doctor to check my SHBG to be safe and my results where
Total test: 27.5noml/l
Free Test: 945pmol/l
Estradiol: 98 pmol/l
And my LH and FSH were both below average due to the shots shutting down natural production.
After some research and talking to my doctor again I came to the conclusion daily injections might benefit me since the low SHBG means i might be metabolizing testosterone to quickly. My doctor agreed but said I was wrong about injections and that they were the issue and causing me to not feel any better because im “overdosing on testosterone” due to my high free testosterone levels. He said with my low SHBG (which he believes to be genetic) I will only benefit from compounded cream applied to my scrotum) so he put me on 150mg of compounded cream via scrotum application once a day.
My issues are that its been 2 weeks and I feel much worse, even less energy, sleeping longer and waking during the night, sometimes waking up sweating, weaker in the gym, feel less motivated, worse mood, and overall even worse then before I started TRT.
My main issue is my age and that I am Canadian so its hard to find a doctor that even cares about my hormones but i feel my current doctor is trying to just fit me into the optimal range even if at the lower end (since his plan is the cream will drop my levels i guess because some test will convert to DHT? at least thats how he explained it ) than treat my symptoms.
I was hoping to get some other peoples thoughts especially those who have similar issues.
my main questions are :
From what ive read the levels raised by cream drop by nearly half after 16 hours, should I not be on the cream twice a day compared to once? would this help? I feel the once a day application is causing my levels to spike and drop by the next morning making me feel worse
Are injections really not going to help ? Id much rather do the injections because atleast I know they are working and I find it easier. My doctor couldn’t quite explain why injections wont work for me just that the cream is what I need.
Is my declining DHEA normal? when I said my doctor he said lower is better and to not worry about it
Could I really have been not feeling better because of an overdose of testosterone? to me I feel my issue was the twice a week injection and that daily injections of 15-20mg would make me feel the effects of trt , if anything based on my total testosterone levels I could go up in dosage let alone be “overdosed” am I wrong in my thinking?
My doctor said the cream absorps very quickly via scotum application and that 3 minutes of rubbing it in and waiting 15 minutes before working out or even showering is enough, I give it an hour before work out and 2 hours before showering to be safe, my main concern with the cream is that i wont absorb it, am I being to paranoid ? is 15 minutes really all it takes to absorb the majority of the cream?
Maybe this is an ignorant question but due to my low SHBG if i naturally had for example 27nmol/l of Total Testosterone wouldn’t i also naturally have high Free testosterone ? If its how my body reacts to testosterone is a high free testosterone really something to be concern about ?
One last thing is while I experienced no significant benefits on the injections I also didn’t notice a single side effect and even the long sleeping I believe may have been from another medication although it has gotten worse while switching to the cream, I’m sleeping 12 hours waking up feeling extra tired, even sleepy when usually I am fatigued not sleepy.
I realized I wrote a lot but I want to give a clear picture and I have no other place to ask these questions as when I try to ask my doctor I dont always get an answer although he does try to work with me and explain things.
I am 6 foot 1 and 180lbs if that relevant and all other blood work shows I am perfectly healthy. I also take daily vitamins like Zinc (25mg) Vitamin C (1000mg) Vitamin D (5000iu) and have eat at my maintenance calories, high protein diet, I eat very little sugar and my insulin levels are fine as well. I did lose 100lbs from 16-17 years old and have kept it off the last 6 years. I am still skeptical about TRT at my age but if its something that can help me I’d rather try it now then in 5 years. I am also on lembroxant for insomnia but its my only other medication other than TRT and thyroid 30mg (my doctor switched me to this from cytomel because the cytomel caused my t4 levels to drop ).
Any and all opinions are welcome and appreciated !