No Energy on TRT? Here's Help

Bigger Stronger Leaner Over 35 Lifter
21

[quote]Dr.PowerClean wrote:
Just my personal experience here, but I went on a five year holistic medicine exploration in my early forties and tried many things for various reasons. I don’t sleep well and have tried dozens of things for this, as well as for general stress relief. I tried Relora, felt nothing. But I feel nothing from Melatonin, 5HTP, valerian, and many other herbals/OTC’s that others swear by.

The one herbal that I TRULY benefitted from was high quality Kava Kava. For me, it was almost as calming as taking a Xanax, with no downside. In the early part of this decade, they took it off the shelves because some stupid teenagers were OD’íng on it, and I gave up on it. But I just googled, and it never got totally banned, just “warnings” slapped on it.[/quote]

Kava Kava is great stuff. T-Nation almost came out with a product based on it, amoungst other things.

Anytime the Biotest boys stir up interest in any particular compound I figure something must be up with it.

22

Hey e-loo,
A little over a year ago, I started on HRT/TRT and very soon felt like I was twenty again ( libido, outlook, etc.) and within a few months started feeling moody, sad, you name it. After a fair bit of research, I found out that HRT lowers the thyroid for most people and takes away the “happies”. Blood work agreed, my thyroid meds were adjusted, and very soon all was well. (check my old posts for the whole story).

My new doctor wondering why with good T & E numbers and thyroid too, why am I tired all the time…? I was tested and found out I suffer from adrenal fatigue and am now being treated for that as well. I don’t feel like I did when TRT started, and maybe I never will (at least not on 200mg/week), but I am starting to see daylight again and have a first class doctor, again. Good luck.

23

[quote]KNB wrote:
Hey e-loo,
A little over a year ago, I started on HRT/TRT and very soon felt like I was twenty again ( libido, outlook, etc.) and within a few months started feeling moody, sad, you name it. After a fair bit of research, I found out that HRT lowers the thyroid for most people and takes away the “happies”. Blood work agreed, my thyroid meds were adjusted, and very soon all was well. [/quote]

Thanks for the heads-up – I am going in for a blood draw tomorrow so I will ask the doc to look at thyroid function.

24

This thread jumped out at me because I am showing all the symptoms…incredible fatigue and no drive to accomplish anything.

I am hypothyroid (since 2003) and 200 mcg of levoxyl is dealing with that. My testicular function went out the window (discovered early 2007) and two packets of androgel is dealing with that.

Two months ago I began 1 mg anastrazole weekly to keep estradiol down.
All my numbers are “in range” and all I want to do is take a nap!

I have an appt this week to see about this fatigue issue. It is very frustrating as I am not one to run and whine to the Dr. about every little thing.
I do think I will see about the wellbutrin and hopefully this will help.
Thanks for lettin me vent.

25

[quote]fedorov wrote:
This thread jumped out at me because I am showing all the symptoms…incredible fatigue and no drive to accomplish anything.

I am hypothyroid (since 2003) and 200 mcg of levoxyl is dealing with that. My testicular function went out the window (discovered early 2007) and two packets of androgel is dealing with that.

Two months ago I began 1 mg anastrazole weekly to keep estradiol down.
All my numbers are “in range” and all I want to do is take a nap!

I have an appt this week to see about this fatigue issue. It is very frustrating as I am not one to run and whine to the Dr. about every little thing.
I do think I will see about the wellbutrin and hopefully this will help.
Thanks for lettin me vent.[/quote]

Question: What were your E2 numbers before the adex, and what are the last test results? I am curious if the T is lowering your thyroid as well. Do you have the b/w results?

26

Estrogen total serum was 90 pg/ml back in Aug (I realize it is not specifically E2) this number however, put me in the high end range. I began the adex based on this.
No blood work has been done since the adex dosage was started.

I have access to all blood results, and the T and thyroid have been consistantly in range.
Are you suggesting the introduction of adex has affected thyroid? 200 mcg is a very high dose of levoxyl-it would seem unlikely I would need more. But, perhaps the whole interactive system has been thrown askew with the introduction of adex.

27

[quote]fedorov wrote:
This thread jumped out at me because I am showing all the symptoms…incredible fatigue and no drive to accomplish anything.

I am hypothyroid (since 2003) and 200 mcg of levoxyl is dealing with that. My testicular function went out the window (discovered early 2007) and two packets of androgel is dealing with that.

Two months ago I began 1 mg anastrazole weekly to keep estradiol down.
All my numbers are “in range” and all I want to do is take a nap!

I have an appt this week to see about this fatigue issue. It is very frustrating as I am not one to run and whine to the Dr. about every little thing.
I do think I will see about the wellbutrin and hopefully this will help.
Thanks for lettin me vent.[/quote]

It’s possible you may have adrenal fatigue. It’s very common with people that are hypothyroid. I’d recommend getting a 4 point cortisol saliva analysis done. You should be at the high end of the range in the morning. It’s generally 8am ,12pm, 4pm, and 8pm.

If you adrenals are shot, all the testosterone in the world won’t help. It’ll prevent your thyroid meds from working as well, since cortisol is needed for the thyroid hormones to be utilized.

Your estradiol numbers may be in range but not optimal. I’m very sensitive to estradiol changes myself since my SHBG is low. The lower your SHBG the less of a window you have to dial in your estradiol levels. Even small variations in E2 will cause large fluctuations.

If you have adrenal fatigue, Wellbutrin may make you feel worse. It’s like whipping a tired horse. You can only do it so long. Wellbutrin’s stimulant nature tends to be more demanding on the adrenals similar to caffeine.

dopamineloveaffair

28

[quote]KSman wrote:
I have done PMs with many guys here. Some get good T levels, have their estrogen controlled and lack energy, can’t get things done. Apathy about many things can be a dominate issue.

Some doctors suspect a thyroid issue and prescribe, even if levels are otherwise quite decent. This can make one feel agitated but not do anything about the apathy and energy levels.

This situation can be a type of depression, characterised, no surprise, by low energy, not getting things done and apathy. In these situations there does not need to be any “profound sadness” that is typical in may depressions.

I bring this up, because I have gone through this as well as some others that I am aware of.

I think that SSRIs would be a really bad route for many. Wellbutrin can eliminate most symptoms quickly. For me, I changed profoundly and am busy doing things all day.

Sleep problems can reinforce the above type of depression. And some prescription or OTC sleep aids may create problems when these are used long term. I found trazodone to work very well, and it has some good anti-depressant effects as well… $4.00 per month at Walmart or Sam’s. You sleep aids/drugs may be a major issue. I had been using a antihistamine type non-benadryl sleep aid for years. I think that that was messing things up, but one does need to sleep. The first night on traz gave me a deep sleep and I felt fantastic and energized the next day. I was stunned.

These things were transforming for me and I wanted to share my experiences in case some others might recognize some of these things in themselves.

Elevated estrogen can also be a huge factor and getting that under control may be critical in dealing with things like depression. Estrogen may strongly contribute to depression.

Sexual sides: Wellbutrin has a reputation for enhancing libido. For me, I don’t see much of that. That reputation would certainly be true for those who have been chemically castrated by SSRIs. Both Wellbutrin and trazodone are known to, for some, increase erections. Trazodone has a warning about erections that will not go away, go the the hospital ASAP etc. So no sexual downsides for many.

If you have something to say about this that you are not comfortable posting here, you can PM me.

Thanks to Dr.PowerClean who helped me understand some of this and what the drug options were. Part of the problem is that one does not know that they have [this form of] depression. Dr.PowerClean helped me understand that these things happen.

It is all too theoretical, but when your life gets obviously turned around for the better in one week, this all takes on a different level of meaning. I had some good local support to help me, but I needed some context and understanding so I could be less than passive with my Doc.

Edit: minor changes [/quote]
Hi KSman - Its been awhile since I posted, my probs beginning a few years ago were depression, fatigue, overall fogginess and lack of interest in things I once loved. Long story short, I have been on 100testcyp/weekly injections for almost a year. Also taking Zoloft and a little bit of xanax. The TRT alone was not doing much
beyond keeping my libido up. My gut feeling is that its the
meds that have helped my depression symptoms, and I am thinking of dropping the TRT. Although my T was low before TRT (235),
replacing it did not help my mood problems. My question: what can I expect if I discontinue TRT and how should I do it - taper
off slowly or just stop, and how long before my body starts making its own T again. My mood is much better but I am exhausted most of the time. sorry for the long post and as usual, thanks for the wealth of info from everyone on this site.
any tips on TRT, meds that won’t make me tired etc… would be
welcome. Thanks - PV

29

[quote]fedorov wrote:
This thread jumped out at me because I am showing all the symptoms…incredible fatigue and no drive to accomplish anything.

I am hypothyroid (since 2003) and 200 mcg of levoxyl is dealing with that. My testicular function went out the window (discovered early 2007) and two packets of androgel is dealing with that.

Two months ago I began 1 mg anastrazole weekly to keep estradiol down.
All my numbers are “in range” and all I want to do is take a nap!

I have an appt this week to see about this fatigue issue. It is very frustrating as I am not one to run and whine to the Dr. about every little thing.
I do think I will see about the wellbutrin and hopefully this will help.
Thanks for lettin me vent.[/quote]

Many on T4 only have had a terrible time with it and in many cases I don’t know why some doctor’s have not had malpractice suits. Taking T4 can reduce TSH as one would expect. But that reduces thyroid activity, as expected; which can then reduce T3 production. For those who have a reduced ability to convert T4–>T3, they can feel as you describe, can go onto having skin problems and hair falling out as damage to the body occurs, and feel close to death. Many feel that a doctor that prescribes T4 alone is an ignorant idiot… that is why I am jumping to these conclusions. If FT4 and FT3 numbers are good, that could be ok, but not expected to be the outcome. If T4 and T3 are normal, that means in normal range. That does not imply anything about health, vitality or optimal levels!!! The normal ranges are only a statistical norm of lab results collected by a lab. Some of those samples are from people who have thyroid levels that are too high or too low, who probably feel well or vital.

The best thing is Armour thyroid or a drug with the same effects. Doctors are ‘educated’ by drug reps who push their synthetic drugs that are not a proper therapy most of the time. Having an induced T3 deficiency is not a proper standard of care. Many doctors have been taught by drug reps that Armour is a primitive and repulsive medicine, and that synthetic [mono] drug products are the only way to go. As a consequence, many doctors absolutely refuse to prescribe Armour. It is an extract of pork thyroid glands; perhaps a doctor of the Jewish faith might have a built in problem with this… but they probably prescribed bovine/porcine insulin years ago.

There is nothing wrong at all with a synthetic hormone [man made] that is bio-identical. Hormone therapies need to achieve a balance; single hormones that are blindly prescribed easily cause great harm.

Read this link. There are many things in it and could results in days of reading. This link jumps to a location in the URL, addendum, that I think that you should read first, then go to the top of the page and start exploring. The addendum really spells out a real situation, the dire effects and how doctors were killing the author.

http://personal.lig.bellsouth.net/w/u/wurmstei/#ADD

You may have a adrenal problem… perhaps resulting from low T3. It might be wiser to correct combined T3-T4 issues before correcting some things that may be a symptom of thyroid problems.

“in-range” is not a proper outcome. In many cases, one needs a doctor who really understands things deeply… a different doctor.

30

Great info KSman, what a releif for me. I will inquire about Armour natural thyroid tomorrow when I see the Doc.
I’ll also broach the topic of the adrenals.
I will keep you posted.

31

[quote]Dr.PowerClean wrote:
I will say, though, sometimes mental illness can rob you of the ability (energy, mental clarity, drive) to do what you need to do. That’s when you really need help. I would think most of us can think of a time when we felt that way, but most of us guys just tough things out, as long as it takes.
[/quote]

I read this and almost felt like crying, except for the whole apathy thing. I’m almost 35 and I already feel like my life is in the shitter, with no way out. Bummed all the time, can’t focus on shit, have little energy, and have a hell of time just keeping on track with the somewhat spotty training I do now.

With everything I do, and I literally mean everything, from training, to work, to friendships, to learning, it feels like I’m wading through molasses.

Feels like damn near every action is a struggle. I’m always irritated or pissed off, and when I’m not, I am exhausted or depressed as hell. It’s pretty much ruining all of the benefits I’m getting from the training. I’m stronger, faster, and more muscular but it feels like I’m spinning my wheels. I know that I can be better and I’ve been busting my ass but just not seeing the results I want.

However, I just got a new doc (the old doc couldn’t care less about my health and happiness, he was just a pill pusher), and this new guy happens to be a member of the Life Extension Foundation. One of the only ones where I am, apparently.

Sorry to hijack, I just felt like I needed to rant a little.

32

[quote]RhunDraco wrote:
Dr.PowerClean wrote:
I will say, though, sometimes mental illness can rob you of the ability (energy, mental clarity, drive) to do what you need to do. That’s when you really need help. I would think most of us can think of a time when we felt that way, but most of us guys just tough things out, as long as it takes.

I read this and almost felt like crying, except for the whole apathy thing. I’m almost 35 and I already feel like my life is in the shitter, with no way out. Bummed all the time, can’t focus on shit, have little energy, and have a hell of time just keeping on track with the somewhat spotty training I do now.

With everything I do, and I literally mean everything, from training, to work, to friendships, to learning, it feels like I’m wading through molasses.

Feels like damn near every action is a struggle. I’m always irritated or pissed off, and when I’m not, I am exhausted or depressed as hell. It’s pretty much ruining all of the benefits I’m getting from the training. I’m stronger, faster, and more muscular but it feels like I’m spinning my wheels. I know that I can be better and I’ve been busting my ass but just not seeing the results I want.

However, I just got a new doc (the old doc couldn’t care less about my health and happiness, he was just a pill pusher), and this new guy happens to be a member of the Life Extension Foundation. One of the only ones where I am, apparently.

Sorry to hijack, I just felt like I needed to rant a little.[/quote]

Hey, let me know how your new doc treats you, especially if you don't get good results. The best part of T-Nation, among the mature posters, is that we tend to all want to help each other out.                       Doc
33

Ok, well, let me ask some questions.

I have had sleep issues (insomnia) since my early/mid 20s.
I would say that it has really hurt my quality of life…a great deal. Since 2000, I have been taking 20-30 mgs of Amitrypyline (Elavil) right before bed and that has helped. Sometimes my sleep is good, sometimes ok and sometimes bad, but, in any case, it is better than before taking Elavil. I also find that taking Magnesium and L-Ornithine before bed helps also.

I took part in a Sleep Study at Stanford Sleep Center and, all I know, is that my sleep issues are not due to sleep apnea or restless leg syndrome.

Could the sleep be related to depression? When asked if I am depressed I dont know how to answer. On the days that I sleep well, I feel on top of the world. On days that I sleep bad, well, I feel kind of depressed. So I dont know which comes first the chicken or the egg. I am hoping Doc Powerclean can help me with this, but I also look forward to any input you other guys have on the matter.

Would any of the drugs mentioned Wellbutrin, etc, be worth trying?

Oh, I am waiting to get results back on the Male Panel blood test…However, since this problem dates from my early 20s, I wonder if that test will give insight.

34

Do all of you guys take HCG with your TRT also?
I’m wondering how much an affect on energy that has. Have you guys also tried pregnenolone cream?

I am going to start shots tomorrow switching from Transdermals so this topic really interests me. I don’t want to lose that great feeling I hope I’m going to get with shots. I’m a diabetic also so that throws even more wrenches into the mix.

I have decent energy now but my main problem is with motivation and anhedonia. Only time I felt absolutely fantastic was for three days coming off effexor due to the spike in adrenaline that was built up. I never felt so great in my life even though I didnt sleep for 3 days! Yet my cortisol and adrenals test fine.

Only thing that is always guaranteed to work for me is lifting weights.

Frustrating but it’s getting better.

35

Same with me, when I sleep good (I know this when I dream) I feel great the next day. I think you answered your own question, you get sleep you feel good. Sleep comes first. I started taking 5-HTP 50mg before bed and it really works good, never feel groggy like if I take too much melatonin.

I believe the depression is related to not sleeping. Certainly believe that’s my problem. Cutting out coffee really helped me.

[quote]entheogens wrote:
Ok, well, let me ask some questions.

I have had sleep issues (insomnia) since my early/mid 20s.
I would say that it has really hurt my quality of life…a great deal. Since 2000, I have been taking 20-30 mgs of Amitrypyline (Elavil) right before bed and that has helped. Sometimes my sleep is good, sometimes ok and sometimes bad, but, in any case, it is better than before taking Elavil. I also find that taking Magnesium and L-Ornithine before bed helps also.

I took part in a Sleep Study at Stanford Sleep Center and, all I know, is that my sleep issues are not due to sleep apnea or restless leg syndrome.

Could the sleep be related to depression? When asked if I am depressed I dont know how to answer. On the days that I sleep well, I feel on top of the world. On days that I sleep bad, well, I feel kind of depressed. So I dont know which comes first the chicken or the egg. I am hoping Doc Powerclean can help me with this, but I also look forward to any input you other guys have on the matter.

Would any of the drugs mentioned Wellbutrin, etc, be worth trying?

Oh, I am waiting to get results back on the Male Panel blood test…However, since this problem dates from my early 20s, I wonder if that test will give insight.

[/quote]

36

[quote]aculpep wrote:
Same with me, when I sleep good (I know this when I dream) I feel great the next day. I think you answered your own question, you get sleep you feel good. Sleep comes first. I started taking 5-HTP 50mg before bed and it really works good, never feel groggy like if I take too much melatonin.

I believe the depression is related to not sleeping. Certainly believe that’s my problem. Cutting out coffee really helped me.
[/quote]

I have tried melatonin, valerian, 5-HTP, Kava Kava (this latter helped a little)…I have tried acupuncture, I have tried homeopathy (when I was in Europe where you actually have to have a medical background to prescribe it). The homeopathy actually worked for a while (may have been placebo effect) but then was useless. So far, the only thing that really works is the Amitryptyline.

Well, Ambien works as well, but I dont want to take that long term. I also rarely if ever take caffeine, be it tea, coffee or chocolate. I dont smoke.

I have also done the cognitive/behavior Sleep program at Stanford. That’s a ten week/once-a-week, group class.
It helped a little, but not much.
Even with the Amitryptyline it seems periodic. I will have a period of a week or two where I am sleeping great and then, BOOM, I will sleep badly a few nights, then sleep more or less ok, then have another period of sleeping well. I can’t figure out this cycle.

Oh, by the way, I tend to sleep worse around full moons…AWOOOOOOOO. I would be embarrassed to mention this but out of 20 participants in my sleep class at Stanford, 5 mentioned this as well. Maybe I am a in-the-closet werewolf :slight_smile:

37

Has anyone tried SAMe? It is apparently used in Europe and the people at LEF have favorable things to say about it (although they warn that most brands in the market place have little or even no SAMe in them).

Also, does trazodone work effectively as a sleep aid?

38

Yes, and yes.
SAM-E did nothing for me, and I tried the high doses recommended which with a good brand will set you back some serious money for an OTC supplement. I did suggest it to dozens of patients, and a couple of them found it did help.

Trazodone works quite well as a sleep aid, probably in 6-7 out of 10 patients. Some folks get grogginess in the morning from it, this can be alleviated taking it two hours before bed, or working with the dose.                               Doc
39

[quote]Dr.PowerClean wrote:

Trazodone works quite well as a sleep aid, probably in 6-7 out of 10 patients. Some folks get grogginess in the morning from it, this can be alleviated taking it two hours before bed, or working with the dose.                               Doc

[/quote]

So, would it be possible for me to switch from Amitryptyline to Trazodone, just to test it out. By this, I mean, should I gradually taper off the Amitryptyline (i.e. reduce dosage…I take 30mg/night)before trying the Trazodone or can I just immediately switch from Amitryptyline?

I will have to go see my Kaiser Permanente Doctor, of course, to do this, but I was wondering what your opinion was.

40

Came upon this site while researching stuff we are discussing here. May be of interest. Certainly takes a different approach than mainstream psychiatry or so it seems to me. Check it out: