T Nation

Sleep, Energy, Mood and Sex Drive are Toast, Need Direction. Labs Included

28 years old, former recreational steroid abuser, have not taken exogenous hormones in well over a year and a half. Symptoms have been gradually gaining negative momentum. Main issues have been terrible sleep, no real emotion towards anything, no drive (especially sex drive) no morning wood and 0 energy. Appetite is also very low. My body in previous attempts has acted very strange to TRT and hormones in general since abusing everything under the sun. Thyroid and adrenals may be a compounding issue with the hormones, currently taking Vitamin C and D, fish oil, DHEA and herbal adrenal supplements. Not drinking or using drugs etc just overall feel like total trash. Current labs below indicating primary hypogonadism. Any input is appreciated thank you.

Your current labs are indicating primary hypogonadism, your testicles are fried. Your LH is high, FSH very high and testosterone is low, this can only be testicular failure.

Your limbic system could be damaged/sensitive do to steroid abuse and goes haywire any time you try to introduce exogenous hormones. You could look at it as a defensive mechanism.

Normally I would tell people who are prone to anxiety to inject daily doses since the peaks and troughs are minimal.

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Yea id have to agree with most of that. My frustration lands in which approach to take. So far test E is my thought for supplement of choice. and doing daily small dosing is the only logical approach since trt approaches make me feel sub par the last few times I’ve attempted it.

what’s your history exactly?

what have you taken and when? How much and how many times?

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Topics to discuss with your doc:
Why the calcium is elevated. For now stop dairy and any calcium-rich food; elevated calcium certainly can cause mood/energy problems.
The need to keep very good blood pressure control for the rest of your life

What you’re doing that can contribute to problems:
-fish oil can cause insomnia and mood problems in some people, consider dropping it for a year at least (to push it way off the radar screen)
-your calcium is high yet you are taking Vitamin D…big no-no; for now D should be stopped
-practically speaking “adrenal support” isn’t a scientifically valid concept for the supermajority of people; consider dropping the supplements that clearly aren’t fixing anything. If hell-bent on supplements, consider ashwagandha 1 hour before bedtime.

Sleep:
-maintain perfect sleep hygiene (diet, no cheese/dairy, caffeine, exercise, night activitiy, light exposure, temperature, etc)
-consider actigraphy with pulse sleep monitor (e.g. Fibit) as well as a sound recording app to sniff about for sleep apnea
–if things are horrific, and no contraindications, consider a low-dose amitriptyline (e.g. 5 or 10mg) for 2-3 months to help with sleep +/- mood

Your testicles are functioning and there is should be genuine encouragement that with time they’ll come back online to a greater degree; seems like you’ve dosed T after stopping the abuse, confounding things? Need 9+ months off everything to get a sense if things are normalizing…and that assume having been checking every month off of the juice

Consider insisting on no more cholesterol testing for another 12 years (triglycerides notwithstanding). The numbers will not change appreciably and you are not a candidate for pills (statins) that themselves can contribute to mood and other problems.

Most certainly the low sex hormones are causing the majority if not all of your symptoms, but if I were you, I’d try to absolutely max-out effort on the topics above before resort to hormone replacement. Often the storm comes before the calm, and if one jumps in and starts messing with things, issues become “chronic and unsolvable” for want of more patience…as hard as that can be to muster, particularly when everyone around you is telling you “you’ve got to be doing more tests and pills.” Working well with a doc who listens can help.

Have you checked prolactin? Have you taken steroids from the Nandrolone group?

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I started androgens when I was 20. At first I’d cycle on and off, by the time I was 23 I was living on 1000-2000mg a week and stayed at 1000 total mg or above for at least 3-4years. I’ve legitimately taken everything you could imagine that still exists in today’s world. (Powerlifting) most notably when I used trenbalone (and eventually stopped) my problems seems to expand (roughly 2016)

Lots of details to take into consideration, not sure why calcium is high so I can work on that. I can minimize OTC supplements. Honestly though the adrenal formula actually made a great difference at one point so I can’t knock it and that’s what leads me to believe there’s an issue there. Also I am diagnosed with sleep apnea and still wear a mask even though I’ve dropped to 185 from 245 when I was originally diagnosed. I agree that constantly manipulating things doesn’t help, However if all things are considered and I see no improvement or things get worse I will be antsy to find a solution because having all of these symptoms gets exhausting! Thanks for your thoughts I appreciate it.

Prolactin was 9.2 on a scale of 2-18 which was literally a year before this blood work. Also yes I have taken trenbalone probably 5 or more years ago now. Definitely caused issues for me after stopping.

Trenbolone is something terrible. People continue to discover what havoc it can wreck on your system. I know many steroid abusers that would not wanna even touch this thing

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Yes trenbolone is absolute garbage for your health. A lot of problems came into the foreground once my body got acquainted to it. I’d imagine I’m not the only person.

dude 1000mg for 3-4 years straight? I’m sure you did some B&C during that time.

I’m still working on optimizing my hormones after 3 superdrol cycles at 20 and 2 test E cycles when i was 22. Just 500mg 12 weeks each.

How does your body react to TRT.

This is going to be a tough hill to climb up, hopefully its possible for you.

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Sleep
-Try to make sure the type of apnea you have is being appropriately addressed by your equipment. Depending on your machine, you can monitor this yourself; research the sleepyhead shareware (app) +/- apnea boards. Regardless, the hormones are screwing with this and it should be transient, if taking many months to stabilize.
-consider avoiding melatonin unless you’re willing to further muck with variables that will disturb your body trying to figure itself out. Try to have more faith in the body than pills while understanding that the body takes literally many moon cycles to sort itself.
****Be exquisitely sensitive to when your brain is sending you the “it’s time to sleep now” signal. Be at home, be ready to sleep, and just do it. If you wake up at 3am and can’t fall asleep, try to start your day. This is actually normal for the body historically, certainly in more advanced age (when testosterone depleted anyway), and in much of the worlds primitive populations today.
-Quite difficult with low hormones, but attempt to not nap during the day…if it’s going to happen, 20 minutes max then get in the sun and walk around.

Light hack
If you don’t have personal or family history of mania, consider investing in a bright light for bright light therapy (BLT). This tends to help the serotonin system as well as synching clock genes (don’t recall the lumen # you need, but if you buy a $30 light, it probably needs to be 8 inches from your eyes…google it). Given that it’s January and assuming you’re in the Northern hemisphere, you might notice a boost from this pretty quickly, but light in the morning (e.g. starting between 6-8AM).

The problem of polypharmacy
On “adrenals.” Suppose your adrenals are burned and you’re tired. And supposed you took ‘adrenals support’ tabs that contained cocaine. As a matter of simple logic, what you’d experience is that the cocaine tabs in fact improved your function, but only in the short-run. In the longer term the pills would lose their effectiveness, and, and this is important, if the cocaine allowed you to do stuff that prevented the ~underlying
problem to remedy itself…well…now you’ve got two problems: the first underlying problem, and the ~cocaine burnout problem too. Cocaine used for example purposes to make the point here.

This cocaine analogy/allegory is what lay people don’t tend to grasp about taking pills/injections to treat disease. For sure the desire to get better quickly is strong, and when you see/hear stories of other people taking some magic bean combo and getting better…well, we want to be that guy too. But don’t underestimate the body to right itself. It’s counterintuitive to think, and sucky to experience, but feeling like $hit sort
of has a therapeutic value in a world without doctors, pills, and lab tests. 3,000 years ago if you felt like crap you’d invariably stop what you were doing (that caused you to feel like $hit in the first place), and invariably you’d get better, even if it took a long time.

If you’re in the US, try to see if there is a direct primary care (DPC) physician where you live. Such docs charge like $50-75 a month for theoretically unlimited visits. Not that you need to visit often, but usually they have visits that are 30 or more minutes long. You might be able to find a competent physician willing to work with you to help you understand how your body is recovering and provide education/emotional support. An HCG trial might be reasonable to get your estrogen (and T) up to feel better in the short run. Both your pituitary and testicles are online, and that’s a very good thing for long-term thinking, but in the short-run a subtle whipping the boys (T factory) might be reasonable to improve internal function with relatively benign external prodding.

Overall it sounds like you’re on the right path and mature about things. When hormones are off it can be hard to think about the distant future…the hormones change how we view everything…but your numbers and outlook are very promising.

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Thank you for the articulate and thorough amount of information, there is a lot to cover but I read it and will take multiple points into account, I agree that the body sometimes needs less intervention not more, which has been my mentality as of late. Hence not using hormones for a while now. Once again the input is appreciated. Thank you.

Yes I took hormone abuse to another dimension, way worse than what you’ve done. Your situation is probably way less extreme than mine which is a good thing. My body’s response to hormones is very odd now, for example I used to take 9cc a week for months with no problem, now if I did 1cc of Cyp I feel way off mentally, bogged down, no real effects, that lasts for a while then all the sudden weeks later I’ll actually feel well and then back to crashing. It’s odd but it’s what happens from obnoxious hormone abuse. I wish you the best on your case!

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I replied but it may not have tagged you, just scroll up, thanks again for your input!