T Nation

Sombebody Please Help Me

Is it normal to look emaciated after going of hrt? I’m the same weight as when I was a teenager, but after taking HRT from my endo I gained 25 lb of muscle.

Then a medical condition (panic attacks and super high blood pressure) - all what seemed like over active adrenals, required me to stop taking hrt after 1 yr. I went to all sorts of doctors, even the mayo clinic. It was a nightmare and I still have no answers. Not an adrenal tumor, nothing like that. They just could not explain it. The doctors said that somehow the HRT caused my HPA axis to get me wired up for panic attacks, and one doctor thought it was because the first endo had me jacked up too high on T injections (my serum T was 1800 for a long time).

I fell to pieces after they cut it in half. Then the mayo clinic told me to stop taking it all together. I’ve been off for over 2 years now. but I look like a skeleton.

So I have subsequently lost that 25 lb I gained, now I’m back down to my original weight. But I do not look like I used to. My skin hangs my face skin droops, I look like an emaciated old man. Except I’m just 35 years old.

We have to suspect that the hrt changed my physique so this must be permanent. Is this normal to look like crap after hrt even though I’m back to my original body weight? It’s terrible.

Honestly I wish I could take the HRT again but the high blood pressure scared me (200/105) and the panic attacks were strange. I don’t have these problems anymore, except I’m on a beta blocker now. This is really sucking.

So by using vitamin C, zinc, copper, magnesium B6 and a bunch of other stuff, I got my serum t up to 450 and my Free T up to 10 (both within like 20% of normal). These used to be flagged low, before starting HRT.

I’d give any amount of money if I could just get myself back together again. But my main question for now… is it normal to look emaciated given these circumstances? Or do you supose that something else is wrong? Maybe the beta blocker is causing this emaciated look?


what was your original treatment plan? mg/frequency, medications, etc.

what were your original blood test results?

what medication/supplements/vitamins are you taking now?

what were your latest blood test results?

severe muscle wasting, “catabolic”

get your T levels tested, you need some to survive, just need to find the balance.

Your adrenals may have been shot, perhaps thyroid too. These systems can be unable to withstand the increased metabolic demands of TRT if not right.

Do a male panel, thyroid panel, DHEA-S and 4 sample cortisol saliva.

I’ve done several blood tests and saliva tests for cortisol and DHEA,s. All come back normal these days, but they used to be way out of range. My most recent T (serum) is 430. When I was on TRT, I could certainly tell it was doing something to my adrenals.

Also I used to have hypothyroidism but that is treated with synthroid. The endo found out that I had low T after she diagnosed me with hypothyroidism. She prescribed 100mg t injections every other week at first.

A nurse injected me each week (I’m a girlyman when it comes to needles). They cut it down to 50mg then the mayo clinic cut me off, after some (adrenal?) problems devleoped.

Before getting cut off I had a problem with estradiol being way too high. So I asked the endo to give me an aromatase inhibitor but she refused. So I went to another doc, he prescribed arimidex. I had a reaction to that. Later went to the mayo and they cut me off everything. The panic attacks, high blood pressure, muscle loss and everything else that ensued… terrible!!!

One curious thing is that about 2 months after this I went back to the original endo and begged her to give me an injection of T. She had the nurse give me 50mg of T enanthate, and WITHIN JUST 15 MINUTES, I was nearly UNCONCIOUS! I got sooooo dizzy and light headed that I had to pull over (was driving). Then the blood vessels in my neck enlarged, my eyes felt like they were coming out, like somebody was choking me around the neck. My heart was POUNDING… wife drove me to the ER, they hooked me up and did an x-ray. Said I just had GAS. WTF? I GUESS that nurse injected into a blood vein??? Does that sound familiar?

Anyway, I went back to the mayo and they did every type of blood test possible (related to adrenals, thyroid, hormones, etc.), not to mention MRIs, CT scans (of my brain, abdomen, etc.) even had blood flow tests of my nuts and so forth. Everything came back “just fine”, except that my DHEA was a little high.

Shortly after this I met a quack doctor who tried me on Armour and Cortison tablets. I’m not sure, but I THINK this is when I became VERY sick. My blood pressure around 2 months after this treatment plan started shooting up from 90/60mmHg to 200/105, almost daily. I kept going to the ER… cardiologist finally put me on all kinds of cardiac pulls. Finally cutting me down to just an extended release of metoprolol (still on today). Not sure if THAT helped my blood pressure or the fact that I fired the quack and resumed my regular synthroid. But those blood pressure flucations don’t happen anymore, thank God.

A few months later I hired Dr. Crisler from MI to consult with one of my doctors in a teleconference. He ordered urine tests which also showed my DHEA to be too high. My ACTH was high, but cortisol was normal. Some things sort of suggested that my adrenals were burned out, however my cortisol was normal! So, they just shrugged it off (recent blood tests of ACTH show that it�??�?�¢??s in normal range anyway). Some strange things, but nothing concrete.

Original blood tests before TRT showed my serum T at 190 (below low range) and Free T around 7 or 8 (also flagged low). I was not taking any supplements. I got to wondering if my body had ALWAYS been low in T. My brother has always been 2 times larger than me. I was never very big to begin with, so maybe that kid that who kicked me in the nuts in gradeschool did something. However, my blood flow tests showed nothing abnormal. I digress. Yet, I always have a strange pain in the left testicle. I digress again.

Fast forward 2 or 3 years after stopping HRT:

These days I take 2000mg Vitamin C, 100mcg selenium, 30mg zinc, 2mg copper (both zinc and copper are in normal range on lab results), 350mg magnesium, 1000IU D3, B vitamin complex, also taking Udo’s oil for Omega 3 and Udo’s probiotics. I also spend about 30 minutes in the sun without my shirt on (very important for T production). WITHOUT this regimen my testosterone would be flagged LOW on the blood tests (200ngml), but WITH this stuff, my T goes to 450ngml. That’s significant! So if nothing else maybe this post will help somebody else.

While my T is now in normal range it’s still too low for my liking. But I’m doing some exercises (takes me 2 days to recover), eating good (green tea, eggs, oatmeal, veggies, lean meat).

This might be a clue: my arms, face and chest are VERY cut, looking like 1% fat. But my belly is maybe 20% fat. This seems to be an indication that my cortisol or estrogen is high or T is low. But none of those are true (according to blood tests). I haven’t checked SHBG or anything else lately, but I suspect everything is normal.

I know that T tells the body where to store fat. So maybe when I had elevated T levels, that might have permanently changed something as far as fat distribution so that now the high T levels are taken away, all that fat migrated downwards, more so than before the TRT. Possible?

Ok maybe I’m just fooling myself and I need more T. But that’s a scary thought (given above circumstances).

The bottom line is I look and feel like crap, yet I don’t want to go through all those medical issues again. If I can “explain away” why I look emaciated, I guess I could carry on with diet and exercise. At the same time I’m just a little concerned that something is terribly wrong.

Being in this position it is quite scary… just doing “nothing” isn’t right, and going to more “men’s hormone” doctors also isn’t right. There are doctors who will listen to these complaints and tell you “sure, you just need to take some cortisol, some progesterone, T shots - you will be fine”. Scary thought.

A few interesting things I found online:

  1. Testosterone (or one of its metabolites) can decrease the sensitivity of the adrenal glands, meaning that for a given amount of ACTH (a hormone excreted by the pituitary gland in the brain) less adrenal hormones are produced, including cortisol.

  2. Testosterone replacement can blunt the cortisol response to ACTH. Without sufficient cortisol the ability of serotonin to inhibit glutamatergic activity in the lateral amygdala is greatly reduced. The amygdale is an area of the brain that is implicated in “flight or fight” stress response, in other words anxiety and panic attacks.

  3. One of the metabolites of testosterone (namely estradiol via aromatisation of testosterone) can increase glutamatergic activity in the brain. Too much activity and we perceive that as stress, anxiety and panic.

that is quite a story, and I am very sorry that you are having to go through this. I know that it has got to be tough on you and your family.

This should really be a warning for others about the dangers of jumping into HRT (not that you did anything wrong).

btw, did you ever try Transdermal T?

100mg every other week = shut down your natural production and not provide enough external T to make up for the loss. (crazy doc #1)

then she gets even crazier changing it to 50mg biweekly made things even worse.

what amount of Armour and Cortisol were you taking?
what were your Thyroid levels before you started that treatment plan?

every system needs to be in balance at the same time.

Taking T when you have thyroid or cortisol problems could equal serious imbalances.
Shutting down your T production and not fully replacing it when you have thyroid or cortisol problems could equal serious imbalances.
Taking Thyroid and Cortisol when you have insufficient T could equal serious imbalances.

It looks like each doctor has been treating one issue at a time rather than your whole system at once with a average (or even low) dose of Test, Cortisol, and Thyroid.

My TSH used to be 6 prior to taking synthroid. Around the time that I was tried on HRT my TSH was perfect, just around 1 or 2. My FT4 and other stuff was good too. but the long-standing adrenal imbalance (from previously being hypothyroid) may have been my weak point.

Yes I tried transdermal T a couple times, but didn’t help much. Other than causing a huge spike in estradiol. My E2 was sky high with Androgel and Testim Gel. I required TWO tubes of this stuff a day just to get my serum T up to 400 (that Rx is $700 a month!!).

Then one doctor (who consulted Dr. Crisler) tried me on custom cream from a compounding pharmacy. That stuff got my T way up there, but made me TOTALLY sick… it has crysin [sp?] in it. I was so dizzy I didn’t know up from down. Actually the story goes on and on (my post above is just abbreviated). The transdermal stuff was tried before the Armour/Cortisone tabs.

I don’t recall how many grains of Armour or MGs of Cortisone it was, but they were just normal amounts. Not too low or too high. The stuff made me sick, yet it helps so many other people. I’m just different.

The endo who kept switching me around was frightened by seeing the astronomical T results on my first two tests, so she started making mistakes left and right to get rid of me or whatever. She didn’t want to risk her medical license (I mean, the lab results made it look like she was overdosing me on purpose, which wasn’t accurate). She just dabbled in something she had no experience in (neither did I) but for God’s sake I trusted her, she was a doctor. But I think she used me as an experiment. She totally blew me off during all the blood pressure spikes, anxiety issues, etc.

The mayo clinic, although well known for looking at the “entire picture”, will not address things like elevated E2 (arimidex? that’s crazy!), adrenal fatigue (no such thing man!). They stick strictly to their teaching of western medicine even if something is glaringly wrong. I mean, if you have a lot of “little” things wrong (such as imbalances like mine), they will not piece it all together… because each one of those “little” things just doesn’t exist in their textbooks. You could be crawling in on your knees gasping for air, and so long as those coke-bottle-glasses-wearing nerds can’t identify each symptom from their textbooks, then the only diagnosis you will be getting is “GAD” (an anxiety disorder).

What really stinks is that I have acquaintances who take HRT and they look and feel fine, even after several years of non-stop use. Maybe their RBC is up a little so they have to donate blood or whatever. But otherwise they seem fine. I suppose that they would fall apart like me if they ever stopped taking it.

wow bro. sucks.

You’re gonna need to post your lab test results with ranges. Hypothyroid and Low T go hand in hand for a lot of guys. FWIW that info you’re posting about how your thyroid was tested and treated… leads me to believe it was not properly tested or treated at all. You say they tested your T4… but what about your T3? T3 is the active thyroid hormone. Have you ever had your FREET3 level tested? If so what was the result and range.

I understand the doctor search and frustration. The fact is you’re going to have to find one that really gets it. I’m going to point you towards the Holtorf Medical Group in California. Check out their website and read as many articles there as you can.

There is obviously something wrong here and you need to find someone that can help you with it. I know how it feels to think you’ve been to the “best” doctor and to have spent SO MUCH FUCKING money and realize you have to keep looking but it is what it is.

[quote]Hallowed wrote:
I’m going to point you towards the Holtorf Medical Group in California[/quote]

Thanks I’m going to check that out!

BTW I had the FT3 test also, T3, RT3, TPOAb and TgAB (I got those antibodies down from 2000 to zero just by taking selenium). Not totally sure if my thyroid is optimal but it probably isn’t. At any rate I have a huge goiter that is visible in my neck. That’s how all this started… one day I saw a big lump in the mirror, family doc did a bunch of tests (uptake scans, ultrasounds, biopsies), found out I had “hashimoto’s thyroiditis”.

Thanks again. I will check out Holtorf.

[quote]mrlowt wrote:

[quote]Hallowed wrote:
I’m going to point you towards the Holtorf Medical Group in California[/quote]

Thanks I’m going to check that out!

BTW I had the FT3 test also, T3, RT3, TPOAb and TgAB (I got those antibodies down from 2000 to zero just by taking selenium). Not totally sure if my thyroid is optimal but it probably isn’t. At any rate I have a huge goiter that is visible in my neck. That’s how all this started… one day I saw a big lump in the mirror, family doc did a bunch of tests (uptake scans, ultrasounds, biopsies), found out I had “hashimoto’s thyroiditis”.

Thanks again. I will check out Holtorf.

Keep me posted. i won’t say they saved my life… they just made it worth living again. The thyroid is nothing to mess with. (and yes goiter = thyroid)