T Nation

TRT and Adrenal Fatigue/HPA Dysfunction

About a year ago I started a testosterone only cycle, my second one. 500mg a week with some proviron thrown in.

While running it I was training 6 or 7 days a week for a couple hours a day, but also working in a very stressful environment 12 hours a day, with a day or two off every few weeks. After a few months of this I started feeling awful, with depression, anxiety and joint pain. I decided to come off and did PCT with nolva, clomid and HCG. When I did this my symptoms increased ten-fold, and I was no longer functional. Not able to think atall clearly, with depression, anxiety and pain like I had never known before.

I thought that perhaps my testosterone had not come back, so I spent a couple of months like this, not really able to leave the house after previously being very active and outgoing, thinking that I just needed to wait for my levels to come back.

I was finally able to get to a lab to get bloodwork but only got E2 and test as I no longer had an idea of what I was doing due to how I was feeling. The labs showed that my E2 and testosterone were within normal range.

I went to the hospital where they ran some tests that I think were b12, cortisol and a heart ECG. They all came back fine and I was advised to go to a psychiatrist. I live in SE Asia and don’t believe that the quality of care I received in the hospital was very good.

I began looking at what the problem could be by myself, and realised that I likely had adrenal fatigue AKA HPA dysfunction, and started taking steps to keep myself as relaxed as possible, which was a difficult task given my state of mind.

I tried coming back on testosterone, which seemed to help a little, as long as I spread out the dose into 25mg shots. If I did more than this, the same symptoms would come back almost as bad as they were originally.

It’s now 9 months since I originally came off, and have been back on for about 4.5 months, and my state of mind and body are still not working anywhere near how they were. I have to be really careful about exerting myself in any way, and putting myself under any stress.

As a result of this situation my finances are in a bad condition due to me not being able to work. In a couple of weeks I will have a few hundred dollars that I can spend on medical treatment, and I have decided that I want to try and come off the testosterone, as I may want to have children in the future, and realise that if I try and jump off much later than this it’s going to be alot more tricky.

I realise that the whole situation is an absolute mess so don’t need any comments informing me of this. I’d appreciate any solid advice as to what I should do next.

Do you have the labs?

TESTOSTERONE ng/dl 249.00-836.00 679.00
FREE TESTOSTERONE 5.71-17.84 ng/dl 11.30
Estradiol Hormone pg/ml 7.63-42.6 19.93


Have probable adrenal fatigue, on testosterone and want to come off. What should I do.

No, you don’t. If those are your numbers ON testosterone, you aren’t taking enough. You went from a healthy cycle keeping you at a level you can’t actually do, to killing yourself with a too much while trying to PCT and then - shock and horror - you found that the schedule you had trouble with gassed is killing you natural. Do fewer things, eat more and sleep more. If you are off, get current labs that show where you are off. If those labs just above are you off of test, then eat more, sleep more, and cut down on your stress. And maybe start drinking strong coffee.

Did you even read my post?

Yes, I did. More than once. Don’t worry about the fad disease of the day. Adrenal fatigue isn’t what yu think it is and isn’t what a lot of people put out there. Your adrenals don’t actually become “Fatigued” and produce less. If your 639 total test is “ON”, you’re not taking enough. If that’s current and natural (Hard to tell between those posts if you really are on or off at the moment - you seem to vaccillate on the answer) then your levels are decent for natural levels. If you are mentally comparing natural to what you could do on that cycle - and you no doubt are at least a little - then you are deluding yourself.

Get that FT up and you’ll probably feel better

Jeeze, get his FT up? Mine has been 5.2ng/dl for at least three years… started TRT 4 weeks ago, tomorrow is my last pin of the 4th week… I do MWF, 40mg, 20mg, 40mg… no AI. My estradiol was 39 before starting, but it was the ECLIA method, so maybe worthless… SHBG a little high at 67. I have just started feeling really crappy… lethargic, breathing poorly, anxiety (low grade but feels like it could get worse anytime)… I read online that this is not uncommon for a newbie… any recommendations? Thx!

You are going to need a bigger dose than that to overcome the SHBG.

Admittedly it’s not as clear as it could be in my post, but those test results are when I came off. I’m now back on and have been for 4.5 months.

I realise that adrenal fatigue isn’t likely to actually be what’s up with me, but most people refer to it when they mean HPA dysfunction, which is why I included it in my post.

I don’t expect to be able to do all the things I was, I just want to be able to have a somewhat normal life again. I have not been anywhere near my normal self for 10 months. If I went anywhere near a coffee I’d be in bed for a couple of days currently.

I need to know what bloods to get at the labs. I don’t have much cash to get this sorted out so needs to be something that’s done in one go ideally.

My symptoms are:

Brain fog
Crunchy joints
Aching muscles
Low energy

If I overexert myself it makes these symptoms far worse

Why? Caffeine is a relatively weak stimulant, but it does do all of the things that give you a little adrenaline push. Some people can’t sleep when they use it, but for most it’s literally the cheapest and safest option for a boost. It’s healthier than the energy drinks, and not dangerously addictive like amphetines can be. So, what exactly does it do to you?

These all sound like low Estrogen.

These sound like low test. Wouldn’t be a shock if you had both low. It is entirely possible that you damaged your system permanently by cycling AAS. It happens. You maybe cycled your way to permanent TRT.

I have the test results, shown above, to prove that my test levels recovered fine. I don’t know why caffeine does that to me now. I realise that those are symptoms of low estrogen, but it makes no sense that it would be that. Low estrogen does not cause exercise or caffeine sensitivity as far as I know.

Also why would I have low test when I am doing 100mg test a week?

100mg a week is not much test. 185mg a week gets my levels to mid 800’s. Not top of range, and not a ton higher than your test results. That’s 185mg a week. 100mg a week would leave me no better than I was natural, which was worse than you.

I wonder if I just add some boron to the mix… to lower the SHBG…?? I hate to increase my T dose when I am feeling so crappy… wait until maybe I acclimate? Thx!

The best way to lower SHBG is to increase androgens, like testosterone. Up your dose.

If you´re concerned about your adrenal fatigue, as you seem to have a few symptoms of it, did you consult an endo already?
He should prescribe you an ACT test, cortisol 24h test, and so on. You may rule out (or rule in) that situation.