T Nation

TRT Libido, Fatigue, Focus and Memory


i was just reading through some forums and i was very impressed with the knowledge and responses floating around on here between you guys. i'm looking for some ideas to get rid of the fatigue,libido and other issues i'm having.

the background: fell 60 feet off of a cliff and broke my back. everything slowly diminished from there. libido, energy, muscle mass, fat increased but slowly over a 3 year period. i started taking creatine and before i knew it i was taking 30g a day just to get through my day, workout and get up the next morning. i stopped the creatine for blood work and instantly got fat 10%bf to 15% in 6 weeks, couldn't recover from a workout and couldn't get out of bed.

Test results, T-400, E2-<20 too low to read, SHBG-20, LH and FSH VERY Low in Range
Prescribed, Tcyp 75mg 2x weekly - felt great for 3 weeks then everything fell off
Test results after 2 weeks - T-986, E2-20
Test results after 4 weeks - T-560, E2-38, SHBG-19
Prescribed, Tcyp 100mg x2 weekly, hcg 500 x2 weekly, adex .5 2x weekly

i've been on the tcyp hcg adex combo for 4 weeks now and for the first 2 weeks i felt amazing. good as new and now back to nothing. i look better, more vascular, bodyfat is lower again and feel like shit. i can't get out of my own way and spent the entire weekend in bed again. i have no desire or drive for anything and cooking breakfast feels like running 5 miles. i've read a few guys talking about prolactin, progesterone, dopamine dht and thyroid.

post tcyp only results:
Prolactin - 5.6 (2.6-13.1)
Progesterone - .88 (.14-2.06)
DHEA-S - 154 (85-690) started taking 50mg dhea ed
DHT - 365 (106-719)
TSH - .8 (.34-3.5)
T3 - 125 (87-187)
T4 - .9 (.5-1.6)
IGF-1 - 260 (before any trt)

I'm lost at this point. My T and E2 levels with the cyp/hcg should be pretty good. There isn't anything else out of line on my lab results. dht seemed to be the bandaid with creatine. would gels be a better route for me with their dht raising properties? Had a girl pop by yesterday that i went peter north on 2 weeks ago and gladly she didn't go there because i would have been looking for popsicle sticks and duct tape. i'm tired all of the time, can't remember anything, can't think clearly and can't focus on anything. Any ideas or info would be greatly appreciated! thanks


With E2=38, you have estrogen poisoning. Lower E2 to near E2=22pg/ml and you may feel that life is a whole lot better.

Read the protocol for injections sticky and you will find out what you need to do. Read the other stickies too.

You are injecting 200mg/week now? If so, 1mg/week adex is not going to work. Rule of thumb is 1mg adex per 100mg of injected T ester per week.

Estrogen management is often mission critical.

The half life of adex [anastrozole] makes dosing twice a week a problem. You should dose EOD. EOD is also better for hCG.

Note that lab numbers depend on when you test after injecting. Suggest that you test 1/2 way between and always keep this the same so changes are not an artifact of lab timing.

Your primary hypogonadism could easily be from damage to your pituitary resulting from your fall.


This. It seems that his doctor didn't have him on any E2 control or HCG when he first started TCyp (100 mg/week), and his levels were close to 1000 with good E2 immediately, but as soon as his T levels took a dive down to 550 range, doc doubled his T dose instead of addressing the REAL problem of E2 (granted he did presceibe Adex, but not enough).

Another story of a clueless doctor.

I was thinking a possible adrenal issue from the trauma. This doesn't seem to be manifesting itself in the form of poor thyroid function, but should be kept in the back of mind.


looks like you are overdosing on T to compensate for some other problem which is leading to estrogen issues which leads to trying to control via Arimidex which leads to too large of arimidex doses which leads to other complications etc. etc. etc.

You need several more tests to see what is going on, and I would think you should consider backing off of the ultra-high T-Cyp and HCG dosage (500iu is huge to start with - most go with 250iu)

based onthe very limited information provided, it sounds like it may be a cortisol/adrenal issue.

I would recommend getting tests for:
Free T3
Free T4
Reverse T3
8am Total Cortisol
8am Free Cortisol
Total Iron Binding Capacity

What were your CHOL numbers?

What is your avg daily temperature?


Wow! Thanks for all of the info!

Estrogen balance seems to be the most important part of the equation here. VTBalla and PureChance, taking a 4 part cortisol test in the next day or 2 and i agree that these are very important to the total equation. Can't wait to get the results.

Pure chance - TSH, T3, T4, 8am Total cortisol, Ferritin, Magnesium all came back normal. Others haven't been checked but are very interesting and I'm definitely going to look into them. The Chol came back just out of range low at 136.

i was given the option of 150-200mg of t per week after having ran 150mg per week for 4 weeks. i used the "more is always better" approach like an idiot. i've backed off this week to 160mg per week and will lower the hcg to 250 3x per week. it sounds like as a starting point i should be taking 1.5mg of adex per week based on this dose so 1/2mg eod roughly. i'm feeling a bit more clear headed but i still don't have any get up and go. i can't tell you how much i appreciate all of the info. the support and knowledge on here is awesome.


NORMAL = cuss words around these parts. Lab NORMAL ranges include 95% of the population. Do you think that 95% of the population is in ideal health? Are there people in that population who are near death or in the worst possible shape? Why would you use those ranges to determine if you are "normal"? Would you rather be "normal" or "ideal/optimal"?

Can you post your actual test results so that we can pick them apart? or check out the blood test sticky. There are some "ideal" ranges there.

also Total T3 = basically useless / Total T4 = basically useless. I was advising Free T3 and Free T4 - it sure does seems like 90% of doctors have never heard of those options before.