T Nation

Type 2 Diabetic with Low Testosterone

Hi Everyone,

I need some advice, am 33 years old and was recently diagnosed with type 2 diabetes, also my testosterone levels are very low for my age below are my test results.

Total Testosterone 10.0 NMOL/L Range is 9 - 35
Bio Testosterone is 4 NMOL/L Range is 3 - 15

LH and FSH was tested and were all borderline low (don’t have the results with me). I was prescribed Testosterone Enanthate 125mg per week with HCG 400IUs 3 times a week - Mon, Wed, Fri. I am on my 4th injection and will be getting followup blood work in January 2011

I currently take metformin along with diet and exercise for my diabetes. I have changed my diet to a lower carb with mostly veggies, with chicken and fish and limit red meats. I have low libido and constantly tired and have lost strength in the gym.

Am trying to lose 30 lbs of fat so I can get off the oral medications, I train 4 to six days a week with intense cardio mostly and weights 2x weekly.

Since Starting the Testosterone I have seen some improvements in my blood sugar however am Noticing the following:

  1. Increase in Blood Pressure with headaches, prior to TRT my Blood Pressure was 125/80, now its 130/90-95, I test my BP in the morning and evening and my diastolic seems to be fluctuating. Does TRT cause this and what can be done?
  2. Am feeling Bloated (water retention) and have brain fog with some anxiety during the day, is this common side effect?
  3. I am getting much harder erections however am not getting any morning wood, why would this happen?

I emailed my Dr. and my 4 week bloodwork will include tests for E2, and he said if its high he will treat it with Letrozole.

Any any advice or suggestions would be helpful on how to manage these side effects, any supplement advise or so would be helpful.

Thanks for your reply in advance

No Response, come on I know someone can offer some advice

I’m no doc, but I doubt a BP of 130/90 will cause headaches. Your BP will easily exceed that during excercise so if you don’t get headaches during excercise, I doubt the BP is the cause. Are you getting any kind of reaction at the injection sites?

I had the same thing happen to me (Higher BP - feeling like pressure in the head, water retention) when I first started getting injections. All the symptoms except the blood pressure subsided about the time I switched to more frequent injections and started controlling my E2. I could not tell you wether the symptoms were transient and just coincidental with the change in protocol, or whether the change in protocol was responsible.

You are taking a bigger dose of HCG than most which could cause more E2 problems. Most people here take between 500-875Iu of HCG per week. Others have mentioned that HCG increases E2 conversion in the testicles and that aromatase inhibitors like anastrozole are ineffective at control that conversion.

The popular opnion here is that Anastrozole (Arimidex) is much more appropriate for E2 control than Letrozole while on TRT.

I don’t know that much about HRT but you simply just need to get healthier as you probably already know Diabetes is never an overnight process. The constant bombardment of Roller-coastering your Insulin is what forces your body to adapt in turn creating Insulin Resistance, down-regulating Receptors and so on. Without getting to much involved in your lifestyle 4 supplements that you must be taking regardless of your condition, goals and/or what you think you should be taking is

Vitamin D 10K (Healthy Origins 360 caps)
Co-enzyme Q10 - (Doctor’s Best with Bioperine 100mg , 120 caps)
Magnesium - (Now Foods, magnesium caps, 400 mg 180 caps)
Fish oil (EPA and DHA , 3-5 g total if not more)

Iherb.com <—great site for Vitamin D,Co-enzyme Q10, Magnesium)

These 4 supplements are paramount to Overall Health Period!

—Cruical Lab tests related to those supplements—

25(OH)D (25-hydroxy Vitamin D)
Red blood cell Magnesium (not Serum magnesium!)

Thanks for the responses, question, if I split my Test E dose in Half and inject twice weekly at 60mg twice weekly, what days should I inject and what protocol should I follow for the HCG? Am planning to drop my dosage to 200IU for the HCG, would this decrease the chance of Aromatization? Is there any Sticky on HCG dosage?

jrm850 I will speak to my Dr about Adex.

Fulford I am currently taking All the supplements you mentioned except the Magnesium. For Magnesium supplementation dont you have to take calcium for it to absorb?


pregnenolone would be helpful as well, helps with cortisol which is important for stabilizing blood sugar etc,
your bio T is low so maybe Test is aromatising too much to E2 and lowering bio/freeT. Maybe stop hcg for awhile and add it back later at a lower dose.

Sometimes it easier to go back to basics like just the Test and splitting the doses to twice a week like u mentioned is a good idea. Then wait 4-6 weeks and retest, treat E2 problems if there still there and then later add the hcg at a lower dose. Just one thing at a time and retest after each and see what everything is doing before adding the next supp. Pregnenolone is a good supp to use on T as it helps replace other hormones etc that are shut down from the Testosterone.

Low carbs are the way to go if non-insulin diabetic but stay on the metformin until u have lost a good amount of weight, metformin can help with weight loss. Maybe more weights and less cardio but dont burn your self out as well, rest is important too.


How much Vitamin D, Co-enzyme Q10 , Fish oil are you taking on daily basis? as dosage determines effectiveness. For Vitamin D at least a 10K bottle is ideal as it will allow for effective dosing strategies (Bolus vs Daily). Simply taking anything under 4k daily will result in sub-optimal levels year round.

Regarding Magnesium it is actually the opposite, you need sufficient Magnesium to absorb Calcium. If this wasn’t the case most supplements if not all would include Magnesium with Calcium. It’s Perfectly fine taken by it’s self. The only real thing you need to worry about is different forms of magnesium as different forms absorb better into specific tissues.