T Nation

Will TRT Help Severe Fatigue?

Hi everyone. My doctor dialed in the protocol I need to follow TRT. I will start in a week on 160mg Test E weekly and 800 IU HCG.

Just wanted to ask if someone had fatigue when having low normal testosterone levels (332 ng/dl). My previous testosterone test was 281. The fatigue is just killing me. I barely do my cardio in the morning and surviving the day is a pretty hard task. Anyone had any experience with that kind of trouble?

Blood work for reference:
Testosterone - 11.55 nmol/l (9.90 - 27.80) - That translates to 333 ng/dl
Free Test - 6.82ng/dl = 2.05%
Albumin - 46.30 g/l (35 - 52)
SHBG - 29.46 nmol/l (18 - 54)
LH - 7.20 IU/l (1.7 - 8.6)
FSH - 2.82 IU/l (1.5 - 12.40)
Estradiol - 92.73 pmol/l (94.80 - 223)
Prolactin - 166.10 mIU/l (85 - 325)

FT3 - 4.20 pmol/l (3.20 - 6.80)
FT4 - 13.95 pmol/l (12 - 22)
TSH - 1.87 mIU/l (0.3 - 4.2)

Glucose - 5.4 mmol/l (3.6 - 6.1)
Cholesterol Total - 4.95 mmol/l (up to 5.2)
Cholesterol LDL - 2.83 mmol/l (up to 3)
Cholesterol HDL - 0.96 mmol/l (over 1.45)
Triglycerides - 2.55 mmol/l (up to 1.8)

Cortisol - 301 nmol/l (124.2 - 662.4)

WBC - 8.64 x10^9/L (3.50 - 10.50)
Ly% - 26.4 % (20.0 - 48.0)
Mo% - 8.6 % (1.0 - 11.0)
Eos% - 2.1 % (Up to 6.5)
Baso% - 0.70 % (up to 2)
Neu% - 62.2 % (40 - 70)
Ly# - 2.28 x10^9/L (1 - 4)
Mo# - 0.74 x10^9/L (up to 0.8)
Eos# - 0.180 x10^9/L (up to 0.5)
Baso# - 0.06 x10^9/L (up to 0.140)
Neu# - 5.380 x10^9/L (2.000 - 7.000)
RBC - 5.58 x10^12/L (4.40 - 5.90)
Hemoglobin - 161 g/L (135 - 180)
Hematocrit - 0.477 L/L (0.400 - 0.530)
MCV - 85.5 fL (80.0 - 96.0)
MCH - 28.9 pg (27.0 - 33.0)
MCHC - 338 g/L (300 - 360)
RDW - 13.2 % (11.5 - 14.5)
Plt - 281 x10^9/L (130 - 440)
MPV - 10.2 fL (6.1 - 13.5)
Pct - 2.90 ml/L (1 - 4.80)
PDW - 12.9 fL (8.0 - 23.0)

Any input is greatly appreciated. :slight_smile:

Do you also suffer from sleep apnea? I did and was having full on narcolepsy incidents where I would doze off at work and while driving. Once I got my apnea cured thru sinus surgery I’m doing much better with fatigue.

My gf says I sometimes snore a lot. Could this be related to sleep apnea?

Definitely. Sleep apnea is where we actually stop breathing for short periods of time. It prevents us from getting into REM sleep which is where deep, restorative sleep happens and HGH is released, etc.

Dont not get TRT. Just consider seeing a sleep disorder or sinus doc. There are other options other than a CPAP machine. I had balloon sinuplasty and they also removed my uvula and stiffened my soft palette.

Also, if you have a thick neck you are more prone to sleep apnea

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Yeah get a sleep study. You may very well need TRT but you need to solve this first. I was diagnosed with very mild apnea where a CPAP wouldn’t work on me and could actually worsen my situation. I snore because I still have my tonsils and I have a large uvula. Doc said he could take all that out but only gave me about a 40% chance of curing my issue. I took a chance and bought a $30 dental device off of Amazon and it decreased my snoring by about 95%. Changed my life.

My sleep improved for a while on trt, but once I started to pack on some size (I was pretty skinny when I started) the sleep apnea issues returned.

Bottom line is this: fix sleep before anything else. Sometimes trt is the answer, sometimes it’s not. But getting better sleep is always a good path to go down.

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Thanks a lot guys. Really appreciate your opinions.

Your fatigue is a moot point, you will soon have testicular failure as you are looking to have primary hypogonadism. High LH and low testosterone is testicular failure and if we let this process play out, LH will soon sail over the ranges.

Your TRT dosage is going to be way too much as you seem sensitive to testosterone. You’ll probably only need a Total T of 650 ng/dL to feel optimal.

I would dial-in on TRT only, then add HCG later if you want otherwise it may complicate the dialing in process.

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Thanks systemlord. I am waiting for my father to bring me Galenika Test E from Serbia. He already bought it. About the dosage … you said in my first post I could actually hold on to that dosage as my e2 was really low and free test is in the basement. :slight_smile:

You’re welcome.

You will not need an AI, selecting the dosage and injection frequency will be key to dialing in. A minimum of two 50mg injections per week is needed.

Would you elaborate on the surgery you had? I’m almost positive I’ve got it but I don’t want to wear a mask and if I get diagnosed with it I’ll have to get double the amount of DOT physicals/paperwork/headache

I can’t imagine choosing fatigue over wearing a mask at night (if indeed you need one). Especially since after a week you will get used to it. It’s like the guys that have 100 T levels and won’t start trt because they have to spend 30 secs twice a week doing injections. When I had severe fatigue I would have literally done anything to not feel that way. And I mean anything. For me the answer was supplementing Iron. I’m getting a sleep test done anyway just to see as my sleep isn’t great. You may want to get thyroid, adrenals and iron levels checked as well. If you go to discountlabs and search fatigue they have a panel that lists the tests for most anything that could cause fatigue. You can take that to your doc and have him run those tests. The future energized you will look back and not believe you went so long feeling like shit.


Balloon sinuplasty opens up ur nasal passages and drains all the junk.

I also had my uvula ( the thing hanging in the back of ur throat) removed and did shots in my throat in my soft palette to stiffen it up.

Get tested for sleep apnea but don’t assume just because you snore that you’ve found the magic bullet. I chased OSA for far too long and after 3 sleep studies, I still don’t have it.

I don’t snore. I stop breathing usually. Sometimes I’ll wake up gasping for air. Apparently my sub conscious wants to kill me

Better than your conscious wanting to kill you. That one is a lot more effective at getting the job done.

I used to have this same issue, btw. It stopped (mostly) when lost a metric tonne of weight. It came back slowly as I bulked up. So for me I need to ~45lbs lighter if I want to breathe properly all night. Doesn’t matter if it’s fat or muscle, my body hates being over 145lbs, which is unrealistic.

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