Could really use some help!

[LowTDude]

Hello guys. I could really use some help please!! Here's my story. I am 28 years old, have always been an overweight guy up until the last year when I lost about 65 pounds.

For the last 5 years or so, I have been battling with severe fatigue, tiredness, lost of concentration, short term memory loss, etc... I have seen around 6 different doctors who had me do all sorts of test and nothing. Finally a friend of mine told me to go get my T level tested. I went to a local testosterone replacement therapy (TRT) clinic and sure enough I was at 136 ng/dL! So they started me on 100mg of test cyp a week, plus zinc. I started feeling a little better but nothing great. Well now, 3 months later and I still feel like crap. I feel as if im getting dumber sometimes. I forget to spell certain words, my memory sucks, I feel like crap. At this point I don't know what else to do. I am on 180mg of test cyp now.

Here are my labs. Please give me some advice. I am so sick and tired of being tired that its actually giving me depression. I would appreciate any help. Thanks

5/1/2012:

Estradiol: 23.0 pg/mL (Reference Interval 7.6-42.6)
Prostate Specific Ag, Serum: 0.5 ng/mL (Reference Interval 0.0-4.0)
Testosterone, Serum: 136 ng/dL (Reference Interval 348-1197)
Hemoglobin: 15.3 g/dL (Reference Interval 12.5-17.0)
LH: 4.1 mIU/mL (Reference Interval 1.7-8.6)
FSH: 1.5 mIU/mL (Reference Interval 1.5-12.4)
Prolactin: 8.5 ng/mL (Reference Interval 4.0-15.2)

5/23/2012:

Estradoil: 31.0 pg/mL (Reference Interval 7.6-42.6)
Testosterone: 340 ng/dL (Reference Interval 348-1197)
Hemoglobin: 15.5 g/dL (Reference Interval 12.5-17.0)

Was given the Anaztrozole right after this lab came back due to higher Estrogen levels. .5mg twice a week.
Also started Human Chorionic Gonadotropin (HCG) twice a week.

8/2/2012:

Prostate Specific Ag, Serum: 0.7 ng/mL (Reference Interval 0.0-4.0)
Testosterone: 445 ng/dL (Reference Interval 348-1197)
Sex Horm Binding Glob, Serum: 12.8 nmol/L (Reference Interval 16.5-55.9)
Estradiol: 17.5 pg/mL (Reference Interval 7.6-42.6)
Hemoglobin: 16.7 g/dL (Reference Interval 12.6-17.7)
Albumium: 4.3 g/dL
Free Testosterone: 14.3 ng/dL = 3.13%
Bioavailable Testosterone: 334 ng/dL = 73.4%

So as of now I still feel really crappy. Please let me know what you think. Could it be that my estrogen went down too much? And what is SHBG? Mine is low, it looks like it.

Any help would be greatly appreciated.
Thanks

 

[Megatron28]

How often are you injecting 180mg? Still once per week? And relative to when you inject, when were your lab test done? If you are still weekly, it is normal for your T be highest after injecting and lowest seven days later right before you would inject again. So when in your protocol did you come in with a lab test of 445?

 

[transcend2007]

LowT, could you please provide your current body fat %, diet and exercise routine. It is possible that your nutrition is not optimal.

 

[LowTDude]

5'5" 175, 21% BF. I try and run 2 or 3 times a week but I feel so crappy that a lot of times I can't. Or the days I do run I come home and sleep all day because I'm so tired. The 445 results were taken at 9AM and then I got the injection. I'm sure my total T is higher now. I was at 150mg a week. I've been on 180mg only 2 weeks

 

[LowTDude]

The labs were taken at the end of my injection week.

 

[Megatron28]

I wouldn't be surprised if your T was near 1000 shortly after your injections. Some people here recommend going to injections every 84 hours. You would half your dose. That might even out your levels more.

Do you feel decent shortly after your injections or do always feel crummy? If the swings in your T levels is what affects you changing your injection frequency may be worth trying out.

 

[Die$eL~Man]

I think a psychiatrist could help ya a lil bit also.....

 

[LowTDude]

I wouldn't be surprised if your T was near 1000 shortly after your injections. Some people here recommend going to injections every 84 hours. You would half your dose. That might even out your levels more.

Do you feel decent shortly after your injections or do always feel crummy? If the swings in your T levels is what affects you changing your injection frequency may be worth trying out.

I feel crummy all the time. I don't notice anything after the injections.

 

[LowTDude]

Now that I think about it, I actually feel worse after he upped my dosage. Is this normal? Maybe I can tell them to put me back down to 150mg a week.

 

[2rude4u]

Have you had any thyroid testing done? You are describing almost exactly how I felt before discovering my thyroid issue. Many doctors, ok most doctors do not understand how important the thyroid functions are and the havoc they can play on your endocrine system. Most also do not have a clue how to properly test thyroid function.

Let me ask you a question. You ever feel like you're going crazy or have panic/anxiety attacks? How about thinning eyebrows, dizzy spells, difficulty sleeping or brain fog?

 

[LowTDude]

All of the above except thin eyebrows lol.. I have very thick eyebrows lol.. What should I request exactly to properly test thyroid? I know I've had it tested a few times already.

 

[LowTDude]

There's days I can sleep all day too.. Weak muscles too

 

[nesto719]

Check the adrenals too.

 

[2rude4u]

All of the above except thin eyebrows lol.. I have very thick eyebrows lol.. What should I request exactly to properly test thyroid? I know I've had it tested a few times already.

Most docs run Total T4, Total T3 & TSH because they don't know any better. Although these levels are nice to know what you really have to test are the Free T4, Free T3 & Reverse T3 levels.

T4 is the storage hormone that converts to either Free T3 or Reverse T3 or may convert in such small amounts the body becomes hypo thyroid even with adequate Total levels. Technically it converts to both, but too much Reverse T3 creates the same symptoms as being Hypo thyroid and indicates a conversion or adrenal issue. Free T3 levels are the most important because this is the thyroid hormone the body can utilize.

Your Total T4 & T3 can be fine, but your Free T4 & T3 can be low causing every symptom you mentioned. The Reverse T3 is not something most docs are familiar with but it can be important in telling you if there is an adrenal or other unknown issue. Adrenals, liver problems and physical injury are just a few that can cause T3 convertion issues.

 

[LowTDude]

So if it is my T3 and T4 that's low how do I fix that?

 

[LowTDude]

Got some labs back today.

Vitamin D, 25-OH, Total: 37 ng/mL
Vitamin D, 25-OH, D3: 37 ng/mL
Vitamin D, 25-OH, D2: <4 ng/mL

Total Testosterone: 668 ng/dL
Free Testosterone: 189.7 pg/mL

What is 189.7 pg/mL in ng/dL? I'm horrible at math. Thanks

 

[2rude4u]

So if it is my T3 and T4 that's low how do I fix that?

You correct the cause or take a thyroid med. Remember that YOU MUST have the FREE T4, T3 & Reverse T3 numbers to figure out the issue. The Total T4 & T3 only tell you if your thyroid is producing, it does not tell you how your body is converting or utilizing it.

As an example: you may be producing sufficient amounts of Total thyroid hormone, but not converting into sufficient amounts of Free thyroid hormone. This would indicate a potential issue with the liver amongst other possible organs or simply a defiency of certain vitamins and minerals.

Another example: you may be producing sufficient amounts of Total thyroid hormone, but converting too much into reverse T3. This could indicate an adrenal or liver issue as well as a possible stressor to your system such as injury or unknown disease.

Once you know if there is or is not a thyroid problem you can start to narrow down the possibilities.

You total & free test below are fine, but what does the E look like? Your Vit D is on the low end of the range.