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My struggle with Low T and TRT failure.
I'm a young man of 26, average physique, normal %bf, relatively lean, no major health issues.
Diagnosis of low t dates to back to 2014. Symptoms: fatigue, muscle weakness, exercise intolerance, painful brain fog, bad anxiety with high BP, hair loss (body and facial), nipple discharge, total loss of libido, ED with genital "anesthesia" sensation. Autoimmune thyroiditis diagnosed at the same time.
First bloodwork:
CBC as a pic for convenience. Microcytic erythrocytosis is due to hereditary beta-thalassemia.
Total T: 1.5 ng/ml
Free T: 8 pg/ml (no idea about the method)
Cholesterol 209.
Iron studies, kidney and liver function normal.
TSH 5.76, FT4 0.65 ng/ml (0.7 - 1.6), FT3 3.00 pg/ml (3 - 5), elevated ab titers (currently on 125mcg LT4).
FSH 4.2, LH 1.7, PRL 12.41.
Had a MRI done and again one year later: a rather small, stable pituitary "lesion" of ~0.5cm is appreciable. Not big enough to induce hypogonadism, according to my endo. Also not of the secreting type.
TRT: Tostrex gel, 20mg/die, morning application.
At the very start, it was feeling better, but as the weeks progressed, I gradually became even more lethargic, slouchy, and weak than before. Dizziness all of the time. Developed dark urine and light colored stools. However, anxiety subsided, and dick felt actually as being "there". BP normalized. Body hair increased.
Successive BW showed reduced RBC, hemoglobin, and hematocrit. Two hours-post gel application T levels were 731 ng/dl.
What's worst, brain fog got somewhat extreme. Eventually lost appetite and thirst sensation. Ended up pretty much crippled, malnourished (looked like a zombie), and dehydrated. Dropped about 10Kg/25lbs. Lethargy was severe enough to impair my ability to understand what was going, and docs were of no help (actually, I was referred to a psychiatrist). Yet, somehow I managed to see things through, and to recover my condition. Worst summer of my life so far...
In autumn, had BW again. CBC unchanged, Hgb 12.0, Total T with no prior application of gel was 0.75 ng/dl!
Realized how much of a mistake was made, and went searching for a new endo. Eventually found a prof, whom started me on Nebido and thyroid hormone.
Huge improvement! Prior to Nebid I was having achy muscles and joints all over my body. Energy and lethargy lifted a bit. However, it did only last about 5 weeks, and the pattern represented itself with each pin, in a slow crescendo over time. Libido took a whole year to make a shy appearance.
Side effects: depression (was really anxious pre-TRT, but NEVER depressed), lot of bloating, water retention, debilitating dizziness. Swollen ankles.
What's more interesting, I immediately experienced a rapid worsening of symptoms after each pin, only to feel better two weeks later. If I had morning boner until pin day, tomorrow it disappeared.
Had multiple BWs while checking for thyroid: RBC mostly the same, Hct raised by 2%, Hgb 12.7. Overall, CBC was still better pre-TRT, until thyroid finally stabilized (this year). Total T ranging from >13.50 to 600. SHBG 66 to 40 (last reading whilst on nebid). NEVER pulled E2. Vit. D3 and B12 OK. Zinc kinda low at 54mcg, after months of supplementing. Cholesterol normalized.
At one point, serum Iron was down to 19 mcg/dl, although ferritin was normal. Made me feel really lousy and had to supplement, and still I'm to the present day.
Energy and mood never lifted to pre-TRT levels. Lack of consistent results thus drove me to reconsider Nebid , so approached my endo again. He stated Nebid is the "most advanced TRT available", refusing any alternative other than gels, which I refused. Asked for HCG, but he was unwillingly because its use is for fertility, and not everyone tolerates it well. He labeled most of the side effects as "strange" and didn't offer significant help.
Last pin of Nebid was 5 months ago.
So, I'm trying TRT on my very own now. I didn't await passively for symptoms to subside but actually researched a lot, and mostly important, I do accept every risks that came with this decision.
Most recent BW in the attachments.
Current protocol: 150 mg Test E, IM, E5D. UGL grade.
I'm targeting the vastus lateralis, rotating sides. I'm kinda thin, but I know how to do it. I'm having lot of fun with pinning, actually.
Also, I realized most of the side effects experienced with Nebid COULD have been due to excessive oestradiol, but impaired liver detox is also an option. Anyway, I've included 6.12 mg exemestane EOD.
Almost a month so far. Not sure how I feel. Will be pulling bloods this week. As an additional challenge, sensitive oestradiol isn't available here. Not sure if Free T is reliable either.
Thoughts?
