Low T and Chronic Fatigue

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    Low T and Chronic Fatigue


    Hi All,

    I've been fighting the low T, and chronic fatigue for a couple of years now. Additionally I've have been treated on and off for depression for about 10 years now. I'm a 37 white male and healthy other than for the hypogonadism, depression and fatigue.

    I started out on compounded T creme, moved to androgel, then injections. Currently getting 1cc weekly for the last six months and my endo says the T-levels are low normal now and all the other blood levels are fine (sorry I don't have specifics on the levels) So she sent me to a shrink. The shrink started me on 20mg of lexapro and I no longer have the daily crying fits and uncontrolable urges to bump myself off which I am grateful for.

    Problem is I still have extreme fatigue. A trip across the street to the grocery store will result in me coming home and sleeping for 2 hours. Can't even think about going out to dinner or a movies with my wife as I'm ready for a 3 hour nap by the time we get there. Haven't been able to work for 8 months now and life is pretty dismal overall.

    Now the shrink wants to put me on Ritalin. 5mg in the morning and another 5mg in the afternoon. I don't have ADD or ADHD, but he says it's an amphedamine and will boost my energy.

    I'm a bit skeptical of this plan and haven't started it yet. My endo says it won't screw up my Hypogonadism treatment and will likely help with the fatigue. My red-flag-o-meter is waving pretty strong as I feel like this is just putting a band-aid on slashed wrist so to speak. Stops the bleeding, but....

    What do you all think??

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    Quote Originally Posted by toast View Post
    Hi All,

    I've been fighting the low T, and chronic fatigue for a couple of years now. Additionally I've have been treated on and off for depression for about 10 years now. I'm a 37 white male and healthy other than for the hypogonadism, depression and fatigue.

    I started out on compounded T creme, moved to androgel, then injections. Currently getting 1cc weekly for the last six months and my endo says the T-levels are low normal now and all the other blood levels are fine (sorry I don't have specifics on the levels) So she sent me to a shrink. The shrink started me on 20mg of lexapro and I no longer have the daily crying fits and uncontrolable urges to bump myself off which I am grateful for.

    Problem is I still have extreme fatigue. A trip across the street to the grocery store will result in me coming home and sleeping for 2 hours. Can't even think about going out to dinner or a movies with my wife as I'm ready for a 3 hour nap by the time we get there. Haven't been able to work for 8 months now and life is pretty dismal overall.

    Now the shrink wants to put me on Ritalin. 5mg in the morning and another 5mg in the afternoon. I don't have ADD or ADHD, but he says it's an amphedamine and will boost my energy.

    I'm a bit skeptical of this plan and haven't started it yet. My endo says it won't screw up my Hypogonadism treatment and will likely help with the fatigue. My red-flag-o-meter is waving pretty strong as I feel like this is just putting a band-aid on slashed wrist so to speak. Stops the bleeding, but....

    What do you all think??
    Keep your records, with out them it is hard to communicate and possibly get help.
    Check your testosterone, estrogens, adrenals and thyroid.
    Do a blood test and post results here (with ranges).
    Post also (detailed) medications that you use and for how long.
    Best, get the test and a blood drawn at Quest Diagnostics.
    I can give you longer test, but below is a minimum for now.
    If all of the tests show within a range, stay with shrink, if not we could help you.
    If you a candidate for a shrink, you should contact Dr Marianco on the other board.

    Bioavailable, free and total Testosterone
    SHBG
    Albumin
    LH
    FSH
    Prolactin
    Pregnenolone
    Progesterone

    Estradiol, sensitive
    Estradiol, bioavailable
    Total Estrogenes
    Estrone

    FreeT3
    FreeT4

    DHEA
    Cortisol AM/PM
    ----------------------------------
    I am sure others will chime in with their ideas.
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    Chronic fatigue and low thyroid function/low T/high E2 go hand in hand.

    Get that bloodwork above, and post it up.
    •   
       

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    ok, here's some labs:

    Testosterone 428 ng/dl was 137 before hrt
    Free Test. 11.2 pg/ml was 2.2 before hrt
    Estradiol 37pg/ml
    FSH 1.3 mU/ml
    Leutein .4 mIU/ml
    LH 1.2 mU/ml
    IGF-1 141 ng/ml

    TSH 1.15 uIU/ml
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    Quote Originally Posted by toast View Post
    Hi All,

    I've been fighting the low T, and chronic fatigue for a couple of years now. Additionally I've have been treated on and off for depression for about 10 years now. I'm a 37 white male and healthy other than for the hypogonadism, depression and fatigue.

    I started out on compounded T creme, moved to androgel, then injections. Currently getting 1cc weekly for the last six months and my endo says the T-levels are low normal now and all the other blood levels are fine (sorry I don't have specifics on the levels) So she sent me to a shrink. The shrink started me on 20mg of lexapro and I no longer have the daily crying fits and uncontrolable urges to bump myself off which I am grateful for.

    Problem is I still have extreme fatigue. A trip across the street to the grocery store will result in me coming home and sleeping for 2 hours. Can't even think about going out to dinner or a movies with my wife as I'm ready for a 3 hour nap by the time we get there. Haven't been able to work for 8 months now and life is pretty dismal overall.

    Now the shrink wants to put me on Ritalin. 5mg in the morning and another 5mg in the afternoon. I don't have ADD or ADHD, but he says it's an amphedamine and will boost my energy.

    I'm a bit skeptical of this plan and haven't started it yet. My endo says it won't screw up my Hypogonadism treatment and will likely help with the fatigue. My red-flag-o-meter is waving pretty strong as I feel like this is just putting a band-aid on slashed wrist so to speak. Stops the bleeding, but....

    What do you all think??

    Sounds REAL familiar. I had fatigue for years now treating for adrenal fatigue, hrt and depression and things are much better. The Cortef made a night and day difference in fatigue, it is amazing.
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    Quote Originally Posted by toast View Post
    ok, here's some labs:

    Testosterone 428 ng/dl was 137 before hrt
    Free Test. 11.2 pg/ml was 2.2 before hrt
    Estradiol 37pg/ml
    FSH 1.3 mU/ml
    Leutein .4 mIU/ml
    LH 1.2 mU/ml
    IGF-1 141 ng/ml

    TSH 1.15 uIU/ml
    Ok. Thyroid looks great. Get a t3/t4 reading to make sure.

    You need more T. What kind of T and how much are you using?

    Man, I had a feeling your E2 level was going to be high. High E2 and emotional instability go hand in hand. Your E2 level would be fine if you had a T level that was DOUBLE what yours is.

    I have a feeling that if you start taking more T(which you need to) that E will go up even more.

    Your IGF level is bad as well. Do you get sore, achy joints after even little exercise? Difficulty sleeping? This is all GH related.
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    Quote Originally Posted by plymouth city View Post
    Ok. Thyroid looks great. Get a t3/t4 reading to make sure.

    You need more T. What kind of T and how much are you using?

    **** 1cc depo T IM weekly in the buttock.

    Man, I had a feeling your E2 level was going to be high. High E2 and emotional instability go hand in hand. Your E2 level would be fine if you had a T level that was DOUBLE what yours is.

    **** Interesting the docs have always said it was fine because it is in the range that the test result sheet says it should be. From what you are describing it sounds like the stated normal range for E2 in the book is based upon a normal T range. Hence a normal range for E2doesn't apply if the T is too low?

    I have a feeling that if you start taking more T(which you need to) that E will go up even more.

    Your IGF level is bad as well. Do you get sore, achy joints after even little exercise? Difficulty sleeping? This is all GH related.
    ***Let me tell you about achy joints man. My energy level crashes several times everyday and when I get too tired my wrists, rt ankle and lower back ache like I've been beaten with a baseball bat. After I sleep a couple hours or so the ache goes away for awhile. Also day or two before my shot, the ache is constant all day long. My primary doc blames this on hypochondria... no kidding.

    I started the 5mg Ritalin today. Thats an interesting experience. I took the first one at 8:00am while I was very groggy as I usually am in the morning. 30 minutes later I felt very well rested. Not really energetic,but I wasn't feeling tired or achy either. By 11:30 the aches started and by 12:00 I was ready to go back to bed. So I took my second pill and same deal. 30 Min later, felt rested. 4:00 went looking for my bed and just now got up 6:15 or so. I feel just like I did prior to taking the stuff. Very fatigued like I need to sleep. I think I will ask if I can take a 3rd pill which should take me to 8:00pm.

    Anyway the story continues....
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    Quote Originally Posted by plymouth city View Post
    Do you get sore, achy joints after even little exercise? Difficulty sleeping? This is all GH related.
    I didn't know that. My knees, elbows etc.....hurt like hell. I didn't know it was GH related.
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    Its great that the ritalin seems to be helping, but it appears to be just covering up the issue as opposed to resolving it.

    Drs seem to like that dont they...good for business isnt it?

    I would have cortisol checked.
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    Quote Originally Posted by spinn View Post
    Its great that the ritalin seems to be helping, but it appears to be just covering up the issue as opposed to resolving it.

    Drs seem to like that dont they...good for business isnt it?

    I would have cortisol checked.

    BINGO SPIN check the cortisol because elevated cortiosl can cause lack of memory along with escessive estrogen..
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    Quote Originally Posted by hardasnails1973 View Post
    BINGO SPIN check the cortisol because elevated cortiosl can cause lack of memory along with escessive estrogen..

    Well if I remember right they did do a cortisol test a long time ago. Had to pee in a jug for a day... I don't have #'s but they said no problem.


    I'm not really looking for a fix here. There are no easy fixes and sorry I don't trust play Dr's. And it's not like my Dr. is going to run a bunch of tests because I ask her to. She's going to do what ever the hell she thinks is best and I will either start feeling better and keep seeing her or I won't and just get used to feeling like crap. Or I'll just freaking killmyself and get it over with. Because I'm a defective person without a popular condition it's what they really want anyway.

    The question was about ritalin and does anyone have an anecdotal experience about whether adding it will make things worse or better?

    You know what just forget about it. Go play Dr. or whatever it is you do.
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    Quote Originally Posted by SoMdHunter View Post
    I didn't know that. My knees, elbows etc.....hurt like hell. I didn't know it was GH related.
    Big time. Check the IGF board on this site. You will see lots of stuff from guys who have had great success with GH treatment. Most report that alot of the side effects of middle age(achy joints/back/etc. clear themselves up after GH treatment.

    And we are not talking about taking Barry Bonds amount of GH either here were your head will double in size. Just enough to put you in normal range(300)
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    Quote Originally Posted by toast View Post
    Go play Dr. or whatever it is you do.
    I know more about HRT and endocrinology than your doctor does.

    And Im a business student.
    Last edited by plymouth city; 04-07-2007 at 02:05 PM. Reason: none
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    Quote Originally Posted by SoMdHunter View Post
    I didn't know that. My knees, elbows etc.....hurt like hell. I didn't know it was GH related.
    There are also lots of other reasons to have achey joints - some hormonal and some not. Low T or adrenal fatique could give you achey joints. Arthritis unrelated to hormonal levels could also give you achey joints. Since this board is mostly about hormone replacement, it is natural to think about hormones first, but don't eliminate all the other things that could be causing the joint pain.
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    Quote Originally Posted by cpeil2 View Post
    There are also lots of other reasons to have achey joints - some hormonal and some not. Low T or adrenal fatique could give you achey joints. Arthritis unrelated to hormonal levels could also give you achey joints. Since this board is mostly about hormone replacement, it is natural to think about hormones first, but don't eliminate all the other things that could be causing the joint pain.
    Wanna bet that alot of the cartilage wear and tear that leads to arthritis can be slowed down (and pretty much prevented for people under 70) with HRT and GH treatment?

    And I don't even need to explain the wonders of testosterone and how it affects bone density and bone strength
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    Quote Originally Posted by plymouth city View Post
    Wanna bet that alot of the cartilage wear and tear that leads to arthritis can be slowed down (and pretty much prevented for people under 70) with HRT and GH treatment?

    And I don't even need to explain the wonders of testosterone and how it affects bone density and bone strength
    No doubt, but I do think it is a mistake to assume that a symptom such as joint pain is necessarily a result of GH deficiency.
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    Quote Originally Posted by cpeil2 View Post
    No doubt, but I do think it is a mistake to assume that a symptom such as joint pain is necessarily a result of GH deficiency.
    I agree with ya in the respect that every joint pain isn't always related to GH. But mine have been more than simple joint pain. My elbows hurt at times to the point to where I almost can't use my arms! This is much more than achiness, this is all out terrible pain.....to the point of waking me up at night.

    I thought maybe that it was estrogen related, but since my last E2 test came back slightly above optimal (37pg/dl) I doubt it is E2.
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    Quote Originally Posted by toast View Post
    Hi All,

    I've been fighting the low T, and chronic fatigue for a couple of years now. Additionally I've have been treated on and off for depression for about 10 years now. I'm a 37 white male and healthy other than for the hypogonadism, depression and fatigue.
    I started out on compounded T creme, moved to androgel, then injections. Currently getting 1cc weekly for the last six months and my endo says the T-levels are low normal now and all the other blood levels are fine (sorry I don't have specifics on the levels) So she sent me to a shrink. The shrink started me on 20mg of lexapro and I no longer have the daily crying fits and uncontrolable urges to bump myself off which I am grateful for.

    Problem is I still have extreme fatigue. A trip across the street to the grocery store will result in me coming home and sleeping for 2 hours. Can't even think about going out to dinner or a movies with my wife as I'm ready for a 3 hour nap by the time we get there. Haven't been able to work for 8 months now and life is pretty dismal overall.

    Now the shrink wants to put me on Ritalin. 5mg in the morning and another 5mg in the afternoon. I don't have ADD or ADHD, but he says it's an amphedamine and will boost my energy.

    I'm a bit skeptical of this plan and haven't started it yet. My endo says it won't screw up my Hypogonadism treatment and will likely help with the fatigue. My red-flag-o-meter is waving pretty strong as I feel like this is just putting a band-aid on slashed wrist so to speak. Stops the bleeding, but....

    What do you all think??
    hypogonadism, depression and fatigue..............

    most likely it is just hypogonadism, the other come with hypo..

    My take:
    Get self help, nobody can feel what you feel.
    Learn as much as you can about TRT.
    Learn to speak softly, no matter how much it hurts inside.
    Get sympatetic doctor, who will do sanity checks but otherwise let you self treat.
    Start with TRT, adrenals, thyroid.
    Personally I would try my best to stay with transdermals to avoid ups and downs.
    Adjust first BioAvailableTestosterone=5.5(n mol/L),
    do not worry about TT and FreeT
    Then do E2 and other Estrogens
    Check FreeT3, DHEA, cortisol
    after the above is within a range for about 1/2 year, look for other reasons of you troubles.
  

  
 

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